2012 Summer TECHNEWS

2012

|

VOL UME 35 I S S UE 4

PREMIER JOURNAL

FOR

CANADIAN VETERINARY TECHNICIANS

SUMMER

A NATIONAL JOURNAL PUBLISHED BY THE ONTARIO ASSOCATION OF VETERINARY TECHNICIANS

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

CONTINUING EDUCATION • Emergency Management of Pleural Space Disease • Why So Many Vomiting Cats?

• Veterinary Anesthesia Drug Substitution Strategies Plus: CAPC Predicts Higher-than-Average Heartworm Risk, ‘Pet Ownership, Interactions, and AnimalAssociated Disease Risks in Canadian Households,’ Thank You from Farley Foundation, The Underrecognized Mouse and Rat Poison: Zinc Phosphide!, Equine News, Effective Horse Handling and more!

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2012 Platinum Sponsors Making continuing education better & more accessible across Canada Bayer HealthCare Animal Health Division Hill’s Pet Nutrition Canada, Inc. Merck Animal Health Royal Canin Medi Cal Pfizer Animal Health These companies are generously supporting a series of outstanding learning opportunities for registered veterinary technicians through OAVT. 35th Annual OAVT Conference & Trade Show February 21 - 23, 2013 London, Ontario This meeting continues to expand and grow in stature, as the largest and best stand alone Registered Veterinary Technician/Technologist meeting in the world.

Professionalism & Ethics Course Outstanding one-day CE courses offered during the year. Call the office for the date and location closest to you.

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

Making information, education, industry news and career opportunities available to technicians - everyday and everywhere! www.oavt.org We applaud these companies for working closely with Canadian veterinary technicians and OAVT in the design and delivery of these exciting programs throughout 2012.

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Letter from the Editor............................................................................................................... 2 CAPC Predicts Higher-than-Average Heartworm Risk.............................................................. 3 Help Clients Keep Their Pets Safe and Healthy at the Dog Park This Summer......................... 4 Safety Column: Pet Ownership, Interactions, and Animal-Associated Disease Risks in Canadian Households...................................................................................................... 5 Pharmacology Column: S-Adenosylmethionine (SAMe)........................................................... 8 CE Article #1: Emergency Management of Pleural Space Disease....................................... 9 Thank You for Helping to Bring the Farley Foundation to Your Community.......................... 13 CE Article #2: Why So Many Vomiting Cats?.................................................................... 14 TECHNEWS Subscriptions.................................................................................................... 17 CE Article #3: Veterinary Anesthesia Drug Substitution Strategies................................... 19 Apps and Websites to Watch................................................................................................... 21 Tech Tips and Tidbits.............................................................................................................. 22 TECHNEWS Spring 2012 CE Quizzes............................................................................. 23 Continuing Education Opportunities..................................................................................... 25 Global News........................................................................................................................... 26 Poisoning Toxicology Column: The Under-recognized Mouse and Rat Poison: Zinc Phosphide! ........................................................................... 28 Equine News........................................................................................................................... 30 The Canadian Animal Assistance Team in Botswana................................................................ 32 Submitting Articles to TECHNEWS...................................................................................... 33 Employment Ads..................................................................................................................... 35 Effective Horse Handling ....................................................................................................... 38 Puzzle...................................................................................................................................... 39 Did You Know? ...................................................................................................................... 40

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Next Issue: Fall 2012 Deadline for Material: August 1, 2012 Distribution Date: September 15, 2012 TECHNEWS is a quarterly publication published by the OAVT.

Employment Ads: Please see Employment Ad Information on Page 35 For advertising information: Contact Laura Fanthome: Tel. (800) 675-1859 Fax (519) 836-3638

• Editor - Laura Fanthome (lauraf@oavt.org) • Technical Editor - Shirley Inglis, AHT, RVT (shirley@naccvp.com)

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

TECHNEWS | VOLUME 35 ISSUE 4

Printed on recycled paper

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Hello fellow RVTs. As I enter my new role as the editor of TECHNEWS, it has allowed me to reflect on my career as an RVT over the years. Many changes have occurred, one being that I have gotten older, wiser (insert laugh), and also I have merged many aspects of my education and past careers into one. On that note, I wanted

other RVTs to be able to inform readers about their present accomplishments and give kudos to those “Amazing RVTs” around the world. We are all linked as

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members of our profession but how we are performing in our roles can be so very unique.

“Career Spotlights” will be your forum to reconnect with each other and our profession, whether it is through an interview, a short story or a biography.

It will be an opportunity to look for inspiration and explore exciting new possibilities. Maybe you would like to hear about how one member has followed his career to New York, and another to Dubai? Perhaps you are wondering about how a companion animal RVT has found their way into the production animal industry?

In the beginning we are all RVTs recognized in Ontario. Where will your “R” take you?

Looking forward to hearing about some great RVTs and please feel free to drop me a line about one too.

Yours truly,

Laura Fanthome Editor, TECHNEWS

TECHNEWS | VOLUME 35 ISSUE 4

Companion Animal Parasite Council Predicts Higherthan-Average Heartworm Risk The Nonprofit Companion Animal Parasite Council (CAPC) Celebrates 10-year Anniversary with Redesigned Website, www.CAPCVet.org

BEL AIR, Md. (April 5, 2012) – Leading parasitologists with the nonprofit Companion Animal Parasite Council (CAPC, www.PetsandParasites.org) have developed a first-of-its-kind parasite forecast that predicts how prevalent certain parasites will be in upcoming seasons. The Spring 2012 CAPC Parasite Forecast focuses on heartworm, a potentially fatal disease in dogs and cats transmitted via mosquito bites, and warns that most of the country will experience high populations of the troublesome parasite in the coming months.

“The CAPC is proud to provide the Parasite Forecast as a public service,” said Byron Blagburn, MS, Ph.D., parasitologist, CAPC board member, former CAPC president and distinguished professor at the Auburn University College of Veterinary Medicine in Auburn, Ala. Blagburn – one of fewer than a dozen veterinary parasitologists in the country who specializes in heartworms – was instrumental in the data analysis for and compilation of the CAPC Parasite Forecast. “We want everyone to be especially vigilant in protecting themselves and their pets from the risks that parasites pose in every state in the country. It’s important to remember that almost all parasites are completely preventable.”

Even so, data shows that roughly half of the more than 78 million pet dogs in the United States are unprotected against heartworms – parasites that can be prevented with year-round, easy-to-administer medication. The CAPC hopes its Parasite Forecast will remind pet owners to have their animals examined annually by a veterinarian and give their pets preventives that eliminate the risk of infection by heartworms and other parasites.

Through April 2012, it calls for the following levels of heartworm populations in five U.S. regions*: “extremely high” in the South; “high” in the Northeast and Midwest; “moderate to higher-thannormal” in the Northwest; and “persistent spikes” in parts of the West.

The CAPC based its Forecast on National Weather Service data, weather trends, parasite prevalence statistics from veterinary clinics and animal shelters across the country. The forecast is also the collective expert opinion of respected parasitologists, who engage in ongoing research and data interpretation to better understand and monitor disease transmission and changing life cycles. This fall, the CAPC will issue another Parasite Forecast that covers heartworm and ticks.

TECHNEWS | VOLUME 35 ISSUE 4

About the Companion Animal Parasite Council (CAPC) The Companion Animal Parasite Council (www.capcvet.org) is an independent nonprofit comprised of parasitologists, veterinarians, medical, public health and other professionals that provides information for the optimal control of internal and external parasites that threaten the health of pets and people. Formed in 2002, the CAPC works to help veterinary professionals and pet owners develop the best practices in parasite management that protect pets from parasitic infections and reduce the risk of zoonotic parasite transmission.

The key indicators that point to increased numbers of heartworms this spring are anticipated above-normal temperatures and precipitation amounts, because mosquitoes thrive in wet, warm climates.* While there are medications available to treat heartworm disease, they are costly and often ineffective. Prevention is the best defense against heartworms, which rarely also affect humans.

To protect pets and families from parasites and parasitic disease, the CAPC recommends that all pet owners administer parasite control medication to dogs and cats year-round. Many parasite prevention products require a simple monthly application. Regular veterinarian checkups are also important so that pets may be tested and treated for any external or internal parasites that doctors find.

For more information about the CAPC, the number of dogs affected by heartworm and other parasites where you live, as well as disease prevention tips, please visit www.PetsandParasites.org. *Please see the Spring 2012 CAPC Parasite Forecast at www.PetsandParasites.org for more details.

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CAPC Spring 2012 Parasite Forcast

Help Clients Keep Their Pets Safe and Healthy at the Dog Park This Summer With summer comes an increase in visits to the dog parks. More and more, pet owners are utilizing dog parks than ever before.

Extremely high parasite populations in all areas

High parasite populations, particularly in areas with above-average temperatures and rainfall

Moderate to higher-than-normal parasite populations, localized and persistent parasite spikes possible in areas with above-average temperatures and rainfall

Moderate, lower-elevation areas with increased temperatures and rainfall could experience persistent parasite spikes

The CAPC issues its First-Ever Spring 2012 Parasite Forecast for the Following Five Regions: SOUTH:

Extremely high parasite populations in all areas (West Virginia, Virginia, Kentucky, North Carolina, South Carolina, Georgia, Florida, Alabama, Tennessee, Mississippi, Arkansas, Oklahoma, Texas and Louisiana)

NORTHEAST:

High parasite populations, particularly in areas with above-average temperatures and rainfall (Maine, Vermont, New Hampshire, Massachusetts, New York, Rhode Island, Connecticut, New Jersey, Pennsylvania, Delaware, Maryland and the District of Columbia)

MIDWEST:

High parasite populations, particularly in areas with above-average rainfall (Kansas, Missouri, Illinois, Indiana, Ohio, Michigan, Wisconsin, Iowa, Minnesota, North Dakota, South Dakota and Nebraska)

NORTHWEST: Moderate to higher-than-normal parasite populations, localized and persistent parasite spikes possible in areas with above-average temperatures and rainfall (Washington, Oregon and Northern California) WEST:

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Moderate, lower-elevation areas with increased temperatures and rainfall could experience persistent parasite spikes (Southern California, Arizona, New Mexico, Nevada, Utah, Colorado, Wyoming, Montana and Idaho)

With a 34 percent increase over the past five years, dog parks are the fastest-growing segment of city parks in the U.S., according to a study by the non-profit Trust for Public Land. As dog park visits increase, remind dog-owning clients about the importance of safety when visiting their favorite dog park.

In 2011, VPI policyholders spent more than $8.6 million on medical conditions that are commonly associated with a visit to the dog park. According to VPI, here are the most common dog park related injuries: • Sprains and soft tissue injuries • Lacerations and bite wounds • Kennel cough/upper respiratory infection • Insect bites • Head trauma • Hyperthermia or heat stroke • Parasites • Parvovirus Before visiting the dog park, make sure your clients understand that dog parks have their rules, just like any other community. Below are a few simple but important tips for ensuring a fun and safe trip to the dog park: • Obey all posted rules and regulations • Pay attention to your dog at all times • Don’t bring a puppy younger than four months old • Make sure your dog is up to date on vaccinations and has a valid license • Keep a collar on your dog • On very warm days, avoid the dog park during peak temperature hours, typically between 10 a.m. and 4 p.m.

• Look for signs of overheating, including profuse and rapid panting, a bright red tongue, thick drooling saliva, and lack of coordination. If this occurs, take your dog to a veterinarian immediately. (Firstline)

TECHNEWS | VOLUME 35 ISSUE 4

SAFETY COLUMN

Pet Ownership, Interactions, and Animal-Associated Disease Risks in Canadian Households

by J.W. Stull1, A.S. Peregrine1, J. Sargeant2, J.S. Weese1 1 Dept. of Pathobiology 2 Dept. of Population Medicine, University of Guelph, Guelph, Ontario, Canada

Introduction Many human infections are potentially transmitted through direct and indirect contact with animals (zoonoses), including household pets. Despite the importance of household pets as a potential source of human infections, little is known of the general population’s pet ownership, animal contact practices and knowledge of animal-associated diseases and methods to reduce such infections.

The objective of this study was to describe household knowledge, perceptions, and practices of pet ownership and animal interaction for a sample of the general population in Ontario.

ute self-administered written questionnaire on-site or at a later time.

Materials and Methods Two multi-doctor general practice physician offices located in Kitchener and Cambridge, ON participated in the study.

Data were analyzed using Intercooled Stata version 10.1. Statistical significance was based on a P-value <0.05.

During 4 weeks in October and November, 2010, individuals present in the waiting areas of participating clinics were invited to take part in the study.

Inclusion criteria for participation: >=18 yrs of age, able to read and speak English, no signs of distress or pain, no one from their household had previously taken part in the study.

Participants were asked to complete an anonymous, confidential 10-min-

TECHNEWS | VOLUME 35 ISSUE 4

Questionnaire: Developed and piloted with guidance from epidemiologists, veterinarians, physicians, and zoonotic disease experts. The questionnaire gathered both individual and household-level data including demographics, respondent knowledge and concern of zoonotic diseases, disease information provided by medical professionals and other sources, and pet ownership, management, and animal contact practices. A non-pet owner survey was created by discarding questions specific to current pet ownership.

Results 74.7% (641/858) of individuals approached completed the survey.

63.7% (408/641; 95% CI: 59.8-67.4) of participants reported having one or more pets in their household.

36.7% of non-pet owning households reported >= 1 person having at least weekly physical contact with animals. This proportion was similar to that of pet-owning households (Table 1).

Zoonotic disease risk and receipt of zoonotic disease information differed between pet-owning and non-owning households (Table 1). Cat and dog bites/ scratches were commonly reported in pet-owning households; although less common, these injuries also occurred in non-owning households.

Most respondents did not report having received zoonotic disease information from any source or being asked by their health care provider if they own any pets.

Of those who did receive this information, veterinarians were often listed by pet-owning households (72%), while family physicians were listed less often by either group (20-29%).

Perceptions of pet ownership, zoonotic disease risk and knowledge of risk reduction differed between pet-owning and non-owning households (Table 2). Respondents from pet-owning households reporting fewer concerns and a higher level of comfort with disease knowledge and risk reduction than those from nonowning households.

Pet-owning households had a higher mean zoonotic disease knowledge score than non-pet-owning households (6.5 vs. 6.2; t-test, P=0.02).

Dogs and cats were most commonly owned, with other species less often reported (Table 3). Higher risk behaviours and management practices were identified in many pet-owning households with the feeding of raw food products and poor hand/face hygiene being the most common. Although infrequently owned, a high proportion of households with reptiles reported higher risk practices (e.g., children < 5 or immunocompromised individual in household, washing animal or cage in common use areas).

