Difficult decisions

Setting up a nurse-led nutrition service

Nutrition is a very important aspect of basic veterinary care. This is recognised by the WSAVA, as nutritional assessment is regarded as the 5th vital assessment. Veterinary nurses play a key role is nutritional assessment, nutritional recommendation, and follow up. This article will describe how to set up a nurse-led nutrition service, with Utrecht University Companion Animal Clinic as an example.

Faecal-oral parasite transmission and the veterinary nurse's role in education

There are a wide range of parasites endemic in the UK which can infect cats and dogs, their pathological and zoonotic potential mean it is essential veterinary nurses (VNs) educate clients on how to prevent exposure and therefore minimise risk. A key mode of transmission is the faecal-oral route in which infective stages of parasites can pass directly to other hosts. The three main groups of parasites which can be transmitted via this route are roundworms (Toxocara spp.), intestinal protozoa and tapeworms. Through effective communication and the development of partnerships with clients VNs can improve compliance thus reducing parasite risk which is of benefit to both pet and owner.

Poisons affecting the kidney

The kidney has an essential role in maintaining normal physiological functions but it can be affected by various drugs and chemicals. A common seasonal cause of renal failure in cats is ingestion of antifreeze containing ethylene glycol. It is not the ethylene glycol itself which causes renal failure but toxic metabolites which result in deposition of calcium oxalate crystals in the renal tubules. Various non-steroidal anti-inflammatory drugs (NSAIDs), particularly those used in human medicine such as ibuprofen, flurbiprofen and naproxen, cause renal effects through inhibition of prostaglandin synthesis which results in reduced renal blood flow and disruption of normal renal function and homeostatic mechanisms. For some common substances, such as lilies in cats and grapes and their dried fruit in dogs, kidney injury occurs through unknown mechanisms. Management of poison-induced kidney injury is supportive with monitoring and support of renal function. Although haemodialysis and other extracorporeal techniques can be used, they are rarely available in veterinary medicine and therefore preventive measures are used. This includes aggressive intravenous fluid therapy before onset of signs for lily and grape poisoning and early use of the antidote (ethanol) in ethylene glycol poisoning to prevent formation of toxic metabolites, allowing excretion of the parent compound. In most cases, once kidney injury is advanced, prognosis is poor.

A multimodal approach to hindlimb surgical analgesia: femoral and sciatic nerve blocks

The provision of safe and optimal analgesia is a fundamental consideration for veterinary practitioners, ensuring the welfare of patients entrusted to their care. The registered veterinary nurse's role is often key with regards to pain scoring patients, identifying pain emergence and liaising with the veterinary surgeon.

Behavioural first aid advice for canine patients

Despite the need for evidence-based advice regarding the behavioural health of their companion animals, owners may struggle to realise that this advice can be readily accessed from their veterinary practice. Many veterinary clients still rely, instead, on popular misconceptions perpetuated by the media and other pet owners. Furthering this problem is the reticence of some veterinary professionals to become involved in queries about patient behaviour, as they feel ill equipped to support the client and patient. This article forms part of a species-specific series of articles, intended to provide basic behavioural guidance that can be delivered by practice staff. This specific article focuses on enabling any veterinary practice to give basic support for the emotional and behavioural needs of their canine patients.

How to nurse the avian patient

This article provides an overview of the basic requirements for hospitalising and treating avian patients. These include species-specific considerations, transmissible disease considerations and insight into how to reduce stress in hospitalised birds. Proper handling techniques are discussed along with a brief overview of drug and fluid administration.

Hyperthyroidism in cats: should we be routinely testing for early diagnosis?

Background: Routine testing for hyperthyroidism could become standard practice in all cats, before the onset of clinical signs. Aims: To describe serum total thyroxine (T4) concentration levels in a population of clinically normal cats; to determine the range of T4 levels in clinically normal cats; to estimate the prevalence of hyperthyroidism in clinically normal cats and to identify risk factors for elevated T4 levels in clinically normal cats tested for hyperthyroidism and are diagnosed. Methods: Total T4 records of 202 clinically normal cats, tested for routine pre-anaesthetic bloods, using a Quantum Saturno 100 Vet wet chemistry analyser, were analysed retrospectively. Any result above or below the normal reference range was classified as being hypo/hyperthyroid. Statistical Package for Social Sciences (SPSS) software assisted in the analysis of blood results and highlighted risk factors associated with the disease. Results: Out of the 202 clinically normal cats, 76 did, in fact, have hyperthyroidism. There was a statistically significant association between breed and T4 result, with a much higher prevalence of hyperthyroidism and higher median T4 result in purebreed cats compared with crossbreed cats. Thus providing evidence that routine testing on all purebreed cats could be worthwhile. Age, weight, gender, neutered status and colour were not significantly associated with hyperthyroidism or T4 result. Conclusion: Purebreed cats are a group that could be routinely tested for hyperthyroidism, as results showed a statistically significant association between breed and T4 result.

Veterinary nurses must be conscious of recent research indicating early neutering of bitches increases incontinence risk

A new study by the Royal Veterinary College has found that there is a link between early-onset urinary incontinence in female dogs and the age at which they are neutered. RVC epidemiologist Camilla Pegram explains.