The RVT Journal (formerly TECHNEWS) -- Fall 2014 by Ontario Association of Veterinary Technicians

REGISTERED VETERIN ARY TECHNICIAN

FALL 2014 VOLUME 38 ISSUE 1

THE

ASSOCIA TI O

T VE

R T R

IN IC N AR Y T E C H

Proudly published by the Ontario Association of Veterinary Technicians (OAVT)

Love your job! Celebrate National Veterinary Technician Week (NVTW) October 12-18.…page 19

JOURN AL

REG ISTERED VETERIN ARY TECHNICIAN

JOURN AL

FALL 2014 VOLUME 38 ISSUE 1

THE

ASSOCIA T

T VE

R T R

IN IC N AR Y T E C H

Proudly published by the Ontario Association of Veterinary Technicians (OAVT)

Love your job! Celebrate National Veterinary Technician Week (NVTW) October 12-18.…page 19

Special to this issue:

Crystal Brear, RVT and Chip are celebrating NVTW week with an RVT seal tattoo.

Welcome to The RVT Journal

Focus on NVTW: The RVT profession is gaining ground and recognition thanks to committed RVTs who take the time to share their stories. Find out 8 ways you can help celebrate National Veterinary Technician Week (NVTW).....................................................................................

(formerly TECHNEWS) Our team is working hard to bring Canadian RVTs all the great content you loved in TECHNEWS, with a new name, and a new look. Thanks for reading – and for joining us in celebrating the RVT profession!

Regular columns:

Thank you to the 2014 sponsors of OAVT’s annual conference! Your support makes continuing education better and more accessible across Canada. Thank you for supporting a series of outstanding learning opportunities for RVTs through the OAVT. Gold Merial

Platinum Hill’s Royal Canin Bayer Zoetis

Bronze Ceva Virbac P&G Pet Care Veterinary Purchasing

Silver The Personal

The 37th Annual OAVT Conference & Trade Show has been confirmed for February 26-28, 2015 at the Scotiabank Convention Centre in Niagara Falls. Thanks to our contributors this issue! Nancy Brock Tracey Firth Lynn R. Hovda Tyne K. Hovda Gary Landsberg

Vo l unte eri ng Helping animals and their people...........................................................

An es the si a The F circle breathing unit ......................................................................

Be ha vi ou r Meeting the behavioural needs of the indoor cat ..................................

Ca re er Professional attitude: Own it ..................................................................

Fin anc e Disability Savings Plans: An easy way to help someone you love ........

Poi s on in g Soaps, detergents and fabric softeners .................................................

Pro fes s ion a lis m & E thi c s RVT's status revoked for professional misconduct.................................

Chris Robinson Rebecca Rose Jinelle Webb Colleen Wilson Cheryl Yuill

RVT R oun dup .............................................................................................

36 38

The RVT Journal team Lynn Chudleigh (layout) Lisa McLean (editor-in-chief) Shirley Visser-Meier (technical editor) Thank you to our volunteer reviewers: Gemma Bell, Marg Brown, Tine Curran, Jillian Gordon, Julie Lawrence The RVT Journal is a quarterly national publication with three CE articles in each issue delivered directly to your door! The Ontario Association of Veterinary Technicians (OAVT) 100 Stone Road West, Suite 104 Guelph, Ontario Canada N1G 5L3

Continuing Education (CE) articles in this issue: CE1

CE article #1 – Gastrointestinal and esophageal foreign bodies in the dog and cat Dr. Jinelle Webb, DVM, explains blockages along the intestinal track. ................................................6

CE2

CE article #2 – Making sense of medications: Tracey Firth, Programs Director, Canadian Animal Health Institute (CAHI) offers insights on understanding the animal health product regulatory process. .......................................................

CE article #3 – Developing a protocol manual for an animal shelter Most shelters run on the commitment of dedicated volunteers who have varying levels of veterinary medical experience. Dr. Cheryl Yuill, DVM, discusses the importance of a good policy manual. ................................................................................................................................................

CE3

Making information, education, industry

news and career opportunities available to technicians - everyday and everywhere!

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Don’t forget – RVTs can gain valuable CE credits by completing CE quizzes in The RVT Journal. Simply visit www.oavt.org for more details. Want to write CE articles for The RVT Journal? We are particularly interested in helping RVTs share their knowledge! Send your ideas to The RVT Journal technical editor Shirley Visser-Meier at Shirley@oavt.org.

Vol u n tee rin g

Helping animals and their people by Chris Robinson, RVT, Executive Director CAAT

keep him warm and talked to him to let him know she was there. She and her whole family stayed with him for the rest of the afternoon until he was ready to go home. The next day, as we prepared for another long day of helping medical and surgical patients, I saw the same woman patiently standing in line again, this time without Peanut. I immediately went over to ask if he was okay. Her face opened up into a big smile, she said he was doing very well and she was extremely happy she had brought him to us. She knew that he was going to be healthier because of the care he had received. Her face opened up into a big smile, she said he was doing very well and she was extremely happy she had brought him to us. She knew that he was going to be healthier because of the care he had received. As I looked across the large gymnasium where we had set up our temporary MASHstyle hospital, I saw the lineup of people with their pets growing. We were in for a busy day. I was lucky enough to be part of the Canadian Animal Assistance Team (CAAT), a volunteer veterinary team that travels to communities to provide veterinary services for low-income families. I was well aware of the fact that animal overpopulation and disease issues are common concerns where veterinary care is not routinely available, and it has a devastating effect on animal welfare. I was there to be part of the solution. As I scanned the growing line of people and pets of various sizes and types, I noticed an older lady with a very tiny white dog in her arms. She held him very close and was patiently waiting for her turn. She told me his

name was Peanut, and he was there for his vaccination and surgery. After examining him I discovered he was a cryptorchid. I explained that there are definite health risks with this condition that can be quite serious. She was very nervous about surgery but after reassuring her that we would do all we could to ensure his safety, she looked at me with trusting eyes and very carefully handed him over to me. I took him into my arms with great care and looked into her eyes to let her know I understood how important he was to her. After a successful surgery Peanut was moved into our recovery area, which was also where I was assigned to work for the day. I called his owner over and set up a chair for her so she could sit with him. She was so relieved and delighted to have her little friend back in her arms. She snuggled him in a blanket to

4 The RVT Journal

She told me that she was waiting in line so she could properly thank us. The night before, once they had returned home, her daughter had explained to her that our entire team of people were volunteering our time, had paid our own way to the community, and fundraised so we could provide our services. She told me that she and her family decided at the dinner table that they would all contribute what they could. She had come to bring a donation to our organization to thank us for what we had done. I was speechless. Watching that family leave, so happy that they were able to provide what was needed for their little dog, I couldnâ&#x20AC;&#x2122;t help but smile. I became involved in this organization to contribute to the welfare of the animals. However, moments like this prove to me that helping the animals, helping the people and helping the community as a whole are all undeniably intertwined. On our last day, our team packed up our hospital supplies and equipment to leave the

Helping Animals and their people...continued

gymnasium as we found it. It looked like we

I was sad to leave that wonderful community

were never there. However, I know that out in the village, and in the homes in the surrounding countryside, in the animal shelters and the pound, it will be very evident for a long time.

and move on but there are countless other communities in need that are at the same point this one was at four years ago. We need to start our work elsewhere. I have no doubt that in every place, I will meet people just like Peanut’s owner, who love their pets, want to help their pets and just need the opportunity to be able to do so.

Since we started our annual clinics here four years ago, the impoundment rate at the local pound has decreased by 75 per cent and the local rescue group’s intake has decreased 50 per cent. The overpopulation issues that were overwhelming were brought under control. The local animal welfare groups will continue to work to maintain what we started.

If you are interested in becoming involved with the Canadian Animal Assistance Team, go to www.caat-canada.org to learn more and to become a member! We are always in need of new members, and RVTs are invaluable!

The Canadian Animal Assistance Team (CAAT) is a group of veterinary technologists, veterinary assistants, veterinarians and people passionate about animal welfare, dedicated to providing veterinary medicine and humane education in support of needy animals worldwide. www.caat-canada.org and https://www.facebook.com/CAAT.Canada

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5 The RVT Journal

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CE CE articles help RVTs earn credits toward their RVT certification. Correctly answer the quiz associated with this article to earn one CE credit.

ARTICLE #1

Gastrointestinal and esophageal foreign bodies in the dog and cat By Jinelle Webb, DVM, DVSc, Diplomate ACVIM Internal Medicine Dept, Mississauga-Oakville Veterinary Emergency Hospital and Referral Group Adjunct Professor, Ontario Veterinary College

www.thervtquizzes.ca/login.pl

However much we try, our dogs and cats like to eat things that they should not. In some cases, even items that they are given, such as a rawhide or chew, can get stuck somewhere along the gastrointestinal tract. Dogs and cats with gastrointestinal foreign bodies most commonly present with vomiting and decreased appetite, although some may present with lethargy and abdominal pain. Esophageal foreign bodies often cause regurgitation, cervical discomfort, and in some cases, respiratory distress. If not removed rapidly, foreign bodies of the esophagus and intestine are associated with a high morbidity and mortality. Gastric foreign bodies are best removed quickly, to avoid entrance into the small intestine and possible obstruction. Diagnosis can be made via physical examination, radiography, ultrasonography, and/or exploratory laparotomy. Objects can be removed endoscopically or surgically.

Diagnosis Commonly ingested foreign bodies in dogs include bones, rawhide, toys and balls, greenies, fish hooks, coins, towels, socks, underwear and nylons.1,2,3 Commonly ingested foreign bodies in cats include needles, string, toys, elastics, plastic and hair.1,2,3 In many cases, the owner has witnessed ingestion of the foreign material, or has returned home to find last nightâ&#x20AC;&#x2122;s garbage strewn all over the kitchen. However, sometimes the pet has ingested something out on a walk, or eaten something in the house that is not noticed as missing. Occasionally, foreign body ingestion is not witnessed by an owner in an animal with

no previous history of foreign body ingestion, and yet imaging locates a foreign body within the gastrointestinal tract. Foreign body ingestion should always be a differential diagnosis in the acutely vomiting or inappetent pet, regardless of age and history. Common clinical signs associated with esophageal foreign bodies include retching, regurgitation of food and water, ptyalism, anorexia, restlessness and cervical pain.2,3 Less common presenting complaints include dyspnea, cough, and lethargy.2,3 Clinical signs of gastrointestinal foreign bodies may be less pronounced than with esophageal foreign bodies, and may be intermittent. Clinical signs can include vomiting, hematemesis, anorexia, lethargy, abdominal pain, or the foreign body may be an incidental finding.2,3 Physical examination may reveal ptyalism and cervical discomfort in pets with an esophageal foreign body. Gastrointestinal foreign bodies may have a normal abdominal palpation, or there may be a suspicious region felt or painful area noted.3 Electrolyte abnormalities are common with gastrointestinal foreign bodies, including, in order of most to least common, hypochloremia, metabolic alkalosis, hypokalemia, and hyponatremia; hyperlactatemia is also common.2,3,4

Diagnostic Imaging Radiography can be suggestive or diagnostic in many cases of esophageal and gastrointestinal foreign bodies, especially if metallic. Esophageal foreign bodies are usually visible on plain thoracic radiographs.2,3 An opacity is noted within the esophagus,

6 The RVT Journal

most commonly in the distal esophagus or at the level of the carina. The esophagus proximal to the foreign object is typically dilated with air and sometimes fluid or food. The upper esophageal sphincter is often visible on radiographs and can be mistaken for an esophageal foreign body; it should be noted that esophageal foreign bodies are uncommon in this region. In equivocal cases, a contrast agent can be administered, however there is a relatively high risk of aspiration of the contrast medium if an esophageal foreign body is present. 2,3 It is therefore safer to perform esophagoscopy if there is a suspicion of an esophageal foreign body. Ultrasonography is rarely useful in cases of esophageal foreign bodies. Gastric foreign bodies (other than metallic) can be challenging to definitively diagnose on both radiographs and ultrasound examination, as there is often gas and food material present in the stomach that can cause shadowing and masking of objects by overlying opacities. Barium administration can outline some gastric foreign bodies, but often does not provide a definitive diagnosis. However, both radiographs and ultrasound can strongly suggest the presence of a gastric foreign body. If food and/or gas are present, then imaging can be repeated after a period of fasting, however owners should be counselled that this could allow a potential object to enter the small intestine. Radiography can be useful in some cases of small intestinal foreign bodies. Plain radiographs can reveal a suggestive gas pattern indicating obstruction, and bunching of intestines can be noted in linear foreign bodies

