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

IDEXX: Contributing to something bigger

Walter Brown, BS, RVTg, and Adam Christman, DVM, MBA, on stage at Fetch Charlotte

Over the past weekend, our unforgettable Fetch 

 Conference in Charlotte, North Carolina took place. If you were not able to be there, no worries! We have coverage from keynote speakers Elizabeth Colleran, DVM, DABVP (Feline); Jan Bellows, DVM, DAVDC, DABVP, FAVD; and Walter Brown, BS, RVTg.

From out of the ordinary emergency room cases to managing chronic feline pain, there is something for everyone. Happy reading!

Chronic feline pain from all perspectives

: Kicking off day 1 of the Fetch Charlotte conference was Colleran and her lecture on how to better explain and understand feline pain to clients in order to improve their pets quality of life.

Dental hacks to make every case more manageable

: Bellows started day 2 of the conference by sharing tips on how veterinary professionals can make dentistry cases easier.

: Finally, Brown closed out the conference by sharing interesting emergency room case studies he has come across, and how to manage them from a veterinary technicians point of view.

Did you miss the conference or ready to attend another? Don’t worry, you are in luck because we have more conferences on the horizon. Go 

 to find a conference near you, or in a location you'd love to visit!

Articles

Articles reporting on the 3 keynote addresses

3 Must-reads from Fetch Charlotte 2023

When a patient has a fever of unknown origin (FUO), both clients and clinicians may become frustrated searching for a diagnosis. To assist veterinary professionals, a practical approach to the diagnosis of FUOs was discussed by Stuart Walton, BVSc, MANZCVS, DACVIM, clinical assistant professor at the University of Florida, in a session at the 2023 Fetch 

 conference in Charlotte, North Carolina.

Walton cautioned attendees that the term 

 is often overused in practice. FUO should not be applied to a higher body temperature identified at a single time point. A true FUO is a persistent elevation of body temperature over a period of weeks or months. It may wax and wane over this period. He noted that when searching for a cause, it is important to remember that the fever is a clinical sign and is usually an "uncommon manifestation of a common disease."

The most common causes vary by species and age and include the following:

When working to narrow the differential diagnosis list, "a thorough history is everything," said Walton. This should include vaccinations, medications, previous medical diagnoses and comorbidities, prior surgeries, travel, environment, and contact with other animals. Combining this information with signalment, especially age and breed, can help to guide the diagnostic workup.

Setting appropriate client expectations is essential when embarking on a workup for FUO. Walton shared that on average, obtaining a diagnosis requires 10 procedures per dog. Owners must be prepared to make both a financial and time commitment. Patience is essential as a diagnosis often takes days or weeks to achieve, and some tests will need to be repeated over time.

"The most important thing is going back to basics," said Walton. "Get a good history and do a good physical examination.”

Identifying risk factors in the history and abnormalities on physical examination will help to focus diagnostic testing. The physical examination should include comprehensive rectal, fundic, orthopedic, and neurologic evaluations. Sometimes, repeating the physical examination throughout a 24-hour period of hospitalization can help to detect subtle changes that may wax and wane, such as intermittent pain or swelling.

Walton recommended beginning testing with safe, simple, and inexpensive tests. A CBC with a blood smear, chemistry panel, and urinalysis help to evaluate systemic wellness. Changes may be present but are often nonspecific. "Imaging will find abnormalities but not give a diagnosis," says Walton, whose "diagnostic test of choice will always be aspirates."

Ultimately, cytopathology and histopathology are the tests that most often provide a definitive diagnosis. Other tests, such as imaging, are needed to determine what tissues or fluids need to be collected for evaluation. Walton encouraged general practitioners to do diagnostics, stating that many tests can be done in general practice, including arthrocentesis, CSF taps, and ultrasound-guided aspiration of organs. "The thing that stops us from doing a lot of tests in practice is fear," he stated.

Many tests are available to identify an infectious cause of FUO, but Walton said that clinicians do not need to run every available test. Instead, select tests that are most likely to provide helpful information. For instance, antigen testing for particular organisms has good sensitivity when the organism is present. Antibody testing at a single time point is not very helpful as it does not confirm active infection. Blood cultures often have a low diagnostic yield, but about 80% of the organisms grown show antimicrobial resistance, which can be valuable information.

The goal of the diagnostic workup is to identify an underlying disease process. This will allow the veterinarian to develop a treatment plan that treats the cause of the fever and not just the symptom.

