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The Veterinary Nurse offers online CPD, allowing subscribers to complete 10 multiple-choice-based modules per year, enabling you to achieve 15 hours CPD each year to fulfil the UK mandatory requirement of 45 hours' CPD over a 3-year period.

Every CPD module is approved by Harper Adams University, one of the UK's leading providers of veterinary nursing education, so you can be confident in the quality of your CPD.

The online CPD is easy to use and you can complete modules at your own pace. All you need to do is read the relevant CPD article, then record your answers to the multiple-choice questions in your personal online dashboard. Once completed, you will receive a personalised certificate that can be downloaded and printed to store in your personal CPD portfolio.

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Small animal post-operative orthopaedic rehabilitation

Post-operative rehabilitation of the canine patient is now becoming recognized as an important facet of veterinary medicine. Rehabilitation may be provided by a variety of animal health professionals including animal physiotherapists, veterinarians and veterinary nurses. This article outlines the aims of rehabilitation following orthopaedic surgery, when to commence therapy, appropriate selection, administration and monitoring of treatment techniques, contraindications and when to refer on to a qualified animal physiotherapist or back to the referring veterinarian.

Feline hypertension: an overview

High blood pressure (hypertension) is an common problem in geriatric cats. Routine measurement of blood pressure can contribute to optimal clinical care. Veterinary nurses play an important role in measurement of blood pressure in routine clinical practice. This article discusses the procedure of blood pressure monitoring in cats, the interpretation of results and the management of hypertension.

Diabetes pathophysiology and disease management

Diabetes is a disease that presents in many different forms, but diabetes mellitus is the most common form seen in dogs and cats. Insulin dependent diabetes mellitus is more common in dogs than cats and non-insulin dependent diabetes mellitus is more common in cats than dogs. The incidence of diabetes varies depending on the species, age, physical attributes, genetic make up and gender of the animal. Clinical signs almost always include polyuria and polydipsia, but can also include polyphagia, weakness, weight loss, unkempt haircoat and changes in behaviour, among others. There are a number of successful treatment strategies that can enable the diabetic dog or cat to lead a long fulfilling life. Many of these treatment plans require careful monitoring of blood glucose, daily insulin injections and modifications in diet and lifestyle habits. This article provides a detailed overview of these clinical signs and the treatment of diabetes.

Anaesthesia for caesarean section in the bitch

No anaesthetic should be considered ‘routine’ and each should be tailored to the individual patient. This is particularly important when considering an anaesthetic protocol for caesarean surgery, where the veterinary nurse will encounter many additional complicating factors that influence the selection of drugs and the dose rates used. This article looks at the challenges to anaesthesia that are presented by the altered physiology of the bitch during pregnancy, and the immature physiology of the neonates, and aims to provide the veterinary nurse with the knowledge required to select appropriate anaesthetic agents and techniques to maximize survival rates of both bitch and puppies. Download the full article here.

Feline hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is the most common cardiac disease in the cat. A recent study showed that in a cardiology referral centre, 46% of cats with heart disease showed no clinical signs of heart failure, which highlights how difficult it can be for veterinary nurses to recognize a cat with severe heart disease. Stress should be avoided at all costs because it acutely increases the body’s metabolic demands, and patients with heart failure do not have sufficient cardiac reserve to accommodate such an increase in demand. Cats therefore should always be handled in a calm and competent manner. If a cat presents to the veterinary practice in respiratory distress, first line treatment should include oxygen therapy, diuresis and minimal handling. Download the article here

Ticks and tick-borne diseases of pets in the UK: risks to travellers

The ticks most commonly found on dogs and cats in the UK are Ixodes ricinus, Ixodes hexagonus and Ixodes canisuga with other Ixodes species rarely seen. Ixodes ricinus is known to transmit some diseases in the UK. Dermacentor reticulatus and Haemaphysalis punctata also are indigenous and found occasionally on pets in some areas. Rhipicephalus sanguineus has been identified after importation on pets from continental Europe and elsewhere, despite the requirements for treatment for ticks under the pet travel scheme. The increasing movement of pets between the UK and countries with a high incidence of tick-borne disease will require the use of strong parasite control programmes to prevent the spread and import of tick-borne disease. Download the full article here

Dietary management of the cat with chronic kidney disease

Chronic kidney disease (CKD) is one of the most common diagnoses made in clinical practice. Most affected cats are middle aged or older and one survey estimated that a third of cats over the age of 10 years suffer from this condition. In recent years there have been many advances in treatment options and long-term home care can be very rewarding for all involved. Treatment aims to help the patient to compensate for their renal disease allowing them to live for as long as possible with as good a quality of life as possible. Dietary management of cats with CKD is the most proven treatment for this condition — several studies have now shown emphatically that cats with CKD that will eat prescription renal diets will live much longer, healthier lives. Typical survival times are increased from 7 to 16 months when cats with CKD are fed a renal prescription diet. In those situations where feeding a renal prescription diet is not possible, standard cat food can be modified in some ways to more closely meet the needs of a cat with CKD. Other treatments can be extremely helpful to the individual and should be used where specific indications exist. Download the full article here.

Principles of barrier nursing in the veterinary hospital

This article aims to remind the reader of the importance of following barrier nursing techniques when patients are in isolation. It covers not only the use of personal protective clothing and equipment to protect veterinary nurses and patients and disinfection of the unit, but also how important the psychological needs of patients are as well as effective communication between veterinarians, nurses and clients. Download the full article here.

