The RVT Journal (formerly TECHNEWS) summer 2014

SUMMER 2014 VOLUME 37 ISSUE 4

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

Focus on career Guelph RVT Stacey Huneke pursued her passion for working with large and small animals - including her donkey, Bandit -- before joining the OAVT as Member Services Manager.…page 20

JOURN AL

Introducing Zoetis. After 60 years as Pfizer Animal Health, we’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 you’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

Special to this issue: Focus on career: The RVT profession is growing up! A recent survey by OAVT suggests the low wages and general instability that once plagued the profession is a thing of the past. Read, Measure for Measure to find out more. .....................................................................................................

Cover image courtesy of Scott Campbell Imaging

Welcome to The RVT Journal (formerly TECHNEWS)

Plus:

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!

So you've been asked to give a presentation....................................................

Gold Merial Silver The Personal

Bronze Ceva Virbac P&G Pet Care Veterinary Purchasing

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!

Stephanie Allen, RVT Nancy Brock Kara M. Burns Sagi Denenberg Lynn R. Hovda Ned F. Kuehn

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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. Platinum Hill’s Royal Canin Bayer Zoetis

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Vo l unte eri ng CAAT on Grand Turk Island .....................................................................

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An es the si a Anesthesia for Exploratory Laparotomy .................................................

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Be ha vi ou r Approaches to treat canine separation anxiety .....................................

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Ca re er Career options: Getting out of practice ..................................................

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Fin anc e Keep dreaming, but start planning .........................................................

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Poi s on in g Blue-green algae (Cyanobacteria) ..........................................................

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Pro fes s ion a lis m & E thi c s RVT encouraged to maintain professional standards after workplace conflict ...................................................................................

Gary Landsberg Chris Robinson Rebecca Rose Debbie Stoewen Alison Weller, RVT Colleen Wilson

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

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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 – Nutrition for companion birds For companion birds, there is a strong correlation between health and quality of life and life span.

Kara M Burns discusses proper nutrition and feeding management as they relate to individual physiology. ................................................................................................................................................6

CE2

CE article #2 – Feline nasal disease Learn the hallmark clinical signs of diseases of the nose in cats. This in-depth look by Dr. Ned F. Kuehn is a follow-up to last issue's CE article, featuring canine nasal disease. .........

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CE article #3 – Compassion satisfaction: Flourishing in practice part 2 As veterinary caregivers, our hearts go out through sustained compassion -but our hearts can eventually give way to fatigue. Hear from Dr. Debbie Stoewen about the importance of positivity among RVTs in Part 2 of this article series. .............................................

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CE3

Making information, education, industry

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

www.oavt.org

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

CAAT on Grand Turk Island

By Chris Robinson

The Canadian Animal Assistance Team

owners need to understand the importance

(CAAT) arrived on Grand Turk Island in late April to work with the local SPCA and the Turks & Caicos Government to provide an Animal Health Care Clinic on the island.

There is no resident veterinarian on the island and there are countless dogs and a few cats.

of early sterilization, CTVTs and heartworm prevention (made available through the SPCA). Education is key.

The Caribbean breeze and the turquoise sea create a beautiful setting, however, the clinic work, with more fleas, ticks and mange than any of us have seen, was more of our every day reality while we were there. The local people brought in their dogs (and a few cats) for medical treatments, sterilization and vaccinations. Many of the dogs were very social and friendly, however, some were strays and some were semi-feral despite being loosely “owned.” The Turks & Caicos SPCA team worked tirelessly to bring in many of our patients because they were either stray, their owners were unable to transport them and/or they were difficult to catch despite being loosely owned.

It is rare that we have worked on large animals on our projects, however, we were asked to try to help a horse that was at the local dump.

recommends "CAAT began as a disaster relief team in the aftermath of Hurricane Katrina on the Gulf Coast. Trained First Response teams go into a disaster zones and assess the situation and the need for animal relief."

In 2008 it was estimated that 71 per cent of the feral dogs in the Turks & Caicos Islands had Ehrlichia canis and 58 per cent had Dirofilaria immitis (Canadian Veterinary Journal, June 2008, McEwen, Peregrine, Hoff). Along with these diseases, Canine Transmissible Venereal Tumours are rampant on the island. Controlling the dog population growth and thus reducing the number of feral dogs is critical to their welfare. Pediatric sterilizations are important; they will not only reduce the population growth but reduce the number of CTVTs if done prior to sexual maturity. Education is also a vital component in addressing the animal health issues. More

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The most commonly seen dogs on the island are a mixed breed that the locals call “potcakes” – a name that originated from the congealed rice and pea mixture that local residents traditionally fed dogs. The potcake dogs are medium-sized short-hair mixed breed, and are common everywhere on the island. There are also Island horses, donkeys and cattle, some owned, some wild and it is difficult to distinguish which is which since they all roam the island freely.

One particular stray potcake dog was captured through the SPCA’s humane trap.

She had four large puppies she was caring for so they all came in together. We were able to spay and neuter them all so that they would no longer contribute to the overpopulation problem on the island. Each one was vaccinated and dewormed and given new collars, tags and licenses. They were all leaving the clinic with a new foster home to go to until they found forever homes.

We rarely work on large animals on our projects, however, we were asked to try to help a horse that was at the local dump. The dump, we discovered, is a regular hangout for the horses and donkeys of the island, where they scavenge for food. When we arrived to examine her, she had a piece of nylon tied just above her fetlock that had become embedded into her skin. We sedated her, removed the embedded nylon, cleaned and flushed the wound and gave her antibiotics.

CAAT on Grand Turk Island ...continued

The most commonly seen dogs on the island are a mixed breed that the locals call “potcakes” – a name that originated from the congealed rice and pea mixture that local residents traditionally fed dogs.

We explained her needs for the next couple of weeks and the next morning, and when we went to check on her we found someone had tied her to a shade tree, and provided a large bucket of water. The local government animal officer committed to returning twice each day to feed her, make sure she had water, and give her antibiotic injections. She was already looking much better by the time we left the island.

Working somewhere like Grand Turk gives us a renewed appreciation for what we take for granted, especially as pet owners. Food, water, basic health care, protection from parasites (internal and external) and sometimes, just a cuddle. In recovery, after a sterilization surgery, many dogs’ first reflex that returned when they heard us speak to them with our gentle, encouraging voices was the thumping of a tail. That made it all worthwhile.

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

CE CE articles help RVTs earn credits toward their RVT certification.

ARTICLE #1

Nutrition for companion birds

By Kara M. Burns, MS, MEd, LVT, VTS (Nutrition) President, Academy of Veterinary Nutrition Technicians

Correctly answer the quiz associated with this article to earn one CE credit. www.technewsquizzes.ca/login.pl

balanced diet, best achieved through a formulated food. These formulated foods come in a variety of forms with the most popular being2:

1) Pellets 2) Extruded diets with a pellet appearance 3) Whole grains and/or seeds with added pelleted material.

Of the three components that affect the life of an animal – genetics, environment and nutrition – nutrition is the one factor that veterinary healthcare team can easily impact.

This is particularly true of companion birds, for which there is a strong correlation between health and quality of life and life span. For birds, proper nutrition and feeding management is the foundation upon which healing and the maintenance of health rests.

Each species of bird has specific nutritional requirements and this is typically determined by the individual physiology.1 Nutrition must be viewed in lifestages; as nutritional requirements in birds, as in other species, vary from neonate to adult to senior – with other life stage variations in between. This article will focus on birds that have been weaned and are being provided an adult formulation.

It is suggested that birds are provided a

A seed-based food with a vitamin/mineral mix coating on the outside of the seed is another option. However, typically the seed is not hulled. When the bird dehulls the coated seed, necessary vitamins and minerals are removed thus creating a nutritional imbalance putting the bird’s health at risk.

Two processes are used when pelleted diets are manufactured - bound and extruded.

Bound pellet manufacturing involves the grinding of grains such as corn, soybean, and oat groats (oat berries). Following the grinding process vitamins, minerals, and other components are added to produce a balanced food (per the manufacturer’s recommendation). The grinding process produces a consistent pellet which makes it difficult for birds to pick out their favourite part of the diet.With bound pellets in general, the food material is not cooked and the diet will have a longer fiber chain length. Bound pelleted diets may not be as palatable as the extruded diet.2,3 Extruded pellets utilize finely ground grains which are mixed with vitamins, minerals, etc. until a balanced formulation is reached. This

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pellet mixture is then forced through an extruder, under pressure and high temperatures. The mixture will take on the shape of the ‘die’ in the extrusion process.

This allows for extruded pellets to be made into different shapes and colours.3 Extruded pelleted diets come in a variety of sizes and should be selected based on the species and size of bird. Owners must be instructed to monitor their bird to prevent picking out certain coloured pellets and ignoring others. Owners should not choose colours or shapes because their bird ‘likes these’ as this can be expensive and wasteful.

Companion birds are healthier when they are psychologically stimulated and this can occur by presenting multi-coloured pellets in an assortment of shapes.

Historically, providing diets for birds has included seed-based diets. Although pelleted diets have allowed bird owners to provide a better balanced diet without vitamin and mineral supplementation, not every bird will eat them.4 Also as discussed earlier, each species has different nutritional requirements. For example, certain passerine species (e.g., canary and finch) require seed in their base diet. However, for the psittacine species, (e.g., budgerigar, cockatiel, lovebird, etc.) seed is not the recommended diet and a balanced pelleted food is advised as the appropriate base diet.

Nutrition for companion birds...continued

Overall, many seed diets are high in fat and lower in other essential nutrients and therefore should be considered a treat. As with any species, treats should be offered in small quantities or the bird will be at risk for malnutrition – most likely obesity.

Transitioning from a seed diet to a pellet is believed to be difficult. However, this is not the case even in older birds. Healthcare team members must educate owners on what to look for when transitioning a bird from seed to pellets. Owners should ensure that their pet is ingesting the food and not simply crushing the pellet in the hopes of finding a kernel inside. Two signs that indicate that the bird is actually eating the pellets are seen in the production of fecal material and a colour change of the fecal material associated with the pellet colour being ingested.3

To aid owners in transitioning their birds from seed to pellet, formed seed products have been manufactured (i.e., Nutriberries® Lafeber Co., Cornell, IL) (Figure 1). These products are comprised of whole grains and seeds which are mixed with additional components and are stuck together. This is similar to pellets but this product is not ground. The bird must pick off the seed to eat.

Figure 1 – Meyer’s parrot with Seed Ball/Nutriberries® Lafeber Co., Cornell, IL (©Kara M. Burns)

Companion birds are healthier when they are psychologically stimulated and this can occur by presenting multi coloured pellets in an assortment of shapes.

Owners can also learn to transition their birds from seed to pellets through the slow introduction of increased pellets in the seed mixture over a period of time. The transition is recommended to take 7 -14 days with the final diet consisting of 100% pellets.

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Nutrition for companion birds...continued

Avian Key Nutritional Factors Water Water is the most critical nutrient, and all birds should have access to fresh, clean water at all times. Water should be changed on a daily basis and the healthcare team is responsible for reviewing this important piece of husbandry with owners. Birds typically accept municipal tap water, but it is recommended that well water be boiled before allowing the bird to drink freely. If owners are hesitant to boil water, the healthcare team should recommend providing bottled water to their birds. This recommendation is made due to the fact that well water can be contaminated easily by bacteria colonies in the pipes leading to the faucet. 5

Protein and amino acids Protein requirements differ among species.

The minimum recommended protein allowance for maintenance in granivorous (species that consume grain) companion birds is 12%.6 As with all foods, the quality of the protein is dependent upon bioavailability and essential amino acid content. Bird food formulations must avoid excess and deficiency of proteins and amino acids. For the majority of companion birds the following amino acids are considered essential: arginine, isoleucine, lysine, methionine, phenylalanine, valine, tryptophan, and threonine. Budgies also require glycine. 6 Too much protein in the diet of birds has been associated with renal disease, behavioural changes (biting, feather picking, nervousness, rejection of food), and regurgitation. Poor weight gain, poor feathering, stress lines on feathers, plumage colour changes, and poor reproductive performance are clinical signs

associated with protein and amino acid deficiencies.6

shifted away from growth and production and instead utilized in glucose synthesis.7

Fats and essential fatty acids

Carbohydrates are the only source of energy utilizable by the nervous system; therefore neurological abnormalities may indicate deficiency in a diet that is otherwise adequate in kilojoule content.5,7

Fats are a more concentrated source of energy in a diet. Essential fatty acids (linoleic and arachidonic) are required in birds for the following: the formation of membranes and cell organelles, hormone precursors, and the basis for psittacofulvins (i.e. feather pigments found in psittacine species). The typical recommended fat allowance for granivorous companion bird diets is approximately 4%.6 It is important for healthcare team members to note that in birds lipogenesis takes place primarily in the liver. Pet birds fed high energy diets may develop illness associated with hepatic lipidosis. This is heightened if exercise is restricted in the bird.

