Day one core competencies in veterinary dentistry.

This article describes the core competencies recommended for inclusion in the veterinary curriculum for all veterinary graduates based on the American Association of Veterinary Medical Colleges Competency-Based Veterinary Education document. General practice companion animal veterinarians are frequently presented with patients having dental, oral, or maxillofacial pathology, and veterinary graduates will be relied upon for recommendations for the maintenance of oral health, including the prevention of periodontal disease, identification of endodontic disease, and knowledge of developmental defects. These recommendations should be made for all veterinary patients starting at a young age. These core competencies can apply to many companion species, but mainly are focused on the dog and cat. Because periodontal disease is the most common abnormality observed in dogs and cats, the first key step is taking a few seconds during examination of every patient of any age presented for any reason to examine the oral cavity. Although dental, oral, and maxillofacial pathology is often diagnosed after imaging and evaluation under anesthesia, the first step is observation of dentition and gingivae during the conscious exam to assess periodontal health status. The physical exam of the oral cavity may reveal oral behavior (eg, observation of uncomplicated crown fractures due to chewing on hard objects), which will permit recommendations for enhanced prevention by daily oral hygiene or professional treatment. There are now many involved dental and surgical treatments available, some of which require specialist-level instrumentation and expertise. General practitioners should be able to competently perform the following immediately upon graduation from veterinary school: For patients for whom the owner's reason for the veterinary visit is not dental, oral, or maxillofacial disease, obtain a brief (1 or 2 questions) history of the oral health of the patient. On lifting the lip of every patient, recognize presence or absence of accumulated dental plaque or calculus on the crowns of the teeth, presence or absence of gingival inflammation or ulceration, and presence or absence of other dental, oral, and maxillofacial pathology. On anesthetized patients that have dental, oral, and maxillofacial pathology for which professional treatment is indicated, be able to obtain and interpret appropriately positioned and exposed dental radiographs. When the presence of dental, oral, and maxillofacial pathology is recognized, determine whether each tooth present in the mouth does or does not require professional treatment beyond dental subgingival and supragingival scaling and polishing. List the indications for tooth extraction, know indications for potential oral/dental treatments beyond subgingival and supragingival scaling and polishing or extraction, and determine whether the professional treatment that may be indicated, such as root canal treatment or mass resection of oral tissues, requires referral for specialist-level expertise and instrumentation. Complete a thorough periodontal evaluation and therapy with periodontal probing, including professional subgingival and supragingival ultrasonic scaling with polishing under anesthesia. Demonstrate the ability to extract teeth indicated for extraction, using gentle and appropriate techniques that will risk minimal injury to the jaws and oral soft tissues and reduce postoperative patient pain. Provide appropriate postoperative care, including recognition of when postoperative analgesia and possibly antibiotic administration are indicated.

Evaluation of a continuous glucose monitoring system for use in veterinary medicine.

BACKGROUND: With the emergence of continuous glucose monitoring systems being used to provide a detailed glucose picture in humans, a commercially available system (CGMS(R), Medtronic Minimed, Northridge, CA) was examined for use in veterinary species. METHODS: Adult, clinically normal horses (n = 7), cats (n = 3), dogs (n = 4), and cows (n = 5) were studied. Cats (n = 4), dogs (n = 5), and one horse with diabetes were included in the study. Several of the normal horses, including the horse with diabetes, and one cow were subjected to an intravenous glucose tolerance test. The CGMS was attached to each animal, and the recorded interstitial glucose concentrations were compared with whole blood glucose concentrations as determined by a point-of-care glucose meter. Events such as insulin administration, feeding, travel, or administration of intravenous glucose were all noted and compared with results from the CGMS. RESULTS: There was a positive correlation between interstitial and whole blood glucose concentrations for all the clinically normal species, those with diabetes mellitus, and those receiving intravenous glucose. Events such as feeding, glucose or insulin administration, and transport to the clinic were noted by the owner or clinician and could be identified on the graph and correlated with time of occurrence. CONCLUSIONS: Our data indicate that the use of the CGMS is valid for use in the species examined. Use of this system alleviated the need for multiple blood samples and the stress associated with obtaining those samples. This system may provide greater monitoring capabilities in patients with diabetes and promote the diagnostic and research potential of serial glucose monitoring in veterinary species.