Discussion Although animal contact, resulting human injury, and higher risk settings (e.g., child < 5 years or immunocompromised individual) were frequently reported, a minority of respondents received zoonotic disease information. When individuals had received this information, it was of-

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table 1 > Animal contact, zoonotic disease risk, and receipt of zoonotic disease

information in Canadian households with and without pets (N=641) Response

Drug

Pet Currently in Household Yes, N (%)

No, N (%)

P-Value1

One or more higher risk individuals in household (641)2

Yes

184 (45.1)

151 (64.8)

<0.001

Anyone in household have regular (>= weekly) physical contact with animals in places outside of the home (573)

Yes

128 (35.0)

76 (36.7)

0.676

During the past 12 months, anyone in household bitten or scratched by any dog or cat, where the skin was broken (616)

Yes

144 (36.4)

22 (10.0)

<0.001

Ever received information from any source about diseases that you can get from pets or precautions to take with pets to reduce the risk of disease (630)

Yes

145 (35.8)3

48 (21.3)4

<0.001

Any of your medical doctors or their staff ever asked if you owned any pets (630)

Yes

31 (7.7)

7 (3.1)

0.003

Taken one or more of your animal(s) to a veterinarian in past 12 months (403)

Yes

332 (82.4)5

NA

NA

x2 test comparing â&#x20AC;&#x153;yesâ&#x20AC;? to no responses (not shown), grouped by pet ownership Higher risk defined as individuals < 5 yrs, >= 65 yrs, or diagnosed with an immunocompromising condition 3 Most common sources (%): veterinarian (72.5), internet (31.7), books (28.9), tv/newspaper/magazine (20.4), family physician (19.7) 4 Most common sources (%): internet (37.5), friend/relative (35.4), family physician (29.2). veterinarian (29.2), books (25.0) 5 89 (26.8%) reported to have ever received information from a veterinarian about zoonotic diseases or precautions to reduce risk 1 2

table 2 > Perceptions of pet ownership, zoonotic disease risk, and knowledge of risk

reduction in Canadian households with and without pets (N=641)

P < 0.001 for each comparison (X2 test)

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TECHNEWS | VOLUME 35 ISSUE 4

table 3 > Species ownership and higher risk practices in Canadian households with

pets (N=641)

Dog N(%)

Cat N(%)

Reptile N(%)

Fish N(%)

Bird N(%)

Pocket Pet N(%)

Species in household

274 (42.8)

191 (29.8)

22 (3.4)

53 (8.3)

22 (3.4)

29 (4.5)

Immunocompromised individual in household

60 (26.4)

55 (34.0)

9 (47.4)

15 (35.7)

7 (35.0)

8 (34.8)

At least 1 child < 5 yrs in household

44 (16.1)

26 (13.6)

2 (9.1)

10 (18.9)

1 (4.6)

3 (10.3)

Feed at least one of the following to the animal(s): raw eggs, raw meat, raw dairy products, raw animal product treats

85 (32.2)

10 (5.4)

NA

NA

NA

NA

Households with all children < 5 yrs report child(ren) never or sometimes wash their hands after touching the animal(s)

17 (73.9)

8 (66.7)

0

NA

NA

NA

Households with all children < 5 report animal(s) daily or often licks child(ren) face(s)

5 (21.7)

NA

NA

NA

NA

NA

Cage or animal washed in kitchen sink, bathtub, or bathroom sink

NA

NA

6 (27.3)

NA

NA

NA

Variable

NA: Not asked or not applicable

ten self-acquired through active research (e.g., internet). Physicians and public health personnel were infrequent providers of this information. Despite the prominent role veterinarians played in providing zoonotic disease information to pet-owning households, a minority of respondents who had been to the veterinarian within the past year reported having received this information from veterinarians.

Although pet-owning households reported less concern and had greater knowledge of zoonotic diseases than non-owning households, knowledge deficits were evident. Higher risk practices were frequently reported in pet-owning households.

These results suggest there is a need for consistent, dependable zoonotic disease information for both pet and non-owning households. Although this information must actively come from both animal and human health spheres, large efforts should be made by human and public health personnel to ensure both pet and non-pet households are reached.

Calculated as the frequency participants correctly classified the following as zoonotic or nonzoonotic: rabies, intestinal worms, HIV/AIDS, distemper, Salmonella, Giardia, hepatitis, infectious diarrhea, ringworm, MRSA, measles (Min-Max possible score: 0-11).

Acknowledgements: The authors wish to thank the 2 clinics and their patients that participated in this study.

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P H A R M AC O L O G Y C O L U M N Side Effects Occasionally, an animal experiences vomiting after SAMe administration, though other than this there are no known side effects of SAMe.

by Dr. Wendy Brooks, DVM, DipABVP (Educational Director, Veterinary Partner.com)

Brand name: Denosyl, Novifit, Vetri-SAMe, and Denamarin (a combination of SAMe and Silybin) Available in 90 mg tablets, 225 mg tablets, and an assortment of sizes and doses for human consumption.

Background SAMe is a natural biochemical produced in the body from the amino acid methionine. It is involved in several biochemical processes.

• Transmethylation Our cells possess an outer skin called a cell membrane. Cell membranes perform an assortment of functions as they are the interface between the cell and the cell’s environment. Cell membranes are made of special fats called phospholipids.

SAMe biochemically donates its methyl group to these phospholipids, thereby enhancing the abilities and functions of the phospholipids.

One specific phospholipid is called phosphatidylcholine, and it makes up the cell membranes of liver cells.

Phosphatidylcholine is made using a process involving SAMe such that the more SAMe is available, the more phosphatidylcholine is produced, and the more fluid the liver cell membranes become, leading to better bile flow.

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• Transsulfuration After SAMe has donated its methyl group as above, it is gradually converted into a compound called glutathione, which is an antioxidant.

Antioxidants serve to protect cells from harmful biochemicals that might cause cancer development or cell death. Since liver cells are directly involved in detoxification of the body, they are especially at risk for accumulating harmful biochemicals. Antioxidants help protect cells, especially in the liver; further, it has been shown that most canine and feline liver patients are deficient in glutathione.

• Aminoproplyation SAMe can be converted to a compound called methylthioadenosine via a process called aminopropylation.

Methylthioadenosine has direct antiinflammatory and analgesic properties plus it is supportive of cartilage matrix production.

Use of this Medication In veterinary medicine this product is chiefly used in liver disease; however, in humans it is frequently recommended for joint pain and mood elevation. Antioxidants are an important treatment in preserving mental acuity in old age and Novifit is primarily marketed for this purpose, while Denosyl and Denamarin are mostly marketed for liver support.

Interactions with other Drugs In theory, SAMe could interact with the pain reliever tramadol in such a way that an increase in the neurotransmitter serotonin might occur, leading to dangerously high blood pressure. Until this has been studied more carefully, it is recommended that these two medications not be used together.

Concerns and Cautions SAMe is best absorbed on an empty stomach.

SAMe comes in a blister pack (single pill packets with a foil wrapper). SAMe is sensitive to air and moisture and broken tablets should be discarded.

SAMe is considered by the FDA to be a nutritional supplement rather than a drug, which means it does not have to undergo the same rigid testing for efficacy as a licensed drug. There is a definite problem with lack of quality control in regard to nutritional supplements for human consumption thus products for human consumption do not undergo standardized production.

© 2012 Dr Wendy Brooks, DVM, DipABVP and VIN, All rights reserved.

Editor’s Note: Reprinted courtesy of Veterinary Information Network (VIN). VIN (www.vin.com) is the largest online veterinary community, information source and CE provider. The VIN community is the online home for over 30,000 colleagues worldwide.

VIN supports the Veterinary Support Personnel Network (VSPN.org); a FREE online community, information source for veterinary support staff. VSPN offers a wide range of interactive practical CE courses for veterinary support staff -- for a small fee. Visit www. vspn.org for more information.

TECHNEWS | VOLUME 35 ISSUE 4

Patients with difficulty breathing represent the highest level of urgency. When a patient presents in respiratory distress, teamwork could not be more important.

Compassionate handling of these patients (and their panicked owners!), as well as a high standard of nursing care, should not be undervalued.

Definitions and Goals of Emergency Care

Pleural space abnormalities result when air, fluid or tissue infiltrate the pleural cavity causing clinical signs. The pleural space lies between the thoracic wall and the intrathoracic organs, lined by the pleura. There are normally a few millilitres of intrapleural fluid to allow frictionless movement of the lungs1. Effusion results when fluid accumulates in the pleural cavity. Intrapleural air is referred to as pneumothorax. Space occupying tissue is most commonly caused by diaphragmatic hernia or masses. Due to space limitation, this article will focus only on pleural effusion and pneumothorax.

Treatment on an emergency basis is aimed at stabilization and supportive care, namely oxygen therapy and thoracocentesis for an immediate improvement in respiration.

The method of oxygen supplementation chosen should be well-tolerated in order to keep the patient as comfortable as possible.

Examples include flow-by, face masks, hoods, cages, nasal prongs and nasal catheters. IV access should be obtained early and a sedative choice with minimal cardiac and respiratory suppression can reduce patient anxiety and facilitate treatment2. Diagnosis is made by clinical signs, physical examination, a detailed history, laboratory evaluation of effusions and radiographic findings.

Further diagnostic tests to determine the underlying cause can include complete blood count, serum biochemistry, blood gas analysis, coagulation testing, EKG, thoracic ultrasound, echocardiography, com-

CE Article #1 Emergency Management of Pleural Space Disease puted tomography (CT), magnetic resonance imaging (MRI), tissue biopsies and exploratory thoracotomy.

Goals for team members are to recognize emergencies when owners contact the clinic, provide instructions on the safe transport of these pets according to established protocols and having a plan and emergency supplies ready upon patient arrival.

Clinical Signs and Physical Exam Inability to expand the lungs leads to atelectasis causing clinical signs. Patients present tachypneic or in overt respiratory distress (dyspnea). It is important to remember that over-handling can lead a tachypneic patient into life-threatening dyspnea. Small dogs can be ‘scooped’ by placing one arm around the front legs and other behind the stifles.

It may be possible to carry a cat this way, or by using firmer restraint (scruffed with front legs together and held close to the body) being cautious not to compromise breathing by scruffing too tightly or putting pressure on the chest. A rolling table is

the best method to move a large dog from one area to another. Considering the degree of stress these patients are under, handlers should remember that a normally friendly pet may bite unexpectedly. Often only a cursory physical exam can be performed on these patients2.

The breathing rate is usually rapid and shallow with a significant abdominal effort.

Open-mouth breathing, cyanosis or pale mucous membranes, neck extension, a reluctance to lay down or sternal recumbency with abducted elbows (orthopnea) may be seen. Other signs can include lethargy, coughing, elevated or decreased temperature, weight loss, anorexia, heart murmurs and/or arrhythmias3.

Auscultation, percussion and compression of the thorax can detect if pleural disease is present. Heart and lung sounds are suspiciously quiet over the affected areas. If fluid is present, breath sounds are dull in the ventral thorax, and if air is present breath sounds are dull in the dorsal thorax4. On thoracic percussion, intrapleural fluid cre-

Lori Williamson graduated from the Veterinary Technician program at Seneca College in 2008 and obtained RVT status that year. She has been a full-time RVT at the Vaughan-Richmond Hill Veterinary Emergency Clinic since 2009, with special interests in staff training and clinical pathology. She currently lives in York Region with her cat, “the grey affair” Ernie. His recent diagnosis of feline hypertrophic cardiomyopathy inspired her to write this article.

TECHNEWS | VOLUME 35 ISSUE 4

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guided tissue biopsy is minimally invasive and histopathology is the only way to diagnose malignant mesothelioma6,7.

ates a low-pitched shorter sound, whereas air creates a high-pitched longer sound.

Degree of chest compression should be evaluated in cats when a cranial thoracic mass is suspected1.

Pyothorax (septic suppurative exudate) has been noted as being the most common septic disorder in cats2, typically from multicat households. In dogs, thoracic wounds and migrating inhaled foreign bodies are more common4. Treatment for pyothorax involves placement of a thoracostomy tube for continuous drainage, thoracic lavage and antibiotic selection based on culture results. The effusive form of feline infectious peritonitis (FIP) is a non-septic exudate or a modified transudate, frequently with bicavital effusions. Unfortunately, the prognosis for FIP is grave and treatment is expensive4.

Pleural Effusion

There are several causes of fluid build-up within the pleural space and each will be discussed below. Surprisingly, up to 300 mL of fluid may be present in feline patients before signs of dyspnea are elicited3.

Oxygen therapy is necessary for all cases and it is recommended that 10 minutes of quiet O2 be administered before attempting a cautious physical exam. Thoracocentesis (Table 1) may need to be performed immediately to stabilize in the presence of severe dyspnea prior to x-rays.

Fluid samples should be collected in sterile tubes for total protein, biochemical testing, specific gravity, and culture and sensitivity. Collect samples for morphology and total nucleated cell counts (TNCC) in EDTA and make smears soon after collection. Gross fluid characteristics should be noted such as turbidity and colour. To prevent damaging cells, centrifuge samples on urine speed. If tissue samples contained in formalin are to be shipped, these must be kept separate from fluid samples since the formalin will affect staining and lyse cells.

An in-clinic cursory exam of fluid can be useful, but diagnosis with a pathologist is necessary5.

On radiographs pleural effusion can show a blurred cardiac silhouette, “leafing” of lung lobes, displacement of the lung margins from the thoracic walls, “scalloping” of the lung margins at the sternum and an enlarged mediastinum1 (Figure 1). Evidence of pulmonary edema and/or cardiomegaly may be seen in some cases. Ventrodorsal views should not be performed in animals with severely compromised breathing. Also, exposure settings may need to be increased in anticipation of fluid being present. Radiographs taken after a chest tap may help to define anatomic structures, remaining fluid and iatrogenic pneumothorax from thoracocentesis.

Fluid Types

Transudative Effusion Pure transudates are clear and low in protein and cellularity. They are more common in abdominal effusions, but can also exist in bicavital effusions. Pure transudates can be the result of severe hypoalbuminemia, hypertension and fluid overload6.

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Figure 1: Ventrodorsal (top) and lateral (bottom) views of a dog with pleural effusion. VD view shows leafing of lung lobes and retraction from the thoracic walls. Lateral view shows a blurred cardiac silhouette and fluid ventrally.

Modified transudates are highly represented in pleural effusion6. Protein levels are 2.5 -3.5 g/dL and cell counts can vary between 1000-5000 cells/uL. Gross appearance may be clear to turbid, serous or blood-tinged.

