VOLUME 24 No. 86 JUNE 2018
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CONTENTS
04
VO LUME 24 No. 8 6 JU NE 2 01 8
05 EXECUTIVE COMMITTEE OFFICERS
06
President Julie Hutt PO Box 35831 Browns Bay Auckland 0753 021 599 059 president@nzvna.org.nz
07 10 12 15
National Secretary Fiona Hastie 021 993 045 secretary@nzvna.org.nz
21
JOURNAL EDITOR
EDITORIAL BOARD Exotics: Kylie Martin Equine: Lyn Hobbs Photography: Miranda Samson OSH: Libby Leader CPD: Christina Jenkins and Patricia Gleason
OUR VISION
SPCA rabbit. Photograph by Miranda Samson
Caring for our community by promoting excellence in animal healthcare.
The registration or list badge order forms, merchandise order forms and new membership forms can now all be found on the website www.nzvna.org.nz or by emailing membership@nzvna.org.nz
by Kathy Waugh
An Interview with Alice Gasnier Vet Nurse of the Year 2017 CPD corner: The real skill for the job: part two - developing Emotional Intelligence What is Rabbit Calicivirus? by Kylie Martin
HUHA - Helping You Help Animals charitable trust by Carolyn Press-MacKenzie
20 Nutraceuticals: the basics part one
by Sheree Smith
The New Zealand Veterinary Nursing Association would like to thank Hill’s™ Pet Nutrition NZ, our gold sponsors, for their continued support of the NZVNA and the veterinary nursing profession.
COVER:
NZVNA FORMS
Membership Secretary report
by Patricia Gleason
Treasurer & Membership Secretary Kathy Waugh 021 843 277 treasurer@nzvna.org.nz
Assistant Editor: Catherine Taylor catherine.ellen.taylor@gmail.com
Letter from the Editor by Antoinette Ratcliffe
by Catherine Taylor
Vice-President Amy Ross 021 852 664 vicepresident@nzvna.org.nz
Antoinette Ratcliffe journal@nzvna.org.nz
Vice President’s report by Amy Ross
DISCLAIMER The New Zealand Veterinary Nursing Association Journal is published by the New Zealand Veterinary Nursing Association Incorporated (NZVNA). The views expressed in the articles and letters do not necessarily represent those of the NZVNA or the editor, and neither the NZVNA nor the editor endorse any products or services advertised. The NZVNA is not the source of the information reproduced in this publication and has not independently verified the truth of the information. It does not accept any legal responsibility for the truth or accuracy of the information contained herein. Neither the NZVNA nor the editor accepts any liability whatsoever for the contents of this publication or for any consequences which may result from the use of the information contained herein or advice given herein. The provision is intended to exclude the NZVNA, the editor and its staff from all liability whatsoever, including liability for negligence in the publication or reproduction of the materials set out herein.
26 Occupational stress and burnout in veterinary nursing: what is it and how can we cope? by Ana Djokovic
28 31
Hyperbaric Oxygen Therapy by Tania Nilsen
Mastitis: destroying the milking machine by Emma Annear
34 36 38
WSAVA: taking a stand on global issues Increase your word power Book review by Amy Ross
34
NZVNA
Vice President’s report Over the past few years, the veterinary industry worldwide has been showing us great techniques on how to recognize when we need to alleviate the stress and various emotions that our jobs create. Within our profession, while we are predominantly there to help the animals, we are also there to help their owners. On top of this we are exposed to their emotions, the emotions of our colleagues, as well as trying to make sense of our own – that is a lot to take on board. It is very important to express our emotions and everyone has their own way of doing this – whether it is to go for a walk in the fresh air, cry, talk through the problem, or have hobbies outside of our job where we can put work out of our mind. Find out what works for you - it may even be a combination of things - and embrace them. An ex-colleague of mine used to light a candle at the end of each week for the animals that could not be saved. One of the things that I like to do is remember moments of my career that have put a smile on my face – whether it was the wag of a tail from a dog that was unwell (but happy for attention) or, when I was working at the SPCA, a member of the public gave us a $500 donation because I was able to tell her that we could help the fledgling sparrow that she had found. Over the years, I have also made wonderful friends with some of the people that I work with. As you all know, you need to be able to work well with your team for everything to run smoothly. Things might not always go to plan but it is great to be able to sit down and debrief with everyone about what went wrong and what worked perfectly, have those times when you have to crazy laugh together, or you could very well end up sitting in a corner rocking backwards and forwards. It is also good to acknowledge our teammates for going above and beyond, being a shoulder to cry on when we need the support or even just for doing their jobs. We live in a culture where everyone gets on with their job and does not expect thanks for it. 4 June 2018
The fact that we get paid for doing something we love is enough isn’t it? The Thursday afternoon before Easter, our senior vet gave myself and the other staff that were working either a Whittaker’s chocolate Kiwi or a Lindt chocolate rabbit to say thanks. I was personally blown away by this touching thought, because our roster rotates so that everyone does their fair share of public holidays and being rostered on for Good Friday is not very different to being rostered on for Waitangi Day or Anzac Day, especially when they fall on a Friday or Monday, giving us a long weekend. I will admit that I was also very grateful for the chocolate boost as we had a few intensive care patients in, and we had two unscheduled anaesthetic procedures that could not wait until Tuesday because of the health of the animals. Needless to say they were busy, long days and, as I write this, we still have two days of Easter left to go and I am wondering what tomorrow will bring. Another way of saying thank you to the other veterinary nurses that we work with is to nominate them for Vet Nurse of the Year. I’m sure that if you mentioned to them that you were going to nominate them they will ask, “Why? I do the same job that all of you do”. And yes, you should be nominated too! While we can only have three finalists and ultimately one Vet Nurse of the Year each year, this is a great way to acknowledge to your teammates how much you appreciate the work that they do day in and day out. How they help you to get through those tough days and celebrate the success. It can be hard to recognize in yourself that you are constantly going above and beyond as this can start to feel like the norm. But having your teammates stay late after their shift has finished just to help you and the rest of the team get those few extra things sorted is not the norm. And while it is appreciated, are you actually showing them how much you appreciate it? Nominating them for Vet Nurse of the Year is a great way to show your support and acknowledgement for doing something that they love. Choose a job that you love and you won’t work a day in your life – Confucius Amy
NZVNA
Letter from the Editor Next month I’ll be hanging up my scrubs indefinitely and, as I start packing everything in my house for my move to Wellington, I have to thank Django, my cat’s boyfriend (our neighbour and friends’ cat) for looking after her when I’ve been too busy editing to spend enough time with her – we’ll both miss you so much! I want to also thank my assistant editor Catherine Taylor, as well as Candi Fletcher and Kristina Naden, for helping to get this journal to print in time; without your expertise and kindly volunteered time my job would be a lot harder and a lot less enjoyable. In this edition Emma Annear walks us through mastitis, and Kylie Martin examines the new strain of calicivirus, looking at how we can protect our pet rabbits. Carolyn Press-McKenzie, the founder of HUHA, has written an inspiring piece about her passion for animal
welfare, and we hear about how the 2017 Vet Nurse of the Year is doing in Catherine Taylor’s interview with Alice Gasnier. We have two articles about ways to look after ourselves: Ana Djokovic talks us through occupational stress, and Patricia Gleason’s second part to her article about emotional intelligence talks us through how we can use this to affect the team in a positive way. We also look at complementary therapies in Tania Nilson’s article about hyperbaric oxygen therapy, and the first part of two articles about nutraceuticals by Sheree Smith. Conference is just a few weeks away, so if you have an idea for an article or have had an interesting case study please feel free to approach me for a chat, otherwise you’re welcome to send me an email about your idea at journal@nzvna.org.nz so we can discuss it further. Antoinette
| Above: Lovebirds Cece and Django
June 2018 5
NZVNA
Membership Secretary report We are now well on the way with our sustainability plan. Renewal reminders are now being sent out by email, and invoices will only be sent on request. If you have not heard from us recently, please let me know by emailing membership@nzvna. org.nz to confirm your email address, as all future communications will be done by email.
Did you know that employment opportunities can be found on the website? We often send them to you by email but there may be others that you will only find on the website, so make sure you check them out at www.nzvna.org.nz. Kathy
TIME TO START PLANNING HOW YOU’LL BE CELEBRATING
VET NURSE AWARENESS WEEK IN YOUR CLINIC
Vet Nurse Awareness Week 8th – 12th October 2018 6 June 2018
VNOTY
An Interview with Alice Gasnier Vet Nurse of the Year 2017 By Catherine Taylor RVN, Animal Referral Centre, NZVNJ Assistant Editor
The New Zealand Veterinary Nursing Association (NZNVA) and Hill’s Pet Nutrition NZ Ltd joined together for the fifth consecutive year, to recognise the dedication and commitment shown of nominated veterinary nurses for their outstanding achievements within the profession. The selection process was particularly difficult with such a high calibre of nominees to choose from, making the achievement of being named the Vet Nurse of the Year 2017 a huge honour for winner, Alice Gasnier. Alice, can you tell me a little about yourself and why you decided to become a veterinary nurse? I grew up in an area of England called the New Forest, which is about two hours South-West of London. I lived with my Grandad, Mum, Dad, two brothers and sister in a house in the forest, where there were always a lot of animals around to have fun with. After my Grandad passed away my parents decided to move to New Zealand, and we moved in November 1996. This results in a natural split of loyalties when it comes to some things, but I have now spent more of my life here than in the UK!
Throughout my schooling I knew I wanted to do something science-based as a career, for the most part. I studied in both the arts and sciences, but was not quite sure what to continue with! I love my animals - like most of us I’m sure - and I’ve had pets all my life ranging from dogs and cats to sheep, goats, pigs, birds, a rabbit, a cow, a fish, and even an axolotl! I chose veterinary nursing because of this, but I balance it out by continuing to be creative outside of work. Can you tell me a bit about your career path and your current role? When I first began my training, only the Certificate in Veterinary Nursing was available. I worked at a few rural clinics during my years of training, beginning to gain nursing experience. My first official job was at the SPCA as an auxiliary officer, which was essentially an inspector but with no ability to seize animals. This was a really emotionally trying job and on leaving, I subsequently took a break from nursing. In hindsight that particular job was a bit much for me to handle at just 20 years old with very little experience.
June 2018 7
VNOTY
What are your interests/passions within the industry? My main interests in the industry have changed over the years, and the areas I tend to enjoy the most are those where I can really utilise my skills.
After a break I enrolled in the newly available Diploma of Veterinary Nursing, and subsequently was employed at Hamilton Veterinary Services. I have been here since 2007, making it 11 years this April, and over this time I have progressed to the position of Head Nurse. We have a team of six nurses, three full time veterinarians, one part time veterinarian, a referral surgeon, and our wonderful admin staff. The clinic has evolved a lot over the years from being a mixed practice including equine, to now being exclusively small animal with our other divisions having set up their own facilities. Do you have any pets of your own? Too many! • Four dogs: Peggy, Jeff, Dora and Lottie • Eight cats (with various ailments): Oscar (hypothyroid post-I131), Dolly, Neil, Malcolm (hand-raised from being presented to the clinic with his placenta attached!), Olive (also hand raised), Margaret, Matthew (born from a pregnant foster cat), and James (with IBS and pancreatic insufficiency!!) • One cow, Gracie, from Ag day, who is now 20! • Six sheep: Gerald, Buddy, Big Twin, Little Twin, Bunty, Julie • One Kune Kune pig, Marlene • Two Muscovy ducks: Pearl and Myrtle • Two finches: Mr and Mr Finch
Anaesthesia is one of my main interests. Although, when I first started it is what terrified me the most, so in order to change my fears I educated myself as much as possible. Anaesthesia and our education around it, I feel, has changed quite a lot in a comparatively short period of time. I remember clinics with no monitoring equipment or charts and having to answer the phone at the same time as monitoring anaesthesia - I am hoping there is less of this everywhere now.
