Learn how IDEXX is enhancing the lives of animals, people, and the planet.

IDEXX: Contributing to something bigger

Morris Animal Foundation has selected 5 new studies to receive funding this year focused on equine colic—a significant and potentially life-threatening disease.

“Colic consistently ranks among the top health concerns of horse owners and veterinarians,” said Janet Patterson-Kane, BVSc, PhD, FRCVS, Chief Scientific Officer of Morris Animal Foundation, in an organizational release.

“We decided to focus on this topic in this year’s equine call for proposals to advance our understanding of intestinal disease associated with colic and ultimately assist in improving outcomes for horses around the world,” she added.

According to the release, about 4 to 10% of horses will suffer from colic at least once in their lifetimes and this number may even be higher. Even though most can be treated successfully on the farm, about 10% need a referral for advanced care such as surgery.

Based on scientific excellence and impact, the Foundation’s Large Animal Scientific Advisory Board assessed each submitted grant application and chose the studies with the most potential to save lives, maintain health, and accelerate care for horses with colic.

The following equine colic studies are funded for 2022:

Two separate research teams will use variations of an approach to examine the interaction between inflammation and gut motility, to help develop methods of preventing ileus (reduced gut motility) following colic surgery. The findings could significantly assist recovery and reduce hospitalization times.

Understanding Risk Factors for Colic Secondary to Transportation: 

Researchers will search for colic risk factors related to transportation to create improved management suggestions for horses requiring transport.

Helping Underserved Communities Recognize Early Signs of Colic: 

Researchers will produce an educational program for horse owners in underserved Colombian communities to enhance early recognition of colic, a primary aspect of successful treatment.

New Prognostic Test for Postoperative Complications: 

Researchers will find biomarkers to detect horses at higher risk for postoperative surgical complications as an initiative to a new prognostic test.

Morris Animal Foundation announces new studies focused on equine colic. Morris Animal Foundation. January 27, 2022. Accessed January 28, 2022. https://holistichorse.com/zones/in-the-news/morris-animal-foundation-announces-new-studies-focused-on-eq/

Articles

The organization has selected 5 studies to fund based on their ability to save equine lives. 

Morris Animal Foundation research to focus on equine colic

Ozzie was deemed a legend at Zoo Atlanta (Photo courtesy of Zoo Atlanta). 

Zoo Atlanta announced that Ozzie—the world’s oldest male gorilla—has died at age 61 on January 25, 2022.

“This is a devastating loss for Zoo Atlanta. While we knew this time would come someday, that inevitability does nothing to stem the deep sadness we feel at losing a legend,” said Raymond B. King, president and CEO of Zoo Atlanta, in an organizational release.

“Ozzie’s life’s contributions are indelible, in the generations of individuals he leaves behind in the gorilla population and in the world’s body of knowledge in the care of his species. Our thoughts are with his care team, who have lost a part of their lives and a part of their hearts,” he added.

Ozzie’s cause of death is currently unknown. A necropsy will be performed through the Zoo’s partnership with the University of Georgia Zoo and Exotic Animal Pathology Service in the College of Veterinary Medicine. Zoo Atlanta will share the results once they are available.

Ozzie displayed decreased appetite on Thursday, January 20, 2022, and the animal care and veterinary teams offered him supportive care to urge him to eat and drink. During the past 24 hours of his life, Ozzie was treated after demonstrating symptoms including facial swelling, weakness, and inability to eat or drink.

Ozzie was a legend in Zoo Atlanta’s history and an icon during his time, symbolic of the dramatic rebirth of the Zoo in the 1980s. He was the last surviving member of the original generation of gorillas that arrived at Zoo Atlanta with the opening of The Ford African Rain Forest in 1988.

In 2009, he made history when he was the first gorilla worldwide to ever partake in a voluntary blood pressure reading. Impressively, he was geriatric even at the time of that achievement, at age 48. Gorillas are considered geriatric after the age of about 40.