Cells can include RBCs, WBCs, mesothelial cells ± neoplastic cells. Congestive heart failure and neoplasia are common causes of modified transudative effusions3.

Exudative Effusion Exudates are high in protein and cellularity, >3.5 g/dL and >5000 cells/uL respectively. They are grossly turbid and may be bloody/purulent. Exudates result from inflammation and are classified as septic or non-septic. Neutrophils and macrophages are the prodominant cell types and are examined for phagocytized bacteria5. Culture and sensitivity testing is recommended for all exudates4.

Neoplasia can also result in an exudative effusion6. Lymphosarcomas are highly represented in cats3 and hemangiosarcomas in dogs6. Cytology should be cautiously interpreted since hyperplastic mesothelial cells can share the same characteristics of neoplastic cells (Figure 2). Any condition causing a pleural effusion can result in mesothelial cell hyperplasia7. Ultrasound

Chylous Effusion Total protein is often >2.5 g/dL, cell counts are variable and are predominately small lymphocytes ± mesothelial cells. Neutrophils increase relevant to chronicity6. The hallmark appearance of a chylous effusion is a milky white-pink effusion with a supernatant that stays milky after centrifugation.

Figure 2: Hyperplastic or neoplastic? In-house exam of pleural effusion from a cat. Shown are single and binucleate pleomorphic cells with basophilic cytoplasm. Euthanasia was elected and external pathology was not performed. Note the RBCs at the far left and right for size comparison.

Fluid chemical analysis is needed to confirm a diagnosis of a greater than serum triglyceride concentration and equal or lower cholesterol. The fluid is rich in lymph and chilomicrons.

Causes can include heart disease, trauma or obstruction of the thoracic duct, lung lobe torsion, thromboembolism, diaphragmatic hernia and heartworm disease. Initial therapy for chylothorax involves thoracocentesis and a low-triglyceride diet. Surgical correction is indicated if medical management fails3.

TECHNEWS | VOLUME 35 ISSUE 4

Hemorrhagic Effusion Hemothorax has a total protein of >3.0 g/ dL and is bloody with a hematocrit that is 25% higher than the patient’s PCV4. Platelets and a clear or hemolytic supernatant indicate iatrogenic blood contamination or recent hemorrhage, whereas icteric serum, a lack of platelets and erythrophagocytosis indicate older hemorrhage5.

Major causes of pleural hemorrhage include thoracic trauma (diaphragmatic hernia) and coagulopathy (rodenticide ingestion). Cats are much less likely than dogs to have hemothorax from coagulopathy3.

Treatment includes fluid therapy and blood transfusion as indicated. During thoracocentesis only enough blood should be removed to improve respiration, since the blood that remains will eventually be resorbed. Surgery is not usually necessary unless the hemorrhage cannot be controlled or there is a penetrating object.

Pneumothorax

Pneumothorax is considered either nontension or tension, and can be from traumatic or spontaneous causes. The source of the air leak may be open, in which air enters the pleural space through the thoracic wall.

If the thoracic wall is intact, then the pneumothorax is closed and the air has come from a perforation somewhere in the respiratory tract. Traumatic pneumothorax can be caused by injuries or iatrogenic damage.

Traumatic pleural injuries are frequently the result of car accidents, high-rise syndrome, bite wounds and piercing objects.

Iatrogenic trauma can result from thoracocentesis, thoracic surgery, thoracostomy tubes, barotrauma from positive-pressure ventilation and rough endotracheal intubation4. Iatrogenic pneumothorax following thoracocentesis happens infrequently in dogs, but is common in cats with chronic pleural disease since fibrosed pleura does not heal well3. Traumatic pneumothorax is for the most part self-limiting2. Spontaneous pneumothorax can be caused by

table 1 > Thoracocentesis Supplies:

• • • • • •

Sedative selection Endotracheal tubes for emergency ventilation if required Sterile gloves Lidocaine 1-2 mg/kg8 for local block 25-60 ml syringes; 22 G needles, butterfly catheters or peripheral IV catheters; IV line tubing, 3-way stopcock Vacutainers for sample collection and submission, refractometer for total solids, slides

Method:

• • • • •

Comfortably restrain the patient in sternal recumbency (cats) or standing (large dogs)9 Shave and surgically prep an area between the 7th and 9th intercostal spaces on the affected side(s) either at the mid-upper thorax (air) or the lower third of the thorax (fluid)8 Administer local block The needle is inserted at a 45 degree angle to the body wall cranial to the rib Once fluid/air appears in the needle hub, the needle is placed parallel to the body wall and fluid/air is aspirated

TIP: the assistant should keep the stopcock valve in the OFF position on initial entry and during all re-directions to prevent introducing air or fluid back into the space9.

TECHNEWS | VOLUME 35 ISSUE 4

abscesses (gas-producing bacteria), masses of the pulmonary parenchyma, severe coughing from bronchial/airway disease (pneumonia, asthma), heartworm disease and migrating foreign bodies3. Pulmonary bullous emphysema in dogs has been cited as the most frequent cause of spontaneous pneumothorax, typically occurring in Siberian Huskies4. Often an exploratory thoracotomy is needed to correct the cause of spontaneous pneumothorax2.

Animals with non-tension pneumothorax present with rapid shallow breathing. Air auscultated should be removed by thoracocentesis (Table 1) and the volume of air noted. If repeat taps yield a smaller volume of air, then placement of a thoracostomy tube may not be needed. If however, a patient requires more than 2 thoracocenteses in which the air volume has not decreased, then a chest tube should be placed to allow for continuous suction2,4. Pain management and oxygen therapy are supportive care measures.

Tension pneumothorax is a life-threatening condition which requires immediate thoracocentesis to remove air built up in the pleural space. The site of air leakage into the space is a one-way valve in which air enters the pleural space on inspiration and cannot exit back through the airways on expiration1,4. Pressure in the chest increases which rapidly leads to cardiovascular collapse. Animals present dyspneic with very little chest movement but exaggerated abdominal effort. As tension builds, animals have a “barrel-chested” appearance with widened intercostal spaces and gasp for breath2. If relief of dyspnea cannot be achieved with thoracocentesis or if unconsciousness occurs, then intubation with an emergency thoracostomy can be life saving.

A thoracostomy tube for ongoing suction is placed once the animal has been stabilized.

The patient should be referred to a 24-hour care facility for an exploratory thoracotomy and ongoing care2.

Radiographic signs of pneumothorax are dorsal elevation of the heart on lateral view and lung retraction from the thoracic walls on ventrodorsal or dorsoventral views1 (Illustration 3). Often subcutaneous emphysema is evident3 (Illustration 4).

Conclusion

Prognosis of pleural space disease depends on the etiology and the patient’s response to treatment. Many cases may need to be

11

glossary4,6,10 >

Figure 3: A dog who was HBC. The heart is elevated off the sternum in lateral view.

Figure 4: Cat and High-Rise Syndrome with mild pneumothorax evident on lateral view (top), subcutaneous emphysema obvious on dorsoventral view (bottom), and pelvic fractures (not shown).

Atelectasis - Airless state of the lung alveoli Chilomicrons - A fat droplet that contains triglycerides, cholesterol, phospholipids and protein. After eating, chilomicrons circulate from the intestinal lymphatics to the thoracic duct.

Dyspnea - Difficulty breathing from insufficient oxygenation resulting from a pathological cause.

Erythrophagocytosis - Ingestion of red blood cells by macrophages indicating chronicity of the effusion.

Iatrogenic - Caused by a physician.

Mesothelial Cells - Epithelial cell which lines the pleural and peritoneal cavities.

Percussion - Using a finger, the chest is tapped and the auscultated sound indicates the presence and location of fluid or air.

Pulmonary Bullous Emphysema Pathological air-accumulation in lung tissue resulting from circular air-filled blisters called blebs or bullae which impair gas-exchange.

Tachypnea - Rapid respiratory rate with shallow chest excursions which may be from a pathological cause or stress.

Thoracocentesis - Also called thoracentesis, the insertion of a needle into the pleural space to drain fluid or air for therapeutic and diagnostic purposes.

Thoracotomy - Incision of the chest wall for surgical exploration ± resection of tissues.

references > 1. 1. Silverstein, Deborah C. “Pleural Space Disease.” Textbook of Respiratory Diseases in Dogs and Cats. Ed. Lesley G. King. St. Louis: Saunders, 2004. Print.

2. Mathews, Karol A. Veterinary Emergency Critical Care Manual. Guelph: Lifelearn Inc., 2006. Print.

3. de Laforcade, Armelle, Elizabeth Rozanski and Amy V. Trow. “Respiratory Emergencies and Pleural Space Disease.”

Feline Emergency and Critical Care Medicine. Eds. Kenneth J. Drobatz and Merilee F. Costello. Ames: Blackwell Publishing Ltd, 2010. Print.

4. Sauvé, Valérie. “Pleural Space Disease.”

Small Animal Critical Care Medicine.

Eds. Deborah C. Silverstein and Kate Hopper. St. Louis: Saunders Elsevier, 2009. Print.

5. Cowell, Rick L. and K. E. Dorsey. “Cytological Examination.” Lab Procedures for Veterinary Technicians. Ed. Charles M. Hendrix. St. Louis: Mosby, 2002.

Print.

6. Center, Sharon A. “Fluid Accumulation Disorders.” Small Animal Clinical Diagnosis by Laboratory Methods.

Eds. Michael D. Willard and Harold Tvedten. St. Louis: Saunders, 2004.

Print.

7. Kavula, Laurena A., Kenneth S. Latimer and Perry J. Bain. “Mesothelioma in Dogs.” Veterinary Clinical Pathology Clerkship Program. N. p. 2003. Web. 16 Apr. 2012.

under 24 hour ICU care with referral for special diagnotics. The cost of treatment and duration of hospitalization are factors that owners need to consider. Critical patients need close attention to vital signs and disposition. Changes in comfort level, respiration rate and pattern, pulse oximetry, capnography, temperature, heart rate and blood pressure can indicate the need for intervention. Patient comfort is an area in which technicians play a big part. Animals should remain in sternal recumbency to optimize breathing, but if in lateral they may have sides rotated every 4 hours2. Ventilation should not be forgotten; the effort of breathing combined with oxygen inside a cage or hood can elevate temperature.

Preparation is another tool in your toolbox.

12

Being familiar with your clinic’s emergency procedures in advance will help the veterinary support team work quickly while providing optimal care.

8. Sigrist, Nadja E. “Thoracentesis.” Small Animal Critical Care Medicine. Eds. Deborah C. Silverstein and Kate Hopper. St. Louis: Saunders Elsevier, 2009.

Print.

9. Battaglia, Andrea M. and Don Shawver.

Cytology photo by Lori Williamson All radiographs courtesy of the Vaughan-Richmond Hill Veterinary Emergency Clinic

“Respiratory Emergencies.” Small Animal Emergency and Critical Care for Veterinary Technicians, 2nd Edition.

Ed. Andrea M. Battaglia. St. Louis: Saunders Elsevier, 2007. Print.

10. Blood, D. C. and V. P. Studdert.

Saunders Comprehensive Veterinary Dictionary 2nd Edition. WB Saunders Elsevier, 2005. Print.

TECHNEWS | VOLUME 35 ISSUE 4

Thank you

for Helping to bring

to your Community!

by Nadia Vercillo, Manager of Development & Public Relations

On behalf of people in need and their sick/injured pets, the Farley Foundation would like to extend its sincerest appreciation to veterinary technicians across the province who have played an integral role both in applying for funding on behalf of clients and in helping to organize so many wonderful events and fundraisers during the annual P&G Pet Care Fundraise for Farley Month campaign.

Some of our top fundraising clinics this year had the following to say about the role their technicians played in last year’s campaigns:

Thunder Bay Technical Staff: Laurel Cameron, Katie Van de Vooren, Jo-Anne Parisee, Tina Maclam-Buie, Julie Stone. Missing are: Maureen Page, Trista King, Anne-Marie Mayes

TECHNEWS | VOLUME 35 ISSUE 4

“Our vet techs do a ton of work for the community each year,” says Dr. Jeff Kubinec owner of Thunder Bay Veterinary Hospital, top Fundraise for Farley Month fundraiser for three years running.

“They run $5 Farley nail trims, help keep pets still and happy during our pet portrait days, and help with our “Sponsor a spay/neuter program”. At our annual (now 16 years running) Leash-athon, our technicians donate their time to work at the late registration table and water station, sell food at the picnic, and distribute prizes to participants. With all of their help, our event has been a huge success every year.”

“The great success of our Farley Foundation Walk and BBQ this year was only possible as a result of the incredible job and time that Mallory Schell, RVT, spent organizing, promoting and running the event,” says Dr. Natalie Eves, Cottage Country Animal Clinic.

“Since we first began running our highly successful Farley Fund Raising Month in 1997, the enthusiasm and organizational skills of all our technicians have played a critical role in planning and executing the activities. In particular, Ali Solman and Krystal Wallace have and have been instrumental in coordinating the entire staff,” Dr. Michael Belovich, Yonge Street

Animal Hospital.

To all the veterinary technicians who do so much for people and pets in need, our sincerest thanks.

Interested in bringing Fundraiser for Farley Month to your clinic?

As we gear up for the P&G Pet Care Fundraise for Farley Month 2012 campaign, please know that the Farley Foundation is here to support all clinics throughout their campaigns.

Participating is easy... and fun. Call 1.888.262.9811 or write to info@farleyfoundation.org and we’ll walk you through it. We’ll send you free campaign materials, including free giveaway items for clients, fun temporary tattoos, paper paw prints, brochures, posters, a participants’ guide loaded with tips, helpful information and even a sample press release your clinic can use to try to get some great positive stories running in your local newspapers and TV news programs.

Are you a cyclist? Join our 2012 Ride for Farley. Choose from a 50, 100 or 160 km event through Halton region. For details visit www.farleyfoundation.org or write to jhayes@ovma.org

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Vomiting is the active expulsion of stomach and sometimes duodenal contents, and is typically preceded by nausea and retching.

Chronic vomiting is a very common clinical sign in cats and can be associated with a wide variety of disorders, both gastrointestinal and non-gastrointestinal. It is important to differentiate between vomiting and regurgitation in order to avoid unnecessary tests.

