Lord Soulsby died last month at the age of 90. Perhaps better known by veterinary surgeons than veterinary nurses, the lord of the worms, as he was affectionately known by his students, was an important figure in the veterinary profession. His amazing book Helminths, Arthropods and Protozoa of Domesticated Animals is one of those texts that is so well known it's usually referred to simply as ‘Soulsby’ (e.g. ‘have you checked in Soulsby?’). As early as the 1960s Lord Soulsby was advocating ‘One Medicine’, encouraging his colleagues and students to look at animal and human medicine as a continuum — a concept that is now known as One Health. One Health recognises that the health of humans, animals and ecosystems are interconnected. It involves applying a coordinated, collaborative, multidisciplinary and cross-sectoral approach to address potential or existing risks that originate at the animal-human-ecosystems interface. The veterinary profession and the medical profession working together. It is a current buzz word — but a concept that has been around thanks to Lord Soulsby for over 40 years.
Feline diabetes mellitus is one of the most common endocrine disorders in cats. Veterinary nurses play a huge role in management of these feline patients by helping with diagnostics, monitoring blood glucose levels, administering medication, providing skilled nursing care during the time of hospitalisation as well as educating and advising the clients. This patient care report discusses the care provided to a diabetic feline patient that was hospitalised for a blood glucose curve.
Canine enteropathy is often a difficult condition to treat. The cause is usually idiopathic and the treatment process can be stressful for both patients and their owners. Procedures such as endoscopy are unable to assist in diagnosing the root of the problem, but merely confirm inflammation and damage to the digestive tract is present. The condition can be confused with adverse food reactions due to similar clinical signs, however when challenged with their original diets, patients with canine enteropathy do not relapse. Studies have shown that hydrolysed diets are successful in treating the gastrointestinal signs associated with adverse food reactions. These diets prevent immune recognition of an intact protein by removing the allergenic epitopes in a chemical reaction called enzymatic hydrolysis. There are minimal studies available proving the efficacy of hydrolysed protein diets in treating enteropathy when an adverse food reaction is not the cause, however they all concur that patients remain in remission post treatment. This review aims to explore the studies available which test the efficacy of hydrolysed diets in treating enteropathies and discuss their use in the veterinary practice.
Chelonians are not commonly seen in general veterinary practice. Stress, distress and pain can be very difficult to observe or measure in this group of reptiles. As ectotherms they are totally reliant on the captive environment for provision of suitable conditions to maintain good health and wellbeing. This is essential to avoid environmental stress in chelonians. Stress in captivity is likely to be chronic, and is often due to poor husbandry or environmental conditions. Transportation, treatment and handling could also lead to acute stress episodes. Any treatment, extended stay or handling at the veterinary practice requires provision of suitable accommodation, which is often not available.
It is important that veterinary professionals are able to recognise and assess pain in patients under their care. Veterinary patients cannot verbalise, or self-report on the amount of pain they are experiencing, so it is the responsibility of the professionals caring for them to be able to recognise the signs of pain, which can differ greatly between species. Once the veterinary professional has recognised the signs of pain during assessment they can then determine and appreciate the type or types of pain the patient is suffering, for example neuropathic, acute and chronic, and create an individual analgesic treatment plan. The assessment of pain in animals is for the most part based on the recognition of behavioural changes in response to pain, which cannot only vary between species but also between individuals within that species. Pain scoring systems can be utilised to quantify pain; putting a number on the level of pain for the purpose of determining whether pain exists, whether analgesia is sufficient, and in order to monitor patient progress in terms of pain management. These take into account the behavioural changes and responses of the patient and guide the user towards the calculation of a score. This article explores some of the key concepts relating to the recognition and quantification of pain, and the reliability and validity of pain scores, before considering the different pain scoring systems available for use in veterinary practice and their relative merits.
Otitis externa is a common presentation in small animal veterinary practice and the veterinary nurse can play a vital role in managing these cases. Ear sampling techniques are relatively straightforward and together with microscopic examination form two vital investigative processes in which veterinary nurses can become competent.
Sepsis is a common condition affecting many in patients in veterinary practice, and has a high morbidity and mortality rate. Veterinary nurses play a key role in practice, often spending much of their time with the hospitalised patients. Therefore, it is important to stay informed on current research and guidelines, to be able to recognise changes in patients that may indicate sepsis.
Veterinary team members encounter end-of-life situations on a very regular basis, with euthanasia of animals being a common occurence. Over 80% of pets in the UK are euthanased at the end of their life (O'Neill et al, 2013), and almost a quarter of veterinary team members estimated that they had end-of-life discussions on a daily basis (Compassion Understood, 2016a). This is a source of stress for all members of the team, not least the clinical team members who have to actively participate in an animal's death. Further, supporting an often distressed and emotional animal owner, places a further strain. Compassion fatigue is a common consequence (Figley and Roop, 2006) and has a personal impact on the ability of the sufferer to ‘bounce back’ from these frequent stressors. In this final part of the compassionate journey series, the focus is on the impact that euthanasia and end-of-life care can have on the veterinary practice team and individuals and the steps that can be taken to minimise any negative effect.
A recent survey by the RSPCA has revealed that almost half of people questioned believe it is acceptable to leave dogs in the car on a hot day. You may have seen their campaign on social media emphasising that ‘Not long is too long’. James Yeates from the RSPCA urges readers of The Veterinary Nurse to get on board with their campaign. Together we can help to stop dogs, and other animals, suffering.