According to the release, Ozzie is survived by daughter Kuchi; sons Kekla, Stadi, and Charlie; granddaughter Lulu; great-granddaughter Andi, and great-grandson Floyd, all residents at Zoo Atlanta. His legacy includes children, grandchildren, and great-grandchildren living at other attributed zoos in the US and Canada.

Ozzie’s remarkable life reflects the care, expertise, and substantial innovations of the Zoo’s Gorilla Care Team, which is well-known for geriatric gorilla care.

Ozzie, world’s oldest male gorilla, has died. News release. Zoo Atlanta. January 25, 2022. Accessed January 28, 2022.https://zooatlanta.org/ozzie-worlds-oldest-male-gorilla-has-died/

Ozzie was the oldest gorilla at Zoo Atlanta and third-oldest gorilla in the world. 

World’s oldest male gorilla dies at 61

Photo credit: Lap of Love Veterinary Hospice

Lap of Love Veterinary Hospice, a national service provider, has resumed in-home veterinary hospice care for aging and terminally ill pets after these offerings were limited in response to the COVID-19 pandemic.

 Lap of Love is the largest network of veterinarians in the United States dedicated to providing in-home euthanasia, hospice, and pet loss support services. The company is based in Tampa, Florida, and is a family-focused, medically supervised, and team-oriented service dedicated to maintaining the comfort and quality of life for terminally ill or senior pets, according to a company press release.

“Hospice is about living well until the end, however that end may be. We make sure [each] pet is as pain free and as anxiety free as possible. There are many things we can help with that go far above just medicine. With in-home hospice services, our veterinarians will create a custom care plan, and each family will be supported by a full hospice care team, including dedicated hospice care nurses,” said Dani McVety, DVM, founder and CEO of Lap of Love, in a company press release.

Although in-home euthanasia appointments continued during the pandemic, in-home hospice care services were suspended. During that time, the company provided virtual hospice care through tele-advice services. However, Mary Gardner, DVM, cofounder and chief information officer at Lap of Love, and author of 

It’s Never Long Enough: A Practical Guide to Caring for Your Geriatric Dog

, noted that it can be difficult to provide remote hospice care.

“Our goal is to maintain the bond between humans and animals while focusing on comfort and education for families,” Gardner said in a company press release.

 “We are very pleased that our care teams are now ready to resume in-home hospice care following appropriate safety measures.”

®, Suzanne Ellis, DVM, a veterinarian at Lap of Love in New Jersey, said the company aims to help clients and empower with control over their pets’ geriatric and end-of-life care. With many visits in general practice, pets are taken from their owners upon arrival, and that is the biggest difference for clients with in-home veterinary visits, she explained.

“You’re in the home. The pet is not stressed. You don’t have them being anxious from their vet visit,” Ellis said.

Veterinary hospice care is focused on comfort and quality of life for terminally ill or geriatric pets by managing symptoms and keeping them happy. Hospice services are not focused on curing the animal’s condition, nor do they include routine care or diagnostic services, according to Lap of Love. Hospice care continues until death naturally occurs or a client has elected euthanasia.

Primarily, the euthanasia process for the Lap of Love veterinarian is largely the same as in general practice, according to Ellis. However, these visiting veterinarians do not place intravenous (IV) catheters.

 “We’re giving an initial injection, which is a very heavy sedative and pain medication. [It] gets the pet in a really good, sedative [state for the] final injection, either an IV or another route that helps them transition,” she said. Returning hospice care to in-home services is bringing Lap of Love back to its roots, according to McVety.

Lap of Love veterinarians can serve up to 6 hospice care or euthanasia appointments a day, factoring in driving time between visits to clients, according to Ellis. Although their schedules are known in advance, veterinarians frequently receive same-day cancelations and last-minute appointments added in, Ellis said.

Ellis said the most rewarding part of her job of performing hospice and euthanasia services is the reactions she receives from clients.