Four main pathways stimulate the vomiting centre in the medulla: 1) Peripheral sensory receptors a. Intra-abdominal

i. Stomach, intestines, pancreas,

liver, peritoneum, kidneys, bladder

ii. Visceral afferent fibres in sym pathetic and vagal nerves b. Heart and large vessels, via vagus nerve c. Pharynx, via glossopharyngeal nerve 2) Stimulation of the chemoreceptor trigger zone a. Uremia b. Electrolyte imbalances c. Bacterial toxins d. Drugs 3) Vestibular input a. Inflammatory disorders b. Motion sickness, via acoustic nerve 4) Higher central nervous system centres a. Psychogenic, e.g., fear, stress, excitement via catecholamine release b. Inflammatory CNS lesions Therefore, evaluation of the vomiting cat requires consideration of the whole animal (not just the GI tract) and a logical diagnostic approach. Some common causes of vomiting in cats include:

CE Article #2 Why So Many Vomiting Cats?

Getting the Diagnosis

1) Gastrointestinal disease a. Infectious disease: bacterial (e.g., Helicobacter, Salmonella), viral b. Parasites: Giardia, Ollulanus, ascarids c. Obstruction: foreign body, intussusception d. Neoplasia: e.g., lymphoma e. Inflammation: e.g., gastritis, inflammatory bowel disease f. Dietary: food intolerance, food allergy, dietary indiscretion 2) Non-gastrointestinal disease a. Metabolic, systemic: e.g., heartworm, renal disease, hyperthyroidism, diabetic ketoacidosis, urethral obstruction, hepatic disease, pancreatitis, peritonitis, electrolyte imbalance, cholangitis b. Toxins, drugs: chemotherapy drugs, NSAIDs, antibiotics, plants (e.g., lily), ethylene glycol, and others c. Neurological: e.g., vestibular disease, motion sickness The signalment and clinical history for vomiting cats must be detailed and complete to determine differential diagnoses and guide diagnostic testing and therapeutics.

The following areas should be considered: 1) Signalment: younger cats are more likely to ingest foreign bodies; older cats

are more likely to have systemic disease 2) Diet: current diet, recent changes, â&#x20AC;&#x2DC;tableâ&#x20AC;&#x2122; food, supplements, hunting 3) Environment: plants, potential foreign bodies, toxins 4) Duration and frequency: acute (<7 days) versus chronic, severity 5) Relationship to eating: >8 hours after eating implies gastric outlet obstruction or motility disorder; no relationship to eating implies systemic disease 6) Vomiting process: distinguish vomiting from regurgitation 7) Vomitus: presence of blood (gastric mucosal damage), bile (reflux from small intestine), parasites (e.g., Ollulanus tricuspis), food (state of digestion), hair 8) Deworming history 9) Previous illnesses 10) Current medications 11) Other changes: anorexia, polydipsia/ polyuria, diarrhea, weight loss, etc. (may imply a systemic disorder) The most common type of vomiting is acute gastroenteritis. This is typically self-limiting and seen in patients that are otherwise well.

Treatment may include withholding food for 24 hours to reduce stimulation of the gastric and intestinal mucosa. Once clinical signs have resolved, small portions of a highly digestible, high protein, low carbohydrate diet are fed for 2 to 3 days. Supportive care, such as fluid therapy or anti-

Susan Little, DVM, DABVP (Feline) received her BSc from Dalhousie University (Nova Scotia, Canada) in 1983 and her DVM in 1988 from the Ontario Veterinary College, University of Guelph. She has been in feline practice since 1990 and achieved specialty board certification in Feline Practice in 1997, re-certifying in 2006. She is part owner of two feline specialty practices in Ottawa, Canada. She serves on the board of the Winn Feline Foundation, and is a feline medicine consultant for the Veterinary Information Network (VIN). Dr. Little also serves as a consultant for IDEXX Laboratories and Fort Dodge Animal Health.

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TECHNEWS | VOLUME 35 ISSUE 4

emetics (Table 1), can be provided as necessary.

Some vomiting cats will require surgical intervention and this should be determined as soon as possible. Indications for surgical intervention include: 1) History of foreign body ingestion with evidence of obstruction 2) Palpation of intussusception, foreign body, intestinal plication 3) Projectile vomiting with metabolic alkalosis and evidence of obstruction 4) Radiographic changes that include evidence of intussusception or foreign body, free gas within the peritoneum, intestinal plication, ground glass appearance (septic peritonitis), urinary tract rupture

Vomiting

Otherwise well

If no abnormalities on physical exam: • Broad- spectrum deworming (e.g., fenbendazole) • S y m p t o m a t i c therapy

Unwell

If persistent, follow plan for unwell cats

Imaging (radiographs, ultrasound)

Cats with chronic vomiting should be evaluated initially with a minimum database (Figure 1). Many patients will benefit from a full GI panel as well (fPLI, fTLI, cobalamin, folate). Problems such as dehydration should be corrected. Hydroxycobalamin is used to treat cobalamin deficiency at 150-250 mcg/cat SC once weekly for 6 weeks, then once monthly for 1 or 2 injections. Serum cobalamin should be evaluated 1 month later.

Imaging is indicated unless the cause of the vomiting is readily apparent. Plain radiographs are used to identify foreign bodies, gastric size and position, liver and kidney size, abdominal masses, ileus, etc.

The most common cause of chronic intermittent vomiting in the cat is food intolerance (non-immunologic reaction to preservatives or colorings) or allergy (immunologic reaction to a protein antigen). Most of these patients are otherwise healthy and have little or no weight loss. The minimum database will be normal or have minimal changes. Removal of the offending food agent will result

CBC, serum chemistries, urinalysis, FeLV/FIV, +/- total T4

Advanced testing • Cobalamin, folate • fPLI, fTLI

Biopsy samples (exploratory laparotomy, laparoscopy, endoscopy)

Figure 1: Summary of diagnostic steps for investigation of vomiting in cats

table 1 > Common antiemetic drugs used to treat vomiting in cats Drug

Dosage

Comments

Metoclopramide

0.2 – 0.4 mg/kg SC, PO q 8hr 1 – 2 mg/kg/day CRI

Also prokinetic Centrally acting?

Dolasetron Ondansetron

0.5 - 1 mg/kg IV, PO q 24 hrs 0.5 mg/kg PO q 12 hrs

5-HT3 receptor antagonists Expensive

Maropitant

1 mg/kg IV, SC, PO q 24 hrs (up to 5 days)

Inhibits substance P binding to NK-1 receptors Use with caution in hepatic disease

Phenothiazines: prochlorperazine chlorpromazine

0.1 – 0.5 mg/kg SC q 8hr

Centrally acting via multiple mechanisms May cause sedation

Mirtazapine

1.9 – 3.75 mg/cat PO q 48 hrs Often given as ¼ of 15 mg tablet

5-HT3 receptor antagonist Appetite stimulant Reduce by 30% in hepatic or renal impairment

TECHNEWS | VOLUME 35 ISSUE 4

15

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in prompt improvement in cats with food intolerance. Food allergies may require several weeks of therapy with a hypoallergenic, highly digestible diet to resolve.

Cats with significant or severe disease (persistent vomiting, hematemesis, weight loss, etc.) require more in-depth evaluation.

Contrast radiography may be required for detecting gastric masses, foreign bodies, size and shape of stomach, size of liver, etc. Ultrasonography is more sensitive than radiography for examining masses, intestinal mural thickness, mesenteric lymphadenopathy and full evaluation of the pancreas, liver, and kidneys. Intussusception, non-radiopaque and linear foreign bodies can sometimes be observed. More advanced investigations may include endoscopy or exploratory surgery.

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Chandler M. 2010. Vomiting in dogs and cats -- is it medical or surgical?

In Pract.32: 82-9.

Hall J. Clinical approach to chronic vomiting. 1997. In August J, editor: Consultations in feline internal medicine. ed 3, Philadelphia, Saunders.

MacPhail C. 2002. Gastrointestinal obstruction. Clin Tech Small Anim Pract 17:178-183.

Mansell J, Willard MD. 2003. Biopsy of the gastrointestinal tract. Vet Clin North Am Small Anim Pract33,1099-1116.

McGrotty Y. 2010. Medical management of acute and chronic vomiting in dogs and cats. In Pract. 32:478-83.

Suchodolski JS, Steiner JM. 2003. Laboratory assessment of gastrointestinal function. Clin Tech Small Anim Pract 18,203-210.

Trepanier L. 2010. Acute vomiting in cats: Rational treatment selection. J Feline Med Surg 12:225-230.

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This article is an excerpt from a detailed 25 page Drug-ShortageStrategies guide that includes protocol suggestions and drug dosages. It is accompanied by a 2 hour video presentation both of which are available through my website at: www.nancybrockvetservices.com.

Introduction

As a practicing veterinarian in Canada, I too am struggling to deal with the recently announced injectable drug production slowdown by Sandoz Canada. It appears that Sandoz Canada is taking pre-emptive action to upgrade its manufacturing plant in Boucherville, Quebec in order to address concerns put forward by the Federal Drug Administration (FDA) in the USA. Sandoz ran the risk of being unable to export its Canadian manufactured products to the USA and so decided to take action to prevent this situation from occurring.

The centralization of injectable drugs manufacturing in the hands of one company and one location, (Sandoz, Boucherville, Quebec) has resulted in veterinary wholesalers being denied access to the following injectable products (listed here alphabetically), until mid 2013, in order to protect human medical facility supplies: • Diazepam • Diphenhydramine • Dobutamine • Ephedrine • Fentanyl citrate injectable • Glycopyrrolate • Hydromorphone 2 and 10 mg/mL • Meperidine 50 and 100 mg/mL • Metoclopramide • Midazolam • Morphine • Naloxone

CE Article #3 Veterinary Anesthesia Drug Substitution Strategies Addressing the Injectable Opioid and Benzodiazepine Shortages

General strategies to help you navigate the drug shortage: • Use local anesthesia for surgical pain control in order to reduce the need for opioids and make non-opioid analgesics effective.

• Administer intra-operative IV, IM or SQ NSAIDs. • Administer buprenorphine to both dogs and cats to treat the pain of elective surgeries.

• Fentanyl patches are available to treat moderate and severe surgical pain.

• Reserve injectable hydromorphone and morphine for acute traumatic pain.

• Use Alfaxan as an IM sedative instead of midazolam or diazepam.

• Use oral medications to achieve ef-

fective chemical restraint in difficult patients.

• Use oral analgesic medications to provide preventive analgesia for patients undergoing moderately to severely painful procedures.

Use of Alfaxan for Premedication and Induction Generic name: alfaxalone or alphaxalone Steroid with anesthetic properties but no systemic steroid effects Beneficial qualities: • Minimal hypotension • Minimal changes in heart rate • Minimal respiratory depression • No tissue irritation if administered

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

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

TECHNEWS | VOLUME 35 ISSUE 4

19

perivascularly

• Suitable as an intramuscular sedative • Excellent muscle relaxation providing ease of endotracheal intubation

Undesirable characteristics: Calculated volume may be impractical for I.M. sedation of larger patients (dogs).

Special instructions: No preservative - contents of opened bottle should be handled aseptically. Alfaxan package insert specifications in Canada are to discard unused portions of the vial after initial drug dose is drawn. I handle the solution differently. This is what I do upon opening a new vial of Alfaxan: 1. Wipe the vial’s rubber stopper with alcohol.

2. Insert a 20 gauge needle into the vial.

3. Withdraw the entire vial contents into a series of 1 and 3 mL syringes via the pre-placed needle being careful not to touch the needle or the syringe tips with fingers. Preferably wear gloves.

4. Cap each filled syringe with its own needle.

5. Label and date all syringes.

6. Store syringes refrigerated for up to 7 days.

7. Remove individual syringes from refrigerator as needed.

8. Discard all unused syringes after 7 days.

9. Once a syringe has been partially used, discard the remainder of the syringe contents.

Indications: • I.V. Induction of anesthesia.

• I.M. chemical restraint/sedation for non-painful manipulations such as diagnostic imaging, IV catheter placement.

Dose recommendations: 2 mg/kg IM for chemical restraint or anesthetic premedication 1 to 3 mg/kg IV for induction of anesthesia.

How do I administer Alfaxan (this is NOT the same as the package insert): Always premedicate before administering Alfaxan for anesthetic induction.

1. Draw up 3 mg/kg as an induction dose for both cats and dogs. I usually end up administering 2 mg/kg but I like to have some extra leftover to administer if needed during inhalant anesthesia.

2. Administer 0.5 mg/kg IV every 30 seconds until the patient fails to pull its foot back on toe pinch.

20

3. As soon as the patient tolerates a face mask, deliver oxygen for the duration of the induction process.

4. You will probably administer about 1 to 3 mg/kg total dose. The total dose will vary as a result of differences in premedication drugs/doses, as well as in acute illness or advanced age.

5. If the patient has a pronounced cough at intubation, administer an additional 0.5 mg/kg Alfaxan to help smooth the transition to inhalant.

N.B. Respiratory depression is always possible so be vigilant about monitoring your patient.

Anesthesia for the Healthy Adult Dog and Cat with no acute pre-surgical pain Premedication: Choose from among the following to allow IV catheter placement: a) Acepromazine 0.05 mg/kg + butorphanol 0.2 mg/kg IM Optional: Add atropine 0.02 mg/kg IM to the above. b) Medetomidine 5 to 10 ug/kg IM or dexmedetomidine 2.5 to 5 ug/kg IM can be substituted for acepromazine in the above protocols for heavier chemical restraint. If you use either medetomidine or dexmedetomidine, omit the atropine.

How will the substitution of butorphanol for hydromorphone or morphine in premedication affect anesthesia?

• Better ventilation • More rapid return of normal appetite and overall G.I. function • No vomiting after premedication • Reduced incidence of feline hyperthermia • Possibly a lighter plane of anesthesia Hints for using medetomidine or dexmedetomidine as anesthesia premedication in both dogs and cats: • Tailor the dose to the patient’s temperament: if it is anxious or fractious, use high dose. If quiet and calm, use low dose.

• Always use in combination with an opioid.

• Administer IV induction drugs in 10% increments slowly allowing 60 seconds between increments because of the slower circulation time.

• Expect as much as a 90% reduction in the need for inhalant anesthesia. Don’t

be afraid to turn the vapourizer off.

• The higher the dose of (dex)medeto-

midine, the greater the reduction in induction and maintenance drug doses.

• Do not administer an anticholinergic drug to raise the heart rate unless it is associated with hypotension or at least 45 minutes has passed since the medetomidine administration.

Induction: Choose from among the following. This is my order of preference.

• IV Alfaxan • IV propofol + ketamine aka “Ketofol” • IV propofol • IV pentothal (thiopental) Inducing anesthesia with IV propofol and ketamine (Ketofol) 1. Draw up 5 mg/kg of propofol and 5 mg/kg ketamine together into a syringe.

2. Administer 0.1 mL/kg IV as a bolus.

3. As soon as possible place a face mask (with diaphragm removed) over the patient’s mouth and deliver supplemental oxygen. If the patient resists face mask placement, do not force it. The patient will likely readily accept the mask after receiving about 0.2 mL/kg of its calculated volume.