Although it is tempting to treat the fever before obtaining a definitive diagnosis, Walton reminded veterinarians that a fever is a protective mechanism for the body. Additionally, treating without a diagnosis may confound some test results and make a definitive diagnosis more difficult to obtain.

Low grade fevers may not require treatment if the pet is otherwise well. For high grade fevers, hospitalization may be required for treatment. In cases where a diagnosis is not obtained, empirical therapy can be considered. Discuss the risks and benefits of a therapeutic trial with the owners and monitor the patient carefully.

Walton also reminded veterinarians that when prescribing antibiotics, an appropriate dose and duration should be used. Drug choice should consider location of the infection and penetration into that area of the body.

Obtaining a definitive diagnosis for a FUO requires time, patience, and often numerous tests. Test selection should be guided by careful evaluation of signalment, a detailed history, and thorough and repeated physical examinations.

Walton S. Fever of unknown origin. Presented at: Fetch dvm360 Conference; March 24-26, 2023. Charlotte, NC.

Patients presenting with a high body temperature may require time, a thorough history, physical examination, and often extensive but targeted diagnostic testing.

A practical approach to a fever of unknown origin

A live, virtual conversation between veterinarians and groomers will be hosted by The Bridge Club, a company that initiates conversations with the goal of elevating veterinary medicine. The virtual event is designed to help figure out how both groups can coexist to help improve pet care and will include Marty Greer, DVM, JD; Andrew Rich, an award-winning groomer and breeder from Greendale, Wisconsin; and Erin Meyer, American Kennel Club grooming programs administrator, and project analyst.

“While some practitioners may not be ready for a partnership, I value the relationships I have with all the groomers in my area. They have saved the lives of many pets by seeing something and immediately directing the pet parent to get an appointment with my team,” said Greer, in an organizational release.

 the conversation will take a closer look into the rift between the 2 professions touching on topics such as the groomer’s lack of licensing, teeth scaling, and diagnosing prescription verse over the counter products. On the groomer's side, topics include their role in maintaining the health of their clients and their crucial role in the welfare of companion animals.

“Groomers are a unique bunch and like many professions, it is important to know who you are working with. But the majority of us commit ourselves to ongoing education, recognize our role, and work hard to build trust with our pet parents. We would love to do the same with the veterinarians who care for the same pets,” said Rich in the release.

The conversation, open to all veterinary and grooming professionals, will take place on April 19, 2023, at 5 PM PST. The event is open to all veterinary and grooming professionals and will be conducted on the Zoom platform. 

To learn more and register, visit The Bridge Club website.

Building a Bridge Between Veterinarians and Groomers. News release. The Bridge Club. March 13, 2023. Accessed March 27, 2023.

The goal of the virtual conversation is to unite professions and elevate patient care.

Bridge Club aims to bring groomers and veterinarians together

The American Board of Veterinary Specialties (ABVS) has approved a petition for full recognition of shelter medicine as a veterinary specialty. A part of the American Board of Veterinary Practitioners (ABVP), the Shelter Medicine Practice (SMP) specialty includes all aspects of veterinary practice important to the care and management of shelter animals. Its mission is to improve the health and wellbeing of both animals and humans through education, discovery, and the promotion of clinical excellence.

“This milestone caps the diligent efforts of so many, who have worked tirelessly over the years to establish, strengthen, and grow shelter medicine as a specialty,” said Stephanie Janeczko, DVM, MS, DABVP, CAWA, regent for SMP and vice president of shelter services for the American Society for the Prevention of Cruelty to Animals (ASPCA), in an organizational release. “This was possible because of the efforts of our organizing committee, our ABVP SMP diplomates, ABVP’s leadership, and all our colleagues.”

Shelter medicine has expanded significantly in the past decade. To control infectious disease and promote health and wellness in shelter medicine, specialists must have a broadened understanding of things like epidemiology, infectious disease and preventative medicine and veterinary forensics.

“Animal shelters and rescues have become more prominent, and the number of animals in need of care has grown” said Tom Van Winkle, executive director of the Association of Shelter Veterinarians, in the release. “As the demands of shelter medicine continue to evolve, this recognition will make it possible for specialists to go beyond a conventional veterinary education and improve the health and welfare of shelter animals.”

Shelter medicine practice is now fully recognized by ABVS. News release. March 27, 2023. Accessed March 27, 2023. [email]

Specialists in shelter medicine need a broad understanding of epidemiology, infectious disease, preventative care, and veterinary forensics, among other areas of animal health.