Gastrointestinal and esophageal foreign bodies in the dog and cat...continued

resulting in intestinal plication.3 Abdominal ultrasonography remains the most useful noninvasive method for diagnosis of small intestinal foreign bodies.3.5 In most cases, a shadowing object is noted within the small intestine, typically causing some degree of intestinal dilation at the site of obstruction. The small intestine proximal to the obstruction is usually dilated with fluid, and this can extend to a markedly fluid-distended stomach if the obstruction is in the upper small intestine. The small intestine distal to the obstruction should appear normal. In cases of linear foreign bodies, the small intestine can plicate or bunch around the echogenic foreign material. If a small intestinal foreign body is present for more than a short period, the associated mesentery may be hyperechoic, and associated lymph nodes may be enlarged. If free abdominal fluid is present, this may indicate perforation, and a sample should be obtained for cytology and bacterial culture.2,5 The presence of free abdominal air on radiographs or ultrasound indicates gastrointestinal perforation, the need for immediate surgical intervention, and a guarded prognosis. Colonic foreign bodies are extremely rare due to the increased diameter of the colonic lumen, and the fecal material present. Pins or other sharp objects that have managed to traverse the entire small intestinal tract can become lodged within the colonic wall or rectum. Animals may display no symptoms, or have hematochezia, tenesmus, etc.2 As almost all colonic foreign bodies requiring intervention are metallic, they are easily visualized on radiography, although often several views will be required to definitively determine if they are in the colon or small intestine. Abdominal ultrasound can be useful to visualize the foreign object, although fecal material can create shadowing that makes objects within

the dorsal colonic wall difficult to visualize. However, abdominal ultrasound is useful to rule out colonic perforation leading to septic peritonitis. The administration of contrast material in cases of suspected esophageal and gastrointestinal foreign bodies is often contemplated. As mentioned earlier, this carries the risk of aspiration of contrast material due to the presence of regurgitation/vomiting. If aspirated, barium is Gastric foreign bodies (other than metallic) can be challenging to definitively diagnose on both radiographs and ultrasound examination, as there is often gas and food material present in the stomach that can cause shadowing and masking of objects by overlying opacities.

much better tolerated than iodine-based contrast agents, however both can have longterm consequences if aspirated. If esophageal perforation is suspected, iodine contrast agents are safer than barium.2,3 Contrast administration creates shadowing artifact in the stomach and small intestine (and colon) on abdominal ultrasound, and will therefore reduce the ability of this modality to accurately diagnose a gastrointestinal foreign body. It can create complications at surgical removal of a foreign body, as well. If abdominal ultrasound is available, this imaging modality is preferred over contrast administration.3,5 Contrast administration also limits the ability to visualize objects endoscopically, and can damage the endoscope when suctioned. Attempting to feed animals with suspected foreign bodies should not be performed if radiography, ultrasonography, endoscopy, or surgery is likely.

7 The RVT Journal

Removal of Foreign Bodies The decision on whether to remove the foreign body depends on location, clinical signs, time since ingestion of the item, and size, shape and nature of the foreign body.3 Esophageal foreign bodies require immediate removal in all cases, whereas gastrointestinal foreign bodies may pass through the entire gastrointestinal tract without issue.3 Immediate removal is indicated for large objects, objects with sharp points or sharp surfaces, irregular objects, and causticcontaining material such as batteries or pennies. A discussion about the pros and cons of removal of smaller objects should be performed in all cases, so that owners can make educated decisions about whether to pursue removal.3

Esophageal foreign bodies All esophageal foreign bodies are an emergency requiring immediate removal.3 Delay of even a few hours can greatly increase the chance of esophageal stricture following removal. Foreign material present for an extended time in the esophagus, foreign bodies that have sharp points, and foreign bodies that expand resulting in pressure necrosis, are all at increased risk of esophageal perforation. Greenies are an example of a substance that expands and is at high risk of pressure necrosis, although recent changes to their composition have reduced this risk.6 Esophageal perforation, and requirement for thoracotomy to address an esophageal foreign body, both result in a much higher morbidity, mortality and complication rate.7 However, most esophageal foreign bodies can be removed endoscopically.2 There are a variety of endoscopic grasping forceps, nets and snares that can be used to remove

Gastrointestinal and esophageal foreign bodies in the dog and cat...continued

foreign objects, and ideally several different types should be available. Occasionally, a urinary catheter with an expandable balloon can be endoscopically-placed beyond the foreign object, at which point the balloon can be expanded and then used to pull the foreign body rostrally out of the esophagus. Approximately 10% of esophageal foreign bodies cannot be removed orally and are pushed into the stomach; the material can either be digested and passed, or removed via gastrotomy or endoscopic removal from the stomach.2,3

object can be sheathed in a protective covering for endoscopic removal (baby bottle liner technique). If a very large object, or an object with a very smooth, round surface (such as a smooth rock), is present, then gastrotomy may be indicated. If an object is anchored in the stomach but extends beyond the proximal duodenum, then endoscopic removal may not be indicated. As for esophageal foreign bodies, having a large number of different endoscopic removal devices will increase the chance of removal. Most gastric foreign bodies can be removed rapidly and without complication.

Difficulty ventilating a patient post removal may indicate esophageal perforation and pneumothorax. This is a medical emergency, and immediate thoracocentesis is required once the condition is diagnosed radiographically. After removal, if a perforation is suspected based on the endoscopic appearance of the esophagus, or due to the nature of the foreign object (i.e., a sharp point), then thoracic radiographs should be performed prior to recovery. Esophageal perforation requires immediate thoracotomy and surgical intervention, and the prognosis for recovery is guarded.

Gastrotomy is a relatively simple procedure to remove foreign material. The stomach should be packed off, and stay sutures used to elevate the stomach. Once all material is removed, gloves should be changed prior to closure of the stomach. The small intestine should be thoroughly evaluated in case there are additional foreign bodies present. Complications associated with a gastrotomy performed to remove a foreign object are uncommon but can include dehiscence and septic peritonitis.[Hayes]1

Small intestinal foreign bodies Gastric foreign bodies The majority of gastric foreign bodies can be removed endoscopically. However, there are specific indications for gastrotomy. If a large number of foreign objects are present, then endoscopic removal will require a longer anesthetic time, and there could be damage to the esophagus with a large number of objects being removed individually, therefore gastrotomy is indicated. If an object has a very sharp surface (such as a razor blade) or sharp point (such as a fish hook), endoscopic removal may pose too high a risk to removal through the esophagus. In some cases, the sharp

Enterotomy is indicated when a small intestinal foreign body has been diagnosed. [Tams, Washabau]2,3 Endoscopic removal of small intestinal foreign bodies is rarely successful and therefore very rarely indicated. [Washabau]3 For a single, focal small intestinal foreign body, one enterotomy can be performed, which is typically a relatively quick procedure. However, many cases will present with multiple foreign bodies, which require several enterotomies. Linear foreign bodies often require multiple enterotomies to remove them safely. Some cases may present with longer standing foreign bodies, linear foreign bodies, or foreign bodies that result in

8 The RVT Journal

circumferential pressure necrosis (such as a corn cob), In these cases, there may be areas of intestine with substantial damage from pressure necrosis or excessive plication, which may require resection and anastomosis. Complications are uncommon after enterotomies and resection/anastomosis, but include dehiscence and septic peritonitis.1 If a large amount of small intestine is removed, then small bowel syndrome can develop. As with gastrotomies, once the foreign material is removed, the entire gastrointestinal tract should be evaluated for additional foreign material.

Colonic foreign bodies Colonoscopy remains the most effective and least invasive method of removal for colonic foreign bodies. Colonotomy is avoided if at all possible due to the potential for contamination of the abdominal cavity. However, if radiography or abdominal ultrasound evaluation suggests complete perforation of the colonic wall, or septic peritonitis, then exploratory laparotomy is indicated.

Post-procedure recovery Esophageal foreign bodies Immediately after removal of the esophageal foreign body, the esophagus should be evaluated for damage. Stricture formation is most likely if substantial circumferential damage is present.3 Even deep ulcers, if present in only a focal region, will likely heal without stricture formation. Percutaneous endoscopically-placed gastrotomy tubes (PEG tubes) are rarely indicated after removal of an esophageal foreign body, and there is anecdotal evidence that the passage of food through the site of the previous esophageal

Gastrointestinal and esophageal foreign bodies in the dog and cat...continued

foreign body may reduce the formation of a stricture. Typical medical therapy includes a histamine-2 antagonist or proton-pump inhibitor, sucralfate, and feeding gastrointestinal canned dog food as soon as possible after retrieval. If there is deep ulceration present, delaying feeding for 24 hours is recommended. Medical therapy is continued for typically for 3-7 days, depending on the degree of damage noted. Most cases can be discharged the same day or next day. In cases with a potential for stricture formation, or any cases that present with regurgitation, ptyalism, or cervical discomfort after esophageal foreign body removal, repeat endoscopy is recommended approximately 5-7 days after removal to assess for esophageal stricture formation.

Gastric and colonic foreign bodies removed endoscopically

Gastrointestinal foreign bodies removed surgically

Immediately after removal of the gastric or colonic foreign body, the stomach or colon should be evaluated for additional foreign material and damage. All air and fluid should be suctioned prior to completion. Typical medical therapy for gastric foreign bodies includes a histamine-2 antagonist or protonpump inhibitor and sucralfate; a special diet is not usually required. If there is deep ulceration present, delaying feeding for 24 hours is often recommended. Medical therapy is continued for typically for 3-7 days, depending on the degree of damage noted. There is no specific medical therapy for colonic foreign bodies post endoscopic removal; occasionally antibiotic therapy may be pursued if deep penetration of the colonic wall is suspected. Most cases of gastric or colonic foreign body can be discharged the same day.

Post gastrotomy or enterotomy, pets should receive adequate analgesia, appropriate antibiotic therapy (cefazolin or similar), a histamine-2 antagonist or proton-pump inhibitor, sucralfate if indicated, and be fed a gastrointestinal canned dog food. Feeding should be delayed at least 12-24 hours after gastrotomy or enterotomy. Medical therapy is continued for typically for 7-10 days. Most cases can be discharged 1-2 days after surgery. Pets should be monitored closely for evidence of pain, fever, vomiting and inappetence, and should be seen immediately if any of these symptoms develop.

Esophageal foreign bodies require immediate removal in all cases, whereas gastrointestinal foreign bodies may pass through the entire gastrointestinal tract without issue.

Figure 1a â&#x2013; Lateral thoracic radiograph revealing a gastroesophageal foreign body (bone) in a Shih Tzu.

9 The RVT Journal

Figure 1b â&#x2013; The foreign body (Figure 1a) visualized in the esophagus endoscopically. The foreign body was removed with a snare via flexible endoscope.

Gastrointestinal and esophageal foreign bodies in the dog and cat...continued

Figure 2a ■ Lateral thoracic radiograph showing a large esophageal foreign body (bone).

Figure 3a ■ Ultrasound examination showing a large, shadowing foreign object in the stomach of a Doberman puppy. The dog had been seen ingesting the foam pad used to support his ear post-cropping; the object was retrieved endoscopically.

Figure 2b ■ Lateral abdominal radiograph revealing a foreign body (large hairball) in a cat, causing vomiting and anorexia.

Figure 3b ■ Ultrasound examination Figure 4a ■ Mild, patchy but circumferential showing a shadowing foreign body (sock) in erosion after removal of a distal esophageal the small intestine of a mature Standard foreign body. Poodle; the small intestine distal to the foreign body (right side of image) returns abruptly to normal.

Figure 4b ■ Deep, focal ulceration after removal of a sharp, bony esophageal foreign body.

Dr. Jinelle Webb Dr. Jinelle Webb completed her Small Animal Internal Medicine Residency and DVSc in 2005 at the Ontario Veterinary College, and obtained board certification with the American College of Veterinary Internal Medicine that year. In 2006, Dr. Webb started the Internal Medicine Service at the Mississauga-Oakville Veterinary Emergency Hospital. Dr. Webb has also spearheaded the rotating internship and Internal Medicine residency programs at this practice. She is an Adjunct Professor at the OVC. Dr. Webb's main clinical research interests include: investigating the use of laboratory testing and non-invasive imaging modalities in healthy dogs and cats, developing novel approaches to internal medicine procedures and investigating ways to reduce the invasiveness of procedures. She is a published author and speaker.

Full references for this publication are available at www.oavt.org. 10 The RVT Journal

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Anasthesia

The F circle breathing circuit By Nancy Brock, DVM, Dip ACVA

Many of you now use the convenient and lightweight F breathing circuit for gas anesthetic delivery. This is the circuit with the green or blue hose traveling within a clear outer corrugated hose. It is sometimes referred to as a coaxial circuit. The term coaxial refers to the hose-within-a-hose design. The F circuit is similar in appearance to the Bain circuit, another example of a coaxial breathing circuit. However, although it looks like a Bain non-rebreathing (non-circle) circuit, it is a rebreathing (circle) circuit designed to attach and function with an absorber canister whereas the Bain is intended to be used without the absorber canister. The F circuit was conceived and designed for human anesthesia in order to reduce the degree of hypothermia that anesthetized patients experience. It was thought that by having inhaled and exhaled gases travel close to each other, you could transfer the heat from the exhaled gas (at body temperature) to the inhaled gas (at room temperature) and help a patient stay warm. The lightweight, compact single limb of the circuit was also considered to be an asset.

