Veterinary nurses on the front line in the battle against superbugs

Multidrug resistant bacteria, such as meticillin-resistant Staphylococcus aureus (MRSA), are an increasing public health concern and there is a growing body of evidence about how animals may, or may not, be contributing to the spread of these organisms. A few weeks ago I came across a journal article, published in January of this year, which reported on a survey of companion animal wound cultures showing an alarming number of positive cases of MRSA infection (Vincze et al, 2014a). A similar study by some of the same authors, and published only a few weeks ago, looked at risk factors related to MRSA infection in companion animals and it mentions how nosocomial infections are a distinct route of infection (Vincze et al, 2014b). Other past studies report how veterinary staff have a higher incidence of being MRSA carriers than the general population (Jordan et al, 2011).

Travel regulations are changing…

Most of us should now be well accustomed to the Pet Travel Scheme (PETS) regulations (998/2003) that came into force in the UK on 1 January 2012. But many people may not realise that further amendments to these regulations are set to come into effect on 29th December 2014.

Analysis of predisposition factors for limb amputation in dogs with survival analysis in those diagnosed with appendicular cancer

Aims:This study aimed to contribute to the knowledge of epidemiological factors contributing to limb amputation in dogs. A survival analysis for limb amputees from cancerous causes was also performed.Methods:Data were collected in 2010 from 152 owners of amputee dogs. And a statistical analysis was performed to differentiate effects of gender, castration, age, breed, treatment and behaviour after surgery. A cox regression was also performed to analyse these same effects in survivability.Results:A larger proportion of amputee bitches than dogs are associated with cancer while a larger proportion of amputee dogs than bitches are associated with trauma; castrated/spayed dogs were diagnosed older than intact dogs; cancerous causes of amputation were diagnosed later in dogs' lives than traumatic causes; dogs showing an animal behaviour in the first week after amputation were diagnosed with cancer younger than dogs showing a vegetal/rock behaviour. Treatment by chemotherapy has a better survivability than holistic therapy, and patient receiving chemotherapy exhibit animal rather than vegetal/rock behaviour.Conclusion:The survival analysis gives clear indication of the benefits of chemotherapy over holistic treatments. Animal behaviour post surgery is also related to survivability.

Assessing pain and emotional wellbeing in feline patients with chronic kidney disease

Pain is both a sensory and emotional experience and can be measured with the use of pain scoring charts. Pain scoring is seen as a valuable tool especially as an aid to post-operative nursing care. Currently pain scoring systems are designed for assessing acute post-operative pain and have been validated for use in dogs. However they can be useful in assessing pain experienced in cats suffering from diseases such as chronic kidney disease, and can assist the nursing care provided to patients hospitalised for treatment of the disease. Patient care could be improved if a more holistic approach to nursing was adopted which encouraged veterinary nurses to not only consider the physical aspects of pain but also the emotional side.

Developing a social media profile for a veterinary practice

Setting up a social media profile for a veterinary practice requires good planning, knowledge about the various social networks and an investment in professional branding. It also requires selecting a suitable person for the job of posting content and interacting with the profile's fan base. Establishing a large fan base can be a challenge, but with professionalism and consistently good content the profile will engage fans, develop loyalty to the practice and potentially bring in new clients as well as increase visibility in the wider community.

Canine angiostrongylosis: an update

The canine ‘lungworm’, Angiostrongylus vasorum, continues to grab the headlines when it comes to parasite infections of dogs in the UK. Geographical spread appears to continue apace, with fresh evidence of autocthonous infections in northern England and Scotland, leading practices to constantly re-evaluate their advice to clients on preventive worming regimens, as well as their approach to respiratory and other presentations in dogs. Recent developments offer improved information in support of practice decisions in these areas. In particular, a new point-of-care test based on detection of circulating worm antigen should help to support definitive diagnosis, so often elusive using previous tests, and to revolutionise awareness of the local level of risk. This and related serological tests are underpinning large-scale surveys to provide new epidemiological insights. The options for treatment and control of infection are also expanding, with milbemycin oxime joining moxidectin in having been shown to prevent patent infection. Surveys of clinical incidence suggest that increased awareness and improved control of the parasite can quell disease in identified ‘hotspots’. Therefore, although the threat of angiostrongylosis seems to be increasing in the UK, and extending to new areas, a growing toolkit for diagnosis and control places the veterinary professions in a strong position to counter this threat. Veterinary nurses have a particularly important role in providing laboratory support for evidence-based medicine, and for leading informed discussion of risks with dog owners. This should enable appropriate, risk-based advice on preventive worming regimens for dogs. Ongoing research suggests that other factors, such as age, breed, and individual behaviour, might also be taken into account to ensure that dogs are appropriately protected from this often mild, but potentially fatal, parasitic infection.

How to perform effleurage and passive range of motion exercises

There are a number of basic physiotherapy techniques that can be performed by veterinary nurses, under the direction of a veterinary surgeon, which could be extremely beneficial to the patients in their care. For example, effleurage is a massage technique which helps relax the patient, reduces oedema, improves blood flow and reduces pain. Additionally, passive range of motion (PROM) exercises are essential to maintain the range of motion (ROM) of joints when patients have reduced mobility. Without the use of PROM exercises a permanent reduced ROM could result. These physiotherapy techniques are best used as part of a rehabilitation programme designed to support the patient to make a full functional recovery.

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 timings of 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.

Canine urinary tract infection

Canine urinary tract infections (UTIs) are common in both first opinion and referral practice patients. Understanding the aetiology will help to identify those at-risk patients. Diagnosis incorporates findings from the history, clinical examination, complete urinalysis and urine culture. A UTI may be a primary disease or secondary to a wide array of underlying predisposing conditions. Recurrence of infection is likely unless any predisposing condition is identified and treated appropriately.