Evaluation of a continuous glucose monitoring system for use in dogs, cats, and horses.

OBJECTIVE: To evaluate a continuous glucose monitoring system (CGMS) for use in dogs, cats, and horses. DESIGN: Prospective clinical study. Animals-7 horses, 3 cats, and 4 dogs that were clinically normal and 1 horse, 2 cats, and 3 dogs with diabetes mellitus. PROCEDURE: Interstitial glucose concentrations were monitored and recorded every 5 minutes by use of a CGMS. Interstitial glucose concentrations were compared with whole blood glucose concentrations as determined by a point-of-care glucose meter. Interstitial glucose concentrations were also monitored in 2 clinically normal horses after oral and i.v. administration of glucose. RESULTS: There was a positive correlation between interstitial and whole blood glucose concentrations for clinically normal dogs, cats, and horses and those with diabetes mellitus. Events such as feeding, glucose or insulin administration, restraint, and transport to the clinic were recorded by the owner or clinician and could be identified on the graph and associated with time of occurrence. CONCLUSIONS AND CLINICAL RELEVANCE: Our data indicate that use of CGMS is valid for dogs, cats, and horses. This system alleviated the need for multiple blood samples and the stress associated with obtaining those samples. Because hospitalization was not required, information obtained from the CGMS provided a more accurate assessment of the animal's glucose concentrations for an extended period, compared with measurement of blood glucose concentrations. Use of the CGMS will promote the diagnostic and research potential of serial glucose monitoring.

Measurement of body temperature by use of auricular thermometers versus rectal thermometers in dogs with otitis externa.

OBJECTIVE: To compare measurements of body temperature obtained with auricular thermometers versus rectal thermometers in dogs with otitis externa. DESIGN: Prospective study. ANIMALS: 100 client-owned dogs: 50 with and 50 without clinical evidence of otitis externa. PROCEDURE: Dogs were evaluated for the presence of otitis externa on the basis of clinical signs, otoscopic examination, and cytologic evaluation of ear exudate. Auricular and rectal temperatures were obtained simultaneously in all dogs prior to and following ear examination. RESULTS: There was a high correlation between auricular and rectal temperatures in dogs with otitis externa both prior to and after ear manipulation. Significant differences were not detected in temperature measurements among dogs with different degrees of otitis externa. CONCLUSIONS AND CLINICAL RELEVANCE: Auricular temperature readings obtained by use of an auricular thermometer in dogs with otitis externa are accurate measurements of body temperature, compared with rectal temperature measurements. Temperature measurements are reliable before and after examination of the ear canal.

Older Latinos, pets, and health.

The majority of thefindings regarding pet ownership, interaction, and the human-animal bond have involved only Caucasians or have included other ethnic group members only incidentally. The extent to which older adultsfrom other ethnic groups may benefitfrom pet ownership and interaction is unclear. If the benefits of human-animal interaction are to be used effectively in promoting health and preventing illness, it is necessary to identify the "boundaries" of effectiveness for this interaction across various populations. The present study is an initial effort at describing one ethnic minority group, Latino pet owners, the extent of their relationships with their pet, and the extent to which these relationships may be beneficial in facilitating health. Twenty-four Latinos over age 50 were studied and are described in terms of their demographic characteristics, relationships with their pets, health, and exercise practices. The findings suggest that the participants were very devoted to their pets, had been involved with pets since childhood, and viewed themselves as healthy.

Animal-assisted interventions research: issues and answers.

Animal visitation programs have been used in a wide variety of clinical settings with predominantly positive outcomes reported anecdotally. However, there is also a growing body of research investigating the effects of these interventions. Developing and conducting rigorous studies of animal interventions can be a complex and challenging process, The purpose of this article is to identify and discuss several issues arising with this type of research and to posit suggestions for avoiding pitfalls.

Conservative management of chronic kidney disease in cats: recommendations for veterinarians and compounding pharmacists.

