Volume 11 Issue 9
Clinical governance: quality improvement and clinical audits in practice
Quality improvement (QI) has been employed successfully across various industries, including human healthcare, as well as the aviation and automotive industries. In the veterinary sector, practices are starting to see the many benefits that QI can offer — particularly those that come from conducting clinical audits. Clinical audits are a part of QI and aim to look at how closely clinical practice is carried out when compared with set guidelines or protocols. This article looks at the steps of clinical auditing and some of the main barriers faced when first trying to implement them into clinical practice.
Canine diet and cutaneous adverse food reactions
The veterinary nurse can play an important role in providing nutritional advice to dog owners. With the wide range of commercial diets that are available, it is important to tailor the diet to each individual animal. Selection of a diet to investigate a cutaneous adverse food reaction (CAFR) should be made after taking a thorough dietary history from the owner and a conversation to decide which diet is most appropriate for each individual. Selection of a diet should involve the use of a novel or hydrolysed protein source for that dog, but other factors such as palatability, convenience, nutritional content and cost need also to be considered. If a diet is carefully matched to owner and pet requirements, the chances of good owner compliance and a response to the diet can be maximised.
CPD article: Role of cats in human toxocarosis
Toxocara cati, the feline ascarid, is ubiquitous in domestic cats globally and is increasingly recognised as an important zoonotic species. In the definitive host, infections with the adult ascarid usually do not present any clinical signs; if clinical signs do appear, it is usually in kittens infected with T. cati, especially by the trans-mammary route. Diseases may include cachexia, a pot-bellied appearance, respiratory disorders, diarrhoea, vomiting, among other signs, and these may present as early as 3 weeks of age. However, infections with Toxocara spp. larvae in paratenic hosts (including humans and many other animals), can result in serious complications from the migration of larvae. Historically, there has been an assumption that Toxocara canis was the most likely cause of Toxocara spp.-related disease; while it is probably true that T. canis is responsible for the majority of infections, it is important that those caused by T. cati are accurately identified so that the contribution of this parasite to human disease can be established and then handled appropriately. Overall, the detection of infections in cats and the control of parasite stages in the environment are essential to minimise the infection risk to other animals or humans.
CPD article: Weight loss considerations in the older cat
The companion animal population is continuing to live longer, with approximately 40% of pet dogs and cats aged 7 years or older. Continued improvements in veterinary care and disease prevention strategies, veterinary nutrition, breeding and husbandry are just a few of the factors contributing to pet longevity, resulting in a significant population of senior small companion animals. This article considers the most common causes of weight loss in the older cat through review of the definitions and pathophysiology of muscle loss, and examining the most common concurrent metabolic and endocrine diseases associated with weight loss in the older feline patient.
Kirby's Rule of 20: the veterinary nurse's critical patient checklist part 4
Kirby's Rule of 20 is a patient checklist including 20 parameters that should be checked daily in the critically ill patient. It reviews the established evidence-based information regarding patient checklist use in veterinary emergency and critical care medicine. The list of 20 will be discussed over a four-part series to give an appropriate level of information and attention to each patient parameter. Part 4 includes: wound healing, drug dosage and metabolism, pain control, nursing care, tender loving care.
Rehabilitation and recovery times for canine patients post hemilaminectomy
The recovery of ambulation is a crucial part of the recovery process for canine patients with intervertebral disc disease undergoing a hemilaminectomy. Although ambulation is accomplished in most cases, many are left with deficits in strength and coordination. Human medicine suggests that postoperative rehabilitation improves patient outcomes; it is therefore useful to examine whether the same would be true for canine patients. Additionally, as veterinary nurses it is important to understand why certain rehabilitative procedures are being performed for spinal patients, and whether those procedures actually help the patient to recover.
Treatment of acute idiopathic polyradiculoneuritis with intravenous human immunoglobulin therapy
The patient was presented to a veterinary hospital with acute progressive onset of non-ambulatory tetraparesis. An appropriate diagnosis of acute idiopathic polyradiculoneuritis was made and suitable supportive nursing care implemented. The patient was later diagnosed with pneumonia as a consequence of prolonged recumbency, requiring further nursing interventions. Treatment with intravenous human immunoglobulin therapy was subsequently initiated and the patient improved but was sadly later euthanased.
Myth or truth — are flat-faced dogs really less healthy?
New research from the Royal Veterinary College (RVC) confirms that flat-faced (brachycephalic) breeds — including Chihuahuas, Pugs, French Bulldogs and British Bulldogs — are generally less healthy than their non-brachycephalic counterparts, answering the burning question about whether flat-faced dogs truly are less healthy overall.