2013 Fall TECHNEWS

2013

|

VOL UME 37 I S S UE 1

PREMIER JOURNAL

FOR

CANADIAN VETERINARY TECHNICIANS

FALL

A NATIONAL JOURNAL PUBLISHED BY THE ONTARIO ASSOCATION OF VETERINARY TECHNICIANS

D E D I C AT E D TO PROFESSIONALISM PUBLICATION MAIL AGREEMENT NUMBER 40034241 • PUBLISHED

BY THE OAVT • Return Canadian undeliverable address to: OAVT, 100 Stone Rd W., Suite 104 Guelph, ON N1G 5L3

CONTINUING EDUCATION • Innovative Pet Care: Shining Light on Animal Health • Weight Loss in Dogs and Cats: The Bottom Lines for Success • Optimizing Canine Reproduction: Artificial Insemination and Breeding Management Plus: Career Spotlight: Jessica Lauzon, CAAT in Northwestern BC, Anesthesia for the dog with MVD, Crate Training Cats, Medical Management of Rodenticides, and more...

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by Hill’s Pet Nutrition, Inc. TECHNEWS | VOLUME 37 ISSUE 1

2013 Platinum Sponsors Making continuing education better & more accessible across Canada Bayer HealthCare Animal Health Division Hill’s Pet Nutrition Canada, Inc. Royal Canin Medi Cal

Career Spotlight: Jessica Lauzon, RVT.......................................................................................5 C.A.A.T. in Northwest British Columbia.................................................................................. 6 Anesthesia for the Dog with Mitral Valve Disease...................................................................... 8 Introducing the 2013 Hospital of the Year................................................................................ 9 Pharmacology Column: Marbofloxacin................................................................................... 10 CE Article #1: Innovative Pet Care: Shining Light on Animal Health............................... 11

Zoetis These companies are generously supporting a series of outstanding learning opportunities for registered veterinary technicians through OAVT.

Safety Column: Canada Proposes New Regulations to Implement the UN’s System................ 15 Apps, Blogs & Websites to Watch........................................................................................... 16 Tech Tips and Tidbits.............................................................................................................. 18 CE Article #2: Weight Loss in Dogs and Cats: The Bottom Lines for Success................... 20 Submitting Articles to TECHNEWS...................................................................................... 25 Employment Ads..................................................................................................................... 26

The 36th Annual OAVT Conference

Behaviour Column: Crate Training Cats and the Benefits of Positive Confinement................. 28

& Trade Show has been confirmed

CE Article #3: Optimizing Canine Reproduction: Artificial Insemination and Breeding........ 29

for February 27-March 1, 2014 at the

TECHNEWS Fall 2013 CE Quizzes................................................................................. 33

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Global News........................................................................................................................... 36 Puzzle...................................................................................................................................... 37

TECHNEWS The quarterly national publication with three CE articles in each issue delivered directly to

Poisoning Column: Medical Management and Treatment of Rodenticides.............................. 38 Continuing Education Opportunities..................................................................................... 41 Did You Know?....................................................................................................................... 43

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We applaud these companies for working closely with Canadian veterinary technicians and OAVT in the design and delivery of these exciting programs throughout 2013.

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Double page spread..................on request Full page........................................ $1395.00 Half page.........................................$895.00 Quarter page...................................$595.00 Insert..........................................on request Business Card.................................$295.00

Next Issue: Winter 2013 Deadline for Material: November 1, 2013 Distribution Date: December 15, 2013 TECHNEWS is a quarterly publication published by the OAVT.

Employment Ads: Please see Employment Ad Information on Page 26 EECI 13453

For advertising information: Contact Laura Fanthome: Tel. (800) 675-1859 Fax (519) 836-3638

• Editor - Laura Fanthome, RVT, MES, BEd (lauraf@oavt.org) • Technical Editor - Shirley Inglis, AHT, RVT (Shirley@oavt.org)

The opinions expressed in this publication do not necessarily reflect the opinion of the Board of Directors nor the members of the Association.

TECHNEWS | VOLUME 37 ISSUE 1

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Career Spotlight Jessica Lauzon, RVT Interviewed by the OAVT As most Technicians in our field, Jessica’s love for animals started at a very young age. Her earliest interactions with animals were the injured wildlife she would take in and attempt to nurse back to health. With little success of a positive outcome for the wildlife, the passions to care for and protect all animals remain a constant theme in her life. board certified Anesthesiologist, she developed a strong interest in pain management and critical care.

After starting a family, Jessica decided to return to her roots, ie.

McLean Animal Hospital. This is the clinic where she brought her childhood companion. This is the clinic where she would bring her childhood companion “Kelly” the Dalmatian, and it was this clinic that sparked her interest as a child to plan a career around helping animals. Jessica worked as an RVT at McLean Animal Hospital for 5 years. It was a clinic she loved and called her second home. McLean Animal Hospital is owned by Vet Strategy, a veterinary managing group that is the only 100% Canadian company of its kind. They now own many clinics across Canada and continue to grow.

Wanting to become a veterinarian seemed like the most logical career choice. However, it was the hands-on care and many potential career outlets that were most appealing when choosing the Vet Tech career path. Jessica worked for a few years in a regular small animal practice before attending the Vet Tech program at Northern College. Jessica graduated in 2004, obtained her RVT status shortly after graduating and has been a proud member of the OAVT since.

Jessica jumped right into the Veterinary Emergency Clinic South where after graduation she worked in the ER department, then later in referral surgery for a few years. While working under a

TECHNEWS | VOLUME 37 ISSUE 1

Having spent 15 years in a variety of busy veterinary settings, Jessica was ready to hang up her scrubs and explore the management side to this field. She worked as a Practice Manager for West Hill Animal Clinic (owned by Vet Strategy) last year and is now the Operations Director for Eastern Ontario. Under her umbrella of clinics, she oversees Coxwell Animal Clinic, West Hill Animal Clinic, and McLean Animal Hospital. Jessica has been with Vet Strategy for the past 7 years, and even though she is on the management side now, she still gets her hands dirty when she visits the clinics and enjoys flexing her Tech muscle once in a while. The greatest perk to her current position is she now makes a difference in the lives of animals and clients on a much larger scale. Jessica is thrilled to be a part of the Vet Strategy management team as an RVT and has enjoyed watching this compassionate organization grow from the ground up.

When she is not busy with work, she is busy at home with her two wonderful little girls Leah, age 7, and Avery, age 2. She and her family live in Toronto, but enjoy taking road trips up north to escape the city life and hopefully catch a glimpse of wildlife on the way so that she can educate her little ones too.

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C.A.A.T. in Northwestern British Columbia

By Kris Burns, RVT Rising out of bed I feel the damp, cool air on my face. It is 5:30 am and the sun has not closed its heavy eyes from the day before. Ready to start my day, I step out of my tent and absorb the sounds of nature. The mist is lifting from the land, slowly revealing the coastal mountain ranges that surround me, and the headwaters of the salmon rivers winding in between. I am in awe of this land, of this untouched, beautiful landscape. I am witnessing the beauty of the northwest corridor of British Columbia, learning about the culture and the traditions that protect these respected lands.

Am I on vacation? In a way, yes, in many ways, no. I am waking to start my day as a volunteer of the Canadian Animal Assistance Team (CAAT). We are here to provide veterinary care to communities in need, communities where veterinary medicine is found hours and hours away.

The Canadian Animal Assistance Team is an organization that started providing veterinary care and disaster relief work during the aftermath of Hurricane Katrina in 2005. Donna Lasser, a veterinary technician in Vancouver, founded the organization, identifying a need for veterinary care in areas of extreme need.

The hurricane had left many animals injured, without a family, and without a home. Seeing the extent of the damage, Donna called upon veterinary technicians, veterinarians, and veterinary assistants to volunteer their time, skills, and knowledge. This volunteer association is now made up of volunteers from across the country, dedicating more than 4,500 hours to CAAT’s efforts last year alone.

On this trip to British Columbia, we focused on the three communities who had requested our assistance: Fraser Lake/ Stellaquo, Burns Lake, and Kitwanga, all of whom are First Nations communities in the northwest division of this province.

Our trip started in Fraser Lake where we were introduced to the proud community of Stellaquo. I had been on a CAAT trip before, but I could not have anticipated the intense appreciation this community offered us. The entire village clearly loved animals; pets were part of their families and their daily routines.

With a lack of accessible pet care, their dog and cat population

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boom was inevitable. We spent a significant amount of time with the people of this community, as they were incredibly involved in the process and eager to acquire education regarding responsible pet ownership. Making it clear that they appreciated our presence, we were constantly being thanked; we were thanked with words, thanked with trust, and most of all we were thanked with food! The community came together to assist us in our efforts, providing as much as they could to make our 12-15 hour days enjoyable. This community had an exceptional number of cats, a rarity when so many dogs roam the village.

By the end of our 3 working days, we were sad to leave, but excited to see what awaited us in Burns Lake. Our adventures continued as we hopped into our slightly run down van, and hoped it would carry us to the next town.

Surviving the van ride and the lack of radio stations, we immediately set up the community hall in Burns Lake. Little did we know there was a line formed outside the door!

As one of the Registered Veterinary Technicians on the team, I was literally off to a running start. I was delegated the role of getting the animals from the initial examination phase onto the surgery table. I happily sedated, catheterized, intubated, and prepped 35 animals for surgery that day, with a total of 60 animals being spayed or neutered in the Burns Lake community alone. My skills and techniques were challenged, and I loved every minute of it. Utilizing an anesthetic protocol much different to any ‘regular’ small animal veterinary hospital, my senses and awareness were constantly challenged to support the best outcome throughout surgery.

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“I strongly encourage everyone to try at least one professional volunteer trip, it will not be regretted!”

By 8pm we were all exhausted, stinky, and smiling, knowing that we had a very successful day of surgeries, health checks, vaccinations, and community education. We caught the ferry in our grumbling van and settled into the Lakeside Legacy Bed and Breakfast on Burns Lake. Enjoying my hot shower, hot meal, and the unbelievable sunset, I was recharged for the next few days.

Throughout these CAAT trips there are many lessons learned along the way. We are reminded daily of our path and why we chose it. Though each community is very different, they show us the same appreciation of our willingness to help them increase the quality of life of their pet and inevitably, their family. It seems so easy to take for granted the availability of pet care at home; in many cities veterinary hospitals are a stone’s throw away from each other. Pet care is sometimes a luxury not available to all and not afforded by many in our country. Going into these villages I bear witness to the intense bond between human and animal, the bond that bring smiles to faces and warmth to hearts. Many individuals struggle everyday to work through life’s challenges, whether it is poverty, mental health, or a lack of family and support. Pet ownership is not a choice to be made lightly, but it is a choice that will change one’s life forever.

To own a pet is to increase one’s quality of life, to brighten one’s day, and to create a sense of family and belonging. Having taken part on two of these volunteer trips, I will forever remind me of my personal goals as an RVT: to provide essential care to animals and advocate for the human animal bond. Despite the long hours, I come away from these trips feeling refreshed and renewed in my profession − a feeling that is difficult to create and even more difficult to shake. Knowing that my efforts have made a positive difference in the lives of these pet owners has continued to grow within me.

can continue to influence the lives of others. Our time spent volunteering does not go to waste but instead creates awareness and positive pet ownership.

I strongly encourage everyone to try at least one professional volunteer trip, it will not be regretted! Understanding that this is not an option for everyone in the field, CAAT has created other methods for contributing to their efforts. CAAT accepts Aeroplan Miles to assist with our trips, cash donations, and they are always looking for volunteers for local fundraisers. This year they have even created an opportunity to donate through the purchase of Mabel’s Labels, as well as their “In Memorandum” cards. Whichever way you decide to volunteer, it won’t go unnoticed. Every effort to support CAAT is an effort to further the reaches of veterinary care across Canada.

For more information on the Canadian Animal Assistance Team, their animal wellness clinics, or fundraising efforts, please visit: www.caat-canada.org

There are so many volunteer opportunities available to Canadian RVTs or veterinarians. We so quickly forget that we

TECHNEWS | VOLUME 37 ISSUE 1

7

Anesthesia

for the dog with Mitral Valve Disease

By Nancy Brock, DVM, Dip ACVA In this article, we will review some strategies for safe anesthesia delivery to dogs with heart murmurs caused by mitral valve dysfunction.

Many patients with mitral valve dysfunction can undergo anesthesia safely and without the need for complicated anesthesia protocols. In order to illustrate how the decision making process unfolds for such patients. I will describe the recent anesthetic delivery to a patient of mine that was suffering from mitral valve disease.

Spike is an 8 year old intact male Maltese with a heart murmur. He suffers from prostatic hypertrophy requiring orchidectomy (neuter) surgery.

The cause of Spike’s heart murmur was identified by ultrasound 3 years ago. He has mitral valve disease and though he has never experienced an episode of heart failure, he has been receiving oral furosemide twice a day since the cause of the heart murmur was identified.

On recent repeat survey chest X-rays (within the past 2 months), Spike’s cardiac silhouette showed left atrial enlargement and normal pulmonary vasculature. X-ray appearance was similar to that of 8 months ago, suggesting that Spike’s heart disease is not progressing. His owners have been monitoring his resting respiratory rate at home as a means of assessing his disease at home and this parameter has been stable and within normal range (less than 30/ minute). Spike does not cough, has never experienced syncopal episodes, nor does he exhibit any difficulty with strenuous exercise. Spike’s owners have made a last minute request for dental cleaning while he is under anesthesia for his neuter surgery, if possible.

Even if cardiac ultrasound is not repeated prior to Spike’s anesthesia, we know quite a bit about his heart function and that he has sufficient cardiac function to undergo anesthesia: His chest X-rays do not show any changes in his cardiac silhouette or his pulmonary blood vessel size • He is active and energetic • He does not cough and has a normal respiratory rate at rest.

Thus, Spike fits into the category of mild to moderately severe heart disease.

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Anesthesia delivery to dogs with mild or even moderate levels of mitral valve disease is not very different from anesthesia for dogs without heart murmurs: Spike’s premedication consisted of intravenous (IV) butorphanol 0.1 mg/kg and midazolam 0.05 mg/kg delivered through a preplaced catheter in the lateral saphenous vein.

I prefer to catheterize unpremedicated dogs in that hind leg vein as even the most wellmannered patient may “take offense” at having their front feet touched. If you prefer to premedicate before IV catheter placement, or are tending to a less-than-cooperative patient, the same drugs administered intramuscularly (IM) at twice the IV dose would be an acceptable choice. If your patient is especially anxious, a low dose of acepromazine (0.01 to 0.02 mg/ kg) can safely be added. If your patient is a land-shark, phenobarbital at 5 to 10 mg/kg orally at home before hospital admission, is a wise step. Additional IM premedication can be administered once the dog is hospitalized.

Bradycardia can increase the amount of blood escaping backwards out through the leaky mitral valve. So, regardless of how you premedicate, the addition of atropine or glycopyrrolate IM is advised to preemptively reduce the intensity of the bradycardia that will accompany the use of butorphanol, acepromazine and later, inhalant anesthesia.

Induction for Spike was with alfaxalone IV to effect, in 0.5 mg/kg increments every 30 seconds. He required 2 mg/kg total alfaxalone dosing in order for intubation to take place. He then began to receive isoflurane in oxygen via his endotracheal tube, starting off at a relatively high vaporizer dial setting of 2% and an oxygen flow rate of 1 liter/minute for 10 minutes. At this point, his anesthetic depth was re-assessed (jaw tone and palpebral reflex strength, depth of respiration, end tidal carbon dioxide measurement) and the oxygen flow reduced from 1 liter to 500 mL/minute to reduce the amount of isoflurane that Spike was receiving. To continue at a high inhalant dose would have continued to deepen Spike’s plane of anesthesia.