There are a few other important features of the F circuit that you should be aware of in order to use it safely and effectively in veterinary anesthesia:

1. I have a suggested maximum patient size for this circuit: If you place a 9.5 mm or larger endotracheal tube (ett) in a patient’s airway, you should not use the F circuit but rather deliver gas anesthesia through the traditional re-breathing circuit with a Y piece. The inner hose of the F circuit has the diameter of a 9.5 mm ett. If the patient’s airway is wider than that, the patient will encounter resistance to gas flow through the inner F circuit hose. The larger the patient, the more pronounced the flow resistance. Why might this be clinically important? The resistance might cause a patient to breathe with greater effort. Unfortunately, this breathing effort may erroneously be attributed to an excessively light plane of anesthesia at which point the vaporizer dial setting is often adjusted upward unnecessarily. 2. Just as there is a maximum patient size, so too is there is also a recommended minimum patient size for the F circuit. This is because of the surprisingly large amount of dead space at the patient end of the hose. I recommend the F circuit for

patients above 6 kg body weight because of the significant amount of dead space present. 3. Unlike the traditional circle circuit where both limbs are identical and therefore interchangeable, it is possible to accidentally attach the F circuit onto your breathing circle in a backwards configuration (see photo). Although gas will flow to and from the patient, this backwards setup forces the patient to exhale out through the narrower inner hose causing odd breathing patterns since the narrow hose cannot easily handle the large volume of exhaled gas. To avoid this, simply colour-code the ends of the F circuit hoses and the limbs of the circle with corresponding pieces of coloured tape. Matching up the colours will prevent accidental connection of the inspiratory end of the F circuit to the expiratory end of the circle. To determine which is the inspiratory side of your circle, simply assemble a set of breathing hoses and reservoir bag onto your anesthetic machine, fill the reservoir bag with some

12 The RVT Journal

oxygen and then squeeze the bag. The valve that lifts when you squeeze is positioned on the expiratory side. The other side is the inspiratory side. 4. It is not possible to evaluate the integrity and function of the inner hose of the F circuit. It is hidden inside the outer corrugated hose and not accessible for physical inspection. Furthermore, when you perform a leak test of your circuit, that test does not evaluate the inner hose for leaks. There is in fact, no easy way to evaluate this inner hose. So you hook the F circuit to the anesthetic machine, perform a leak test and hope that the inner hose is not leaking, plugged, twisted on itself (I’ve seen this) or even detached from its anchor point at the tip of the corrugated hose. The only way you can detect a problem with the inner hose is with capnography and clinical observation. The capnograph will detect and display an elevated level of inhaled carbon dioxide (inhaled carbon dioxide levels should be 3 mm Hg or less) despite the fact that your patient is breathing “well” with large and

The F circle breathing circuit ...continued

possibly even rapid breaths. In the absence of a capnograph, you may temporarily disconnect your patient from the F circuit. If the circuit is the source of the patientâ&#x20AC;&#x2122;s breathing problem it will resolve almost as soon as the circuit is disconnected. You may have gathered that I am not a huge fan of the F circuit even though at first, I embraced it as a compact, convenient hose design. As I visited practices to deliver

anesthesia to high risk patients, I found approximately 50% of them had the F circuit installed backwards. I have also consulted with practices that had to deal with intraoperative difficulties that were traced back to a malfunctioning inner F circuit hose. I have not witnessed a significant reduction in the severity of hypothermia in my anesthetized patients with its use. In addition, the amount of dead space at the endotracheal tube adaptor end of the hose is a significant

problem for cats and small dogs under about 6-7 kg. I detected this once I began to use capnography. As time passes, I find myself reaching for the pediatric circle system for my smaller patients and the larger traditional circle system for my larger patients making the F circuits somewhat unnecessary. In future articles we will explore the pediatric circle system and how it differs from the larger adult version.

Nancy Brock

recommends Want to see your pet's pic in print? Submit your photos (500kb or higher) to lisa@oavt.org.

Dr. Nancy Brock obtained her DVM degree from the University of Guelph in 1982. She practiced at Picton Animal Hospital 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, BC, Dr. Brock is a regular contributor and consultant for the VIN (Veterinary Anesthesia Network) and is also a clinical instructor at Douglas Collegeâ&#x20AC;&#x2122;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 via telephone consultation, the in-clinic delivery of anesthesia to high risk or fragile patients and the training of veterinarians and technicians in advanced anesthesia techniques.

13 The RVT Journal

Behaviour

Meeting the behavioural needs of the indoor cat By Colleen Wilson Bsc., DVM, Specialty Training Program ACVB, Gary Landsberg, BSc, DVM, DACVB, dipECVBM-CA

There is some controversy as to whether cats require time outdoors in order to live a behaviourally normal life. In most urban and suburban areas in Canada and the United States it is considered to be in the cat’s best interest (as well as that of the local songbird population) if they are housed indoors. However, if the cat’s basic needs are not addressed, the consequences of living indoors can be deleterious to the owner, the cat, and the pet-owner bond. Normal behaviours that can become problems when cats are kept indoors include: soiling, play biting, counter-surfing, climbing, scratching, or perching in inappropriate locations. Cats may also become destructive and develop negative ingestive behaviours, and/or nocturnal pursuits that do not fit into the owner’s schedule. Therefore veterinarians and staff play a critical role in educating cat owners on normal feline behaviour and how to meet the cat’s behavioural needs.

Elimination: An indoor elimination area chasing a toy may further heighten the cat’s will be required that is desirable for both the owner and the cat. Litter boxes filled with commercial litter will usually do the trick since cats generally prefer to eliminate in a substrate in which they can scratch and dig. However, for some cats the type of litter, the number, size and type of litter boxes, litter cleaning, and litter location, may be issues that need to be addressed to ensure that the box is consistently used.

level of arousal even though the novelty of the toy may quickly wear off. Therefore, two or three toys should be offered at each play session, followed by a small meal or feeding toy to redirect the cat’s attention as well as to simulate prey capture. Training the cat to learn a few simple commands such as come or sit using treats or catnip, also provides a positive form of social interaction as well as an important tool for further communication.

confinement, closing off rooms, or the use of booby traps (e.g. Ssscat motion detector spray, double sided tape, upside down carpet runners) might then be used to help prevent or discourage what is undesirable while encouraging what is desirable. Punishment by the owner should be avoided as it is likely to be ineffective and will weaken the bond between cat and owner. 1. Neville PF, Journal of Feline Medicine & Surgery, Volume 6, Issue 1, February 2004, Pages 43-48.

Feeding: Most cats free feed or are fed a Object play, exploration and few times a day. However, in an outdoor scratching: Cats may also have an interest environment cats hunt, capture, kill and eat about eight mice per day.1 As alternatives to hunting, cat owners can offer toys that require rolling, batting or pawing to release the food. By filling these toys with small measured amounts of food throughout the day, eating will require far greater time, effort and expenditure of mental and physical energy. Food can also be scattered or hidden throughout the home to encourage food seeking activities.

in spending time exploring or playing on their own. Offering shelled walnuts or ping pong balls to bat around, toys that hang from door knobs or play centres and food filled toys (discussed above) can all help to meet this need. For scratching, make sure that the surface texture, location and structure of the scratching post appeal to the cat. Also provide places for climbing and perching, novel objects to explore such as cardboard boxes, and a comfortable bedding area.

Social Interactions: Although there is a Neutering: This is usually a necessity in great deal of individual variability, cats are a social species. Social times with the owner and/or other cats are an important part of the day both for comfort and play. Prey type toys attached to a wand or rope can be dangled and pulled in front of the cat to stimulate prey hunting. However, studies have shown that

males to reduce urine marking, intercat aggression, and a desire to roam, and to eliminate the heat cycles of females. Prevention: Once appropriate outlets have been provided for each of the cat’s behavioural needs, preventive measures including

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This article was co-authored with Dr. Colleen Wilson, BSc, DVM, Resident ACVB and mentored by Dr. Landsberg. Dr. Wilson provides an approved veterinary behaviour specialty training program at Osgoode Veterinary Services (osgoodevet. com). Dr. Landsberg practices veterinary behaviour, by referral, with Dr Sagi Denenberg, at the North Toronto Animal Clinic in Thornhill (northtorontovets.com). Both Dr. Landsberg and Dr. Denenberg are board certified diplomates of the American College of Veterinary Behaviorists and the European College of Animal Welfare and Behavioural Medicine.

ARTICLE #2

Making sense of medications An RVT’s guide to navigating the regulation and approvals of animal meds By Tracey Firth, Programs Director, Canadian Animal Health Institute

CE articles help RVTs earn credits toward their RVT certification. Correctly answer the quiz associated with this article to earn one CE credit. www.thervtquizzes.ca/login.pl

When animals get sick, RVTs are a key part of the health care team to recommend and advocate the use of animal health products. But for many RVTs, the regulation of animal medications in Canada is difficult to understand. Securing and maintaining the license to market a product in Canada requires strict adherence to stringent requirements and is time consuming and costly for medication sponsors. Here’s a rundown of key information you need to know to communicate confidently about the science and safety of animal medications in Canada that may be sold through veterinary clinics.

Big responsibility, huge safety requirements The animal health products administered every day in veterinary clinics, on farm and sold over-the-counter must meet stringent regulatory requirements prior to being approved for sale in Canada. Veterinary drugs are governed by Health Canada – the same federal regulatory authority that oversees human pharmaceuticals. But there are some key differences between human drugs and their veterinary counterparts – chief among them, the size of the industry. While global sales for all (human and animal) in 2011 were estimated at $955 billion (USD)1, the Canadian animal health market is estimated at a fraction – $700 million.

the rest for pets2. The burden of proof for ensuring a product’s safety is much higher for those products used on-farm. Companies are required to conduct additional research and testing that confirms that the product is safe for the person administering it and for the humans eating any meat, milk, or eggs from the animal. A drug’s impact on the environment and whether it will affect the microbial resistance to human drugs are also key considerations requiring thorough assessment.3 Three-quarters of emerging human infections are believed to have originated in animals.

Regulation for veterinary The market for veterinary medicines is not just drugs

many times smaller than its human counterpart – it is also more multi-faceted and fragmented. This adds to the complexity of obtaining (and maintaining) the approval of regulators to market the product. For example, unlike human medicine, veterinary medicines are used in a variety of species, in a range of dosages and formulations. To reflect these variations, companies are required to conduct a variety of studies to meet the needs of each individual species segment and the conditions under which medicines are administered. And, when the product is destined for use in a food-producing animal, that responsibility grows. Globally, about three dollars in five spent on animal health is for farm animals,

The Veterinary Drugs Directorate (VDD), the division within Health Canada that oversees animal drug licensure ensures that product manufacturers meet federal requirements for a product’s safety, efficacy, and quality. That means significant time and cost be directed to research and development. A product’s integrity is only proven through the submission of volumes (often thousands of pages and dozens of studies) of documentation to the VDD. Experts within one of three departments within the VDD assess each element of a submission for (1) human and animal safety, (2) manufacturing and quality control, and (3) efficacy. Table 1

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provides an overview of many of the studies required on the part of a product sponsor when submitting a product to the VDD. Only once the VDD’s independent scientists have been satisfied that the manufacturer’s technical data supports the product’s label claims is a Notice of Compliance (NOC) and DIN (Drug Identification Number) issued.

The significant research investment It is generally accepted that of the nearly 1,500 infectious diseases impacting people, almost two thirds can pass between animals and people. Three-quarters of emerging human infections are believed to have originated in animals4. Discovering, developing, and bringing a new veterinary medicine to market can take up to 12 years and costs can exceed more than US $100 million. It is during this development process that the huge volumes of data establishing the quality, safety, and efficacy of a product are generated5. Sponsors of new medicines must protect their investment because without the ability to make a fair return, innovators and investors will direct their expertise and resources to other areas. Manufacturers are able to protect their inventions through patents which last 20 years. Often however, more than half of a patent life lapses before a product is launched for sale. The delay stems from the time to fully meet commercialization requirements, including

Making sense of medications...continued

carefully controlled safety and efficacy studies and quality characterization, followed by the regulatory assessment.6

Regulatory loopholes & potential impact on animal & food safety Animal drugs are under the authority of the 60 year old Food and Drugs Act, and the Regulations associated with it. While the Regulations are frequently updated, they are primarily targeted at human medicine. CAHI has been trying to address two loopholes in Regulation: Animal-owner Own-Use Importation (OUI) of finished over-the-counter drugs and importation and use of Active Pharmaceutical Ingredients (API) or bulk chemicals by health professionals such as veterinarians and pharmacists. Both of these practices have potential animal safety, food safety, user safety and environmental safety risks associated with them. This is because OUI product or API product and uses have not undergone the third-party assessment undertaken by Health Canada. There is no dispute on the part of our industry that Canadian law does permit the importation and use of unauthorized products by animal owners, however the original intent of Health Canada’s OUI policy was to accommodate visitors and immigrants to Canada by allowing for importation of a 90day supply of medications. It was thought that the 90 days should enable the individual to secure a primary care physician who would then diagnose and prescribe a course of action to address the disease or condition. However, the policy allows an individual to import product 4 times a year for as many animals as one owns. Unfortunately, in many cases the policy is abused with large quantities of these non-approved products

being imported for use in food animal production. OUI product imported from, for example, the United States, may be interpreted by an animal owner as ‘equivalent’ to the product available for sale in Canada, however label directions (for example withdrawal times for meat or milk) between the two countries may differ, leading to the potential for residues. Separate Veterinary Drug Regulation, which CAHI hopes to see Health Canada implement, should take these loopholes into consideration. Health Canada oversight of these practices would also ensure knowledge of drug use which includes adverse event reporting or pharmacovigilance.