Options for skin coverage: reconstruction and skin grafts

Surgical skin reconstruction is increasingly being used in small animal practice to achieve maximal skin coverage. This reconstruction can take the form of either skin flaps or free skin grafts depending on the location of the tissue deficit. A variety of skin flaps are available for use, with or without the inclusion of the direct cutaneous arteries (DCAs) to maintain their vascular supply. Where closure of the deficit is not achievable using a local skin flap then a free skin graft may be selected. The ultimate success of the skin graft ‘take’ will depend greatly on surgical technique as well as post-operative care which is where the role of the veterinary nurse is vitally important in pro-actively achieving a good outcome. Relatively ‘new’ techniques such as the use of negative pressure wound therapy or vacuum assisted closure (VAC) is also being introduced to the management of both open wounds and skin flaps and grafts and so far the studies suggest that its use can result in a much more favourable outcome for wound closure. Download the full article here

Preventative dental care: educating the client

Many pets seen every day in general practice have dental diseases requiring treatment. Most owners are unaware that their pet has a problem so it is up to veterinary professionals to recognize and treat these diseases to ensure that pets have an infection free and pain free mouth. The role of the veterinary nurse is vital in educating clients about dental problems and helping to prevent them occurring, or helping to prevent the disease progressing further. This article discuss common dental diseases and how the nurse can get the owner engaged in dental clinics. Download the full article here

Inflammatory bowel disease in dogs and cats

Inflammatory bowel disease (IBD) has been defined clinically as a spectrum of intestinal disorders associated with chronic inflammation and thickening of the small and/or large intestinal tract. The condition can affect both dogs and cats and there is a notable breed disposition with some forms of the disease. The cause of IBD is largely unknown but dietary allergy, parasite sensitivity, bacterial imbalance and breed predisposition may be important factors contributing to the condition. Definitive diagnosis usually involves intestinal biopsy and treatment is typically centred around management of the clinical signs. Complete remission of the disease is not always possible. Dietary support is a very important part of long-term management of this condition and veterinary nurses can play an important role in client education. Download the full article here.

A patient care report of a Doberman in heart failure

This article describes the nursing care provided to a Doberman in acute life threatening heart failure due to dilated cardiomyopathy (DCM). DCM is a common problem seen in medium–large breed dogs. It can sometimes lead to congestive heart failure (CHF) and cause arrhythmias, further compromising cardiac function. Nursing care, monitoring and therapy are vital for the patient both in the short term, but also long term, to optimize quality of life.
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Approach to analgesia in the feline geriatric patient

The appropriate provision of analgesia is essential in all species. Pain causes intensification of the stress response, activates the sympathetic nervous system, affects food intake and metabolism, modifies behaviour and can adversely affect the immune response. If excessive pain is improperly managed, the sequelae can contribute to morbidity and mortality, particularly in already debilitated patients. In order to effectively manage pain, it is important to be able to recognize pain, utilize a multimodal approach and select appropriate analgesic drugs. Detection of pain, particularly chronic pain, can be difficult in cats and there are relatively few analgesic products licensed for long-term use in this species. Provision of effective analgesia in the geriatric cat can be challenging. This review aims to summarize how to first recognize the presence of pain in older cats and consider the pharmacological effects of ageing, and second how to adopt a multifaceted approach using the different classes of analgesics available.
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How to prevent perioperative hypothermia in the dog and cat: causes and consequences

Perioperative hypothermia is a common problem during anaesthesia in dogs and cats, and can have detrimental effects on the patient’s physiology, such as impairment of kidney function. Veterinary nurses are usually heavily involved in veterinary anaesthesia, participating in pre-anaesthetic assessments, premedication, induction and monitoring of anaesthesia and observations during the recovery of the patient. Perioperative hypothermia is a problem that many veterinary nurses know must be prevented by using patient warming methods, but they may be unaware of the full pathophysiology of this condition and why certain preventative methods may or may not be successful. This article examines the causes of perioperative hypothermia, the consequences to the patients and the methods of prevention.

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A practical approach to caring for patients with appetite reduction

Nutrition is a critical component of caring for and treating small animals and one in which nursing staff play a crucial role. A reduction in appetite should not be considered a normal consequence of illness, therefore it is essential to identify the reasons for this alteration in feeding habits and address the primary underlying disease. It is vital that veterinary nurses utilize their knowledge and skills to assist in the identification of patients at risk of malnutrition, formulation of feeding plans and provision of necessary nutritional support.

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Hay for a healthy rabbit: the importance of appropriate feed

Rabbits are herbivores with teeth and a gastrointestinal system adapted for a high-fibre, low-nutrient diet. Providing an appropriate diet, based on grass or grass hay supplemented with vegetables and only small amounts of concentrates, is important for tooth health, gut function and maintenance of a healthy weight. Water is also essential, and most rabbits prefer a bowl to a sipper bottle. Rabbits that fail to ingest their caecotrophs and those with diarrhoea (which is rarer) may become soiled and prone to flystrike. Obesity resulting from excess concentrate feed can lead to health problems including soiling and arthritis, and obese rabbits are more likely to develop life-threatening hepatic lipidosis if they stop eating for any reason. Stress minimization is important in hospitalized rabbits to avoid anorexia, which has potentially life-threatening consequences.

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Cardiopulmonary cerebral resuscitation: advanced life support and post-resuscitation care

Cardiopulmonary arrest (CPA) is the cessation of spontaneous ventilation and systemic perfusion, which, if not rapidly detected and treated, leads to hypoxia and death. Cardiopulmonary cerebral resuscitation (CPCR) is a technique employed to reverse CPA. The goal of CPCR is not only to achieve return of spontaneous circulation (ROSC) but to ensure survival following discharge from hospital with a good quality of life. This article provides a review of how to provide effective advanced life support after basic life support has been initiated, while highlighting the importance of post-resuscitation care in order to optimize the chance of the patient being discharged from hospital. This review of veterinary and human literature aims to suggest some guidelines for nurses to follow.

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Unintentional hypothermia: implications and management of the post-operative patient

Inadvertent hypothermia is not uncommon in the immediate post-operative period and is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. While there is much research to support the negative effects of hypothermia, often the focus is aimed towards minimizing heat loss in the peri and intra-operative period, however patients continue to lose heat post operatively, which can contribute to both short and long-term problems. Veterinary nurses have a pivotal role to play in minimizing such losses, with the main objectives consisting of detecting and recording post-operative hypothermia, as well as minimizing further heat loss and correcting any temperature deficits. Simple nursing interventions including careful positioning of post-operative patients away from draughty areas of the ward, frequent monitoring and recording of body temperature, and a combination of passive and active rewarming techniques can prove extremely beneficial to the recovery of hypothermic patients in the post-operative period. Using the recommendations highlighted within this article it may be possible to minimize the physiological effects of hypothermia as well as to improve patient comfort during this important recovery phase.