This is the point during anesthesia delivery where changes or adjustments are needed to

customize the anesthesia for the patient with mitral valve disease, with fluid therapy and the correction of hypotension. It may be common for surgical pain to be addressed with a deep plane of inhalant anesthesia. But this approach increases the likelihood that hypotension will arise and would require treatment with fluid therapy. The patient with mitral valve disease may have a reduced capacity to cope with aggressive fluid therapy.

I modified my anesthetic protocol for Spike so that high rates of fluid therapy were not required. Once under anesthesia, Spike underwent bilateral pre-incision intra-testicular regional anesthesia with bupivacaine (about 0.5 mL of 0.5% bupivacaine into each testicle + a small amount subcutaneously pre-scrotal). As a result of this step, I was able to keep Spike at a light plane of anesthesia and still eliminate all response to painful surgical manipulation.

Even with pre-anesthesia chest X-rays, it is difficult to predict how much IV fluid a dog with mitral valve can safely process. I recommend that 5 mL/kg/hour be the initial delivery rate for crystalloids for a dog like Spike plus a bolus of 5 mL/kg be administered intra-operatively if hypotension develops and the starting PCV and Total Solids measurement suggest slight dehydration.

Based on this anesthetic protocol description, you can deduce that anesthesia monitoring for Spike involved blood pressure measurement.

This measurement is repeated every 5 minutes during anesthesia in order to determine the blood pressure trend. Fine tuning modifications to anesthetic delivery are then easy if the blood pressure is trending too high (above 120 mm Hg, patient is at risk of moving) or too low (systolic blood pressure via Doppler of 80 mm Hg or lower). It is possible for dogs with enlarged left atria to experience abnormal heart rhythms during anesthesia. A lead 2 ECG trace is helpful in determining what is the nature of the abnormal rhythm. Most arrhythmias that make their first appearances during anesthesia do not require interventions. But without a tracing to evaluate, it is difficult to categorize an arrhythmia as benign or malignant.

TECHNEWS | VOLUME 37 ISSUE 1

“Mr. Anesthetist, if the patient can stay awake, surely you can!” - WILFRED TROTTER I also monitored Spike’s end tidal carbon dioxide with the use of a capnograph. This extra information allowed me to more effectively evaluate anesthetic depth (an increasing tidal carbon dioxide = deepening plane of anesthesia) and fine tune the inhalant anesthetic to Spike’s needs. With the surgical site devoid of sensation, I only delivered enough isoflurane to Spike’s brain to produce unconsciousness, immobility and relaxation.

Spike’s pain control was provided courtesy of the local anesthetic and continued into the post-operative period for about 4 hours. If lidocaine were substituted for the bupivacaine local anesthesia, then sensation would return within about 90 minutes.

There is nothing about Spike’s heart disease that precluded the use of NSAIDs as long as he returned to normal eating and drinking and did not dehydrate. A strong case could be made for discontinuing Spike’s furosemide therapy postoperatively to help reduce the possibility of dehydration at home. So that is what I instructed his owners to do. No furosemide after surgery.

Spike received 0.1 mg/kg subcutaneous meloxicam once the surgeon began to close the incision. One bonus benefit of the addition of regional pain control for Spike was that he proved able and very, very willing to eat a nice meal within an hour of extubation since he was so comfortable and free of opioid-induced nausea.

So, the take home message is: ultrasound will tell you what is causing a heart murmur. In a perfect world, all dogs with heart murmurs would undergo cardiac ultrasound. But in the real world that is just not the case. Use history, physical examination and chest X-rays to help you determine what category of heart disease your patient fits into. If you can categorize a patient as having mild heart disease then your everyday anesthesia protocol is probably appropriate as long as you use vigilant monitoring, titrate the anesthesia and use regional analgesia whenever possible. The only drug category I would steer clear of in the presence of an undiagnosed heart murmur is alpha 2 sedatives.

Nancy Brock, DVM, Dip ACVA, Originally from Montreal, Dr. Nancy Brock obtained her DVM degree from the Ontario Veterinary College at the University of Guelph in 1982. She practiced at Picton Animal Hospital in Eastern Ontario until 1984 and the London (Ontario) Emergency Clinic until 1985. She completed a residency in anesthesia and critical care at the University of California, Davis in 1988. In 1995, she became certified as a veterinary anesthesia specialist and is a Diplomate of the American College of Veterinary Anesthesiologists.

Based in Vancouver British Columbia, Dr. Brock is a regular contributor and consultant for the VIN (Veterinary Anesthesia Network). She is also a clinical instructor of anesthesia at Douglas College’s AHT program in Coquitlam BC. As part of her anesthesia referral practice, Dr Brock provides veterinarians and their nursing staff with anesthesia assistance and expertise. This assistance comes in the form of telephone consultation, in-clinic delivery of anesthesia to high risk or fragile patients and the training of veterinarians and technicians in advanced anesthesia techniques. She is also the author of a quick reference anesthesia publication entitled Veterinary Anesthesia Update for small animal practitioners.

Introducing the 2013 Hospital of the Year!

AllandaleVeterinary Hospital (AVH), in Barrie, Ontario wins Veterinary Economics Hospital Design of theYear award For twenty years, Dr. Patricia Lechten had the dream of owning a small animal practice.

After much hard work, her vision that “Dreams do come true” actually came true.

Over the years, Dr. Lechten had collected many ideas on the type of practice she wanted. It would be a hospital where patients would be comfortable and clients could feel that they are part of the family.

Construction was a year-long process which really paid off. The hospital that once operated out of an old renovated garage moved into an 8720 square foot facility. It houses a luxury boarding facility, a canine rehabilitation centre, separate ICU wards for dog and cats, and dual surgery suites – plus TECHNEWS | VOLUME 37 ISSUE 1

much more. The judges praised Dr. Lechten’s practice for some of the best looking luxury boarding suites, as well as the comfortable feeling throughout the hospital.

Lisa Randon, RVT, VTS (Anesthesia), saw this vision grow as she has been working alongside Dr. Lechten since graduating in 1994. “We were on top of one another in our old building, constantly trying to find a computer station and a phone to get our work done. The new hospital is so large that I can’t find anyone anymore”, laughs Lisa.

With the new hospital grew new employment.

AVH, a five doctor practice, had to hold a job fair to fill the positions needed. New positions included a rehab technician, and a client greeter.

A client service representative now answers the phones, while another may greet clients and patients as soon as they walk in the

door, offering them freshly baked cookies and coffee. The inventory clerk prepares medication for the doctor and explains the instructions to the client as they are discharged. A client service representative focuses on the client in front of them without any interruptions.

“It’s an ideal hospital with everything you need all under one roof, and I am very proud to be a part of it” adds Lisa.

In August, Dr Lechten and Lisa flew to the Central Veterinary Conference, held in Kansas City, to accept the prestigious hospital design award from Veterinary Economics.

They feel very honoured as Canadians to have been chosen considering the large amount of worthy entries from hospitals and clinics internationally. Congratulations!

Visit the hospital’s virtual tour found at www.allandalevet.com.

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P H A R M AC O L O G Y C O L U M N

Marbof loxacin (Zeniquin)

by Dr. Wendy Brooks, DVM, DipABVP (Educational Director, Veterinary Partner.com) (for veterinary use only)

Brand name: Zeniquin Available Sizes: 25 mg, 50 mg, 100 mg, 200 mg

Background Human beings have been at odds with microbes since the beginning of time and the quest for new medications continues even today. When sulfa drugs came on the scene in the 1940s, an “age of antibiotics” was born and a new dimension had opened in the combat against microbes. From there a proliferation of antibiotics developed, each new medication exploiting a different aspect of bacterial metabolism until it seemed that the war on microbes would soon be won.

Despite this progress, one particular bacterial species remained seemingly invincible: Pseudomonas aeruginosa. This species of bacteria was able to change its antibiotic susceptibility with each antibiotic exposure, become resistant to multiple drugs in response to every medication used against it. Eventually, the aminoglycoside class of antibiotics was developed and there was finally a way to kill Pseudomonas fairly reliably but the price was that medication was injectable only, necessitating hospitalization for the patient, and potential kidney damage could result with prolonged use.

A major breakthrough against Pseudomonas came with the development of the fluoroquinolone class of antibiotics (including enrofloxacin, its counterpart for human use called ciprofloxacin, and several others). These medications are active against many bacterial types including Pseudomonas. They are available as tablets and are not associated with the serious side effects that plagued the aminoglycoside group. Marbofloxacin is a veterinary fluoroquinolone that addresses the need for treatment of Pseudomonas infections in pets.

inside a cell. Segments to be used must be uncoiled by an enzyme called DNA gyrase.

The fluoroquinolone antibiotic deactivates DNA gyrase, making the reading of DNA impossible. The bacterial cell dies. Mammalian DNA gyrase is of a completely different shape and remains unharmed.

Uses of this medication This medication may be used in either dogs or cats to combat different types of infections, especially those involving Pseudomonas and/or other gram-negative bacteria. Marbofloxacin is also active against Staphylococci, and thus is commonly used for skin infections.

Side Effects As with most oral medications, the most common side effects of marbofloxacin are related to the GI tract: vomiting, diarrhea, and reduced appetite.

In immature dogs (less than 8 months of age) damage to developing joint cartilage can occur. This phenomenon is only seen in growing dogs and does not seem to be a problem in cats. It is preferable not to use this medication in puppies unless the severity of the infection warrants it.

Enrofloxacin, the first veterinary fluoroquinolone, was found to lead to retinal damage and blindness when used in higher doses in cats because the feline retina tends to accumulate enrofloxacin. Marbofloxacin was developed to have less affinity for the feline retina but it is unknown if this problem still occurs in higher doses.

Fluoroquinolone antibiotics may lower the seizure threshold and increase a patient’s tendency to have seizures. This is of no concern in a normal animal but is worth a cautionary statement for patients with a pre-existing seizure disorder.

Interactions with other drugs Sucralfate (a medication used to treat stomach ulcers) may bind marbofloxacin and prevent it from entering the body. These medications should be given at least 2 hours apart if they are used together. A similar phenomenon occurs with magnesium and calcium-containing antacids.

Theophylline (an airway dilator) blood levels may be higher than usual if this medication is used concurrently with marbofloxacin. The dose of theophylline may need to be reduced.

If marbofloxacin is used with oral cyclosporine (an immunosuppressive medication used for inflammatory bowel disease), the kidneydamaging properties of cyclosporine may become worse.

Medications or supplements containing iron, zinc, magnesium or aluminum will bind enrofloxacin and prevent absorption into the body. Administration of such medications should be separated from marbofloxacin by at least 2 hours.

Concerns and Cautions Pseudomonas infections are especially common in canine ears. In this location, higher doses of marbofloxacin are needed to clear this infection. Expect expense as marbofloxacin is a unique antibiotic and at this time there is no comparable generic.

Marbofloxacin should not be used in pregnant or nursing pets, or in immature dogs, unless the severity of the infection warrants it.

© 2013 Dr Wendy Brooks, DVM, DipABVP and VIN, All rights reserved Editor’s Note: Reprinted courtesy of Veterinary Information Network (VIN). VIN (www.vin.com) is the largest online veterinary community, information source and CE provider. The VIN community is the online home for over 30,000 colleagues worldwide. VIN supports the Veterinary Support Personnel Network (VSPN.org); a FREE online community, information source for veterinary support staff. VSPN offers a wide range of interactive practical CE courses for veterinary support staff -- for a small fee. Visit www.vspn.org for more information.

Fluoroquinolones act by deactivating bacterial enzymes necessary for the transcription of DNA. DNA is tightly coiled in order to fit

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TECHNEWS | VOLUME 37 ISSUE 1

CE Article #1 Innovative Pet Care: Shining Light on Animal Health Fernanda Saraga, PhD, Karen Ward, DVM & Karen Link, RVT

Signalment Species: Canine Breed: German Shepherd x Rhodesian Ridgeback Sex: Male intact Weight: 36 Kg Age: 1 year old

History and physical examination Hit by a car Given Hydromorphine at nearby clinic and transferred to Toronto Humane Society for medical surrender Multiple abrasions Full thickness laceration – medial aspect of right hock Hematoma Hind end disconnection Non-ambulatory

Diagnostics X-ray - fractured pelvis involving the right sacroiliac, pubic bone and pelvic floor

Plans Conservative fluid therapy Hydromorphine/Ketamine/Lidocaine drip for pain overnight Flush and clean wound Analgesics: Gabapentin, Tramadol & Meloxicam Laser Therapy - right hip daily for 5 days then reduce to 3 times per week Bandage RH – Hock No surgical intervention Rehabilitation exercises introduced after a few weeks (passive range of motion, massage & slow leash walks)

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Dougie, a one-year-old Rhodesian Ridgeback cross, was playing in the park when suddenly he ran across the street and was hit by a van.

Dougie was in intense pain and was surrendered by his owner to the Toronto Humane Society (THS) for medical help. He suffered a fractured pelvis involving the sacroiliac, pubic bone and pelvic floor. Dougie was treated conservatively and managed with cage rest/ restricted activity, pain relief (Meloxicam, Tramadol and Gabapentin) and low level laser therapy focusing over the hip area to reduce pain and inflammation at the injured site and began the process of rehabilitation.

What is laser therapy?

Laser therapy is a non-invasive, pain-free, light-based therapy that uses red and infrared light to target inflamed, injured and diseased tissues. Unlike high-powered lasers which can heat and destroy tissue, low intensity laser therapy stimulates tissue regeneration at the cellular level, accelerating the healing process substantially compared to conventional care.

How does laser therapy work?

Individual particles of light, or photons, are absorbed by the mitochondria in skin, muscle, and nerves at the injured site and stimulate adenosine tri-phosphate (ATP) production.1 ATP provides the necessary energy for a cell to

function properly. It also provides a means to signal additional molecules to resolve inflammation and regenerate tissue including muscle, bone, cartilage and nerves.2, 3, 4 Laser therapy has been shown to improve arterial circulation in injured tissue in addition to stimulating the formation of new blood vessels, a process termed angiogenesis and neovascularization.

Increased collagen, fibroblast and keratinocyte production greatly accelerates the wound and soft tissue healing process.5 Laser therapy has also been shown to significantly reduce edema and inflammation around an injured site.6 What conditions can be treated with laser therapy?

Given that laser therapy has a biostimulatory effect at the cellular level, it is highly effective in the treatment of a wide range of acute and chronic conditions.

Inflammatory Conditions: Any condition that requires a resolution of inflammation can benefit from the application of laser therapy, including cellulitis, tendonitis, bursitis and pancreatitis. Ear infections, otitis externa, are extremely common and difficult to manage among small animals. Laser therapy is a viable alternative to steroids to restore the normal structures of the horizontal and/or vertical ear canals.

Dr. Ward graduated from the Ontario Veterinary College in 1990 and has been at theToronto Humane Society since 1992. Dr. Ward is passionate about shelter medicine and is currently the Director of Shelter Medicine at the THS. Dr. Ward was recently awarded a prestigious Loren Eslinger Shelter Medicine Fellowship for 2012 / 2013.

Karen is an RVT, graduating from Northern College. She attended the rehabilitation course at the University of Tennessee. She has worked since graduation in small animal clinics. She currently is a Professor at Northern College, teaching in the Companion Animal Physical Rehabilitation Program. Karen has developed many of the courses in this program. Karen also currently practices at the Englehart Animal Hospital with a special interest in rehabilitation.