4. Wait 60 seconds before injecting additional volume.

5. Continue steps 2 and 4 until the patient’s head is down and resting quietly in a face mask. This will probably require about 0.3 mL/kg.

How Alfaxan or “ketofol” induction will affect anesthesia: • Apnea at induction is less common than with propofol administration • No apneustic breathing pattern as seen with ketamine/diazepam induction • Hypotension may occur but is less common and less pronounced than with propofol induction • Transition to inhalant anesthesia maintenance is smoother • Higher vapourizer dial settings may be required to keep a patient at a proper plane of anesthesia I do not recommend mask induction because 1) it requires heavier premedication 2) it offers no advantages over injectable protocols, 3) it is associated with excess occupational exposure to waste gases and 4) it is associated with struggling and is an unpleasant experience for patients.

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To facilitate feline endotracheal intubation: deposit 0.1 to 0.2 mL of 2% injectable lidocaine (without epinephrine) on the arytenoid cartilages after the initial dose of induction drugs. Allow at least 10 seconds (count 10 steamboats) before attempting intubation, administering further induction drug boluses as needed for intubation.

Maintenance: Sevoflurane or isoflurane are equally safe and effective.

Analgesic strategies for mild to moderate surgical pain • Follow the same anesthesia protocol as above.

• Perform regional nerve blocks or tissue infiltration with bupivacaine or lidocaine prior to the beginning of surgery • If regional analgesia is not an option or if it appears to be ineffective based on your patient’s response to surgical stimulation, administer buprenorphine 10 ug/ kg IV. Because it is short acting, butorphanol premedication can be followed by buprenorphine without concern over drug incompatibilities.

• Administer IM or IV NSAIDs periop-

eratively once 1) the patient has demonstrated cardiovascular stability under anesthesia and 2) the risk of significant surgical hemorrhage has passed. This will vary from one procedure to the next. Onset of NSAID’s analgesic effects is over an hour, so it should not be relied upon for sole surgical analgesia in the immediate postoperative period.

NSAIDs are best suited to deal with residual pain that is experienced once the local analgesia begins to wear off. I do not administer NSAIDs preoperatively.

Analgesic strategies for moderate to severe surgical pain without hydromorphone or morphine access: • Follow the same anesthesia protocol as above.

• Perform regional nerve blocks or tissue infiltration with bupivacaine or lidocaine prior to the beginning of surgery.

• Administer intra-operative buprenorphine 20 ug/kg IV to small dogs and cats early on in the surgical procedure.

• In some situations, you may want to place a fentanyl patch intra-operatively since buprenorphine use may be cost

prohibitive in medium and large dogs.

• Larger dogs also benefit from pre-surgi-

cal oral analgesics administered the evening before surgery and which remain readily available.

• If regional analgesia is not an option or if it appears to be ineffective based on your patient’s response to surgical stimulation, initiate a ketamine constant rate infusion (CRI) as soon as possible and continue it into recovery.

• NOTE: The use of ketamine CRI in the face of effective regional analgesia will set the stage for a dysphoric recovery.

The longer the delivery of the CRI the more likely your patient will become dysphoric, probably as a reflection of diminishing analgesic requirements over time as pain subsides.

Anesthesia for the Healthy Adult Dog and Cat with no acute pre-surgical pain Premedication:

Some of you may have this product on your shelves as a substitute for injectable diazepam. Unfortunately, I have not found very much information in the scientific lit-

Apps and Websites to Watch Startups Interested in Pet Industry Betakit recently profiled the rise of startups seeking success in the pet industry. Inspired by the success of sample subscription startups, BarkBox was launched to provide dog owners with a monthly delivery of toys, treats and grooming accessories. Based in New York City, BarkBox was founded in 2011 by Henrik Werdelin, Matt Meeker and Carly Strife.

With subscriptions starting at $17 per month, BarkBox is targeting the young, urban professional with no children, a passion for pets and plenty of disposable income. DogVacay.com features health and liability insurance, host training, reviews, online scheduling and daily photo updates. Startup SpotWag’s platform facilitates leveraging the resources of existing trusted networks to seek out help and support in pet care and boarding. Kickstarter-funded AnyVivo, aims to be the “Amazon for living things” and is starting with, of all living things, jellyfish. For $499, customers can get jellyfish, an aquarium and food.

Pet Poison Help (0.99) by Pet Poison Helpline Compatible with iPhone, iPod touch, and iPad.Requires iOS 4.3 or later.

Let your clients know that there’s an easy way to get answers about potential household toxins and poisons. Download Pet Poison Help for information on hundreds of household products and plants that are potentially toxic to your pet, and steps to take if a dog or cat is exposed to one of these toxins.

Pet Poison Help provides: • Life-saving access to poison information with one-touch direct dialing to Pet Poison Helpline.

• A searchable database of over 250 poisonous plants, foods, medications and household items, all with pictures.

• Descriptions of how specific poisons affect pets, their alternate common names, and symptoms to watch for.

• Instructions on what to do if a dog or cat is exposed to a dangerous substance.

TECHNEWS | VOLUME 35 ISSUE 4

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erature to guide me in the safe use of this product and so am not administering it to any of my patients.

Excerpted from the product package insert: “DIAZEMULS is an injectable emulsion of diazepam, a drug with known anxiolyticsedative and muscle relaxant properties..... Diazepam must first be released from the oil phase of the DIAZEMULS emulsion before it can exert a therapeutic effect. .... peak blood levels of diazepam are reached only after 15 minutes following intravenous injection of DIAZEMULS, and after 2 hours following intramuscular administration........ …Rapid injection or the use of veins with too small a lumen carries the risk of thrombophlebitis. Intravenous injection should therefore be directly into a large lumen vessel, such as an antecubital vein, and the drug should be administered slowly, at the rate of no more than 5mg (1 mL) per minute. Extreme care should be taken to avoid intra-arterial administration or extravasation when used intravenously.

Diazemuls should be injected directly into the vein without prior dilution or mixing with other products or solutions.

DIAZEMULS has been shown to be incompatible with morphine and glycopyrrolate.

Mixing or further diluting DIAZEMULS with products or solutions other than its own emulsion base (Intralipid) may de-stabilize the emulsion. Although such an effect may not be recognizable on visual inspection, it could give rise to potentially serious adverse reactions. Polyethylene-lined or glass infusion sets and polyethylene / polypropylene plastic syringes are recommended for use with DIAZEMULS. Do not use infusion sets containing polyvinylchloride. The vehicle used in DIAZEMULS (diazepam injectable emulsion) is identical to one of the lipid preparations used in parenteral alimentation (Intralipid).

Fecal Check Compliance Clients may not know what a fecal sample is, so don’t be afraid to use the word “poop.” Keep your communication simple and clear. You want your clients to understand you.

Asking the client to obtain the sample at home is easier on you and on the pet. When you obtain the sample at the clinic, it’s easier on the client. Weigh the pros and cons before sending home a fecal collection container. If the owner is elderly or wheelchair-bound, for example, it may be better to try to obtain the sample during the pet’s visit.

If you’re sending home a fecal collection container, ask the owner to prepay for the fecal test. This greatly increases the chances the client will return a sample. It also makes it quick and easy to drop off the sample, and it guarantees you charge for the test.

Always label the fecal container before you put the fecal matter in it.

After all, one jar of poop looks pretty much like the next. It’s also wise to always document a client’s refusal in the patient’s medical chart when a pet owner declines fecal testing—or any other recommended test—for their pet. (Firstline) Veterinarians Donate Oxygen Masks Designed For pets to Fire Departments – Something to Consider Doing Locally According to the Mobile Press-Register, local veterinarians have supplied fire departments in Baldwin County with masks designed to fit pets. “It’s such a pain to give oxygen to a dog or cat with an essentially flat, human mask,” said Danielle Bercier, a vet from Silverhill. She met with Gulf Shores Fire Marshal George Surry to talk about pet oxygen kits, and discovered a need at most all of the county’s fire stations. The customized kits cost $75 each and include three different-sized, reusable masks; oxygen tubing; leashes; and pet CPR information. While the masks are designed for a dog’s longer snout, they can assist even small creatures like ferrets. So far, four veterinarian clinics have bought several kits each and donated them to local firehouses. (Veterinary Advantage Weekly News) Slideshow When time permits, give each new client a tour of your facility, but if timing is off due to what’s happening in the back, you can still highlight your whole hospital through a digital slideshow. Computers in each exam room and/or digital frames can run different photos of every area of the hospital as well as feature all staff members. Update images frequently and most of all, have fun with it! (Veterinary Economics)

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CE Article #1: Pleural Space Disease 1. Goals of emergency treatment are: a) Initiate treatment based on the underlying cause b) Confirmation of underlying cause by in-house cytology c) Thoracocentesis every 4 hours or more if needed d) Stabilization and supportive care 2. Clinical signs of respiratory distress from pleural space disease is/are: a) Lateral recumbency and whining b) Prolonged inspiration with short expiration c) Rapid shallow breathing with significant effort d) Crackles and nasal discharge 3. Chest percussion of intrapleural fluid sounds: a) Dull dorsally and tympannic ventrally b) Dull, low-pitched and short-duration ventrally c) High-pitched and long-duration dorsally d) Chest percussion should not be performed at all

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4. The area to prepare for a thoracocentesis is: a) 3rd to 5th intercostal spaces over the constochondral junction b) 7th to 9th intercostal spaces over the affected thoracic area c) 5th to 9th intercostal spaces at the costophrenic angles c) Most of the thorax should be shaved since multiple entry sites are needed 5. Fluid evaluation consists of: a) Gross fluid quality, TP and TNCC b) Biochemical analysis of fluid c) Cellular morphology confirmed by pathologist d) All of the above 6. Tension pneumothorax is described as: a) A one-way valve in which air builds up in the chest b) An opening in the thoracic wall that allows air in and out c) A traumatic pulmonary contusion which requires immediate surgery d) A critical but non-emergency situation

7. An iatrogenic cause of pneumothorax is: a) Applying too much pressure during ventilation b) Lacerating the lungs during thoracocentesis or thoracostomy tube placement c) Complications of thoracic surgery d) All of the above 8. A breed known to develop pneumothorax from pulmonary bullous emphysema is: a) Alaskan Malamute b) Siberian Husky c) German Shepherd d) English Bulldog 9. During thoracocentesis, the assistant should always leave the stopcock in the open position during all redirections: a) True b) False 10. What neoplasia is often responsible for pleural exudates in cats? a) Malignant mesothelioma b) Thymoma c) Lymphosarcoma d) Lymphangiosarcoma

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CE Article #2: Why So Many Vomiting Cats?

1. Acute gastroenteritis is typically self-limiting and seen in patients that are otherwise well. Treatment may include: a) Low protein, high carbohydrate diet for 2 or 3 days b) Fasting for 48 hours c) Fasting for 24 hours d) Thoracic radiographs 2. Contrast radiographs are indicated in every occurrence of chronic vomiting. a) True b) False 3. Causes of vomiting in cats include: a) Vestibular disease, neoplasia, obstructions b) Parasites, bacterial infections, dental procedures c) Toxins, chemotherapy drugs, renal disease d) a and c

4. There is no difference between vomiting and regurgitation. a) True b) False 5. Exploratory surgery may be necessary in what instances: a) Cats presenting with signs of vestibular disease b) Cats with pancreatitis c) Cats with a history of foreign body ingestion d) Cats with food intolerance 6. Four main pathways stimulate the vomiting centre in the brain stem. a) True b) False

8. A cat which usually vomits 4 hours after eating may have an obstruction or a motility disorder. a) True b) False 9. Antiemetic drugs include: a) Metoclopramide, amikacin and ondansetron b) Mirtazapine, prochlorperazine and maropitant c) Metoclopramide, dolasetron and atropine d) Maropitant, mirtazapine and detomidine 10. Vomiting, anorexia, PU/PD and weight loss may indicate systemic disease. a) True b) False

7. Intestinal mural thickness, mass examination and a full evaluation of the pancreas, liver and kidneys can be evaluated best by using: a) Ultrasound b) Contrast radiographs c) Plain radiographs d) GI blood panel

CE Article #3: Anesthesia Drug Shortages 1. Hypertension may occur with â&#x20AC;&#x2DC;ketofolâ&#x20AC;&#x2122; induction. a) True b) False 2. Mask induction is not recommended for the following reason(s): a) Short induction times b) Staff may breathe in waste gas c) More pre-meds may be necessary d) Both b and c 3. Fentanyl patches can be used to treat moderate to severe surgical pain. a) True b) False 4. According to the article, the following drugs are temporarily unavailable from the manufacturer Sandoz: a) Fentanyl citrate injectable, midazolam injectable, diphenhydramine injectable b) Diazepam oral, metoclopramide injectable and glycopyrrolate injectable c) Fentanyl patches, Dobutamine injectable, Diazepam injectable d) Morphine injectable, ephedrine injectable, Diphenhydramine oral

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5. Diazemuls can be used as a direct replacement for injectable diazepam. a) True b) False

10. The higher the dose of medetomidine, the higher the dose for induction drug(s). a) True b) False

6. Oral medications can be used to achieve effective chemical restraint in some patients. a) True b) False 7. Which statement about alfaxalone is incorrect: a) When using alfaxalone for anesthesia, a premedicant is advised b) Alfaxalone is an ideal I.M. sedative c) Alfaxalone contains a preservative d) Alfaxalone will not change the heart rate overtly 8. Alfaxalone is ideal for use for: a) Bandage changes b) Anesthesia induction c) Survey radiographs for hip dysplasia d) All of the above 9. Dexmedetomidine premed should be used in combination with an opiod. a) True b) False

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

Current as of: May 2012

Dechra Adds New Education Modules Dechra Veterinary Products announced the addition of three new modules to its U.S. continuing education site: www.DechraCE.com In addition to the original modules, Diagnosing Canine Hyperadrenocorticism (Cushing’s Syndrome) and Treating Canine Hyperadrenocorticism, the site now offers three new modules: Diagnosing Feline Hyperthyroidism; Treating Feline Hyperthyroidism; and Cushing’s Syndrome: Inside and Out. Dr. Bryon Blagburn, MS, PhD: Emerging Issues in Heartworm Health Available on demand. www.heartwormwebinar.ca Flea & Tick Borne Diseases, Bayer HealthCare, Animal Health Webinar: www.learnwithbayer.ca

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2012 July 10, 2012 12:00-1:00pm CST Toxins in your Garage Poisonous to Small Animals Speakers: Justine A. Lee, DVM, DACVECC Ahna G. Brutlag, DVM, MS I Hour of RACE approved CE Register at www.petpoisonhelpline.com/ veterinarians/webinars July 11-14 Canadian Veterinary Medical Association. 64th CVMA Convention “Learn à la Montréal” Best Medicine Practices – Timely Topics.