• And one lovebird, Kora, our ex clinic bird who didn’t take to clinic life I think it is possibly the least pets I have had at any one time! My most special girl was Hattie, who came to me at just a few days old when I was at the SPCA, and was not expected to live. Hattie taught me a lot about dogs; it’s impossible to talk about my life or nursing without including her. Her loss in 2016 was devastating to me, she was a once in a lifetime soul dog. What do you like to do in your spare time? I’m a bit of a homebody who enjoys living rurally. My spare time is often spent looking after my pets. I do agility with one of my dogs, training with my other ones, and am working towards trick dog titles. Recently I have started training towards trying a half marathon - we will see how that goes! I love to work on anything creative such as baking, cake decorating, some sewing, and jewellery making. However, my biggest hobby and passion right now is definitely my glass lampworking and bead making. Eventually I want to be able to make beads for people with their pet’s ashes encased in them. I have wanted to learn to do this after I lost my special girl, Hattie, in August 2016, and have set about making it happen - even creating a Facebook page!
8 June 2018
I also really enjoy learning about physical rehabilitation and helping clients to achieve the best possible outcome for their pet. How did you feel when you were first nominated? I was shocked! Not much gets past me at the clinic (I hope!) but everyone had managed to keep it a secret. I think I was genuinely lost for words, it had never been something I had thought of for myself. What was your reaction when you found out you were one of the three finalists? I found that out at the same time. No one had told me they had nominated me, they had managed to keep it super secret! How long did it take for it to sink in that you had won VNOTY 2017? It took quite some time! After meeting the other finalists, I didn’t think I would be the winner. As we heard everyone’s nominations read aloud, I became even more overwhelmed about being the winner. I think it probably sunk in the most after the reactions of congratulations and well wishes I received from family, friends, colleagues and our clients when it got posted to the clinic Facebook page - I received such lovely messages from everyone. Even my windows at home were decorated with a big banner! What do you think made you stand out from the other nominees to be selected? I really don’t know! After hearing the
VNOTY
we all had quite different reasons for our nominations, but the overall dedication to nursing was the reason for us all being there.
nominations of the other finalists, I thought they sounded amazing, and was thrilled to be considered a nominee. The other finalists are all absolutely lovely,
Do you have any words of encouragement for other veterinary nurses that want to become the next Hill’s and NZVNA Vet Nurse of the Year? My words of encouragement to other veterinary nurses would be to just be the best nurse that you can be. Don’t worry about introducing new ideas, and just focus on developing the ones you have as I believe in the old adage, “If you always do what you’ve always done, you will always get what you’ve always got”. If the best interests of your patients, clients, and colleagues are always at the forefront of
your mind, then you will be the best nurse that you can be. My best piece of advice in your career is to never neglect yourself, self care is paramount. Having interests outside of work really helps to balance the demands of our profession. You can’t help heal others, if you are broken yourself. For anyone interested in the multitalented Alice’s work, you can find her beadwork over on her Facebook page, aptly named after her beloved Hattie, ‘Hattie & Friends Studio’. @hattieandfriendsstudio
Do you want to be a list or registered nurse in 2019? To gain entry on to the list or register for 2019 veterinary nurses must: Voluntary list
Voluntary register
Hold a veterinary nursing qualification equivalent to one year full time study.
Hold a veterinary nursing qualification equivalent or greater than two years full time study.
Complete at least 40 hours paid or unpaid work as a veterinary nurse in a veterinary facility per year. Complete at least 20 hours of CPD* per year – 8 of the 20 points can be claimed as quality non accredited CPD. * Newly qualified veterinary nurses are exempt from the 20 hours CPD requirement for the year in which they qualify e.g. if a veterinary nurse qualifies in 2017 they are not required to complete 20 hours CPD during 2018. However you must upload proof of your qualification to MyCPD Record prior to 31st December. If you have not received your diploma then a letter from your provider is sufficient in the meantime. Only a maximum of eight online quizzes can be used towards your years CPD What do I need to do? • NZVNA members will upload their CPD certificates and points using ‘MyCPD’ on the NZVNA website by the 31st of December 2018 • Provide proof of 40 hours veterinary work in the CPD year (ie. letter or payslip) • Ensure your qualification is already uploaded to the NZVNA website Successful participants will be entered on to the list or register as appropriate to their qualification. The list/ register for 2019 will not be published until on or before the 1st of March 2019. In order to gain entry on to the list or register for 2018 you must supply evidence that you meet the criteria by 31 December 2018. Submit all evidence via ‘MyCPD Record’ on the NZVNA website. All CPD must have been achieved during the year of submission. June 2018 9
CPD CORNER
The real skill for the job: part two – developing Emotional Intelligence By Patricia Gleason RVN, Professional Standards Committee Photograph by Miranda Samson
As described in the last edition of this column, emotional intelligence (EI) involves two parts. The first part is gaining awareness of how emotions, both our own and others’, drive behaviour. The second part is developing skills to manage emotions intelligently (Newman, 2009). What’s come before in veterinary practice? Most of the articles written on EI within the veterinary field to date have focused on veterinarians. Veterinarians tend to deal with a lot of people, both clients and staff, on a daily basis, and can be managers and leaders within veterinary practices. They have a demanding and stressful job, with a huge amount of responsibility; don’t forget that currently everything we do as veterinary nurses falls within their legal liability. Veterinarians’ success, as leaders of both people and businesses, is hugely reliant on a highly effective EI, so it makes sense that the literature has focused on them. For over a decade, the Journal of Veterinary Medical Education has published works urging veterinary schools to incorporate soft skills and EI ‘training’ into the curriculum, because it has been identified as such a crucial element to their psychological and financial success (Burge, 2003; Lloyd & Walsh, 2003). That is not to say all veterinarians have had access to learning and development, or that they have received any additional support in this realm once they have left vet school. Very likely this is an area of development for the whole team.
After a career in biodiversity conservation, Patricia completed her Dip VN (Distinction) at Massey University, and worked at veterinary clinics in the Bay of Plenty and Waikato, before becoming a veterinary nurse educator. She is a founding member of the AVPRC and Chair of its Professional Standards Committee. She now works in a learning and development role coaching staff and teams in the educational sector.
10 June 2018
Where to for vet nurses? Veterinary nurses have a tremendous amount to gain by focusing some professional (and personal!) development time and energy on our EI. We are frequently at the interface of many relationships; sometimes between vets and clients, between veterinarians within our practice, and also between nurses within our practice. We may be supervising a
team of nurses, or even the whole practice. We deal with many situations in a normal day that require us to shift gears, adapt to changes, handle ourselves and our own emotions, as well as how we respond to all of those around us. We can have a tremendous impact on the atmosphere in our clinics based simply on how we react to our emotions. Some of us do this extremely well, and others, well, we could use some work. Responding to our emotions is natural and unavoidable. However, we do not have to allow our ability to reason to be hijacked by our emotions. Honing our EI allows us to reroute our thinking, to control our initial emotional response (limbic brain), and ensure the signal keeps moving up to our neocortex (hello logical brain!) for a response based on reason. Taking a deep breath before responding does A LOT to help this process. Emotions are a fundamental part of who we are. In fields such as veterinary medicine, some of us have been conditioned to focus on the elements of the “hard” sciences that support our professional competency. In health care in general, despite the fact that we are in a “caring” industry, we sometimes see the care part as the technical aspects of service delivery. Cultivating the “soft” side of our skill set can lead to increased collaboration, satisfaction and productivity—all factors that can improve the bottom line (Stamp, 2012). Some next steps There are plenty of things out there you could read; the book Emotional Intelligence 2.0 by Travis Bradberry is a good starting place. There are also some good, reputable resources available online to learn more about the skills and tips for things you can do to develop your EI. You can follow thought leaders on social media like LinkedIn to stay informed of the latest research and thought.
CPD CORNER
On a practical basis, there are many things we can do on a daily basis to improve our EI. These are habits of mind, so take work, practice and repetition to become our new way of being. MindTools.com and RocheMartin both have some good, free resources available that could immediately help on this journey:
• Take responsibility for your emotions we decide how we respond to things, no one can ‘make’ you mad, you choose to respond that way • Grow your empathy – seek to understand and appreciate the feelings and thoughts of your co-workers and clients
https://www.mindtools.com/pages/article/ newCDV_59.htm
This is just the tip of the iceberg for practical things we can do every day to grow our EI, and contribute to our success as professionals, as veterinary nurses and valued members of the team. Maybe it’s time to reflect and create a personal development plan for growing our EI. The key skills in these tasks, recognising areas for development and reflective practice requires self-awareness and honesty with ourselves, are key attributes of emotional intelligence.
https://www.rochemartin.com/blog/50tips-improving-emotional-intelligence/ A few examples are: • Pay attention to your behaviour practice observing how you feel at different times and explore the way that feeling is present in your body, such as feeling tense or sore when recognising you are feeling stressed • Get to know yourself a bit better – recognise how your emotions impact your attitudes and judgements • Think about how your words may affect others before saying them – wouldn’t it be grand to wipe, “that’s not what I meant” from your vocabulary? • Question your own opinions – on what fact or data do you base this opinion? Why do you believe this? How else could you view this?
References Burge, G. (2003). “Six Barriers to Veterinary Career Success.” Journal of Veterinary Medical Education, 30: 1. Retrieved from: http://jvme. utpjournals.press/doi/abs/10.3138/ jvme.30.1.1?journalCode=jvme Campbell Quick, J. and Macik-Frey, M. (2007). Healthy, Productive Work: Positive Strength through
Communication Competence and Interpersonal Interdependence. (Ch 3) in Nelson, D., and Cooper, C (eds) (2007) Positive Organisational Behaviour, London: Sage Publications. Lawler, E. E. I. (2003). Treat People Right! How organisations and individuals can propel each other into a virtuous spiral of success. San Francisco, CA: Jossey-Bass. Lloyd, J. and Walsh, D. (2003). “Template for a recommended curriculum in veterinary professional development and career success.” Journal of Veterinary Medical Education, 29: 2. Retrieved from: http:// jvme.utpjournals.press/doi/abs/10.3138/ jvme.29.2.84 Newman, M. (2009). Emotional Capitalists: The new leaders. Chichester: Wiley & Sons. Stamp, S. (2012). “The Jury is In: Considering the Case for Emotional Intelligence” Veterinary Team Brief. Retrieved from: https://www. veterinaryteambrief.com/article/juryconsidering-case-emotional-intelligence Veterinary Business Advisors, Inc. (2016). Emotional Intelligence: From surviving to thriving. Retrieved from: http:// veterinarybusinessadvisors.com/ emotional-intelligence-from-survivingto-thriving/ June 2018 11
CALICIVIRUS
What is Rabbit Calicivirus? By Kylie Martin Cert VN Photograph by Sam Kennedy
Rabbit Calicivirus (RCD), also known as rabbit haemorrhagic disease virus (RHDV), is a highly infectious viral disease that primarily affects the European rabbit (Oryctolagus cuniculus). The virus spreads easily from wild rabbits to pets and is usually 100% fatal.
Kylie has been a veterinary nurse for twenty years. She has worked in New Zealand and abroad with some amazing furred, scaled, feathered, horned and shelled creatures. When she is not teaching yoga she volunteers her time on conservation projects, her highlight was working with Kakapo on Codfish Island.
