Physical Rehabilitation in Zoological Companion Animals.

Animal physical rehabilitation is one of the fast-growing fields in veterinary medicine in recent years. It has become increasingly common in small animal practice and will continue to emerge as an essential aspect of veterinary medicine that plays a vital role in the care of animals with physical impairments or disabilities from surgery, injuries, or diseases.1 This is true now more than ever because of the increasing advances in lifesaving treatments, the increased lifespan of companion animals, and the growth of chronic conditions, of which many are associated with movement disorders. The American Association of Rehabilitation Veterinarians (AARV) defines APR as "the diagnosis and management of patients with painful or functionally limiting conditions, particularly those with injury or illness related to the neurologic and musculoskeletal systems." Rehabilitation not only focuses on recovery after surgical procedures but also on improving the function and quality of life in animals suffering from debilitating diseases such as arthritis or neurologic disorders. The overall goal of APR is to decrease pain, reduce edema, promote tissue healing, restore gait and mobility to its prior activity level, regain strength, prevent further injury, and promote optimal quality of life. Typically, a multimodal approach with pharmaceutical and nonpharmaceutical interventions is used by APR therapists to manage patients during their recovery. The purpose of this article aims to provide knowledge and guidance on physical rehabilitation to help veterinarians in the proper return of their patients with ZCA safely after injury and/or surgery.

Is there any change in the prevalence of intestinal or cardiopulmonary parasite infections in companion animals (dogs and cats) in Germany between 2004-2006 and 2015-2017? An assessment of the impact of the first ESCCAP guidelines.

Main objective of the present nationwide study was to assess the impact of the ESCCAP guideline for the control of worm infections in dogs and cats 8-10 years after its first publication in Germany. A secondary aim was to determine the prevalence of canine and feline cardiopulmonary nematodes and intestinal protozoa. Faecal samples of 53,693 dogs and 26,491 cats in 2004-2006 as well as of 129,578 dogs and 45,709 cats in 2015-2017 routinely submitted by veterinarians to a private veterinary laboratory were examined using appropriate parasitological methods. In dogs, the prevalence of Toxocara and taeniid egg shedding was significantly lower in 2015-2017 (3.8 % and 0.16 %, respectively) than in 2004-2006 (4.6 % and 0.27 %, respectively). The prevalence of hookworm and Capillaria eggs was higher in the second study period (2.3 % and 0.77 %, respectively) than in the first (1.3 % and 0.6 %, respectively). For Toxascaris leonina (0.55-0.6 %) and Trichuris (0.8-0.9 %), the difference was not significant between the study periods. Dogs shed more often Angiostrongylus vasorum larvae in the second study (3.1 %) than in the first (1.0 %), whereas the prevalence of Crenosoma vulpis did not change significantly (2.2-2.6 %). Cystoisospora canis and C. ohioensis-like infections were less detected in the second study period (1.0 % and 2.1 %, respectively) than in the first (1.8 % and 2.7 %, respectively). Neospora-like oocysts and Sarcocystis sporocysts were more prevalent in the second study period (0.19 % and 0.13 %, respectively) than in the first (0.13 % and 0.06 %, respectively). The percentage of Giardia or Cryptosporidium coproantigen-positive samples was lower in the second study period (18.9 % and 6.7 %, respectively) than in the first (22.8 % and 10.0 %, respectively). In cats, the prevalence of egg shedding of T. cati, Capillaria and taeniids was significantly lower in 2015-2017 (3.5 %, 0.25 % and 0.1 %, respectively) than in 2004-2006 (4.8 %, 0.54 % and 0.22 %, respectively). No difference was recorded for hookworms (0.12-0.13 %) and Ts. leonina (0.04-0.05 %). Aelurostrongylus-like larvae were detected more often in the second study period (6.5 %) than in the first (2.6 %). Infections with Cystoisospora felis, C. rivolta, Toxoplasma-like coccids and Sarcocystis were less prevalent in the second study period (1.9 %, 0.7 %, 0.24 % and 0.02 %, respectively) than in the first (2.7 %, 1.1 %, 0.36 % and 0.1 %, respectively). The percentage of Giardia or Cryptosporidium coproantigen-positive samples was significantly lower in the second study period (10.6 % and 4.8 %, respectively) than in the first (15.4 % and 8.3 %, respectively). Although these results indicate a decline of the occurrence of most canine and feline intestinal parasites in Germany over the years, a transmission risk of zoonotic parasites remains. Therefore, the control of helminth infections in domestic dogs and cats continues to be a challenge for veterinarians and pet owners.