November 6, 2012 12:00-1:00pm CST Kitchen Toxins Dangerous to Pets Speakers: Justine A. Lee, DVM, DACVECC Ahna G. Brutlag, DVM, MS I Hour of RACE approved CE Register at www.petpoisonhelpline.com/ veterinarians/webinars.

November 10 Champlain Dog Club; Dr. Jean Dodds Seminar - Thyroid Related Problems Location: Petawawa, Ontario November 9-11 The Communication Summit for the Veterinary Practice Team A Communication Boot Camp that will take your practice to the next level in customer relations, teamwork and patient care.

Location: Hockley Valley Resort,

Ontario www.iccvm.com 1-888-527-3434 for more details.

2013 February 21-23 35th Annual OAVT Conference and Trade Fair Location: The London Convention Centre, 300 York Street, London, Ontario

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US - New York Lawmakers Want DVMs to Check Controlled-Substance-Abuse Registry - According to DVM Newsmagazine, some New York legislators want healthcare practitioners --including veterinarians -- to start checking a controlled-substance-abuse registry before prescribing some medications. Assembly Bill 9121 was introduced Jan. 25 and would apply to all pharmacists and doctors who prescribe controlled substances. It would require healthcare professions -- including veterinarians -- to crosscheck a controlled substance abuse registry before prescribing painkillers.

Global news

Canada - 125 Dogs Removed from Breeding Operation in Quebec - Animal welfare advocates have removed 125 dogs from a breeding operation south of Quebec City they say wasn’t properly caring for the animals. Provincial officials and Humane Society International’s Canadian branch converged on a commercial breeding operation to remove the dogs and puppies. Multiple investigations indicated the dogs were not receiving proper care and the security and welfare of the animals was compromised.

Quebec has long been considered the puppy-mill capital of North America, with an estimated 800 unregulated

breeding operations in Montreal alone.

In December 2011, the province sharpened the teeth of its laws against animal cruelty, tabling legislation that would hike fines to amounts that could go as high as $75,000 in serious cases. The bill, which has not yet passed, cracks down on puppy mills, gives the government the power to close a kennel if it finds animals are being abused, and establishes rules on what methods of euthanasia can be used.

In September 2011, more than 500 dogs were seized from a Quebec puppy mill in what could represent the largest animalcruelty case in the province’s history.

Nearly 40 malnourished Huskies were found a month earlier chained to trees on a property northwest of Montreal.

Reports in May 2011 of animal suffering at Montreal’s privately held Berger Blanc pound also shocked many across the country. Quebec was named “the best province to be an animal abuser” in the 2011 annual report prepared by the U.S.-based Animal Legal Defence Fund.

The fund, which examined animal protection laws in jurisdictions across the country, also placed Nunavut, Alberta and the Northwest Territories in the bottom tier of its rankings. (Canadian Press)

A fox has assumed ownership of a crow’s nest at UPETI. (UPEI)

Canada - Fox Living High Life in Crow’s Nest at UPEI- This spring, a fox has taken over a crow’s nest behind the utility building at the University of Prince Edward Island. The fox has nested there for more than two weeks according to university staff. The tree is slanted, so the fox can walk up the tree and into the nest, which is almost two storeys high.

Crows in the area aren’t too pleased about the takeover, and every morning there’s a standoff between the fox and the crows, said staff. The fox has been around campus for the last two years, and is comfortable enough with people that he’s known to walk right up to them. It’s not the first time a mammal has taken over the nest. Last fall, squirrels made it their home. (cbcnews).

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Canada - Octopus Eating Seagull Captured in Photos - A deadly struggle between an octopus and a gull has been captured in a series of unlikely wildlife photographs taken by a Victoria, B.C., woman.

Amateur photographer Ginger Morneau snapped images of the almost metre-long Great Pacific octopus eating the frantic gull, and when she searched for other images of similar battles she couldn’t find any — lots of seagulls eating small octopuses, but not the other way around.

The BBC Wildlife magazine and octopus researchers from around the world have contacted Morneau about the photos, which have become internet sensations.

Octopuses are known to have highly complex nervous systems and their arms can perform complex reflex actions.

Some of the West Coast’s most stunning undersea sights are located near the Ogden Point breakwater, which is frequented by undersea diving enthusiasts.

Dive shops located near the breakwater advertise the presence of the Great Pacific octopus, saying the breakwater’s wall is home to 10 or 15 at any given time. Some can weigh up to 25 kilograms and their arms can measure more than 10 metres long. (cbcnews) US - Healthcare Cost for Overweight Pets Examined - The New York Times recently examined the cost associated with pet obesity. About half of all dogs and cats in American homes are overweight or obese, up slightly from 2010, according to a recent study by the Association for Pet Obesity Prevention. In a nation of 170 million pets, many of them as beloved as children, that means that roughly 85 million are carrying too much weight. The average cost of veterinary care for a diabetic dog or cat in 2011 was more than $900, according to Petplan USA. Treatment for arthritis and cruciate ligament tears, which can be caused by the strain of an overweight frame that weakens joints, especially in dogs, cost pet owners an average of $2,000. In 2011 alone, pet insurance claims for diabetes increased by 253 percent, according to Petplan. Claims for heart disease rose by 32 percent, while claims for arthritis soared by 348 percent. (Veterinary Advantage Weekly News)

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An octopus struggles with a seagull in the water off Victoria in this photo taken by Ginger Morneau. (Courtesy of Ginger Morneau)

US - Bill Introduced in New York to make Tatooing, Piercing of Pets Illegal - Saying that she was “sickened” by a TV program about cosmetic procedures for pets, New York State Assemblywoman Nicole Malliotakis has introduced a bill that would make it a misdemeanor to subject a dog, cat or other companion animal to piercings, tattoos and unnecessary appearance-altering surgeries, according to the Staten Island Daily News.

The surgeries, including tummy tucks and devocalization, are become more common, Ms. Malliotakis (R-East Shore/ Brooklyn) said. She was alerted to the problem by a segment called “Pet Crazy” on the “20/20” news show. “I was sickened after seeing the images of dogs with tattoos and piercings through their eyebrows and noses,” said Ms. Malliotakis.

“These non-medical cosmetic procedures are not just odd and unnecessary, they amount to animal cruelty.” Conviction under the bill would be punishable by up to one year imprisonment, a fine of up to $1,000, or both. (Veterinary Advantage Weekly News)

US - Hip and Elbow Certification Program Discontinued The OVCs Hip and Elbow Certification Program has been discontinued. The program had been put on hold last fall to deal with a backlog of cases.

There are two options for clients seeking hip and elbow certification for their animals. They are: • The Orthopedic Foundation for Animals (offa.org) • PennHIP (penhip.org) US - ”Rattlesnake Bit Me in WalMart” Man Says- Mica Craig, 47, says he was shopping in the outdoor garden department of a Clarkston store when he was bitten May 12th. Craig says it latched onto his hand and that he screamed, shook loose the snake and stomped it to death.

A bystander drove Craig to an emergency room in nearby Lewiston. Craig said he was treated with six bags of anti-venom and was told that his hand could be permanently disfigured. (AP)

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P O I S O N I N G T OX I C O L O G Y C O L U M N

The Under-recognized Mouse and Rat Poison: Zinc Phosphide!

by Jessica Driscoll, CVT, Pet Poison Helpline and Justine A. Lee, DVM, DACVECC, Associate Director of Veterinary Services, Pet Poison Helpline

rapidly in the acidic, moist environment of the stomach producing toxic phosphine gas.1-4 As food (e.g., milk, toast, etc.) tends to increase gastric acid production (which in turn can increase phosphine gas production), veterinary professionals should never recommend feeding a pet that has recently ingested a phosphide-based rodenticide.

Many veterinary professionals in the clinic setting are familiar with certain types of mouse and rat poisons (rodenticides), including anticoagulants (which results in coagulopathy), bromethalin (which results in cerebral edema), or cholecalciferol rodenticides (which results in hypercalcemia and acute renal failure). However, most are unaware of the common mole and gopher poison: zinc phosphide. While phosphide rodenticides have been around since the 1940’s,1-4 this toxicosis is not well recognized by veterinary professionals. Zinc phosphide rodenticides pose a public health risk due to the poisonous phosphine gas released; this can be poisonous to both pet owners and veterinary staff. Therefore, veterinary professionals should be aware of this less commonly recognized rodenticide.4-6 Zinc, calcium, and aluminum phosphide is most often found in mole and gopher baits, but are occasionally seen in some mouse and rat baits, as well as products used to fumigate grains and animal feed.4,5 Phosphide baits are often formulated as tablets, pellets, pastes, or powder forms and are meant to be buried or placed within the animals’ tunnels or burrows.4 Pet exposure often occurs either from incorrect use (i.e., spreading the bait on top of the ground instead of burying it) or allowing animals access to areas of buried bait, and in instances where grain and feed fumigants are used.

With phosphide rodenticides, ingestion by pets results in acute, rapid poisoning. When ingested, the rodenticide hydrolyzes

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Clincal Signs Onset of clinical signs can be seen as early as 15 minutes postingestion to several hours post-ingestion. Vomiting is typically the first clinical sign, followed by hypersalivation, abdominal discomfort, depression, bloat, laboured breathing, tremors, weakness, and shock. Seizures and “running fits” have also been documented; however, these are relatively uncommon. According to Gray et al,4 41.2% (141/342) of dogs poisoned by zinc phosphide had clinical signs. The most common clinical sign seen involved the gastrointestinal tract (66.7% [n = 120/180 reported signs]) followed by generalized malaise (17.8% [32/180]), central nervous system signs (8.9% [16/180]), respiratory signs (3.3% [6/180]), and cardiovascular signs (1.7% [3/180]).4 Diagnosis The diagnosis of zinc phosphide rodenticide toxicity is based on history, presence of the rodenticide in the environment, and correct identification of the active ingredient. Phosphine gas has often been characterized as smelling like rotten garlic, eggs, or fish. This odour may be helpful in diagnosing phosphide poisoning, but do not rely on presence of odour alone. A dog presenting with similar clinical signs in conjunction with this malodourous scent may help fine-tune the diagnosis of phosphide poisoning. Specialized testing of vomitus, stomach contents, blood and other tissues can be performed at veterinary diagnostic laboratories.

Treatment There is no antidote for phosphide rodenticide toxicosis. Vitamin K1, the antidote to anticoagulant rodenticides, is not in-

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references > 1. Gray S. Phosphides. In: Osweiler, Hovda, Brutlag, Lee, eds. Small Animal Toxicology. Ames, IA, Wiley-Blackwell, 2011; pp781-790.

2. Casteel SW, Bailey EM. A review of zinc phosphide poisoning. Vet Hum Toxicol 1986; 28:151-153.

3. Stowe CM, Nelson R, Werdin R, et al. Zinc phosphide poisoning in dogs. J Am Vet Med Assoc 1978;173(3):270.

4. Gray S, Lee JA, Hovda L, et al. Zinc phosphide rodenticide toxicity in dogs: 362 cases (2004-2009). ). J Am Vet Med Assoc 2011;239(5):646-651.

5. Easter L, Chaffin MK, Marsh PS, et al. Phosphine intoxication following oral exposure of horses to aluminum phosphide treated feed. J Am Vet Med Assoc 2010; 236(4):446-450.

6. Occupational Phosphine Gas Poisoning at Veterinary Hospitals from Dogs that Ingested Zinc Phosphide — Michigan, Iowa, and Washington, 2006–2011.

Accessed online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6116a3.htm, May 8, 2012.

trol and Prevention) has documented cases where more serious human poisonings have occurred.6 Pet owners and veterinary staff should be appropriately educated on these public health risks.

dicated for the acute treatment of phosphide intoxication. Treatment should include appropriate decontamination, which should ideally be performed at the veterinary clinic. First, the pet owner or veterinary staff can administer a liquid antacid (e.g., milk of magnesia, aluminum hydroxide, etc.) at the time of poisoning, provided the patient is not vomiting, to help decrease phosphine gas production. With recent ingestion in asymptomatic patients, emesis induction should be performed in a well-ventilated area or outdoors to minimize human exposure to the poisonous phosphine gas.

In symptomatic patients with recent ingestion, the use of gastric lavage (with water and diluted sodium bicarbonate) in an anesthetized, intubated patient may be advantageous, along with the administration of a single dose of activated charcoal with a cathartic after gastric lavage has been performed. Additional treatment includes the use of anti-emetics (e.g., maropitant, dolasetron, ondansetron, etc.), gastrointestinal protectants, and intravenous fluid crystalloid therapy.

Rarely, analgesic therapy may be necessary in dogs with abdominal pain. Overall, the prognosis for zinc phosphide toxi-

TECHNEWS | VOLUME 35 ISSUE 4

cosis is good with treatment. According to Gray et al, the overall survival rate was 98.3% (291/296) of dogs poisoned by zinc phosphide.4 Public Health Risks It is important to note that pet owners and veterinary staff may be at risk for poisoning if they inhale the phosphine gas (e.g., if the dog vomits in the car, the phosphine gas may be released into the environment). Therefore, it is recommended to induce emesis either outside or in a well-ventilated area and ensure pet owners have their vehicle windows safely open in case the pet vomits during transportation to the veterinary facility. Clinical signs associated with humans inhaling the gas from a pet’s emesis can include shortness of breath, respiratory irritation, chest pain, headache, dizziness, a sore throat and nausea.4-6 Most cases of human exposure due to inhaling gas from patient emesis have not required medical intervention or hospitalization. Symptoms tend to be selflimiting and only last for a few hours.

However, a report recently released by the CDC (U.S. Centers for Disease Con-

Conclusion In the United States, new Environmental Protection Agency (EPA) government regulations (effective 2010) make anticoagulant rodenticides less available; as a result, veterinary professionals will be seeing more animals with exposures to phosphides, bromethalin, and cholecalciferol rodenticides. Keep in mind that with any type of rodenticide, the active ingredient cannot be identified based on physical appearance alone; it is always important to correctly identify the active ingredient, which is required to be on the box or container. If such information is not available or the container is unreadable, calling the manufacturer is recommended. Although phosphide ingestions are serious exposures, prompt veterinary care can help ensure a positive outcome.