Continuous improvement through pre-and postmarket product assurance A growing area of focus for regulators and the animal health industry relies on pharmacovigilance, the science and activity relating to the detection, assessment, understanding, and prevention of adverse effects or any other related problem associated with use of an animal health (or human) product. While products undergo rigorous testing throughout the pre-market phase of development, post market surveillance of how a product interacts in everyday conditions fosters pharmacovigilance activity. RVTs can play a key role in helping to identify any unrecognized or unintended effects of a drug that cannot be identified until it is administered to a larger population than is possible during pre-approval lab and clinical trial studies. That way, every member of the veterinary team is able to advocate his or her confidence in a product’s safety, quality, and efficacy.

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Risk management through the therapeutic decision cascade Not every product is approved for use in every species or disease. Deciding which products to bring to a specific market are often made by the global parents of many animal health firms. For example, when looking specifically at Minor Use / Minor Species products, our small market for sheep or aquaculture products makes it difficult for a product sponsor to justify the regulatory requirements for some products for these species that may be available in countries with higher stocking densities such as Australia for sheep or Norway for aquaculture. In those cases, the Therapeutic Decision Cascade can provide guidance. The tool was developed to support the responsible use of medication while giving due consideration to both animal and public health. It is a longstanding legal tool used in Europe that allows flexibility and provides a rational balance between the legislative requirement for veterinarians to prescribe and use authorized veterinary medicines where they are available, and the need for professional freedom to prescribe other medicines where they are not. Implementation of this tool as a professional best practice will curb the potential for treatment failures, adverse reactions and deaths as well as for the risks associated with the development of antimicrobial resistance. As members of the veterinary community, it is important for veterinary technicians to be aware of the Therapeutic Decision Cascade and its risk mitigation impact.

Making sense of medications...continued

Therapeutic Decision Cascade for Animal & Public Safety

Conclusion As frontline members of the animal health community, veterinary technicians are often the advocates of animal health product sponsors with animal owners. When animal owners react to a product’s price, they are likely un-aware of the multitude of challenges faced by product sponsors in securing and maintaining the license to market that product. We have just scratched the surface of the regulatory requirements that a product sponsor must meet to make these products available to the veterinary community. We hope that you too, will give due consideration to the science, safety and effort that goes into every product our members make available to your facility and patients.

To support responsible use of medications1, giving due consideration to both animal and public health, veterinarians should follow the Therapeutic Decision Cascade when prescribing medications for their patients. Choose the first available level on the cascade below:

Approved Veterinary Drug - DIN (Label Instructions) Approved Veterinary - DIN (Extra Label Drug Use - ELDU) Approved Human Drug - DIN (ELDU) Compounded Product: from Approved Veterinary Drug - DIN (ELDU) Compounded Product: from Approved Human Drug - DIN (ELDU) Compounded Product: from Active Pharmaceutical Ingredient - API (ELDU)2 1

ELDU does not apply to pesticides and biologicals (vaccines).

ELDU is not permissible in livestock feeds without a veterinary prescription. ELDU is not recommended by Health Canada with Drugs/classes of Very High Importance in human medicine which are listed as Category 1 Antimicrobials.

recommends Want to write for The RVT Journal? We accept CE articles and general content articles, and we LOVE it when RVTs contribute. Email lisa@oavt.org for details.

Tracey Firth Tracey Firth is the Programs Director at the Canadian Animal Health Institute (CAHI), having joined the organization in 2001. She is a graduate of the University of Guelph’s Bachelor of Science in Agriculture program, majoring in Animal Science. She has earned the “ Certificate of Accreditation as an Animal Health Representative through • the U of G and CAHI as well as a Certified Association Executive designation from the Canadian Society of Association Executives. An avid piper, she is Pipe Sergeant with St. Andrews Pipes and Drums, Mississauga, a band dedicated to teaching the art of the Highland Bagpipe. She and her husband Jon are pet parents to a 5 year old cat “Ginnie”. CAHI is the trade association that represents the manufacturers and distributors of animal medicines in Canada. CAHI is an advocacy group that works on behalf of companies that provide your clinic with the products to prevent, control and treat animal disease. While its work focuses on ensuring access to safe, effective and affordable products for administration and sale by animal health facilities, most of the companies CAHI represents are part of a larger international family of animal health companies. Formore information about CAHI, visit http://www.cahi-icsa.ca

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Making sense of medications...continued

Table 1 Animal Safety

Human Safety

Lab Animal Studies 1. Acute Toxicity Studies 2. Subchronic Toxicity Studies 3. Chronic Toxicity Studies 4. Irritation Studies (dermal sensitization, dermal, ocular & tissue irritation) 5. Reproduction & Teratogenicity Studies 6. Other Studies

Lab Animal Toxicity Studies 1. Subchronic Oral Toxicity Studies 2. Chronic Toxicity Studies 3. Carcinogenicity Studies 4. Combined Chronic Toxicity & Carcinogenicity Studies 5. Multigeneration Reproductive Studies 6. Teratogenicity Testing 7. Short-term Tests for Genetic Toxicity Target Animal Safety Studies Studies 1. Margin-of-Safety Studies 8. Pharmacological Studies 2. Safety Under the Proposed Conditions 9. Immunotoxicity Studies of Use 10. Neurotoxicity Studies 3. Topical Drug Studies 11. Hormonal Studies in Primates 4. Inhalant Drug Studies 12. Observations in Humans 5. Tissue Irritation Studies 13. Other Studies 6. Udder Irritation Studies 7. Reproductive Function Studies 8. Clinical Safety Studies 9. Pharmacovigilance Data

Efficacy 1. 2. 3. 4.

Microbiology Studies Laboratory Studies Animal Model Efficacy Studies Clinical Pharmacology Studies i) Pharmacokinetic Studies ii) Bioavailability Studies iii) Pharmacodynamic Studies 5. Dose Determination Studies i) Optimum Dose Studies ii) Challenge Studies 6. Dose Confirmation Studies i) Pivotal Studies ii) Clinical Studies 7. Supplementary Supportive Efficacy Studies

Microbiological Safety Studies Antimicrobials 1. Info on the antimicrobial 2. Activity Spectrum of the antimicrobial 3. Administration 4. Antimicrobial Resistance Studies i) Resistance Mechanism ii) Transfer of Antimicrobial Resistance Genes iii) Cross Resistance iv) Co-Resistance v) Resistance Development 5. Effect on the Animal Gut Microflora 6. Effect on Human Gut Microflora 7. Impact on Human Medicine 8. Pharmacokinetics Residue Studies 1. Pharmacokinetics i) Pharmacokinetic Studies in the Intended Species ii) Metabolism Studies in the Intended Species iii) Comparative Metabolism Studies in Laboratory Animals 2. Residue Studies i) Analytical Methodology ii) Validation of the Regulatory Methods for the Detection & Confirmation of Residues of Veterinary Drugs in Food iii) Drug Residue Depletion Studies iv) Procedure for Establishing Maximum Residue Limits

Manufacturing & Quality Control Drug Substance 1. General Information on the Drug Substance 2. Method of Manufacture 3. Structure Elucidation & Confirmation 4. Impurities 5. Control of the Drug Substance 6. Reference Studies 7. Packaging 8. Stability

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Drug Product 1. Description of the Drug Product 2. Pharmaceutical Development 3. Method of Manufacture i) Formula ii) Manufacturing Process iii) Process Validation iv) Control of Excipients 4. Control of the Drug Product i) Specifications ii) Analytical Procedures iii) Validation of Analytical Procedures iv) Batch Analyses v) Justification of Specifications vi) Packaging vii) Stability 5. Additional Information

Cover story REGISTERED VETERIN ARY TECHNICIAN

JOURN AL

FALL 2014 VOLUME 38 ISSUE 1

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Proudly published by the Ontario Association of Veterinary Technicians (OAVT)

Love your job!

Love your job! Celebrate National Veterinary Technician Week (NVTW) October 12-18.…page 19

National Veterinary Technician Week By Lisa McLean

Let’s be honest

– two decades ago, the RVT profession was not well known or respected. RVTs burned out quickly, due to low wages and lack of respect. In recent years, that tide has changed. Fortunately RVTs are gaining more recognition from the veterinary community and the general public, as highly-trained professionals that have a unique and valuable skill set for improving animal health.

ways to show RVT pride

In 1993, the National Association of Veterinary Technicians in America (NAVTA) launched National Veterinary Technician Week (NVTW) – an annual celebration of the commitment RVTs bring to their profession. Now in its 21st year, the success of NVTW is largely due to RVTs in North America who make a point of celebrating the profession. As Canada’s largest provincial RVT association, the Ontario Association of Veterinary Technicians (OAVT) is encouraging members to show their RVT pride this NVTW. Here are eight ways to get in on the action from October 12 to 18:

1 1

Tell five people about RVTs – The RVT profession

has come a long way in recent years, in part, thanks to word-ofmouth within the public and veterinary community. Challenge yourself to share the RVT word. Help people in your community understand that RVTs are highly trained, have a specialized skill set, and that they are part of a self-regulated profession, with certain professional expectations they must follow to keep their RVT designation.

Ask your mayor to proclaim NVTW in your city. (It’s easier than you think!)

Some Canadian cities issue proclamations – a formal pronouncement, issued by the Mayor, of a message of importance, interest, and or benefit to a significant number of citizens. Search your city’s website for the process to request a proclamation. OAVT has the wording drawn up already – all you need to do, as a citizen of your community, is submit it! Contact us kirsti@oavt.org for details.

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Put a good word in with your MPP

Did you know, throughout the year, OAVT’s Board of Directors has meetings at Queen’s Park to talk to Members of Provincial Parliament (MPP)? We’re spreading the word about the profession and why the law needs to be modernized to create distinction between RVTs from non-credentialed auxiliaries. MPPs always like to hear from constituents in their riding about what’s important to them. You can help to make a difference by getting involved in these

Love Your Job!...continued

Check in with OAVT for other outreach opportunities – OAVT

places a strong focus on community outreach. Whether we’re entering a float in Toronto’s Pride parade or connecting with families at special events through our stuffie hospital, contact Stacey@oavt.org for ways you can get involved.

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Check out your municipal website for community flagpole or flag raising protocols, and then contact kirsti@oavt.org to arrange an RVT flag raising in your area.

Get some profile – and enter our contest –Enter OAVT’s Crest Campaign contest for a chance to win great prizes! During NVTW (October 12 to 18) get some profile for yourself as an RVT. Send us a sample (web link, screen capture, pdf or other proof) of your name and RVT designation being used. Have you been quoted as an RVT in an article? Is your name and RVT status prominently featured on your clinic’s website? Do you have an RVT license plate or crest on your clinic door? Visit www.oavt.org for full contest details.

Help us “raise the RVT flag” in communities across Canada –

OAVT Annual Conference, a variety of awards are presented to some outstanding members and contributors to our profession and association. Take some time to think about RVTs you know who have made a difference to the profession, and consider nominating them. Visit www.oavt.org for award criteria. Nomination deadline is October 28, 2014.

we hear about creative ways veterinary clinics across Canada are celebrating their RVTs. Help OAVT build a collection of NVTW celebration ideas and inspiration! Email, tweet or Facebook your photos and stories -we can’t wait to hear from you.

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Nominate a great RVT for the OAVT awards – Each year at the

Tweet/Facebook or email us information about what your workplace is doing to celebrate RVTs during NVTW Each year

ON TA

advocacy efforts. We will be organizing RVT volunteers to share the details of a proposal to government to enhance the laws that regulate the RVT profession and need your help to create awareness with Ontario’s political leaders. Contact Rory at the OAVT office for more details at rory@oavt.org or 519-836-4910 x223.

A R Y

H T E C

Introducing Zoetis. After 60 years as Pfizer Animal Health, weâ&#x20AC;&#x2122;re taking on a new name. And our commitment to veterinarians has never been greater. To provide the medicines, vaccines, and services necessary to maintain healthy animals. To deliver the solutions you require, through a highly diversified R&D program. Whether youâ&#x20AC;&#x2122;re treating one animal, or vaccinating 2,000. Because at Zoetis, your success, and the health of your animals counts. To see how we do it, visit us at zoetis.ca.

