Champions of progress

This past week I read an interesting report on how human oncology nurses in a large public hospital established a new guideline-based antiemetic therapy. They did it by noticing that their chemotherapy patients were not getting efective antiemetic treatment and they used current guidelines coupled with their own observations to determine how treatment could be improved. What is interesting about this report is that it was the nursing observations that determined that the treatments were not always efective and it was the nurses themselves who took responsibility for addressing the problem by establishing their own objective measurements and collecting data about which patients were most at risk for not receiving efective treatment. While it is not the nurses who ultimately make decisions for what medication to prescribe, in this case, it was the nurse's evidence that assisted doctors to make better decisions about which treatments to implement. This collaboration of the medical team produced a much better outcome for the patients.

Setbacks in saving tigers from disease

Wildlife Vets International has increasing evidence that the world's most endangered tigers are facing a new and deadly danger from canine distemper virus. Olivia Walter explains.

The use of skin flaps for wound reconstruction

Wound reconstruction may be necessary for traumatic wounds, or iatrogenic wounds. The latter are usually the result of excision of malignant skin tumours. It is important not to compromise the successful removal of a malignant tumour by taking too small a margin. However, attempts to suture large wounds by simple apposition may result in tension at the wound edges. Wounds do not heal, or heal very poorly, when under any tension. Skin flaps provide a versatile way of reconstructing wounds without tension. This article outlines the main types and uses of skin flaps and illustrates these with case examples.

Boxer cardiomyopathy

Arrhythmogenic cardiomyopathy is a specific myocardial disease affecting Boxer dogs. It is an adult-onset disease that affects dogs over a wide age range, and results in a wide spectrum of clinical signs: asymptomatic ventricular tachycardia, syncope, congestive heart failure and sudden death. Veterinary nurses should be aware of this disease because it has implications for nursing of Boxer dogs with episodes of syncope. Patients with a history of fainting should be treated with caution and stress should be minimised. If a patient has an episode while in the practice, the veterinary surgeon should be informed immediately and routine airway, breathing and circulation checks commenced. Placement of an intravenous catheter would be useful in case antiarrhythmic medication is required, and an electrocardiogram (ECG) would provide important diagnostic information.

How to perform fine needle aspirates

Fine needle aspirates (commonly referred to as FNAs) are common diagnostic tools performed to obtain cytological information that could help aid in diagnosing veterinary patients. They can be performed on external or internal masses, or lymph nodes. Since veterinary nurses can perform FNAs on external masses and lymph nodes, it important for them to understand how to perform them correctly so a diagnostic sample can be obtained. This article will focus on two different methods of performing FNAs, and how to prepare the sample on microscope slides that will be used to obtain cellular information.

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 effective 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.

Anticipating grief – the role of pre-euthanasia discussions

Given the deep emotional relationships that many people share with their pets, discussing euthanasia is stressful for both pet owners and veterinary professionals. Such discussion is however essential, and the manner in which veterinary personnel provide care for a client whose pet is approaching the end of its life has the potential to alleviate or aggravate grief. Where the loss can be anticipated, as is the case with terminally ill pets, discussion prior to the loss of the pet can be extremely helpful in lessening owners' feelings of responsibility, validating their decisions and enabling them to know they did their best for their treasured companion.

The nurses' role in managing gut stasis in rabbits

Gut stasis is a gastrointestinal disease in rabbits and is identified by a low appetite and lack of faecal production. It is a very common disease in the rabbit that requires intense and specialised nursing care.Hospitalising the gut stasis patient creates a challenge with reagrds to how to limit the many stress factors in hospital that could aggravate the condition. Kennel enrichment is therefore important to try to meet the rabbit environmental and behavioural needs. If the rabbit is less stressed in practice an accurate pain assessment could also be easier to perform.Treatment of gut stasis has traditionally been force feeding, analgesics and pro-kinetic agents, but new protocols including appetite stimulants, blood glucose measuring, nasogastric feeding and abdominal massage have been introduced into practice.Having a nursing team that has knowledge about rabbits and critical care needs will greatly improve patient care and case success.

Non-steroidal anti-inflammatory drugs in veterinary practice part 2: side effects and contraindications

Non-steroidal anti-inflammatory drugs are extensively used in veterinary practice for the management of both acute and chronic pain; however, while they are generally fairly effective analgesics, they have a spectrum of potential side effects ranging from mild to life threatening. This article will discuss the adverse effects that may occur with these drugs and the mechanisms by which they arise, and also describe the situations in which these agents should be avoided.