5 Questions Asked of Veterinary Technician Specialists

5 Questions

Asked of Veterinary Technician Specialists

Each person was asked the following questions:

1. A tip you have for veterinarians. 2. Favorite tool of your specialty (describe what it does please). 3. Advice for a colleague thinking of pursuing your field. 4. Feather in your cap (an acknowledgment you received, a success story you are part of, a difference you make). 5. Best trade secret you learned and from who.

Lori Balliet, BS Biology/ Chemistry, CVT, VTS (Clinical Pathology)

Specialty Field: VTS Clinical Pathology- Academy AVCPT (Past President - 2019-2021) Employer: Quakertown Veterinary Clinic (Laboratory Supervisor) and Northampton Community College (adjunct professor Vet Tech Program/Clinical Pathology Lab) 1. Make sure that you are requesting the correct test and the correct sample.

Writing down an incorrect test name or not the test you really want (“it sounded similar”) can cause delays in testing because the lab will need to contact someone to find out what the test is that is being requested. If you have the correct name, then you should be submitting the correct sample. The incorrect sample causes more delays. 2. A microscope! I love looking at slides: blood smears, urine dry slides, cytology slides, and so on. There is so much information you can gain from those slides. At Quakertown Veterinary Clinic, the lab techs are trained to examine the slides rather than having the doctors use their time to look at all the slides. 3. Get as much experience as you can. Run the lab tests if you can. If you are assisting a doctor, ask questions about the tests. If the doctor is examining slides, ask if you can take a look. Get CE that is dedicated to or contains information about clinical pathology/lab work. 4. I was the second person in the United

States and Canada to earn my VTS in

Clinical Pathology. There are only about a dozen people in this specialty in North

America. The Academy of Veterinary

Clinical Pathology Technicians (AVCPT) is a newer academy receiving its provisional status in 2012 and is just starting to increase its membership. 5. Several years ago I attended a CE about urinalysis. The doctor presenting demonstrated the technique for making a dry slide or cytology slide of the concentrated urine and then staining it with Diffquik. Identifying bacteria and differentiating epithelial cells is much easier and more accurate than using a traditional urine stain, which becomes contaminated easily.

Karen Becki, BS, CVT, VTS (Oncology)

Specialty Field: Oncology Employer: PVSEC BluePearl

1. If referring a patient to an oncology service, one of the best things to do is to have a definitive diagnosis upon the patient’s arrival to oncology consult. This may mean that special stains, or other labs, may need to be requested from a biopsy sample prior to referral. However, it will allow the oncologist to give the owners more accurate information regarding prognosis and treatment options for their pet. (For example, histiocytic sarcomas, soft tissue sarcomas, and hemangiosarcomas all have different treatment protocols and survival rates.) 2. We use a closed-system transfer device, or CSTD, and a biological safety cabinet to draw up the chemotherapy we use to treat our patients. The CSTD replaces regular needles and syringes, allowing us to draw up the chemotherapy in a ventilated box with less risk of exposure to fumes in the rare chance there is a leak.

Since chemotherapeutic medications are considered Group One Hazardous Drugs, it is of upmost importance for an oncology technician to be exposed to the least amount of drug possible when drawing up and administering chemotherapy to their patients. 3. Despite what you may think, oncology is not all doom and gloom! Yes, there are definitely sad moments when we have to help a family say goodbye to a beloved pet. Most days though, we are administering treatments to our patients so they are able to have more time and make more memories with their families. 4. In the oncology department, the technicians are the main communicators with owners during many of their pet’s appointments. A success story is when clients tell me that I have helped them to have a better experience throughout these visits. For me, the goal of oncology is not just for pets to live longer, but for pets and their families to have the best quality of life together. 5. Not a secret, but just something I learned throughout my years in oncology: Don’t be afraid to place an IV catheter in an atypical vein. If you speak to a long-time oncology technician, don’t be surprised to hear that an ear vein has been used for an IV catheter placement. It is imperative that chemotherapy is administered through a clean-stick catheter in an unused vein. While I learned this skill in school, my original oncology skills were taught to me by some awesome technicians: Maureen, Cat, Jody, and Jess.