As with other companion animals and humans, too much fat in the diet of a bird may result in obesity, hepatic lipidosis, congestive heart failure, diarrhea, and oily feather texture. Increased fat levels may also interfere with the absorption of other nutrients such as calcium. Low amounts of fat in the diet may lead to weight loss, reduced disease resistance, and overall poor growth, especially when coupled with restriction of other energy producing nutrients.5,7

Carbohydrates Carbohydrates are another energy source which in birds can be converted into fat in the liver and vice versa. Glucagon is the major component of carbohydrate metabolism in birds. The result of inadequate carbohydrates in the diet is the utilization of glucogenic amino acids to manufacture carbohydrates.

The process involves amino acids being

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Calcium Calcium is an important dietary element for companion and caged birds. Calcium is essential for bone and eggshell formation.

Calcium is also necessary for blood coagulation and nerve and muscle function.

It is recommended that all birds should have calcium supplementation in their cage regardless of the type of diet they are eating.

This is especially true for birds fed a seed diet.

Calcium supplementation can be provided in the form of a cuttlebone, mineral block, crushed oyster shell, or baked crushed eggshell. Birds will eat the calcium if provided and when needed to meet physiologic demands. Cuttlebones should be placed in the cage with the soft side facing the bird.

Cuttlebones are strictly a calcium source and are not beak sharpening devices.3 It should also be noted that high phosphorus in the diet can negate adequate amounts of calcium in the diet. High phosphorus levels will interfere with calcium absorption from the intestinal tract. The calcium to phosphorus ratio should be range from 1:1 to 2:1.3, 7 This is another reason to provide a nutritionally balanced diet as seeds, fruits, vegetables and meat are extremely calcium deficient but do have higher amounts of phosphorus. For example, corn has a 1:37 ratio and muscle meat has a 1:20 ratio.3

Nutrition for companion birds...continued

Vitamins and Minerals

Fruits and Vegetables

Vitamin requirements for companion birds are similar to those of companion mammals. The major exception being that the active form of vitamin D required by birds is vitamin D3 (cholecalciferol) as opposed to vitamin D2 (ergocholeciferol). Vitamin C is important in specific fruit-eating species, but for the majority of passerine and psittacine species a complete and balanced diet will provide the necessary amounts of vitamin C. However, vitamin C supplementation has been suggested to assist debilitated birds as the ability to create vitamin C is reduced and the patients’ requirements are greater.5, 7

Fruits and vegetables are typically presented as supplementation to the pet birds’ commercial diet. Fruits are made up of mainly sugars and water and thus should not be offered in excess. Fruit is a necessary part of the diet for some psittacine species such as eclectus and lories, but these are exceptions.

Fruit should not be fed more than a couple of times in a seven day period.

If the bird is prescribed antibiotics, the healthcare team should monitor the patient closely as vitamin deficiencies may result from the antibiotics interfering with normal intestinal microflora. Intestinal infections (e.g.

Giardiasis) may block vitamin absorption from the intestine (e.g. vitamin E, vitamin A).

Hypervitaminosis has become an increasing problem, as clients may over-supplement formulated food or multivitamin preparations, thereby causing renal failure due to hypervitaminosis D. Hypervitaminosis A can also result in disease, especially in nectarivorous (those birds that eat the sugarrich nectar of flowering plants or the juices of fruits) birds. 3,5, 7

A seed-based food with a vitamin/mineral mix coating on the outside of the seed is another option. However, typically the seed is not hulled. When the bird dehulls the coated seed, necessary vitamins and minerals are removed thus creating a nutritional imbalance putting the bird’s health at risk.

Companion birds receive greater nutritional benefit from vegetables as opposed to fruits.

As much as possible, fresh or cooked dark green, red, and orange vegetables should be offered on a daily basis. One vegetable that should NOT be offered is comfrey. Comfrey is a green leaf herb especially popular in canary aviaries, which may to lead to liver damage.

Proper husbandry suggests the healthcare team educate owners to place fruits and vegetables in a separate container and leave in the cage no longer than 30 minutes. Time restriction will help decrease the likelihood of microorganism growth.3

Summary Optimal feeding practices of companion birds are constantly being evaluated. It is imperative that healthcare team members understand the key nutritional factors in avian nutrition. This will allow for the proper recommendation and education of nutrition to bird owners. Pet bird parents influence their bird’s diet and therefore have a major impact on their bird’s health and longevity. Today’s pet birds may live decades depending on the species so it is imperative that proper nutrition habits be adopted by the owner for their beloved avian family member.

Educating the owner on proper nutrition is one of the most important roles of the veterinary healthcare team.

Owners can also learn to transition their birds from seed to pellets through the slow introduction of increased pellets in the seed mixture over a period of time. The transition is recommended to take 7 -14 days with the final diet consisting of 100% pellets.

Kara Burns Kara Burns is a licensed veterinary technician originally from New England, now living in Kansas. She holds a master’s degree in physiology and one in counseling psychology. She began her career in human medicine working as an emergency psychologist. She also worked at Maine Poison Control as a poison specialist.

She made the move to veterinary medicine and worked in small animal private practice and a small animal and avian practice.

Kara is the Founder and President of the Academy of Veterinary Nutrition Technicians, the tenth recognized specialty for veterinary technicians. Currently, she works for Hill’s Pet Nutrition as the veterinary technician specialist working with the technician profession in all aspects. Kara has authored many articles and textbook chapters and is an internationally invited speaker, focusing on topics of nutrition, leadership, and technician utilization. She enjoys spending time with her wife Dr. Ellen Lowery and their children. The family also includes three horses, two sheep, 2 pugs, a French bulldog, 3 birds, 4 indoor cats, and assorted other critters.

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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!

Anasthesia

Anesthesia for Exploratory Laparotomy

By Nancy Brock, DVM, Dip ACVA

I find laparotomies exciting. Many times, you think you know how the procedure will unfold, but you really don’t. There’s always that element of the unknown, hence the term “exploratory”. Even spay surgery can present us with unexpected challenges. Given these circumstances, how should we approach anesthesia for laparotomy surgery? Here are a few suggestions:

these patients risk pronounced hypotension from: • Release of tumour necrosis factor or histamine during manipulation of a mass • Intolerance of high levels of inhalant anesthesia • Intolerance of certain injectable anesthetic agents such as propofol and thiopental • Traction or masses impinging on the vena cava and interfering with blood flow back to the heart.

• Cardiac arrhythmias secondary to uncorrected electrolyte imbalances specifically hypokalemia, hypercalcemia and hyponatremia

What problems should we prepare for?

I divide my laparotomy patients into two categories: the acutely ill and the relatively healthy, as these two groups present slightly different challenges. Regardless of which of the above categories a patient fits into, all abdominal surgery brings the risk of: • Hidden, unexpected and sometimes difficult to measure blood loss • Severe hypothermia • Esophageal reflux • Severe hypoventilation as a result of organ retraction and manipulation • Post-operative somatic (incision) and visceral pain Acutely ill patients are anorexic, depressed, possibly dehydrated and/or anemic/ hypoproteinemic. These patients rely on high sympathetic tone to cope with the stress of their disease to an extent that we don’t fully appreciate until they are under anesthesia and the sympathetic nervous system and the rest of the brain are put to sleep by our anesthesia drugs. In addition to the problems listed above,

We often cannot assess the full extent of the risk because the nature of the abdominal pathology may be unknown, so we have to be vigilant as well as prepared to implement additional supportive measures if the need arises. I find anesthetic management of the sick patient undergoing laparotomy to be the most challenging of all my clinical work.

Anesthesia drug Premedication:

selection

-

Reduce the need for heavy chemical restraint in sick patients by placing an IV catheter in the medial (feline) or lateral (canine) saphenous vein. Use the blood in the catheter stylet to measure baseline packed cell volume (PCV), total solids (TS) and blood glucose. Choose from among the following drugs: Butorphanol 0.2 mg/kg IM for sedation when your patient is free of acute pre-surgical pain Oxymorphone or hydromorphone 0.05 mg/kg IM (beware of vomiting).

If vomiting would be deleterious to the patient, administer oxymorphone or hydromorphone IV

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or precede with IM acepromazine 0.02 mg/kg (healthy patients only) OR SQ maropitant 1 mg/kg at least 10 and preferably 20 minutes prior to opioid administration.

If an IV catheter can be placed without sedation administer the above drugs through the catheter at 1/2 the above dose. In acutely ill patients that are expected to experience cardiovascular instability during anesthesia I administer IV fentanyl 5 ug/kg.

I prefer not to administer any anticholinergic agents in premedication but rather deliver them intra-operatively if needed. This allows me to use the heart rate to assess depth of anesthesia, response to painful manipulation and possibly hidden bleeding.

Anesthesia drug selection - Induction: For relatively healthy patients, induction drug selection can be quite flexible although propofol and thiopental may increase splenic size to the point that it makes abdominal exploration a bit challenging.

Very sick patients may not tolerate any of your usual induction drug protocols. I prefer to administer IV alfaxalone to very sick cats or IV fentanyl to very sick dogs.

Mask induction is contraindicated.

Maintenance: Sevoflurane or isoflurane are equally safe or unsafe - very ill patients will not tolerate inhalant anesthesia well and may experience profound hypotension within a few moments of exposure to either gas.

Although seldom used these days, nitrous oxide is contraindicated.

Anesthesia for Exploratory Laparotomy ...continued

Support: IV LRS or equivalent should be started at 5 mls/kg/hour. This rate is flexible and dictated by blood pressure, heart rate, initial hematocrit and total solids measurement and hemorrhage.

Be on alert for trends of increasing heart rate and concurrent decreasing blood pressure.

This may be your only clue that hidden abdominal hemorrhage is occurring. Tell your surgeon of this occurrence so that he/she can go looking for hidden bleeding. Administer IV boluses of 5 mls/kg LRS repeated up to 3 times to reverse the trend.

If your patient remains hypotensive, start a dopamine constant rate infusion (CRI) and administer colloid. However, unless your patient is in shock, do not administer dopamine in the presence of active bleeding as it will only speed up the rate of blood loss.

abdomen and in gauze squares. Keep all blood soaked gauze squares in sight.

Measure the PCV/TS every 30 minutes or more frequently if hemorrhage is occurring. If the initial blood glucose is low, continue to measure it throughout surgery along with PCV until it begins to climb.

Measure the body temperature using an intranasal thermometer. Hypothermia can be pronounced in patients with open body cavities during lengthy surgery.

I divide my laparotomy patients into two categories: the acutely ill and the relatively healthy, as these two groups present slightly different challenges.

Special instructions:

If sudden and profound hypotension occurs, consider the possible presence of a mast cell tumour, or tumour necrosis factor. Begin dopamine CRI and administer colloid.

Use warmed fluids for abdominal lavage. If the animal’s condition is stable, leave the fluids in the abdomen for a minute to allow heat transfer. Your goal is to awaken the patient with a temperature as close to or above 36 degrees Celsius.

Consider intermittent positive pressure ventilation (IPPV) if surgical manipulation or retraction cause hypoventilation but be very conservative with breath size and rate as hypotension may be a side effect of ventilation support.

Before the patient awakens, examine the pharynx for evidence of gastric reflux. If reflux is present, suction the pharynx and the upper esophagus and extubate when a strong swallow reflex is present and with the ETT tube cuff partially inflated.

Pain management: Epidural morphine or buprenorphine is advised for all abdominal procedures.

Epidural opioid + bupivacaine is indicated for abdominal procedures in which hemorrhage or cardiovascular instability is not anticipated.

When in doubt, omit the local anesthetic from the epidural and use it to perform incision infiltration.

Epidural opioid analgesia should last 18 to 24 hours. It can be followed by buprenorphine 0.02 mg/kg PO BID for 5 to 7 days to cats or tramadol 5 mg/kg BID to TID for 5 to 7 days for dogs.

If additional intra-operative analgesia is required, a ketamine, ketamine/morphine or ketamine/morphine/lidocaine (canine only) CRI can be initiated. Continue this CRI through to recovery tapering once the patient is extubated and pain can be assessed.

Tramadol 5 mg/kg BID to TID for 5 to 7 days can supplement the transdermal fentanyl if needed. NSAIDs are contraindicated for most animals undergoing laparotomy if GI pathology exists.

Do not combine buprenorphine with transdermal fentanyl.

Monitoring:

Nancy Brock

It may be difficult to assess your patient’s breathing if the reservoir bag is empty and the animal’s chest is hidden by drapes.

Capnography removes the guesswork by providing end tidal carbon dioxide (etCO2) measurement. In the absence of capnography, partially close the pop-off valve to maintain some volume in the reservoir bag and assess breathing by observing reservoir bag movement. Monitor for depressed ventilation during retraction of abdominal organs.

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.

To help in tracking blood loss, monitor the blood in suction canisters, on drapes, in the

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 College’s AHT program in Coquitlam, BC. As part of her anesthesia referral practice, Dr Brock provides veterinarians and their nursing staff with anesthesia assistance and expertise 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.

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CE

ARTICLE #2

Feline Nasal Disease Ned F. Kuehn, DVM, MS, DACVIM (SAIM)

CE articles help RVTs earn credits toward their RVT certification.