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Flea allergy dermatitis: the continued challenge

Flea allergy dermatitis (FAD) is a progressive form of skin hypersensitivity in dogs and cats caused by exposure to flea saliva through flea bites. This condition represents a source of frustration to pet owners and veterinary practitioners. FAD is associated with a wide spectrum of dermatological manifestations, which can have a dramatic impact on the quality of life of the patient. Significant progress has been made in unravelling the pathogenesis of this disease. Research evidence suggests that both host- and flea-derived factors play a critical role in the pathophysiology of FAD. Despite the availability of effective modern anti-flea chemotherapeutic products, flea infestation and FAD remain a challenging problem. These facts underscore the importance of maintaining sustainable preventive measures, including a rational flea control regimen, judicious use of chemotherapeutic agents and pet owner education.

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Nursing care of the burns patient

Nursing patients with burn injuries can be hugely challenging as the individual may have severe metabolic, cardiovascular and pulmonary derangements, not to mention large tissue deficits. A range of systems have been developed to classify burn wounds including percentage of body surface involved, through to depth of tissue involved and the use of these systems may help in giving a prognosis of the extent of the injury. The treatment of burn wounds can start at home by the owner and appropriate early therapy can make a huge difference to the extent of the injury. All major body systems may be affected due to the nature of the injury and so early fluid therapy, analgesia, respiratory derangements, including carbon monoxide toxicity, wound management and analgesia need to be addressed appropriately. The close monitoring of these patients is vital in order to achieve a good outcome and so these cases rely heavily on good nursing care and attention to detail, so a good background knowledge of these considerations is essential.

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Pain management in critically ill patients

Pain in critical care patients is a frequent occurrence due to surgery, trauma, invasive monitoring, changing dressings, suctioning various fluids and prolonged immobilization. These varied sources of pain make pain in the critical patient one of the most challenging areas of clinical practice for human nurses, and the same is true for veterinary nurses. Pain is defined as an unpleasant sensory and somewhat emotional experience that is typically associated with tissue damage, or is described in terms of actual or potential tissue damage. The body’s nociceptive system initially detects a noxious stimulus, such as heat or a surgical incision, and generates a physiological and behavioural response to the injury; this process can also occur following any form of neuroplastic change, even after a wound or injury is considered healed. Pain is a very complicated concept and there are many physiological processes involved, which can make it difficult to assess and understand in animal patients, especially where pain has developed and seems unrelated to any obvious or identifiable physical process or injury. Due to these difficulties in pain assessment in veterinary patients it is recommended to take a liberal approach to analgesic use for their benefit.

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Aseptic skin preparation: reducing the risk of surgical site infection

Surgical site infection (SSI) is a potentially serious complication of surgery, with the consequences of infection varying from local inflammation to life threatening septicaemia. SSIs result in increased patient discomfort and client dissatisfaction due to prolonged periods of hospitalization and financial implications. Infections after surgery are often blamed on poor owner compliance or patient interference; however the patient’s normal skin flora has been shown to be one of the leading causes of SSIs. Efforts to reduce patient sources of infection are aimed at decreasing the number of bacteria on the skin prior to surgery and reducing potential bacterial contamination from within the patient during surgery. This article will focus on the former of these sources via discussion of aseptic surgical skin preparation.

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Pathophysiology and treatment of kidney disease in cats

Surgical site infection (SSI) is a potentially serious complication of surgery, with the consequences of infection varying from local inflammation to life threatening septicaemia. SSIs result in increased patient discomfort and client dissatisfaction due to prolonged periods of hospitalization and financial implications. Infections after surgery are often blamed on poor owner compliance or patient interference; however the patient’s normal skin flora has been shown to be one of the leading causes of SSIs. Efforts to reduce patient sources of infection are aimed at decreasing the number of bacteria on the skin prior to surgery and reducing potential bacterial contamination from within the patient during surgery. This article will focus on the former of these sources via discussion of aseptic surgical skin preparation.

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Reducing the risk of gossypiboma and other retained items during surgery

A surprising number of foreign bodies may be inadvertently left in tissues after surgery, including suture material, needles, surgical instruments, starch powder from gloves, fragments of lint and gauze swabs. In particular, the problem of the retained gauze swab is well recognised in human surgery, perhaps not surprisingly as there are so many used in each procedure. The inflammatory reaction to a retained gauze swab is called gossypiboma — from the Latin word gossypium in reference to the cotton fibres of the swab and the Swahili word boma meaning ‘place of concealment’. Gossypibomas occur because there is a failure to account for all the swabs used during a surgical procedure. Depending on the proximity to vital structures and the degree of associated inflammation and infection, the consequences of a retained surgical swab can range from abscess or fistula formation to life-threatening septicaemia or tumour formation. The veterinary nurse assisting in theatre has a vital role to play in minimising the incidence of retained items via surgical counting, good trolley management and effective communication. Download the full article here

The Role of Antimicrobials in Wound Dressings

Dressings have played a vitally important role in wound management since the 1960s. More recently as we see more evidence of antimicrobial resistance, there has been in increase in the number of antimicrobial dressings available, and in use. Antimicrobials differ from antibiotics in their mode of action against bacteria; meaning bacterial resistance is less likely. The current range of antimicrobials commonly incorporated into dressings includes silver, honey and polyhexameth- ylene biguanide (PHMB), with iodine being less commonly used in companion animal practice.http://www.theveterinarynurse.com/cgi-bin/go.pl/library/article.cgi?uid=97769;article=_4_2_98_105 Download the full article here

Factors associated with steam sterilisation failure

The continued prevalence of antibiotic resistant bacterial infections has raised awareness and standards of hygiene within veterinary practices. As the range and complexity of surgical procedures carried out within veterinary practice increases, so does the awareness and expectations of clients. Infection control measures, such as the appointment of a designated infection control officer, and protocols, such as the World Health Organisation (WHO) 6-step hand hygiene method, have done much to raise standards, and are now routine practice throughout many veterinary surgeries. But has the same level of consideration been given to surgical supplies? Can we be sure that as long as the chemical indicator has initiated the expected colour change, the contents of a pack is sterile? Human errors are frequently associated with sterilisation failure. This article aims to discuss some such errors and the ways in which they may be prevented. Download the full article here

Effects of Neutering on Weight and Metabolism on Cats

Obesity is the most common nutritional condition of domestic cats in the UK, and is associated with a number of detrimental effects on health. Neutering of cats, which is absolutely essential for obvious reasons of population control and animal welfare, has long been recognised as an important risk factor in its development. Download the full article here