Zoetis is a trademark of Zoetis or its licensor licensor,, used under license by Zoetis Canada Inc

Career

Professional attitude – own it By Rebecca Rose, CVT CATALYST Veterinary Practice Consultants

Professional

What is your definition of a Professional? When I envision a professional, I see someone who is selfconfident, knowledgeable, well-groomed, respected by their peers, courteous, unlikely to gossip, goal-oriented and willing to gracefully admit their mistakes. How does anyone do all that, all the time? It is a conscious choice someone makes every day, in every moment. A professional is aware of his or her surroundings, clued in, and committed to creating a positive, professional presence. Here are some key characteristics that will help you adopt and maintain a professional attitude: Definition of a professional: adjective, businesslike, conforming to the standards of skill, competence, or character normally expected of a properly qualified and experienced person in a work environment. Definition of a professional: noun, somebody whose occupation requires extensive education or specialized training. A worker in a paid occupation that usually requires a high degree of training or skill or competency.

Self-confidence is manifested from knowing who you are – the foundation of all successful, professional individuals. “Know thyself” is more difficult than one initially imagines. Understanding your own limitations, weaknesses, strengths, interests and passions will enhance your selfconfidence. Ask yourself: What (in my work environment) brings me the greatest joy? What is my greatest weakness? What is my greatest strength? How can I enhance my strength? How can I decrease my weakness?

Knowledge can be learned in many ways. When someone chooses to become an expert in a particular procedure, skill or mindset then that person expands his or her professionalism. For example, if you believe your greatest strength to be in grief counseling, increasing your knowledge on how best to support a family during the difficulties related to euthanizing a beloved pet raises your level of understanding, making you an asset – a sought-out professional. Networking with other veterinary professionals who offer specialty services in euthanasia will increase knowledge. Listening

to stories of children who have had “good” experiences with the passing of a pet is always heartwarming. Ask yourself: What one thing can I do tomorrow to learn more about my strength? What one class can I take to learn more about my strength? What mentor can I contact and ask out to lunch to learn more about my strength? Being well-groomed is important. In Peggy Klaus’ book, The Hard Truths About Soft Skills, she includes an entire sub-chapter titled “Books are judged by their covers and the same is true for you.” We are judged by our appearance. Anyone who tells you differently is lying to you. Every moment of every day you have an opportunity to make a first impression, with your posture, your eye contact, your attire, your personal hygiene and your smile. You may be saying to yourself, “I wear scrubs all day long. That’s the attire of a veterinary technician.” I can’t argue with that, however clean scrubs are more professional than stained scrubs. Personal hygiene is determined every morning before you walk out the door. Who says you can’t wear a nice set of studded earrings or classy necklace? Posture, standing tall, smiling and

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a firm handshake speaks volumes when meeting a new client or sales representative. Years ago, a percentage of technicians attending continuing educational classes wore scrubs to those events. Now when I give presentations, the majority of technicians and students are opting to look professional by wearing appropriate attire and nice accessories. They are making great first impressions. I am looking to see what impression they have chosen to make. Ask yourself: Do I look as professional as I feel? What can I do to appear more professional? What change do I intend to make next week at work that will enhance my professional attitude?

Professionals are respected by their peers. Colleagues support their peers who are making a difference, taking steps to increase their knowledge, belonging to professional organizations and taking calculated risks. Individuals who network outside of their comfort zone will expand their circle of influence and are being proactive. Steve Covey writes in his book The 7 Habits of Highly Effective People, “There are some people who interpret ‘proactive’ to mean

Professional attitude – own it ...continued

pushy, aggressive, or insensitive, but that isn’t the case at all. Proactive people aren’t pushy. They’re smart, they’re value-driven, they read reality and they know what is needed.” Proactive people are generally respected by their peers, they lead by example, they are making a difference in their profession and that exudes professionalism. Ask yourself: How do I show respect to my peers? Amongst my peers, who do I most respect? Why? How do my peers show me respect? What am I doing to enhance the veterinary profession?

Being courteous speaks volumes. Saying “Thank you,” “I apologize” and “You are welcome” are common courtesies and the right thing to do. Add a bit of true sincerity and you have shown professionalism in its simplest form. For example, in a veterinary hospital, assisting an elderly pet owner by walking his or her dog to the car is courteous. When a client gives you a compliment, accept it by saying “thank you” because shrugging or offering no response at all is rude. Ask yourself: How many times this past week did I assist a client above and beyond “the call of duty?” What simple courtesy have I denied a fellow co-worker? What simple courtesy have I shown a fellow co-worker? Beginning next week, how will I be more courteous?

Gossip is unprofessional. Choosing to redirect a conversation that is full of hearsay is a way to demonstrate your professionalism. How often have you caught yourself in the middle of a trashy conversation chosen to redirect it? Gossip, especially malicious conversation is darn right rude and unproductive.

By the Numbers, “9 ways to get the boot” listed “Ricky Rumor” spreading a plague of stories and bad feelings that infects the entire team. The best remedy ─ excise the tumour! Ask yourself: How often do I engage in unproductive conversation about someone else? How often do I redirect gossip? How can I improve creating informative, constructive conversations? Next week, what will I do when I find myself engaged in gossip?

Goal-oriented professionals achieve

in 2013? How often do I set goals, projects, and dreams and achieve them? How often have I let a co-worker down by not following through on a project?

Admitting mistakes is professional. Everyone makes mistakes, and it shows great integrity and trustworthiness to admit your mistakes. When an error occurs, fess up, make corrections, apologize, re-adjust and keep moving forward. Within the veterinary medical profession our mistakes can mean life or death for a patient. This is serious business and we are committed to accuracy when calculating doses. When an accident occurs, it is professional to bring the error to light. This is easier than it sounds and often mistakes are not discovered until after the fact. We all have stories of tragedy and mistakes. Problem-solving is just as important as admitting your mistakes.

more. Success looks different for everyone, however individuals who write out goals, identify projects, create a weekly plan and share their visions will manifest their dreams and goals. Effective self-management includes both big picture and details. When you say you are able to do something you add it to your goals, you generate a timeline and you accomplish the goal. Follow-through shows professionalism. Achieving goals, either personal or work-related, creates trust. When you hold yourself accountable and follow through on your own dreams, goals and projects, you lead by example. The best place to be is leading by example.

Ask yourself: What mistake have I confessed to? What mistake have I yet to confess to? How do I deal with my mistakes? How do I support co-workers when they have made a mistake? We all make mistakes and we all need to treat each other with respect.

Steve Covey has this to say about weekly planning and self-management: “It helps you to create balance in your life. It helps you to rise above the limitations of daily planning and organize and schedule in the context of the week. And when a higher value conflicts with what you have planned, it empowers you to use your self-awareness and your conscience to maintain integrity to the principles and purposes you have determined are most important. Instead of using a road map, you’re using a compass.”

In conclusion: Each and every person has the potential to be a professional. Within the veterinary community you have ample opportunities to be self-confident, knowledgeable, wellgroomed, respected by your peers, courteous, conscious of gossip, goal-oriented and aware of your mistakes. What is stopping you from being a professional? What are you going to do next week to increase your professional character?

Ask yourself: What professional goals have I set for myself in 2014? What goals did I complete

Full references for this article are available at www.oavt.org.

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ARTICLE #3

Developing a protocol manual for an animal shelter by Cheryl Yuill, DVM, MSc

CE articles help RVTs earn credits toward their RVT certification. Correctly answer the quiz associated with this article to earn one CE credit. www.thervtquizzes.ca/login.pl

Most animal shelters rely on volunteers with varying levels of veterinary medical knowledge. That’s why a comprehensive and user-friendly protocol manual is a key requirement for any well-run facility. RVTs have a lot to contribute to this process. With their educational background and veterinary training, they possess the necessary skills to assess the practicality and accuracy of any pre-existing manuals. They can also contribute to the development and implementation of an effective and workable document that is compatible with both current veterinary medical standards and the expectations of the general public. For the purposes of this article, an animal shelter is considered to be any premise where animals are kept temporarily for the purpose of placing them under permanent ownership elsewhere. By this definition, animal shelters could include kennels, catteries, animal rescue groups, municipal pounds, private animal shelters or humane societies associated with an SPCA. The main differences between these groups are the source of the animals in the population, the ownership of the animals (strays, surrendered animals, purpose-bred animals) and species and/or breed differences. It is impossible for a person who has not worked ‘in the trenches’ of a shelter environment to appreciate the unique problems faced in these facilities. Of paramount importance is the difference between individual companion animal care in a private practice and care for an ever-changing population of animals that often arrive at the animal shelter with little or no background history. In most cases, the shelter management team understands this difference, but it is not always easy for junior employees or volunteers to recognize how these differences influence the way care is provided to the resident animals.

Guidelines for policy development When developing policies for the care of animals in a shelter environment, consideration must go beyond the health and well-being of the individual animal. Decisionmakers must also reflect on the health and well-being of other animals housed at the facility and in the surrounding community. Humans who may have direct or indirect contact with the animals (including employees or volunteers and their family members) are also a key area of concern.

organism, and host factors. In some cases, staff members may be misinformed about one or more areas of animal husbandry, or they may hold beliefs that are more myth than fact. Thus, another important role that RVTs can assume in an animal shelter is to ensure that staff members and volunteers have a basic knowledge about issues that directly relate to the animals under their care, as well as the true risks of working with animals in a shelter environment.

Develop policies in spirit of the ‘five freedoms’ A significant number of people who work at

animal shelters have little veterinary knowledge, and usually have only minimal training with respect to animal physiology, animal diseases, nutrition, sanitation, fomites, movement of animals, zoonotic risks, or even the connection between environment, disease

Big or small, all-inclusive or species-specific, private facility or municipal shelter – whatever the situation, all animal shelters have the same basic needs for procedures and policies. The primary goal of all policies and procedures should be to provide the animals

24 The RVT Journal

in the facility with the five basic freedoms for animals under human control: freedom from hunger or thirst, freedom from discomfort, freedom from pain, injury or disease, freedom to express normal behaviour and freedom from fear and distress. It is not possible to eliminate all forms of stress for stray or unwanted animals, nor is it possible to completely satisfy all components of these basic freedoms in a temporary housing environment such as an animal shelter. However, with their veterinary training and skills, RVTs are in an ideal position to assess the available resources and develop an effective protocol manual that is practical, meets the spirit of the five freedoms, and is easily implemented by personnel of any background or educational level. In theory it is possible to use pre-prepared protocol manuals that are available online or in shelter medicine textbooks. However, in

Developing a protocol manual for an animal shelter...continued

practice the differences between the ideal scenario in the reference source and the situation at hand are usually enough that few policies are able to be used as written. Regional differences in climate will mean that diseases or infectious agents that are commonplace in one area may not exist in another location. Endemic diseases and parasites will vary from town to town, as will the breeds and types of animals that are popular in the area.

Disease control important in shelter policies One of the most important, but frequently overlooked, areas of disease control in a shelter situation is the rational movement of animals within the shelter. For example, animals that are randomly placed in holding cages and then randomly moved into the adoption area can spread disease quickly in a shelter. More effective disease control can be achieved by developing a plan for grouping animals in cohorts. For example, a cohort of all animals with confirmed vaccination and parasite control status should be kept separate from puppies and stray animals with an unknown treatment history. Stray animals could be put into groups based on their date of arrival or date of vaccination, and then moved as a group into a specific adoption area. Then, if an animal showed symptoms of a specific disease or problem, it would only be necessary to isolate a small portion of the shelter rather than completely shutting down the entire facility. In some cases, the design of an older animal shelter may preclude the ability to move animals in cohorts. In these cases, the skill and

knowledge of the RVT will be put to the test to develop a workable protocol that will minimize exposure to subclinical disease.

The basics: Protocol musthaves for shelter facilities A protocol manual must contain information about how the premises are cleaned and sanitized to provide a safe and wholesome environment for both humans and animals. It must outline clear procedures for how animals are admitted into the shelter (including any triage protocols), and where they will be housed on admission. Manuals must also state expectations for what sort of basic preventive medicine animals will be given on arrival, how they will be cared for during their stay, how they will be moved from holding to adoption areas, how their health will be monitored while in residence, what will happen if there is a threat to their health or welfare, and when and how they will find a new home. Of paramount importance is the difference between individual companion animal care in a private practice and care for an everchanging population of animals that often arrive at the animal shelter with little or no background history. At its best, a manual will also cover such diverse topics as record keeping, behavioural assessment, environmental enrichment, how to recognize potential outbreak situations, isolation or foster care for high-risk animals such as puppies or kittens, health and safety for staff and volunteers, specific risks for immunocompromised people, following up rehomed pets, etc. (See Tables 1-3).

25 The RVT Journal

Flow charts and key points summaries make reference easier The ideal manual will also be broken down into multiple sections, including a section for quick reference that gives the basic facts, or provides flow charts that direct the decision making process. Several sections may provide more detailed information for team members who are keen to know more about individual topics. It is also helpful to have separate sections on symptoms, classes of contagious diseases, individual contagious diseases, and managing outbreaks of disease. In the case of a protocol manual, repetition of information is good, because it reinforces the importance of key information. Each individual protocol should contain enough information that it can ‘stand alone’ without the need to flip pages for further instructions. Ideally, no individual protocol should be longer than two to three pages. Finally, each individual protocol should have a ‘key points summary’ at the beginning for rapid reference. This key points summary can be in the form of bullet points that contain the important take home message for the reader.