Correctly answer the quiz associated with this article to earn one CE credit. www.technewsquizzes.ca/login.pl

Nasal discharge, sneezing, stertorous respiration, obstructive nasal breathing, and open-mouth breathing (rare) are clinical signs associated with chronic nasal disease in cats. Chronic sneezing is a common clinical sign in cats and often is accompanied by nasal discharge. Epiphora or mucoid ocular discharge may be seen with obstruction of the nasolacrimal duct or concurrent ocular infection.

Unilateral nasal discharge may be associated with nasal foreign bodies, early nasal neoplasia, and dental disease; however, some cats with chronic rhinosinusitis may be surprisingly unilateral in their presentation. Bilateral nasal discharge is most commonly seen with chronic nasal disease and its presence does not further define the cause for the nasal disease. Mucopurulent nasal discharge is most commonly seen in cats with chronic nasal disease. As compared to dogs, epistaxis is not commonly seen in cats with chronic nasal disease. Epistaxis is seen with aggressive intranasal diseases causing erosion of blood vessels (e.g. neoplasia, inflammation) or coagulopathies.

Oronasal fistula in adult cats or cleft palate in kittens may be associated with food material appearing in the nasal discharge.

Table 1 Differential Diagnosis for Chronic Rhinitis in Cats Viral infection Feline rhinotracheitis virus Feline calicivirus Bacterial infection Mycoplasma spp Pasteurella multocida Bordetella bronchiseptica Anaerobic bacteria Fungal infection Cryptococcus spp Aspergillus spp Parasitic infection Cuterebra spp Eucoleus (Capillaria) boehmi Neoplasia (nasal, oral, extraocular) Dental disease Foreign body Palatine defects Hyperviscosity syndrome Coagulopathy Idiopathic chronic rhinosinusitis Lymphoplasmacytic rhinitis Allergic rhinitis Nasopharyngeal polyp Stenotic nares Extranasal disease Nasopharyngeal stenosis Pneumonia Vomiting Esophageal stricture Cricopharyngeal disease

Diagnosis Chronic nasal disease is a common and important problem in cats that may result from a number of intranasal or systemic disorders (Table 1). Chronic rhinosinusitis and nasal neoplasia are the most common causes of chronic nasal disease in cats (Table 2)1,2.

Nasopharyngeal polyps, fungal rhinitis, nasal foreign bodies, dental disease, parasitic rhinitis (Cuterebra spp.) and nasopharyngeal stenosis are less frequent, but important causes of nasal disease in cats. Neoplastic disease is of greater concern in cats older than 8 years of age1,2. Nasopharyngeal polyps are typically seen in young cats3.

Brachycephalic breeds (e.g., Persians), cats in high density housing situations (e.g., multicat households, poorly maintained catteries or pet stores), and stray or barn cats are more likely

to develop chronic rhinosinusitis. Outdoor cats have a higher occurrence of nasal foreign bodies, nasal trauma, parasitic rhinitis, and fungal rhinosinusitis.

Viral infection should be suspected when acute upper respiratory infection is present in multiple cats within a household. The prior history of a cat with chronic nasal disease acquired at a later age should be obtained if possible to review previous lifestyle, housing conditions, and vaccination status. While vaccination will not prevent viral upper respiratory infection, it may diminish the severity of clinical signs4. Many cats with prior viral upper respiratory infection will have recurrent bouts of rhinitis throughout their lives. Any sudden change in the nature or severity of nasal disease in cats with known chronic rhinosinusitis should prompt

Table 2 Recent 7 year retrospective study looking at clinical diagnosis after advanced diagnostic imaging in 67 cats with chronic rhinitis referred to BluePearl Veterinary Partners – Michigan.

Diagnosis

Number

Percent

Neoplasia

32

48%

Chronic rhinosinusitis

32

48%

Nasopharyngeal polyp

2

3%

Sino-orbital aspergillosis

1

1%

13 The RVT Journal

Feline Nasal Disease...continued

investigation into the possibility of another cause for change in clinical signs such as neoplasia or fungal rhinitis.

potential value in those patients where chronic rhinosinusitis is suspected.

A thorough physical examination with particular attention to orofacial structures is important in the evaluation of cats with chronic rhinitis. The maxillary and frontal sinus regions should be visualized and palpated for evidence of asymmetry or swellings. The eyes should be examined for any evidence of exophthalmia. The external nares should be studied for symmetry and masses protruding through the openings.

Facial asymmetry or exophthalmia would suggest an underlying neoplastic process or the presence of fungal rhinosinusitis.

Approximately 35% of cats with nasal cryptococcosis have prominent swellings over the bridge of the nose and some cats with nasal cryptococcosis will have a polypoid mass protruding through the nostril.

Diagnostic Imaging

A complete blood count, chemistry profile, and urinalysis should be performed to rule out extranasal systemic causes for the nasal discharge (e.g., hyperviscosity syndrome, polycythemia, thrombocytopenia).

A coagulation profile is indicated if epistaxis is present and a coagulopathy is suspected.

Blood pressure should be determined if hypertension is suspected. Serum titer for cryptococcal antigen is a very specific and sensitive test for cryptococcosis and should be performed if clinical findings are suggestive of this disease5. Thoracic radiographs are of limited value, but should be performed if pneumonia is suspected.

Culturing of nasal discharge for bacterial or fungal organisms are not recommended as secondary bacterial contaminates are typically isolated. Deep culture of nasal tissue is of

For most cats with chronic rhinitis, diagnostic imaging, endoscopic studies, and nasal biopsy will be required to establish a diagnosis.

Diagnostic imaging studies must be completed prior to endoscopic studies of the nose or nasal biopsies are performed. The introduction of instruments into the nose often induces hemorrhage, which will obscure or confuse the diagnostic imaging studies.

General anesthesia is required for further evaluation of cats with chronic rhinitis. Prior to diagnostic imaging, the oral cavity should be carefully inspected for the presence of masses, oronasal fistulae, or clefts in the hard or soft palate. The soft palate should be palpated for the presence of masses (e.g., nasopharyngeal polyp) in the nasopharyngeal region. If a mass is palpated above the soft palate, a spay hook may be used to gently retract the soft palate forward for visualization of the mass.

Following thorough oral and nasopharyngeal examination, skull radiographs or preferably nasal computed tomography should be performed. Imaging studies must be performed while the cat is anesthetized and before performing any invasive procedures within the nasal cavities. Radiography may greatly underestimate the extent or severity of disease due to overlying structures, low contrast resolution, and complexity of nasal anatomy6. For these reasons, computed tomography is preferred for evaluation of the sinonasal cavities and surrounding structures in cats with chronic nasal disease. The

14 The RVT Journal

referenced articles here provide a comprehensive review of nasal radiography7 and nasal CT8, respectively. If routine diagnostic steps do not provide a cause for rhinitis, referral to an institution providing CT imaging is advised.

Rhinoscopy Rhinoscopy is often of limited value because of the specialized equipment required and the small size of the nasal passages in cats. The nasopharyngeal region can readily be evaluated with the use of a small diameter flexible endoscope. The scope is advanced orally to the caudal margin of the soft palate and then the tip is turned 180째 to visualize the area above the soft palate and caudal nares.

Alternatively, a spay hook may be used to carefully pull the caudal margin of the soft palate forward and downward and a dental mirror with aid of a light source is used to view the nasopharyngeal region.

Tissue biopsies of nasal tissue are collected with the cat remaining under anesthesia and only following diagnostic imaging and rhinoscopic studies. Small clamshell forceps are suitable for collecting nasal tissue using blind techniques in cats. The biopsy forceps are directed to mass lesions based on radiographic or tomographic findings. Multiple random samples should be obtained with diffuse disease. The nose of the cat should be pointed at a downward angle to minimize the pooling of blood within the nasopharynx and caudal oropharynx. If chronic rhinosinusitis is suspected, deep tissue samples also should be submitted for aerobic and anaerobic bacterial cultures. The caudal pharyngeal region should be suctioned following nasal

Feline Nasal Disease...continued

biopsy to remove blood clots, hemorrhage, and other secretions. Nasal lavage may be required to dislodge foreign material identified or suspected to be present within the nose. The rostral aspect of the nose should be directed downward while copious amounts of saline are flushed vigorously through the nostrils. The endotracheal tube cuff should be inflated to prevent aspiration pneumonia and the glottis should be surrounded with surgical sponges or gauze.

Chronic Rhinosinusitis Chronic rhinosinusitis is an extremely significant cause of chronic nasal disease in cats having high morbidity and an uncertain etiopathogenesis4,5. Chronic rhinosinusitis may follow severe acute upper respiratory tract infection, particularly in kittens or adult cats exposed to an infected cat. Acute upper respiratory tract infection seems to be caused by infection with feline herpesvirus type 1 (FHV-1) or feline calicivirus and is often complicated by secondary bacterial components. Bacterial agents Chlamydophila felis, Mycoplasma spp., Bordetella bronchiseptica, and Streptococcus canis have less commonly been implicated in primary acute upper respiratory tract infection4,5.

Acute infection is convincingly linked to stress, crowding, and poor husbandry.

Although viral infection is often implicated as the initiating cause of acute upper respiratory tract infection, the pathogenesis of the progression to chronic rhinosinusitis is unknown. Even though cats with chronic rhinosinusitis have similar clinical signs, the disease syndrome appears heterogenous

among the population perhaps due to specific microbial pathogens or strains involved, presence of coinfection, genetic characteristics of the inflammatory response, imbalances between innate and adaptive immune responses, and environmental factors (e.g., stress).

Chronic rhinosinusitis may be seen in cats of any age, although younger cats are most often afflicted4,5. Affected cats with this disease syndrome typically have a recurrent history of chronic intermittent or progressive sneezing, stertor, and nasal discharge. The nasal discharge is usually copious, bilateral, and mucopurulent to purulent, although occasionally the discharge can be unilateral or intermittently contain blood. Systemic or ocular disease is generally not present. Older cats may develop anorexia due to loss of smell, which may exacerbate other underlying disease conditions (i.e., chronic kidney, liver, or gastrointestinal disease). Physical examination findings are generally unremarkable other than abnormalities confined to the upper respiratory tract.

Cats with chronic rhinosinusitis frequently prove to be very refractory to treatment5.

Broad spectrum antibiotics are often used for treatment of bacterial infection within the nasal and paranasal sinus cavities. Potentially pathogenic bacteria and a wider variety of bacterial species are isolated from cats with chronic rhinitis than from cats without disease9. Antibiotics recommended include doxycycline, clindamycin, azithromycin, and fluoroquinolones. Cats with chronic rhinitis demonstrating an initial response to antibiotic therapy should have treatment continued for 6-8 weeks or longer. Antiviral therapy is not

15 The RVT Journal

routinely recommended, as the role of active viral infection in cats with chronic rhinosinusitis is not established. Lysine (500 mg PO q12h) therapy may benefit some cats if intranuclear inclusions or an eosinophilic inflammatory infiltrate is reported on histopathology, which might suggest FHV-1 involvement. Lysine replaces arginine in viral proteins rendering them nonfunctional and thereby reducing FHV-1 replication. For those cats demonstrating response to lysine, therapy may be continued indefinitely as it is safe to use in young or older cats. The use of immunosuppressant agents in management of chronic rhinosinusitis is poorly understood.

Glucocorticoids might exacerbate viral infection, cause recrudescence of viral shedding, or suppress immune response to bacterial infection. Piroxicam is a nonsteroidal antiinflammatory agent that can partially ameliorate nasal inflammation in some cats with chronic rhinosinusitis5.

Piroxicam may also be combined with antibiotic therapy. Moisturization of nasal secretions promotes sneezing and evacuation of mucous from the nasal cavity. Some cats will tolerate the instillation of saline drops within the nasal cavity. Finally, there are no clinical studies with evidence to support the use of immune stimulators (e.g., interferon) in the management of this disease12. In summary, the prognosis for cats with chronic rhinosinusitis is extremely guarded. The chronic nasal discharge and sneezing are very difficult to control, and once control is achieved it is often temporary with recurrence expected. Owners must understand that this disease may be controlled, but is rarely cured.

Feline Nasal Disease...continued

Neoplasia Nasal neoplasia is the second most common causes of chronic nasal disease in cats, mostly occuring in cats older than 8 years of age1,2. Nasal lymphoma is most common with various carcinomas occasionally seen and other neoplasms encountered much less frequently. Immunohistochemical staining for B-cell and T-cell markers should be requested in older cats with severe lymphoplasmacytic inflammation to rule out lymphoma. Radiation therapy is the treatment of choice for nasal neoplasia.

Fungal rhinitis Fungal rhinitis is an uncommon cause of chronic rhinitis in cats, although in some geographic areas the disease is seen frequently. Nasal cryptococcosis is most common and sino-nasal aspergillosis is only occasionally encountered5. Younger cats are more often affected with fungal infection, whereas older cats are more often afflicted with nasal neoplasia. Exophthalmia may be present in cats with sino-orbital aspergillosis, however this may also be seen in cats with nasal neoplasia. Facial deformity of the rostral aspect of the nose is often striking in cats with cryptococcosis. Occasionally granulomatous tissue may be seen projecting through the external nares. The clinical signs of cryptococcosis are obstructive rhinitis with mucopurulent nasal discharge. Mucopurulent conjunctivitis may develop in some cats.

