There are many scenarios in practice where animals present with acute, chronic, and acute on chronic bouts of pancreatitis. By investigating the risk of pancreatitis in association with high fat diets in a clinical setting, dietary manipulation could be instigated to reduce the risk of pancreatitis or the risk of recurrence.Many animals are placed on low fat diets when diagnosed with pancreatitis, but there are no evidence-based fat levels suggested for these animals. Nutritional recommendations for adult dogs are a minimum of 5.5 g per 100 g dry matter of the food consumed, based on an energy requirement of 95 kcal/kg bwt0.75; there is no recommendation on the type of fats, but that the essential fatty acids are provided.A review of evidence concerning fat levels indicates that hyperlipidaemia will predispose to pancreatitis, but no defined levels have been published.
All veterinary professionals should involve themselves in clinical governance. Clinical audit can be used to monitor the quality of care in a practice. Significant event audit is a qualitative form of clinical audit. It starts with a noblame meeting of the practice team; this looks at what happened, why it happened, what has been learned and what needs to change. The results can be that training needs are identified, protocols are changed or drawn up considering the evidence base, and further audits may be planned. Significant event audit is about improving systems, not about blaming individuals.
I wouldn't claim to be particularly knowledgeable about rabbits, or even very interested, I am definitely a dog/cat nurse. I think that comes from being employed in an orthopaedic referral centre; we just don't see many rabbits in our practice.
Tooth resorption in feline patients is an enigma in veterinary practice as the aetiology remains unknown despite it being studied for a number of decades. Tooth resorption is however common within the feline population and can lead to a multitude of problems for patients including an inability to eat, and pain. This article aims to review what is known about the development of resorptive lesions in cats and provide an overview of current thinking regarding their treatment and ongoing management.
With a prevalence of over 70% amongst some breeds, hip dysplasia is one of the most common developmental orthopaedic diseases diagnosed in first opinion practice. With a multimodal approach leading to the best form of management of the condition, this two-part article looks at the causes and treatment of the condition, and the role that the veterinary nurse and rehabilitation can play. Part one below focuses on aetiology and treatment.
Neonatal maladjustment syndrome (NMS) is not completely understood, but is linked to variable degrees of hypoxia before or after parturition. This condition can be expected in any foal with a history of premature placental separation; delivery by Caesarean section; prolonged dystocia; premature delivery or foals that have been resuscitated for any reason. Recent studies have shown an association between NMS and a persistence of high concentrations of neurosteroid in the post-natal period. These neurosteroids are thought to be partly responsible for keeping the foal in a sleep like state of unconsciousness while in utero. It is thought that physical pressure on the foal while in the birth canal during a normal delivery signals to the foal to stop producing the sedative inducing neurosteroids, and causes the foal to ‘wake up’. This theory is supported by the fact that NMS appears more frequently in foals with abnormal births.Nursing care in the treatment of the ‘dummy foal’ has an impact on the outcome of the patient. Managing and nursing a recumbent neonate is laborious, time consuming and personnel intensive, and requires proper facilities that can provide 24-hour nursing care.
National Microchipping Month is held in June each year; during this month veterinary professionals and pet owners are encouraged to think about the benefits of microchipping. By law all dogs over 8 weeks of age are required to be microchipped, and there are also benefits to other pets such as cats. Having a practice policy on microchipping could help to ensure that discussions about microchips become routine.
Xylitol is a commonly available sugar substitute found in sugar-free chewing gums and as an excipient in some medicines. It is used for its benefits on oral hygiene and its low-calorie content. It is also found in some peanut butters, ice creams and toothpastes, and can be used as a sugar substitute in baking. Xylitol causes hypoglycaemia (due to stimulation of insulin release) and liver failure in dogs, but not in cats, rabbits or rodents. The hypoglycaemia may be rapid in onset but can be delayed if xylitol-containing chewing gum has been ingested. Management of dogs that have ingested xylitol includes gut decontamination, monitoring, correction of hypoglycaemia and liver protectants. Prognosis is good in most cases and death from profound, uncontrolled hypoglycaemia or liver failure is not common.
Triage is the process of organising patients according to the severity of their condition and getting each patient treatment within an appropriate time frame. Good triage should be implemented in every stage of patient care, from the primary phone call to the patient arrival, to ensure each patient receives the care it needs. This article discusses the different triage scoring systems available, communication with the owner over the phone and face to face, and triage of the patient on arrival through assessment of the three major body systems. There is also discussion of the secondary survey to determine the patients that do not have an immediately life-threatening condition, but where there is potential for their condition to worsen rapidly.