Volume 11 Issue 4
Euthanasia: not an every day experience
Euthanasia can be a very personal and often dreaded time for veterinary clients. As veterinary professionals we carry out euthanasias on a weekly or even daily basis and are therefore liable to suffer from compassion fatigue, potentially leading to burnout or apathetic behaviour. Behaviours such as these could have a negative effect on the care given during euthanasia visits. The aim is to make the 30–40 minute appointment that is a regular occurrence for veterinary professionals truly memorable and special for the client, as although we may not remember every euthanasia we carry out, the client will certainly remember it. Ideally the client should feel comfortable returning to the practice with other pets, although this is not always possible. This article will look at how veterinary practices can provide a memorable euthanasia visit for their clients, from the initial phone call, right through until days or even months after the appointment, using simple skills and inexpensive, but effective methods of making each visit a personalised experience.
Feline idiopathic cystitis: what to suggest
This paper reviews the available evidence for the treatments for feline idiopathic cystitis (FIC). The true pathophysiology of FIC can vary between patients, and includes intrinsic abnormalities, increased sensitivity to stressors, reduced nerve sensitivity or an abnormal sympathoneural outflow. Current treatment for FIC involves a variety of medications including analgesia, antibiotics, nutraceuticals, antispasmodics, environmental modification and diet alteration. Environmental changes have been shown to reduce the occurrence of symptoms; however, the trials indicating this were uncontrolled because of the number of changing variables. Evidence for the use of medications is lacking, identifying the need for further research in this area.
The role of nutrition in critical care
Critically ill patients have conditions that are considered life-threatening and require comprehensive care and constant monitoring; nutritional support plays a key role in the recovery of these patients and is an area of veterinary medicine that is very easy for the registered veterinary nurse (RVN) to have an active role in. Critically ill patients are at increased risk of malnutrition; acute and chronic illness, trauma and inflammation induced stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting. Challenges exist in the provision of support, especially in the anorexic patient.This article focuses on how severe physiological stress affects animals that are critically ill and how this might lead to malnutrition, how to accurately calculate energy requirements, and discusses the importance of selecting the most appropriate diet to improve patient outcomes.
Anaesthetic management of paediatric and neonatal patients
This article aims to highlight the key physiological differences in the paediatric patient in comparison to the adult and how they may impact anaesthetic management in practice from pre-operative considerations through to recovery. The critical importance of communication within the veterinary team is highlighted to ensure successful outcomes and reduce the risk of mortality. Potential complications are discussed as they are inherent to anaesthesia, however early identification and intervention can help ensure patient safety. Although paediatric and neonatal anaesthesia may be challenging, it can also be incredibly satisfying for the registered veterinary nurse (RVN) as specific nursing care needs to be provided throughout the peri-operative period to facilitate a smooth anaesthetic and recovery.
Acute pancreatitis in canine patients
Canine acute pancreatitis (AP) is now commonly seen in veterinary practice. AP can be challenging to manage and patients may require intensive nursing care. This article aims to explain the pathophysiology of the disease, some of the common clinical findings, diagnostic testing available and treatment required by these patients. It will focus on the specific nursing care: analgesia and nutrition. The use of early enteral nutrition (EN) is now a well-established treatment method in human medicine for patients with pancreatitis, and should be considered in veterinary patients also. The benefits of EN over parenteral nutrition (PN) and suggested routes of administration will be discussed.
How to get the most from blood samples: a guide to producing diagnostic blood smears
The production of high-quality diagnostic blood smears is a skill often overlooked in first opinion veterinary practices despite their usefulness in providing diagnostic information that would otherwise be omitted from results generated from automated analysers. Well made, well stained diagnostic blood smears can instantly provide vital information regarding the health of the patient and even provide a diagnosis. However, making quality blood smears is open to intraspecific and interspecific observer error and therefore this article aims to provide best practice guidelines along with a comprehensive troubleshooting guide to aid veterinary clinicians, nurses, technicians and students in the production of diagnostic blood smears.
Does meloxicam provide adequate pain management as a post-operative analgesic in canine ovariohysterectomy patients?
Background: Meloxicam is an analgesic agent with anti-inflammatory properties, commonly used in veterinary practices to treat a variety of different long-term medical conditions and is also used as a short-term pain relief following particularly traumatic surgeries. Aims: An observational study was conducted to determine whether meloxicam provides adequate pain management as a post-operative analgesic for canine ovariohysterectomies. Methods: 13 canines were admitted for ovariohysterectomy. Each patient was assessed using the Glasgow composite pain scale (CMPS) prior to surgery during the admission procedure, 15 minutes post-operatively, at discharge and at their post-operative check (POC) 3–5 days after surgery. Results: Data were statistically analysed to determine the overall effectiveness of meloxicam in reducing pain following canine ovariohysterectomy. The results showed a statistically significant difference (Kruskal-Wallis test: H3 =12.98, <i>p</i>=0.005) in pain scores between admission, 15 minutes post operatively, discharge and 3–5 days POC. The greatest decrease in pain score was between 15 minutes post-operatively and POC (Mann-Whitney U test: W=236, n=13, 13, <i>p</i>=0.0014) and between discharge and POC (Mann-Whitney U test: W=227, n=13, 13, <i>p</i>=0.0060). Overall, this demonstrated that there was an improvement in pain suggesting meloxicam is effective between these time frames. In addition, 69.2% (n=9) of patients in the study showed a pain score of 0, indicating an absence of pain, on their final POC. Statistical analysis was also used to determine if there was any difference in pain score between the 3, 4 or 5 day POC pain score. The results show there was no significant difference (Kruskal-Wallis test: H2 =0.090, <i>p</i>=0.638) suggesting that meloxicam's effectiveness was similar across this range of time post surgery. Conclusion: The results from the study indicate that meloxicam is an effective post-operative analgesic for canine patients undergoing an ovariohysterectomy.
Spring parasite update 2020
While COVID-19 is impacting all of us, the veterinary profession continue to do an amazing job of continuing pet health care while keeping risk to staff and clients to a minimum. During the crisis, parasite control remains a vital part of maintaining animal health, and ESCCAP UK and Ireland continues to help disseminate the latest evidence-based parasite control advice by email, phone, website and CPD platforms to keep pets healthy and to guard against zoonotic risk. This article will provide a brief overview of some of the current parasite hot topics and threats to the UK, taking information from the quarterly Parasite Forecast published on the ESCCAP UK and Ireland website: www.esccapuk.org.uk.