Cryptococcal antigen latex agglutination serological testing is indicated in cats suspected to have nasal cryptococcosis as the assay has a high sensitivity and specificity.

Cytology is also highly diagnostic for nasal cryptococcosis. Fresh material from granulomatous lesions within the nose are gently smeared on a slide and stained with India ink. Cryptococcus spp. is recognized as a thick, encapsulated 20-30 Îźm round to oval yeast organism.

Nasal and sino-orbital aspergillosis is rare in cats. The clinical signs are initially that of copious unilateral mucopurulent nasal discharge. Bilateral mucopurulent nasal discharge can be seen later in the disease.

Intermittent bleeding is not uncommon. Nasal pain is often present and exophthalmia may be present with orbital involvement. Anorexia and depression may develop as the disease progresses, especially with frontal sinus involvement or with destruction of maxillary bones. Extensive turbinate destruction is present. The extent of destruction and determination of sinus or maxillary bone involvement is best demonstrated with computed tomography. The diagnosis of aspergillosis is made by direct observation of fungal plaques, identification of fungal elements in biopsy specimens or direct cytology obtained from affected tissue, or positive fungal culture of affected tissue.

Nasopharyngeal polyps Nasopharyngeal polyps occur predominately in young cats or kittens3. Nasopharyngeal polyps usually arise from the middle ear and grow down the eustachian tube to the nasopharyngeal region. Polyps occasionally may be visible in the external ear canal.

Clinical signs are caused by direct obstruction of either the oropharynx or nasopharynx.

Chronic rhinitis develops secondary to

16 The RVT Journal

obstruction of nasopharyngeal region causing lack of clearance of nasal secretions and secondary bacterial overgrowth. Clinical signs observed in the early stage of disease include stertorous respiration (snuffling sound), gagging, and minimal sneezing or nasal discharge. As the polyps attain greater size, obstructive breathing and increased nasal discharge with sneezing are seen. These signs may be indistinguishable from those of chronic rhinosinusitis, especially in a young cat with a prior history of acute upper respiratory infection. For this reason, any cat with chronic rhinitis (especially those of young age) should be carefully evaluated for the presence of polyps.

The diagnosis of nasopharyngeal polyp is relatively straight forward. Oropharyngeal examination and palpation of the area above the soft palate for a mass or direct visualization of the nasopharyngeal region is diagnostic. Nasopharyngeal polyps may be removed by traction avulsion, however recurrence is common10. It has been advocated that bulla osteotomy should always be performed on the side of polyp origin. For polyps with recurrence following traction avulsion, bulla osteotomy on the side of polyp origin should always be recommended to allow for removal of the origin of the polyp.

Foreign body rhinitis Nasal or nasopharyngeal foreign bodies are infrequent in cats and are usually due to blades of grass lodged within the nasal cavity.

Seeds, small sticks and grass awns are less frequently encountered. Clinical signs associated with foreign bodies within the

Feline Nasal Disease...continued

nasopharyngeal region are often peracute with coughing, gagging, and hard swallowing response usually observed. With time, stertorous respiration, phonation changes, nasal discharge, and sneezing may develop with nasopharyngeal foreign bodies.

Grass blades and similar material can usually be removed under direct examination of the nasopharynx or nasal cavities. Retroflex nasopharyngoscopy is often diagnostic for nasopharyngeal foreign bodies. Flushing the nose with copious amounts of warm saline

may dislodge smaller particles (e.g., seeds) within the nasal cavity. Rhinotomy may be required for foreign bodies resistant to direct removal.

Nasopharyngeal stenosis Nasopharyngeal stenosis is a rare complication of acute upper respiratory tract infection or following episodes of severe vomiting (aspiration rhinitis)1. Progressively worsening stertor is initially present, often with absence of nasal discharge. With severe

stenosis, nasal discharge and extreme difficulty with nasal breathing is observed.

Retroflex nasopharyngoscopy will often reveal circumferential stricturing or narrowing of a focal region of the nasopharynx. Early stenosis may be managed by stretching the affected region followed by corticosteroid therapy to reduce scar tissue and reformation of the stricture. Recurrence unfortunately is very common necessitating placement of metallic mesh stents to span and maintain patency of the stenotic region.

Figure 1 â– Computed tomography images of the nasal cavity from a cat with idiopathic chronic rhinitis.

In the images to the left and centre turbinate structures are obscured due to the presence of mucosal edema and soft tissue attenuating densities (mucopurulent debris) within the air passages. The image on the right shows the caudal nasal cavity and frontal sinuses to be relatively free of inflammation although the nasopharynx has a moderate amount of soft tissue attenuating material (arrow).

Figure 2 â– Computed tomography images of the nasal cavity from a cat with severe idiopathic chronic rhinitis.

Images obtained from several sequences through the nose show marked turbinate atrophy due to severe idiopathic chronic rhinitis. Herpesviral infections may result in severe osteolysis of turbinate structures.

17 The RVT Journal

Feline Nasal Disease...continued

Figure 3 ■ Computed tomography images of the nasal cavity from a cat with nasal lymphoma.

Images obtained at several sequences through the nose.

Turbinate structures are obscured due to the presence of soft tissue attenuating densities present in the air passages. Turbinate structures are intact. This cat had nasal lymphoma. Nasal lymphoma may be infiltrative within the nasal turbinate mucosa or be seen as highly destructive mass lesion (see Figure 4). The changes seen here are very similar to those seen in some cats with chronic rhinitis (compare to Figure 1).

Figure 4 ■ Computed tomography images of the nasal cavity from a cat with nasal lymphoma.

In the image on the left, turbinate structures are destroyed on the right side with ventral destruction of the turbinates on the ventral right side of the rostral nasal cavity due to a soft tissue attenuating mass. There is ventral destruction of the nasal septum (horizontal arrow). There is bony destruction of the maxilla dorsally on the right side (double arrow). Right-sided facial asymmetry can be seen in the area of breach of the maxilla. In the image on the right, there is a soft tissue attenuating mass causing destruction of the left orbital wall with extension into the orbital region (double arrow). The left eye is deviated rostrally and laterally due to the mass in the orbital region. This cat had nasal lymphoma.

Figure 5 ■ Computed tomography images of the nasal cavity from a cat with nasal carcinoma.

Images obtained at several sequences through the nose turbinate structures are obscured with multifocal destruction of turbinates due the presence of soft tissue attenuating mass within the air passages. In the image on the right, the soft tissue attenuating mass has caused destruction of the right orbital wall with extension into the orbital region (double arrow). Right-sided facial asymmetry can be appreciated. This cat had nasal carcinoma. Nasal carcinomas frequently cause destruction of the orbital wall, perhaps due to arising initially within the caudal aspect of the nasal cavity.

18 The RVT Journal

Feline Nasal Disease...continued

Figure 6 â– Computed tomography images of the nasal cavity from a cat with a nasopharyngeal polyp.

The left CT image shows that turbinate structures are obscured rostrally within the nasal cavity due the presence of soft tissue attenuating densities (mucopurulent debris) within the air passages. The centre CT image shows a soft tissue mass within the nasopharynx (arrow). The right CT image shows the bulla on the left side filled with a soft tissue attenuating density (arrow). This cat had a nasopharyngeal polyp with origin in the right middle ear. The photograph below the CT images shows the polyp after removal.

Figure 7 â– Magnetic resonance imaging (MRI) sequence from a cat with a right frontal sinus fungal granuloma.

The MRI image on the left shows a contrast enhancing tissue density within the right frontal sinus (arrow).

The photograph on the right shows the granulomatous material surgically removed from the right frontal sinus. This cat had fungal sinusitis due to aspergillosis.

Dr. Ned F. Kuehn

recommends

Dr. Ned F. Kuehn received his DVM from Michigan State University followed by a small animal internship at Louisiana State University and residency and MS degree in internal medicine at Purdue University. He has authored 50 scientific articles, clinical research abstracts and book chapters and has lectured to veterinary audiences worldwide. His areas of clinical interest are diseases of the nose in dogs and cats. Dr. Kuehn is currently Chief of Internal Medicine Services and Director of Internal Medicine Residency Training at BluePearl Veterinary Partners in Southfield, Michigan.

Did you know? You can order your Ontario license plate with the RVT seal? Email stacey@oavt.org for details.

19 The RVT Journal

Cover story

Measure for measure OAVT wage survey offers insights into value of RVT profession

By Lisa McLean

Veterinary Technicians (OAVT). She credits her decade of experience working as an RVT – the positive and the negative experiences – with helping her in her current role, where she is a resource for several RVTs daily.

“I used to say I wasn’t a people person, but it turns out I am,” Huneke says. “I get to tell people that I know how they feel. When they’re frustrated, I can help.”

RRSP top-ups, paid vacation and sick leave and even a gym membership.

And, as the drive to retain good employees becomes increasingly important, some employers are getting even more creative with how to reward commitment. One RVT told The RVT Journal that her first employer offered an all expenses trip for two to a five star resort in Cabo for any employee that was with the clinic for five years.

Wages: what the survey says In spring 2014, Huneke launched the OAVT wage survey. The mission was simple: get a handle on how much RVTs across Ontario are earning – in salary and other job benefits and perks.

Stacey Huneke, RVT, became an RVT after identifying two key characteristics about herself: she wanted to work with animals, and she did not want to be a vet.

“The vets I knew at the time seemed to be exhausted all the time, and generally unhealthy, and I really didn’t see myself as a ‘people person,’” Huneke says. “So I entered school with blinders on, thinking a small animal clinic was exactly where I needed to be.”

Huneke did land in a mixed animal clinic for seven years – after working at a racetrack, equine hospitals and with other large animals first. Her RVT career was not without challenges. Eventually, the physical nature of working with animals every day got to her.

She injured her back in 2010, and, at the recommendation of her doctor, left the clinic environment for good.

Today, Huneke is the Member Services Manager for the Ontario Association of

“I get a lot of inquiries from RVTs, and many of them ask me what they should negotiate for salary,” Huneke says. “I wanted to do a survey so that we have our own data about what’s happening in our profession.”

The survey garnered more than 1,000 responses, roughly a third of OAVT membership. According to the numbers, the average wage for RVTs who responded to the survey is $19.05 per hour. That ranges from conventional veterinary hospitals for exotics and pocket pets reported at just under $17 per hour, to RVTs working in research settings reporting just over $26 per hour. (See sidebar on page 22 for more details.)

What’s more, perqs and benefits can be generous. More than half of RVTs surveyed reported their employers pay their professional fees (such as OAVT dues and CE fees), they offer free or discounted animal medication and supplies, as well as medical care. Some RVTs are part of a profit sharing program, have a pet insurance allowance,

20 The RVT Journal

“These days RVTs are integral to improving client education, managing the practice and assisting with medical cases; I think more people are seeing value in the work RVTs do.”

--Dr. Bob Van Delst, DVM, President, OVMA

Getting over the five-year hump It’s commonly known in RVT circles that the profession once had a five-year expiry date.

The profession had a poor reputation for its instability, and it was estimated that many RVTs “burned out” within five years. Low wages, a lack of respect and utilization plagued many RVTs, who found themselves too often cleaning cages, answering phones and acting as office administrators instead of putting their years of specialized education to good use.

Has there been a shift in recent years? RVTs are staying in the profession for longer – and the wages reflected in OAVT’s wage survey are higher than similar studies might suggest.

“I do think there has been a shift, because it used to be that positions in practices were not always a fit for a long-term future,” says Dr. Bob Van Delst, President of the Ontario Veterinary Medical Association (OVMA).

“These days RVTs are integral to improving

Measure for measure...continued

client education, managing the practice and assisting with medical cases; I think more people are seeing value in the work RVTs do.”

Van Delst visits practices across Canada in his role with Hill’s Pet Nutrition Canada. He says it’s the RVTs with staying power that make themselves invaluable to the day-to-day operations of the business, especially those who have a hearty dose of enthusiasm for taking on more responsibility.

“RVTs that step forward to offer help and also declare areas of personal interest earn more opportunities,” Van Delst says.

The significance of RVTs in a clinic Van Delst’s early encounters with RVTs helped solidify for him their essential place on the veterinary health care team.

“As a young grad working in my first clinic, the RVTs were lifesavers,” he says. “RVTs taught me all the things I was supposed to remember from the labs I did in school. I was so grateful for that knowledge.”

Today, he says, RVTs represent an important ally in a field that is rapidly changing.

“There’s a huge element of trust -- RVTs are responsible for their own actions, they understand what is happening, and they know how to relay information to pet owners.”

A little recognition, a lot of satisfaction Huneke says the OAVT wage survey will be conducted annually. It will launch again in 2015 in line with OAVT’s annual renewals. In the meantime, she hopes RVTs will find the results a useful resource in their career planning.

“Sometimes communication about the skills RVTs have to offer can help pet owners better understand what they’re paying for at their clinic,” Huneke says. “They see a credentialed professional taking blood and running tests, and they know it’s worth paying for. It’s more meaningful to them.”

arise. For example, this year for the first time, OAVT has been working with other provincial ministries to identify areas of Ontario’s rabies control program that suit the skills and training of RVTs. Van Delst sees a role for OAVT in working more closely with OVMA moving forward too.