Amy Dowling, AAS Animal Science

Specialty Field: VTS Anesthesia and Analgesia Employer: University of Pennsylvania, Matthew J. Ryan Veterinary School

1. Any patient receiving anesthesia should have a checklist of things that should be completed before their procedure. They should have full blood work. This can vary from case to case, but usually a complete blood count and a chemistry is needed.

Additional tests that may be needed could be a blood type, coagulation panel, or other metabolic screens.

It is important to obtain a full medical history. This may include records from other veterinarians or specialists who the pet has seen in the past. Look for any history of heart disease, allergies, past anesthesia records, and what medications they are taking. In some cases, the patient may need to stop some medications the day prior to anesthesia. Some medications can make it difficult to treat hypotension intraoperatively and others may prolong recovery. A consent form should be signed and thoroughly reviewed with the owners in case complications do happen. It can be beneficial to have different consent forms for different animals. For example, it may be hard to do a full exam or get blood work on an aggressive dog, so the owner should know that higher doses of drugs may be needed. For most surgical cases, I highly recommend having the owners give gabapentin,

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Each person was asked the following questions:

1. A tip you have for veterinarians. 2. Favorite tool of your specialty (describe what it does please). 3. Advice for a colleague thinking of pursuing your field. 4. Feather in your cap (an acknowledgment you received, a success story you are part of, a difference you make). 5. Best trade secret you learned and from who.

trazodone, and Cerenia the night before and repeat the gabapentin and trazodone a couple hours before coming to the hospital. This reduces the amount of anesthetics that we may need for premedication and can make it a better experience for the patient and hospital staff. 2. Recently my tool of choice is the ultrasound. An ultrasound works by using a transducer to transmit sound waves into the body and record the waves that echo back. I use this as a guide for local and regional nerve blocks. By understanding anatomy, imaging of the nerves, and anatomical structures, I can deliver precise local anesthetic. This will provide optimal analgesia and decrease other anesthetics that can depress the cardiovascular and respiratory system. 3. Take pride in your career. It can be emotionally and physically draining at times, but what we do is important and life changing. There are so many opportunities to advance in this field and you are always learning. It’s very important to support your teammates and learn to have a good work-life balance. 4. I won the 2021 Award for Excellence in

Veterinary Nursing Education from Harcum

College. I really enjoy teaching and working with students and new technicians. After doing this for 20 years, I have learned from my mistakes and find myself advocating for new technicians so they know their worth. 5. Years ago I worked with Donna Sisak, CVT,

VTS AVTAA. She was an amazing mentor to me and taught me so much. The biggest mark she left on me was to “take care of your peeps!” She taught me we have to work as a team and support each other.

We can’t take care of our patients if we don’t take care of ourselves.

Jamie DeFazio Guiberson, CVT, BS

Specialty Field: Equine Veterinary Nursing Employer: University of Pennsylvania, New Bolton Center

1. Before referring a colic, always pass a nasogastric tube (bonus points for relaying how the animal was to tube). Also, extension sets are amazing accessories to IV catheters placed in referral patients.

The extension sets let us easily check for patency and make it easier for IV fluid administration. 2. My favorite tool is the nasogastric tube!

Without this tool, so many lives would be lost to gastrointestinal rupture. As a veterinary nurse and VTS, being able to pass a nasogastric tube correctly and quickly is something I take great pride in!

My second-favorite tool is my phone with a texting app that lets me communicate patient changes and send patient photos to clinicians at any moment. This has been game changing for improving the standard of care in hospitalized patients! 3. Do it for yourself. YOU need to be invested in this journey. Also, find a mentor and someone who will be there to help and support you in your journey! 4. I was the PA Vet Tech of the Year in 2009, which really pushed me to keep doing everything I could to promote equine nursing. This year I also accepted an adjunct position at Harcum College, where

I will be teaching their first class dedicated to large animal medicine! I look forward to helping the next generation of equine veterinary nurses be the best they can be. 5. This is a super tough question to answer since I learn something from our amazing faculty and staff every day! Some of the best overall lessons I’ve learned, however, are from Dr. Sue McDonnell regarding equine behavior. Through her and the semi-feral ponies that I have adopted from her program, I have learned more about patience and positive reinforcement. Sue’s teachings have helped me greatly with some of the more challenging patients we see in the hospital.