12 June 2018
RCD is transmitted directly from rabbit to rabbit. The possible route of the disease is through the eyes, nose, mouth and conjunctiva. Infected rabbits may also shed viral particles through their urine, faeces and respiratory secretions, so it may also be transmitted through contaminated objects such as food, bedding, water, cages and equipment. Flies, fleas and possibly some mosquitoes have also been shown to be efficient vectors of the disease. Where did it originate and how did it get to New Zealand? The first reported outbreak occurred in China in 1984, in a group of commerciallybred Angora rabbits imported from Germany. Within the first year of its
discovery it was responsible for the death of 140 million domestic rabbits in China. In 1997, the New Zealand government decided against introducing RCD as a biological control agent to control wild rabbits. Their main concerns were the risks to ecosystems and other species. The virus was later illegally imported and released in the Central Otago region, and is known as New Zealand’s biggest intentional bio-security breach. Whilst farmers and landowners rejoiced, the Ministry of Agriculture and Fisheries (MAF) worked hard to isolate the outbreak, forbidding any rabbit material be removed from the area. It spread throughout the country and significantly reduced the wild rabbit population in many regions. Recent application Since its introduction in 1997, wild rabbits are now becoming immune to the disease and rabbit populations are again increasing in numbers. It is believed that young rabbits (under 12 weeks of age),
CALICIVIRUS
exposed to the disease acquire protective antibodies following exposure, and have since survived and bred. This has resulted in rabbit numbers increasing, and costing an estimated $100 million loss in crops. Last year an application from Environment Canterbury (ECan) to release the new variant RHDV1 K5 was approved by the Ministry For Primary Industries (MPI). It was not considered to be a new organism so it made it past two laws, the Agricultural and Veterinary Medicines Act and the Biosecurity Act. This is a new Korean strain of the existing Czech virus; it is not a new virus. As this journal goes to print, RHDV1 K5 has been released in Otago and Canterbury. And pre-feeding is happening in other problem areas such as the Waikato area. How to recognise RCD As a first point of contact for worried rabbit owners, and with the release of the new strain imminent, it is important we refresh ourselves so we can give informed advice to clients. RCD has a rapid incubation period ranging from one to three days. Rabbits will usually succumb within 48-72 hours post infection. Many rabbits will die before showing any clinical signs of disease; these are known as peracute cases with the owners not realising that the rabbit has succumbed to RCD. Acute cases show uneasiness, excitement, inappetence, swollen eyelids, paralysis, bleeding from the eyes and neurological clinical signs such as paddling, opisthotonos and ataxia. Respiratory signs have also been observed resulting in foamy and bloody nasal discharge. Subacute cases may present the same but show milder symptoms. These rabbits often survive. NZVA recommend supportive care including, but not limited to, fluid therapy, syringe feeding, warmth etc., as there is no specific treatment for affected rabbits. Barrier nursing is required. The disease is characterised by haemorrhages and congestions in several organs. Particularly in the lungs, heart and
kidneys due to disseminated intravascular coagulation (DIC) which is usually the cause of death. Diagnosis is normally made at post mortem examination. What can pet owners do to minimise the risk to their pets Vaccination is the best protection currently available. Zoetis™ recommends the current protocol for “Cylap® to be administered at 10 to 12 weeks of age. If epizootic conditions make vaccinations advisable before the age of ten weeks, the animal should be re-vaccinated at 10 to 12 weeks of age. An annual booster is recommended.” 1ml is injected high on the neck and the injection site massaged for 10 seconds following to reduce the incidence of skin reaction (Zoetis, 2016). NZVA recommend the current protocol that rabbits 12 weeks of age and under to be vaccinated at 10 to 12 weeks of age, then a follow up off label booster given four weeks after initial vaccine. Hygiene advice to present to owners: • Change bedding regularly and remove old food to minimise flies, as they are the main vector • Insect and parasite control especially flies and fleas • House rabbits indoors or rabbit proofing backyards. This has its limitations as it can be spread by infected insects • Regularly clean cages and feed bowls with either 10 % bleach or 10 % sodium hydroxide or SteriGene®/Virkon™ (contact time is 10 minutes, then rinse well) • Source clean bedding, hay and feed where they are sure there is no, chance of contamination from wild rabbits / flies • Quarantine any new rabbits for five days, practise strict quarantine measures in this period and always handle new rabbits last • Limit contact with unknown rabbits and wash hands and clothes thoroughly after contact If an animal is found deceased consider disposal methods, keeping in mind the virus can stay in the environment for three months. Advice from local governments releasing the virus request carcasses are
not removed so as to not dilute the virus and wild rabbits becoming immune to it. However it may be advisable that pet rabbits be disposed of to reduce the risk of spread to other pet rabbits. Keep in mind, animals that do survive this disease are carriers and can shed the virus for at least 42 days. RCD is not zoonotic but a feline strain does exist in New Zealand. The two viruses are completely different and won’t spread between species or to any other animal. References Abrantes et al. (2010). Rabbit haemorrhagic disease (RHD) and rabbit haemorrhagic disease virus (RHDV): a review. Retrieved from: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3331820/ Landcare Research. (n.d.) Evolution of rabbit Haemorrhagic disease virus in New Zealand. Retrieved from https://www.landcareresearch. co.nz/publications/newsletters/ kararehe-kino/kararehe-kino-issue-26/ rabbit-haemorrhagic-disease Ministry For Primary Industries. (2018). Wild rabbits. Retrieved from https:// www.mpi.govt.nz/protection-andresponse/long-term-pest-management/ wild-rabbits/ New Zealand Veterinary Association. (2018). Advice for pet owners on protecting their pet rabbits from RHDV1-K5. Retrieved from http:// www.nzva.org.nz/news/389789/ Advice-for-pet-owners-on-protectingtheir-pet-rabbits-from-RHDV1-K5-.htm Parliamentary Commissioner for the Environment (1998). The Rabbit Calicivirus Disease (RCD) saga, a biosecurity/bio-control fiasco. Retrieved from http://www.pce.parliament. nz/publications/archive/1997-2006/ the-rabbit-calicivirus-disease-rcd-sagaa-biosecuritybio-control-fiasco Rosenwax, A. (2013). Myxomatosis and Calicivirus in Rabbits. Paper presented at the 2013 AVA Annual Conference, Australia. Retrieved from http://www. sciquest.org.nz/node/87754 Zoetis. (2016). Cylap RCD Vaccine. Retrieved from: https://www.zoetis.com.au/ product-class-new/vaccines/cylap-rcdvaccine.aspx June 2018 13
Epi-Otic
®
The gentle way to treat problem ears
Better together
Return ears to full health by using Epi-Otic® and easOtic® in tandem. Medication doesn’t do any good if it’s difficult to administer. When your patient’s ears are sore, you want to reach for a medication that makes life as easy as possible for your client. With its soft nozzle tip, measured dose pump and straw-less siphon, Eas-Otic® is the easiest ear medication to administer. Its unique combination of ingredients is an extremely safe and effective first line treatment for otitis externa caused by yeast, bacteria or allergic inflammatory processes.
For both augmenting the efficacy of topical ointment, or routine cleaning to help prevent infections, Epi-Otic® is an outstanding skin and ear cleaner. The screw-close tip makes applying the cleaner easier and less-messy than other lid types, and the soothing active ingredients makes a disagreeable job less trouble. Pro-tip: Cold cleaner is unpleasant in the ears; slightly warming the bottle by standing it in a jug of warm water for a few minutes can make pet and pet parent much happier.
Talk to your Virbac Area Sales Manager about easOtic® and Epi-Otic® together can help your client’s ears get better faster.
nz.virbac.com/ears easOtic® is a Restricted Veterinary Medicine available only under Veterinary Authorisation. Epi-Otic® and easOtic® are Registered Pursuant to the ACVM Act 1997. ACVM Nos. A6006 and A10305.
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HUHA - Helping You Help Animals charitable trust By Carolyn Press-MacKenzie Photographs by Jo Moore
When someone brings a baby starling into the clinic, that has fallen from the nest and is unable to be reunited with it’s parents, what do you do? Do you sigh under your breath, “Grrrr not another one, what am I supposed to do with that?”, or do you thank the members of the public for going out of their way for the little one, and then set about creating a portable nursery that you can take with you everywhere you go for the weeks of dependency that lie ahead? It may seem a strange and insignificant question, but the answer can be life defining. The first scenario doesn’t necessarily mean that you are a bad veterinary nurse; a starling isn’t a native, or maybe you prefer to leave your scrubs at the door when your shift ends. You have other priorities and that’s just fine. But for those of you who jump in, boots and all, to the second scenario…. you are the ones to watch, you are the ones that understand the most pure and important philosophy of our trade: “Every animal matters.” As a youngster my Mum taught me something that I carry with me everyday: “If you don’t do it, who will?” To be honest, it’s still something that I ask myself several times a day when confronted with scenarios like the helpless baby
bird needing care. It’s a question that I encourage my team to stop and ask themselves as we navigate through HUHA’s daily demands too. The full prep room bin that everyone keeps walking past, the used dirt tray; your action, or lack of action, will directly affect others. But Mum’s question is also relevant for the big issues… the tired and confused monkeys being used for entertainment in the circus, the 36 beagles left forgotten in a closed vivisection lab, or the Government announcement that psychoactive drugs will be tested on animals in New Zealand. This is when asking yourself, “If I don’t, who will?” can really make an impact. For me the answer is always the same…I will! And every time I do. Without question or hesitation. In 2006 my husband Jim and I got those monkeys out of the circus, and in 2012 my HUHA team and I liberated 36 beagles from a real-life Cruella de Vil vivisector. In 2013 we fronted the government and changed the law so that party pills were not tested on animals. And 31 years after embarking on a veterinary nursing career, I still take the fledglings home. Maybe my approach is merely hardwired tenacity, or maybe it’s taking a moment to be considerate. But ultimately, it’s the
Carolyn Press-McKenzie is the founder of HUHA, Helping You Help Animals Charitable Trust. Carolyn’s inspired problem-solving and drive has led a team of HUHA volunteers to save thousands of animals from death row and to find safe outcomes for hundreds of animals.
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attributes that makes change and saves lives. Mary, the previous New Zealand Veterinary Nurse journal editor came to visit me in 2017; she had volunteered for HUHA and was dropping some donated pet food into our vet clinic. Mary had just finished reading my book “Animal Magic”, a book about how I came to start HUHA, saving thousands of lives along the way. She asked if I would write this article for the journal, to explain what happened next in my journey. It got me thinking. I started this journey as a young vet nurse three decades ago. Since then I’ve founded, and still run, New Zealand’s leading ‘no kill’ animal shelters (HUHA), which have recently been identified by MPI as a stakeholder in NZ animal welfare. What happens next is that every day, seven days a week, 365 days a year, I get out of bed and voluntarily run the three shelters and the veterinary clinic. I do this with an amazing and dedicated core team; we manage hundreds of volunteers and thousands of animals. We receive over 2000 calls for help a month and I can be often found sleeping in my car on the side of the road because I didn’t quite make it home. The sad reality is that in NZ there is an overwhelming demand for the type of proactive and hands on problem solving that HUHA provides. Through all the blood, sweat and tears there are some incredible achievements and proud moments. But the question I keep pondering is ’How did this happen?’, and I always end up back at the beginning.
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My Mum’s seemingly innocent words of wisdom which have ultimately led to the change animal welfare expectations and outcomes in NZ.
forgotten the lessons I learnt as a youngster and as a veterinary nurse - that every animal matters and that as owners/ caregivers their destiny is in our methods.
So to give you an idea of where HUHA is heading and what comes next, I would say that that depends on New Zealanders and the disposable culture we so desperately need to move past. I believe it is important to acknowledge how we all learn and grow on our personal journeys, our successes and our mistakes, and I am so grateful for the growth I have experienced on my journey. But, I hope with all my heart that the New Zealanders we help along the way are learning and growing from their experiences too. The cycle of poor choices for pets and animals in New Zealand needs to stop, a new and more considerate normal needs to form, and maybe HUHA could have a day off due to low demand!
And for me, my method and greatest motivator, is simply stopping and asking myself “If I don’t, who will?”
So now, I type this with my own pack of 14 rescue and foster dogs snoozing together at my feet, a paddock full of rescued farm animals, and a backyard holding five enriched ex circus monkeys, all because: “If I didn’t who would?” The wonky, the blind, the deaf and the reforming biters - even though each of their stories have taken me through a diversity of troubles, joys and other experiences. Even though I have helped so many animals, for me my journey and the imprinting of my philosophies and values, started in a rather simple way…my childhood cat! Most importantly, as I journey through life meeting animals in need and other characters along the way, I have never
Extract from Carolyn Press-McKenzie’s book Animal Magic: “I have always been surrounded by the magic of animals. Growing up in a lazy seaside village our family cat, called Blue, was the most devoted and constant companion a young girl could ever ask for. Blue arrived in our family several years before I was born. My father had been putting aside some money for new curtains. When the money had been saved, my mother did go shopping for curtains, but instead arrived home with a tiny little blue point Siamese kitten she named Blue Print Press. Mum often told the story of why she spent the curtain money on a kitten that day, and in a way it became a family fable. My father claimed a strong dislike for cats; he would say they were too disloyal and independent. But every Saturday morning my mother would watch Dad sitting on the steps of the front porch, leaning down to slip his shoes on and tie the laces. And every Saturday morning the neighbour’s cat would be present and correct, ready to assist with my father’s routine. After he had tied the laces the two of them would just sit side by side contemplating the day that lay ahead. As my mother watched my perpetually hard-working and stressed
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father, who during the week left for work at 4am as a fruit and vegetable auctioneer, stop unconsciously to take a moment, relax and soften, giving the visiting creature conversation and gentle strokes and even a smile. She decided that it was time for our family, which was then just Mum, Dad and a toddler Stephen and a baby David, to expand. It was time to bring the magic of an animal into our home. Knowing my father would stiffen and protest at the idea, she just went ahead and did it anyway, knowing as she always seemed to that it was for the absolute best, and as always she was absolutely right.
that plagued him in the beginning was severe. But even as a young girl I quickly realised that no matter what the animal’s story, no matter where they came from and what they had been through, it was the here and now that mattered. Each animal that passed through my life growing up had had troubles along the way, but every single one of them learnt very quickly the magic of trust and respect. They learnt that my family treasured them and that they were important, included and safe. And so the timid newcomer thrived and carried on the legacy of a Press family cat, known to all that met him as exceptional.