“I’d like to see more collaboration at the clinic level, the provincial association level and on public outreach between RVTs and veterinarians – there is a lot we can achieve together,”he says.

As for helping RVTs determine what they should negotiate for she says there’s no quick answer.

“They need to make a budget and figure out what they need to live, and ask for it,” she says. “Ideally, these survey results will arm them with a conversation starter the next time wages are up for discussion. And it might also be a reality check for some people who don’t think they’re earning enough, to see what their colleagues are earning.”

Moving forward together As the RVT profession continues to progress as a vital and respected piece of the veterinary medical team, new opportunities

21 The RVT Journal

Dr. Bob Van Delst, DVM and president of the Ontario Veterinary Medical Association (OVMA) presented the Canadian Association of Animal Health Technologists and Technicians (CAAHT) "Technician of the Year" award to Gillian Smith, RVT in 2012."

Measure for measure...continued

OAVT wage survey 2014 Conventional veterinary hospital – exotics/pocket pets:

$16.82 Conventional veterinary hospital – small animal

$17.62

Shelter

Research

$21.83

$26.14

Total average wage per hour:

$19.05 Breakdown: Average hourly wage for…

Emergency Veterinary Hospital – equine

$22.43

Many RVTs also enjoy benefits – this is an important improvement in hiring practices over the years. Here are some key benefit types: • CE fees • OAVT dues • Free or discounted animal medication and supplies • Free or discounted animal exams, diagnostic tests or surgeries • Profit sharing program • Gym membership (full or partial) • Paid vacation and sick leave • Pet insurance allowance • RRSP contributions

Industry sales – pharmaceuticals

$24.70

Emergency Veterinary hospital – small animal

Industry sales – other

$19.91

$20.77

Advertise with The RVT Journal The RVT journal provides the single best direct route to more than 3,000 Registered Veterinary Technicians (RVTs), as well as technologists, hospital auxiliaries, affiliated industry partners and educational institutions in Canada. As the voice of Canadian RVTs, we welcome the opportunity to help you reach your audience.

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22 The RVT Journal

Behaviour

Approaches to treat canine separation anxiety Colleen Wilson BSc, DVM, Resident ACVB (Veterinary Behaviour), Gary Landsberg, BSc, DVM, DACVB, DECAWBM, Sagi Denenberg, DVM, DACVB, DECAWBM

While destructive behaviour can sometimes arise as part of a dog’s normal behaviour repertoire, some destructive behaviours may be due to underlying anxiety. For example, when destruction is directed at doorways, windows, and exit points, rather than garbage cans, food cupboards, or a pair of leather shoes, further assessment is needed to confirm whether this may be due to separation anxiety.

The behaviour program should focus on teaching the dog acceptable and alternative behaviours in which to engage when alone.

A diagnosis of separation anxiety typically includes one or more of these symptoms: destructiveness, distress vocalization, housesoiling or other signs of anxiety such as salivation. Signs usually arise immediately following the owner’s departure. If any of these behaviours are seen when family members are present, other causes should be considered. Evidence of destructive behaviours or house soiling should be easy to identify when family members return home, but vocalization ranging from whining to howling may often go undetected except when severe enough to disturb neighbours. Video monitoring is useful to verify the diagnosis as well as to monitor the efficacy of a treatment program. Dogs with separation anxiety often have hyper attachment and begin to show anxiety as the owner prepares to leave.

Dogs suffering from separation anxiety are panicked, fearful, and traumatized when left alone. Successful resolution of separation anxiety usually requires a combination of behavioural management and medication.

The behaviour program should focus on teaching the dog acceptable and alternative behaviours in which to engage when alone.

Provided the dog’s daily needs are adequately met, training should focus on encouraging the dog to find a safe retreat to rest or play with its favourite toys, so it can learn to settle and occupy itself away from the owners. During these sessions, attention-seeking behaviour must be ignored, while settled behaviours should gradually be increased and positively reinforced. Some dogs may be less anxious when crated or confined as they find some comfort from this routine; others are more panicked. Since pre-departure anxiety is often associated with the handling of keys, mobile phones or shoes, desensitization and counterconditioning can be as simple as picking up keys or a briefcase, giving a favoured treat or toy, and setting them back down without leaving. Repetition teaches the dog that departure cues may be pleasant and not always associated with actual departures.

Family members should practice nonemotional departures and greetings.

Punishment never alleviates anxiety and has no place in the treatment of separation anxiety.

At actual departure times, food puzzle toys, chews and favoured treats can be provided to distract and occupy the dog. However, in the short term it may be necessary to find day care until the behaviour program and medication can be effectively implemented. Another option in the short term is to give benzodiazepines such as alprazolam prior to departure to reduce anxiety for a few hours.

Since dogs with separation anxiety are highly anxious when left alone, behaviour modification should be combined with drug

23 The RVT Journal

therapy both for the well-being of the dog and to improve treatment success. Clomipramine (Clomicalm®, Novartis Animal Health), is currently licensed for the treatment of separation anxiety. Unfortunately, fluoxetine (Reconcile®, Elanco Animal Health) a licensed veterinary product is no longer available, although the human generic product is. The primary action of both drugs is to enhance serotonin transmission, but peak effect may not be achieved for three to four weeks. Dog Appeasing Pheromone (Adaptil®, CEVA Animal Health) has also been shown to be effective alone or in combination with medication. Other short acting drugs such as benzodiazepines, trazodone or clonidine might also be added prior to departure.

Often families attribute their dog’s misbehaviours when left alone to vengeance or spite. However, dog owners need to understand that the behavioural signs are due to anxiety and distress and that medication can help alleviate their dog’s suffering.

Punishment never alleviates anxiety and has no place in the treatment of separation anxiety.

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.

Career

Career options: Getting out of practice Rebecca Rose, AAS, CVT CATALYST Veterinary Practice Consultants, LLC

Registered Veterinary Technicians (RVTs) could have many roles within the veterinary community. From consultant to small business owner or educator, career choices are only limited by an RVT’s imagination. The book Career Choices for Veterinary Technicians offers hundreds of options for RVTs. Chapters include in-depth reviews of government agencies, industry, not-for-profit, education and other potential workplaces.

Service Canada estimates more than three quarters of Canadians working as veterinary and animal health technologists and technicians are employed in the “professional, scientific and technical services” classification. For the purpose of this article, we will focus on careers in the remaining 25 per cent -- careers beyond the veterinary hospital.

MAIN AREAS OF EMPLOYMENT Main Areas of Employment

Percentage

Professional, Scientific and Technical Services

76.6%

- Other Professional, Scientific and Technical Services (Veterinary Services included)

64.5%

- Scientific Research and Development Services

11.7%

Health Care and Social assistance

8.6%

Universities

4.4%

Service Canada - last modified 2013-09-03

Consider a career in industry A variety of companies make products or perform services for veterinarians and pet owners. These include medications, medical supplies, medical equipment, pet foods, laboratory supplies, equipment and insurance.

In recent years, the veterinary industry has gained a stronger appreciation for the resources available to them when they hire an associate with veterinary technician skills.

Technicians are hired in every business that manufactures, provides, or distributes these products and services.

Industry representatives tend to be accessible at the clinic, but also at education courses and major events that they sponsor.

Working in a corporate rather than clinic setting has some specific requirements too.

All of these jobs require an ability to work within the structure of a business organization, including following all the company policies and procedures. You should

enjoy working as part of a team, and be interested in keeping up your knowledge of company products and the associated diseases or management problems. Basic computer skills as well as good writing and speaking skills are necessary. Experience with a wide variety of animal species and a passion for greatness are helpful. Knowing how to interact with the media is useful.

Companies often send their employees to speaker training or media training workshops.

If working in industry appeals to you, consider speaking with a sales representative who appears to enjoy his or her job. Veterinary conferences allow you the opportunity to cruise around the exhibit hall, speak with representatives about their job, and exchange business cards. (The best time for chatting is when everyone else is in class or conference session.) There are many advantages to working for a corporation, e.g., yearly evaluations based on commission/sales, advancement and career development.

24 The RVT Journal

Working in education Technicians know a great deal about a variety of scientific subjects. If you enjoy teaching others, you can get a job at a community college, veterinary technician program or veterinary teaching hospital. There are many jobs that can be filled by a registered veterinary technician without additional training and that don’t require research work.

Technicians may be qualified to teach a number of science, anatomy, office management or animal production courses.

They may also be hired as counselors, directors, college retail store administrators, website assistants or internship coordinators.

Consider contacting a former teacher or program director and ask them about career advancements in education. You will find a complete list of AHT/VT programs on the Canadian Association of Animal Health Technologists and Technicians: www.caahttacttsa.ca.

Career options: Getting out of practice ...continued

You may also find it beneficial to review the Association of Veterinary Technician Educators http://avte.net, serving both Canadian and American veterinary technician educators. AVTE’s next Symposium will be held in Niagara Falls, Canada in July 2015.

assisting with preventative health care, rigorous dietary studies, food studies and wellness programs. To find out more, continue to research your options at the Canadian Association for Laboratory Animal Sciences, www.calas-acsal.org.

RVT careers in universities, research Working in the public sector & development What do the words “working

The R & D technician may manage the animal facility, including care and feeding of a large number of animals, treatment of sick or injured animals, and preventive health care.

Technicians and veterinarians work closely in this environment monitoring the use of animals in research projects to be sure that experiments are both necessary and appropriate, and makes sure the facility passes inspection by meeting government requirements. In most cases this person has advanced training in laboratory animal medicine.

You may find a position in the pet food industry, maintaining a variety of animals,

for the government” mean to you? The reality of government work is far more varied than you may think. These jobs pay well, offer mental stimulation and can still fill your need to work with animals, if you so desire. One important area of “government” jobs is animal shelter work.

When considering public sector jobs, remember to look beyond jobs that require higher degrees, to those that simply ask for someone with a science background, or someone with a degree in microbiology, biology, or chemistry. Think of your overall qualifications, not just your degrees; for example, you may write well, you may have held supervisory positions and have dealt with the public. You may find a position working for a shelter, provincial veterinarian, Canadian Air Transport Security Authority, Ministry of Agriculture, or Public Health.

Career

Research and development is the area to explore if you have an interest in clinical medicine and still want hands-on work with animals. Many positions are open to veterinary technicians, although some require additional training. Some R & D jobs allow you to stay in one place, but others require travel. Compared with some other industry jobs, the hours of some R & D jobs can be long since there are often deadlines to meet.

Technicians in these positions must be comfortable with the company’s use of animals in research. Basic research often requires specialists such as veterinary pathologists, toxicologists, and laboratory animal technicians. However, technicians may be employed as assistants to these specialists.

Careers in not-for-profit There are good opportunities for technicians to work in organized veterinary medicine.

“Organized veterinary medicine” is a term used by veterinarians and their teams that refers to the associations that focus on professional issues. In addition to those groups with direct ties to veterinary teams, many other livestock or animal-related groups may have jobs for RVTs.

25 The RVT Journal

Many well-known RVTs pursue work outside of the clinic setting. Sandra Lean Leighton, RVT (top) is producing a one-woman theatre show, Behind the Furry Curtain. Nancy Goudreault, RVT is the veterinary sciences program coordinator and professor at Northern College. Danielle Bouvier, RVT, is an area coordinator and an appointed inspector under the Food Safety and Quality Act 2001.

options

Career options: Getting out of practice ...continued

These are primarily indoor jobs that include telephone communication, reading, and writing, supervising, and managing. Some positions require extensive travel and involve lots of meetings. Many allow for continual contact with veterinary teams. Some positions that would be ideal for a technician are not necessarily advertised that way, and many times the person responsible for hiring has a typical stereotypic view of “technician,” which may result in you being told that the group doesn’t have any jobs for a “tech.”

Modify your approach to ask about any job openings at all, and then see for yourself whether any are suitable for your talents.

To learn more, talk to technicians and veterinarians who are on association committees or on a Board of Directors.

Volunteering on a board or committee is a good way to gain experience; these are parttime, volunteer positions. Once you are involved with a particular association, you will have a better idea of how to advance to a paid position. By searching veterinary association websites, you may find a job waiting for you enhancing the very profession you are passionate about. For a brief list of professional organizations in Canada visit www.vetcontact.com.

Careers in consulting A consultant is someone who charges a fee to share special knowledge and to give specific help or advice to a client. The advice can be in the area of business, career coaching, technology, computers, management, or just about anything else. .

Most consultants are regular speakers at veterinary, technician and related industry meetings. Speaking is a way to educate as

well as to let potential clients evaluate the consultant’s expertise. Many consultants also create their own seminars, which they offer independently from other veterinary related meetings. Clients may attend these seminars as a way to pick up business tips, and then decide to hire the consultant for specific help.

Consultants also publish regularly in journals or magazines appropriate to their area of expertise (e.g., business consultants might write for Veterinary Economics magazine, technician utilization consultants might write for Firstline). Writing is done for the exposure, to disseminate word about their work, to establish their credentials, and to educate potential clients about the benefits or need for their services.

Follow your passions For some veterinary technicians, thoughts of a change start with dissatisfaction with their current jobs. However, to gain happiness in a new job or new career path, you must be driven by more than the desire to get away from your old one. It’s time to turn dissatisfaction into desire. Enjoy your pursuit!