Medical Three-Dimensional Printing in Zoological Medicine.

Medical 3-dimensional printing allows the creation of anatomic models by using a sequence of computer software programs. Diagnostic imaging data are used to create a physical model that allows clinicians to plan for surgical procedures and create prosthetics and surgical implants and instruments, among other applications. Its use in zoological medicine is limited, but is an area with a great growth potential. This publication reviews the process of creating a 3-dimensional anatomic model, its application in human and small animal medicine and surgery, and reviews peer-reviewed data regarding its use in exotic animals, wildlife, and zoo animals.

Smartphone-Based Device in Exotic Pet Medicine.

This article reviews the use of the smartphone in exotic pet medicine. The mobile app is the most instinctive use of the smartphone; however, there are very limited software dedicated to the exotic pet specifically. With an adapter, the smartphone can be attached to a regular endoscope and acts as a small endoscopic unit. Additional devices, such as infrared thermography or ultrasound, can be connected to the smartphone through the micro-USB port. The medical use of the smartphone is still in its infancy in veterinary medicine but can bring several solutions to the exotic pet practitioner and improve point-of-care evaluation.

Advances in Pain Management: Palliative Care Applications.

One of the most important goals of palliative medicine and hospice care is pain relief. Although great strides have been made in veterinary analgesia, severe pain, especially at home, is still difficult to control. Pain control in the context of palliative medicine and hospice care is far more advanced in human medicine. Many modalities used in chronically or terminally ill humans might be adapted to animals to better manage severe pain. This article discusses drugs and procedures used to control pain in humans that are relatively nascent or unavailable in veterinary medicine and deserve further attention.

Private Practice Oncology: Viewpoint on End-of-Life Decision-Making.

Veterinary oncology has evolved rapidly over the past 30 years, with combinations of surgery, chemotherapy, immunotherapy, and radiation therapy now representing standard practice for managing pets with cancer. Recently, additional effort has been directed toward optimizing palliative strategies for mitigating clinical signs associated with advanced-stage disease, thereby reducing patient morbidity as pet owners navigate end-of-life decision making. This is a multi-dimensional, individualized process, which demands attention to the primary neoplastic condition, concurrent diseases, and emotional needs of the family. An approach to oncologic referral and end-of-life care is described, with attention to the dynamics between oncologist, referring veterinarian, and client.

Current Topics in Serious Illness and Palliative Medicine: A Curricular Initiative in a US Veterinary Teaching Institution.

Although interest in hospice and palliative care for companion animals is on the rise, formal training in these areas is limited. Veterinary teaching institutions, professional organizations, and accrediting bodies have much to gain from the human palliative medicine field. Core competencies, curricular milestones, and scope of practice for palliative medicine are identified. A formal palliative care intervention has been implemented in a US veterinary teaching institution, and preliminary evaluation data reflect significant potential for integration of palliative care training into veterinary teaching. Positive outcomes for veterinarian well-being and ability to cope with emotional demands are suggested.

Palliative Care Services at Home: Viewpoint from a Multidoctor Practice.

A growing, multidoctor, mobile hospice and palliative care practice in Louisville, Kentucky, is described. Services are exclusively dedicated to palliative medicine, hospice, and end-of-life care. The characteristics of, and unique considerations associated with, this practice's patient population are discussed. Demand for hospice and palliative care services is increasing even though these fields are in the early stages of growth and development, and availability of services is limited. Research is an essential step toward improving care provision and evaluating the value of hospice and palliative care services in terms of patient comfort, quality of life, and survival time.