Fernanda Saraga holds an Honours Bachelor’s Degree in Physics and a Master of Science and Doctorate Degree in Physiology from the University of Toronto. She has published 6 articles in peer-reviewed journals and has previously lectured at York University and the University of Toronto. Since joining BioFlexVet, Fernanda has been actively involved in the Clinical Research and Education Department, including lecturing in the Laser Therapy Certification Programme, Advanced Laser Therapy trainings and International Conferences.

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Musculoskeletal Conditions: Throughout their lifetime, animals may suffer from an extensive range of musculoskeletal conditions, many which further deteriorate with age. These include soft tissue and ligamentous injuries, muscle strains and tears, myofascitis, tendinosis, meniscal tears and disc herniations.

laser therapy can be applied as either a preventative or therapeutic measure for osteoarthritis, hip dysplasia and certain dermatological conditions. It is possible to decrease, delay or avoid degeneration in the joints of companion animals with a maintenance program of laser therapy.

Dogs with hip dysplasia, one of the most common causes of hip arthritis, can benefit from laser therapy, helping to restore the normal range of motion and functionality. In the case of chronic conditions,

Pain Relief: Laser therapy is highly effective in providing pain relief for acute and chronic musculoskeletal conditions, post-surgical pain and even palliative care through a reduction in prostaglandin levels and release of endogenous endorphins.7

Physiological Effects of Laser Therapy Courtesy of BioFlexVet

Wounds & Dermatological Conditions: Wound recovery can be greatly expedited with the application of laser therapy.

Dermal ulcers, post-surgical wounds, lacerations and burns all respond quickly with less scarring and improved skin quality.

Dermatological conditions such as dermatitis, hot spots and lick granulomas have also benefited from laser therapy.

Nerve Injuries: Laser therapy effectively improves both sensory and motor nerve deficits that can result from motor vehicle accidents, fractures, bite wounds and iatrogenic lesions. There is extensive research to support the application of laser therapy for nerve injures, regenerating both the nerve itself and the insulating nerve covering (myelin sheath).8 Fractures: Laser therapy has been shown to stimulate bone healing through the increased production of osteoblasts. Fractures as a result of trauma or due to a pre-existing disease can be treated without adverse side effects and dramatically reduce recovery time.

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What is the difference between class III and class IV lasers?

Lasers are broadly classified by power output as Class I, II, IIIa, IIIb and IV based on relative health risks to the eye (see Table 1). In addition, Class IV devices may not be placed in direct contact with the skin due to possible thermal damage to skin. Therapeutic lasers mostly lie within the Class IIIb, also known as cold laser, and Class IV range of power output.

Class IIIb devices have power outputs of 5 - 500 mW, while Class IV lasers have power outputs above 500 mW. Surgical lasers are in the high end of the Class IV laser category. There has been much confusion on the efficacy of each type of laser and even the mechanism of action. While intuitively more power may appear be better, published research has shown that lower powered lasers applied over longer durations, provide more significant anti-inflammatory and tissue regeneration effects. Beyond a certain power level and photon dosage, biostimulatory effects are diminished and replaced with bioinhibitory and thermal effects.

The majority of published research (close to 3,000 articles for LLLT) was performed with Class IIIb devices, with only a handful

TECHNEWS | VOLUME 37 ISSUE 1

Conditions Treated Successfully with Laser Therapy. Courtesy of BioFlexVet

of articles published with Class IV devices (none in companion animals).

More research needs to be performed to determine the mechanism of action of higher powered laser.

CLASS

POWER

HEAT GENERATION

SAFETY GOGGLES

Class I

> 0.4 μW

No

Not required

Class II

0.4 μW – 1 mW

No

Not required

Class IIIa

1 – 5 mW

No

Not required

Class IIIb

5 – 500 mW

No (cold laser)

Required

Class IV

> 500 mW

Yes (hot laser)

Required

Are there any contraindications to using laser therapy?

The only contraindications in animals to using laser therapy would be to apply the laser directly over a malignant tumour or over the womb during pregnancy. It is completely safe to use over any implanted metal pins.

Laser therapy has no adverse side-effects and can be a relaxing form of treatment for animals once they understand that the treatment is painless and non-invasive.

After 2-3 sessions, animals will gladly sit or lie-down for their treatment; some may even take a nap during treatment.

Table 1. Classes of Lasers

How long is an average treatment?

How many treatments are needed?

Treatment times can range from 5-30 minutes depending on the condition being treated. Generally speaking, smaller dogs and cats will have shorter treatment times because the treated areas are of lesser dimension. Larger animals may require additional time to ensure that laser therapy is administered to the entire injured area for a sufficient period.

The number of treatments required depends on the condition.

Acute conditions may only require 1-5 treatments, while more chronic conditions may require 10-15 treatments. In addition, some older animals benefit from ongoing maintenance treatment on a weekly or monthly basis.

TECHNEWS | VOLUME 37 ISSUE 1

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How is laser therapy treatment applied?

Depending on the device, laser therapy may be applied simply with a laser probe, or it may include a series of light-emitting diode (LED) arrays. These LED arrays have the advantage of covering a larger surface area and may be held in place with Velcro straps, stockinet or by an owner.

No eye protection needs to be worn when using these arrays as they are not lasers and cannot damage the eyes.

Class IIIb devices may be used in direct contact with the animal, ensuring the light enters the underlying tissue. Class IV devices cannot have direct contact with the animal due to the possibility of heating or burning the skin. Great care must be used when operating a Class IV device and the laser probe may not be held in a single location, but must be moved around the area constantly. Safety glasses specific to the device must be worn by the person applying the treatment with either Class IIIb or Class IV devices. If treating around the facial area of the animal, a cloth may be placed across the animal’s eyes to prevent possible ocular damage.

Animals can lie down or stand up during treatment, whichever is more comfortable and still allows access to the injured site.

Animals do not need to be sedated during treatment. In the case where hind legs or hips are undergoing treatment, consider inflating a small exercise ball to support the animal‘s hindquarters.

What kind of training is needed to administer the therapy?

Both a veterinarian and a veterinarian technician can administer laser therapy to animals. Training is not standardized and can range from a small safety pamphlet that is included with the device or an extensive 1 day hands-on course that reviews how to apply the treatment for particular conditions. Provincial regulations specify safety requirements for operating Lasers in general in the veterinary practice but do not specify the level of training or certification required.

Overall safety associated with the installation and use of lasers in a veterinary facility remains the responsibility of the veterinarian. For class

14

IIIb and IV lasers, the veterinarian shall designate a Laser Safety Officer (LSO), to be responsible for implementing a laser safety program. It is the responsibility of the veterinarian to ensure an operator in the veterinary facility is aware of the requirements for safe use.

How much does it cost?

physical therapy. The ability to reduce pain and inflammation while simultaneously regenerating healthy tissue, makes laser therapy an invaluable tool in veterinary practice. The RVT is in a key position to effectively administer laser therapy, thereby accelerating the recovery period and improving clinical outcomes for their patients.

Therapeutic lasers can cost in the range of $10,000 to $30,000 and are often leased on a monthly basis for approximately $200-$600 per month. Average treatment price can vary depending on the location of the clinic and services offered, whether part of an overlying treatment plan or as a separate cost. Most clinics charge $30$60 per treatment.

Dougie received daily laser therapy treatments for the first week, then treatments on alternating days for the next 3 weeks. Today he is able to take long walks on the beach and enjoy swimming in the lake. His new foster parents have seen a remarkable transformation through Dougie’s rehabilitation process with laser therapy.

How do I explain the treatment to clients?

Many people have never heard of laser therapy and often associate lasers with high powered surgical devices. Explaining how laser therapy works in an easy to understand manner will ensure better compliance with the treatment program and increase referrals as clients can educate friends and family on this innovative treatment. The following are two simple analogies to use with clients: 1. The body consists of billions of cells.

Cellular activity tries to repair an injured site. Sometimes they are stressed with work and need extra fuel so they can do their jobs effectively. Laser therapy allows cells to produce extra fuel which helps accelerate the recovery process.

2. We know that light promotes regeneration and growth in plants. An animal’s body has the ability to absorb light and produce energy to boost the healing properties of the cells. Light accelerates and enhances the normal recovery and repair process.

Conclusions

An article in the 2012 issue of Veterinary Economics looked at which products and services veterinarians most wanted to add to their clinic. Laser therapy was ranked at #2, ahead of in-house diagnostic testing, imaging machines and rehabilitation/

REFERENCES 1. Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J. Photochem Photobiol B. 1999;49(1):-17 2. Bjordal, J. M., C. Couppe, R. T. Chow, J. Tuner, and E. A. Ljunggren. A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Aust. J. Physiother.

2003;49:107–116.

3. Lopes-Martins RA, et al. Effect of low-level laser (Ga-Al-As 655 nm) on skeletal muscle fatigue induced by electrical stimulation in rats. J Appl Physiol 2006;101(1):283 – 8.

4. Maria Stella Peccin, et al.Helium–neon laser improves bone repair in rabbits: comparison at two anatomic sites. Lasers Med Sci 2013; 28:1125–1130.

5. Hawkins, D., and H. Abrahamse.

Biological effects of helium-neon laser irradiation on normal and woundedhuman skin fibroblasts. Photomed. Laser Surg.

2005;23:251–259.

6. Michael R. Hamblin, et al. Mechanisms for low light therapy. Proc. of SPIE. 2006; Vol. 6140, 614001.

7. Ferreira DM, et al. Analgesic effect of HeNe (632.8 nm) low-level laser therapy on acute inflammatory pain. Photomed Laser Surg. 2005 Apr;23(2):177-81.

8. Rochkind S, et al. Laser phototherapy (780 nm), a new modality in treatment of longterm incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. Photomed Laser Surg. 2007 Oct;25(5):436-42.

TECHNEWS | VOLUME 37 ISSUE 1

SAFETY COLUMN

Canada Proposes New Regulations to Implement the UN’s Globally Harmonized System (for Classifying & Labelling Chemicals) July 1st, 2013: OHS Insider (http://ohsinsider.com ) Canada has always intended to adopt the UN’s Globally Harmonized System (GHS), an international system for classifying and labelling chemicals, and align with the US’s version. On June 29, 2013, the Canada Gazette published a notice that Health Canada is seeking comments on a proposal to repeal and replace the Controlled Products Regulations under the Hazardous Products Act and make other changes to related laws to implement the GHS in Canada. Here’s a look at what Health Canada had to say about the proposed changes to what’s now WHMIS. THE PROPOSED CHANGES IMPACTED LAWS: The proposed changes primarily impact the Controlled Products Regulations (CPR), which would be repealed and replaced with new regulations to be called the Hazardous Products Regulations (HPR). In addition, minor changes to the Hazardous Materials Information Review Regulations, Hazardous Materials Information Review Act Appeal Board Procedures Regulations and other related laws will be made.

ALIGNMENT WITH THE US: The new regulations are generally aligned with the US Occupational Safety and Health Administration’s Hazard Communication Standard (HCS 2012), with the exception of areas where a variance is needed to maintain the current level of protection given to Canadian workers or to respect the framework of Canadian laws and regulations.

KEY AREAS CHANGED: Health Canada has a detailed description of the proposed HPR, including changes that will primarily impact suppliers and importers of hazardous products. But for Canadian employers concerned with protecting their workers, the key areas the proposed HPR would change include:

ADOPTED HAZARD CLASSES. The HPR proposes adoption of two GHS hazard classes in alignment with HCS 2012: TECHNEWS | VOLUME 37 ISSUE 1

• Physical hazard classes, which represent hazards relating to chemical properties, such as flammability; and • Health hazard classes, which represent hazards to health arising from exposure to a substance or mixture.

As expected, the proposed HPR does not adopt the GHS’s environmental hazards class. As to the physical and health hazard classes, although the GHS classes subdivide these hazards differently than the CPR, these classes address all of the physical and health hazards that are currently covered in those regulations and introduce some additional hazards that aren’t currently covered but would enhance worker protections.

HAZARD COMMUNICATION: The HPR would require a label and “safety data sheet” (SDS) for each product that meets hazard classification criteria. The CPR requirements for labels and MSDSs would be changed to reflect the GHS’s content and format specifications and to align with the HCS 2012. For example, the term “safety data sheet” would replace the term “material safety data sheet.” But the general WHMIS approach to communicating the hazards of a product on a label and SDS through pictures and statements would stay the same.

For example, despite the unilingual HCS 2012 requirements, information on a label and SDS would still have to be provided in both English and French, which could appear on a single SDS or two separate ones. But SDSs wouldn’t have to be revised every three years in the absence of new information because this requirement is duplicative of the requirement that an SDS and label be accurate at the time of sale or import.

EXEMPTIONS: The current regulations allow, under certain conditions, exemptions to some SDS and label requirements. In the proposed HPR, some of these exemptions would be removed, some kept without modification, some retained with modification

and a few new exemptions would be created.

For example, the CPR bulk shipment exemption would be extended to products sold without packaging of any sort regardless of whether they’re shipped, which is aligned with the HCS 2012. In addition, these products would be exempted from the label requirement as all label information would be included on the required SDS. And only two of the existing exemptions from the labelling of the outer container of a hazardous product would be retained: • When the inner container label is visible and legible through the outer container; and • When the outer container has a label that complies with the TDGA Regulations.

One of the key new exemptions proposed is that an SDS and label wouldn’t have to reflect significant new information for a period of 90 and 180 days, respectively, from the date when the information became available provided that the new information and date it became available are sent by the seller, or obtained or prepared by the importer, in written form.

ANALYSIS Based on the most recent timeline on GHS implementation, Health Canada has met its goal of introducing amendments to the Hazardous Products Act and related regulations in the Spring 2013. So it appears the agency is on schedule to finalize the changes to the key laws and regulations by Spring 2014. Then it’ll be up to the provinces and territories to amend their corresponding OHS laws by June 2015.

In the meantime, go to http://ohsinsider.com/ search-by-index/whmis/ghs-special-report to read the special report on GHS for an overview of the system and what steps you can take now to prepare for its implementation. The OHS Insider’s WHMIS/GHS Compliance Centre also has additional resources on GHS. And stay tuned for information on an upcoming webinar on the proposed changes and new GHS regulations.

15

Apps,Blogs

&Websites

To Watch Want to catch a glimpse of one of the rarest of cats?

Check out the big cat view from the Center for International Forestry Research’s 30 hidden cameras in the rainforests of Java (http://tinyurl.com/Javaleopard).

Images of three Javan leopards looking healthy and acting normally have given hope to researchers studying these beautiful and endangered animals. The Javan leopard population is believed to comprise fewer than 250 adults. (veterinarypartner.com) Boehringer Ingelheim’s DuramuneLyme.com and DuramuneLepto.com are great educational resources for the veterinary profession. They provide interesting information about Lyme Disease and Leptospirosis, associated risk factors for pets and how routine vaccination can help dogs stay disease-free. Also find information on vaccine safety, benefits and efficacy.

PET MONITORING Pet owners with an affinity for technology will have a new toy to play with this year with the release of the Whistle, a wearable device for dogs that tracks their activity and rest patterns. The disc-shaped, waterproof device attaches to a dog’s collar to provide roundthe-clock monitoring of the animal’s activity and rest patterns. (Veterinary Advantage Weekly News) Some dogs need their space. That’s the message of YellowDogProject.com, which is raising awareness of the meaning of a yellow ribbon on a dog’s leash. The ribbons mean a dog may be fearful, aggressive or even too fragile to be pounced on by friendly people or dogs.

Sometimes the situation is temporary and the dog is being rehabilitated, either physically or mentally. But sometimes the Yellow Ribbon status is permanent. The website says the concept has been introduced in almost 50 countries. It’s based on putting a ribbon on a horse’s tail, to indicate an animal who may kick.