Follow your passions! Within veterinary technology there are a tremendous amount of career options beyond veterinary practice. Do your research, meet up with a colleague who has made a similar career move and begin mapping your journey down a new path.

When researching veterinary technician consultants in Canada, you may find a host of veterinary professionals who have written books, have their own blogs, offer advanced learning and training, are grief counselors, or even practice management specialists. The sky is the limit and this truly is the case when it comes to consulting.

Rebecca Rose, CVT CATALYST Veterinary Practice Consultants, LLC. Littleton, CO Ms. Rose currently owns her own business, Catalyst Veterinary Practice Consultants, LLC. She graduated from Colorado Mountain College in 1987 with an AAS in veterinary technology and became credentialed as a certified veterinary technician in the same year.

AAHA Press recently updated her book, Career Choices for Veterinary Technicians; Opportunities for Animal Lovers. This one project opened up many opportunities. Over the years Rebecca has been honoured with many veterinary industry and academic awards. Rebecca’s diverse career includes working as a veterinary technician in a mixed animal practice, offering relief services throughout Colorado, being the first paid administrator to the Colorado Association of Certified Veterinary Technicians, managing two AAHA veterinary practices, and working with various industry leaders in an array of areas.

She invites you to join her on her Facebook business page, Catalyst Veterinary Practice Consultants, LLC. You will see Rebecca finds great joy helping teams succeed.

26 The RVT Journal

Finance

Keep dreaming, but start planning

By Stephanie Allen, RVT

Have you thought recently about your finances? Do you have a financial goal? I’m sure we’ve all dreamed of making a million dollars, but have you determined what it takes to get there - and not by winning the lottery!?

Financial security planning is about more than retirement—it’s about making dreams come true through prudent budgeting, saving and investment. Whether it’s saving for your child’s education, planning a vacation, building a nest egg for retirement, investing in a small business or managing your debt, it is important to create a plan tailored to your needs.

86 per cent of Canadians have debt, and RVTs are no exception; with student debt, mortgages and growing families, it’s hard not to be in the red.

Understand what financial security means to you If you don’t have a lot of money to invest right now, start with what you have. Right now, your most valuable asset may be your ability to earn an income, but you need to use your income wisely to ensure your goals are met.

It’s important to help protect your income in any of life’s uncontrollable events, such as job loss, disability, a natural disaster or a change in your domestic situation.

Identify any roadblocks to achieving your goals Is your household balance sheet in the red?

You’re not alone - 86 per cent of Canadians have debt, and RVTs are no exception; with student debt, mortgages and growing families, it’s hard not to be in the red. But if you suddenly find yourself submerged in debt, the effects may be disastrous. You never know

when a financial emergency may arise, so, it’s important to seek out debt assistance before it is too late.

Refinancing and reorganization of debt are two strategies some use to reposition debt for more efficient payoff, as it may help to consolidate your debt at a reduced interest rate. Using these strategies you may be able free up your cash flow and allow you to invest money for your future and create an emergency fund. However, it’s important not to fall back into debt with the new found money, and create the problem all over again.

Understand your current situation, goals and dreams Setting financial goals throughout your lifetime is important to building a budget.

Identifying your short-term financial goals along with your long-term goals is the first step towards achieving results through planning and goal tracking.

28 The RVT Journal

I can attest that goal-setting works. I paid off my student loan in six months because I had a goal. Sure, I also worked hard at cutting costs, but paying down my student debt had everything to do with setting a goal and finding the motivation to follow a plan. Next, I took the same regular payments I’d paid to my student loan, and placed part of them in my child’s education fund, and the remainder in an emergency fund. These payments were already budgeted for, so it was easy to redirect them rather than spend them.

Everyone needs an emergency fund. An unexpected expense, illness or job loss can bankrupt you if you don't have an emergency fund to fall back on. Financial security advisors recommend having an emergency fund of three to six months worth of expenses. It is also important to invest a portion of your money in solutions that will help you achieve your savings goals.

Keep dreaming, but start planning ...continued

Build a ďŹ nancial security plan step by step to achieve your dreams A detailed, step-by-step financial security plan is necessary in helping achieve your financial goals efficiently. Stick to realistic ideas and numbers, set a time-frame for completing your financial goals, and plan on slow and steady progress. Creating and adhering to a plan allows you to measure exactly how much progress you have made, which also serves to keep you motivated. Starting is always the hardest; but it does get easier.

Keep it simple: Make a plan, keep your plan, adjust it to your lifestyle, be patient. In time, it can help you achieve your goals and make your dreams come true.

Refinancing and reorganization of debt are two strategies some use to reposition debt for more efficient payoff, as it may help to consolidate your debt at a reduced interest rate.

Stephanie Allen Stephanie Allen FSA, R.V.T., is a financial security advisor with Freedom 55 Financial, a division of London Life Insurance Company. She can be contacted at 519-352-6840, extension 364, by cell at 519-359-5901, or by email to Stephanie.allen@f55f.com.

The information provided is based on current laws, regulations and other rules applicable to Canadian residents. It is accurate to the best of the writer’s knowledge as of the date submitted for publication. Rules and their interpretation may change, affecting the accuracy of the information. The information provided is general in nature, and should not be relied upon as a substitute for advice in any specific situation.

For specific situations, advice should be obtained from the appropriate legal, accounting, tax or other professional advisors.

29 The RVT Journal

Poisoning

Blue-Green Algae (Cyanobacteria) Lynn Rolland Hovda, RPh, DVM, MS, DACVIM, Director, Veterinary Services, Safetycall International and Pet Poison Helpline

green algae blooms should be considered toxic unless proven otherwise. Species of blue-green algae known to be toxigenic on a worldwide basis include Anabena, Aphanizomenon, Lyngbya, Microcystis, Oscillatoria, and Planktothrix. Microcystins, potent hepatotoxins, and anatoxins (anatoxina and anatoxin-as), powerful neurotoxins, are the important toxins produced by these species.

Some blooms produce toxins that result in damage to the neurological, hepatic, or gastrointestinal system.

As the days become hot and humid, algae “blooms” occur in bodies of fresh and brackish (not quite fresh, not quite salt) water. Algal blooms result in concentrations of hundreds to millions of algae/mL water, often appearing as scum and turning the water a different colour. Blooms are generally green, but different species of algae produce other colours such as orange/red or yellow/brown.

In addition to changing the colour of the water, blooms may cause an odour and/or abnormal taste to the water and irritation to the skin. Some blooms produce toxins that result in damage to the neurological, hepatic, or gastrointestinal system.

Cyanobacteria, commonly referred to as bluegreen algae, cause the brilliant green, pea green, or iridescent bluish green scum or tinge to water. Most of the cyanobacteria blooms are nontoxic and of the over 2,000 cyanobacteria species, only 80 or so are toxigenic. It is impossible to determine toxicity simply by looking at the water so all blue-

All animals – including dogs, cats, farm and wild animals and birds – as well as humans, are susceptible to the toxins produced by blue-green algae. Toxigenic blue-green algae blooms occur in the hot days of summer when the water temperature rises and rain water run-off results in more nutrients, such as phosphorous and nitrogen, in the water.

Animals are poisoned by drinking contaminated water with only a few mouthfuls, enough to cause clinical signs in many of them. Some absorption through the respiratory route as well as skin has been suggested. Dogs, especially water-loving dogs that hunt or swim, are the species most commonly affected. Cats are seldom affected primarily because they rarely swim and are unlikely to drink water that is not fresh.

Backyard ponds, stagnant water holes, streams, and lakes are common sources of poisoning. Water left in old aquariums and buckets of watery scum removed from ponds or waterholes and left indiscriminately around animals are potential sources of poisoning.

Strong or steady winds may push a bloom toward the shore and allow easy access for thirsty animals.

Diagnosis is still difficult for most cyanobacteria ingestions. Many animals are just found dead next to a pond or lake. Some

30 The RVT Journal

dogs may have algae clinging to their hair coat or in the vomit, but this does not necessarily confirm the diagnosis as strain specificity occurs. Gastric and water sources should be saved and submitted for diagnostic testing.

Blood cholinesterase activity may be used to help diagnose poisoning from anatoxin-as.

Microcystins (hepatotoxins) Animals ingesting microcystins generally become ill within 30 minutes after access to contaminated water. Early signs include anorexia, lethargy, vomiting, diarrhea, weakness, and pale mucous membranes followed by a rapid onset of shock and death.

Some animals develop restlessness, recumbency, and seizures prior to death.

Laboratory abnormalities including hyperkalemia, hypoglycemia, and increases in bilirubin and liver enzymes are common in animals which survive for a few hours. Long term hepatic issues including photosensitization may develop in those animals that survive the acute toxicosis.

Microcystins literally dissolve the cytoskeletal structure of the liver and hepatocytes (liver cells) carried by the portal vein can be found in the lungs at postmortem.

Anatoxins (neurotoxins) Clinical signs associated with ingestion of anatoxin-a or anatoxin-as occur within a matter of minutes. Animals ingesting anatoxin-a develop cyanosis, respiratory failure, stiffness, and muscle tremors followed by paralysis and death in minutes to a few hours. In addition to the signs seen with anatoxin-a, animals ingesting anatoxin-as

Blue-Green Algae (Cyanobacteria) ...continued

often present with salivation, lacrimation, excess urination, and diarrhea. Most animals die within 30 minutes of access to contaminated water. No significant laboratory abnormities are associated with anatoxin toxicosis.

There is no specific treatment for poisoning from blue-green algae toxins. The rapid onset of clinical signs precludes most attempts.

Once the signs of poisoning have developed the prognosis is very poor. Asymptomatic animals with very recent exposures should be bathed to prevent further contamination and emesis induced. The use of activated charcoal has not shown to be effective in absorbing toxins, but cholestyramine was recently used successfully in dog surviving the initial insult.

Atropine may be useful in animals poisoned with analtoxin-as and if time allows, a test dose used. Further treatment is supportive but may include IV crystalloids or colloids for shock, blood products as needed for hemorrhage or coagulation deficits, anticonvulsants (diazepam, phenobarbital), methocarbamol for tremors, phytonadione for coagulation abnormalities, and liver protectants such as silymarin and SAMe.

All animals – including dogs, cats, farm and wild animals and birds – as well as humans, are susceptible to the toxins produced by blue-green algae.

FURTHER READING Puschner B, Pratt C, Tor ER. Treatment and diagnosis of a dog with fulminant neurological deterioration due to anatoxin-a intoxication. J Vet Emerg Crit Care 2010;20:518-522.

DeVries SE, Galley FD, Namikoshi M, et al. Clinical and pathologic findings of blue-green algae (Microcystis aeruginosa) intoxication in a dog. J Vet Diagn Invest 1993;5:403–408.

Rankin KA, Alroy KA, Kudela RM, et al. Treatment of cyanobacterial (Microcystin) toxicosis using oral cholestyramine: case report of a dog from Montana. Toxins 2013;5:1051-1063.

It is important to remember that blue-green algae is a human toxin and those individuals handling affected animals need to take special safety precautions to prevent respiratory irritation, contact dermatitis, or death. Protective clothing, including safety suits or aprons, long gloves, and eye protection, should be worn and good ventilation provided.

Pet Poison Helpline:

®

31 The RVT Journal

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 Helpline’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.

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Presentation

So you’ve been asked to give a presentation

By Alison Weller, ACT, RVT, RMLAT, ZAT

One RVT’s guide to a great delivery I have had the privilege of presenting in front of a variety of people during competitions, at conferences, to students, and on the job.

Presenting – from preparation to delivery – is hard work. For me, the first few felt like a disaster. However, every occasion gave me a little more confidence; and I’ve used that knowledge to improve.

Over the years, I have studied how to give a successful presentation – by observing and talking with people I felt were excellent speakers, by reading articles and books on the topic of presenting, and by trying to understand and learn from my own strengths and weaknesses. I’ve learned that if you’re prepared and feel confident about your topic, your enthusiasm will emanate from you. Here are some suggestions to help you along the way.

Step 2

Step 1 Develop your presentation An abstract is a summary of your presentation, and is usually required before the development of your presentation for consideration and publication. As there is limited word space available, use this to decide what areas are to be highlighted in your completed presentation.

Most likely you’ll work with a program such as Microsoft PowerPoint or Prezi to deliver your presentation. Remember that colour slides are more effective, and dark backgrounds with light lettering can be easier to read. What might look good on your computer screen doesn’t always adjust when you see it through the projector. Test your chosen slide design by running it through a projector so you can judge how your presentation looks from a distance.

Your presentation’s structure should include an opening slide with your presentation title, your professional details, and the date and name of the conference you’re presenting at.

I’ve noticed many great presentations also have an outline that provides an overview of the presentation. The last two slides should include references/acknowledgements, and an ending slide. This will indicated the end of your presentation, invite the audience to ask questions at this time, and help them recognize when to applaud.

As a general rule, try to limit each slide to no more than 25 words in short sentences or bullets. Communicate only one idea per slide, using no more than 5 points. And, always keep readability in mind: text needs to be large, clear and readable, and you should make good use of white space.