Nursing The head Trauma Patient

Head trauma patients are commonly seen within veterinary practice, and the treatment of these patients can prove challenging. In order to achieve a positive outcome in these cases, patients require intensive treatment and nursing care. Nurses play a vital role in monitoring these patients, and alerting the veterinary surgeon to any changes in their condition. The mainstays of therapy include intravenous fluids and hyperosmolar agents, with the administration of corticosteroids being somewhat outdated. Download the full article here

Improving patient safety in the peri-operative period: surgical safety checklists

Surgical complications are an unfortunate part of both medical and veterinary practice, but many are considered to be preventable if appropriate measures are implemented. In human healthcare, one of these measures has been the introduc- tion of surgical safety checklists (SSCs). With proven origins in aviation, another high risk industry, checklists have been linked with the reduction of peri-operative complications and deaths in human hospitals by significant amounts. Recognising that the core values of SSCs are equally applicable to veterinary prac- tice, the Animal Health Trust implemented their use in November 2008. Since then, positive outcomes observed include increased unity among the multiple specialist teams working in the theatre environment and improved communicaiton of vital information regarding individual patients and surgical procedures. Download the full article here

Early enteral nutrition — principles and practice

This article has three major objectives: to review briefly the physiology and metabolism of the small intestinal mucosa; to summarise the evidence and recommendations regarding early enteral nutrition; and to discuss how to implement early enteral nutrition in small animal veterinary practice. The gastrointestinal tract has a high metabolic rate and is composed mostly of cells that have a short life. Early enteral nutrition (EEN) contributes to improved gastrointestinal (GI) function, decreased GI permeability and improved patient outcomes. EEN can be delivered starting on day 1 for even critically ill patients. A transition from simple to more complex foods over time results in fewer complications. To download the full article click here

Feline pain assessment and scoring systems

Historically, cats have been undertreated for pain. Although there have been many advances in this area, veterinary professionals continue to be challenged by pain recognition and assessment in their feline patients. Pain is a multidimensional experience and thus assessment should incorporate an interactive and non-interactive approach, focusing on behavioural responses. Scoring systems available to assess acute post-operative pain in cats, assist in identifying and recording pain responses, in addition to standardising methods of assessment. This article provides a guide to recognising and assessing indicators of acute pain in feline patients and the practical use of scoring systems within a veterinary practice. Download the full article here

Management of Canine Cognitive Dysfunction Syndrome

As animals age, behaviour changes may be the first indication of declining health and welfare. This is especially true for some of the more common problems as- sociated with ageing, such as pain, sensory decline and cognitive dysfunction syn- drome (CDS). Cognitive dysfunction syndrome is the term used to describe the behavioural changes and learning and memory impairment seen secondary to age- related degeneration of the brain. Using the recommendations highlighted within this article it may prove possible to reduce anxiety levels in dogs suffering from CDS as well as provide support for owners in dealing with this complex and often distressing disease of their ageing companion. Download the full article here

Canine Atopic Dermatitis

Canine atopic dermatitis (CAD) is a common pruritic skin disease that starts in young dogs. The diagnosis is based on a set of clinical criteria as well as ruling out other pruritic skin diseases. Intradermal and serological testing are used to detect allergens for allergen-specific immunotherapy as well as allergen avoid- ance, but these should not be used as diagnostic tests. CAD is an incurable disease, and cases that do not respond to diet trials will require lifelong therapy. Nurses can play a valuable role in the diagnosis and long-term management of this problematic condition. Download the full article here

Evidence for the use of post-operative physiotherapy after surgical repair of the cranial cruciate ligament in dogs

Physiotherapy is well utilised and evidenced in human practice. However, the use of physiotherapy in veterinary practice is a relatively new concept with much of the current treatment based on human evidence. Currently the evidence base for the use of physiotherapy in dogs in the post-operative period after surgery for ruptured cranial cruciate ligament (CCL) is minimal. Published evidence does indicate that the use of cold therapy in the immediate post-operative period can result in reduced swelling, reduced pain and increased range of motion (ROM). Additionally, post-operative physiotherapy programmes were shown to improve ROM, muscle mass and limb use post operatively when compared with a restricted exercise pro- gramme. However, there are some inconsistencies in results, which may in part be due to experiment design — data collection methods and sample numbers. More research is required in this field of veterinary medicine to provide evidence that the benefits of post-operative physiotherapy, widely recognised in human medicine, are truly applicable to the canine patient. Download the full article here

How to Select an Appropriate Wound Dressing

Wound management forms a vital part of nursing practice. With such a vast variety of wound dressings available on the veterinary market, the registered veterinary nurse (RVN) should ensure they are familiar with the function and purpose of the dressings they are ap- plying to their patients. Over recent years, wound care has advanced with the introduction of dressings with anti-microbial properties along with an improved understanding of the science behind wound dressings. This article aims to provide the RVN with a basic knowl- edge of the different varieties of wound dressings available for our veterinary patients, along with a brief overview of their main functions and applications.Download the full article here

How to Run a Puppy Party: Social Saviour or Social Demon

A previous article (Hargrave 2013) discussed some of the predisposing factors that may make it difficult for a puppy’s emotional and behavioural repertoire to develop as their owner may expect, potentially leading to puppies failing to cope in the domestic environ- ment and developing compensating, undesirable behaviours that lead to early difficulties in the human–animal bond. Such puppies and their families require vigilance on the part of the veterinary team to spot them early and to enable the initiation of support. This arti- cle develops the theme by suggesting a comprehensive package of support that practices, possibly in cooperation with appropriately qualified trainers, may offer puppies during practice-led puppy classes. Such support packages should help puppies, both with or without extra challenging predispositions, to cope with the physical and social complex- ity and frustrations of co-existence with humans in a domestic environment. Due to the increasing environmental challenges met by young dogs and the growing sensitivity of the general public to dogs that exhibit behaviours associated with a lack of environmental competency, such preventative behavioural support should be as much a basic of practice welfare policy as preventative puppy vaccinations. Download the full article here