Rebekah Jakum, RVT, CVT, ARDMS/RVT (American Registry of Diagnostic Medical Sonographers – Registered Vascular Technologist)

Specialty Field: Ultrasound Employer: Self Employed (Pennsylvania Mobile VUS, LLC – see below) 1. Ultrasound is an excellent, non-invasive tool that, when done by an experienced professional, can add tremendous diagnostic capabilities to a veterinary practice, providing prompt direction with cases and keeping your patients, clients and revenue inhouse. 2. My specialists. Submitting a comprehensive history and diagnostic image set allows PA Mobile’s veterinary specialists to provide referral-quality service to RDVMs. Establishing an abnormality, sampling it, and getting a diagnosis are gratifying outcomes. 3. Scan, scan, scan, and scan some more!

Actively performing studies and reviewing images are the best ways to improve.

Also, investing in a quality system and understanding the physics of ultrasound will enable setting adjustment and image optimization. 4. Being asked to scan an employee’s pet is always extremely rewarding. Our pets are truly a part of our family, and knowing my skill level is trusted is a big personal reward. 5. There are many different insights that are absorbed during the journey with ultrasound. It is difficult to narrow down one secret and one person, but I would have to say utilization of a vtrough and scanning in dorsal recumbency from a fellow RDMS. It provides a cradle that most patients acclimate to and tolerate well and allows the sonographer a more comfortable position when scanning.

Lorena Lago, BS Biology, AAS Veterinary Technology

Specialty Field: Emergency and Critical Care Employer: Valley Central Veterinary Referral and Emergency Center, Whitehall, PA 1. 1. Do whatever you can to initiate stabilization before transferring a critical pet. Place an IV catheter, unblock the cat, tap the free in the chest so they can breathe better during transport, and so on. Don’t be afraid to call and speak with a specialist for guidance if needed. Post referral: Follow up on those tough cases and see if there is anything that you could learn or do to help future cases. We all have the same goal to improve patient care and outcomes.

2. 2. My favorite piece of equipment in critical care is the mechanical ventilator. It provides respiratory support for those that are unable to maintain adequate ventilation or oxygenation on their own. It helps alleviate the stress and workload for breathing in severe respiratory distress cases while treating the underlying problem. 3. 3. Never stop educating yourself on ways to raise the standard of care for your patients.

Don’t let stress and a few bad days stop you from doing what you love. Find a devoted mentor to help guide and train you to be the tech/nurse you want to be. 4. 4. I recently helped stabilize a 7-month-old,

MN, Basset Hound puppy that went into cardiac arrest, was successfully revived via CPR, underwent surgery to remove its liver from his pericardium, recovered, and returned home to his wonderful family. He thanked us all with tons of kisses when he returned for his suture removal two weeks later. 5. 5. My wonderful mentor, Jennifer Grady-

Holmes, taught me early in my career that continued education and a willingness to teach and train others is essential to the group’s success in achieving quality patient care.

Kristine Rigler, CVT, VTS (Surgery)

Specialty Field: Surgery Employer: Valley Central Veterinary Referral & Emergency Center

1. Ensure that records pertaining to the patient’s visit have been sent to the referral hospital prior to the day of the appointment. Include any radiographs, bloodwork, and aspirate/biopsy results.

This helps immensely in mapping a plan for how to best help the patient and hopefully negates the need to repeat tests that were already performed. 2. I have two favorite “toys.” Force Triad

Electrocautery Unit: This electronic vesselsealing device is versatile in helping to decrease blood loss and is a major time saver in the OR. It shortens the surgical procedure and the time under anesthesia, which relieves stress for the surgeon and the nurse doing the anesthesia on a potentially high-risk patient! Hyperbaric

Oxygen Chamber (HBOT): The treatment consists of 45 minutes in this pain-free chamber, which raises the plasma oxygen concentration and allows oxygen to be distributed evenly in the tissues faster than normal, thereby increasing the rate of healing. HBOT is a useful adjunct to help with wound healing and decreasing inflammation in a variety of other conditions. 3. I would recommend anyone interested in specializing in surgery (or any other

specialty) to attend national conferences or lectures targeting surgery. This will help to gain advanced knowledge in your particular area of interest, allow you to earn necessary credits, and to connect with peers who have already gone through the certification process. 4. I was the recipient of the PVMA 2012 PA

