The veterinary nurse's role in evidence-based medicine

The term evidence-based medicine is something that as veterinary nurses and technicians we see and hear in the veterinary media and in the work place more and more frequently, but how does it really effect what we do in our roles in veterinary practice. Evidence-based veterinary medicine (EBVM) is the use of clinical methods and decision making that have been thoroughly tested by properly controlled, peer-reviewed veterinary research. Evidence-based veterinary medicine is the use of best relevant evidence in conjunction with clinical expertise to make the best possible decision about a veterinary patient. The circumstances of each patient, and the circumstances and values of the owner/carer, must also be considered when making an evidence-based decision (Straus et al, 2005).

The top five clinical consequences of obesity in cats

There are numerous clinical and subclinical consequences of obesity in cats. Deborah Linder discusses the top five.

How to calculate and manage constant rate infusions

A constant rate infusion (CRI) is a medication continuously administered to a patient and is used to maintain consistent plasma levels of that medication. CRIs are commonly administered to patients to achieve appropriate levels of pain management, blood pressure management, sedation, anaesthesia, electrolyte supplementation, insulin, and liquid nutrition via a feeding tube. Delivering a CRI will avoid peak and trough levels of pain management and allow titration to suit the individual patient. When using a CRI to manage blood pressure, medication can easily be increased or decreased to obtain optimal effect and discontinued as needed. While CRI management requires 24 hour monitoring and specialised knowledge by the veterinary staff, the ability to maintain medications at therapeutic levels at all times make CRIs worth the time and knowledge. The veterinary nurse needs to not only understand the effects of the drugs being administered, but also how to calculate and create a variety of CRIs. This article will cover different types of CRI calculations and management.

Feline hyperthyroidism: current treatment options and the role of the veterinary nurse

Feline hyperthyroidism (FH) is the most common endocrinopathy in older cats but is still underdiagnosed. Since the first reported case prevalence has continuously increased. In the UK general practitioners rely mostly on medical management. Recent studies show that the prevalence of carcinoma rises from approximately 2 to 20% following long-term medication. The life expectancy is double with radioiodine treatment compared with medication. Radioiodine is now more available in the UK than at any time both in the number of centres and the reduction in the minimum hospitalisation period to only 5 days. The veterinary nurse has a key role to play in educating cat owners of clinical signs to aid early diagnosis, helping explain treatment choices and in supporting long-term management of this growing patient group.

The raw deal: clarifying the nutritional and public health issues regarding raw meat-based diets

In recent years, there has been growing interest in the feeding of unconventional diets such as raw, vegetarian and home prepared diets to companion animals. BARF diets, often referred to as ‘Biologically Appropriate Raw Food’ or ‘Bones And Raw Food,’ were popularised by Billinghurst in 1993. Such diets typically consist of 60–80% raw meaty bones and 20–40% a wide variety of foods including fruit and vegetables, offal, meat, eggs, or dairy foods.Prior to domestication, the diet of dogs and cats consisted largely of raw food. Once cohabiting with humans, raw food remained the staple diet for cats whereas dogs survived on by-products of human consumption, i.e. table scraps. The nutritional inadequacy of these diets is cited as being responsible for the shortened life span and nutritionally-related digestive, musculoskeletal problems encountered at that time. Yet, current justification for the feeding of this diet stems from the belief that these species are healthier when fed as if still in the wild.This article explores the nutritional adequacy and food safety issues related to feeding raw meat-based diets to companion animals and considers approaches for communicating with pet owners about the concerns regarding these unconventional diets.

Equine neonates and infection control

Providing nursing care to equine neonates requires the veterinary nurse to have specific skills, clinical experience and a comprehensive understanding of infection control. There are many factors that should be considered when a neonate is hospitalised, such as the ability to separate the foal from the mare and the proximity of the accommodation to other inpatients.When considering the development of new biosecurity protocols for equine neonatal nursing there are several lessons that could be learned from studies in the human nursing field. Reflecting on veterinary nursing care is essential as it facilitates progress and improves the quality of patient care.

Motivation and job satisfaction in veterinary nursing

Sustaining continued employee motivation at work is one of the biggest challenges facing employers today, particularly in the present economic climate, which significantly limits their ability to meet repeated employee demands for increased pay. This article discusses what motivates veterinary nurses with reference to key motivation theories and relevant findings of the 2014 Royal College of Veterinary Surgeons' (RCVS') Survey of the Veterinary Nurse Profession (Institute for Employment Studies (IES), 2014). While a great deal has been learned to date about what motivates people at work, there is still much to discover. Research specific to the motivation of veterinary nurses, for example, is non-existent at the present time. For this article, therefore, selected theories and models from academic enquiries conducted by researchers in other work settings have been used where these are considered relevant. Key findings from the RCVS Survey are individually discussed in relation to their impact on veterinary nurse motivation and job satisfaction. The article concludes with a number of recommendations for practice owners and managers who are in a position to influence the motivation of veterinary nurses.

Advanced approaches to handling dogs in practice

There have been ground breaking advances in the field of dog training and behaviour modification in the last 20 years. Traditional theories advocating the use of ‘dominance’ to control dog behaviour have given way to ‘force free’ techniques that rely on understanding and changing the dog's motivation. An entirely hands off approach is not realistic in all cases in veterinary practice. However routine application of contemporary behavioural principles to the approach and handling of dogs in practice can improve welfare and reduce defensive aggression for the benefit of both patient and staff alike.

Hard to heal wounds: dealing with the problematic wound

Wounds are encountered on a daily basis when working within veterinary practice, with the vast majority going on to heal without any issue. Some wounds however, may have issues in healing and these can pose a challenge for clinicians. There are numerous reasons for wounds not to heal; these can include patient factors, such as underlying disease, aetiology, and poor nutrition, but also surgical factors, such as haemotoma formation and infection. This article looks at the underlying causes of delayed wound healing and what action can be taken in terms of both prevention, and treatment.