From the moment I was born Blue was at my side. He had grown into a huge cat with piercing blue eyes and a booming great voice. Any dog brave enough to walk on the footpath outside our home was quickly shown the error of their ways and would know next time to cross the street before passing by number nine. But to me and my brothers Blue was nothing but gentle, attentive and patient. He wasn’t just ‘the cat’, he was an important member of our family. He drove in the car to the shops with us, he holidayed with us, even on boating trips to the Marlborough Sounds, and of course he always had his own piece of fish on fish and chips Sunday.
As a teenager I developed an obsession for horses. Everything in my room was horsey, and the only thing my friends and I talked about was horses. I even had a voluntary job at a racecourse shovelling poo, and grooming and driving trotters around the track every Saturday morning. The stables were located at the Hutt Park race course and were leased to several different trainers. My best friend Fiona and I were lucky to work for a trainer who was a kind man, who respected his six or so horses and treated them well. But as I watched the other trainers I learnt my first lesson in fate. The happiness, well-being and safety of these horses, all came down to the luck of the draw. Being owned by my boss meant good food, enrichment and kindness, but to be owned by one of the other trainers could have meant anything. As with all animals it was 100 percent pure fate who their owners were.
When I was old enough to catch the school bus, Blue would walk me to the bus stop and wait until I was safely on board. Then at 3 pm every week day my mother would smile and laugh as Blue would wake from a deep sleep, stretch and make his way unaccompanied back to the bus stop on the other side of the main road and wait for me to arrive back into his care. I was 12 years old when Blue passed away of kidney failure at the age of 16 years. It seemed our whole community mourned the loss of such a local character. Everyone who knew him was devastated, and as for my immediate family, we were inconsolable. Nothing was right without Blue’s strong and nurturing presence. But as always life goes on and we learnt to cope . . . though we never forgot him. Eventually we decided it was time to bring another cat into our lives. Beauregard was small and timid; he had come from a breeder who had poorly socialised him and the emotional damage
The actions of one particular trainer are burned in my mind forever. He had a young horse that wasn’t performing well, and as the trainer got stressed about the poor performer, his palpable dissatisfaction caused the horse to become stressed, which in turn caused the trainer to lose his temper and so triggered the horse to act out. Other trainers around the yards would laugh and say we’d best all stay clear when he was having one of his moments. But one day as I was walking around the corner of the stable to find the toilet, square in front of me hung the two-year-old pacer hog-tied and hoisted upside-down by its legs. The trainer was kicking the horse and cursing at it, calling it a lazy so-and-so and
he’d show it what a loser deserved. The trainer left the horse hanging for another hour or so, then after he had cooled off he untied the horse and everything was apparently back to normal. Life at the stables carried on. As a shy young girl, I had not yet found my voice and to this day I regret that I didn’t say or do anything. But what has struck me the most, as I look both back and forward, is the effect a human being can have on an animal. Any owner’s method of care or treatment of the animals in their charge is their choice, but the effect of poor choice can be devastating or even deadly to an animal. Whether this is brought about by a lack of education, ignorance or just a bad day, what is most concerning is our culture of turning a blind eye and allowing each animal to just accept its fate. Animals in New Zealand are big business; racing and farming are both apparently important industries and even having animals as pets is woven into the fabric of our society. And yet if we open our eyes and see what is regularly excused within these industries and in many homes, we would too often be horrified by what is complacently accepted as normal. No shelter for stock; sows in crates and factory farming of pigs; tethering goats on road sides; chained-up dogs in backyards; cats and dogs being left undesexed to breed indiscriminately; caged birds with little enrichment; dogs, cats and rabbits being bred in poor and inhumane conditions and very young puppies, kittens and bunnies being taken from their parents for pet store stock. The Animal Welfare Act in June 2018 17
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New Zealand offers little protection. It is perfectly acceptable to shoot your dog in the head if you feel it is not agreeable to your way of life. It is okay for anyone to breed their pet no matter what their situation and with no regard for the wellbeing of the animals or an overwhelmed community. It just goes on and on. Every animal deserves to know the love and safety of a responsible home, whether that is within a business or a suburban backyard, and yet in New Zealand this is sadly often not the case. Surprisingly, safe and sensible homes and businesses are the exception not the rule. Of course the way forward has to be education. The cycle of suffering at the hands of ignorance and complacency needs to stop…” “…It’s true that my cat Blue was exceptional. But that was because he was allowed to be a significant, involved and enriched member of my family. At HUHA we have a saying which we use almost daily as animals with a reputation for being bad, untrainable or useless come into our care. We simply smile confidently and say, ‘Change the environment and you’ll change the animal.’ “ HUHA highlights so far: • Rescued, rehabilitated and re-homed thousands of community animals in need, including companion pets, farm animals and wildlife • Rehabilitated and released hundreds of native birds • Rescued three monkeys from the circus • Thousands of battery hens liberated from factory farms and rehomed as pets 18 June 2018
• The liberation of Piggy Sue for the Mike King Factory Farmed Pig Campaign on TV3’s ‘Sunday’ • Rehabilitated 300 fairy prions that were exhausted after a storm • Relocated 160 homeless animals from Christchurch during and after the earthquakes • Rescued 21 captive bred Kaimanawa horses from slaughter • Liberated 36 beagles from an animal testing facility • Rehomed 15 elderly greyhounds from a closed racing facility • Took in four monkeys with nowhere to go after a zoo closed (Franklin zoo) • Took in eight wallabies with nowhere to go after a zoo closure • Formulated ‘Whoop’ ‘Itch & Ouch’ shampoo and lotion, helping to heal severe skin conditions • Petitioned parliament – ‘Leave Animals Out of Legal High Testing’ (May 2013). HUHA arranged the nationwide march and in the end, won the battle • Launched the ’Stop Breeding Puppies to Death’ campaign against puppy mills and pet shops • Assisted the Whanganui district council in disestablishing their euthanasiaby-gas facility and establishing a compassionate method via a contract with local veterinary surgeons. HUHA mediated and had round-the-table discussions and brought some death row dogs back to the sanctuaries as well of course • Campaign against prong collars • Rehomed 28 alpacas in a day! • Rescued and rehomed 50 hoarded farm dogs
• June 2017: opened ‘HUHA Vets Stokes Valley’ • June 2017: purchased 167 acres of land on which to build the new HUHA Shelter • Invited to consult with MPI to improve New Zealand animal welfare codes and enforceable regulations • September 2017: rescued 75 meat production rabbits and shone a light on the lack of regulation and oversight existing for rabbit farming • Invited to meet with Trade Me to help seek improvements around animal advertising • October 2017: HUHA reached 54000 followers on Facebook • The day after writing this article drove 200 battery hens to pre-approved homes around the lower North Island. • February 2018: started land development for new Haywards Shelter • March 2018: removed 347 prong collars from Uncle Bills Bargain Barns around NZ, achieved written confirmation from the manager that they would not import anymore • April 2018: spoke to Primary Productions Select committee, regarding implementing a retirement policy for surplus laboratory animals as outlined in our “Out of the Labs” collaboration with NZAVS Carolyn’s book Animal Magic is available online at https://huha.mystorbie.com/ animal-magic-by-carolyn-pressmckenzie?gn=Home&gp=7 All profits from the sales of this book go to HUHA.
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NUTRACEUTICALS
Nutraceuticals: The basics – part one By Sheree Smith RVN, UKRVN, Dip Hydrotherapy Owner and Director of Kinesis Veterinary Ltd Photographs by Sam Kennedy
Introduction The purpose of this article is to introduce veterinary nurses to the basics of nutraceuticals: what they are, how they can benefit your practice, how they can benefit your patients and allow you to gain the confidence of your clients to begin to use them in your patients treatment and/ or care plans. What is a nutraceutical? Before drugs were even developed as they are now, they all started off naturally. Nutraceuticals are a pure form of a natural product that, to be more effective, is in high concentration. Nutraceuticals are generally very safe to use, with little or no side effects, and may be used as a primary therapy or alongside conventional medicines. They often help to reduce the amount of chemical drugs necessary to manage disease conditions, such as atopy, degenerative joint disease and raised liver values. They can be of great assistance in supporting recovery and boosting vitality, as well as being a useful fall back for health conditions where drug use is not appropriate, such as chemical side effects, financial constraints and other issues. Veterinary treatment and medicine is typically expensive to the average family, meaning an effective, lower cost alternative can be more desirable.
Sheree Smith is an experienced veterinary nurse, hydro therapist, pain management and rehabilitation practitioner. She graduated in 2002 from Unitec Institute of Technology and has also studied hydrotherapy and pain management in the UK. Sheree has worked as a veterinary nurse in New Zealand, Australia and Europe, spending an extended period working at the cutting edge referral centre in the UK called The Willows.
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Many nutraceutical ingredients have come to be accepted by mainstream medicine for their proven therapeutic benefits, such as glucosamine, chondroitin, omega 3 fatty acids, antioxidants. There is a huge array of other ingredients that are lesser known to the public but can be very effective in helping to benefit patients’ health and quality of life. This can be increased further if used in combination with other nutraceuticals to enable faster action, better absorption, or to counteract contraindications. Unfortunately, many supplements made for humans and animals are made
according to food grade standards, as opposed to pharmaceutical standards, which are far stricter, being designed to govern the content of medicine, and often do not actually contain enough of certain ingredients to do what the label claims. Additionally, many products, being sourced in nature, have limited bioavailability which has a substantial impact on their effectiveness and can also affect the environment. Therefore, you need to check the label and the claims on the products. More on this in “how to read the label” later in article. Thankfully, there are some superb products available in the veterinary market today, many of which have undergone scientific trials or proven their value in case studies. However, make sure you read more into these studies and find out where it was taken, with how many sources, and who it was funded by. You may be interested to find that some companies fund their own trials and of course these have yielded brilliant outcomes for their products. There has been acceptance among veterinarians that many of these products will benefit animal health if used sensibly and intelligently. The following is a brief discussion of some of the more popular categories of pet dietary supplements. Joint Health Because of better diets, feeding practices and modern veterinary care, animals, like humans, are living longer and feeling better well into an advanced age. As animals live longer, they are prone to genetically influenced degenerative conditions such as canine hip dysplasia, intervertebral disk disease and inherited haematologic disorders, as well as non-specific aches and pains. Pet food and supplement manufacturers have responded with a multitude of specialty foods and nutraceuticals containing glucosamine, chondroitin sulphate, boswellia, turmeric, pine bark extract. Manufacturers also add methylsulfonylmethane (MSM), green-
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lipped mussel and yucca, in a variety of combinations. On the other hand, there is ample evidence, sometimes anecdotal, that many of these products have a beneficial effect on joint health. Many of the active ingredients found in oral joint supplements for pets really do work. Seeing positive outcomes is an effective way to measure a client’s response. The ingredients Glucosamine: a component of glycosaminoglycans (GAGs) found in joints, tendons, ligaments, skin and blood vessels. GAGs are comprised of long chains of modified amino sugar molecules that capture water and allow cartilage to adapt to pressure changes in the joint capsule, acting as a shock absorber during mechanical stress. When cartilage begins to break down from overuse, age or disease, the lubricating GAGs are destroyed and lose their shock-absorbing properties.