16

VIRAL MUSIC VIDEO FEATURES DAIRY INDUSTRY In the wake of their successful “Feedin’ A Nation” parody music video, the Midwest Dairy Association has donated $20,000 to Feed America, according to DairyHerd Network. This donation will provide 160,000 meals around the country. The video was created to increase awareness about the commitment and passion of dairy farmers as they help feed the nation. Set to the tune of “Good Vibrations” by the Beach Boys, the video featured more than 65 dairy farmers and was filmed at dairies across the Midwest. As of July 30, the video has been seen over 100,000 times on YouTube, http://www.youtube.com/watch?v=Ss2XGxblNZY.

Don’t throw them out, visit www.medicationsreturn.ca

TECHNEWS | VOLUME 37 ISSUE 1

Controlling canine urinary incontinence just got simpler.

With new PROIN™ Chewable Tablets, you have an easier way to help control female canine urinary incontinence due to urethral sphincter mechanism incompetence (USMI)—also known as urethral sphincter hypotonus. Here’s why.

• Chewable tablets for easy administration • Twice-a-day dosage for enhanced client adherence to your directions • Scored tablets in three strengths to provide accurate dosing • Highly palatable1 – liver-flavour that patients love • Proven efficacy of phenylpropanolamine hydrochloride in controlling USMI1,2 • 98.1% of clients surveyed during a clinical trial of PROIN Chewable Tablets were satisfied with the results2 Thanks to PROIN Chewable Tablets, controlling urinary incontinence is easy for your clients.

Visit www.virbac.ca to learn more.

© 2013 Virbac Canada, Inc. All Rights Reserved.

PROIN is a trademark of Pegasus Laboratories, Inc. and is used under license.

1. Multi-Centre, 28-day, Placebo-controlled, Clinical Field Study (PLI-CL001) Clinical evaluation of PROIN Chewable Tablets for the control of urinary incontinence in dogs due to sphincter hypotonus.

2. Multi-Centre, Open Label, Clinical Field Study (PLI-CL002) Clinical evaluation of the long-term effectiveness and safety of PROIN Chewable Tablets for the control of urinary incontinence in dogs.

0313

Use old radiographic film to widen the small openings of medical waste containers. Shape the film into a cone so that it is wider on the top than on the bottom. The resulting funnel will help you neatly get medical waste into the container.

(Veterinary Medicine)

Do you need to train a client in how to nebulize their pet? For a great Client Information Sheet, go to Veterinary Partner.com.

Tempting a Hospitalized Cat to Eat • Warm food whenever possible • Smear some food on the cat’s paw and nose. Because they’ll want to be clean, most cats will lick it off.

• Take the time to hand feed and pamper the cat.

• Make the cat feel good by washing its face with a soft wet cloth, mimicking a cat’s natural bathing pattern (including the ears). The cat will relax and learn to trust you.

• Use his usual food, but give him privacy by temporarily placing a towel over the front of its kennel. (Veterinary Technician)

TECHNEWS Subscriptions If you are not currently receiving all four TECHNEWS annual issues delivered direct to your door, now is the time to get your subscription! Year-round, issues are full of outstanding continuing education articles and quizzes, interesting personal stories and practical ideas for your work. $39.55 per year includes shipping and is payable by credit card or cheque to ‘OAVT’.

Sign up for your subscription today see Page 33 of this issue!

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TECHNEWS | VOLUME 37 ISSUE 1

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RECOMBITEK LYME is the First and Only Lyme vaccine that contains OspA in a non-adjuvanted formulation with a one-year proven duration of immunity 3 ®

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® RECOMBITEK®, IMRAB®, PUREVAX® and ONCEPT® are registered trademarks of Merial Limited. © 2013 Merial Canada Inc. All rights reserved.

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CE Article #2 Weight Loss in Dogs and Cats: The Bottom Lines for Success Sandy Valverde, DVM, CCRT

Obesity is a serious health concern for dogs and cats and is known to be a risk factor for many other diseases including diabetes mellitus, osteoarthritis, orthopedic disorders, hyperlipidemia and pancreatitis1.

Despite the increased awareness of the health risks associated with obesity, the prevalence of obesity is on the rise. According to the Association for Pet Obesity Prevention 2012 National Pet Obesity Survey (http://www.petobesityprevention.com/), 52.5% of dogs and 58.3% of cats are overweight or obese.

The concept of weight loss is simple: eat fewer calories and expend more calories. Even though this seems straightforward, it can be very challenging for owners to successfully complete a weight loss program for their pet.

To help pet owners be successful, it is important to develop a customized weight loss program that meets the individual needs of the pet and their family.

Communicating health risks of obesity:

The first step in implementing a weight loss program is to identify the pet as overweight and effectively communicate this to the owner. According to the Obesity Prevention Survey, 45.8% of dog owners and

45.3% of cat owners incorrectly identified their overweight or obese pet as being “normal weight”. Ensuring that the client recognizes that their pet is obese and that they understand the health risks associated with obesity is critical to implementing a successful weight loss program. It is this recognition and understanding that will motivate the owner to change feeding and lifestyle habits long term. Without this recognition, pet owners will not believe it is necessary for their pet to lose weight and, as a result, will not be compliant with a weight loss program. To further motivate pet owners, it is important to emphasize that weight loss results in improved general health as well as improvements in associated medical conditions. Weight loss alone results in significant

improvement in the lameness associated with hip osteoarthritis in dogs2 and the insulin sensitivity and normalization of glucose tolerance in diabetic cats3.

The bottom line: Owner recognition that obesity has serious health consequences to their pet is critical to ensure compliance with a weight loss program.

History:

Obtaining a detailed history about the pet’s diet and lifestyle is essential. It provides a foundation for establishing a weight loss program and helps identify potential challenges with implementing the program.

Understanding the limitations that the pet owner is facing allows the veterinary professional to address these limitations and tailor the program accordingly. In addition, identifying these limitations (challenges) and offering solutions that the owner can easily implement will improve compliance during the initiation of a weight loss program. A detailed history should include information about the pet’s past and current diet; including whether or not they are getting any table scraps or treats. In some cases having the owner keep a log of everything the pet consumes over a seven day period is very worthwhile. This information provides an accurate assessment of the current caloric intake and offers insight into the owner’s current feeding practices. A detailed history should also include information on the type, intensity and duration of the exercise the pet is experiencing. It is also important to know if there are any pet or owner limitations to physical activity. Many overweight pets have osteoarthritis (OA). Effective pain management will need to be prescribed to optimize an exercise program. It is essential to discuss both the OA and the need for pain management with the owner prior to starting a weight loss and exercise program.

The bottom line: a detailed history will lead to a customized weight loss program that can be implemented by the owner and will be effective at reducing the pet’s weight.

Dr. Sandy Valverde completed her DVM degree at the Western College of Veterinary Medicine. Upon graduation she worked for 5 years in a small animal practice in Edmonton. In 2001 she joined Medi-Cal/Royal Canin as the Sales Representative for northern Alberta and Saskatchewan and the Technical Services Veterinarian for the western provinces. In 2009, Dr. Valverde was certified as a canine rehabilitation therapist and subsequently worked for 2 years in a referral rehabilitation practice.

For the past 3 years, Dr. Valverde has been a Technical Services Veterinarian for Royal Canin combining her passion for companion animal medicine and nutrition.

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TECHNEWS | VOLUME 37 ISSUE 1

Choosing a diet: why not use a maintenance diet?

If weight loss is all about expending more calories than the pet is consuming, why is it important to feed a diet specifically designed for weight loss? Why can’t we reduce caloric intake by simply cutting back the amount of the pet’s regular food? Consider this: If we simply reduce the volume of a maintenance diet to induce weight loss, we also reduce the total amount of daily protein, vitamins and minerals consumed. The calorie restriction needed for a dog to lose weight ranges from 50-82% (average – 60%) of the maintenance energy requirements (MER) at target body weight4. If a maintenance diet is used to restrict calories, the animal will be consuming protein, vitamins and minerals below physiologic requirements and this may result in nutrient deficiencies5.

The bottom line: weight loss diets are designed to meet the animal nutrient requirements throughout the weight loss program. They are formulated to be higher in protein, vitamins and minerals relative to calories5.

Benefits of protein:

Higher protein intake during weight loss helps to preserve lean body mass and increase satiety in dogs5. Maintaining lean body mass during weight loss is essential to the success of the program as it prevents rebound weight gain once the target weight is achieved6. In addition, when combined with high fibre, high protein results in faster weight loss, a greater percentage weight loss, and greater percentage of fat loss in dogs7.

Cats consuming a higher protein diet have increased energy expenditure which, along with calorie restriction, helps promote weight loss8.

High protein diets in cats have also been shown to reduce the amount of energy restriction needed to lose weight9.

The bottom line: feeding high protein diets have numerous benefits and are recommended for overweight or obese patients to help achieve weight loss.

TECHNEWS | VOLUME 37 ISSUE 1

Begging pets: how to manage satiety

One of the biggest challenges with implementing a successful weight loss program is managing satiety.

Behavioural changes, such as ‘begging’ result from the pet feeling hungry.

The behaviours can be difficult to manage, lead to poor compliance to the program and, ultimately, the program’s failure. Feeding a high protein, high fibre diet increases satiety and decreases voluntary food intake10.

These diets should be prescribed as part of a strategy to manage satiety. In addition, prescribing a diet that is low in fat and with a lower caloric density will allow larger volumes to be fed and potentially reduce begging behaviour.

Providing multiple small meals (at least 3 per day), soaking dry food with water or adding canned food increases satiety and reduces begging behaviour.

It is important not to reward begging behaviour. If the dog or cat is crying or begging, instead of giving treats or food, remove the pet from the situation. For example, if the dog is whining for food while the owner is eating, put the dog in a separate room until the owner’s meal is finished. If the owner is consistent, over time, the begging behaviour will decrease.

Taking a dog for a walk, or using a toy to play with a cat, instead of giving additional food, will provide distraction and also reduce begging behaviour.

Investing in a ‘treat ball’ can also be useful. ‘Treat balls’ are designed to make the pet work for food and dispense small amounts of food as the pet plays with it.

Other creative ways to make a cat work for its food would be to use an empty tissue box (with the plastic removed) with holes cut into the sides just large enough for the cat to reach its paw inside to grab pieces of food or placing small amounts of food in multiple locations around the house.

21

to sit’ transitions. To prevent owner frustration and ensure compliance with the exercise program, it is recommended to prescribe only two to three exercises at the start. It is essential to regularly monitor and adjust an exercise program throughout the weight loss period (and beyond). Regular assessments ensure that the exercises are appropriate (not too easy or too hard) and that the owner and pet are able to complete the exercises prescribed.

Canned or dry food: does it make a difference?

There are a number of benefits to offering canned food in cats. Feeding canned food with added water has been shown to decrease voluntary energy intake and, as a result, reduce weight in cats11. In addition, canned food is easier for many owners to measure accurately.

This increased accuracy improves compliance with a weight loss program and its overall effectiveness.

The bottom line: canned foods should be considered for cats that are having difficulty losing weight.

Why is l-carnitine added to weight loss diets?

Carnitine is an amino acid that plays a key role in fat metabolism and energy production. It is needed for the mitochondrial transport of long chain fatty acids where they undergo B-oxidation and the production of ATP. The bottom line: diets supplemented with L-carnitine, along with calorie restriction result in faster weight loss and maintenance of lean body mass12.

EXERCISE PROGRAMS:

In general, increased physical activity is recommended for patients needing to

22

lose weight. In humans, exercise alone can induce weight loss and it has many benefits including reduction in total fat, reduction in skeletal muscle lipid and improved fitness13. However, the type, intensity and duration of exercise have not been clearly defined in dogs and cats needing to lose weight. There are no specific guidelines or targets that must be met and no specific protocols for weight loss.

Before starting an exercise program, it is important to assess the previous activity of the pet as well as limitations of the pet and owner12.

Since the current physical fitness of an overweight or obese pet may vary widely between patients at the beginning of a weight loss program, it is important to take a thorough history and evaluate the physical fitness of the patient prior to making recommendations for an exercise program. Once the current physical activity and physical fitness have been established, a customized exercise program can then be designed. It should be noted that the exercise program should not be static. Instead it should evolve over time and incorporate more challenging and intense exercises over time. The exercise program should include endurance exercises to increase physical fitness and strengthening exercises to increase muscle mass.

Examples of endurance exercises would be leash walking, land treadmill and swimming. Strengthening exercises would include ‘sit to stand’ and ‘down

Underwater treadmill (UWTM) is a unique tool that should be considered to help overweight and obese patients to lose weight. Sessions in the UWTM can be strictly controlled and the duration, time and speed of the session can be measured.

This allows an objective measure of improvements in physical fitness. Due to the buoyancy of the water joint loading is decreased in the UWTM. This is particularly helpful in obese patients with OA that have limited mobility13.

UWTM also provides resistance due to the viscosity of the water. This increases energy expenditure, increases muscle mass and MER13. Including UWTM and active client education as part of a formal exercise program may improve the rate of weight loss in dogs13.

The bottom line: a customized exercise program is an essential component of a complete weight loss program.

Environmental enrichment:

Environmental enrichment for cats has proven beneficial effects for cats and their owners. Overweight cats undergoing calorie restriction for weight loss that also receive environmental enrichment have increases in activity and slight increases in weight loss compared to cats without environmental enrichment14.

Environmental enrichments include additional litter boxes, water and food bowls, climbing towers, window perches, scratching posts, cat spas, grooming supplies and toys14. It is important to note that cat owners implementing environmental enrichment feel they are playing an active role in their cat’s health and have a more positive image of their cat14.

TECHNEWS | VOLUME 37 ISSUE 1

Monitoring and veterinary supervision:

Monthly assessments by a veterinary health professional and the associated modifications to the diet and exercise recommendations during a weight loss program result in successful weight loss12. In addition, owner challenges and frustrations with the weight loss program can also be addressed. The target for safe weight loss in dogs and cats is 1-2% weight loss/week15. If the pet is losing weight too quickly or not quickly enough, caloric intake can be adjusted to achieve this target. For pets that are on appropriate restriction for weight loss and are not losing weight, reviewing compliance with the owner is indicated to identify challenges with implementing the program. It will be important to review how much the pet is being fed, how the food is being measured, if there are any other food sources for the pet (other pets in the house, other family members feeding the pet, inaccurate measurement of food, treats or chews being given), and inquire if there have been any changes in exercise or lifestyle. Scheduling the initial follow-up visits and ensuring that they are kept will identify noncompliance early and allow immediate adjustments to be made. During these visits, it is important to weigh the patient, review feeding practices and exercise program and discuss any challenges the owner is facing and address them. In addition, these visits provide an opportunity to remotivate the owner and reinforce their commitment to their pet by reminding them of the important health benefits to their. Assigning a dedicated team member at the veterinary hospital to call owners, book appointments, weigh the patients, determine body condition score and identify challenges can be a useful approach to improve owner compliance.

Accurate measurement of food

One of the challenges owners face when implementing a weight loss program is accurately measuring food volume. It is important for the veterinary professional to give precise feeding recommendations that can be easily implemented. Feeding accurate amounts of calories is essential for success, especially in cats that may need very few calories to lose weight. Measuring dry kibble by volume using a measuring cup can be difficult; it has been documented that measuring cups are an inaccurate tool for estimating portions of extruded dry kibble and that over time this could contribute to obesity or failure of a weight loss program16. To ensure that the correct calorie amount is fed, the use of a kitchen gram scale is recommended. The kcal/100 grams of food and the grams/cup of the food being fed can be obtained from the therapeutic guidelines, and grams of food to be fed can then be easily calculated. For example, a cat may require 250 kcal/day to lose weight. The chosen weight loss diet has 222 kcal/cup, 293 kcal/100 g (or 2.93 kcal/ gram) and 76 g in one cup of food. If we were to calculate the volume of food this cat needs, it would be 250 kcal รท 222 kcal/ cup = 1.12 cups/day. It is very difficult for the owner to measure this amount of food accurately using a measuring cup. Instead we should calculate the amount of grams to be fed: Using the number of cups/day: 1.12 cups/day ร 76 grams/cup = 85 grams/day

Using the number of kcal/day: 250 kcal/day รท 2.93 kcal/gram = 85 grams/day

The bottom line: the number of grams of food can be precisely measured using the gram scale and small adjustments can be made easily which will help owners implement a successful weight loss program.