Never backtrack in your presentation. If you are referring to a previous slide, have a duplicate copy in your slide deck. And although PowerPoint offers a variety of catchy “slide changing” options, be aware that many audiences find embellishments such as sound effects distracting.

33 The RVT Journal

Prepare for presenting in front of attendees Practice different voice projections. How loud will you have to be for your audience to hear you? If you’ll be using a microphone, remember it may also pick up little sounds such as throat clearing and breathing. Fullsized paper too, can be distracting for audiences. Try to memorize as much of your presentation as you can.

Plan ahead for the day of the presentation by selecting your best outfit. Wear something you feel comfortable and confident in – preferably business attire, or business casual.

And remember to try not to wear items that can be cumbersome or distracting, such as jewelry that jingles when you move, or highnecked clothing that can muffle your voice.

When you take your place at the front of the room, remember to take deep, quiet breaths and stay calm. Be aware of nervous behaviours such as fidgeting or speaking too

So you’ve been asked to give a presentation ...continued

quickly. Pace the presentation to use 1-2 slides per minute at minimum. Ask audience members to hold off on questions until the end of your presentation so your presentation’s flow is not disrupted. Aim to finish 10 minutes before your allotted time to allow time for questions at the end without going over.

When possible, use the computer screen as your monitor instead of looking at the overhead screen. Remember your voice projects best when you are speaking directly to your audience. Sudden head movements can be distracting.

Step 3 Done!

Immediately after the presentation, take deep (quiet) breaths, and congratulate yourself on a job well done! Make some quick notes about things you noticed from your audience – were they distracted or too focused on certain slides? Did they respond really well to something in particular? You’ll want to use these clues to go over your presentation later, so you can fine tune details for future use while they’re still fresh in your mind.

A wise person once said to me after a presentation which I thought had not gone well: “No one but yourself will know what you did not say, so just focus on how and what you did say – and it was great in my opinion!”

That gave me the confidence to continue. We all have something to teach others, and I hope these points can assist in preparing for and delivering the best presentation you can do.

Hard work does pay off in the end.

recommends If you’re prepared and feel confident about your topic, your enthusiasm will emanate from you.

Groaner alert: What do you call a dog magician?

A labracadabrador!

Alison R. Weller, ACT, RVT, RMLAT, ZAT Alison is the Vivarium Supervisor at the University of Toronto Mississauga vivarium. She has graduated from three College-level programs in Canada: the Animal Care Technician, Veterinary Technician, and Zoological Animal Technician program. After working in several small animal, exotic and emergency employments, she began her career in laboratory animal science in 1999. She received her RLAT in 2001 through the Canadian Association of Laboratory Animal Science (CALAS) and credits attaining the Registered Master Laboratory Animal Technician (RMLAT) certification in 2007 among her biggest academic accomplishments. Alison continues to support the local and national branches of CALAS as a past-President of the Central Ontario regional chapter (CORC) from 2009-2011. As an exotic animal enthusiast from a young age, Alison has had the privilege of working with many different exotic species in her career, ranging from naked mole-rats to saltwater crocodiles, and many things in between.

Good luck!

34 The RVT Journal

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CE

ARTICLE #3

Compassion satisfaction: flourishing in practice Part 2 Debbie Stoewen DVM, MSW, RSW, PhD

CE articles help RVTs earn credits toward their RVT certification.

Correctly answer the quiz associated with this article to earn one CE credit. www.technewsquizzes.ca/login.pl

*The article Compassion Satisfaction: Flourishing in Practice – Part 1 can be found in the Summer issue of The RVT Journal, Volume 37, Issue 3

In the caring professions, the highest level of fulfillment is compassion satisfaction. As introduced in Part 1 of Compassion Satisfaction: Flourishing in Practice, we can enhance our capacity, proficiency and competence, and in this way fulfill our personal and professional potential. We flourish if we strive for the joy that can be found in practice. As stated by Fredrickson & Losada (2005), to flourish means “to live within an optimal range of human functioning, one that connotes goodness, generativity, growth, and resilience.’’1 According to a theoretical model forwarded by Radey & Figley (2007), our ‘physical, intellectual, and social’ resources, and standard of self-care predict whether we will experience compassion satisfaction or compassion fatigue.2, 3 Maximizing these three essentials – and using appropriate discernment and judgment – also maximizes the positivity ratio, and our potential to experience compassion satisfaction. When we commit to cultivating the appropriate perspectives, resources and self-care, we expand our potential to flourish. There are tangible steps – or calls to action – that each of us can take to maximize the positivity ratio. And, when our personal and professional wellbeing thrives, so does the service we provide to our patients, clients and each other. This article outlines what you can do to set your compass due north to achieve compassion satisfaction and flourish in practice.

Essential #1: Sustain a determined by what you focus on.”4 The message in Kohlrieser’s statement is to focus positive attitude The first call to action is to sustain a positive attitude. Daniel Goleman, psychologist, science journalist, and author of the internationally best-selling book, Emotional Intelligence, asked George Kohlrieser, a professor of leadership at the International Institute for Management Development, about the importance of maintaining the right kind of attitude. Kohlrieser said, “The mind's eye is like a flashlight. This flashlight can always search for something positive or something negative. The secret is being able to control that flashlight – to look for the opportunity and the positive. When you do that, you're playing to win. You're able to focus on the right things and maintain that positive self.” He continued, saying, “The brain by default is going to look for what is negative until you're assured of survival. Once you feel that you are able to survive, then you can look for the positive. So many people… are looking at what can go wrong in order to survive, and they don’t play to win. They play not to lose… The state you're in is

your flashlight not on what is not working, but on what is working. Search for and find the opportunities and “silver linings.” As Viktor E. Frankl in his book Man's Search for Meaning said, “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Learning to find positive meanings in the circumstances of our lives is a key route to increasing positivity.5 And as Kohlrieser says, it’s playing to win.

Another route to sustaining a positive attitude is to live your life through an “attitude of gratitude.” Express respect, appreciation and liking; smile at those you pass; and leave kind words behind you. Gratitude is, in fact, good for you. Researchers have found that purposefully generating feelings of gratitude can lower the levels of stress hormones in your body.6 But how do you generate gratitude? It's not easy to feel grateful when colleagues are annoyed and clients are demanding your attention. Here are a few tips to try:7

36 The RVT Journal

• When you hear yourself starting to blame, whine, vent, or complain, stop yourself.

Identify one good thing that's right about the situation and comment on that.

• When you find yourself thinking critical thoughts, say “Hmm… That's interesting, but not true.” and then let the thought go.

Thoughts are just thoughts – you don't have to believe them!

• When you find yourself grumbling about a specific client or situation, don't generalize your feelings. Maintain perspective. Say, “This situation is frustrating, but overall I work in an amazing place!”

The best news of all is that when you start identifying things to appreciate, you are more likely to notice things to appreciate. The practice of appreciation creates a selffulfilling prophecy. So take up the appreciation torch – use gratitude as a strategy to enhance positivity. Give compliments. Acknowledge successes. And most importantly, keep a gratitude journal. At the end of each day, pick out one positive experience that stood out. It can be little, like a smile that warmed your

Compassion Satisfaction: Flourishing in Practice...continued

heart, or big, like having saved a patient’s life when the odds were against you. Journalling not only focuses your attention on developing more grateful thinking, it guards against taking life and the many gifts therein for granted.

“Say ‘Yes’ to life.” Eckhart Tolle, author of The Power of Now, wrote these famous words, adding, “– and see how life suddenly starts working for you rather than against you."

Saying “Yes” means believing in the limitless potential of life. Expect the best; believe that the best is ahead of you – and believe in the best in people. Assume that people are reasonable, honest and grateful. While not everyone always is, most are. If you convey confidence in people, they’ll live up to your expectations. But since no one is perfect, have the grace to give second chances. You’ll find you receive more too.

Saying “Yes” also means embracing change, because life is all about change. When you embrace change, you look forward, live forward, and will find yourself living a life that says “Yes!” Sustaining a positive attitude also becomes possible when you release the humourist within you. We all have experienced moments of being funny. We have witnessed the reverberations as the laughter lit the room or eased up a tough situation. Unfortunately, sometimes we are inclined to suppress our natural sense of humour out of fear of looking unprofessional, being judged, or offending. Of course, humour tends to be spontaneous, but sometimes it takes courage. The keys to releasing the humourist within you are to be bold, take risks, persist, and avoid getting

hung up on responses. Let that natural part of yourself shine. Dare to be funny! Laughter can be especially important when no one feels like laughing. It releases “feel good” endorphins, and studies suggest it may lower blood pressure, boost the immune system, and increase circulation.7 Humour has been regarded as one of the highest forms of coping with life stress. So treat yourself and others to laughter. Good humour is a gift.

If you convey confidence in people, they’ll live up to your expectations. But since no one is perfect, have the grace to give second chances. You’ll find you receive more too.

It’s important not to censor “dark humour.”

Dark humour is not a sign that someone is putting on a facade when “nice” to clients and patients up front, and then, at the back of the hospital, showing their true colours by saying “not so nice” things.8 It’s not a sign that someone doesn’t really care. Both ‘up front’ and ‘at the back’ behaviours are authentic. In truth, every social interaction is actually a performance (guided by our norms, i.e. and how acceptable, what is not, how acceptable etc.), and we all have ‘front stage’ and ‘back stage’ behaviours.

“Front stage behaviours emphasize compassion, while backstage behaviours include dark humour, strategizing, and detachment.”8 Back stage behaviours make front stage behaviours possible. They allow you the time and space to prepare for your role, practice appropriate ways of being, blow off steam, and take a break from the “emotional labour” of practice.8 So don’t censor dark humour; accept and use it. Dark

37 The RVT Journal

humour may even inspire new ideas or alternate meanings. It’s a natural part of being human and may even help you to be able to forgive and let go.

Searching for the positive, living through an “attitude of gratitude,” saying “Yes” to life, and daring to share humour are all routes to sustaining a positive attitude. But there’s more! Positivity can be generated through engaging in acts of altruism, (e.g. pro bono services), benefiting you, your team, and your practice, as well as the beneficiaries. Altruism rouses the social emotion of “elevation,” which is “the warm or glowing feeling in the chest [that] makes people want to become better moral beings.” 2, 9 Elevation, roused by “witnessing acts of human moral beauty or virtue,” enhances the desire to “affiliate with and help others.”2, 9 It fosters hope in the potential of humanity and finds joy in the outcomes, which broadens and builds positivity.

Essential #2: Build your resources The second call to action is to maximize your intellectual, social, and physical resources.

Starting with the intellectual side of you, take advantage of the many continuing education opportunities available to expand your knowledge and skills, such as provincial, national, and international conferences that offer lectures, seminars, workshops, and wetlabs; local veterinary academy meetings; in-class and distance education courses; and industry-delivered educational sessions. Inhouse, you can be creative and develop a peer education program, taking turns researching

Compassion Satisfaction: Flourishing in Practice...continued

Researchers have found that purposefully generating feelings of gratitude can lower the levels of stress hormones in your body. and presenting issues particularly germane to the interests of your staff and practice. Staff meetings are refreshing, fun and appealing when they include a CE focus.

Learning tends to be most meaningful (and thus most memorable) when it happens in context, within the daily flow of practice. This is where pulling a book off a shelf, logging into VIN (Veterinary Information Network), and consulting with peers and specialists comes in. Conducting independent online research, reviewing educational videos/DVDs, reading journals, and keeping up with the publications produced by your regulatory body and provincial association also play a part in your professional development. Research in nursing has found a statistically significant negative correlation between compassion fatigue and ‘knowledge and skill,’ 10 making lifelong learning protective. Even reading for pleasure makes a difference. It develops your vocabulary and keeps your imagination alive, “exercising” your brain outside of veterinary medicine. Consider poetry, crossword puzzles, and word games. Challenge your brain in the more playful and less perfunctory ways.

Moving to the social side of you, get and stay connected – and I don’t mean on Facebook!

Build your social network. Reach out to colleagues, friends, and family. Set aside “sacred time” for those who are important to you. Intentionally affiliate with those who share your values, believe in you, and nurture your growth, both inside and outside of work.

Create social events to honour and celebrate your colleagues. Such events improve the quality of your interactions and enhance the sense of social belonging. Be inclusive. We

are inevitably better when we look to each other for support.

Last, but not least, you need to take care of the physical side of you. Quoting Jim Rohn, businessman, author, and motivational speaker, “Take care of your body. It’s the only place you have to live.” So strive towards a healthy balanced diet, watch your weight, and make sure you maintain adequate activity and rest. In taking care of your physical health, you can better take care of your patients and clients. Your physical health is one of your greatest resources.

Overall, you function at your best when all three resources are optimized. So take the initiative to maximize your intellectual, social, and physical resources. They all contribute to the resilience that sustains positivity.

Essential #3: Take care of yourself The third call to action is to take care of yourself. This encompasses the whole self, the balance of body, mind, and spirit.

Whatever helps you to feel uplifted and rejuvenated counts. It can be as simple as taking your dog for a walk, or as un-simple as taking sky-diving lessons. Pursue your passions, but never forget the simple things in the pursuit of the less simple things.