An Evidence-Based Approach to Infection Control in the Operating Theatre

The aim of operating theatre infection control is to minimise risk of surgical site infections (SSIs). The emergence of multi resistant micro-organisms and the in- creased awareness of appropriate antibiotic use have made the process of theatre infection control and its evidence base ever more relevant. Many theatre practices are widely accepted as ‘common sense’ measures and have become ‘ritualistic’ behaviours. However some practices have little, weak or inconclusive evidence to substantiate them. The multifactorial nature of SSIs means that no single meas- ure is likely to completely eradicate risk and currently the exact nature of the raft of measures necessary requires further investigation. Hand disinfection of the operating team prior to surgery, wearing of sterile surgical gloves by ‘scrubbed’ personnel and disinfection of the surgical site have a strong evidence base and should be mandatory practices however the exact processes require a stronger evidence base. It is likely that the practice of wearing theatre ‘uniforms’ contrib- utes to theatre discipline via behavioural attitudes rather than by specific SSI risk reduction. Future research in this area is also likely to further evaluate the growing evidence base in support of the use of triclosan-coated suture material to possibly reduce SSI. Download the full article here

Flea infestations: epidemiology, treatment and control

Fleas (Insecta, Siphonaptera) are a complex insect species and cause pets and their owners a lot of concern worldwide. Besides being clinically important, the cat flea, Ctenocephalides felis, is responsible for the production of flea allergic dermatitis (FAD), acts as the vector of many bacterial pathogens, and serves as the intermediate host for cestode and filarid parasites. Despite an arsenal of ef- fective products, failures in flea control programmes are commonplace due to poor compliance, inappropriate drug use and unrealistic client expectations. It is vital for veterinary professionals to give good advice, consider compliance and manage expectations if flea control programmes are to be successful. This article discusses the epidemiology, diagnosis, treatment and control of flea infestations. Download the full article here

The chubby bunny: a closer look at obesity in the pet rabbit

The effects of obesity on the health of cats and dogs are well recognised and obese rabbits are susceptible to many of the same problems. There are, however, some conditions related to obesity that are more rabbit specific. This article looks at the deleterious effects of obesity specific to the health of rabbits and how to identify, prevent and manage cases of obesity in this species. Download the full article here

The role of nutrition in the management of cats with diabetes mellitus

As a species, cats have a different nutrient profile requirement to humans and dogs from whom, historically, nutritional information has been extrapolated. The greater understanding of the requirements of both the species and the disease process of diabetes mellitus means that it is now possible to recommend a specific nutrient profile and formulation to help nutritionally support cats with this prevalent disease. A strong link between obesity and feline diabetes mellitus means that weight management is an important part of managing the patient through the disease process and achieving good glycaemic control. Medical treatment with insulin remains the cornerstone of therapy for feline diabetes mellitus; however adaptation of the diet and providing consistency in the type and timingsof food will also help in the long-term management process. Specific considerations should be made in relation to protein and carbohydrate content of the diet, not only to the overall quantity in the diet, but also the source and digestibility. It is recommended that cats should remain on a diet specifically formulated for the management of feline diabetes mellitus life-long (unless concurrent disease suggests otherwise), even if the patient enters remission.. Download the full article here

How to reduce the impact of firework season for owners of sound sensitive pets

Studies estimate that 49% of the canine population are affected by sound sensitivity, with fireworks and thunderstorms being particularly problematic. It is reasonable to assume that a large proportion of pet species will be similarly affected, particularly those from prey species (including cats, horses and rabbits) for whom sensitivity to changes in sound is highly adaptive. As a consequence, firework displays and thunder storms are a major welfare problem for the majority of companion animals. Yet the seasonal nature of the problem leads many owners to overlook the enormity of the issue and its potential to infiltrate into other aspects of their pet's life. This article aims to assist veterinary staff in providing practical guidance to all pet owners, ensuring that fewer pets are sensitised in the future, and that the welfare of pets with existing sound sensitivity is not further depleted. Download the full article here

Mitral valve disease and dilated cardiomyopathy in canines

Heart disease can occur at any stage, either as a result of a congenital defect, such as a stenosis of one of the valves, or with degeneration over time. The two most common acquired diseases in dogs are mitral valve disease (MVD) and di- lated cardiomyopathy (DCM). MVD can take years to develop from the first time it is diagnosed, whereas some cases can present with congestive heart failure (CHF) and need emergency treatment. DCM can have a long asymptomatic period eventually leading to CHF, if not preempted by sudden death. This article will dis- cuss MVD and DCM, focussing on aetiology of both diseases, the diagnostic tests required and subsequent management aims. Download the full article here

Patient safety in anaesthesia

Anaesthesia is a complex process resulting in numerous steps in the assessment of veterinary patients, preparation of drugs and equipment, checking of the equipment and communication between team members at several points. It is imperative that within this veterinary professionals strive to ABOVE ALL uphold their declaration to ‘ensure the health and welfare of animals committed to their care’. The pursuit of patient safety in veterinary anaesthesia is in its infancy but must strive to reduce the gap between best practice and the care currently delivered in veterinary practices. This has to involve an evidence-based approach to veterinary anaesthesia and a realisation that preventable human errors occur every day. It must be recognised that not only do these errors occur but that they are inevitable and that only by the recognition and reporting of these errors can analysis and reflection occur to offer preventative strategies. By using veterinary specific tools such as checklists and reporting systems, weveterinary nurses can make a difference. Download the full article here

Hyperadrenocorticism: the disease, diagnostics, and treatment for dogs

The purpose of this article is to help veterinary nurses understand the pathophysiology of hyperadrenocorticism in canine patients. Veterinary nurses play a vital role in helping diagnose hyperadrenocorticism in dogs: from obtaining histories with key information, to performing diagnostic tests, to explaining treatment plans to owners. Different diagnostic tests used to help diagnose and classify HAC will be discussed, as well as how to perform these tests. In addition, commonly used treatment options will be discussed to help improve patient care and client communication. Download the full article here

The Pet Travel Scheme (PETS) and parasite protection for the travelling pet

Changes to the Pet Travel Scheme (PETS) has led to renewed interest in the scheme and concern surrounding pet travel. In addition to the new rules, the distribution of parasites not covered by the scheme are also changing and it is vital for veterinary professionals to keep up to date, not only with new legal requirements, but also the parasite prevention requirements of pets travelling abroad. Veterinary nurses play a vital role in giving pet travel advice, both in day-to-day interaction with clients and as part of organised travel clinics. This article discusses a practical approach both to the compulsory requirements of the scheme but also other parasite prevention that should be considered. Download the full article here