The bottom line: veterinary supervision of a weight loss program is necessary to identify non-compliance or challenges quickly and to offer solutions.

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23

REFERENCES

Keeping the weight off:

Once the pet has achieved ideal body weight, keeping the weight off can be an ongoing challenge.

Weight gain occurs in approximately half of dogs that have successfully completed a weight loss program1. Continued veterinary supervision and adjustment of caloric intake is critical during this period to ensure that weight gain does not occur.

Dogs that have completed a weight loss program have been shown to have a lower (or reduced) MER, often requiring only 10% more calories than what was required to lose weight7. Some pets may require a specifically formulated diet to ensure optimal protein and nutrient delivery if calories need to be limited to maintain ideal body weight. Dogs maintained on a diet formulated for weight loss after successful weight loss are less likely to

24

regain weight in the follow up period compared to dogs that are transitioned to a standard maintenance diet1.

The bottom line: patients that have successfully completed a weight loss program may benefit from feeding a weight loss diet long term.

Conclusion:

Although achieving successful weight loss can be both challenging and frustrating to both pet owners and veterinary professionals, it can also be very rewarding.

Using a multi-modal approach to weight loss including appropriate dietary management, exercise, and veterinary supervision will ensure successful weight loss and client satisfaction.

1. German A.J, Holden, S.L, Morris P.J., Biourge V. Long-term follow-up after weight management in obese dogs: The role of diet in preventing weight gain. Vet J 2012; 192: 65-70.

2. Impellizeri JA, Tetrick MA, Muir P. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis. J Am Vet Med Assoc 2000; 216: 1089-1091.

3. Biourge V, Nelson RW, Feldman EC, et al. Effect of weight gain and subsequent weight loss on glucose tolerance and insulin response in healthy cats. J Vet Intern Med 1997; 11(2): 86-91.

4. German AJ, Holden SL, Bissot T, Hackett RM, Biourge V. Dietary energy restriction and successful weight loss in obese client-owned dogs. J Vet Intern Med 2007; 21(6): 1174-1180.

5. Nguyen P, Diez M. Nutritional aspects of obesity.

Waltham Focus 2006; 16: 33-38.

6. German AJ, Holden SL, Mather NJ, Morris PJ, Biourge V. Low-maintenance energy requirements of obese dogs after weight loss. Br J Nutr 2011; 106: S93-S96.

7. German AJ, Holden SL, Bissot T, Morris PJ, Biourge V. A high protein high fibre diet improves weight loss in obese dogs. Vet J 2010; 183: 294-297.

8. Wei A, Fascetti J, Liu KJ, Villaverde C, Green AS, Manzanilla EG, Havel PJ, Ramsey JJ. Influence of a high-protein diet on energy balance in obese cats allowed ad libitum access to food. J Anim Physiol Anim Nutr (Berl) 2010; 95 (3): 359-367.

9. Vasconcellos RS, Borges NC, Goncalves KNV, Canola JC, de Paula FJA, Malheiros EB, Brunetto MA, Carciofi AC. Protein intake during weight loss influences the energy required for weight loss and maintenance in cats. J Nutr 2009; 139: 856-860.

10. Weber M, Bissot T, Servet E, Sergheraert R, Biourge V, German AJ. A high-protein, high-fiber diet designed for weight loss improves satiety in dogs. J Vet Intern Med 2007; 21(6): 1203-1208.

11. Wei A, Fascetti AJ, Villaverde C, Wong RK, Ramsey JJ. Effect of water content in a canned food on voluntary food intake and body weight in cats. Am J Vet Res 2011; 72: 918-923.

12. Roudebush P, Schoenherr WD, Delany SJ. An evidence –based review of the use of therapeutic foods, owner education, exercise, and drugs of the management of obese and overweight pets. J Am Vet Med Assoc 2008; 233: 717-725.

13. Chauvet A, Laclair J, Elliot DA, German AJ. Incorporation of exercise, using an underwater treadmill, and active client education into a weight management program for obese dogs. Can Vet J 2011; 52: 491-496.

14. Trippany JR, Funk J, Buffington CAT. Effects of environmental enrichments on weight loss in cats (abstr). J Vet Intern Med 2003; 17: 430.

15. Michel, K. Nutritional Management of Body Weight. In: Fascetti A and Delaney SJ (eds).

Applied Veterinary Clinical Nutrition. 1st Edition. Chichester, UK: Wiley-Blackwell 2012. pp.

109-124.

16. German AJ, Holden SL, Mason SL, Bryner C, Bouldoires C, Morris PJ, Deboise M, Biourge V. Imprecision when using measuring cups to weigh out extruded dry kibble food. J Anim Physiol Anim Nutr (Berl) 2011; 95: 368-373.

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Submitting Articles toTECHNEWS We welcome your participation in the quarterly magazine, TECHNEWS, distributed nationally. In Ontario, articles submitted receive 2 C.E. credits and articles chosen for printing receive an additional 2 C.E. credits. Please contact your Provincial Association Registrar to determine your provincial C.E. values.

Do not forget to include your return address information.

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stick in a format compatible with Microsoft Word 97 or better.

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TECHNEWS is looking for articles from technicians that present current news and information. Articles should contain information on areas of interest to technicians, such as client education, clinical situations,

lab procedures, nursing skills, neonatal care, research, exotics, large animal medicine, emergency procedures or anything else you feel is important to the continuing education of technicians.

Articles received will be reviewed by the TECHNEWS editors and editorial committee. Controversial subjects will be prefaced by editorial commentary.

The TECHNEWS editor reserves the right to make revisions in text when appropriate. Manuscripts may be edited for content, clarity and style. Feel free to contact the editorial office to ensure availability of a particular topic.

Editorial correspondence for TECHNEWS: O.A.V.T. Editorial Submissions Suite 104, 100 Stone Road West Guelph, ON N1G 5L3 Phone - (800) 675-1859 Fax - (519) 836-3638 Email - lauraf@oavt.org

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placement of an employment ad > Placement of an employment ad within the TECHNEWS newsletter is for a one issue period, which also includes placement of the same ad upon the OAVT website at www.oavt.org/employment for a three month period or until the next issue of TECHNEWS is published.

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Rate): $50.00 first 20 words, $1.00 for each additional word • Website and TECHNEWS (Non-Members Rate): $75.00 first 20 words, $1.50 for each additional word * Taxes not included in above mentioned rates If you want to use graphics in employment ads, please refer to the following display ad rates: Full Page $1395.00* Half Page $895.00* Quarter Page $595.00* * Taxes not included in above mentioned rates PLEASE NOTE: All Employment Ads must be submitted on the OAVT website.

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The OAVT does not necessarily endorse any of the following employment opportunities or the interviewing/hiring techniques implemented. There is a fee for placement of ads.

Please see Job Ad Form online for further details. The OAVT reserves the right to edit as space allows.

12233 (Sep 3, 2013): RVT/VeterinaryTechnician Full/Part time

We are looking for a veterinarian technician to join our fast growing cat only practice who has a passion for feline medicine, can work independently and has excellent interpersonal skills. Job description includes technical, customer service and general hospital duties. Great salary, hours and benefits!

Please send resume to mbonder@torontocatclinic.com 12172 (Aug 8, 2013): Receptionist

We are looking for a friendly, self-motivated individual that will help our team provide exceptional service to our excellent clientele. Experience and knowledge of Avimark is required.

You will enjoy the state of the art brand new facility which includes digital radiography, full in house Idexx lab. We are completely computerized.

Some evening and weekends will be required.

If you are interested forward your resume to info@Eglintonmavisvet.com 12159 (Aug 1, 2013): VeterinaryTechnician

The recently opened Yellowknife Veterinary Clinic in Yellowknife is 100% a companion animal practice and is recruiting qualified veterinary technicians.

We have full service blood chemistry, digital radiology, anaesthetic monitoring equipment, etc. We pay very competitive wages and are prepared to offer a relocation allowance. We insist upon, encourage, and support continuing education.

For more information about becoming a team member in a growing, progressive veterinary practice, please email a resume to Dr. Michael Hughes at ykvetjobs@gmail.com, or fax it to 867-920-7833 (RUFF). If you have questions, you can call our clinic at 867-920-7387 (PETS).

12157 (Aug 1, 2013): RVT

We are looking for Technician/ receptionist who is willing to do work flexible shifts and also Saturdays and Sundays. New grads welcome.

Please send resume oxfordanimalhospital@hotmail.com 12154 (Jul 31, 2013): RVT’s Needed

The Veterinary Emergency Clinic and Referral Center is a full service emergency and specialty care provider dedicated to providing service when primary care veterinarians cannot. Operating since 1976, VEC offers stateof-the-art veterinary medical facilities, prepared to manage very complex emergency situations.

The Veterinary Emergency Clinic and Referral Centre has exciting opportunities for RVT’s to work in an exciting environment consisting of emergency, critical care (ICU) and specialty practices (incl. Internal Medicine/ Oncology, Neurology, Surgery, Dermatology, Dentistry, Ophthalmology, Cardiology and Anesthesia). If you are interested in becoming a critical part of a diverse team of professionals, including board-certified specialists, experienced veterinarians, RVTs and support staff, then the VEC is the place for you.

TECHNEWS | VOLUME 37 ISSUE 1

T:3.375” S:2.125”

Key Qualifications - Passionate about patient care - Strong communication skills - Comfortable working in a fast paced environment - Ability to work independently and in a team based environment - Ability to pro-actively manage multiple priorities/patient cases - Attention to Detail What can we offer you?

- Ongoing opportunities for development, including on site CE credit seminars - Comprehensive benefits plan including; life insurance, medical, dental and vision - Challenging and supportive work environment where you can use your skills to the fullest we support and encourage RVTs wishing to become specialized - An array of incentive programs such as OAVT membership, scrub allowance, shift premiums and recognition programs to name a few - Relocation assistance for qualified applicants Please forward your resume to the attention of Claire Followes via e-mail at: cfollowes@vectoronto.com or via fax: (416) 920-6185.

12142 (Jul 30, 2013): Veterinary technician/Assistant

Weight Loss/ Mobility Plus A versatile alternative to single-focused weight loss diets.

Obesity affects the entire pet.

That’s why our diets utilize a total body approach. One that nutritionally addresses…

• Effective weight loss • Body composition • Joint health • Management of inflammation • Overall health

12135 (Jul 30, 2013): RVT for Emergency/After Hours

We need a part time RVT to join a fabulous team in South West Mississauga.

This is a 24 hour continuous care small animal hospital. Looking for great people skills, self motivated, detail oriented. Hours required would be for weeknights/weekend & holiday day or nights. Hours flexible. Please email resume to clarksonvet@rogers.com.

12108 (Jul 17, 2013): Full/part time receptionist

We are a progressive clinic which treats our animal clients with both holistic and conventional medicine. We are looking for a enthusiastic team player to join our clinic who is willing to work in a busy environment where you will be able to use a variety of skills. Experience is an asset.

We offer hourly wages and health benefits.

Please e-mail to: eyac@holisticpetvet.com, Fax: 416-285-7483

www.PGPetwellness.com 1-800-535-VETS (8387)

This is a contract position covering maternity leave until August 2014. New grads are welcome. Email cover letter and resume to cathospitalkw@gmail. com

QUA990656E

12020 (Jun 17, 2013): RVT

© 2012 P&G

12058 (Jun 27, 2013): RVT Wanted

We are seeking an energetic, compassionate individual, new grads welcome, willing to mentor. Preference given to those living in London area.

Please forward resumes via email to bimdolph99@gmail.com

TECHNEWS | VOLUME 37 ISSUE 1

27

T:9.375”

Visit us at www.Eglintonmavisvet.com if you are interested please submit your resume to info@eglintonmavisvet.com

Introducing…

S:9.375”

We are growing and looking for more staff, experienced VT and VA are welcome to apply, knowledge of Avimark is an asset, candidate must be able to work both front and back with good communications and great customer service.

- self motivated, reliable and flexible.

- some evening and weekends will be required.

- you will enjoy the state of art equipments, including digital X.ray, full in house blood work.

- the position is part time that will lead to a full time.

Obesity demands more.

B E H AV I O U R C O L U M N

Crate Training Cats and the Benefits of Positive Confinement

by Gary Landsberg DVM, DACVB, DECAWBM, Sagi Denenberg DVM, Colleen Wilson DVM Crate training is not just for the dogs. In fact, taking time to adapt a cat to a crate or carrier can have tremendous benefits for the cat, the owner and the veterinarian. Cats that are comfortable and secure with their carriers, can be more successfully managed during travel, vacations, visits to the veterinarian, or when confinement is necessary post surgery, or in the management of behaviour problems such as aggression or house soiling.

Many cats become fearful and even aggressive when being placed in their carrier, or even at the sight of a carrier. This is likely to be the case if the cat has been previously forced into the carrier, or the carrier has been associated with unpleasant experiences. If a cat is fearful of its carrier, this can incite fear even before the car ride or veterinary visit. Cat owners should focus from the outset on making the carrier a positive and secure place for the cat.

Although young kittens are generally less fearful and more exploratory, it should be possible to make the carrier inviting for cats of all ages. Start by locating the carrier with the door open in an area where the cat might like to explore, play, eat, or sleep. The key to success is to be creative in finding ways to encourage the cat to voluntarily enter and find comfort in the carrier by offering treats, food, toys, or bedding.

Many cats will be naturally curious to enter the cat carrier; this should be immediately reinforced with treats. Clicker

training is an excellent way to reward crate entry (see www.clickertraining.com). As long as each entry is positive and not forced, the cats own odors and pheromones should make the carrier increasingly more familiar and comfortable.

Cat owners will need to determine what type of carrier is most appealing to their cat. Some cats are more relaxed when they can see what is going on around them, in which case a wire crate might be better. Others feel more secure in a carrier with solid sides. Rigid carriers may be sturdier and easier to keep clean but some cats may more willingly enter a soft-sided carrier. Carriers can open from the side or top. Carriers that offer both options allow the cat to enter from either door while the top opening (or removing the top) might provide a less stressful way to work with cats in a veterinary clinic environment (either in the crate or when removing the cat). Once a cat will readily enter the carrier, the owners should practice lifting and moving the carrier, followed by short car rides that incorpo-

rate treats and rewards to distract the cat.

Make sure the initial trip is an enjoyable experience.

Every effort should be made to condition the cat to its carrier before any stressful outing. However, if there is not enough time to introduce the cat to the carrier before the first trip, the owners should work to insure that confinement is as stress-free as possible. Food or treats and comfortable bedding may help the cat to adapt. In addition, spraying Feliway on the bedding about 15-30 minutes before placing the cat in the carrier, might encourage entry and decrease stress and anxiety. Medication or other natural products to reduce anxiety might also need to be considered.

Finally, for cats that have had a previous negative experience with a carrier, consider re-training with a carrier that is sufficiently different in size, shape or surface texture so that it does not cause fear and the cat is more likely to voluntarily enter.

Putting treats, toys or bedding in the carrier can again help to encourage its use.