 “You never leave an appointment where people aren’t thanking you. They’re so appreciative and thankful we’re providing this service,” she said. “Everybody always thinks you’re going to be surrounded by sadness all day, but it’s the right kind of sadness. There’s also that feeling that you’re really helping. You’re just helping all day, every day—people and pets.”

Lap of Love returns to in-home pet hospice care nationwide. News release. Lap of Love; January 20, 2022. Accessed January 25, 2022. https://www.newswire.com/news/lap-of-love-returns-to-in-home-pet-hospice-care-nationwide-21608455

Inside the practice: inside end of life care for pets at home. 

®. September 10, 2021. Accessed January 25, 2022. https://www.medicalworldnews.com/view/inside-the-practice-inside-end-of-life-care-for-pets-at-home

What is veterinary dog hospice and cat hospice? Lap of Love. Accessed January 25, 2022. https://www.lapoflove.com/our-services/veterinary-hospice

Hospice services for aging and terminally ill pets had been limited because of the COVID-19 pandemic.

National pet hospice network resumes in-home care

During an interview with dvm360®, Debbie A. Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior), shared tips for those implementing Fear Free techniques into the clinic for the first time. Her tips include using an individualized approach, focusing on the younger pets, and more.

View the video below for the entire discussion. The following is a partial transcript.

Debbie A. Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior)

: When a practice is just starting Fear Free, [they should] really focus on the kittens and puppies, the ones that don't have an established fear of the [veterinary] hospital already–hopefully. And so you can really focus on them because it's going to go faster, right? They don't have this negative image or [have] had frightening things happen yet that were slightly uncomfortable. So focus on those young puppies and kittens [and] their first visits, and you'll see what a huge difference it makes.

Videos

In an interview with dvm360®, Debbie A. Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior), offered insight on how to approach Fear Free when first incorporating it into the practice. 

Invaluable advice for those new to Fear Free

Happy Friday! As we head into February, dvm360® spent this final week of January reporting on the latest news in veterinary medicine.  

Here is a quick look at this week's highlights:

Debbie A. Martin, CPDT-KA, KPA CTP, LVT, VTS (Behavior), highlighted variations of 

 and explained the importance of an individualized approach.

 for dogs and cats—Phovia—to help accelerate natural skin regeneration.

Tasha McNerney, CVT, CVPP, VTS (Anesthesia and Analgesia), urged 

veterinary technicians to advocate for themselves financially

 to ensure a sustainable, fulfilling career.

treated a Komodo dragon with Synovetin OA

, making it the first exotic animal to receive this treatment. 

3 new ultra-portable wireless smartphone ultrasound scanners

 that are each approximately the size of an iPhone.

Stay tuned on social media and dvm360.com for more veterinary news.

News wrap-up: This week's veterinary headlines, plus first fluorescent light therapy system for dogs and cats

Canine and feline diabetes is an endocrinopathy most often caused by an insulin-dependent etiology similar to type 1 diabetes in humans. Treatment for diabetes relies on exogenous insulin therapy, in most cases, to reverse existing glucose toxicity and attempt to achieve near normoglycemia.

 Following an initial diagnosis and institution of insulin and dietary therapy, patient monitoring is key to finding optimal insulin.

Until recently, it has been advisable to perform a blood glucose curve to determine whether adjustments in the initial dose were needed. Typically, attaining a blood glucose curve means collecting a blood sample every 1 to 2 hours, either with a hospitalized patient using conventional venipuncture or using a monitor such as AlphaTRAK.

 It is well documented that blood glucose curves vary from day to day in the same patient.

 In-hospital sampling rarely collects more than 12 data points during a 12-hour workday. Home sampling results using an AlphaTRAKglucometer are owner-dependent and often lead to stress in both owner and patient, which for certain patients can have clinical significance.

 These problems reveal the most obvious benefit of continuous glucose monitoring (CGM): Providing the clinician with an accurate picture of the blood glucose patterns in the patient 24 hours a day for up to 14 days. However, in this author’s experience, it was the unexpected benefits to the owner and patient that made the difference.