Providing supplemental glucosamine to joint tissues stimulates them to produce more GAGs. There have been numerous studies of human and animal tissues that have shown that glucosamine is readily incorporated, without modification or degradation, into GAGs. Although glucosamine can be synthesized within tissues, exogenous glucosamine is an indistinguishable substrate for the biosynthesis of GAG molecules. In this regard, glucosamine can be considered a conditionally essential nutrient. Chondroitin sulfate: a linear carbohydrate polymer that also contains glucosamine molecules, is a specific type of GAG found in joint cartilage. It attracts water into its fibrous matrix, nourishing the cartilage and enabling it to protect joint structures under compressive loads. Chondroitin supplements can slow the process of degradation in a diseased joint by binding up and neutralizing some of the unhelpful
enzymes. It also may stimulate the body to produce additional substrates important for a healthy joint. Chondroitin can be extracted commercially in a highly heterogeneous form from animal cartilage or connective tissue, most commonly bovine tracheal tissue. Extracts of shark cartilage, squid cartilage, perna mussel or sea cucumber are also used. But make sure that where they are sourced from is sustainable, for example, a by-product from this market (that we see as waste) is a better option rather than hurting the environment. Methyl-Sulphonyl Methane (MSM): a derivative of Dimethyl sulfoxide (DMSO), which has anti-inflammatory and analgesic properties, improves joint flexibility as well as elasticity of connective tissue, making it a useful supplement for muscle and tendon repair. In hopes of improving the performance of glucosamine and/or chondroitin products,
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potent anti-inflammatory action. It starts to work in the first four to seven days of use, helping with the smooth running of the joint, it has also been shown to be beneficial to gut health and lower raised liver parameters (Ridha et al., 2016). Turmeric/curcumin complex: standard turmeric is not very bioavailable, however with a unique complex procedure which optimizes the curcumoids, the active components, results in 40 times greater bioavailability than standard turmeric. Turmeric is an antioxidant defender as well as helping to support the body’s natural anti-inflammatory processes and complements the actions of boswellia. Many patients already on non-steroidals find that after the first week on a boswellia/ curcumin based nutraceutical, the NSAID dose could be reduced (assessed on a case by case basis) and most of practices use this first line of support. For example, “Let’s try this nutraceutical first, then in time as the disease progresses we could look to introduce NSAIDs”. Many animals can be maintained on nutraceuticals alone without the need to start the NSAIDs quite so soon. Veterinarians report they are pushing that point back by up to two years (Bland, 2015).
some pet product manufacturers add methylsulfonylmethane (MSM), a source of organic sulphur thought to be important in helping the body form a strong collagen matrix. Vitamin C: trace minerals such as copper, manganese and zinc play active roles as cofactors in enzymatic reaction and Ester-C ascorbates, non-acidic forms of vitamin C that have anti-inflammatory and analgesic properties, as well as being essential for the formation and maintenance of collagen. Some supplements also contain other anti-inflammatory additives such as devil’s claw or white willow bark, which reduce pain symptoms but, like other 22 June 2018
supplements, do not treat the cause. Vitamin C carries dual importance as the body’s premier water-soluble antioxidant and as a coenzyme essential for collagen synthesis. It reduces free radicals, prevents lipid oxidation, and helps to regenerate other antioxidants.
Proanthocyanidins: a subclass of bioflavonoids found in blue and purple berries, purple grapes, and extracts of grape-seed and pine bark (enzogenol). Research suggests a strong role for dietary bioflavonoids, including proanthocyanidins, in supporting and maintaining sound cardiovascular function. Proanthocyanidins have been studied extensively and documented benefits include the support of healthy immune function, maintenance of healthy peripheral circulation and they help retain capillary strength and vascular function.
Boswellia: is a plant extract from the frankincense family and is also found in gum tree resin. When you harvest the resin (boswellia serrata) it is a processed form of boswellic acids which are the key active component in a more concentrated form. Boswellia has been used for thousands of years but over the past 15 years there are over 400 clinical trials into its very
They are useful in veterinary practice for many disease conditions including osteoarthritis (OA), infections, heart disease, saddle thrombus in cats, and have been found to be irreplaceable as a safe and reliable adjunct therapy for neurological problems, autoimmune conditions, allergies, neoplasia and simply to support vivacity and general energy levels in compromised animals.
NUTRACEUTICALS
Proanthocyanidins also have an antiinflammatory action as well as being a powerful antioxidant and works in soft tissue injuries (Li et al., 2015). Pine bark: complements milk thistle (silymarin) which, as well as having an anti-inflammatory action, helps to support the liver. Look to see if they use the whole milk thistle rather than just the silybin portion. Type II collagen: Dogs treated with active UC-II alone or in combination with HCA-SX and CM showed marked reductions in arthritic pain and lameness. Overall, the dogs became very active and playful. The supplements did not produce any side effects and were well tolerated. Relapse of arthritic signs, seen following a 30-day withdrawal, suggests that continuous therapy is needed (Peal et al., 2007). Sprinkle capsules are easier to administer, as they can either be given whole or opened and mixed into something you know the pet likes. Look that they contain 100 percent of the active ingredient, and there are no flavourings or fillers. What you tend to find with your “tasty” or “chewy” tablets, is that they have under a gram of active ingredient in the 2g tablet and the rest is flavourings and/or fillers. These tend to be quite high in fat and the fillers are synthetic, so this effectively results in an unnatural product to make them tasty; not ideal when a lot of OA patients need to be reducing their fat intake not increasing it! Gastrointestinal support We all know how important it is to maintain a healthy gut and it’s equally as important for our patients. These work by helping restore normal digestive function, promote and feed the friendly bacteria, which then helps restore the gut balance. The kaolin part of the product binds the toxins to it so then they can be eliminating it out the other end. This in turn then helps improve the stool consistency and will help reduce flatulence. Usually comes in a paste form to help aid the healthy balance of the gut. You want to make sure they come in a high strength prebiotic or probiotic, that taste nice and are easy to administer. Prebiotic (Enterococcus faecium): should be supplied in a 2mL dose, with over four
billion bacteria, to support a healthy gut. Enterococcus helps normalise faecal consistency and boosts immune system.
neurological development and retinal development. This could be why they seem to be behind their mum fed counterparts.
Probiotic: studies have shown that FOS (fructo-oligosaccharides) and MOS (mannan-oligosaccharides) increase the number of beneficial bacteria in the gut while blocking harmful bacteria.
It can take approximately six weeks for the full effect to be seen but they should see symptoms of senility lessen during that time – feedback has shown marked improvements within the first one to two weeks.
Kaolin: acts as the absorbent part and binds toxins to it; it also absorbs water to help firm up stools. But be careful as some products use high kaolin to stop animals having loose stools but not actually providing any bacterial support. Some of these products are bitter for the animals, but some companies are now adding flavours. Be careful of additives as they can upset the tummy more. Sweet basil is a great flavour enhancer that is natural and animals enjoy it, with the added benefit of supporting the gut at the same time. Product mode of action is important to know; most importantly ask the company how the pre/probiotics are transported to the lower intestines (as this is where they need to be). Some coat the particles in an oil and so when it enters the stomach they are safe from the stomach acids until they get to the small intestine, where they can work their magic. Breeders tend to have intestinal nutraceuticals on hand for young puppies. It also advised that having some in your animal first aid kit could prove helpful, especially if you’re on holiday and the unexpected happens. Brain and cognitive support Nutraceuticals for brain function can be used at many stages of life including to treat the signs of cognitive dysfunction; senility and dementia, from middle age to slow the brain ageing process, to aid treatment in aggressive dogs. Elevated levels of docosahexaenoic acid (DHA) have also been shown to improve short term memory and learning ability so can be used during the puppy and kitten phase to aid learning. It is particularly helpful in those litters hand reared on milk replacement formula, which is very low in DHA which is crucial for brain development,
It is a similar presentation to omega nutraceuticals with fish gelatin capsules. Can be given whole or snipped open and the viscose jelly squeezed onto the food, for both cats and dogs. The brain is made up of 60% eicosapentaenoic acid (EPA) and favours the omega 3 DHA (Bozzatello et al., 2016). Most diets are found to be so lacking in DHA the brain up takes the omega 6 arachidonic acid which has a proinflammatory effect (Biagi, 2014). A deficiency in DHA has been linked to aggression in dogs and Alzheimer’s in humans (W. Jean Dodd, 2016). Nutraceuticals use the same refined sardine oil source for omega 3 but it has very high levels of DHA and lower levels of EPA. Ideally, use 210mg of omega 3 comprising 165mg DHA and 32mg EPA. This level of DHA hasn’t been seen before in a brain function product, with some only containing approximately 30-35mg, and really gives the brain and central nervous system (CNS) the EPA it needs. A lot of brain ageing is due to free radicals produced in the manufacture of energy by cells. These free radicals cause oxidative stress to the cells and the release of more free radicals. A young healthy body can deal with these free radicals but the ability to do this reduces with age. Ideally a nutraceutical should contain two very powerful antioxidants to help mop up these free radicals and slow down the damage, such as: Ginkgo biloba a potent antioxidant which also increases blood flow to the brain. It has also been shown to improve memory and is useful in dementia treatment. Natural vitamin E is the most bioactive form and a powerful antioxidant which has also been shown to slow the progression of Alzheimer’s (Dodd, 2016). June 2018 23
NUTRACEUTICALS
B vitamins, which improve the integrity of the neurotransmitters and works with DHA to slow brain atrophy. Phosphatidylserine, a phospholipid has neuroprotective properties and promotes neurotransmitter release. It has been shown to improve memory in old animals and humans and is recommended for reducing the risk of cognitive dysfunction in elderly people. How do you know what is in the tablets? To become licensed, drugs must undergo rigorous safety and efficacy studies, and labelling of licensed medications is highly regulated to ensure that the labelling reflects the contents of the package. Nutraceuticals do not have the same requirements. A study has shown mislabelling in 84% of nutraceutical products studied, with the amount of mislabelling ranging from 0% to 115% of the actual product in the package (Chandler et al., 2014). Nutraceuticals are unregulated which means companies do not have to meet their label claim, therefore there are many substandard products on the market. There is nobody checking that what is stated on the label is in the product. Companies don’t even have to state the milligrams and even if they do it is classed as a “label claim”, so they don’t have to meet it. In fact, a company can state they have 1000mg of glucosamine in their product, only put 10mg in, AND get away with it! Many have been tested over the years and found to have between zero and 20% of their label claim. There is one way that you can be sure of guaranteed levels, and that is if they state the percentage purity next to the amount added on the label. This means the product is governed by regulation which means you must prove it. This should be proved at the raw material stage and again at the final product stage, so that is your guarantee that the label claim is being met. This is voluntary and currently in this market only Nutravet® & Vetplus’ Synoquin® comply. Determination of efficacy of the products requires measurable outcomes; a few studies in nutraceuticals have been 24 June 2018
performed to try to measure these, and more scientific evidence is becoming available about some of the products. The type and quantity of research in the use of nutraceuticals varies with the compound under study. The total number of studies on nutraceuticals in medicine numbers in the tens of thousands. In some cases, these studies include clinical trials in both humans and animals. So when checking labels look out for: • Percentage of purity – if they state the percentage of purity this means that they must have 99% pure nutraceuticals in the medication. If they don’t, how much nutraceutical is in them? What else has been added? • Make sure there are no other additives – for example, fillers or flavourings • Are the ingredients ethically and sustainably sourced? Shark cartilage or by products of something we don’t eat, for example squid cartridge Other points to look out for in an excellent product: • Always calculate the cost per tablet for client and clinic affordability • How long does it take for the product to work? A client waiting over four to six weeks to see results could lose interest by then • Look for product use references and literature for clients, ask your local rep also • Look for product trials and find out who conducted and who financed the trial Who is the best person to know about these products? Having a good nutraceutical company is critical for your veterinary clinic, as they should be able to supply staff training on each product and educate staff on how nutraceuticals can benefit your practice. Since nutraceuticals are available over the counter everyone from reception to veterinarians should know about the products, what’s in them and how they can help your client’s animals. In the September edition Sheree Smith will cover anxiety and stress management, bladder support, and allergies and skin dysfunction, and how nutraceuticals can benefit your practice.
