Understanding Declaw Salvage Procedures
Until declaws are eliminated in the United States, you will most likely encounter declawed patients in your practice. With recent advancements in surgery, salvage procedures can help manage pain and improve limb function. Join one of the leading figures in declaw salvage surgery Nicole Martell-Moran, DVM, MPH, DABVP (Feline Practice), to learn about the procedures involved, how to find training, and how you can incorporate it into your practice.
Helping New Pet Owners Create a Fear-Free & Happy Life for Their Pet
New pet owners can be overwhelmed with all the information we want to provide them regarding the health and wellbeing of their pet. However, if a strong human-animal relationship built on trust and empathy is not established, the pet very well may not remain in the home. In this webinar, Kenneth M. Martin, DVM, DACVB, and Debbie Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior), will provide you with 5 tips to give new pet owners so they can start the relationship off on the right paw, facilitate a strong bond, and keep pets in the home and coming back to your veterinary clinic.
Brought to you by Vetoquinol
The “fear center” and the “pain center” occupy adjacent areas of the brain. The thalamus is the area of the brain that registers pain, and on either side of the thalamus is the limbic system, which is responsible for emotions including fear, anxiety, and the sequelae of stress (FAS).
These two areas of the brain “talk” to each other and send signals back and forth. The thalamus sending signals to the limbic system is what causes your reaction to hitting your finger with a hammer. When this thalamic-limbic crosstalk happens in an animal in acute pain, the animal may lash out at the owner or veterinary staff.
So now consider an animal who is in pain and has been presented to you. If experiencing acute pain, the animal may lash out due to a combination of pain and FAS. If experiencing chronic pain, many of these pets act dull and disinterested. The owner may even comment that the pet just doesn’t socialize and lacks the energy and mobility that she used to demonstrate. Even worse is the animal who has chronic pain, say from osteoarthritis, and now has an acute injury on top of it. The distress in some of these animals is almost too much to bear.
It is easy for us to recognize and treat acute pain, but the diagnosis of chronic pain states can be difficult for a variety of reasons. It takes time to take a thorough history and perform a complete pain exam on dogs and cats. However, there are many resources available to make that task easier, including pet owner-friendly screening checklists for osteoarthritis (Cat, Dog) and expert tips for the OA exam (feline OA exam).
Even with successful diagnosis, the treatment of chronic pain can sometimes be difficult especially if your treatment is narrow in focus. But it is essential to make a timely diagnosis of chronic pain and provide effective analgesia to be successful in therapy. And it is also important that the owner understands your diagnosis, whether through education alone or with the help of radiographs and teaching tools (feline and canine chronic pain). The owner is an essential member of the pain treatment team, both in the evaluation of treatments over time but also in enlisting them in the day to day therapies that might be required.
My approach to the treatment of chronic pain in dogs, for example, is to build a pyramid of treatments, and on the base layer I start with an NSAID. The NSAID I use most commonly is Rimadyl® (carprofen), which I really like for its effects on both pain and inflammation. For many chronic OA cases, there are other factors that can influence the ability to manage both pain and disease progression, and they should all be looked at.
For example, consider the animal next. Is he overweight? One study showed that in an obese dog, losing only about 10 percent of body weight can significantly improve lameness1. In other words, weight loss for an overweight dog can amplify the pain relief achieved with an NSAID alone
What about exercise? Again, one human study showed that one-half hour of exercise 5 days a week for people with knee OA was the equivalent of – you guessed it: an NSAID! So now you have tripled your pain-relieving efforts by building a solid foundation of multi-modal therapies, upon which you can add other therapies as needed.
It is beyond the scope of this writing to discuss all possible treatments: medications, physical therapy, acupuncture, and so forth, but I encourage everyone to read or re-read the 2015 AAHA Pain Management Guidelines for a thorough review of all of the pain management options we have for both acute and chronic pain.
What does the future hold for us? The most exciting thing I have seen on the horizon is the introduction of anti-NGF monoclonal antibodies. NGF, or Nerve Growth Factor, is one of several major “players” in the transmission of pain via the nociceptors. The use of these monoclonal antibodies holds great promise to reduce the sensation of pain in our patients with osteoarthritis. More information about the action of anti-NGF monoclonal antibodies can be found at the New Science of OA Pain website.
IMPORTANT SAFETY INFORMATION FOR RIMADYL: As a class, NSAIDs may be associated with gastrointestinal, kidney and liver side effects. These are usually mild but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including Rimadyl. Use with other NSAIDs or corticosteroids should be avoided.
See full Prescribing Information at:
https://www2.zoetisus.com/content/_assets/docs/Petcare/rimadyl-prescribing-information.pdf
Reference:
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Sponsored by our friends at Zoetis Petcare. ©2021 Zoetis Services LLC. All rights reserved RIM-00324
Caring for Caregivers: The Three Areas Crucial to Mental Wellbeing
In this webinar presented by Natalie Marks, DVM, CVJ, you will learn about the variables that place veterinarians at high risk for mental health challenges and how to assess your own wellbeing. Dr. Marks will identify concerning signs in our own health and others as well as the three areas crucial to mental wellbeing: compassion satisfaction, compassion stress, and compassion fatigue. She will also provide realistic strategies to help veterinarians take care of themselves physically and mentally.