Remember scope of audience Many of the currently available resources for shelter medicine are written for veterinary medical personnel. When writing a protocol manual for use in a shelter environment, it is important to tailor the information toward users who may be less familiar with the science of veterinary medicine. Although medical terminology should be used whenever possible, it is also important to explain this terminology in wording that can

Developing a protocol manual for an animal shelter...continued

be understood by the average person, including shelter volunteers. It is helpful to develop a specific template for each class of protocols, and to follow that same template for the individual protocols in that class. For example, Table 5 shows a user-friendly template for a general cleaning protocol, which includes a brief summary of key points at the beginning, followed by a list of supplies that need to be gathered, and then a detailed ‘how to’ description that describes the areas that are being cleaned in that particular facility. An example of a protocol for wound triage can be found in Table 6. A user-friendly template for a flea control protocol could contain key points about the flea life cycle, the products used to treat an animal with an active flea infestation, the flea preventive products used on resident animals, and the products used to treat the shelter environment. When developing specific protocols, remember that they must be based on sound herd health or population medicine principles, should be evidence-based, and ideally should be supported by like-minded colleagues who are experienced in shelter medicine.

Regular review leads to continuous improvement Once the basic protocols are written, it is important to hold staff meetings to discuss them and to answer any questions that may arise. Then it is time to implement them. It is not enough to simply provide hands-on training to staff or volunteers, because it is easy to miss a step or take shortcuts when there are time constraints. Finally, all protocols should be reviewed regularly, at the very least on an annual basis, to ensure that they still remain relevant and are compatible with current veterinary standards of care.

Table 1 Cleaning and environmental monitoring policies: • How to prepare cleaning solutions – emphasizing the importance of proper dilution of products • Routine daily cleaning procedures – including order of cleaning specific areas based on risk assessment • Intensive cleaning and sanitizing procedures – including how often, what products, specific procedures to follow • Cleaning and sanitation during contagious disease outbreaks • Isolation procedures – where, which animals, who treats or cleans them, etc. • Quarantine procedures – both a summary policy, and individual policies for specific contagious and infectious diseases • Routine monitoring for specific contagious diseases such as ringworm

Table 2 Animal care policies: • Evaluation of incoming animals before they’re admitted into the facility (to minimize introduction of contagious diseases or parasites such as fleas or Coccidia) • What to do if an animal has a microchip or other identification • Triage of sick or injured animals (to identify when animals need veterinary intervention) • treatment of animals with contagious conditions such as ear mites, fleas • treatment of infectious but non-contagious conditions such as abscesses • wound management • Expectations and contents of animal charts and records (including elimination, appetite, drinking, behaviour, etc. More details in an animal’s chart will mean that an animal’s health can be effectively evaluated, and problems can be identified more readily) • Location and handling of animals during their stray or holding period prior to adoption • Rational animal movement policies within the shelter (i.e. moving groups of animals from a stray area to an adoption area as a cohort, rather than mixing ) • Timing of reasonable and effective vaccination and deworming protocols that are tailored to the diseases prevalent in the region • Timing of microchip implanting, spaying or neutering, or other processing of shelterowned animals • Surgical and post-surgical care • Instructions for dog walking or other socialization activities • Policies for mixing animals • Entry into communal areas such as cat colonies (including what preventive care treatments should be given prior to entry) • When animals should be placed in foster care • Management and care of pregnant or nursing females • Care of orphaned neonates • Euthanasia policies

26 The RVT Journal

Developing a protocol manual for an animal shelter...continued

Table 3

Table 4

Recommended contents on section for diseases: • General gastrointestinal problems • General urinary problems • General respiratory problems • Specific individual diseases (as relevant to the individual shelter) – canine parvovirus, canine kennel cough complex, canine Bordetella, feline panleukopenia, feline upper respiratory complex, feline calicivirus, feline viral rhinotracheitis, ringworm, Coccidia infections, Giardiasis, etc. • Including evidence based treatment protocols for each disease • Symptom based policies, such as: • Identifying and caring for the animal with diarrhea • Identifying and caring for the animal with coughing • Identifying and caring for the animal with regurgitation or vomiting • Identifying and caring for the animal with an ear disease • Controlling outbreaks of disease in general • Controlling outbreaks of specific diseases

Other: • Storage and accessibility of medications • Handling and preparation of vaccines • Monitoring of refrigeration temperature to safeguard biologics • Microchipping an animal • Post-adoption follow-up • Zoonotic diseases of importance in a shelter environment • Special risks to immunocompromised individuals • Health and Safety protocols for staff and volunteers

ASSOCIA T

T VE

R T

When developing specific protocols, remember that they must be based on sound herd health or population medicine principles, should be evidence-based, and ideally should be supported by like-minded colleagues who are experienced in shelter medicine.

IN IC N AR Y T E C H

About CE articles: Continuing to learn after achieving RVT status is essential for the individual and the advancement of the profession. RVTs in Ontario can earn 1 Continuing Education (CE) credit by reading the CE articles in this publication and submitting successfully completed quizzes that correspond to CE articles. For more information about CE credits in Ontario, visit www.oavt.org.

Dr. Cheryl Yuill Dr. Cheryl Yuill graduated from OVC in 1985, and then completed her Master's Degree in Small Animal Cardiology in 1989. She was an instructor in veterinary anatomy for 4 semesters (1987-1989), and also taught components of the clinical medicine course for 1st, 2nd and 3rd year veterinary students. She is the owner of Blue Cross Animal Hospital in Kitchener. For more than two decades, Dr. Yuill has provided veterinary care as well as staff and volunteer education at Kitchener Waterloo Humane Society. Dr. Yuill routinely presents seminars and lectures on a multitude of veterinary topics to both paraprofessionals and members of the public, including topics that directly relate to the care and comfort of animals in shelter environments.

27 The RVT Journal

Developing a protocol manual for an animal shelter...continued

VE T E RI NARY P ROTO CO L MAN UAL - CLE AN I N G S E CT I O N STANDARD PROTOCOL FOR CLEANING CAT NURSERY ROOM Key points: • It is important to realize that the cats in the nursery are the most vulnerable cats in the Centre. Pregnant cats have a suppressed immune system so that they won’t abort their fetuses, while newborn kittens have an immature immune system that is not capable of properly responding to infectious disease until at least 6 weeks of age. Therefore, only experienced staff members should be cleaning this area. • Pregnant cats that are being put into the cat nursery MUST be vaccinated at least 3-5 days PRIOR to entering the room, according to the established vaccination protocol. Ideally, hold incoming pregnant cats in another location in the Centre for 10 days to minimize the chance that an infectious disease will put the other cats in the nursery in jeopardy. • Nursing cats that come into the shelter with newborn or very young kittens MUST be vaccinated at least 3-5 days prior to entering the nursery. • The only cats or kittens allowed in the nursery are cats that have been properly vaccinated as above, or kittens that are born in the shelter. • For pregnant cats, if it looks like they will be delivering their kittens soon, make sure they have an extra litter box that they can use to give birth in. Put shredded newspaper into the extra litter box. • If a cat has just given birth to a litter, make sure you write down the date of birth and # of kittens on the health chart. • Also, if a cat has just given birth, have it added to the vet list so that the vet can make sure everything is okay. Supplies needed (some of these will be in room, replenish as necessary) • Cat litter and shredded newspaper • Cat food • Some clean dishes for food and water/clean litter pans • Garbage bag • Garbage can • Bucket • Diluted disinfectant product (insert name of product here) • Water • Cloth for washing cage/towel for drying • Scrub brush • Squeegee • Broom/dustpan/brush • Health charts • Newspaper • Clean cat carriers Getting ready: • As soon as you enter the room, put on the lab coat provided. If you need to leave the room, take off the lab coat. • Wash your hands in the sink, using soap and water – make sure you wash for a minimum of 30 seconds. This will avoid cross-contamination. • Make sure all cats have health charts and cage copies. Read the cage copy and make sure that it matches the cat(s) that are in the cage – i.e. correct colour, gender, breed, chip or tattoo (including location) and correct # of cats/kittens.

Cleaning occupied cages in cat nursery: • Fill out all health charts (if you see food vomit, clear or yellow bile, blood in stool or vomit, bloody discharge from the vulva, spots of blood in the cage, or if they are sneezing or have a discharge from the eyes or nose, make sure to write this down on the health chart, and alert a Cat Supervisor ASAP). • On the health charts be sure to check off how much they ate, score the BM, whether they urinated or any other findings of note; sign and date your entry. • Move cat into a clean kennel (use checkerboard arrangement if possible) giving clean food/water dish and litter pan. Do not let the cat walk around on the floor at any time. • Remove newspaper from old kennel. • Sweep out any litter, hair or food. • Scrub down the inside of the cage and door (inside and outside), with the disinfectant solution (let sit for a minimum of 10 minutes), then squeegee kennel. • Dry off the cage with a towel. • Put fresh newspaper in the kennel. • If you cannot use checker-board pattern then clean around cat, or put cat in a cat carrier. Do not let the cat walk around on the floor at any time. • Use the hand sanitizer to sanitize your hands before working with the next cat.

28 The RVT Journal

Cleaning empty cages in cat nursery: • Remove litter pan, dishes and newspaper from the cage. • Sweep any litter, food or hair out of the cage. • Scrub the entire surface of the cage including the clipboard and the inside and outside of the door with the disinfectant solution and allow to sit for minimum of 10 minutes, squeegee kennel. • Dry the cage with a dry towel (including the door and clipboard). • Line the cage with clean newspaper. Cleaning remainder of cat nursery: • Sweep all debris off the floor. • Scrub the floor, walls, room door (inside and out), table, walls and under cages with the disinfectant solution and scrub brush (leave the disinfectant on the surface for a minimum of 10 minutes), then squeegee and dry mop if necessary. • Wipe down sink, paper towel dispenser, soap dispenser, litter/food containers, stool and all other surfaces, using disinfectant. • Remember to disinfect your broom, brush and dustpan before putting them away. • Remove used garbage bag and replace with an empty one. • Restock all supplies. i.e. litter, food, newspaper, health charts, paper towels, garbage bags, etc… • Replace the dirty lab coat you were wearing with a clean one and put dirty lab coat in the laundry room. • Before leaving, make sure that everything in the room is clean and tidy.

Developing a protocol manual for an animal shelter...continued

VE T E RI NARY P ROTO CO L MAN UAL WOUND triage PROTOCOL Key points: When an animal comes into the shelter with a wound, you need to triage the animal, or decide what sort of treatment it needs and exactly when this treatment needs to be started. No matter what you do, you MUST write everything down in the animal’s record. The information in this protocol is very similar to that in the general Triage Protocol, except that it is specific for wounds. The 4 choices for wound triage are: 1. The animal needs emergency veterinary treatment, OR 2. The animal needs veterinary treatment by the veterinarian on call and should be seen as soon as the veterinarian on call is available, OR 3. The animal needs a veterinary examination when the shelter veterinarian comes into the shelter in the afternoon, OR 4. The animal’s wounds can be treated and/or monitored by staff until its stray period is over. Examples of some specific types of wounds or injuries and what steps you should take for care of the animal: 1. If the wound is large or extensive, if there is dirt or gravel in the wound, if the wound is bleeding, if the animal is having difficulty breathing, or if the animal is collapsed, unconscious, or otherwise in distress, the animal needs immediate veterinary care. These conditions represent emergency situations and the animal must be seen by a veterinarian without delay. The animal may need to go to the emergency clinic if it is out of hours. 2. If the wound is a gash that appears to be recent and it looks like it needs to have stitches, the animal needs to be seen by a veterinarian within 6 hours of getting the wound. If a wound is older than 6-8 hours, you will need to make a judgment call as to whether you go to the emergency clinic or to the veterinarian on call once they become available. 3. If, on arrival at the shelter, the wound does not fit into either of the above 2 examples, if the animal is interested in eating or drinking, if it is urinating and defecating, and if the wound is not located near a vital area (open wound by eyes, right beside the rectum, vulva or penis, open wound near the area of the heart, open wound in the jugular area), it is likely okay to leave it until the next scheduled veterinary visit.

4. If there is matted hair over the wound, you may want to try and clip away the hair to assess the severity of the wound. This will also allow air to get at the wound, helping to heal it. Before doing anything, write down the location of the wound, including the approximate size and how much of the wound is contaminated by hair. DO NOT TRY TO DO ANYTHING TO THE WOUND WITHOUT AN ASSISTANT. Once you have an assistant available, put a muzzle or a Buster collar on the animal so it cannot bite you, then wrap it in a towel, put it in a cat bag, or otherwise provide restraint so that you can safely clean up the wound. Once the hair has been removed, if there is pus or other debris present, write down a description of the debris, including colour (or take a photo with your phone). Gently clean the wound with surgical scrub soap. If the area of the wound can be bandaged, you can apply a light bandage. If you’ve never applied a bandage before, get one of the more experienced staff members to apply the bandage, and arrange to have an RVT or veterinarian show you how. Arrange to have the animal examined by the shelter veterinarian at the next visit. In the meantime, monitor the bandage, looking for swelling of the tissues above or below the bandage, pressure sores that develop above or below the bandage, excessive chewing at the bandage by the animal, bleeding or discharges that seep through the bandage or other signs that the bandage is painful or causing distress. If a bandage is too tight and is not removed, the animal could lose the leg that is bandaged!