CGM in veterinary medicine has been described as early as 1993,

 with research papers and reference articles becoming more prominent within the last 5 years.

 Use of CGMs is still largely limited to veterinary teaching hospitals, specialty clinics, and the occasional private practice. However, the general veterinary population can also use this affordable and simple treatment option.

Use of a monitor that can be linked to a smartphone provides real-time accessibility to glucose levels in dogs and cats without the purchase of the reader. A reader must be purchased if the owner does not own a smartphone. Once insulin is started, a prescription to any pharmacy will allow the client to purchase the FreeStyle Libre monitor, and its package insert includes a link to the software on the Abbott website. Within minutes after monitor placement, the Abbott software begins to generate curves that collect a data point every minute for up to 14 days.

This system allows remote access by the veterinarian to manage the case. The response to adjustments in dosage be tracked, and any problems with regulation can be identified and addressed in real-time. The pet owner has access to real-time data as well. Client concerns over the well-being of their pets are common for patients with diabetes, yet the reassurance that clients derive from knowing the numbers often gives them confidence and relief. This author has managed cases beginning with the purchase of a monitor and ending with resolution of a dysregulated diabetic patient without any hands-on contact at all—strictly email and telephone conversations. This is an advantage when practicing during a pandemic.

Concerns regarding reliability have been addressed.

 Continuous glucose monitors measure the interstitial glucose levels, which closely mimic blood glucose levels.

 Abbott states that reliability is highest between 40 and 500 mg/dl (CGM package insert). Outside these limits, the sensor will read “Lo” or continue to report 500 mg/dl, even though values may exceed that amount. Severe persistent hyperglycemia (>300 mg/dl) will be detected by CGM. Should an absolute value be required that is beyond the monitor’s high level of confidence (>500 mg/dl), the clinician can get that through conventional means. In the event of hypoglycemia, timely therapy with an exogenous oral source of calories can prevent an emergency situation. This one attribute of CGM—the capability of the owner to recognize that low blood sugar is imminent, become adept in realizing trends, and have the confidence to self-manage a stressful event­­­—is one of the most important of the unexpected benefits.

Feline patients present a specific challenge when using CGM.

 In this author’s experience, finding a patient that will tolerate a monitor placed between the shoulder blades is a 50:50 proposition: About half of the cats get “tired” of the monitor and figure out ways to dislodge the sensor at some point during the 14-day period. Although frustration may play a role in a client’s decision to continue with CGM, placing another sensor is easy and any data collected have value.

The most challenging cases are those that do not respond to typical insulin types and protocols.

 It is beyond the scope of this article to describe the various causes of diabetic dysregulation in dogs and cats.

 The management of a dysregulated diabetic patient is also problematic for several reasons. There is a dearth of comparative information on the subject, including clinical trials at university research centers and specialty clinics. Use of combination insulin products is complex and individualized.

Therefore, few references and virtually no algorithm exists that can assist the clinician in the process. Fortunately, documenting quality of life (QOL) and maintaining a diabetic clinical score together with CGM provide adequate confidence to both the clinician and the pet owner.

 Euglycemia is not an absolute requirement for a successfully managed case provided the QOL is high and the clinical picture remains normal.

Using some form of CGM when managing diabetic cases has the potential to transform client satisfaction and adds new options for handling diabetic dysregulation in dogs and cats.

Nelson RW, Reusch CE. Animal models of disease: classification and etiology of diabetes in dogs and cats. 

. 2014;222(3):T1-T9. doi:10.1530/JOE-14-0202

Stein JE, Greco DS. Portable blood glucose meters as a means of monitoring blood glucose concentrations in dogs and cats with diabetes mellitus. 

. 2002;17(2):70-72. doi:10.1053/svms.2002.33041

Fleeman LM, Rand JS. Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs. 