Another option is to purchase a carrier with a removable top and to give the cat an opportunity to use the bottom half for feeding or resting. Pet owners should not close the carrier until the cat is comfortable with entering and staying inside.

Dr Gary Landsberg and Dr. Sagi Denenberg operate a behaviour referral practice, North Toronto Veterinary Behaviour Specialty Clinic in Thornhill, ON (northtorontovets.com). Dr. Landsberg is a board certified veterinary behaviorist and Dr. Denenberg has recently completed his residency requirements to sit for both the ACVB and ECAWBM examinations. Dr. Landsberg is also the mentor for the behavior residency program of Dr. Colleen Wilson who sees referral behaviour cases at the Osgoode Animal Clinic (osgoodevet.com).

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TECHNEWS | VOLUME 37 ISSUE 1

CE Article #3 Optimizing Canine Reproduction: Artificial Insemination and Breeding Management J. Verstegen DVM, PhD, Minitube of America, Director of Small Animal Reproduction K. Verstegen-Onclin, University of Florida, LACS, Small Animal Reproduction, Gainsville FL, USA Artificial Insemination (AI) is an assisted reproductive technology whereby semen is collected from the stud dog, evaluated and processed and then deposited into the vagina of a receptive bitch through artificial means.

Because of the many benefits, AI with chilled and frozen-thawed semen has gained increasing interest worldwide and has become very popular among dog breeders and veterinarians.

Although artificial insemination does require organization and good planning, nowadays it is possible to achieve adequate whelping rates and litter sizes as long as proper timing of AI and proper semen deposition are used. There are many factors to consider and attention to detail is critical to success and obtaining results that are similar to natural mating.

With proper training, procedures and equipment, the activities of collection, processing, and transportation of semen can easily be added to a breeding program.

Collection In order for the stud dog owner to supply the proper dose, or number of high quality sperm cells, the ejaculate must be handled and delivered correctly. To ensure this, the stud dog should be manually collected using disposable equipment, or reusable equipment that can be sterilized, which allows fractioning

of the ejaculate. If possible semen should be collected in the presence of an estrus bitch to increase libido and ejaculation quality but can also be done with a teaser bitch that is not in heat. To manually manipulate the stud dog the penis should be massaged through the prepuce at the level of the bulbus glandis until a partial erection begins. The penis should then be circled behind the bulbus glandis and the prepuce quickly retracted past the bulbus glandis. Firm pressure should be applied constantly to the penis behind the bulbus glandis to stimulate the release of the first or prostate fraction. The second fraction, which is sperm-rich usually takes about 2 minutes to release and doesn’t naturally mix with the first and third fractions.

Care must be taken to collect only this spermrich fraction for further extension, and avoiding any deleterious effects during extension, storage or freezing. The semen should be evaluated for motility, morphology and concentration.

If the bitch is on site, the collected semen can be immediately placed in the anterior vagina using a specially designed catheter.

Benefits: • Eliminates the cost, risk and time of shipping and boarding bitches.

• Stud dog is collected without interrupting present activities (eg. shows, trials), and ejaculates can be split if necessary.

• Semen from outstanding stud dogs is more easily available worldwide.

• Semen quality and quantity can be evaluated and known before breeding, and can determine if the dog has any prostatic issues.

• Minimizes transmission of reproductive diseases such as Herpes and Brucella.

• Semen can be frozen to preserve genetics for future generations

Eliminates issues with: 1. Aggressive bitches that refuse a stud dog or aggressive studs that are difficult to handle in the presence of a bitch in heat; 2. Inexperienced stud dogs or excitable males that have an erection/ejaculation before penetration.

Natural breeding in some breeds may be physically difficult.

Dr. John Verstegen has devoted his career to companion animal theriogenology and developed the field of small animal reproduction and endocrinology. He is a founding Diplomate of the European College for Animal Reproduction, past President of the European Society for Small Animal Reproduction and board member of FELASA, BCLAS and ICLAS. Dr. Verstegen has multi-national experience in academic and commercial research while emphasizing innovation in modern small animal reproduction. Dr. Verstegen has published his work in many peer-reviewed articles in journals such as Theriogenology, American Journal of Veterinary Research, and the Journal of Reproduction and Fertility. At Minitube of America, Dr. Verstegen leads a graduate team of scientists and veterinarians to oversee Minitube’s overall research projects including: the research and development of semen and embryo sexing technologies, assisted reproduction technologies and products related to animal reproduction.

Karine is a specialist/diplomate in animal reproduction from the European College of Animal Reproduction (ECAR). Karin spent 13 years working as a clinician and researcher for the University of Liege for and more recently as a clinical assistant for the University of Florida. In her current role at Minitube’s International Center for Biotechnology, Dr. Verstegen is responsible for all activities relating to the canine cryogenic banks, communication with breeders and veterinarians as well as research and development activities in small animal reproduction.

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Optimal breeding •

Dog and bitch should be young and healthy

•

Check for any infections, diseases or defects

• Start early! Keep track of the bitch’s cycle from inception to determine optimal insemination period • Use a combination of vaginal smear, vaginoscopy and progesterone assays to pinpoint the exact timing • Treat each bitch as an individual - there is no such thing as a “textbook” case • Ensure semen concentration and quality meet or exceed minimum requirements • Use proper technique, tools and hygiene for insemination • Coordinate and plan ahead with the breeders and veterinary staff

Processing Fresh semen may be extended in specially developed AI extender to boost motility and give the proper volume for immediate insemination.

With chilled semen, the extender used has a larger influence on the outcome. The semen needs to be extended in a solution that protects the sperm during cooling, supplies nutrients and energy to the sperm cells, maintains pH, osmolarity and ionic strength, and contains antibiotics to prevent bacterial growth. Most extenders preserve the semen for 3-5 days at 5°C so that it can be shipped overnight in a specially designed shipping container.

Recent advancements in chilled semen extender allow semen to be kept 5 to 10 days in a controlled temperature of 5°C and to be shipped in animal protein-free environment. This creates a larger window of opportunity for its successful use.

Semen can also be frozen but this process requires training and is usually done by a veterinary centre that specializes in frozen semen. The semen is stored in liquid nitrogen and can last indefinitely.

Utilising frozen semen also requires special insemination techniques.

Therefore, semen used in AI can be fresh, chilled or frozen. With good breeding management, success rates are similar with fresh or chilled semen. Results after AI with frozen-thawed semen are highly

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variable and depend on the method used, site of deposition, number of inseminated sperm and inseminations, semen quality and handling.

Breeding management Good breeding management is necessary to exactly determine the timing of the estrous cycle and breeding readiness of the recipient bitch. Ovulation timing needs to be determined using several different methods, i.e. vaginal cytology, vaginoscopy, progesterone and luteinizing assays. The behaviour of the bitch should also be noted. It is advisable to check semen motility before inseminations.

Ideally, both dog and bitch should be young and healthy, ranging in age from 2-7 years. The dog should be cleared for Brucella and Herpes, and the bitch for infectious, hormonal and anatomical defects before mating. A negative test result for Brucella within 30 days, or since the last natural breeding, is necessary.

A bitch carrying the Herpes virus can experience pregnancy losses related to the disease so careful monitoring is required.

The minimum insemination dose should contain 100-150 million viable normal sperm, ideally with motility greater than 70 percent. If using chilled semen, a trial collection and a “chill check” is advisable one week before anticipated ship date.

Specially formulated extender and shipping containers designed for canine semen should be used. Everything should be organized with the recipient’s local veterinarian or breeding facility.

Breeding management of the bitch needs to start early, particularly in females who have not had their cycles followed earlier. Due to the very unique reproductive cycle of the dog, the determination of the optimal timing for artificial insemination or mating is vitally important. Even if the bitch accepts mating for several days, the eggs will be fertilizable for only a very short period of time - probably not longer than one or two days. Inadequate timing, particularly when using chilled or frozen semen, can have dramatic consequences. Vaginal smear and vaginoscopy are useful indicators; however optimal reproduction management should also include the follow-up of progesterone dynamics. A single assay will never be enough to determine the optimum time for AI or mating.

The progesterone course during the fertility cycle in an average bitch is displayed in Table 1. However, the average bitch only exists in textbooks. A trained veterinarian is required to analyze and interpret the data in individual bitches.

Dramatic changes and differences can be observed between individual animals not following the “average population”.

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PROGESTERONE LEVEL

PROGESTERONE COURSE

< 1 ng/ml

• Basal progesterone serum concentration

< 3.18 nmol/L

• Either anoestrus or early pro-estrus. If proestrus, vaginal smear and vaginoscopy should be done • Restart testing progesterone only when obvious signs of end pro-estrus or early oestrus are observed at vaginal smear and vaginoscopy

< 1-3 ng/ml < 3.18-9.54 nmol/L

< 4-7 ng/ml < 12.72-22.26 nmol/L 5-10 ng/ml

• Pre-ovulatory progesterone increase • LH-Peak is generally observed when progesterone value is around 2 mg/ml or when the progesterone value is observed to significantly increase from previous values

• Values around the time of ovulation

15.9-31.8 nmol/L

• Period of final maturation of the oocytes, expulsion of the polar bodies and beginning of receptivity of oocytes

> 10 ng/ml

• Beginning of the fertile period

> 31.8 nmol/L

• First mating/insemination time is determined depending on the type of semen used (fresh, chilled or frozen) and depending on the type and number of AI’s • Second service will be performed either 24 or 48 hours after the first one, depending on semen used (fresh, chilled or frozen)

> 20 ng/ml > 63.6 nmol/L

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• In many bitches the cervix will close and a vaginal insemination will not be successful. If necessary a transervical artificial insemination can be performed (ideally endoscopically)

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a transcervical artificial insemination can be performed (ideally endoscopically)

P

Insemination

The actual insemination can be performed vaginally, laproscopically, surgically or transcervically. Vaginal insemination is used to deposit fresh or chilled semen in the vagina. It is most commonly done using a rigid pipette or a specially designed catheter that mimics natural mating. The catheter does not require elevation of the bitch after the deposition of the semen.

Vaginal insemination has good results if there is good quality semen with a large enough volume and adequate time spent on the insemination.

With frozen semen, or fresh/chilled semen that has inadequate number of sperm cells, exhibits poor motility and/ or has morphological issues, intra-uterine insemination is preferred. Although this can be done surgically or laproscopically, in recent years transcervical insemination with a specially designed endoscope has become more prevalent as it does not require anaesthesia or sedation of the bitch.

With this method a standing bitch can

32

have a fiberoptic rigid endoscope inserted and then a plastic catheter passed through the cervical opening to deposit the semen in the uterus.

All methods require good breeding management. The combination of vaginal cytology, vaginoscopy and determination of the progesterone level using a dynamic approach is the basis for optimal and successful canine reproduction management.

Inferior results are generally the consequence of: 路 Poor breeding management 路 Issues with the semen - reduced volume, concentration and/or quality 路 Issues with semen shipping 路 Use of poorly adapted technique for insemination By controlling these factors, results obtained can be easily superior to those of natural breeding with all of the benefits of artificial insemination in terms of management, hygiene and cost.

TECHNEWS | VOLUME 37 ISSUE 1

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Technews Fall 2013 CE Quizzes CE Article #1: Innovative Pet Care:

Shining Light on Animal Health 1. Which of the following is NOT stimulated (increased) by Laser Therapy: (a) ATP (b) Prostaglandins (c) Fibroblasts (d) Keratinocytes

5. Which of the following conditions should NOT be treated by laser therapy? (a) Burn (b) Malignancy (c) Wound (d) Dermatitis

8. Which of the following is a known side effect of Laser Therapy? (a) Dermatitis (b) Erythema (c) Edema (d) No adverse side effects

2.

6. Which of the following is FALSE regarding Laser Therapy? (a) Heat is absorbed (b) Infrared and red light is used (c) Endorphins are released (d) Treatment time varies with the size of area

9. Which of the following is FALSE regarding Laser Therapy (a) It can stimulate insulin secretion (b) It can resolve inflammation (c) It can regenerate tissue (d) It can stimulate angiogenesis

Class IIIb lasers have power outputs of: (a) 1-5 mW (b) 5-100 mW (c 5-500 mW (d) 1000-5000 mW

3. Which of the following is a contraindication to using Laser Therapy? (a) Fracture (b) Laceration (c) Metal implants (d) Over pregnant womb 4. What source of cellular energy is stimulated

by Laser Therapy? (a) Glucose (b) ATP (c) ADP (d) Starch TECHNEWS | VOLUME 36 ISSUE 4 TECHNEWS | VOLUME 37 ISSUE 1

7. Which of the following is TRUE regarding Laser Therapy using Class IIIb devices? (a) Animals need to be sedated (b) Animals must be lying down (c) Only a DVM can administer (d) Safety glasses should be worn during treatment

10. Which of the following is FALSE regarding Laser Therapy (a) It can be useful treating ear infections (b) It can benefit arthritic patients (c) It can treat melanomas (d) It can stimulate bone healing

33

CE Article #2: Weight Loss in Dogs and Cats:

The Bottom Lines for Success 1.

Obesity is a risk factor for: (a) Pancreatitis (b) Hyperlipidemia (c) Osteoarthritis (d) All of the above

2. According to the Association for Pet Obesity Prevention National Pet Obesity Survey (a) 45.8% of dogs are overweight (b) 45.3% of cats are overweight (c) 58.3% of cats are overweight (d) 58.3% of dogs are overweight 3. L-Carnitine is supplemented in weight loss diets to: (a) Improve satiety during calorie

restriction for weight loss (b) Maintain lean body mass during weight loss (c) Prevent protein malnutrition during

calorie restriction (d) Slow down the rate of weight loss 4. What dietary strategies can be used to manage satiety in dogs? (a) Feeding a higher protein, higher

fibre diet (b) Feeding a higher fat, lower calorie diet (c) Lower protein, higher fibre diet (d) Feeding one meal daily

5. The most accurate way to measure dry food portions is by using a: (a) Kitchen gram scale (b) Measuring cup (c) Tupperware container (d) Scoop provided by the pet food manufacturer 6. Overweight dogs with osteoarthritis: (a) Do not show improvements in

lameness with weight loss alone. (b) Should not exercise as it may be

too painful. (c) Do not benefit from underwater treadmill. (d) Require effective pain management

to optimize a weight loss and

exercise program.

7. Choosing a diet specifically designed for weight loss is important because: (a) Weight loss diets are higher in protein

and have increased nutrients (vitamins

and minerals) relative to calories to

avoid potential nutrient deficiencies

when lower amounts of calories are fed. (b) Weight loss diets are higher in fibre

and less palatable to reduce voluntary

food in-take and daily caloric intake. (c) Weight loss diets are lower in protein

and essential nutrients to encourage a

faster rate of weight loss. (d) Weight loss diets are not necessary to

feed for pets to lose weight. Reducing

the amount of a maintenance

food is equally effective.

8. Taking a thorough history prior starting to a weight loss program is essential. What information is important to know? (a) The physical limitations of the owner

and/or pet (eg osteoarthritis) (b) What the pet is currently eating and

how much (c) How the food is being measured (d) All of the above 9. The benefits of higher protein diets during weight loss include: (a) Preservation of lean body mass (b) Increases satiety in dogs (c) Increased energy expenditure in cats (d) All of the above 10. Exercise programs: (a) Are not helpful for pets to lose weight.