Resource: Pet Poison Helpline, a division of SafetyCall International, is an animal poison control service based out of Minneapolis available 24 hours, seven days a week for pet owners and veterinary professionals who require assistance treating a potentially poisoned pet. As the most cost-effective option for animal poison control care, Pet Poison Helpline’s fee of $39 per incident includes unlimited follow-up consultations for that exposure. Pet Poison Helpline is available in North America by calling 800213-6680. Additional information can be found online at www.petpoisonhelpline. com.

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EQUINE NEWS specific conditions, but when those occur, this incredibly potent toxin can be produced. Equine outbreaks are often associated with haylage or silage (which if improperly fermented allow for C. bolulinum to grow) or contamination of round bales (e.g. animal that died of botulism gets incorporated into the bale, where the toxins can persist and/or the bacterium can grow if the right environment is present deep within the bale). In this outbreak, silage is suspected to be the cause. The silage is being tested to confirm the suspicion.

You can never 100% prevent botulism, since strange sources are sometimes found, but avoiding high risk feeds (e.g. silage, haylage, moldy round bales), trying to ensure that dead animals are not caught up in hay bales and taking exceptional care when baling if botulism is present in wildlife in the area can help greatly. A vaccine is available but it only protects against certain types of botulism. If those types are the main types that cause disease in a given area, vaccination can be useful, but good feeding practices are the most important preventive measure.

Vesicular Stomatitis and Canadian Horse Import Restrictions

by Scott Weese, DVM, DVSc, Dipl ACVIM

The Canadian Food Inspection Agency has implemented import restrictions in response to diagnosis of vesicular stomatitis (VS) in a horse in Otero County, New Mexico.

Why the fuss?

Botulism Outbreak Kills 23 Horses

by Scott Weese, DVM, DVSc, Dipl ACVIM

Botulism has been in the news this spring, with numerous outbreaks involving different species and some human food recalls. Botulism outbreaks are often pretty dramatic because of the number of individuals that can be involved, the severity of disease and the fact that it’s often difficult to do much beyond damage control once the problem is recognized. Recently, there have been reported of widespread duck deaths along with a couple different recalls and warnings in Ontario about potentially contaminated smoked salmon and improperly eviscerated salted fish.

On the equine front, there’s also been a large outbreak that is thought to have killed 23 horses in Maine, USA. The outbreak occurred in April and, as is typical, has been devastating because of the profound susceptibility of horses to botulinum toxin and the inability to do much once you realize that botulism is present.

In adult horses, botulism is caused by ingestion of food that’s been contaminated with toxins produced by the bacterium Clostridium botulinum, as it grows. This relatively widespread bacterium doesn’t normally grow and produce toxins in horse food since it requires an oxygen-free environment and other

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VS is a viral infection that can affect a range of animals species. Beyond horses, it can infect cattle, pigs and sheep (and a few others). It produces painful blisters in the mouth and other areas that can result in decreased eating and drinking, lameness, severe weight loss and secondary infections. In food animals, it can cause severe economic losses. Another issue is that in cattle and sheep, it looks like the dreaded food and mouth disease.

Lab tests can distinguish the two, but there can be a lot of angst when sorting out what causes vesicular diseases in cattle.

VS is a reportable disease in Canada and was last identified in the country in 1949. Import restrictions are a routine measure in response to the periodic US cases that occur.

In this case, the following restrictions have been implemented: • Horses cannot be imported from New Mexico.

• Canadian horses that are in New Mexico must either get an import permit and supplemental USDA health certificate, or move their horse to another state for at least 21 days prior to returning to Canada. The supplemental certification indicates they’ve been evaluated by a vet, have not been on a farm where VS was present over the past 60 days and have a negative VS blood test. Horses that are moved to another state require a USDA certificate indicating that they’ve lived in that state for at least 21 days. (This may be complicated by restrictions by other states on accepting horses from New

TECHNEWS | VOLUME 35 ISSUE 4

Equine Veterinary Technician certificate

Mexico) • All horses coming from the US must be certified by the USDA as not having been in New Mexico in the past 21 days.

Veterinarians urge ramped- up disqualification and prosecution of violators of the Horse Protection Act Soring, illegal for more than 40 years, is the abusive act of intentionally inflicting pain on gaited horses through the use of chemical irritants, broken glass wedged in between a horse’s shoe pads and sole, or overly tightened metal hoof bands. The extreme pain caused by these abuses forces the horse to lift its legs faster and higher, perhaps increasing its chance of winning in show rings across the country. Due to budget constraints, USDA inspectors are only able to attend a small number of the shows being held. The AVMA has created an educational video, produced in cooperation with the American Association of Equine Practitioners (AAEP) and the USDA, to provide an overview of the issue of soring and highlight the tell-tale signs of when a horse has been sored. Additional materials, including a factsheet, backgrounder, reporting procedures, and the formal AVMA policy are available for general use at www.avma.org.

(Veterinary Advantage Weekly News)

The Equine Veterinary Technician Certificate is an equine-specific professional development program and is designed to provide students with the opportunity to be self-directed and personally involved in their learning. Consisting of three online courses and three face-to-face practicum courses, this program will stimulate intellectual curiosity and build on the student’s passion for horses.

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Equine Reproduction Equine Critical Care Equine Dentistry

Register by: Telephone: 519-767-5000 Email: info@coles.uoguelph.ca Online: www.coles.uoguelph.ca/equinevettech

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The Canadian Animal Assistance Team in Botswana

by Shirley Inglis, RVT - TECHNEWS Technical Editor

When I began my career as a veterinary technician, it never crossed my mind that, someday, I might find myself driving along a bumpy, winding, narrow dirt “road” in the Botswana bush looking for the next village in which to set up our field hospital. It was all in a day’s work as a member of the Botswana Project for the Canadian Animal Assistance Team (CAAT).

We were a team of four, two veterinarians and two technicians, who travelled to Botswana to work with the Maun An-

imal Welfare Society (MAWS). MAWS invited CAAT to Botswana to work with them on their protocols for their visiting vet program. CAAT has been serving as a field hospital team for seven years in various locations and the knowledge we have gained over that time was something we were more than willing to share with MAWS to assist them in their mission. While there, we worked every day, in different locations, providing sterilization surgery and vaccinations for the dogs owned by the villagers.

As with the Canadian communities that CAAT serves, the control of the domestic dog population is a concern for the animal welfare as well as the human welfare.

Domestic dog sterilization programs

benefits the owners as the dogs roam less (thus increasing protection to the home and/or livestock), the dogs tend to be less aggressive in general (over mating, food, etc.) and there are fewer stray dogs to deal with (fewer unwanted puppies).

The vaccination/deworming portion of the program helps reduce the risk of zoonotic disease transmission. The dogs themselves benefit with improved general health due to less competition for resources, a reduced risk of disease transmission from stray roaming dogs and an increased value to the owner. The unique benefit to sterilization of domestic dogs in Botswana is the effect it has on wildlife conservation. Some of Botswana’s wildlife has been severely threatened by uncontrolled domestic dog populations.

The threat is through the spread of common infectious diseases, such as, Canine Distemper Virus that has resulted in the death of lions, hyenas, leopards, African wild dogs and the bat-eared fox. There is also a concern with unrestrained hunting of native wildlife. The Botswana Predator Conservation Program (BPCP) states that “these problems are common, increasing, and devastating to wildlife in Botswana. The importance of domestic dog control for the conservation of all wildlife, and large carnivores in particular, cannot be overemphasized.”

Each day our CAAT team worked in Maun and in the surrounding villages. Our field hospital accommodation ranged from a community hall, to a house porch to a clearing in the African bush. Each day was a new challenge and in each village we were greeted with people eager to have the opportunity to care for their dogs.

On a day near the end of our time in Botswana, we headed out to work, following our African guides, as always, to our work location. On this day, we were led to a clearing in the African bush.

We assumed we were pulling our Jeeps over for some other reason and would be continuing on but we were told this was the location we would be working for the day! We all looked around at what seemed to us to be the middle of nowhere but our guide assured us it was the “centre” of the village. We set up all our equipment, with some reservation, and were amazed that by the time

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TECHNEWS | VOLUME 35 ISSUE 4

we completed our set up, people started appearing out of the bush. They arrived on foot, in carts and on donkeys. Many people with many dogs! We worked in that location for two solid days with no shortage of patients!

I learned that this was not a recent issue, the dog had been kicked by a cow two years before and had been like this ever since (no veterinarians to access). His owner was a tall African man and he watched over him. I watched as the dog was wandering around, and when he got a little too far from his owner, the owner gave a low whistle and kept doing it to give the dog something to aim toward.

When the dog found him, the owner reached down and scratched the dog’s ear and the dog sat contentedly beside him.

Out in the middle of the African bush, once again, as with all CAAT projects, I saw the strength of the bond between man and dog. No matter where we go, somewhere in the midst of all the poverty, the human social issues, and sometimes the seeming lack of caring, there is always a sign that there are people who care, and those people and their pets are why we are there.

I watched as one dog came out of the bush, he had a head tilt, was blind and stumbling a bit. I thought this poor dog, how is he going to survive? Then,

CAAT holds animal health care projects in communities in Canada and around the world. Whether working in an Inuit community in Nunavut, in a First Na-

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

Do not forget to include your return address information.

Manuscripts should be submitted electronically either via email (address: cass@bayleygroup.com), CD/DVD-R or

USB stick in a format compatible with Microsoft Word 97 or better. Also send a hard copy of the article.

• Articles should be no longer than eight pages of double-spaced type.

• Avoid using trade names.

• Feel free to include tables, boxes, diagrams, etc.

• Include artist’s name if illustrations are used.

• Footnotes should be used for any explanatory notes. Arrange alphabetically using superscripts (ex. a).

• References: document all points reviewed by using numbered superscripts (ex. 3) in the text. Place references in the order they appear, not alphabetically.

TECHNEWS is looking for articles from technicians that present current news and information. Articles should contain information on areas of interest to technicians,

TECHNEWS | VOLUME 35 ISSUE 4

tions community in British Columbia, or an African village in Botswana, each CAAT project is an exceptional experience for a technician. Each one is an opportunity to make a difference in the animal health and welfare in the community we are serving through our sterilization, vaccination and education programs.

These projects challenge your technical skills, take you “outside the box” of clinic work, and give you a unique opportunity to work with veterinarians and veterinary technicians from all across Canada. You have the chance to experience cultures that are often vastly different from ours (even within Canada) and gain a better understanding of those cultures along the way.

We always welcome new members! We are always in need of veterinary technicians that are team players, not afraid of hard work and have a great sense of adventure! Go to www.caat-canada.org to become a member!

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

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

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

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

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The OAVT does not necessarily endorse any of the following employment opportunities or the interviewing/ hiring techniques implemented. There is a fee for placement of ads. Please see Job Ad Form online for further details. The OAVT reserves the right to edit as space allows.

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

• Ads may contain graphics as long as they are no larger than 3.5” x 2” at 300 dpi. All graphics for the web may be in colour format.

• The OAVT reserves the right to edit any employment ads.

• Charges for ad placement are outlined below. Any requested changes to an ad already placed will be treated as a new ad and billed.

Advertisement Rates

• Website Only: $50.00 • Website and TECHNEWS (Members Rate): $50.00 first 20 words, $1.00 for each additional word • Website and TECHNEWS (Non-Members Rate): $75.00 first 20 words, $1.50 for each additional word

If you want to use graphics in employment ads, please refer to the following display ad rates: Full Page $1395.00* Half Page $895.00* Quarter Page $595.00* * Taxes not included in above mentioned rates PLEASE NOTE: All Employment Ads must be submitted on the OAVT website.

Payment by Cheque/Money Order/VISA (payable to OAVT) may be mailed to: OAVT, Job Ad Placement Ontario Agricentre Suite 104, 100 Stone Road West Guelph, ON N1G 5L3

TECHNEWS | VOLUME 35 ISSUE 4

11165 (May 17, 2012) Registered Veterinary Technician A rapidly growing new small animal practice in Pickering is looking for a part-time registered veterinary technician. Candidate must be a multitasker, familiar with Cornerstone an asset, a team player and willing to work flexible hours. please forward resumes via email to; amberleaah@rogers.com.

11164 (May 17, 2012) EMERGENCY/AFTER HOURS RVT required 24 hour continuous care small animal hospital requires both a full and part time RVT. Weeknights, weekends, holidays. Our priority is the highest level of patient and client care. Looking for a good person with excellent communication skills, self motivated, good to multi-task.

Please contact clarksonvet@rogers. com. Thank you.

11163 (May 16, 2012) Full Time RVT The Queen West Animal Hospital is looking for an energetic and enthusiastic RVT/AHT to join our companion animal hospital full-time. Located in the trendy Queen West area of Toronto, our well-equipped and well-known hospital has an excellent clientele - and we always strive to deliver exceptional medical care and service. We’ve created a highly supportive team-focused environment and are looking for individuals who are equally motivated to make our clients (and their owners) happy. We offer competitive salary, paid CE, paid dues, uniform allowance and medical benefits. Candidates must be available for evening and weekend shifts. Please email resumes to: patrickmalabre@gmail.com

11161 (May 16, 2012) Veterinary Technician Wanted MORE EXCITING NEWS! Our Stoney Creek location is fully staffed now, but we are looking for more technicians to join our day team in Brantford.This is a busy, modern, rapidly growing nine Veterinarian AAHA practice offering the most up to date equipment, total use of tecnician skills and great benefits. If you are looking for a challenging job with lots of rewards please send your resume to Angela: e-mail beattie.petvet @rogers.com 11156 (May 15, 2012) RVT/AHT Join our team in North York! Looking for a confident and outgoing RVT/AHT with friendly customer service skills. Please send your cover letter and resume to BMVC2008@ hotmail.com 11148 (May 14, 2012) VETERINARY TECHNICIAN/ASSISTANT Small Animal progressive practice in Mississauga is looking for F/T or P/T veterinary technician/assistant.

Responsibilities include working in treatment, surgery and reception areas. A self starter, team player, with strong communication and interpersonal skills would be preferred.

Working knowledge of Avimark would be an asset. Please forward resumes via email to animaldoc2012@ gmail.com 11145 (May 9, 2012) Overnight Vet Technician Beaches Area Immediate opening for an overnight emergency registered veterinary technician. 30+hrs/week, weekday & weekend shifts. Successful candidate must be able to assist veterinar-

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ian in all aspects of emergency medical care for our patients (restraint, IV placement, blood draws, surgical assistance, anesthetic monitoring), Responsibilities also include customer service and general housekeeping/animal husbandry duties.