Overcoming Obstacles to Palliative Care: Lessons to Learn from Our Physician Counterparts.

In the past 40 years, the field of palliative care for people faced many of the same obstacles in development and expansion that veterinary palliative care now confronts. A series of interviews with pioneers in human palliative care revealed what those early obstacles were professionally, personally, and institutionally. Many of the hurdles are strikingly similar to what veterinary professionals are currently facing in their attempts to grow palliative care as both an independent subspecialty and an integrated part of general practice. We can translate their experiences and successes to help veterinary palliative care flourish.

The Social Worker: An Essential Hospice and Palliative Team Member.

In veterinary hospice and palliative care practice, there is as much or more interaction with people as with the animal patient. It is an emotionally volatile environment, and veterinary professionals do not have the training to assess the mental health and emotional needs of clients. Nor are they qualified to counsel or provide therapy for humans. Providing veterinary treatment in this environment is emotionally draining for the treatment team, necessitating assistance to address workplace stress and compassion fatigue. Social workers are uniquely qualified to serve in these capacities. This article explains how they are essential to the interdisciplinary team.

Common Neurologic Problems: Impact on Patient Welfare, Caregiver Burden and Veterinarian Wellbeing.

Most neurologic diseases are incurable. Palliative care is vital in the treatment of companion animals with serious or chronic neurologic disease. A Neuropalliative Care Core Skill Set includes multifaceted communication competencies and symptom management. Because some of the most common clinical signs of neurologic disease are also associated with stress of caregiving, veterinarians should understand their clients' unique potential for caregiver burden. Acknowledging caregiver burden in their clients, means that veterinarians treating patients with neurologic disease must be proactive in building their own resilience to the occupational stress inherent in treating their patients and supporting their patients' caregivers.

Canine Cognitive Dysfunction: Pathophysiology, Diagnosis, and Treatment.

Canine cognitive dysfunction (CCD) is the canine analog of human Alzheimer disease (AD). The pathophysiology of CCD/AD is multifaceted. CCD is common in aged (>8 years) dogs, affecting between 14% and 35% of the pet dog population. Apparent confusion, anxiety, disturbance of the sleep/wake cycle, and decreased interaction with owners are all common clinical signs of CCD. Although there is no cure for CCD, several proven effective therapeutic approaches are available for improving cognitive ability and maintaining a good quality of life; instituting such therapies early in the disease course is likely to have the greatest positive clinical effect.

Where Have We Been, Where Are We Going: Continuity from 2011.

This article provides a brief review of important foundational concepts and an overview of major milestones in the history of animal hospice and palliative care. This article also presents a view of future goals and challenges that lie ahead of the veterinary profession as the field of animal hospice and palliative care evolves. Some examples of topics reviewed and explored in the article include current "state of-the-art" of animal hospice, future research goals, improved veterinary college curricula, collaboration among medical disciplines, and support of the veterinary staff.

Pain and Palliative Care Service, Massachusetts Society for the Prevention of Cruelty to Animals-Angell Animal Medical Center.

A veterinary palliative care service was developed as a specialty service in 2006 at a large, nonprofit teaching veterinary hospital. The service originally was conceived as a pain medicine service, but quickly refocused on palliative care because a need was evident. The Pain and Palliative Care Service at Angell Animal Medical Center is structured primarily as an outpatient service, but does provide consultation services for hospitalized patients. The goals of the service, appointment structure, referral relationships, client communication issues, and practitioner sustainability are described in detail in this article as an aid to development of similar services.

A retrospective analysis of radiation oncology related scientific articles in the journal Veterinary Radiology and Ultrasound: Trends over 40 years (1976-2015).