Calorie restriction is the only effective

tool for pets to lose weight (b) Should be static and remain constant

during the weight loss period (c) Should be regularly monitored and adjusted to ensure the exercises are

appropriate and that the owner is able

to complete the exercises prescribed (d) Are not recommended for overweight

patients with osteoarthritis

CE Article #3: Optimizing Canine Reproduction:

Artificial Insemination and Breeding

Management 1. A negative Brucella test is necessary for the bitch: (a) Within 60 days of breeding (b) Once in her lifetime (c) If she has been bred before (d) Within 30 days of breeding 2. The eggs are fertilizable for: (a) 5-7 days (b) 1-2 days (c) a matter of hours (d) 3-5 days 3. The minimum insemination dose should contain: (a) 10-15 million viable sperm (b) 100-150 million viable sperm (c) 1 billion viable sperm (d) 1-5 million viable sperm

34

4. According to the article, which one of the following statements is true: (a) Natural mating will always achieve

better pregnancy rates and litter size (b) Using AI will result in better pregnancy

rates and litter size (c) Adequate whelping rates and litter

sizes can always be achieved with AI (d) Adequate whelping rates and litter sizes

can be achieved as long as proper timing

of AI and semen deposition is used.

5. Optimal reproduction management should include: (a) A vaginal smear (b) Vaginoscopy (c) Progesterone dynamics (d) All of the above 6. Chilled semen is routinely inseminated vaginally when: (a) The semen is less than 48 hours old (b) The semen volume is inadequate (c) There is adequate volume of good

quality semen (d) The semen volume is adequate but

there are quality issues

7. For proper storage extended semen should be kept at: (a) 5 C (b) 0 C (c) 10 C (d) 37 C 8.

The sperm rich fraction of the semen is: (a) first (b) second (c) third (d) all of the above

9. The progesterone value at the beginning of the fertile period is generally: (a) > 5 ng/ml (b) > 10 ng/ml (c) < 1-5 ng/ml (d) > 20 ng/ml 10. After collection, semen should be evaluated for: (a) motility (b) morphology (c) concentration (d) all of the above

TECHNEWS | VOLUME 37 ISSUE 1

Give your VIP VIP*s the cleanliness they deserve

*Very Important Pets

Cleaners Dupont Neutrafoam Biosolve Plus

Disinfectants Biosentry 904 Clinicide Virkon & Virkon Tabs www.vetoquinol.ca

To protect VIPs that come into your clinic, no need to roll out the red carpet. Simply ensure that you have a good biosecurity protocol, and apply it every day.

Need more information?

Consult your Biosecurity specialist: Vetoquinol!

nies and associations across the nation. Other organizations, such as the American Society for the Prevention of Cruelty to Animals, also offer insurance through employers, but the number of people who sign up remains small.

VPI has 61 percent of the niche market with only a half-million pets insured nationwide.

VPI offers insurance to companies with more than 100 employees, who can choose payroll deductions or direct billing. (Veterinary Advantage Weekly News)

Global news Pets as possible cause of distracted driving US - A recent article in the Toronto-based Globe and Mail examined distracted driving, which is blamed in more than 10 per cent of all U.S. highway fatalities, according to the U.S. National Highway Traffic Safety Administration (NHTSA). Phones and emailing are part of the reason, but pets can also increase the crash rates if owners aren’t careful, the article says. Researchers at the University of AlabamaBirmingham claim that seniors who drive with pets in the car are twice as likely to end up in a crash. According to NHTSA, drivers should never take their eyes off the road for more than two seconds at a time. A moving pet, especially in the front seat, can cause a driver to do exactly that. If a dog or cat gets startled and moves suddenly, it stands a good chance of causing the driver to lose control of the vehicle. (Veterinary Advantage Weekly News) Pet insurance offered US - The Associated Press recently examined the growing number of companies that discount and subsidize pet insurance as a perk to workers. For instance, the nation’s oldest and largest pet insurer, Veterinary Pet Insurance (VPI), offers policies at one in three Fortune 500 companies, as well as 3,400 other compa36

World - AQUACULTURE Global animal protein production from aquaculture in 2012 surpassed the output from cattle and the gap is widening, claims a new report from the Earth Policy Institute. In 2012, world aquaculture had a record output of 66 million tons, compared to 63 million tons of beef. While there is some way to go before farmed fish production overtakes the pig and poultry meat sectors, its rate of growth is ahead of these protein sources.

US - PEDV Porcine epidemic diarrhea virus has spread rapidly to at least 16 states since it was first identified in the US in April. PEDV is an intestinal virus that takes a heavy toll on young pigs. Herd loss may affect pork production as countless pigs –-- most suckling and early-weaned pigs –-- die from the gastrointestinal disease. Researchers at the University of Minnesota have developed a PEDV rapid diagnostic test. Test results are known within 24 hours. Genetic material is also extracted from the samples, which can be tested and tracked to monitor PEDV spread. Samples including swine fecal swabs, saliva, serum, feed, fecal, intestinal and lung tissues can be tested.

Bird Vaccine for West Nile Virus CANADA - University of British Columbia researchers have developed a vaccine that may halt the spread of West Nile Virus (WNV) among common and endangered bird species.

WNV, a mosquito borne pathogen, arrived in North America in 1999 and is now endemic across the continent. In 2012 alone, WNV killed 286 people in the United States, and 42 people have died from the virus in Canada since 2002. There is currently no effective vaccine against WNV infection in humans or birds.

Common birds such as crows, ravens and jays, and endangered species such as the Greater Sage-Grouse, are also susceptible to WNV infection, with mortality rates in some species and populations as high as 100 per cent. A bird vaccine would go a long way to helping combat these adverse effects.

The research team developed and tested a

vaccine made from components of WNV and found it generated an effective immune response in birds. This may protect against the spread of virus not only among birds but also to other species. The team will now study the vaccine’s effectiveness in protecting birds against mortality caused by the disease.

Veterinarians worried about FDA’s hydroxyethyl starch warning US - A recent FDA warning regarding hydroxyethyl starch (HES) has left veterinarians wondering about the safety of administering hydroxyethyl starches off-label to their patients, according to VIN News Service. In June, the FDA, reacting to recent data showing that HES solutions may cause kidney injury and death in certain cases, advised against administering the drug to critically ill adult patients with preexisting renal dysfunction or sepsis or who are undergoing open heart surgery in association with cardiopulmonary bypass. FDA is requiring pharmaceutical companies to affix a black box warning — the agency’s strongest alert — on package inserts or literature describing HES products. When asked about the warning’s crossover to animal health, a spokeswoman with the FDA’s Center for Veterinary Medicine said the agency could not advise veterinarians because HES is not approved for use in animals. Officials with Abbott Animal Health, maker of the VetStarch, explained that the colloid is a tetrastarch, not a hetastarch, with key characteristic differences including molecular weight and molar substitution. The company said it has not received any reports of adverse events identified in the FDA’s black box warning. (Veterinary Advantage Weekly News) 86 Whistler sled dogs up for adoption after business fails CANADA - The B.C. SPCA is upset a Whistler dog sledding company is shutting its operations and using an animal shelter to care for and find new homes for 86 huskies. The not-for-profit Whistler Sled Dog Company was created in December 2011 when Outdoor Adventures decided to shut down its sled dog operation and give all its dogs, kennels and equipment to the new company.

Some of the animals were originally sold to Outdoor Adventures by Robert Fawcett, the owner of Howling Dogs, who slaughtered 43 of his sled dogs when business slowed down after the 2010 Olympics. He was convicted in 2012 of animal cruelty in the death of nine of the dogs.

TECHNEWS | VOLUME 37 ISSUE 1

The mandate for the new Whistler Sled Dog Company was to find a way to run an ethical dog sledding operation that put the welfare of the animals first. But after running the operation for two seasons, the board decided that the short four-month season in Whistler was not enough to support the proper care of the dogs during the other eight months of the year.

Most of the dogs are now in the care of Whistler Animals Galore and the B.C. SPCA and awaiting adoption. The SPCA says the new code of practice created for the industry after the 2010 sled dog slaughter calls for complete life cycle care for sled dogs, without the need to rely on shelters. The shelter believes the dogs would only make good pets for owners willing to invest the time to socialize them for city life (something that is easier said than done), although the company is paying to help socialize the animals for life in a family home. (cbc) US - Nestle Purina PetCare Co. announced it will acquire Petfinder, the online pet adoption website, from Discovery Communications LLC. In addition to helping facilitate adoptions, Petfinder serves as a resource guide to help people and families select the right pets; Nestle Purina plans to add pet nutrition and welfare information to the site. (Brakke) Muesli no longer recommended for Pet Rabbits

Ty, a 180 kilogram tiger, waits for veterinary surgeons to extract a 1.8 kilogram hairball from his stomach. (BluePearl Veterinary Partners/James Judge/Associated Press)

Vets remove tiger’s soccer ball sized hairball US - It’s not unusual for a cat to get a hairball, but a 180 kilogram tiger needed help from veterinary surgeons when he couldn’t hack up a soccer ball-sized hairball by himself. 17-year-old ‘Ty’ underwent the proce-

Definition

Term 1. brachygnathia 2. brachyodont 3. cheek teeth 4. jaw excursion 5. malocclusion 6. periradicular 7. prognathia 8. odontoblasts 9. arcade 10. periodontal

dure at a veterinary centre in Clearwater, FL. Doctors safely removed the 1.8 kilogram obstruction from Ty’s stomach. The tiger, which is cared for by Wildlife Rescue and Rehabilitation in Florida, was brought to veterinarians after not eating for nearly two weeks. Doctors said they detected the hairball using an endoscope. (AP)

a) surrounding the root of a tooth b) abnormal protrusion of a jaw c) arrangement of teeth in an arch (upper or lower jaw) d) short or low-crowned with well- developed roots e) columnar cells on the outer sur face of the tooth pulp f) situated or occurring around a tooth g) abnormal contact of the upper and lower teeth that interferes with a normal chewing pattern h) abnormal shortness of the lower jaw i) molars and premolars j) movement of the upper and lower jaws during mastication

UK - Two years of research at the University of Edinburgh in the UK have linked muesli-style foods to life-threatening dental and digestive problems in rabbits.

Answers: 1 h), 2 d), 3 i), 4 j), 5 g), 6 a), 7 b), 8 e), 9 c), 10 f)

TECHNEWS | VOLUME 37 ISSUE 1

37

POISONING COLUMN

Medical Management and Treatment of Rodenticides – It’s not just Vitamin K1 anymore!

Justine A. Lee, DVM, DACVECC, DABT, CEO VetGirl As fall approaches, veterinary clinics will be seeing more accidental rodenticide poisonings. Think you know how to treat that dog that just ingested a green or blue block of rodenticide? Well, before reaching for your bottle of Vitamin K1, make sure you identify the correct active ingredient! New mandates by the EPA (effective 2011) were created that will reduce the availability of long-acting anticoagulants (LAAC); instead, bromethalin and cholecalciferol may become more prevalent in the future. So, before you reach for that Vitamin K1, read on!

Rodenticides

One of the most common mistakes seen in the field of veterinary toxicology is assuming that every green or blue block of rat or mouse poison is a long-acting anticoagulant (LAAC) rodenticide. The active ingredient of a rodenticide cannot be identified based on physical appearance (e.g., colour, shape, size, etc.). When in doubt, the EPA-Reg. number or active ingredient (and concentration) must be properly identified to ensure appropriate treatment and management of rodenticide toxicoses. Several different classes of rodenticides exist, including those that contain bromethalin, zinc phosphide, and cholecalciferol (Vitamin D3).

Bromethalin

Bromethalin, a neurotoxic rodenticide, is marketed under several common brand names: Assault®, Tomcat Mole Killer®, Talpirid®, Real Kill®, Clout®, Fastrac®, Vengeance®, etc. Bromethalin is not an anticoagulant rodenticide and should not be treated with Vitamin K1 as an antidote. Bromethalin works by uncoupling oxidative phosphory38

lation in the brain and liver mitochondria.1 This results in decreased ATP production, which affects sodium and potassium pumps; as a result, lipid peroxidation occurs, resulting in sodium accumulation within the cell.1 Edema of the central nervous system (CNS) may result.1 In dogs, the LD50 of bromethalin is 2.383.65 mg/kg, with a minimum lethal dose being 2.5 mg/kg.1 Cats are more sensitive to the effects of bromethalin, and the LD50 is significantly lower (0.54 mg/kg).1 Clinical signs are dose-dependent, and the onset of clinical signs depends on the amount ingested. Typically, with acute ingestion, signs may be seen within 2-24 hours.1 Clinical signs of CNS stimulation or depression, abnormal behaviour, ataxia, hyperesthesia, seizures, and coma may be seen.1 Other common signs include paresis, hind limb paralysis, anisocoria, nystagmus, changes in the pupillary light reflex, and tremors may also be seen. Treatment includes early decontamination, prevention of cerebral edema, and symptomatic supportive care. With recent ingestion in an asymptomatic patient, the use of decontamination (e.g., emesis induction, activated charcoal) is warranted. As bromethalin undergoes enterohepatic recirculation, the use of multiple doses of activated charcoal (without a cathartic) can be administered q6 hours for 24 hours.

Patients should be monitored for signs of neurotoxicity. The use of IV fluid therapy, oxygen support, head elevation, mannitol (to decrease cerebral edema), anticonvulsant therapy, and thermoregulation is warranted if clinical signs develop. The prognosis varies depending on the amount ingested and the severity of clinical signs. If persistent seizures or paralytic syndrome is seen, the prognosis is poorer.

Phosphides

Phosphide rodenticides have been used since the 1930’s and are still readily available on the market.2 Aluminum phosphide is a pelleted product used as a fumigant in grain storage silos, while the more common zinc phosphide is labeled for use in control of rats, mice, ground squirrels, prairie dogs, voles, nutria, muskrats, feral rabbits, and gophers.2 Zinc phosphide, a crystalline, grey powder, is available in 2-10% concentrations as grain or sugar-based baits in a powder, pellet, tablet, or paste formulation.2 Trade names of some of the commercially available zinc phosphide products include: Gopha-Rid, Gopher Bait II, Rodenticide AG, This is the Way, Prozap, Hopkins, and Sweeney’s Poison Peanuts Mole.2 Formulations of phosphides have a unique, distinctive odour similar to rotten fish, garlic, or acetylene.2 You should care about this type of rodenticide because it is potentially poisonous to you, your pet owner, and clinic staff too!

The toxic dose of zinc phosphide in dogs is approximately 20-40 mg/kg, but up to 300 mg/kg on empty stomachs.3 With zinc phosphide, the administration of food (e.g., bread, milk, etc.) is contraindicated, as it may potentially release gastric acid, promoting hydrolysis and further production of phosphine gas.3 Phosphide rodenticides result in the production of phosphine gas. When zinc phosphide combines with gastric acid or moisture (or the presence of food!), liberated phosphine gas is rapidly absorbed across gastric mucosa and distributed systemically, where it exerts its toxic effect. Phosphine gas is considered

TECHNEWS | VOLUME 37 ISSUE 1

a corrosive and a direct irritant to the gastrointestinal tract (GIT). Clinical signs can be seen within 15 minutes to 4 hours; death has been reported within 3-48 hours.3 Clinical signs include severe gastrointestinal (GI) signs (e.g., vomiting, bloat, abdominal pain, hematemesis, melena, etc.), CNS signs (e.g., tremoring, seizuring, death), and rarely, cardiopulmonary signs (e.g., pulmonary edema, tachypnea, pleural effusion, etc.) or organ dysfunction.3 Zinc phosphide also carries a public health risk. Emesis â&#x20AC;&#x201C; whether intentionally induced or occurring due to clinical signs - can result in poisoning to the pet owner or the veterinary professional secondary to exposure of phosphine gas. Clinical signs of nausea and difficulty breathing have been reported in humans exposed. To minimize these risks, emesis induction should always be performed in a well-ventilated area (e.g., opening the car window if the patient vomits or inducing emesis outside). Pet owners should be appropriately educated on the toxic gas exposure to themselves also. Pet owners should be informed not to feed their pet to prevent further production of phosphine gas.