We are fully equipped with the most modern medical equipment - knowledge with iStat, xray, laser, Avimark would be an asset.Above average remuneration with a $/hr o/n incentive, full medical/ dental benefits, free uniforms and CE. Please send resume to hr@vetstoronto. com 11129 (May 1, 2012) Use your skills and make a difference Fun, enthusiastic team members in a fully computerized, progressive practice centered on providing exceptional client and patient care. Uniforms, continuing education allowance and health and dental benefits available. Opportunity to use your skills in anesthesia, surgical, dental, nursing, radiology, sample collection, laboratory with VetLab, medical record keeping, triage and client education. Avimark experience an asset.

Please forward your resume to yorkwood@rogers.com, Fax(905)-4769867 or phone 1-866-476-5967 to schedule an interview.

11127 (May 1, 2012) Emergency Technicians This new, co-operatively owned and operated emergency hospital is looking for 4 to 8 technicians who will work under the direction of an already appointed lead emergency veterinarian to provide after hours and weekend care to the clients of member clinics as well as to the general public. This is an exciting opportunity to work in a supportive environment to provide high quality compassionate care to the residents of the National Capital Region. We are looking to provide unique, caring, personalized experience to our clients and will be carefully selecting applicants who share our vision. Experience and bilingualism will be definite assets. For further information please contact Dr. Paul R. Brown at prbrown@ travel-net.com 11122 (Apr 30, 2012) Registered Veterinary Technician We are looking for an RVT who has an interest in exotic companion animal

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medicine and who will work as a team player in a busy practice. The successful applicant must be willing to work some evenings and weekends. Experience(work or volunteer) will be recognized but interest in exotics will also be considered.

Please send resumes to lroadac@hotmail. com to the attention of Suzanne and we will contact you to make an appointment for an interview.

11121 (Apr 30, 2012) Swine Breeding Technician 1150 Sows, Farm located in Mapleton Township. Email resume to home@bosman.ca with references. ph. 519-3432000 11119 (Apr 26, 2012) Experienced RVTs Wanted Calling all amazing techs! If you feel like you are â&#x20AC;&#x153;stuckâ&#x20AC;? in your current position and are looking for a change, this is the position for you! VetStrategy is a multiclinic organization with opportunities within a few practices that need to be filled. Because we have multiple clinics there is plenty of room to grow and develop within our organization. We offer above average compensation, health and medical benefits, a best in class CE package and more. If you love what you do, you have mastered technical work and would like to take on new challenges please forward a cover letter and resume to sherry@vetstrategy.com.

11110 (Apr 23, 2012) Night Veterinary Technician Opening Soon!- a new 24hr companion animal Hospital in the Hamilton-Wentworth area requires 2 veterinary technicians and 2 veterinary assistants for a full time overnight position. We strive to provide excellent patient care, excellent service to clients and are AAHA accredited. This is a great opportunity for technicians and assistants alike to utilize all their skills in a fast paced, highly technical and modern facility. This facility includes laser surgery, digital x-rays, digital dental, ultrasound etc. We are looking for motivated individuals who want to be part an exceptional team while at the same time be rewarded with a good quality of life and wages (Tech) $18- $24 Contact: Ami Frost at beattie.petvet@ rogers.com, fax 519-756-2305

11106 (Apr 20, 2012) Are you a personable, detailoriented,self-motivating, RVT in Niagara Region?

Are you a personable, detail-oriented, self-motivating, technically capable RVT looking for a full-time position in the Niagara area? Are you an RVT with energy and new ideas willing to bring them to our current team and help us move to the next level of patient care? Court Animal Hospital and Livingston Animal Hospitals are well-established small animal hospitals in St Catharines and Grimsby. We strive to provide excellent care for pets, excellent service to clients and happy working environment for our employees.

Only RVT certified people need to apply.

Send CV to the Director of Operations at stutly@livingstonanimalhospital.com 11103 (Apr 19, 2012) PT Animal Care Attendant, Newmarket The Veterinary Emergency Clinic of York Region is looking for a part-time animal care attendant to work some weekends.

A veterinary technician student would be ideally suited for this position. We have a beautiful, well-equipped facility and we are lucky to have wonderful DVMs and veterinary technicians who enjoy emergency medicine and working as a team to address the needs of our patients.

Please submit your resume and cover letter to: Michele Potter, AHT, CVPM, Hospital Administrator 905-953-5351 (T) 905-953-4136 (F) resumes.vecyr@gmail.com Please note that only those being granted an interview will be contacted. Thank You. 11083 (Apr 11, 2012) Veterinary Technician Technician wanted for new emergency clinic in Peterborough. Competitive salary and benefit package. Please forward resume to info@kvec.ca 11081 (Apr 10, 2012) Veterinary Technician Full time RVT position, small animal hospitals, new grads welcome. Well equipped, Pulse oximeters, BP, ECG, USG,Endoscopy.Email resume to zrostro@gmail.com

TECHNEWS | VOLUME 35 ISSUE 4

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Effective Horse Handling

by Nettie Barr Canadian Natural Horsemanship Inc.

Animals and people: we belong together! We spent a great deal of time evolving together and are meant to be partners.

Of some 4,000 mammal species alive in the past 10,000 years, the horse is one of only a dozen that has been domesticated successfully. The horse is an incredibly astute animal that thrives on Natural Horsemanship, a training process that rests on mutual communication, the sharing and understanding of an idea, and psychology. Often we think that Horsemanship or “Natural Horsemanship”, is mystical or has some sort of secret involved. The “secret” or “mysticism” behind Effective Horse Handling or Horsemanship is the ability to control the movement of the horse. It is that simple! There are two ways to earn a horse’s respect: the ability to move the feet and reward the slightest try.

Effective or Natural Horsemanship is like a handshake. It is where we feel of, feel for, and feel together. Think about when we shake hands with one another. At no time do we need to verbally communicate the different steps of when to connect, and

Figure 1 Effective Horsemanship creates confidence and a willing partner.

when to release in a hand shake. Rather, we do this by reading one another’s body language. We also want to learn and develop the ability to effectively read a horse’s body language to communicate, creating a partner rather than a beast of burden.

Avoid “muscling” a horse. A horse on the average is approximately 1200 lbs, and more in draft horses. That is a lot of pounds of opinion! No matter how strong you are or how sturdy you are built, you cannot muscle a horse. You want to build mind, and the body will automatically follow. Focus on building to responses, rather than to reactions, and acceptance rather than tolerance. Remember the horse is a flight animal, but if pushed too far will fight.

Be conversational with horses. When introducing equipment, or even yourself to a horse, introduce yourself by letting the horse smell you or what you have in your hand. I refer to this as a “handshake”.

When offering my hand I do not have my hand in the form of a claw, but rather palm down so the horse can smell the top of my hand rather than the palm of my hand. Try not be in a hurry. I understand that veterinary procedures at times must be performed quickly. But if you have the choice, slow down: it will take less time.

Even when you are in a hurry, try to have a relaxed, quiet, conversation in your mind.

Your hands will reflect what your mind is saying. You can move efficiently without being abrupt to the horse. Be sure to rub rather than pat a horse.

Be aware of your body language. Are you tense? If so take a deep breath, breathing in through your nose and out through your mouth. You will notice that when you do

this exercise, your core muscles will relax.

If you are bracey, the horse will be bracey.

Avoid too much direct eye contact and be sure to take all the pressure off and get out of their space to allow the horse to “soak” information. Pressure for a horse can be something as simple as your hand or arm still pointing in their direction, or holding the lead shank up higher with your hand than having your arm down and relaxed.

You may even need to turn away from them rather than facing directly, or take a step away and stand quietly. Doing nothing is doing something: it is allowing the horse time to process some information.

Be assertive rather than aggressive. When we are assertive, we have emotional fitness, based on principles of safety and fairness for both you and the horse. When you are

Figure 2 A horse accepting rather than tolerating and responding rather than reacting.

aggressive, there is no emotional fitness, nor are there any considerations for safety and fairness. Being assertive does not mean that we are a pushover with horses. Do as little as possible, but as much as necessary to be effective. If I am in doubt, I always give the horse the benefit of the doubt first, unless my life or the horse’s life is in danger and I am left with no other option. Have your heart in your hands. “Horse’s don’t care how much you know till they know how much you care.” This saying originates from President Theodore Roosevelt who said: “People don’t care how much you know till they know how much you care.”

Consider this when working with your human clients as well.

Keep human emotions out of horsemanship. Animals operate from a very simplistic, primal base of emotions. They do not have the ability to have more complex emo-

Nettie Barr - Canadian Natural Horsemanship Inc. has been developed to effectively reach the needs of equine enthusiasts. Its goals are to reach all levels of horsemen or horsewomen to develop safer, affordable, informative, step by step, user-friendly techniques that apply for all disciplines of horsemanship.

The personal approach of Nettie Barr takes into consideration the confidence and dignity of both horse and handler, creating a relaxed and positive atmosphere for learning. Setting people and horses up for success with lasting results has been the focal point and strength of her approach.

For more information, visit www.canadiannaturalhorsemanship.com

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TECHNEWS | VOLUME 35 ISSUE 4

tions as we do since they do not possess a higher cognitive brain that allows them to reason.

The horse is the fastest learner of all domestic animals. Undesirable behaviours are learned as quickly as desirable behaviours.

Generally if a horse has done something three times with an understanding, they will remember this for the rest of their lives.

So, remember when you are teaching or handling a horse, you are “programming”

Figure 3 A horse accepting rather than tolerating and responding rather than reacting.

the horse. Horses are a lot like computers: they don’t do what we tell them to do, they do what we have programmed them to do.

You can never delete a file, but you can help a horse close a file.

space, have them move back out of your space rather than you taking that step back.

Horses play dominance games with one another by who moves whose feet for whom first. A good example of how large your personal space should be is by drawing a circle with the horseman stick around you.

You want to establish that you are the lead horse rather than the dominant horse. In a herd, there is a dominant horse. This horse is generally on his or her own. They tend to be the “bully” in the herd. There is also the lead horse. This is the horse that everyone follows to the water, or back out to the field. You can relate this to your own life.

You would not wish to be called the dominant Veterinary Technician. This has quite a negative connotation to it. Rather, if I refer to you as a lead Veterinary Technician, or a leader in your workplace, it suddenly takes on a more positive meaning.

Effective Horse Handling and training is broken into two categories: desensitizing and sensitizing. When we desensitize a horse, we apply pressure; when the horse relaxes we take off the pressure. When we sensitize a horse, we apply pressure; when the horse responds we take off the pressure.

Evaluate success on a scale of 0 - 10. We

The horse MUST respect your personal space. Have them get into position for you rather than you getting into position for them. If a horse invades your personal

Figure 4 Introduce yourself to the horse in the form of a “handshake”, allowing the horse to smell the top of your hand.

TECHNEWS | VOLUME 35 ISSUE 4

want the horse to score a 5, which is an understanding, before moving on to another task or step. Over time, the 5’s soon become 6, 7, or even 8’s, bringing the horse to a higher level of understanding, acceptance, and responses.

Horses are sensitized to either rhythmic or fingertip/leg pressure, with the intention being phase one, i.e. slowly increasing fingertip pressure. Rhythmic pressure can be applied with a rope, horseman stick/string, hand, etc. Fingertip pressure is applied with either your fingertips or can also be applied with the horseman stick or leg if under saddle. Rhythmic pressure is applied with pulsating, steady, even pressure. Slowly increase the pressure. Both rhythmic and fingertip pressure teach the horse to respond, yielding to pressure. Always begin very soft and light. Have slow hands to ask, and quick to release.

Keep it simple. The principles of horsemanship are always the same no matter the task at hand. The formula for teaching is first to reach an understanding: quality, then quantity. Training is a series of introduction, followed by bringing the horse to a state of relaxation. Take the time it takes, and reward the slightest try.

Match up the drug type with the drug’s generic names (e.g. cetirizine - antihistamine) Human Trade Name 1. gabapentin 2. tramadol 3. hydroxyzine 4. vancomycin 5. prednisone 6. morphine 7. spironolactone 8. mifepristone 9. methscopolamine bromide 10. milrinone lactate

Veterinary Trade Name a. aminoglycoside antibiotic b. opiod c. potassium-sparing diuretic d. anticonvulsant e. abortifacient f. antihistamine g. positive inotropic agent h. narcotic analgesic i. anticholinergic j. glucocorticoid

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

(Source: North American Companion Animal Formulary, 9th edition, 2010)

Figure 5 Let the horse smell your “tools” or equipment.

Figure 6 Rub a horse rather than pat.

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Did You Know?

Tabbies Have Earned Their Stripes “Tabby” is a general term for striped cats, and tabbies come in many colours and patterns -- more than 40 varieties in all. Red tabbies seem to have a special following and mythology, perhaps because in male cats the red-orange gene is almost always connected with tabby markings, while in females, red-orange cats can be tabbies, tortoiseshells or calicoes. (About one calico in 3,000 is male, but he’s not your usual male: He carries an extra “X” chromosome.) Red tabby males are often called “ginger toms” with great affection.

Tabbies can be further distinguished by differences in the pattern of their stripes. The most recognizable is probably the “mackerel” tabby, with parallel lines placed like the ribs of a fish -- hence the name. All tabby cats carry a special mark in common, an “M” on the top of their heads.

The word “Tabby,” by the way, is thought to come from the “Atabi,” the name of an ancient silk with a striped pattern. (veterinarypartner.com)

New Guidelines In May 2011, the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) teamed up to publish guidelines on feline handling to help reduce stress in cats, clients, and veterinary professionals. The American Animal Hospital Association (AAHA) has endorsed the guidelines.

The AAFP’s complete “2011 Feline Friendly Handling” guidelines are available as a downloadable PDF. Dental health facts you can share with clients: Dogs • Puppies have 28 temporary teeth that begin to show at about 3 to 4 weeks of age.

• They have 42 permanent teeth that generally grow in between 5 to 7 months of age • Periodontal disease is the most common dental issue among dogs Cats • Kittens have 26 temporary teeth that begin to show at about 2 to 3 weeks of age.

• They have 30 permanent teeth that generally grow in by 5 to 6 months of age • Resporptive lesions are the most common tooth disease among cats

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Pets owners spend more on dental conditions than prevention. Encourage clients to be vigilant with their pets’ preventive dental care and help them save money.

Sprinting Cats The average domestic cat can run at a speed of around 30 mph. For comparison, a thoroughbred racehorse can maintain a speed of 45 mph for more than a mile. The fastest racing greyhounds run at speeds of just under 42 mph for about a third of a mile. Cats, well, they’re not marathon runners, or even middle-distance runners; they’re sprinters. While you could never outrun a dog over distances, any decent jogger could best a cat, as they quickly overheat when running and have to stop after just 30 to 60 seconds to rest and cool down.

TECHNEWS | VOLUME 35 ISSUE 4

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