References Al-Yasiry, A., & Kiczorowska, B. (2016). Frankincense - therapeutic properties. Advances in Hygiene and Experimental Medicine, 70. DOI: 10.5604/17322693.1200553. Biagi, G., Mordenti, A., Cocchi & Massimo. (2004). The role of dietary omega-3 and omega-6 essential fatty acids in the nutrition of dogs and cats: A review. Progress in Nutrition. Retrieved from: https://www.researchgate.net/ publication/272784328_The_role_ of_dietary_omega-3_and_omega-6_ essential_fatty_acids_in_the_nutrition_ of_dogs_and_cats_A_review Bland, S. (2015). Canine Osteoarthritis and Treatments: a review. Retrieved from: http://www.pagepress.org/journals/ index.php/vsd/article/view/5931/6327 Bozzatello, P., Brignolo, E., De Grandi, E., & Bellino, S. (2016). Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data. Journal of Clinical Medicine, 5(8), 67. DOI: 10.3390/jcm5080067 Chandler, M., & Wynn, S., (2014). Nutraceuticals: principles and uses. Retrieved from: https://www. vetstream.com/treat/canis/freeform/ nutraceuticals-principles-and-uses D’Altillo, M., Peal, A., Alvery, M., Simms, C., Curtsigner, A., Gupta, R., Canderdy, T., Goad, J., Bagchi, M., & Bagchi, D. (2006). Therapeutic efficacy and safety of undenatured type-II collagen (UC-II) alone or in combination with Glucosamine and chondroitin in arthritic dogs. Toxicology Mechanisms and Methods, 17(4) DOI 10.1080/15376510600910469 Dodd, W. (2016). Nutrition and Thyroid Function Affect Canine Behaviour and Cognition, Nutrition, Behaviour and Cognitive Aging. Paper presented at the Dog Symposium, Norway. Retrieved from: https://dogsymposium.weebly. com/uploads/4/7/5/4/47541947/ nutrition___thyroid_function_-_handout. pdf Li, Y., Feng, J., Zhang, X., & Cui, Y. (2015.) Pine Bark Extracts: Nutraceutical, Pharmacological, and Toxicological Evaluation. The Journal of Pharmacology and experimental therapeutics. Journal of Pharmacology and Experimental Therapeutics, 353 (1) 9-16; DOI: https:// doi.org/10.1124/jpet.114.220277
Introducing
VetFlix
Increasingly, the purpose-built or freshly renovated veterinary practice has no place, and little desire, for supplier paper posters to festoon its walls. However the need is there to support the suppliers’ end user promotions and have conversations with clients about options. Veterinary practices now have free access to the latest digital poster technology. VetFlix offers its A3 high resolution screen embedded into a purpose built surround with six DLE brochure slots. It’s compact, smart and professional. The seven, thirty second video or dynamic posters have no sound and are populated with veterinary supplier promotional material and some educational content built by VetFlix. There is also the option for the clinic to take a poster slot for a nominal one off cost. VetFlix offers free installation and maintenance of its A3 sized screen system to busy companion animal or mixed practices. Clinics are utilising them both in the waiting room area and in some consulting rooms. And yes, there is the ability to turn off the promotional posters that aren’t supported by the clinic. Currently popping up in 40 companion animal and mixed practices north of Taupo, with another ten poised for installation when clinic renovations are complete, the team at VetFlix are steadily building the network nationwide. The plan is to have a large animal option available later in 2018.
Stacey Airey is the Managing Director and has this third party concept working as MediBoard in 61% of Medical Doctors’ surgeries nationwide, and Susie Howells as the Account Manager has over 20 years working in the Veterinary industry. Give them a call 021 513 570 (Stacey) or 0274 989 626 (Susie) or visit www.vetflix.co.nz if you think this may be of interest for your practice.
OSH
Occupational stress and burnout in veterinary nursing: what is it and how can we cope? By Ana Djokovic HR Coordinator, Pet Doctors NZ
Veterinary nursing is an occupation that has been identified as being at risk for occupational stress and burnout (Black, Winefiled & Chur-Hasen, 2011). As a veterinary nurse, there is an on-going expectation to display a high level of consideration and compassion in the workplace, this can have a negative impact on both professional and personal aspects of the role (Brannick et. al 2015). Repeated exposure to patient illness, trauma and euthanasia (Brannick et. al, 2015), combined with a profession which lends itself to longer hours of work, excessive workloads and hazardous work environments (Black et. al, 2011), contribute to heightened levels of both occupational stress and the potential for burnout (Brannick et. al., 2015). Through a review of contemporary research in the veterinary industry, this article will further describe the areas of occupational stress and burnout, examine how they differ, and offer
proven coping techniques and strategies to manage the negative consequences of such a caring, compassionate role and industry. What is occupational stress? Cooper and Cartwright postulated a model (Figure 1) of occupational stress, which encompasses the sources of stress, the symptoms of stress and the subsequent results or ‘disease’. This model suggests that there are two key factors in the manifestation of the symptoms of occupational stress: occupational stressors and individual stressors. Brannick et. al (2015) identified three key common stressors identified in the veterinary workplace, which fall under stressors found in the workplace and personal stressors: • Occupational and environmental: for example, the duration and timing of work (overtime, weekend work and being on-call) as well as interpersonal
Figure 1: Occupational stress (Cooper and Cartwright, 1994) Sources of stress
Symptoms of stress
Intrinsic to the job
Individual symptoms Raised blood pressure
Role in the organisation
Depressed mood Excessive drinking
Relationships at work
Ana is the HR Coordinator for Pet Doctors NZ, and has an undergraduate degree in Commerce & Science from the University of Auckland. She is working towards a Master of Business (MBus), focused on Human Resources Management and Employment Relations, at the Auckland University of Technology.
26 June 2018
Organisational structure and climate Home - work interface
Coronary heart disease Mental illness
Irritability Individual
Career development
Disease
Chest pains Organisational symptoms High absenteeism
Prolonged strikes
High labour turnover
Frequent and severe accidents
Industrial relations difficulties
Apathy
Poor quality control
OSH
potentially leading to the completion of work being below the regular standard, resulting in growing frustration and a sense of a lack of control (Hewson, 2014). Brannick et. al (2015) defines burnout as being: “Related to interactions with the workplace environment and feelings of being ineffective in one’s work”. They reported that of those working in a veterinary clinic, other than veterinarians, 35% were at risk of burnout. In addition, burnout can mimic the effects of post-traumatic stress disorder and can manifest in negative psychosocial behaviours, such as detachment or avoidance behaviours; physical illness such as fatigue; and negative workplace conduct, for example, higher rates of absenteeism or more instances of interpersonal conflicts (Brannick et. al, 2015). Burnout is thought to progress slowly and be experienced on an intermittent basis (Hewson, 2014).
conflicts with colleagues and a high workload • Patient and client related: for example, potential professional mistakes; the threat of the consequences of malpractice, pressure from the clients; and moral stress in decision making • Personal: stressors outside of the work environment which impact on your general well-being and ability to cope with workplace stressors In a study conducted by Black et. al (2011), approximately one third of Australian veterinary nurses were experiencing high levels of occupational stress, and felt they had high job demands with little job control. What is burnout? Unlike occupational stress, burnout is related to a general exhaustion from work as well as a loss of morale from an inability to achieve one’s goals (Hewson, 2014). For example, on-going staffing issues,
How can we cope? The primary literature on coping mechanisms in relation to organisational stress and burnout is in association with human health nursing. However, regardless of the profession, the symptoms are similar and therefore evidential based research into the coping mechanisms of nurses in human health can be applied to veterinary nursing. Examples of positive coping mechanisms for occupational stress and burnout primarily focus on indirect and direct strategies (Hewson, 2014). Indirect approach: Being mindful and understanding the difference between being responsible to the client but not for their emotional response. The key is to normalise the feelings a client may experience, without attempting to introduce positive emotions or try to ‘fix’ the situation. Direct approach: understanding what changes you can make. Practice self-care at work: • taking a break • learning to say ‘no’, where appropriate • staying connected to the wider nursing profession by attending CPD courses • setting time aside for team discussions
on various events in the clinic which have the potential to cause stress at work • encourage debriefing after a stressful event (either informal or formal) Informal debriefing can include talking about stressful events with those you trust, whether that be your friends or your family. It is important to note that with informal debriefings, the type of scenarios may be hard for the untrained listener to handle. Therefore, give them fair warning, “I have had an upsetting case and need to talk to you”, and ask them if they are okay for you to debrief with them. Formal debriefing however should be defined as more regular, meetings scheduled with a senior, trusted member of the team or a specific work-group dedicated to debriefing. Whilst this isn’t as immediate as informal debriefing, it is a useful way of supporting one another and understanding what your peers and colleagues are going through. Occupational stress and burnout is something that we all need to address, especially in veterinary practice. By identifying key stressors and opening up discussions around wellness and wellbeing in the clinic, we are on the pathway to getting a handle on a key health and safety issue. References Black, A., Winefiled, H., & Churn-Hansen, A. (2011). Occupational stress in veterinary nurse: Roles of the work environment and own companion animal. Anthrozoos, 24(2), 191-202. Brannick, E., DeWilde, C., Frey, E., Gluckman, T., Keen, J., Larsen, M., Helke, K. (2015). Taking stock and making strides toward wellness in the veterinary workplace. Journal of American Veterinary Association, 247(7), 739-742. Cooper, C. & Cartwright, S. (1994). Healthy mind; Healthy organisation – A proactive approach to occupational stress. Human Relations, 47(4), 455-471. Hewson, C. (2014). Grief for pets – Part 2: Avoiding compassion fatigue. Veterinary Nursing Journal, 29, 288-391. June 2018 27
HBOT
Hyperbaric Oxygen Therapy By Tania Nilsen Manager of the Centre for Hyperbaric Oxygen Therapy at North Shore Veterinary Emergency and Critical Care
Tania Nilsen runs thecanineclub, a dog training club that has been assisting dog owners on the North Shore for the last 15 years, and runs popular informative classes and home consultations aimed at preventing issues and dealing with problematic behaviours. Tania is currently gaining experience as a first responder with St John Ambulance and working towards a degree in Paramedicine.
28 June 2018
Hyperbaric oxygen therapy (HBOT) is now being used across the globe in veterinary medicine. It has been used in human medicine for over 40 years, and we are now seeing the benefits in incorporating this treatment as part of a patient’s acute or chronic recovery plan. In HBOT we are providing the patient with a 100% oxygen rich environment, at increased pressure, to supersaturate the body. HBOT can be used in conjunction with surgery and other medications, and can provide medicinal benefit for a wide range of conditions.
injuries (Leach et. al., 1998). The application of HBOT has now extended to central nervous system disease and injury, post-operative orthopaedic repair, pulmonary oedema, septicaemia and necrotising pancreatitis (DVM, 2012).
Oxygen is necessary to not only maintain the health of cells, but also to aid repair of injured cells. Breathing 100% oxygen (room air is 21%) at 2 atmospheres of pressure (2 ATA) can result in up to 10 times more oxygen in the bloodstream. This leads to more oxygen reaching diseased or compromised tissues, which use the molecules in their recovery.
Administering Hyperbaric Oxygen Therapy HBOT is non-invasive and is used in conjunction with other treatments such as surgery or medication. The veterinarian will give an initial assessment and set a treatment plan on a case by case basis. The patient is monitored via two screens linked to cameras within the chamber, and there are viewing porthole windows to monitor the comfort and condition of the patient. The treatment is administered by North Shore Veterinary Emergency and Critical care staff, that have completed the Safety and Training Program provided by the Hyperbaric Veterinary Institute.