Canine leishmaniosis: an update

Canine leishmaniosis caused by the protozoan parasite Leishmania infantum has entered the UK. Entry appears linked to pet dogs accompanying their owners (on vacation) to the Mediterranean basin where this vector-borne canine disease is prevalent. The parasite resides in the superficial dermis of infected dogs, either within macrophages or free in host tissue. L. infantum is transmitted naturally through sandfly bites. Sandflies are not currently present in the UK. Vertical transmission from infected bitches to puppies and transmission through blood transfusion have been confirmed, while sharing of hypodermics have only been proven experimentally. Some infected dogs remain asymptomatic with this resistance to disease development being associated with a strong cell-mediated immune response. Diseased dogs present with varied symptoms including generalised enlargement of lymph nodes, scaly dermatitis, anaemia, anterior uveitis and renal dysfunction. Clinically suspect dogs should be tested by fine needle aspiration of lymph nodes and/or bone marrow to perform cytology and polymerase chain reaction (PCR). Blood PCR lacks a certain degree of sensitivity. Indirect diagnosis through serology while routine is problematic in interpreting results and antibody titres. The recommended treatment protocol is a combination of the antimoniate N-metilglucamine subcutaneously, and allopurinol orally. Direct parasite transmission from dogs to humans has not been demonstrated. A commercial vaccine has emerged that offers options for prevention, which is useful for pets travelling to areas where the infection is endemic, particularly if they are staying for an extended period during the season when sandflies are active. Practitioners need to evaluate each individual case, based on client compliance, response to treatment and follow-up evaluation before deciding whether or not to consider euthanasia.Download the full article here

Atopic dermatitis and the veterinary nurse

Dermatological conditions are very common in general practice and veterinary nurses have an active role to play in the diagnosis, monitoring, management and support of these cases. Atopic dermatitis is a chronic disease which initially presents in young animals and develops into a lifelong condition. Many different treatment protocols are available and the success of therapy relies on the willingness of the owner to follow treatment plans. The veterinary nurse is central to owner understanding of the condition ensuring compliance through support and education. Download the full article here

Biology, diagnosis and management of sarcoptic mange

Scabies (also known as sarcoptic mange) is a common, highly contagious skin disease in animals and humans. It is caused by the ectoparasitic burrowing mite Sarcoptes scabiei (family: Sarcoptidae), which has a worldwide distribution. Animals and humans can be infested by their own S. scabiei subtype; however crossspecies transmission may occur. The socioeconomic and public health importance of scabies is significant. The disease occurs when the mite burrows into the skin and feeds on host epidermis. Disease manifestations are mediated via inflammatory and allergic responses to mite products, which result in severely pruritic lesions. Early diagnosis and prompt treatment is essential to minimise the spread of infestation. Veterinary nurses have a vital role to play in early recognition, diagnosis and for providing owners with accurate accessible advice to prevent zoonotic transmission. This article summarises the latest data on the biology, diagnosis and control of scabies.

Feline hyperthyroidism: current treatment options and the role of the veterinary nurse

Feline hyperthyroidism (FH) is the most commonbendocrinopathy in older cats but is still underdiagnosed. Since the first reported case prevalence has continuously increased. In the UK general practitioners rely mostly on medical management. Recent studies show that the prevalence of carcinoma rises from approximately 2 to 20% following long-term medication. The life expectancy is double with radioiodine treatment compared with medication. Radioiodine is now more available in the UK than at any time both in the number of centres and the reduction in the minimum hospitalisation period to only 5 days. The veterinary nurse has a key role to play in educating cat owners of clinical signs to aid early diagnosis, helping explain treatment choices and in supporting long-term management of this growing patient group.Download the full article here

Lyme disease: a growing UK threat?

Lyme disease, caused by the spirochete Borrelia burgdorferi remains the primary tick borne pathogen affecting dogs and people in the UK. Human cases are increasing year by year and dogs have been found to be carrying ticks infected with B.burgdorferi. This article reviews the epidemiology of Lyme disease in the UK, zoonotic risk, diagnosis and treatment. It also discusses practical disease prevention and the role of veterinary nurses in advising pet owners in this respect. Download the full article here

Canine nutrition for a healthy old age

Ageing dogs are commonly seen in veterinary practices. Small breed dogs may be considered geriatric at 12–14 years whereas large and giant breed dog would be geriatric at 7–9 years. When dogs begin to transition from adult to senior or geriatric, it is important that their nutrition is monitored by a veterinary professional so that they maintain health and a high quality of life.The veterinary nurse plays an important role in monitoring patients from the time they are puppies through their senior years assuring that appropriate nutrition is maintained for a long, healthy life. The veterinary nurse’s role in helping the owner to achieve his or her goals of having a healthy older dog begins the minute the patient enters the clinic for the first time. Mature dogs are more prone than younger dogs to certain disease processes such as obesity, degenerative joint disease, cognitive dysfunction, and cardiac, renal, liver, and metabolic diseases. A beneficial feeding plan should be based on risk factors and any disease process affecting the individual dog. The aim is to establish a long healthy old age for the canine. Download the full article here

Oral homecare regimens and products

The maintenance of the oral health of veterinary patients is fundamental to the maintenance of their overall health. Oral ill-health and untreated diseases are considered to contribute significantly to, or exacerbate, many other systemic illnesses that animal patients suffer, often due to a transient bacteraemia originating within the oral cavity, and these diseases can be painful. Download the full article here

Hydrotherapy for the osteoarthritic dog: why might it help and is there any evidence?