Brought to you by Virox Animal Health, Makers of Rescue
The Paw Project and Fear Free Together At Last!
The Paw Project’s beginning was rooted in helping relieve big cats from complications from being declawed. Thankfully, founder and director Dr. Jennifer Conrad saw the same need in domesticated felines. Don’t miss this opportunity to hear about her journey and her rebuttals against the common arguments in favor of elective feline onychectomy.
Fear Free Certified Practice Town Hall: Discontinuing Declaw Procedures
Following the announcement that Fear Free Certified Practices would be required to phase out elective feline onychectomies, we hosted a town hall with Fear Free founder Dr. Marty Becker, founder and director of The Paw Project Dr. Jennifer Conrad, pain management guru Dr. Michael Petty, and board-certified veterinary behaviorist Dr. Valarie Tynes. The “whys” behind this decision were shared and we wrapped up the hour with Q&A from the audience.
Experiences That Matter: Providing Veterinary Care During The Pandemic
Pet owners have many options when choosing their veterinary healthcare provider. Why should they choose you? Differentiating yourself is a challenge at the best of times, made even more problematic during a pandemic where curbside care has limited our ability to created strong, long-lasting bonds with our clients.
In this webinar, Jonathan Bloom, DVM, presents new, easy-to-use strategies that result in “experiences that matter” and that very quickly define you as the veterinarian of choice.
Brought to you by Elanco.
Yes, You CAN Perform a Fear Free Canine Orthopedic Exam
In this webinar, Kristin Kirkby Shaw, DVM, MS, PhD, DACVS-SA, reviews the importance of diagnosing osteoarthritis (OA), how to perform canine exams, and pain management. Dr. Shaw also provides resources from the New Science of OA Pain website, which has canine and feline OA checklists, feline exam videos, and chronic pain teaching tools that can be provided for pet owners.
Brought to you by Zoetis Petcare.
When people make the difficult decision to euthanize a pet, there are many other smaller decisions they’ll have to make, such as when to schedule and whether they or their children should be present. Among the details that should be considered on your end is how you can reduce the animal’s fear, anxiety, and stress during their final moments.
When pets have a fear of the veterinarian and are brought in for euthanasia, their stress levels can escalate. The procedures that may take place before euthanasia can be scary or painful, such as being restrained by a veterinary staff member while their front leg is shaved and an IV catheter is placed. While this usually occurs away from the owner, the experience is often stressful enough that the difference is noticeable when the pet is returned to the exam room.
Even if a particular patient doesn’t routinely require anti-anxiety medications, consider them when clients are bringing pets in for euthanasia. Many pet parents have concerns about their sedating effects, but this is one instance where it truly doesn’t matter–sedation will only help the euthanasia go more smoothly. Dispense them at least a few days ahead of time to ensure that the client is able to give a test dose before the day of the pet’s euthanasia. Some anti-anxiety medications such as gabapentin also help reduce pain, so they can decrease discomfort to procedures such as IV catheter placement prior to euthanasia. If your patient is agitated or is still fearful despite oral pre-visit pharmaceuticals, consider injectable sedation prior to euthanasia. The last thing a pet parent wants to see in their time of grief is their pet flailing, vocalizing, or trying to escape. Sedation will decrease stress for the pet and their family.
If your practice routinely uses IV catheters for euthanasias, have clients rub a lidocaine numbing cream such as Supernumb on the tops of their pet’s forelegs several hours prior to euthanasia. IV catheter placement is painful, and numbing the area will make for a more compassionate experience, especially since multiple catheter attempts are sometimes needed in debilitated pets .
In your Fear Free practice, you use treats with patients during routine visits, and you can use them with euthanasia, too. Providing a smorgasbord of vanilla ice cream, lunch meat, cheese chunks, Churu, peanut butter, or whipped cream will allow clients to continue bonding with their pets while lowering their stress. Take care to avoid giving greasy foods such as burgers–while tempting to offer as a last meal, they can cause nausea and gastrointestinal upset.
If you don’t offer housecalls for patient euthanasia, I urge you to consider it. Even pets who don’t have a strong fear of veterinary visits will never be as relaxed at the vet as they will in their home, with their familiar bed and environment. You can even have classical music playing quietly in the background to help create a calming environment. I’ve euthanized several pets in their homes, and in every instance I felt that the experiences of the pet and the owner were better than they would have been in the clinic environment.
Pets deserve to have a Fear Free death as much as they deserve to have a Fear Free life. By considering a patient’s emotional health during their final days, you’ll help make their passing as compassionate as possible.
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Using Fear Free Principles to Improve Anesthetic Safety In Complicated Patients
Decreasing fear, anxiety, stress (FAS), and pain leads to safer anesthesia by allowing a lower dose of sedative and anesthetic drugs needed for anesthesia premedication, induction, maintenance, and recovery. Lower drug dosages are especially critical in complicated patients with underlying disease and physiologic compromise. In this discussion, Tamara Grubb DVM, PhD, DACVAA, will explore the role of Fear Free principles in anesthetic safety, especially in the compromised/complicated patient.
Brought to you by Zoetis Petcare.