ABVS approves full recognition for shelter medicine practice

Lisa, an elderly African Elephant at Oakland Zoo, was humanely euthanized after several years of chronic and degenerative health issues. Her condition was irreversibly worsened recently after she developed ventral edema, according to the zoo, in Oakland, California.

“We are heartbroken. Over the years-long course of care and treatments to provide her a good quality of life through multimodal pain control, her disease progressed to a point where we didn’t want her last day to be her worst day, and it was time to do the most humane thing and to let her go. This was the best thing for Lisa, but the most painful and heart-wrenching for all her zoo family and the Bay Area community that has loved her for decades,” said Alex Herman, BS, DVM, vice president of veterinary services at Oakland Zoo, in an organizational release.

Lisa the elephant (Image courtesy of Oakland Zoo) 

Lisa first arrived at the Oakland Zoo in 1979, and she was only 1 of 16 female African elephants her age—46 years—or older in AZA-accredited zoos at the time of her death. According to the release,

 as she grew older, she began developing age-related afflictions such as eye ulcers, progressing degenerative arthritis, foot and nail lesions, and ventral edema, which caused excessive fluid retention in her stomach. The excessive fluid then caused external and internal vaginal ulcers.

Lisa’s care team at the Oakland Zoo included veterinarians from the Oakland Zoo and other AZA-accredited zoos, animal care staff, and specialists such as ophthalmologists, physical therapists, arthritis researchers and specialists, and wildlife behaviorists to create a care plan. Her plan included pain medication, cryotherapy, laser treatments, physical therapy, and daily foot soaks in Epsom salt.

The zoo even performed cutting-edge stem cell producers on Lisa in October 2022 and January 2023 in partnership with Michigan State University researchers and veterinarians. This procedure had some improvements on her mobility, but her limbs and joints were still stiff and continued to decline as the winter months went on.

The staff at the zoo are mourning the loss of Lisa, especially after the zookeepers celebrated her 46th birthday with her by giving her treats, enrichment, and pinatas packed with her favorite fruits.

“Lisa has been a deeply beloved part of our Oakland Zoo family since 1979. She was truly special to me, and to all of us here. Her loss is felt by so many, especially her closely bonded elephant keepers. We’ll miss her greatly,” expressed Colleen Kinzley, vice president of animal care, conservation, and research at Oakland Zoo, in the release.

Following her death, Lisa was transported to the UC Davis School of Veterinary Medicine for a necropsy.

Oakland Zoo Mourns Loss of African Elephant, Lisa, Age 46. News release. Oakland Zoo. March 27, 2023. Accessed March 27, 2023.

Lisa the elephant was humanely euthanized due to her suffering from chronic and degenerative health issues

Oakland Zoo mourns the death of an African Elephant

The LSU School of Veterinary Medicine’s Wellness Committee and Hill’s Pet Nutrition announced they will join forces for this year’s Hill’s Great Rover Road Run. The race is a 5K and 1-mile fun run/walk to help improve the health and wellness of humans and their pets to raise money for the LSU Veterinary Teaching Hospital's Good Samaritan Fund.

Open to both pets and their owners, the race is available for both in-person and virtual attendance with a $25 registration fee. According to the release, the place will take place on April 16, 2023, along the levee near LSU Vet Med, at the corner of Skip Bertman Drive and River Road.

Attendees will also be able to win door prizes and giveaways for the duration of the event, with winners being selected at random. LSU Vet Med and Hill’s are asking for participants to tag any videos and pictures posted on social media using the hashtag #HillsGRRR2023

Money raised from the event will go to the LSU Veterinary Teaching Hospital's Good Samaritan Fund, which provides emergency services, crucial care, testing, and intense care unit stays for homeless animals. The LSU Veterinary Teaching Hospital's Good Samaritan Fund has helped more than 300 homeless animals brought to the school’s 24-hour emergency facility.

To learn more about the race and to register, visit 

https://www.lsu.edu/vetmed/events/grrr.php

LSU Vet Med hosts the 33rd Hill's Great Rover Road. News release. Louisiana State University School of Veterinary Medicine. March 7, 2023. Accessed March 27, 2023. https://www.lsu.edu/vetmed/news/2023/grrr.php

The annual race promotes health and wellness for humans and pets, and raises funds for the LSU Veterinary Teaching Hospital's Good Samaritan Fund

SAP Partners