The journal Veterinary Radiology & Ultrasound is a veterinary specialty journal devoted to the fields of veterinary diagnostic imaging and radiation oncology. The purpose of this retrospective, observational study is to evaluate progressive trends in radiation oncology articles published in Veterinary Radiology & Ultrasound during the 40-year period (1976-2015) and describe a shift of trends through several viewpoints. This 40-year period was divided into four subperiods: Period 1 (1976-1985), Period 2 (1986-1995), Period 3 (1996-2005), and Period 4 (2006-2015). These articles were divided into six categories based on the nature of the study: 1) studies related to teletherapy with endpoints being patient outcome, 2) radiation therapy dosimetry/planning, 3) patient setup, 4) reviews, 5) case reports, and 6) others. The number of radiation oncology articles in Veterinary Radiology & Ultrasound has increased over the 40-year period. The number of authors per article has increased between Periods 1 and 3. The number of articles related to linear accelerator has increased between Periods 3 and 4. The median number of treated patients per clinical article related to teletherapy ranged from 15 to 21, which has not changed significantly over the 40-year period. The most commonly used radiation therapy protocols during Periods 2 and 3 were fine-fractionated protocols (defined as 10 or more fractions), whereas coarse-fractionated protocols were more common during Periods 1 and 4. Findings from this study highlight the notable changes of trends in veterinary radiation oncology articles published in Veterinary Radiology & Ultrasound, which clearly reflect changes in the field of veterinary radiation oncology during the past 40 years.

Sterile Pyogranulomatous Dermatitis and Panniculitis.

Canine sterile pyogranulomatous dermatitis and panniculitis is an infrequently described syndrome. No autoantigen, or exogenous antigen, inflammatory stimulus has been identified. This syndrome is characterized by pyogranulomatous nodules, plaques, and ulcers of variable extent and severity. Prodromal and concurrent nonspecific clinical and hematologic signs of inflammation may occur. This waxing and waning condition is typically responsive to systemic immunomodulation. Lifelong therapy may be required to prevent relapse. Differential diagnoses include bacterial and fungal nodular dermatoses, neoplasia, and cutaneous reactive histiocytosis. Diagnosis is achieved via diagnostic exclusion of infectious causes and supportive histopathology findings.

Diagnosis and Treatment of Canine Acral Lick Dermatitis.

Acral lick dermatitis is a common, frustrating disease. It is characterized by incessant licking behavior resulting in raised, thickened, ulcerative plaques, most commonly affecting the lower extremities of dogs. Underlying primary diseases, such as allergic disorders (atopic dermatitis, food allergy, flea allergy), orthopedic or neurologic disorders, parasitic diseases (eg, demodicosis), infections (fungal, bacterial), neoplasia or psychogenic disorders (compulsive/obsessive-compulsive disorder), and perpetuating factors (especially secondary infections) drive the itch-lick cycle. Appropriately addressing the primary underlying disorder and secondary infections and addressing any possible behavioral component via behavioral modification and psychopharmacotherapeutics are vital for successful management of this disease.

Canine and Feline Cutaneous Epitheliotropic Lymphoma and Cutaneous Lymphocytosis.

Cutaneous lymphomas are divided into categories based on histologic evaluation of the skin and location of neoplastic lymphocytes. Epitheliotropic cutaneous lymphoma, also known as cutaneous T-cell lymphoma, is diagnosed when neoplastic lymphocytes show tropism for the epidermis and these cells infiltrate the epidermis and adnexae. In diagnosis of nonepitheliotropic cutaneous lymphoma, neoplastic lymphocytes are found mostly in the dermis and/or subcutis. Neoplastic cells are of either B-cell or T-cell origin. This article focuses on epitheliotropic cutaneous lymphomas and cutaneous lymphocytosis, which is considered a form of indolent lymphoma, in dogs and cats.

Feline Pemphigus Foliaceus.

Feline pemphigus foliaceus is an uncommon skin disorder in cats but still the most common autoimmune skin disorder seen in this species. It is a crusting dermatosis involving the ears, head, paws, and ungual folds primarily. Although cytology is helpful in supporting a diagnosis, biopsy of pustules or crusts for histopathology is required for a definitive diagnosis. Therapy has evolved over the years as we have learned more about the different ways cats respond to drugs and as new drugs became available. Most cats will respond to proper therapy, although it may be needed long term for control.