Indications for Hyperbaric Oxygen Therapy Conditions which were initially treated with HBOT were carbon monoxide toxicity, necrotising infections and osteomyelitis, skin grafts, skin flaps, and wound healing, haemorrhagic shock, acute traumatic ischaemic injuries, including compartmental syndromes and crush
The animal is placed in the chamber, and the atmospheric pressure in the chamber is slowly compressed to 2 ATA. Once at this pressure, the patient will normally be breathing 100% oxygen for approximately 45 to 60 minutes. In a review by veterinarian Melissa Edwards, she states the physiologic effects of the combination of oxygen level and pressure
HBOT
during HBOT. The potential for barotrauma is minimised by careful monitoring and adjusting of pressure levels by trained staff. Fire risk is managed continuously by staff and precautions are exercised prior to treatment beginning. Having access to hyperbaric veterinary medicine in Auckland, New Zealand, allows us the ability to provide the most up to date and inclusive treatment plan for our patients. The effective applications of HBOT are still being realised and explored with an increasing number and variation of conditions responding favourably to the treatment. For information on how to access HBOT for your clients, please visit www.hbot.co.nz
include enhanced, or improved oxygen delivery to cells, antimicrobial effects, stimulation of phagocytosis, stimulation of fibroblasts, modulation of neutrophils, and angiogenesis (Edwards, 2010). Sedation is not required for HBOT; most of the patients will rest or sleep during the treatment. Often early treatment is essential for maximum benefit, however in the case of severely ill patients that may
have to be transported long distances and may require intensive medical support, this can pose a problem (Leech et al., 1998). Monitoring equipment, medications and fluid therapy cannot be used in the chamber during HBOT, and any intravenous catheters or external fixators need to be covered with the appropriate bandaging. Barotrauma and fire are indicated as the predominant risk factors to be considered
References DVM. (2012). Indications HBOT. Retrieved from: http://southpawsvetspecialists. com/pdf/HBOT_Indications_DVM_Full_ Email.pdf Leach, R. M., Rees, P. J., & Wilmshurst, P. (1998). Hyperbaric oxygen therapy. BMJ: British Medical Journal, 317(7166), 1140–1143. Edwards, M. DVM, DACVECC (2010), Hyperbaricoxygentherapy. Part 1: history and principles, Journal of Veterinary Emergency and Critical Care, 20(3) 2010, pp 284–297 doi:10.1111/j.1476-4431.2010.00535.x
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June 2018 29
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MASTITIS
Mastitis: destroying the milking machine By Emma Annear RVT and RVN, South Wairarapa Veterinary Services, Featherston
Introduction Mastitis is an inflammation of the mammary gland, and causes a reduction in milk production. One of the largest health issues in the dairy industry is mastitis, costing New Zealand farmers over $280 million each year (Henson, 2015). Mastitis can occur anytime during the season, and can be a fatal condition if not treated promptly. There is an eight percent reduction of milk if mastitis occurs in the first lactation, and this will continue throughout the cow’s lifetime (Dairy NZ, 2008).
2). If subclinical mastitis is present the detergent reacts with DNA in somatic cells and causes a thickened consistency. Each paddle cup is scored. Scoring is subjective so it is best if it is performed by the same person. Subclinical cows can then be drafted and treated (Hendrix & Sirois, 2007). Figure 1: Milk added to the quadrants
Mastitis categories Mastitis is categorised into two divisions: clinical and subclinical. Clinical mastitis is where clinical signs are apparent in the mammary gland. These can include: • swelling • redness • heat • hardening • pain Also, milk may be watery, have flakes, clots or pus, and the cow may be systemically unwell and lethargic. Clinical mastitis can be serious, with the affected udder quarter turning gangrenous and sloughing off in severe cases (Bassert & McCurnin, 2010). Subclinical mastitis has no obvious clinical signs of inflammation and is more common than clinical mastitis. However, a high somatic cell count (SCC) is caused by the body’s white blood cells attacking the source of infection. Therefore, the best way to diagnose subclinical mastitis is to determine the SCC of each cow (Bassert & McCurnin, 2010). Emma graduated with a Diploma in Veterinary Nursing in 2010 from Massey University. She decided she wanted to work with both small and large animals, so furthered her study with a Bachelor of Veterinary Technology, graduating in 2014. Since then, she has worked for South Wairarapa Veterinary Services, where she enjoys working with a mix of animals and carrying out lab work.
Figure 2: Milk in the quadrants with mastitis concentrate in it. The mastitis concentrate is added by squeezing the bottle end and swirling the mixture together. This is then observed for any congealing which indicates a high somatic cell count
Rapid mastitis test Although time consuming, the rapid mastitis test (RMT) is effective at recognising subclinical cows. A paddle is used and each quarter of the udder is stripped into the corresponding section of the paddle (see Figure 1). Equal portions of RMT solution is then added to the paddle and mixed with the milk (see Figure June 2018 31
MASTITIS
Bacteria Bacteria are the main cause of mastitis. These are divided into two categories; environmental and contagious. Environmental bacteria are spread through the environment (e.g. pasture, walkways or bedding), and are typically streptococci species. Contagious bacteria are spread from cow to cow and are commonly staphylococci species. The cause of spread is often via milking equipment, or milker’s hands, moving from an infected udder to a healthy udder. Usually, environmental mastitis occurs at the beginning of calving and contagious mastitis occurs near the end of the season (Bassert & McCurnin, 2010). Mastitis cultures At South Wairarapa Veterinary Services (SWVS), we conduct our own mastitis cultures under the guidance of New Zealand Veterinary Pathology (NZVP). This is a fantastic method to determine which bacteria is causing the problem. This enables the farmer to use an appropriate treatment, thereby reducing the money spent on unnecessary treatments, and contributing to reducing antibiotic resistance, which is becoming prevalent in the veterinary industry (Bailey, 2017). In order to perform a culture, the farmer takes a milk sample from the affected quarter and brings this into the clinic. Ideally, this is performed as cleanly as possible, to reduce contamination and provide an accurate diagnosis. In the lab we use a loop dipped into the milk to obtain a sample for culture. This sample is then spread onto a blood agar plate in a specific technique that allows separation of bacterial colonies. The plate is then placed into an incubator at 37°C, and is read at 24 and 48 hours to assess the bacterial colonies grown. It is also possible to determine how severely the quarter is infected by describing the growth as heavy, moderate, light or scant (Hendrix & Sirois, 2007). Reading plates Streptococus uberis (S. uberis) and Staphylococcus aureus (S. aureus) are the two most common bacteria grown, although there are many other 32 June 2018
bacteria than can be found. S. uberis is environmental while S. aureus is contagious, and each reacts with the blood agar plate very differently. S. uberis creates a darkening in colour and the colonies are small and metallic blue in colour (Figure 3). S. aureus reacts by creating a ring around each colony (coagulases with the plate), and the colonies are larger in size and commonly pale yellow in colour (Figure 4). Several tests are performed on the colonies once they are grown to provide a conclusive diagnosis. These include the catalase test (using 3% hydrogen peroxide, whereby if bubbles occur the colony is catalase positive), and gram staining the colonies on a slide (to distinguish between rods and cocci, gram positive and gram negative) (Hendrix & Sirois, 2007). Prevention An effective preventative measure for mastitis is to use Teatseal®, paired with Dry Cow Therapy (DCT). DCT is an antibiotic that is infused into the teat canal. Teatseal is a white paste made of bismuth subnitrate in a paraffin base (Zoetis Inc., 2016). The DCT product used should be carefully selected for individual cows. By 2020, the use of DCT will be significantly reduced and only Figure 3: Streptococus uberis
Figure 4: Staphylococcus aureus
cows diagnosed with clinical or subclinical mastitis will be treated with DCT, rather than blanket treating a herd (Bailey, 2017). It is imperative that there is impeccable hygiene when administering this treatment, to ensure that bacteria is not introduced into the teat. DCT is administered, followed by Teatseal. When combination therapy is used, it reduces the number of mastitis cases by up to 70% in the first three weeks of lactation (Zoetis Inc., 2016). Teatseal Teatseal can be used on its own, typically in low SCC cows and heifers. Cows and heifers naturally make a keratin plug but often this does not form adequately, so Teatseal creates a plug thereby reducing the opportunity for bacteria to enter the teat canal and so significantly reducing the risk of mastitis when cows dry off before calving. Teatseal alone should not be used in cows with high SCC, or those showing clinical mastitis, as it will trap the bacteria in the teats and cause a significant problem. Teatseal is a cost saving method, intended to reduce the amount that farmers need to spend on mastitis treatments (Zoetis Inc., 2016). Heifer Teatseal trailer The Teatseal trailer has been running at SWVS for three years with much success, and is remarkably well tolerated by heifers (rising two year olds calving for the first time). It is designed to load five to six heifers depending on their size and offers a safer way of infusing Teatseal, with several bars to protect the technician, since heifers are not accustomed to being in a shed or having their udders handled. Teatseal needs to be administered four weeks before heifers begin their first calving, and can last for up to 14 weeks. It is stripped 12 times from the teat canal at first milking and has a withholding period of eight milkings. Studies have shown that Teatseal alone has reduced S. uberis in heifers at calving by 84% (Zoetis New Zealand Ltd., n.d.). Process Wearing gloves, the technician cleans the teat thoroughly with several alcohol wipes. Once the teat is cleaned, the Teatseal® can
MASTITIS
be infused. The tube should be pushed only three millimetres into the teat to prevent damage. This process should be repeated with the other teats in a clockwise manner. It is important the technician doesn’t let go of the teat they are working on to prevent bacterial contamination and bad behaviour from the heifer! The teats are then all sprayed with 10% iodine solution. The Teatseal trailer can only be used in fine weather as a wet udder will introduce bacteria. The heifers are then moved to a clean paddock and monitored for a minimum of three days for signs of mastitis (Zoetis New Zealand Ltd., n.d.). Conclusion Mastitis is a serious disease with significant costs for the farmer, making prophylactic treatments such as TeatsealŽa prudent management technique. When mastitis is detected, a milk sample should be taken and cultured to diagnose the bacteria affecting the cow or heifer
promptly, thus allowing an appropriate treatment method to be chosen. References Bailey, K. (2017). Milk, Microbes and Me. Retrieved from http://www.gribblesvets. co.nz/index.php/12-what-s-new/456milk-microbes-and-me. Bassert, J.M., & McCurnin, D.M. (2010). Clinical Textbook for Veterinary Technicians. (7th ed.). China: Saunders. Dairy NZ. (2008). 3-10 Somatic Cell Counts (SCC). New Zealand. Hendrix, C.M., & Sirois, M. (2007). Laboratory Procedures for Veterinary Technicians. (5th ed.).Canada: Mosby, Inc. Henson, N. (2015). On Farm Mastitis Test Takes Out Fieldays Innovation Den. Retrieved from http:// www.stuff.co.nz/business/ farming/agribusiness/69307661/ On-farm-mastitis-test-takes-outFieldays-Innovation-Den. Zoetis Inc. (2016). Teatseal. Retrieved from
https://www.zoetis.com.au/productclass-new/intra-mammaries/teatseal. aspx. Zoetis New Zealand Ltd. (n.d.). Frequently asked questions. Retrieved from http:// dairywellness.co.nz/dry-cow-therapy/ frequently-asked-questions.html. Zoetis New Zealand Ltd. (n.d.) Teatseal Administration Guide. Auckland, New Zealand.