Hydrotherapy for the osteoarthritic dog: why might it help and is there any evidence?Download the full article here

Nutritional management of canine urolithiasis

Nutritional management of canine urolithiasis Download the full article here

The flea reproductive break point — what it is and how it is pivotal for successful flea control

The cat flea Ctenocephalides felis is a source of revulsion, distress and irritation for pet owners worldwide. In addition, C. felis can also cause flea allergic dermatitis (FAD) in susceptible pets as well as significant bite reactions in people. This in combination, with the cat flea’s capability of transmitting a number of vectorborne diseases, makes control of this parasite vital. Veterinary nurses play a key role in educating clients about fleas and putting practical control programmes in place. A crucial component of this is the flea reproductive break point, which if not considered will lead to failure of flea control programmes. This article considers flea control, and the importance of the reproductive break point in ensuring that flea control strategies are successful. Download the full article here

CPR: basic life support

Cardiopulmonary arrest is an emergency situation which can present to any veterinary clinic at any time. The RECOVER guidelines (2012) are an evidence-based consensus for current cardiopulmonary resuscitation recommendations for veterinary patients. Being prepared is the key to dealing with the situation in a quick and efficient manner. Preparedness consists of having a ‘ready area’, stocked crash trolley and team training. All members of the team should be trained and confident in delivering basic life support measures which include chest compressions, endotracheal intubation and manually ventilating the patient. Download the full article here

CPR: advanced life support

Cardiopulmonary arrest is an emergency situation which can present to any veterinary clinic at any time. The RECOVER guidelines (2012) are an evidence-based consensus for current cardiopulmonary resuscitation (CPR) recommendations for veterinary patients. Basic life support (BLS) includes circulation, airway and breathing. Advanced life support measures involve the administration of emergency drug therapy and cardiorespiratory monitoring. Alternative drug therapies may be beneficial such as electrolyte supplementation or drug antagonist administration. Both electrocardiogram (ECG) and end tidal carbon dioxide (ETCO2) monitoring are recommended during CPR efforts and the veterinary nurse will play a vital role in ensuring that trends are observed. Debriefing is an important part of any CPR event so that the team can critique one another and improve performance in the future. Download the full article here

Leishmaniosis in dogs and cats

Leishmania are vector-borne protozoan parasites within the group known as the Kinetoplastids. Infection with these parasites can result in a range of clinical diseases dependent upon the infecting species. Leishmania infantum is the main species causing leishmaniosis in dogs and cats, as well as visceral and cutaneous forms of leishmaniosis in humans. Download the full article here

Lipid infusion in the management of poisoning: an introduction

Lipid infusion in the management of poisoning: an introduction Download the full article here

Flea and fly bite hypersensitivity: what every nurse needs to know

Fleas are the most important ectoparasites of dogs and cats worldwide. The annual cost to control fleas in companion animals exceeds $1 billion in the USA and €1.1 billion in Western Europe. As well as acting as vectors of disease, and a source of owner revulsion and bite reactions, they are also the most common causes of allergic dermatitis in cats and dogs. Similarly, biting flies are a major source of allergic skin disease in horses. An allergy is an exacerbated response from an individual when it comes into contact with foreign substances (allergens) such as flea and fly saliva. This article considers mechanisms of flea and fly bite sensitivity, diagnosis, and the role of the veterinary nurse in the prevention of these diseases. Download the full article here

Tick-borne diseases in dogs

Tick-borne diseases (TBDs) can have serious impact on the health and welfare of dogs, and have been described in all continents. The expanding number of tick-borne pathogens, the broad geographic range of many tick species, the ability of tick-borne pathogens to induce infections, and the highly zoonotic potential of some of these pathogens make TBDs the most important subcategory of canine vector-borne infectious diseases worldwide. Indeed, emerging TBDs have become a concern for pet owners and veterinary professionals. The occurrence of babesiosis in a cluster of dogs from Harlow, Essex in 2016 has raised some concerns regarding the inevitable increase in the risk of TBDs particularly after the relaxation of pet travel rules. In addition to babesiosis that has dominated recent headlines other TBDs such as Lyme borreliosis have more quietly expanded to many parts of the country. The large number of tick-borne pathogens, the diversity of tick vectors, the broad range of animal reservoir hosts, limitations associated with diagnosis and treatment, and the ecological complexity of tick-borne pathogens make effective control of TBDs a challenging task. Therefore, it is important for veterinary professionals to be able to detect TBDs early and accurately in order to minimise the morbidity and mortality of these diseases. This article provides an update on some of the most common TBDs in dogs, namely babesiosis, hepatozoonosis, borreliosis, anaplasmosis, and ehrlichiosis. The key roles that veterinary nurses can play to support pet owners in recognising and dealing with ticks and TBDs are also discussed.Download the full article here

Feline lungworm

Parasitic nematodes that affect the respiratory system of felids are spreading in endemic regions and emerging in areas and hosts which were previously free of them. Recent reports of lungworm parasitoses caused by Aelurostrongylus abstrusus, Troglostrongylus brevior and Eucoleus aerophilus have stimulated an increase in scientific interest in the biology, ecology and epidemiology of these nematodes. The majority of literature dedicated to feline metastrongylid lungworms has been focused on A. abstrusus, mainly because it is the most commonly reported in domestic cats. However, this focus may come at the cost of overlooking emerging or less common metastrongylids. This article reviews information on the three major feline metastrongylid nematodes, including their biology and treatment; there is an emphasis on the epidemiology of T. brevior to provide a better understanding of an emerging parasite of domestic cats in Europe.Download the full article here

Antimicrobial drug resistance and antibiosis

Antimicrobial drug resistance (AMR) poses a significant risk to human and animal health and the inappropriate use of antimicrobial drugs provides a selection pressure for its development. Rationalising and optimising their use in veterinary medicine is imperative. Antimicrobial stewardship is a strategy that can reduce the risk of resistance developing as it provides for careful and responsible management of antimicrobial drugs. It could form an integral part of a veterinary practice’s policy on antimicrobial use. Development of an antimicrobial stewardship plan requires detailed knowledge of antimicrobial drugs, infectious agents and their likely resistance patterns, close collaboration with a microbiology service, and it can be informed by an antibiogram. This article discusses AMR, antibiosis and antimicrobial stewardship programmes. Download the full article here

Feeding ferrets

Ferrets are small obligate carnivores. Even more than cats they are designed for a meat diet, and their short digestive system leads to rapid food throughput. Ferrets need to be fed high-quality diets with high levels of animal-origin protein, given little and often, with stashed food removed before it spoils. A varied diet is recommended to avoid the ferret’s food preference becoming fixed. Feeding of inappropriate sweet, high-carbohydrate and high-fibre foods should be avoided. Feeding provides an excellent opportunity for environmental enrichment, which should be used as much as possible. Download the full article here