Chronic kidney disease is a major cause of morbidity and mortality in aging cats, and assessment of that condition suggest that conservative management can provide substantial benefit for patients. The veterinarian's armamentarium is augmented each year with effective therapies for treating renal disease that are designed for human patients but can be successfully adapted for use in cats. The help of an experienced compounding pharmacist is invaluable in converting many of those treatments to the doses and dosage forms appropriate for veterinary patients. In this report, we examine effective approaches to the conservative treatment of chronic kidney disease in cats. Formulations useful in relieving the signs and symptoms of that disorder and in improving both adherence and the patient's quality of life are made available.

Dog-walking: motivation for adherence to a walking program.

Healthy People 2010 cited walking as a major health indicator; however, adherence is challenging, especially among those with multiple chronic illnesses. Studies suggest that walking one's own dog may motivate adherence. However, no research has studied whether walking a "loaner" dog may facilitate adherence. Using a pretest-posttest design, the authors studied adherence to and outcomes of a graduated walking program when 26 public housing residents walked certified therapy dogs with a handler. Participants walked 20 minutes, 5 days/week, for 26 or 50 weeks. In all, 13 participants in the 50-week group had a mean adherence rate of 72% and weight loss of 14.4 pounds (p = .013). Thirteen participants in the 26-week group had a mean adherence rate of 52% and weight loss of 5 pounds (nonsignificant). Participants' most commonly stated reason for adherence was that the dogs "need us to walk them." Commitment to a dog that is not one's own may effectively facilitate physical activity.

Animal-assisted activity among patients with cancer: effects on mood, fatigue, self-perceived health, and sense of coherence.

PURPOSE/OBJECTIVES: To identify to what extent an animal-assisted activity (i.e., visits with a dog) affects the mood, self-perceived health, and sense of coherence among patients undergoing radiation therapy. DESIGN: Pretest/post-test between and within groups. SETTING: Radiation oncology units of two hospitals in a mid-sized, midwestern city. SAMPLE: 30 adult patients undergoing nonpalliative radiation therapy. METHODS: After giving informed consent, participants were randomly assigned to receive 12 dog visits, 12 human visits, or 12 quiet reading sessions over a four-week period. FINDINGS: No statistically significant differences were found; however, compared with others their age, patients receiving dog visits viewed their health as improved over the four-week period. Participants described each of the three activities as beneficial. The study is primarily useful as a basis for planning additional research. CONCLUSIONS: The study warrants replication with a larger sample to determine applicability of animal-assisted activity in patients with cancer who are undergoing radiation therapy. IMPLICATIONS FOR NURSING: Patients may want and express benefit from animal-assisted activity dog visits, but the outcomes of the visits may not be measureable. Nurses should assess to what extent patients believe that such visits are beneficial by asking them. The visits may be valued by patients as helping to relieve their anxiety and as distractions from their disease and therapy.

Chylous effusions revisited.

Varying terms and criteria have been used in the veterinary literature to characterize milky opaque pleural effusions through the years. This article addresses ideas widely repeated in the veterinary and human literature upon which time, experience, diagnostic techniques, experimental data, and improved understanding of pathogenesis have cast doubt. Topics discussed include terminology, pathogenesis of chylous and pseudochylous effusions, criteria for differentiation of chylous from pseudochylous effusions, and clinicopathologic changes associated with drainage of chylous effusions.

Chylothorax associated with cryptococcal mediastinal granuloma in a cat.

A 10-year-old neutered female cat had chylothorax, precaval syndrome, and a mediastinal granuloma resulting from infection with Cryptococcus neoformans. Diagnosis of a chylous effusion was made by cytologic examination of pleural fluid and by finding higher triglyceride levels in the effusion than in serum (825 vs. 64 mg/dl, respectively). Postmortem examination revealed cryptococcal organisms in the mediastinal granuloma, lungs, cerebral meninges, and connective tissues adjacent to the thyroid gland. Chylous effusion in a cat associated with cryptococcosis has not been reported previously. Cryptococcosis should be included in the differential diagnosis in chylous effusions in cats.

Diagnosis of histoplasmosis in a dog by cytologic examination of CSF.

A mixed inflammatory cell pleocytosis was identified in a cytocentrifuged sample of cerebrospinal fluid (CSF) and diagnosis of histoplasmosis was made on the basis of finding Histoplasma capsulatum organisms within macrophages. This dog had disseminated histoplasmosis with multiple organ involvement including the central nervous system (CNS) and eye.