| Above: Teatsealing
June 2018 33
WSAVA
WSAVA: taking a stand on global issues If you are a member of the NZVNA, as a membership benefit, you are also a member of the World Small Animal Veterinary Association (WSAVA). Many of its initiatives and the wealth of resources it creates are highly relevant to veterinary professionals in New Zealand. Make sure you get the best out of your membership by visiting www.wsava.org for more information: The WSAVA takes the lead in raising awareness of global animal welfare issues. During 2017, it: • Condemned the dog and cat meat trade In September the WSAVA expressed its opposition to the dog and cat meat in a position statement calling for the rigorous enforcement of existing laws. It also called for new controls and regulations where current legislation does not exist, aimed at banning what it regards as an inhumane and dangerous practice. The position statement is available at http:// bit.ly/2Cw1ehU
34 June 2018
• Highlighted the plight of brachycephalic animals During FECAVA-WSAVA World Congress, the WSAVA co-hosted an expert panel session on issues raised by brachycephalic breeding, following a lecture stream dedicated to hereditary disease and the importance of responsible breeding. The panel urged more than 200 attendees to ‘dare to speak out’ on this important issue and provided recommendations to help veterinary professionals to work with pet owners to reduce the suffering of affected animals. A press release and details of the recommendations are available at http:// bit.ly/2yb4cFp with follow up activities planned for this year. • Worked to raise standards of animal welfare globally Members of the WSAVA’s Animal Wellness and Welfare Committee continued the development of the latest in the ‘Standardisation Guidelines’ series. Its
WSAVA
Animal Welfare Guidelines will set out recommendations for the veterinary team, following every interaction with a patient to ensure that, in addition to providing the very best health advice and therapy, they offer evidence-based information and guidance to ensure the health, welfare and safety of the animal, the owner and themselves. The Guidelines will be launched during World Congress in 2018. Driving best practice in companion animal medicine Educating the profession globally is one of the WSAVA’s most important priorities. During 2017, it delivered continuing professional development (CPD) lectures in more than 30 countries, spanning four continents. It focuses its efforts in parts of the world in which companion animal practice is still developing and gives members in these countries unique access to global experts. In September 2017, the WSAVA launched its Global Dental Guidelines to support veterinary professionals to provide a higher standard of dental care to patients. Members of the WSAVA Dental Guidelines Committee hope that the new Guidelines will help to bridge a significant gap in veterinary education globally and encourage a greater emphasis on dentistry in the veterinary curriculum. You can download the guidelines at http://www.wsava.org/guidelines/ global-dental-guidelines. Co-chairs of the WSAVA Global Dental Guidelines Committee, Dr Brook Niemiec and Dr Jerzy Gawor, will present a day-long seminar to introduce the guidelines during BSAVA Congress 2018. Building a global veterinary community The WSAVA is working to create a collaborative and supportive community of global veterinary peers through initiatives including: WSAVA Awards The WSAVA’s prestigious awards include: • The WSAVA-Hill’s Next Generation Award to recognise the work of a veterinary professional graduated within the past ten years, who has contributed significantly to the
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betterment of companion animals, the veterinary profession and society at large The WSAVA Global One Health Award to recognise an individual or organisation which has promoted an aspect of One Health relevant to companion animals The WSAVA Award for Scientific Achievement to recognise an individual who has made a significant contribution to the field of small animal medicine The WSAVA Award for Meritorious Service to recognise a veterinary professional who has contributed meritorious service to the veterinary profession The WSAVA Award for Companion Animal Welfare to recognise a veterinarian or veterinary-team member who has contributed to companion animal welfare at a local, regional or international level
‘Getting them to Congress’ The WSAVA runs a scheme through which its financially stronger member associations support member representatives from developing countries to attend WSAVA World Congress and benefit from the learning opportunities on offer. Support for Mission Rabies The WSAVA supports Mission Rabies, a charity led by Dr Luke Gamble – the recipient of the 2016 WSAVA One Health Award. His team’s efforts have resulted in more than 700,000 dogs and cats being vaccinated; 90,000 sterilised and more than 1.6 million children educated on rabies prevention in Asia and Africa. The WSAVA’s charitable Foundation is also focused on developing small animal veterinary associations, infrastructure and sustainability in sub-Saharan Africa. 2018 – what’s new? The WSAVA has a range of new initiatives underway for 2018 including: • Its new website (www.wsava.org), optimised for access on all internetenabled devices, has recently been launched. It is an online hub for the latest veterinary resources, knowledge and news from the WSAVA itself and from its member associations
• It has launched a Professional Wellness and Wellbeing Committee in order to help safeguard the mental health and wellbeing of veterinary professionals globally • It has launched a new Therapeutics Guidelines Group to focus on building equality of therapeutic access, proper use and minimum veterinary pharmacy requirements around the world The WSAVA at a glance The WSAVA represents more than 200,000 veterinary professionals worldwide through 105 member associations and is focused on enhancing the clinical care of companion animals. One of its core activities is the development of WSAVA Global Standardisation Guidelines in key areas of veterinary practice. These Guidelines aim to support members by setting standards for care and recommending best practice. The WSAVA’s global veterinary community is already bringing great benefit to members of our profession but the WSAVA has ambitions to make it even stronger and to provide a global voice for veterinary professionals. The association welcomes more active involvement from members so, if you would like to make 2018 the year that you contribute to your profession at a global level, please contact WSAVA Chief Executive Officer Arpita Bhose at yourwsava@wsava.org for more information. Join us for WSAVA World Congress in Singapore! WSAVA World Congress is much more than a congress. It’s an opportunity to learn and socialise with colleagues from around the world and to participate in a unique global community whose members are passionate about improving standards of veterinary care for companion animals. This year, WSAVA World Congress takes place in Singapore, the ‘Tropical Garden City’, from the 25th - 28th September. It’s the perfect starting point for a holiday in Asia. Full details are available at www. wsava2018.com and Early Bird Rates are available until 25th June. Make this the year that you join us! June 2018 35
WORD POWER
Increase your word power All definitions from Dictionary of Veterinary Nursing (2nd Edition), D. R. Lane and S. Guthrie
Ataxia
Unsteady walking, shaky or unbalanced gait; may indicate a cerebellar disorder
Coagulase
Enzyme produced by staphylococci; an antigenic substance often found in more pathogenic strains and related to thrombus formation in infected tissues
Opisthotonos
Prophylactic
A treatment used to prevent disease
Somatic
Cells that relate to the animal’s body
Streptococcus
Staphylococcus
Vivisection
Relates to the posture where the head, neck and spine are arched back, as seen in toxaemias and other neurological problems
Bacterial group whose Gram-positive organisms always appear in pairs or in short chains Important group of Gram-positive bacteria, often the cause of severe skin infection and food toxin illness Scientific experimentation using animal models
We’ve all had days we’d never want to relive. The veterinary profession can involve long hours and poor work conditions. Compassion fatigue is a very real problem. Despite the struggles, most of us love our jobs, and are proud to work with likeminded individuals. Veterinary professionals all enter the industry with the same passion to help animals. It’s time we helped each other. Looking for a mentor, or looking to be one? Write to us – we’d love to help!
www.theriptideproject.com/cuppa FaceBook: The Riptide Project 36 June 2018
NOMINATIONS ARE NOW OPEN FOR
THE VET NURSE OF THE YEAR AWARD 2018 The New Zealand Veterinary Nursing Association (NZVNA) and Hill’s Pet Nutrition NZ Ltd have joined together for the sixth year running to recognize the dedication and commitment that veterinary nurses show on a regular basis in their chosen profession. We would like to acknowledge the care that you, as veterinary nurses, give to your patients and clients on a daily basis and encourage you to nominate your peers or yourself for the New Zealand Veterinary Nurse of the Year 2018. Hill’s will also award a prize of flights, accommodation and registration to the Hill’s VNA Conference 2019 in Australia to the winner.
Nomination eligibility Nominees must be: • A qualified veterinary nurse • Currently be employed in a New Zealand veterinary practice under the supervision of a New Zealand registered vet for a minimum of 16 hours per week • A current member of the New Zealand Veterinary Nursing Association (NZVNA)
Nominees should provide exceptional service and deliver the highest possible standard of patient care.
Judging panel Entries will be judged by a panel of no less than three judges made up of Hill’s Pet Nutrition (NZ) Ltd staff and NZVNA executive committee members.
Nominations are accepted from employers, practice staff, clients or industry representatives.
Enclosed in this journal is a nomination form. Applications close at 5pm on Friday August 17th, 2018
BOOK REVIEW
Acid-Base and Electrolyte Handbook for Veterinary Technicians Reviewed by Amy Ross RVN, NZVNA Executive Committee member
Edited by Angela Randels-Thorpe and David Liss Published: 2017 Publisher: Wiley Blackwell 210 pages (paperback) $66.97 (also available as an e-book) Angela Randels-Thorp and David Liss, the editors of Acid-Base and Electrolyte Handbook for Veterinary Technicians are both world-renowned specialist veterinary technicians (ECC, SAIM), who both routinely lecture nationally and internationally to veterinary technicians and nurses. This shows in their approach to the layout of this textbook, as well as their easy to understand description of the abnormalities you can encounter with acid-base and electrolyte disturbances. After an introduction to acid-base and electrolytes, which includes a great a refresher on osmosis and osmolarity, the textbook is divided into chapters of the different electrolytes. The following chapters then give you an overview of the physiology of the electrolyte and the part it plays in homeostasis, before delving into the clinical symptoms you may encounter if your patient has a disorder in that electrolyte, e.g. hyponatremia and hypernatremia. Throughout the text you can also find information on how best to nurse your patient with a disorder in an electrolyte, with specific paragraphs on this for sodium disorders. I am not sure why they did not include these paragraphs in the other chapters. The text then goes on to explain acid-base physiology and the approach to blood gases. If you do not have a great understanding of blood gases then, in my opinion, the purchase of this text for this chapter alone is worth the price, for how it explains respiratory
38 June 2018
and metabolic acid-base physiology and subsequently the disorders that can occur within these. While companion exotic animals are increasing in their popularity, it is hard to find literature for advanced veterinary care for these species, so I was excited to find a detailed chapter pertaining to them in this textbook. Due to the number of species and the different factors that can affect the physiological processes of these animals, there is little researched and published data on the common values of acid-base and electrolyte balances for a lot of these species. The chapter in this text not only provides the reader with normal electrolyte ranges and causes of abnormalities seen in common exotic pets, it also provides the reader with detailed explanation on blood collection as well as how the anatomy and physiology of species can affect acid-base and electrolytes. For example, were you aware that non-crocodilian reptile species only have three heart chambers? While this handbook explains the physiology and pathophysiology and how acid-base and electrolyte disturbances affect homeostasis, I feel that first year veterinary nursing/technician students may struggle to fully understand the abnormalities described in this text. Those in their second or third year of study, as well as veterinary nurses and technicians already in practice that have a greater understanding of physiology, will benefit greatly from this resource and it is a great textbook to have in your clinic’s library.
RIVERPOINT PLUS ANTIBACTERIAL SUTURES A great alternative for high-risk patients or procedures where bacteria is a concern.
New Riverpoint PLUS antibacterial sutures provide the same handling and performance of our other suture products, but with the added benefit of antibacterial protection. Riverpoint PLUS sutures are coated with chlorhexidine diacetate, a proven antibacterial agent, that results in a zone of inhibition around the suture line. Our PLUS antibacterial agent is recognised as being effective against bacteria such as Staphylococcus aureus, Staphylococcus epidermidis, MRSA and MRSE.
ZONE OF INHIBITION
VILET® PLUS Violet Coated, braided, Polyglactin 910 (PGLA), synthetic absorbable suture
PLUS Suture product with antibacterial coating
Suture product without antibacterial coating
The petri dish image is for illustrative purposes only. Zone of inhibition testing results can vary
PDM® PLUS Violet Monofilament, Polydioxanone (PDO), synthetic absorbable suture
MONO Q® PLUS Violet Monofilament, Polyglecaprone 25 (PGCL), synthetic absorbable suture
MRSE - Vilet PLUS Suture: size 2/0
S. aureus- Vilet PLUS Suture: size 2/0
Images of Riverpoint PLUS Suture product creating a zone of inhibition in vitro, reducing Staph aureus & MRSE bacterial colonisation.
Key Benefits of Chlorhexidine Coated Antibacterial Sutures: Chlorhexidine protects the suture area inhibiting colonisation of bacteria on the suture Chlorhexidine has been tested to show an inhibition zone around the suture 1mm, this means it will protect against bacterial growth on and 1mm around the suture. This will help to prevent bacteria from migrating down the penetrations made by the suture Chlorhexidine has been proven to protect the suture line for the key initial healing time of over 48 hours Please Note: Gold standard aseptic technique is still recommended.
For more information contact your local Provet branch, Business Account Manager or visit www.provet.co.nz
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And many have the added benefit of being formulated to promote a urinary environment that reduces the risk of developing struvite and calcium oxalate crystals, in addition to managing the primary condition. We’re introducing the S+OXSHIELD™ seal to help you quickly identify these foods and make it easy to communicate this benefit to clients. To learn more about our foods, please talk to your Hill’s representative. ™ shown are trademarks of Hill's Pet Nutrition, Inc © 2018 Hill's Pet Nutrition (NZ) Ltd. HIMA-HB-170F4934
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