In addition, the administration of an antacid (e.g., aluminum hydroxide) prior to emesis induction may help decrease the presence of phosphine gas. With recent ingestion in an asymptomatic patient, the use of emesis induction (following antacid administration) and one dose of activated charcoal with a cathartic is warranted to minimize toxic effects of zinc phosphide. Symptomatic supportive care, including anti-emetic therapy, IV fluid therapy, gastric protectants, and analgesics are warranted.

Cholecalciferol

Cholecalciferol, the chemical name for vitamin D3, is one of the most deadlyâ&#x20AC;&#x201C; and costly â&#x20AC;&#x201C; rodenticides to pets. Ingestion of toxic levels of cholecalciferol can result in severe hypercalcemia and hyperphosphatemia, with secondary acute renal failure (ARF) developing as a result of dystrophic mineralization to the soft tissue and kidneys. Common sources of Vitamin D3 include over-

TECHNEWS | VOLUME 37 ISSUE 1

the-counter (OTC) or prescription vitamins (typically found in a calcium/Vitamin D3 combination), psoriasis creams (in the form of calcipotriene), and rodenticides. With cholecalciferol-containing rodenticides, only a tiny amount of rodenticide needs to be ingested before clinical toxicosis occurs due to a very narrow margin of safety within these products. In dogs, cholecalciferol has an LD50 of 85 mg/kg (based on the rodenticide concentration of 0.075%).4 Doses of Vitamin D3 > 0.1-0.5 mg/kg can result in clinical signs and hypercalcemia, respectively.4 Typically, clinical signs often do not develop for 1-3 days until the patient has already developed clinical signs of ARF.4 That said, renal failure can occur within 12-36 hours following toxic ingestion. Clinical signs and clinicopathologic findings include increased thirst and urination, weakness, lethargy, anorexia, vomiting, generalized malaise, uremic halitosis, dehydration, hypercalcemia, hyperphosphatemia, azotemia, melena, hemorrhagic diarrhea, and death.4 Aggressive treatment must be initiated with cholecalciferol toxicosis, due to the narrow margin of safety. Decontamination should include emesis induction, if ingestion was recent and the patient is asymptomatic. As cholecalciferol undergoes enterohepatic recirculation, the administration of multiple doses of activated charcoal (without a cathartic) is warranted q6 hours X 24 hours.

Additional treatment includes the aggressive use of IV fluid therapy to promote calciuresis (e.g., 0.9% NaCl), calcium monitoring, gastrointestinal support (e.g., anti-emetics, H2 blockers, sucralfate, phosphate binders, etc.), and the use of medications to increase calciuresis (e.g., prednisone, furosemide) and prevent hypercalcemia (e.g., pamidronate, calcitonin). Treatment is often expensive, and requires hospitalization for an extended period of time. Most patients are continued on oral furosemide and prednisone for weeks, following discharge from the hospital.

Frequent monitoring of renal function and electrolytes is imperative. Calcium, phosphorous, BUN, creatinine, and ionized calcium should be evaluated every 12-24 hours while

hospitalized, and then every 2-3 days thereafter for the next 2-4 weeks. This will allow one to assess the ability to titrate the prednisone and furosemide therapy, and to ensure that the patient does not develop secondary ARF [or potentially chronic renal failure (CRF)].

Even with aggressive treatment, CRF may be a secondary sequela.

Long-acting anticoagulants (laac)

First and second generation LAAC anticoagulants result in inhibition of Vitamin K epoxide reductase, resulting in inactivation of clotting factors II, VII, IX, and X. First generation rodenticides (e.g., warfarin, pindone)5 have been largely replaced by more potent second generation anticoagulants (e.g., brodifacoum, bromadiolone, diphacinone, chlorophacinone, etc.).5 Second generation LAACs are more recently developed and are generally considered to be more toxic with a longer duration of action (requiring a longer duration of treatment compared to first generation anticoagulants).5 Each individual LAAC varies in the margin of safety and LD50. Some have very narrow margins of safety (e.g., brodifacoum), while some have very wide margins of safety (e.g., bromadiolone). When in doubt, the toxic dose should be calculated, or Pet Poison Helpline contacted to determine if a toxic dose has been ingested. Finally, keep in mind that species differences exist; cats are much more resistant to the affects of LAAC as compared to dogs.

39

CANINE LD50

FELINE LD50

Difethialone:

4 mg/kg

> 16 mg/kg

Brodifacoum:

0.25-4 mg/kg

25 mg/kg

Bromadiolone

11-20 mg/kg

> 25 mg/kg

Diphacinone:

3-7.5 mg/kg

> 15 mg/kg

When a toxic ingestion of LAAC has occurred, prolongation in coagulation factors [prothrombin (PT) or activated partial thromboplastin time (aPTT)] is not seen for 36-48 hours, as based on the half-life of factor VII. Clinical signs typically do not develop for 3-5 days. Clinical signs are due to clotting factor depletion, resulting in generalized hemorrhage. The most common clinical signs include lethargy, exercise intolerance, inappetence, pallor, dyspnea, coughing, hemoptysis, etc. Hemoabdomen, hemothorax, pericardical effusion may also occur. Rarer clinical signs include gingival bleeding, epistaxis, ecchymoses, petecchia, hematuria, bleeding into the subcutaneous space or joint space, and melena.5 Errors are often made by veterinary professionals when it comes to the medical management of LAAC rodenticides. While it is often appropriate to decontaminate a patient with emesis induction and activated charcoal administration, with non-toxic ingestions (based on the LD10), this is often unnecessary (unless the patient is neonatal, geriatric, has an underlying hepatopathy, or has previously ingested a LAAC before). Next, the administration of a “one-time,” parenteral injection of vitamin K1 at the time of decontamination is unnecessary and potentially detrimental.

First, vitamin K1 is more quickly absorbed orally than parenterally (particularly with a fatty meal). Another reason why the “onetime shot” should be avoided is because it will skew point-of-care, accurate blood results of the PT test. As factor VII has the shortest half-life, PT will be the first blood test to be prolonged with LAAC ingestion; however, this prolongation of the PT will not normally occur until approximately 36-48 hours post-LAAC ingestion. Testing prior to this time is unnecessary (unless the patient has been chronically ingesting a LAAC over several days), as the PT will be normal prior to 36-48 hours. By administering a “one-time shot” of Vitamin K1 therapy, the patient’s PT will be falsely normal at 48 hours, and instead, the patient will be coagulopathic days

40

later (3-5 days, instead of 2 days). Normally, clinical signs of acute, LAAC toxicosis typically occur at 3-5 days post-ingestion. With a “one-time shot,” the patient will bleed out at 5-7 days instead of 3-5 days!

When treating LAAC rodenticides, two considerations for treatments should be utilized.

1) With an acute, one-time ingestion of a LAAC, one can decontaminate and check a PT 48 hours post-initial ingestion. If the PT is prolonged at 48 hours, 3-4 weeks of Vitamin K1 therapy should be initiated (3-5 mg/kg PO, divided q24-12h X 4 weeks). A recheck PT should be performed 48 hours after the last dose; if prolonged, an additional 2 weeks of therapy is indicated, with another PT performed 48 hours after the last dose OR 2) With an acute one-time ingestion of a LAAC, one can just prophylatically treat with Vitamin K1 therapy, particularly if the patient is young, debilitated, geriatric, or has underlying liver pathology. Treatment includes Vitamin K1 therapy (3-5 mg/kg PO, divided q24-12hSID-BID X 4 weeks), with a recheck PT being performed 48 hours after the last dose; if prolonged, an additional 2 weeks of therapy is indicated, with another PT performed 48 hours after the last dose.

REFERENCES 1. Adams CA. Bromethalin. The Five-Minute Veterinary Consult Clinical Companion: Small Animal Toxicology. Ames, IO: WileyBlackwell. pp 769-774.

2. Gray SL, Lee JA, Hovda LR, et al. Potential zinc phosphide rodenticide toxicosis in dogs: 362 cases (2004-2009). Accepted J Am Vet Med Assoc, pending publication.

3. Gray S. Phosphides. The Five-Minute Veterinary Consult Clinical Companion: Small Animal Toxicology. Ames, IO: WileyBlackwell. pp 781-790.

4. Adams CM. Cholecalciferol. The FiveMinute Veterinary Consult Clinical Companion: Small Animal Toxicology. Ames, IO: Wiley-Blackwell. pp 775-780.

5. Murphy M. Anticoagulants. The FiveMinute Veterinary Consult Clinical Companion: Small Animal Toxicology. Ames, IO: Wiley-Blackwell. pp 759-768.

Clinical application:

1. You don’t typically need to bother testing the patient’s PT while they are on chronic Vitamin K1 administration – it will be normal while on therapy (unless the owner is not appropriately administering it)!

2. In dogs ingesting LAACs chronically, there is the risk of potential accumulation within the body. Any “second” exposure should be prophylactically treated with oral Vitamin K1 therapy for the appropriate duration of time.

3. Vitamin K1 should not be administered intramuscularly (IM) or IV. If you suspect a patient is coagulopathic, administer into a vascular muscle bed (IM) can result in a large hematoma within the muscle. Also, intravenous administration of Vitamin K1 can result in anaphylactic shock. Rather, critically ill, actively bleeding dogs should be stabilized with frozen plasma (FP) or fresh frozen plasma (FFP) concurrently.

TECHNEWS | VOLUME 37 ISSUE 1

Investigate the provincial association’s web sites for details on other continuing education opportunities.

Leadership Wellness Plans for Practice Success

University of Guelph, Equine Veterinary Technician Certificate

This hands-on day will focus on practical leadership tips and tools that participants will be able to utilize in their practice environments – tomorrow.

Heather, Senani, and Lorna will tackle three important leadership challenges: 1. Hiring the right people, “onboarding” and assessing for success and fit; 2. Providing motivation, coaching and feedback to inspire; 3. Managing conflict

Equine Veterinary Technician Certificate is an equinespecific professional development program. It is designed to provide a combination of online research and evidencebased courses with laboratory practicums to build the knowledge and skills that you need to integrate into your practice as a Veterinary Technologist.

Sponsored by Hill’s Pet Nutrition and IDEXX Laboratories November 16, 2013, 9:00 AM – 4:00 PM

Canine Semen Preservation and Breeding / A.I. Management Seminars Breslau, ON - Nov. 10-11, 2013

University of Guelph, ON - Courses Scheduled between Aug. 2013 and May 2014.

Learn With Bayer This web site offers a complete menu of learning opportunities for Registered Veterinary Technicians including their popular PSI (Parasite Scene Investigators) series.

Sponsored by Bayer Animal Health For more info visit www.learnwithbayer.ca

Facilitator

Dr. John P. Verstegen, DVM, MSc, PhD., DECAR, Director of International Small Animal Reproduction

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Now offer convenience and safety "all-in-one" to help build compliance

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Intervet Canada Corp., 16750 Transcanada, Kirkland, Québec H9H 4M7 Caninsulin is a registered trademark of Intervet International B.V. Used under license.

Merck Animal Health, 42 operating in Canada as Intervet Canada Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. MERCK is a trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. Copyright © 2012 Intervet International B.V., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. All rights reserved.

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TECHNEWS | VOLUME 37 ISSUE 1

Did You Know?

Cats are able to squeeze through narrow spaces because they don’t have a rigid collarbone to block their way. A cat’s whiskers -- super-sensitive, specialized hairs -- spread roughly as wide as a cat does, helping the animal to judge which nooks and crannies are worth trying. But whiskers don’t grow longer as a cat gets wider, which can lead some corpulent cats into sticky situations.

In most species of parrots kept as pets, the only way to tell males from females is with a DNA test or surgical sexing.

That’s not the case with the Eclectus parrot: Males are a vivid kelly green, while females sport feathers of bright red and royal blue.

Americans spend about $500 on average, or 1 percent of their annual budgets, on their pets. Statistics released by the U.S. Bureau of Labor Statistics reveal that people ages 55 to 64 and couples without children are most likely to spend money on pets and their care, dedicating hundreds of dollars more per year than people in their 20s and 30s. While the spending accounts for $61.4 billion last year, it wasn’t all for health care: One-fourth of all pet owners admitted skipping veterinary visits for wellness care or other pet needs.

Atopic or allergic dermatitis most common canine health condition in 2012. VPI reveals top 10 canine, feline veterinary diagnoses:

Dog

Cat

1. Atopic or allergic dermatitis

Feline cystitis or FLUTD

2. Otitis externa

Periodontitis/dental disease

3. Pyoderma/hot spot

Hyperthyroidism

4. Benign neoplasia

Chronic renal disease

5. Gastropathy

Gastropathy

6. Osteoarthritis

Diabetes mellitus

7. Enteropathy

Enteropathy

8. Cystitis or UTI

Cystitis or UTI

9. Periodontitis/dental disease

Lymphosarcoma or lymphoma

10. Soft tissue trauma

Feline upper respiratory infection

recognizing their own reflections, they are able to use other information seen in the mirror, such as identifying the location of food placed behind them.

That doesn’t necessarily mean other animals aren’t intelligent enough to know when they run across other signs of themselves. The animals who “pass” the mirror test rely on vision as their primary sense.

When a cat or dog first sees his image in the mirror, he often reacts as if a strange animal suddenly appeared. But when the image doesn’t pass the “sniff test,” the pet generally decides to ignore it for good.

Animals do recognize their own urine smell, however, as anyone who has ever walked a male dog knows. Checking “pee-mail” and hitting “reply all” with your own scented urine is a priority in any male dog’s to-do list. As animals who rely more on their sense of smell than vision, dogs believe that when one contradicts the other, what the nose knows goes, every time. (veterinary partner) State of Pet Health in 2013 Here are some quick stats gleaned from the recently released State of Pet Health 2013 as compiled by the Banfield Pet Hospital from their database of 2.2 million dogs and 500,000 cats: • Since 2002, life spans are up 10% for cats and 4% for dogs • Since 2007, arthritis is up 67% in cats and 38% in dogs • Excess body weight - Cats >5 years of age: 90%; Dogs >5 years of age: 37% • Top disease for both dogs and cats: Dental disease: Dogs - 91% have it, Cats - 85% have it

(dvm360)

A top racing greyhound running at full speed can hit 43 mph. Racehorses can go just a little faster. The cheetah can smoke them both, though, hitting 70 mph in full flight. (veterinarypartner.com) The Maine Coon Cat is thought to have the highest incidence of extra toes among all feline breeds. The condition is known as “polydactyl,” and is considered a harmless and even endearing genetic mutation.

What do dogs see when they look in the mirror?

In psychology circles, the mirror test is considered an important evaluation of self-awareness in animals and a sign of the normal development of cognitive skills in children.

Humans are typically 18 months old before they are able to recognize themselves in the mirror. Among animals, only higher primates, dolphins, orcas, elephants and, surprisingly, European magpies are currently known to recognize that what they see in a mirror is a reflection of themselves. Even more interesting, perhaps, is that while pigs show no sign of

If you only see the boy and his dog, you’re missing something.

You’re missing the eggs and larvae that dogs shed when they have fleas. Adult fleas only represent 5% of a flea infestation – the other 95% are eggs, larvae and pupae that hide in beds, carpets and floors.

Recommend Sentinel for flea control, heartworm prevention and intestinal worm protection, and you won’t miss a thing. For more information about Sentinel call 1-800-387-6325.

© 2012 Novartis Animal Health Canada Inc. ® Sentinel is a registered trademark of Novartis Animal Health Canada Inc. ® Flavor Tabs is a registered trademark of Novartis AG – Novartis Animal Health Canada Inc., licensed user.

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