Veterinary Clinical Ethics and Patient Care Dilemmas.

Veterinary ethical dilemmas are common, complex, and unavoidable. Creating a transparent and deliberate approach to ethical issues empowers the entire veterinary team and reduces stress associated with these dilemmas. This article discusses ethical considerations and principles and propose use of the 4Es model and core communication skills to address ethical dilemmas in veterinary practice. It reviews literature defining ethical issues in practice and provides case examples to show the application of our proposed methods. The goal is to provide veterinary professionals with an approach they can use to frame and address their own ethical decisions.

Readability Evaluations of Veterinary Client Handouts and Implications for Patient Care.

Health literacy and readability are important considerations for veterinary medicine, as veterinarians commonly distribute brochures, leaflets and info-graphics to explain health related issues to pet owners. Educational materials that are poorly comprehended by the intended audience could result in negative, unintended consequences. Thus, the National Institutes of Health (NIH) and the American Medical Association (AMA) have recommended readability levels for text on health information be targeted between the fourth and sixth grade levels to accommodate a highly diverse public. In the context of veterinary medicine, an increased awareness among veterinary professionals and educators regarding readability scores and the tools available to generate "easy-to-read" text would likely benefit client adherence with veterinary recommendations, client satisfaction with their veterinarian, and ultimately, pet health. Therefore, the goal of this study was to evaluate the readability levels of a sample of popular client handout materials prepared expressly for veterinarians to download and distribute to their pet-owning clients. Results indicate that 9 of 10 client brochures were written above the recommended sixth grade reading level. Recommendations for improving readability are provided.

Cleaning and disinfection of patient care items, in relation to small animals.

Patient care involves several medical and surgical items, including those that come into contact with sterile or other high-risk body sites and items that have been used on other patients. These situations create a risk for infection if items are contaminated, and the implications can range from single infections to large outbreaks. To minimize the risk, proper equipment cleaning, disinfection/sterilization, storage, and monitoring practices are required. Risks posed by different items; the required level of cleaning, disinfection, or sterilization; the methods that are available and appropriate; and how to ensure efficacy, must be considered when designing and implementing an infection control program.

Continuous renal replacement therapy in dogs and cats.

Continuous renal replacement therapy (CRRT) is a relatively new extracorporeal blood purification modality that is rapidly gaining acceptance for the treatment of acute kidney injury in cats and dogs. The author has used CRRT for the treatment of leptospirosis, tumor lysis syndrome, heatstroke, pre- and postsurgical support of ureteral obstructions, as well as aminoglycoside and melamine toxicities. As the name implies, CRRT is a slow gradual process, and once treatment begins, patients continue therapy until their renal function returns, they are transitioned to intermittent hemodialysis (IHD), or they are euthanized. Unlike IHD, which is a primarily diffusive therapy, CRRT uses diffusion as well as convection. Because of its efficient use of fluids, CRRT units use prepackaged fluids, eliminating the need for costly water purification systems that are needed for IHD.

Continuous renal replacement therapy.

Continuous renal replacement therapy (CRRT) is a blood purification modality that uses a combination of convection and diffusion to eliminate uremic toxins and correct electrolyte imbalances. Although CRRT is usually associated with the treatment of acute renal failure, it can also be useful in treating many types of toxicoses and drug overdoses. Unlike intermittent hemodialysis, in which the patient is treated at set intervals for a specified number of hours, CRRT continues until kidney function is restored. CRRT's array of blood purification techniques and its slow, continuous nature more closely approximate normal kidney function than does intermittent dialysis. Although easier to maintain than traditional dialysis systems, CRRT requires specialized equipment, training, and nursing care.