Veterinary Technician of the Year Award. I was (and still am!) overwhelmingly honored and flabbergasted to have been selected to receive such a prestigious award. Success

Story: A success story I was fortunate to be involved with was Figuero, a 5-year-old neighborhood stray kitty that was being fed by one family. The shed in which “Figgy” and his brother were seeking shelter in

March 2021 caught fire. Unfortunately, his brother didn’t survive, but Figgy was found the following day in the garage of the family that had fed him. Figgy sustained multiple burn wounds over his body, the worst of which were 1st-2nd degree over his ear tips, the top of his head, between his shoulders, and on his paw pads. Fullthickness wounds were also sustained over his nose and muzzle, lumbosacral region, and distal limbs. Trauma to his eyes was also sustained from smoke exposure. Despite all of his injuries, he was so sweet. The family adopted Figgy and he was admitted to our surgery service for treatment.

After approximately three months of hospitalization, intensive wound care and debridement, HBOT treatments (see above!), and loving supportive care, sweet

Figgy returned home for continued wound care. Five months after his trauma, Figgy came in for his final recheck. His wounds had healed, most of his fur had regrown, and he was finally able to live life e-collar free. 5. This isn’t exactly a trade secret, but something I’ve learned by listening to pet owners and coworkers over the years when admitting and discharging patients for surgery. Taking time to explain to owners the timeline for our day, educating them on any uncertainties of the procedure, and answering questions they may have prior to their pet’s admission helps to decrease their anxiety. When it comes time for pets to be returned home, spending time reviewing discharge instructions (e.g., medications and when they are due, suggestions on how to give medications) and anticipating any issues they may experience once at home, along with suggestions on how to deal with said issues, reduces stress for owners and the potential frantic phone calls after discharge. I’ve learned that time spent preemptively educating owners makes them feel prepared, empowered, and relieved, and ultimately saves us time by not having to repeatedly answer phone calls. It seems obvious, but given how hectic our schedules are lately it’s easy to rush through these processes.

Christopher Rizzo, CVT, VTS (EVN, LAIM)

Specialty Field: Equine Veterinary Nursing (EVN) and Large Animal Internal Medicine (LAIM). Lead nurse of the emergency and critical care department and the neonatal intensive care unit. Employer: University of Pennsylvania, School of Veterinary Medicine, New Bolton Center 1. Gather as much information as possible and transfer it to the receiving party. There really is no such thing as too much information. Never offer the client a price quote. This has caused much confusion and leaves everyone feeling frustrated. Allow the referral hospital to give the estimate directly to the client. 2. I absolutely love the Flexineb®. It is a portable equine nebulizer for treatment of respiratory issues in horses. It is incredibly quiet and completely self-contained. Other nebulizing instruments require you to stand with the patient for long periods of time. With this instrument, you can put it on the patient and continue doing other treatments. It works well and is efficient. 3. This is a physical and emotional job. It is not for everyone. Think carefully before deciding to pursue a career in this field. It is incredibly fun and rewarding and you never know what is going to happen at work, but it is not for everyone. 4. I have worked with a variety of species and in different environments including working at a zoo, small animal emergency and critical care hospital, and small animal orthopedic referral service in anesthesia. We once had a 1-kg kitten that coded after a bilateral femoral fracture repair. (The kitten was thrown from a moving vehicle.) There was no heartbeat, and the pupils were fixed and dilated. After immediately beginning CPR and after several rounds of epinephrine and Dopram,

I administered intracardiac epinephrine and the kitten began having electrical activity on the EKG. Shortly after, it began breathing and to make a long story short, the kitten fully recovered and went on to live a normal life. I am also the 2015 recipient of the Gretchen Wolf-Swartz Award, which is presented by the New Bolton Center

Veterinarians in acknowledgment of a veterinary nurse who has paid special attention to all aspects of patient care while also maintaining a professional attitude toward clients, students, and staff. 5. Another small animal trick that I use in large animal, specifically small ruminants, when performing cephalic blood draws, or catheter placement, use a Penrose drain and a hemostat as a tourniquet. This was helpful when we had a sheep that was attacked by a dog and the neck was completely ripped open, rendering the jugular veins unusable for catheter placement.