29 The RVT Journal

5. If the wound has scabbed over, and the scab appears to be firmly attached to the tissues beneath it, leave it alone. Scabs are a ‘natural bandage’ and form to protect the wound and seal out contamination until the tissues beneath have time to heal. You may see a single scab in the case of a skin wound, or you may see a lot of little scabs in the case of an allergy such as flea allergy dermatitis. DO NOT PULL OFF A SCAB THAT IS FIRMLY ATTACHED, even if it is only attached along part of the wound. Have the wound assessed by a veterinarian instead (it is likely okay to wait until the shelter veterinarian arrives, if you have triaged the animal and everything else is okay).If the wound has a firmly attached scab and there does not seem to be any inflammation or irritation around it, there is no evidence of itchiness, and the animal is eating, drinking, etc., you can likely wait to have the animal examined by the veterinarian at the end of its stray period. If you see an animal with a wound that does not fit into any of the above categories, you may need to use common sense and your own judgment to decide what you should do. Remember that we always try to avoid unnecessary pain and suffering for the animals in our care. If you find that you are faced with a situation that is not covered in this protocol, make sure that you speak with the Animal Care Manager or the shelter veterinarian so that you will know what to do the next time you are faced with a similar situation.

Finance

Disability savings plans: An easy way to help someone you love by Terry Waddick, CFP, HBBA

As an RVT, you are trained to help. You help the horse with an abscess, and you help perform surgery on the cat. You help everyone you know clip their dogs’ nails every time you go over to their house for dinner. But what about the people in your life who have a disability that need some financial help? You probably know that individuals living with disabilities and their loved ones can face distinct and often immense financial challenges. Setting up a Registered Disability Savings Plan (RDSP) can help make saving for the future easier through a combination of government-assisted savings and tax-deferred growth opportunities. Unfortunately I have seen this amazing government program being underutilized by the people who need it the most, often because they are unaware of how it works and the benefits it brings. That’s where you can help. You can let them know the basics of an RDSP so that they can make an informed decision about opening one up.

contribution amounts, selecting investments and managing withdrawals. This can be a parent, legal guardian or the disabled individual, provided they are of the age of majority and legally competent to sign a contract. Any friend or family member can make a contribution toward the RDSP, with the holder’s permission. The Canada Disability Savings Grant (CDSG) is a matching grant that the government will deposit into the RDSP. Grants of up to 300% are available, depending on the amount contributed and the beneficiary’s family net income. These grants can total $70,000 over the beneficiary’s lifetime. The Canada

Disability Savings Bond (CDSB) is available to individuals with a low or modest family net income. The bond can be added to an RDSP, even if no contributions are being made. A maximum of $1,000 each year can be deposited, with a limit of $20,000 over the beneficiary’s lifetime. Savings that grow tax –deferred: • Private contributions of $1,500/year for 20 years at 6% growth • $30,000 of total contributions • Potential RDSP value at the end of 20 years: $233,956!

An RDSP can be set up for someone who is: • Eligible for the federal disability tax credit (DTC) • A resident of Canada with a valid Social Insurance Number • Under the age of 60 The person who opens the plan, (called the "holder") makes decisions such as determining

Withdrawals do not impact federal benefits, and most provinces, including Ontario, have implemented an exemption of RDSP income and assets from provincial support programs (such as ODSP). Depending on the individual situation, it is important to speak to a qualified financial planner to determine whether a n RDSP is the right plan.

Terry Waddick, HBBA, is a Certified Financial Planner with Investors Group Financial Services Inc. He can be contacted at (800) 745-0690 ext 4269 or terry.waddick@investorsgroup.com Investors Group is a registered trademark owned by IGM Financial Inc. and licensed to its subsidiary corporations. Family net income is always less than or equal to the “phase-out income” threshold, which in 2013 is $25,356. The rate of return is used only to illustrate the effects of the compound growth rate and is not intended to reflect future values of the mutual fund or returns on investment in the mutual fund. In the first year, the beneficiary has no accumulated CDSG or CDSB room. Contributions, CDSG, and CDSG are applied to the account at the start of each January as annual lump sums. The beneficiary is at all times DTC-eligible, a resident of Canada and turning 49 or younger in the year. No withdrawals are made from the RDSP during the period examined. The Canada Disability Savings Grant (CDSG) and the Canada Disability Savings Bond (CDSB) are provided by the Government of Canada. Eligibility depends on family income levels. Speak to an Investors Group Consultant about RDSP's special rules; any redemption may require repayment of the CDSG and CDSB. This is a general source of information only. It is not intended to provide personalized tax, legal or investment advice, and is not intended as a solicitation to purchase securities. Terry Waddick is solely responsible for its content. For more information on this topic or any other financial matter, please contact an Investors Group Consultant.

30 The RVT Journal

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CHANGE THEIR FOOD. CHANGE THEIR WORLD.

Poisoning

Soaps, detergents and fabric softeners By Tyne K. Hovda and Lynn R. Hovda, RPH, DVM, MS, DACVIM

room or areas where clothes have been folded

They are generally of low toxicity, but the

and stored. More rarely, fabric softener sheets are tucked in shoes or boots as deodorizing agents. Cats, in particular, are more susceptible to poisoning from fabric softeners and should not be allowed to play with fabric softener sheets meant for use in the dryer.

addition of perfumes and other oils may increase their irritant nature. Clinical signs in those animals ingesting soaps are gastrointestinal (GI) in nature and include vomiting and diarrhea. It is not unusual for dogs chewing up a new bar of soap to vomit up most of the soap pieces as well as the packaging. Treatment consists of providing oral fluids, antacids, and GI medications such as an H2 blocker (cimetidine, ranitidine, or famotidine). If vomiting is prolonged, intravenous (IV) fluids and other supportive care may be needed. Animals with soap in their eye(s) can generally be managed at home by flushing the eye(s) with normal saline or tepid water for 15-20 minutes, followed by a rest period of one to two hours. If pain (pawing and digging at the eye) and irritation (redness and tearing) are still present after that time, a trip to the veterinarian is recommended. It is important to remember that most commercially available bar soaps have limited toxicity, but lye containing soaps and those made at home may be much more harmful and that each case should be evaluated based on the specific product.

Soaps and detergents are technically

Laundry soap "pods" and fabric softeners are among common household products that can present a poisoning risk for some pets.

Soaps and detergents are present in virtually all households, veterinary hospitals, grooming facilities, kennels, and barns. Hundreds of these products, including personal care products such as shampoos and bar soaps; household products including liquid dishwashing products, and automatic dishwasher powders, liquids, and “pods”; veterinary products including shampoos, antibacterial disinfectants, and wound cleansers; and a variety of barn and stable products are used on a daily basis. The majority of these products are of low toxicity and clinical signs in affected animals are generally mild to moderate. Exceptions to this are bars of lye soap or homemade soaps that are very alkaline in nature, automatic dishwashing detergents, and cationic detergents. Fabric softeners have a more limited exposure potential, confined primarily to the laundry

composed of surfactants that increase the “wetting” power of water and help remove dirt and grease. Other substances such as perfumes, oils, alcohols, enzymes, and builders are added to make the final product. Surfactants have a hydrophobic (water repelling) part and a hydrophilic (water loving) part, and are classified as nonionic, anionic, cationic and amphoteric based on the hydrophilic portion of the surfactant. Cationic surfactants are the most toxic followed by anionic surfactants, nonionic surfactants, and amphoteric surfactants. The pH of the final product is often used determine how harmful a product is. The risk of corrosive damage is high when the pH of the product is less than 2 or greater than 12. This is not always the case, however, as cationic detergents may be highly corrosive and yet have a neutral or only slightly alkaline pH.

Soaps Soaps, formed from a reaction between fatty acid salts and an alkali, are sometimes considered as a separate category although most of them are actually anionic surfactants.

32 The RVT Journal

Nonionic detergents Nonionic surfactants have a neutral charge. Alkyl ethoxylate, alkyl phenoxy polyethoxy ethanols, and polyethylene glycol stearate are but a few nonionic surfactants. Common nonionic detergents include human and animal shampoos, liquid dishwashing detergents, and some laundry detergents. Clinical signs and treatments are similar to

Soaps, detergents and fabric softeners ...continued

those found with soaps. Shampoos containing

A thorough examination of the mouth,

an insecticide such as permethrin or pyrethrin may cause more serious clinical signs primarily due to the added irritant nature of the pesticides.

oropharynx, and esophagus should be performed looking for erosions and ulcers and evidence of corrosive injury (white to gray appearance of the mucous membranes). Treatment depends on the product ingested but in general includes washing the mouth well with cool fluids, dilution with oral fluids, IV fluids, GI protectants, and further symptomatic and supportive care. The use of an acidic solution to neutralize the product is not effective and not recommended.

Anionic detergents Anionic surfactants carry a negative charge. They are found in basic solutions, but also in some neutral solutions. Products in this category include some laundry detergents, shampoos, and automatic dishwashing detergents. Common anionic surfactants include alkyl sodium sulfate, alkyl sodium sulfonate, and sodium lauryl sulfate. Most are of low to moderate toxicity. Automatic dishwashing detergents of all forms, however, are more toxic and ingestion often results in more serious clinical signs. The reason for this is unknown as the product pH (general range of 11-12) doesnâ&#x20AC;&#x2122;t correlate with the degree of esophageal damage. It is likely a combination of several factors, in particular the concentration, amount ingested, and chemical structure as well as direct tissue necrosis. Clinical signs associated with ingestion of most anionic detergents include GI irritation with vomiting, GI discomfort, and diarrhea. Treatment consists of oral fluids to dilute the product, antacids, and GI protectants. The use of activated charcoal is controversial simply because many animals readily vomit ingested products. More severe signs, including excess salivation, vocalization, panting, retching, gagging, and GI pain, are associated with ingestion of automatic dishwashing products.

Ocular and dermal exposures require decontamination with copious amounts of tepid water and re-evaluation. Due to the corrosive nature of automatic dishwashing products, ophthalmic exposures should be attended to by a veterinarian. Intact skin is a natural barrier to most of these products and washing well is generally all that is required. Open cuts and wounds, inflamed areas, and abraded skin are portals of entry and more thorough decontamination and evaluation should be paid to an exposure in these areas. Animals with hepatic disease may be at increased risk for the development of clinical signs. Ingested detergents are absorbed, metabolized in the liver, and excreted in the urine. Pre-existing liver disease may slow the metabolism of surfactants and intravascular hemolysis may occur secondary to impaired liver function. Treatment includes IV fluids to prevent renal damage from red blood cell breakdown products and monitoring of BUN and creatinine.

33 The RVT Journal

Cationic detergents Cationic surfactants carry a positive charge. Products in this category are among the most toxic to animals. Germicides frequently referred to as â&#x20AC;&#x153;quatsâ&#x20AC;? (benzalkonium chloride, benzethonium chloride), sanitizers, and some fabric softeners are included in this category. Toxicity depends on the concentration and species affected. Ingestion of low concentration products (1-2%) in most species results in local effects with irritation to the mucous membranes most likely to occur. Exposure to higher concentration (>7.5%) ingestions, even at a neutral pH, results in corrosive burns. Cats appear to be much more sensitive than other species and develop mouth lesions and other signs at concentrations as low as 2%. Tipped over containers of liquid fabric softeners as well as dryer sheets, especially unused ones, are sources of poisoning for cats. Clinical signs include profuse salivation, vocalization, pawing at the mouth, gagging, retching, dyspnea, stridor, respiratory distress, and hyperthermia. Mucous membranes are inflamed with erosions and ulcers present. Treatment is symptomatic and includes gentle oral lavage, IV fluids, analgesics, and close attention to respiratory issues. The use of activated charcoal is generally not recommended. Ophthalmic and dermal exposures should be carefully evaluated. Exposed eyes should be flushed with isotonic saline or room temperature water for 15-20 minutes and evaluated for corrosive burns by a

Soaps, detergents and fabric softeners ...continued

veterinarian. Skin should be washed well with

low and treated similar to nonionic

quickly lick up automatic dishwasher

room temperature water; animals licking the product from the skin may develop oral lesions.

surfactants.

detergent inadvertently spilled on the floor and cats tip over containers left open for only a few moments and lick up the contents or play with dryer sheets. When these accidents occur it is important that the product is accurately identified and the animal treated appropriately. If there are any questions about the ingredients or toxic effects an animal poison control centre should be contacted for advice.

Amphoteric surfactants The charge varies depending on the pH of the solution. In acidic conditions (low pH) they act as cationic detergents; in basic solutions (high pH) they act as anionic surfactants. Toxicity associated with these surfactants is generally

In conclusion, it is easy to see how soaps and detergents can poison animals as they are found and used in so many areas of the home, outbuildings, boarding facility, and veterinary clinic. Keeping them locked up and away from pets is the best insurance for a good outcome; however, sometimes things go wrong even in the most well-managed homes and facilities. Dogs snatch bars of soap from the shower or

Tyne Hovda Tyne Hovda is a fourth year veterinary student at Texas A and M University in College Station, Texas and a part time employee of Safetycall and Pet Poison Helpline.