. 2003;222(3):317-321. doi:10.2460/javma.2003.222.317

Nelson R. Stress hyperglycemia and diabetes mellitus in cats. 

. 2002;16(2):121-122. doi:10.1892/0891-6640(2002)16<121:shadmi>2.0.co;2

Moussy F, Harrison DJ, O’Brien DW, Rajotte RV. Performance of subcutaneously implanted needle-type glucose sensors employing a novel trilayer coating. 

. 1993;65(15):2072-2077. doi:10.1021/ac00063a023

Bennett N. Monitoring techniques for diabetes mellitus in the dog and the cat. 

. 2002;17(2):65-69. doi:10.1053/svms.2002.33044

Wiedmeyer CE, Johnson PJ, Cohn LA, et al. Evaluation of a continuous glucose monitoring system for use in veterinary medicine. 

. 2005;7(6):885-895. doi:10.1089/dia.2005.7.885

Cook AK. Monitoring methods for dogs and cats with diabetes mellitus. 

. 2012;6(3):491-495. doi:10.1177/193229681200600302

Fleeman L. Flash glucose monitoring of diabetic dogs and cats. Presented at: 2019 American College of Veterinary Internal Medicine Forum; June 5-8, 2019; Phoenix, AZ.

Deiting V, Mischke R. Use of the “FreeStyle Libre” glucose monitoring system in diabetic cats. 

. 2021;135:253-259. doi:10.1016/j.rvsc.2020.09.015

Gerritsen M, Jansen JA, Kros A, et al. Influence of inflammatory cells and serum on the performance of implantable glucose sensors. 

. 2001;54(1):69-75. doi:10.1002/1097-4636(200101)54:1<69::aid-jbm8>3.0.co;2-q

Dietiker-Moretti S, Müller C, Sieber-Ruckstuhl N, et al. Comparison of a continuous glucose monitoring system with a portable blood glucose meter to determine insulin dose in cats with diabetes mellitus. 

. 2011;25(5):1084-1088. doi:10.1111/j.1939-1676.2011.00778.x

Brunner R, Kitzberger R, Miehsler W, Herkner H, Madl C, Holzinger U. Accuracy and reliability of a subcutaneous continuous glucose-monitoring system in critically ill patients. 

. 2011;39(4):659-664. doi:10.1097/CCM.0b013e318206bf2e

Surman S, Fleeman L. Continuous glucose monitoring in small animals. 

. 2013;43(2):381-406. doi:10.1016/j.cvsm.2013.01.002

Corradini S, Pilosio B, Dondi F, et al. Accuracy of a flash glucose monitoring system in diabetic dogs. 

. 2016;30(4):983-988. doi:10.1111/jvim.14355

Kim W, Kim H, Kang S, et al. Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report. 

Del Baldo F, Canton C, Testa S, et al. Comparison between a flash glucose monitoring system and a portable blood glucose meter for monitoring dogs with diabetes mellitus

. 2020;34(6):2296-2305. doi:10.1111/jvim.15930

Del Baldo, F, Fracassi, F, Pires, J, et al. Accuracy of a flash glucose monitoring system in cats and determination of the time lag between blood glucose and interstitial glucose concentrations. 

Gilor, Chen. Continuous glucose monitoring in practice. Presented at: 2019 American College of Veterinary Internal Medicine Forum; June 5-8, 2019; Phoenix, AZ.

Shoelson AM, Mahony OM, Pavlick M. Complications associated with a flash glucose monitoring system in diabetic cats. 

. 2021;23(6):557-562. doi:10.1177/1098612X20965012

Challenging canine diabetics: case studies

. Presented at: British Small Animal Veterinary Association Congress; April 6-9, 2017; Birmingham, England.

Zerrenner D, Peterson, M, Crawford MA. The evolution of insulin therapy. 

Ackerman N, Benchekroun G, Bourne D, et al. Diabetes mellitus: guidance for managing diabetes in practice 

Continuous glucose monitoring devices provide a complete picture of the glucose trends in patients with diabetes.