Pet travel: the lesser known threats to UK pets

Increased pet travel, human migration and climate change are leading to the rapid spread of parasitic diseases and their vectors. This, in turn, increases the risk of pets and their owners encountering these agents while abroad and bringing them back to the UK. In addition, legal and illegal imports of dogs from continental Europe are also increasing the likelihood of novel parasites being introduced. Some of these, such as Leishmania infantum, are unlikely to establish as the UK neither possesses their vectors nor has ideal conditions for their establishment. Mosquitoes, fruit fl ies and ticks, however, are already common across the British Isles and can transmit a number of parasites with veterinary and zoonotic signifi cance. The fl uid nature of parasite distributions means that an increasing range of parasites need to be considered and general principals in control and biosecurity implemented. Veterinary nurses are key players in the fi ght to keep exotic diseases out of the UK. This article considers some of the control measures required to protect the UK and its pets as well as some of the more novel parasites that have entered the UK in travelled and imported pets. Download the full article here

Unravelling dominance in dogs

Aggression is the canine behaviour most likely to lead to relinquishment or euthanasia. Understanding how dogs socially interact and manage confl ict is therefore of particular importance to veterinary professionals. Traditional approaches to the prevention and management of canine aggression advocated owners assert themselves as ‘pack leader’ through routine control of all resources and correction of any perceived challenge for them. At its most extreme this included physical punishment and steps to inhibit any initiative by the dog, including free movement and social interaction. The theory evolved from early to mid 20th century research into captive wolf behaviour, embellished by subsequent generations of dog trainers and behaviourists. However, more recent research into the behaviour of non-captive wolves and domesticated dogs, both in the home and living ferally, has brought the dominance theory into question. Perhaps more importantly, progress in the fi elds of animal welfare and training have highlighted ethical concerns and risks associated with the punitive methods of handling and training recommended by advocates. Modern approaches to modifying and managing the behaviour of the domestic dog use scientifi c principles to understand the motivation for their behaviour. Change is then facilitated through management of triggers, changing the dog’s emotional response to them and manipulating things the dog wants, to encourage preferred behaviour. Download the full article here

Supporting quality of life in feline patients with chronic kidney disease

Chronic kidney disease (CKD) is a progressive terminal disease that is commonly seen in cats in small animal veterinary practices. Veterinary nurses will be involved in caring for these patients during the diagnostic and treatment phases including providing end-of-life care when symptoms increase and the patient either dies a natural death or is euthanased. Palliative or hospice care will be provided by owners in the home environment. Veterinary nurses have a role in supporting owners to deliver high quality care to their pet and when making difficult decisions about their pet's death. Download the full article here

The veterinary nurse's role in recognising sepsis

Sepsis is a common condition affecting many in patients in veterinary practice, and has a high morbidity and mortality rate. Veterinary nurses play a key role in practice, often spending much of their time with the hospitalised patients. Therefore, it is important to stay informed on current research and guidelines, to be able to recognise changes in patients that may indicate sepsis. Download the full article here

The effect of climate change on the distribution and incidence of UK parasitic disease

While the prevalence of some UK parasites such as Toxocara spp. remains fairly constant despite fluctuations in climate, some other parasites are heavily dependent on mild, humid conditions to feed and reproduce. Recent mild winters and wet summers in the UK have benefitted three parasites in particular. Angiostrongylus vasorum has continued to spread across the UK with increased distribution and numbers of infected foxes, numbers of flea infestations appear to have increased in domestic cats and dogs, and Ixodes spp. tick numbers have increased with a longer seasonal period of activity. Veterinary professionals need to be aware of these changes in distribution and increased risk of disease transmission to domestic pets. This article discusses these changes and how they should inform advice given to clients. Download the full article here

Stress in the veterinary surgery: small mammals

The term 'small mammals' encompasses a wide range of species. Each has its own environmental, nutritional and social grouping needs. They also have species-specific activity rhythms, behaviours and communication signals. Many veterinary professionals have limited knowledge of these small, and usually prey, species. This may mean they do not take adequate practical steps to help reduce stress, and thus facilitate recovery, when these animals come to the surgery. Further, there are various long-held, if inaccurate, common beliefs about the needs, lifespans and availability of veterinary care for these small animals. These inaccurate perceptions mean many owners do not know how to reduce stress at home or recognise when the animal is showing signs of stress, ill-health or pain. It is the author’s aim to help the reader rectify this through a brief exploration of four aspects of these animals: size, sight, sound and scent, and how these relate to sources of stress. Download the full article here

Canine angiostrongylosis: an increasing concern

Canine angiostrongylosis is a snail-borne parasitic infection caused by the nematode Angiostrongylus vasorum. This metastrongyloid nematode poses a signi cant threat to canine populations. It is capable of infecting wild and domestic canines as their de nitive host, using gastropods as intermediate hosts. Recent data strongly suggest an increased geographic expansion of this parasite in wildlife animals that can serve as a reservoir. Once localised to the southern UK, A. vasorum now represents a tangible threat to dogs throughout the country, presenting asymptomatically or causing a wide range of clinical signs including dyspnoea and haemorrhage. Veterinary professionals have a range of ef cacious anthelmintics that, when used correctly, can signi cantly reduce mortality, clinical illness and associated health complications. Effective control of this disease, however, entails more understanding of the role of wildlife in spreading A. vasorum. Combined with this is the need for an appropriate framework for engaging and educating pet owners, improved management of adverse health effects of infection in dogs, guidelines on precautions to be adopted in order to minimise risk of infection, and the rational use of preventatives to control this disease. This review focuses on current knowledge about A. vasorum - which affects the respiratory system of dogs - and covers diagnostics, treatment and a brief account of other species of canine lungworms. Download the full article here

How to maximise your auscultation technique

Auscultation is a cheap and easy diagnostic tool available in veterinary practice. Yet it often creates uncertainty, prompting both nurses and veterinary surgeons to seek second opinions amongst colleagues. The purpose of this article is to explore the best techniques for auscultation, and discuss the different sounds that can be heard in dogs and cats when listening to the heart. The starting point of auscultation is to identify normal heart sounds. This will then help recognise abnormal heart sounds, which can then be split into loudness, timing, and point of maximal intensity. Download the full article here