Sometimes the simplest things make the biggest difference. The key is to find what enlivens you. Cultivate interests, activities, and hobbies beyond work. Participate in sports. Make time to read and play. Eat well – and what you enjoy. Embrace spirituality.

Practice relaxation techniques. Get in touch

38 The RVT Journal

with nature and the outdoors. Take meandering, soul-filling walks. Interact with children and animals. Volunteer and contribute to your community. There are many creative and personally meaningful ways to feel invigorated and soothe your senses and make you feel alive, relaxed, and well.

Practices can take care of you too, and in this way help you to take care of yourself. They can provide appropriate training and supervision, the necessary tools to practice well, opportunities for continuing education, schedules that honour work-life balance, and adequate salaries and benefits.

Use good judgment The last call to action is to discern the degree to which you give of yourself. Be sensitive to healthy boundaries to avoid under- or overextending the self, attending to both personal as well as professional boundaries. Self- and other-awareness are the prerequisites to good judgment. Know yourself, what motivates you, and why, and question your motives and actions. Be aware of the needs and interests of others. Checking in with a trusted friend or colleague can help you maintain balance and perspective.

Ultimate outcomes With appropriate boundaries, increased affect, resources, and self-care can generate a higher positivity-negativity ratio, creating the optimal potential for compassion satisfaction, and hence, the opportunity to flourish in practice. But it doesn’t end here!

Compassion Satisfaction: Flourishing in Practice...continued

About CE articles: Continuing to learn after achieving RVT status is essential for the individual and the advancement of the profession.

For more information about CE credits in Ontario, visit www.oavt.org.

IO

ASSOCIA T

IO

OF N

S

R T R

IA

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.

TA

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• Warm, considerate, and respectful interactions with colleagues, generating mutual goodwill and support, improved morale, improved productivity, happier

Compassion for animals and people is a raison d'être for doing the work we do. The satisfaction we experience from engaging in

T VE

• Stronger veterinary-client partnerships, which promote greater adherence to treatment plans and improved patient healthcare outcomes, and enhanced veterinary-client relationships, which promote greater commitment to you and your practice, reduced complaints and malpractice claims, and increased referrals

The bottom line with all of these outcomes is greater prosperity, for you, your patients, your clients, your colleagues, and your practice.

compassionate care is the deeply rewarding sense of fulfillment that comes from helping others. Maximizing positivity to experience compassion satisfaction and flourish is “playing to win” and, ultimately, is a win – for everyone. Set your compass due north and aim for peak performance, the place where work becomes play. Find the joy – and flourish!

N

• More conscientious, creative, and consistent patient care, and a higher commitment to patient advocacy, resulting in improved patient quantity and quality of life, and greater client appreciation and loyalty

workplaces, and an even greater capacity to care for patients and clients

ON

Research in nursing has demonstrated a statistically significant positive correlation between compassion satisfaction and caring, meaning that compassion satisfaction motivates caring.10 This means that when you experience the reward of compassion satisfaction, it will motivate you to care even more for your patients, clients, and each other, which potentiates a number of valued outcomes. Greater caring means:

IN IC N AR Y T E C H

Debbie Stoewen DVM, MSW, RSW, PhD As an entrepreneur, facilitator, and academic, Dr. Debbie Stoewen is committed to advancing the health and welfare of people and animals at the intersections of industry, academia, and civic society. As Pets Plus Us Care & Empathy Officer and the Director of Veterinary Services, she provides a fully accredited, evidence-based continuing education program called The Social Side of Practice for veterinarians and their teams across Canada. Compassion Satisfaction: Flourishing in Practice is one of the sessions in the CE module on Veterinary Wellness.

39 The RVT Journal

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

RVT encouraged to maintain professional standards after workplace conflict By the OAVT complaints committee

RVTs face challenging situations and decisions every day. When an action is called into question, it may be reviewed by the OAVT Complaints Committee. This column aims to help RVTs learn from real situations about working within the boundaries and requirements of this demanding, self-regulated profession. For more information about filing or responding to complaints, visit www.oavt.org.

Complaint Summary: An RVT worked alongside Dr. B. at a small animal clinic. On several occasions, Dr. B. alleged that the RVT performed surgical procedures, even after he informed her that

3. That the RVT disregarded the instructions

provided was inconclusive. The OAVT By-Law

of the attending veterinarian, Dr. B. to

#2, Article 2, Professional Standards puts the

stop performing major surgeries.

onus on the Registered Veterinary Technician

4. That the RVT engaged in unprofessional

to perform his or her duties in a professional

behaviour by sabotaging the safety of Dr.

and conscientious manner with a high regard

B.’s personal vehicle.

for the well-being of the patient.

the College of Veterinarians of Ontario prohibits this. Dr. B. felt that the owner of the

Committee encouraged the RVT to maintain

Decision:

professional standards in accordance with

practice, Dr. C., either condoned or encouraged this. Dr. B. also alleged that the RVT had done damage to his car after they argued.

Allegations: 1. That the RVT (who is not a licensed veterinarian) performed major surgeries at the request of her employer, Dr. C. 2. That the RVT was performing dental extractions, laser declaws, and feline

This

As a self-regulated profession, the OAVT

this By-Law.

Complaints Committee has the option to refer certain incidents to the OAVT Discipline

Reasons for decision:

Committee (which determines allegations of

In reaching its decision, the Committee

professional misconduct) or the OAVT Fitness

considered all submissions. There was no

to Practice Committee (which determines

substantiating evidence provided to prove the

whether an RVT is fit to practice). In this case,

allegations made by Dr. B. There was no

the OAVT Complaints Committee decided

evidence of professional misconduct, or the

that the RVT’s actions and conduct did not

performance of major surgeries by the RVT.

warrant a referral to either committee.

Likewise, there was no evidence provided to

The Committee recognized that the evidence

speak to the vandalism of Dr. B’s property.

neuters.

40 The RVT Journal

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

2

3

4

5

6

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.

Royal Reserved. © Ro yal Canin SAS 2014. All Rights Reserv ed.

KEEPS PETS FULL, L LONGER. ONGER.

Roundup 2014 Animal Health Week September Follow Ontario vet students as they 28-October 4 blog all externship long The Canadian Veterinary Medical Association is highlighting antimicrobial stewardship during Animal Health Week from September 28 to October 4, 2014. It is the opportunity to promote veterinarians as responsible stewards of the important medications that keep animals and humans healthy.

--The Canadian Association of Animal Health Technologists and Technicians (CAHTT)

Why did the snapping turtle cross the road?

Diagnostics, clinical skills, problem solving, and working with clients are all critical pieces in a student veterinarian’s education. Handson opportunities are invaluable. Each summer DVM students from the Ontario Veterinary College (OVC) delve into that practical experience at veterinary clinics across Ontario and additional locales. They visit farms to treat cows and horses, work with dogs, cats and all manner of companion animals while applying the skills they’ve studied. Funded by the Ontario Ministry of Agriculture and Food and Ministry of Rural Affairs (OMAF and MRA), students must complete an eight-week externship course between third and fourth year in a mixed (companion and food animal or companion and equine) practice. This summer, you’ll have the opportunity to tag along with five of them as they blog about their experiences. To learn more about the program, visit: http://ovc.uoguelph.ca/externship --The Ontario Veterinary College.

April to November is prime turtle crossing season on Canadian roads. That’s because turtles often need to cross roads to get to their nesting sites. If you wish to help a turtle cross the street, ensure your own safety first! Then, gently move the turtle in the direction she is going, handling her as little as possible.

“Most turtles can be picked up carefully with two hands,” says the Kawartha Turtle Trauma Centre blog. “But be careful helping a snapping turtle across the road – keep a safe distance from their head as they will snap at you if they feel threatened.” For more information about how to pick up a snapping turtle – or how to help an injured turtle – visit www.kawarthaturtle.org.

recommends Did you know? Less than 1 in a hundred turtle eggs laid will hatch and grow into an adult turtle. Unlike birds, turtles do not tend their nests once laid, nor care for their young once they hatch. - Kawartha Turtle Trauma Centre

Canada to host World Equestrian Games Bromont/Montreal is the host city for the prestigious 2018 FEI World Equestrian Games.

To accommodate the best in the world coming

42 The RVT Journal

to Canadian soil to vie for the podium in 2018, the Bromont Olympic Equestrian Park will also be expanded and enhanced so the eight FEI disciplines of jumping, dressage, eventing, para-dressage, reining, driving, endurance and vaulting will have top-notch, world class competition facilities. This will leave the already outstanding equestrian venue in Bromont as a legacy to Canadian equestrian sport. The FEI World Equestrian Games are held every four years, in the middle of the Olympic cycle. The 2014 Games will be held in Normandy, FRA, from August 23 to September 7.

--Standarbred Canada

RVT title adopted by B.C. British Columbia Animal Health Technologists have official changed from AHTs to RVTs. As of May 7th, 2014 their professional title is Registered Veterinary Technologist.

CVMA antimicrobial smartvet app now available Antimicrobial SmartVet, a new treatment decision application from the Canadian Veterinary Medical Association (CVMA), is now available for download onto your Apple or Android smartphone or tablet. Developed by a veterinary expert panel, the SmartVet app is a bilingual antimicrobial treatment decision tool for companion animal practitioners. This app will guide you through the process of selecting appropriate antimicrobial therapy for specific bacterial diseases of dogs and cats, including diagnostic steps, recommended first, second and third line treatments and recommendations for advance diagnostics and/or referral. A urinary tract infection (UTI) application is the first of a set of decision

Do you have news the RVT community can use?

Email lisa@oavt.org to be included in The RVT Journal.

tools being built into CVMA’s SmartVet app.

The UTI app provides an algorithm on how to manage simple and complicated UTIs, an antimicrobial treatment reference table and supplemental resources to guide you through successful antimicrobial therapy. - Canadian Veterinary Medical Association

OSCPA launches No Hot Pets campaign for summer The summer can be a wonderful time for you and your pet. It’s also a time where you need to be careful of the dangers surrounding your animal. You can help spread the word by sharing how deadly it is to leave your pet in your vehicle. No Hot Pets is a campaign encouraging pet owners to take their pet with them when they park their car. Share this message and take the pledge today! Let’s have no hot pets this summer! Visit www.nohotpets.ca for more information.

Trupanion medical insurance updates Boehringer Ingelheim (Canada) Ltd. its core policy launches Semintra® for cats with chronic kidney disease Trupanion, a medical insurance provider for pets, announced updates to its core policy based on suggestions and feedback from veterinarians and pet owners to make its policy even more comprehensive and accessible for pets. The company offers one simple, fair and comprehensive plan for pets that are sick or injured. Eliminating concerns of a predetermined benefit schedule and amount, Trupanion’s comprehensive policy will continue to pay 90% of actual veterinary costs for covered claims for the treatment of illnesses and injuries. See www.trupanion.com for more information.

Canadian Animal Health Institute (CAHI) member companies agree to phase-out antibiotics for growth Docsinnovent introduces V-gel species specific supraglottic airway promotion devices for anesthesia and resuscitation

V-gel uses a non-inflatable, super-soft and anatomically shaped cuff that creates a superb airway seal around the pharyngeal, laryngeal, perilaryngeal and the upper esophageal structures.

Reporting animal cruelty is as simple as calling If you find an animal left vehicle,, unattended in a vehicle, please cal 310-SPCA 10-SPCA SPCA calll 3 or your local poli police ce services services

Farm Food Care Ontario

Dial 310-SPCA (7722) to report cruelty in Ontario In April 2014, The Ontario SPCA introduced a centralized call centre for reporting animal cruelty 310-SPCA (7722). This number works across all of Ontario. Operation V.A.L.U.E Vulnerable Animals Left Unattended Everyday -- is now entering its third year, and has also now expanded to becoming a provincial crime prevention initiative. Visit www.ontariospca.ca for more information.

A new treatment option for cats diagnosed with chronic kidney disease has been launched in Canada by Boehringer Ingelheim (Canada) Ltd. Semintra® is the first ever angiotensin receptor blocker to receive marketing authorization in veterinary medicine, and contains the active ingredient telmisartan. It is licensed for the reduction of proteinuria (the unwanted loss of protein via the urine) associated with chronic kidney disease (CKD) in cats. CKD is characterized by a progressive loss in renal function over a period of months or years. It is a common disease affecting around 10% of all cats and up to 35% of geriatric cats.

In April 2014, CAHI members announced their intent to work with the Veterinary Drugs Directorate (VDD), Health Canada to align all affected antibiotics with the U.S. Food and Drug Administration’s (FDA) policy on prudent use of antibiotics. Under the policy, the growth promotion uses of medically important antibiotics will be phased out in conjunction with the implementation of veterinary oversight for the therapeutic antibiotics used in feed and water. --CAHI

43 The RVT Journal

V-gel for Cats and V-gel for Rabbits gives a high performance alternative to using endotracheal tubes. A high quality seal is obtained through the combination of a gel-like material with design contours that mirror the anatomical airway structures of the cat and rabbit species. This delivers for a competent user, a clear and safe airway in less than 4 seconds and avoiding patient trauma.

Distributed in Canada by Benson Medical and will be available through the purchasing groups AVP, WDDC, MVP, VP & CDMV. -Benson Medical Industries Inc.

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