Pet Poison Helpline:

ÂŽ

Pet Poison Helpline, an animal poison control center based out of Minneapolis, is available 24 hours, seven days a week for pet owners and veterinary professionals who require assistance treating a potentially poisoned pet. Staff provide treatment advice for poisoning cases of all species, including dogs, cats, birds, small mammals, large animals and exotic species. As the most cost-effective option for animal poison control care, Pet Poison Helplineâ&#x20AC;&#x2122;s fee of $39 per incident includes follow-up consultation for the duration of the poison case. Pet Poison Helpline is available in North America by calling 800-213-6680. Additional information can be found online at www.petpoisonhelpline.com.

34 The RVT Journal

Zoetis and Juvita are trademarks of Zoetis or its licensors, used under license by Zoetis Canada Inc

Pro fe s si on a l i sm & Ethi cs

RVT’s status revoked for professional misconduct By The OAVT Complaints Committee

Complaint Summary: RVT Y. was employed at the ABC Veterinary Corporation for a period of approximately 11 months as an office manager. During that time Dr. Z. noticed losses of financial assets and clinic property. Dr. Z. filed a complaint against RVT Y.

Allegations: 1. RVT Y. engaged in fraudulent financial activities including unauthorized payroll advances to himself, falsely claiming repayments of the advances into accounting records without making the repayments, increasing his pay rate without authorization, use of the clinical credit card without authorization and falsifying/altering deposit slips. 2. RVT Y. engaged in thefts from the clinic, including: a. Paying himself for days not worked; b. Reversing charges to his personal account for services and supplies delivered by the workplace; c. Not charging himself for services and supplies rendered by the workplace; d. Theft of pet food and supplies; e. Reversing charges from client invoices to his personal account; f. Theft of cash from daily deposits; and g. Theft of office supplies, including electronics and computer supplies. 3. RVT Y. was charged with 70 counts of fraud, theft, and falsifying medical and accounting records, and subsequently convicted and sentenced to house arrest, community service, and now maintains a criminal record. 4. RVT Y. engaged in unprofessional conduct by abandoning his workplace duties by

taking an unscheduled and unapproved vacation. 5. RVT Y. engaged in conduct unbecoming of a professional RVT by publicly defaming Dr. Z.’s character and launching a vexatious lawsuit against Dr. Z.

Decision: Regarding this case, the Committee weighed all of the information before it and the options available to it. In this matter, the Committee had concerns with the professional conduct of Mr. Y. while representing himself as an RVT. Prior to making a final decision, the committee evaluated all possible options based on the information that was provided to the committee from both the complainant and the respondent. Based on the evidence that was submitted to the committee, the committee made the decision that Mr. Y.’s status as a Registered Veterinary Technician be immediately revoked and all references to his RVT status be withdrawn from use.

Reasons for Decision: The committee has determined that Mr. Y. is in contravention of By Law 2 Article 1.1 b) Admission Standards and By Law 2 Article 2.1 Professional Misconduct 1.1 Admission Standards Every person must: (b) Produce evidence, in a form prescribed by the Registrar that he/she has not been convicted of a criminal offence. 2.1 Professional Misconduct The following are acts of professional misconduct for the purposes of these by-laws: 2.1.1 Practice of the Profession

36 The RVT Journal

2.1.1.2 Failing to meet the standards of the profession 2.1.1.9 Using information obtained during a professional relationship with a client or using her professional position of authority to coerce, improperly influence, harass or exploit a client or former client certificate of registration. 2.1.1.13 Putting the Member’s interest, other than their personal health or safety, ahead of the patient’s or client’s in the course of performing the Member’s professional duties. 2.1.3 Record Keeping and Reports 2.1.3.1 Falsifying a patient record 2.1.3.3 Making a record, or issuing or signing a certificate, report or other document in the course of practising the profession that the Member knows, or ought reasonably to know is false, misleading or otherwise improper There is evidence that Mr. Y. did not act in the professional manner that is required by the Association. Legal documents confirmed that Mr. Y. was convicted of one count of fraud and one count of theft. Prior to coming to a decision, the committee reviewed the submissions and the supporting documentation. Mr. Y. had been convicted of one count of fraud and one count of theft, relating directly to his employment at Dr. Z.’s practice. Mr. Y. no longer meets the requirements of the Association to maintain his status as an RVT. Finally, it should be noted that, according to By-Law #2 ARTICLE 1, members who have had their registration status revoked do have the right to appeal the decision.

Give your 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!

Roundup OVC scientists highlighted in U of G Trupanion data reveals dog breeds Research magazine most prone to allergies An OVC graduate student is featured on the cover of the 2013-2014 Agri-Food Yearbook Edition of the University of Guelph’s Research magazine. Steven Roche, who recently completed a PhD in epidemiology in the Department of Population Medicine, developed a short animated whiteboard video aimed at spreading awareness of the detection, spread and management of Johne’s disease. The goal is to engage farmers and provide a quick, easy way to highlight management practices to limit Johne’s, a chronic disease of cattle, sheep, and other ruminants caused by the bacterium Mycobacterium avium ssp. paratuberculosis (MAP).

October marks the Royal Canin Fundraise for Farley Month

While allergies hit humans hard in the spring, data recently analyzed by Trupanion shows that allergies affect pets later in the year. The company’s analysis found pet allergies peak in late summer—specifically August. Some breeds are more prone to allergens than others, especially flat-faced breeds, like English and French Bulldogs. Here’s what the data suggests about the top 12 dog breeds most prone to allergies: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

English Bulldog French Bulldog West Highland White Terrier American Bulldog Basset Hound Rhodesian Ridgeback American Pit Bull Terrier Shiba Inu Bichon Frise Boston Terrier Miniature Poodle Yorkiepoo

Eastern Equine Encephalitis Conﬁrmed in Eastern Ontario Fundraise for Farley Month has been sponsored by Royal Canin Canada, leading the event to create new elements, and a new logo. The new logo includes exclusive art penned by Lynn Johnston, Canadian artist, cartoonist and creator of the syndicated comic strip, For Better of For Worse. Register by writing to info@farleyfoundation.org. The Farley Foundation was established by the Ontario Veterinary Medical Association (OVMA) in 2001 and assists people in need by subsidizing the cost of veterinary care for the pets that mean the world to them.

On August 9, 2014, the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) was notified of a confirmed case of Eastern Equine Encephalitis (EEE) in a horse in the United Counties of Stormont, Dundas and Glengarry. The 12-year old unvaccinated gelding with no travel history was euthanized following the sudden onset and progression of fever and neurological signs. The horse presented with signs of nystagmus and strabismus (abnormal eye position and movement) along with ataxia (wobbly gait) and eventual recumbency. A post-mortem examination was performed at the Animal

38 The RVT Journal

Health Laboratory in Kemptville, Ontario and EEE was confirmed by testing of brain tissue. Veterinarians in Ontario should consider EEE as a differential diagnosis in horses exhibiting neurological signs and can identify positive

cases through appropriate testing. IgM antibodies for EEE can be detected in serum from horses with neurological signs. Signs of EEE (including circling, head-pressing, ataxia and depression) can mimic a variety of encephalitides including rabies, West Nile virus, botulism, hepatic encephalopathy, equine protozoal myeloencephalitis, and equine herpes myeloencephalopathy. Most equine cases of EEE in Ontario occur between August and September, although cases can occur in October if environmental conditions permit the survival of the mosquito vector species. Effective equine vaccines for EEE are available and veterinarians should ensure that vaccinations are up-to-date for their clients' animals. Once clinical infection develops, treatment options are limited to supportive care. The mortality rate in unvaccinated horses is high --Ontario Ministry of Agriculture, Food and Rural Affairs

Do you have news the RVT community can use? Email lisa@oavt.org to be included in The RVT Journal.

Neutering health eﬀects more severe Canada invests in review of Poultry for golden retrievers than Labradors Code of Practice Labrador retrievers are less vulnerable than golden retrievers to the long-term health effects of neutering, as evidenced by higher rates of certain joint disorders and devastating cancers, according to a new study by researchers at the University of California, Davis, School of Veterinary Medicine. Results of the study now appear online in the openaccess journal PLOS ONE. “We found in both breeds that neutering before the age of 6 months, which is common practice in the United States, significantly increased the occurrence of joint disorders – especially in the golden retrievers,” said lead investigator Benjamin Hart, a distinguished professor emeritus in the School of Veterinary Medicine. “The data, however, showed that the incidence rates of both joint disorders and cancers at various neuter ages were much more pronounced in golden retrievers than in the Labrador retrievers,” he said. He noted that the findings not only offer insights for researchers in both human and veterinary medicine, but are also important for breeders and dog owners contemplating when, and if, to neuter their dogs. This new comparison of the two breeds was prompted by the research team’s earlier study, reported in February 2013, which found a marked increase in the incidence of two joint disorders and three cancers in golden retrievers that had been neutered. --UC Davis

The companies expect to complete the transaction in the second-half of 2014, subject to regulatory approvals.

OAVT oﬃcially rejoins CAAHTT The affiliation between the OAVT and CAAHTT was finalized and signed at the CAAHTT AGM held during the CVMA convention in St. John's Newfoundland.

Farm & Food Care Ontario

The Canadian government has announced new funding of $2.2 million for the National Farm Animal Care Council (NFACC), the organization responsible for reviewing the national Codes of Practice for farm animals. The Codes are science-based and go through rigorous examination, discussion, and assessment, including a 60-day public comment period. Many different groups are represented on the Codes Committees, including farmers, veterinarians, scientists and researchers, and groups associated with animal health and welfare protection.

Mars, Incorporated to buy signiﬁcant portion of Procter & Gamble’s pet food business Mars, Incorporated and The Procter & Gamble Company announced that Mars has agreed to buy the IAMS®, EUKANUBA®, and NATURA® brands in major markets for US$2.9 Billion in cash. The company’s news release says this is a significant strategic move for Mars Petcare to complement its large and growing global Petcare business.

39 The RVT Journal

The OAVT and CAAHTT have been working very hard while preparing an agreement that would best support Ontario members in Canada's national body of animal health technologists and technicians. The Board is thrilled to share this news of our continued relationship with CAAHTT.

Left to right, CAAHTT Vice President Jody Carrick, RVT, CAAHTT Director Laura Sutton, RVT, CAAHTT President Elisabeth Zabori, B.Sc., RAHT, RYT

recommends Did you know? It’s been one hundred years since veterinarian and Canadian soldier Lt. Harry Colebourn adopted a black bear cub. He named the cub after his adopted hometown of Winnipeg -- launching the saga of Winnie the Pooh.

Full F ulll of scie science ence on the ins inside. side. In the management of excess excess weight weight and obesity, the scientific lit literature erature is full of data dat a on Ro Royal yal Canin Satiety Support. It’ It’ss the only only diet proven proven to to help pets feel feel full, llonger onger and has numerous numerous benefits ffor or yyour our patients, including:

फ Reduc फ Reduced ed begging to to help help 1,2 1, optimize compliance compliance 2 फ cessful w फ Suc Successful weight eight loss loss with maintained muscle maintained muscle mass mass2,3 फ Long-t फ Long-term erm benefits of improved quality of life improved life -6 and stabilized stabilized weight weight 44-6 References: References: 1

Bissot Bissot T, Servet Servet E, Vidal S, et al. Novel Novel dietary dietary strategies strategies can can improve improve the outcome outcome of weight weight loss loss pr programmes ogrammes in obese client-owned client-owned cats. cats. J Feline Feline Med Surg Surg 2010; 12(2): 104-112. Weber Weber M, Bissot Bissot T, Servet Servet E, et al. A high pr protein, improves oves satiety in otein, high fibre fibre diet designed for for weight weight loss loss impr dogs. J Vet Vet Intern Intern Med 2007; 21(6): 1203-1208. German AJ, AJ, Holden SL, Bissot Bissot T, et al. A high protein, protein, high fibre Vet J fibre diet improves improves weight weight loss loss in obese dogs. Vet 2010; 183(3): 294-297. German AJ, AJ, Holden SL, Mather NJ, et al. Low-maintenece after weight er w eight lloss. oss. Low-maintenece energy energy requirements requirements of obese dogs aft Br J Nutr 2011; 106 (Suppl 1): S93-S96. German AJ, AJ, Holden SL, Morris PJ, PJ, et al. al Long tterm role erm follow-up follow-up after after weight weight management in obese dogs. The role of diet in preventing preventing regain. regain. Vet Vet J 2012; 192 (1): 65-70. German AJ, AJ, Holden SL, Wiseman-Orr ML, et al. Quality of life improves oves after after life is reduced reduced in obese dogs but impr successful successful weight weight loss. loss. Vet Vet J 2012; 192(3): 428-434.

KEEPS PETS FULL, L LONGER. ONGER.