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While running errands, Craig McLahan, VMD, regularly passed by a vacant old bank building that caught his eye. He always thought it was a beautiful building that would make for a fun veterinary facility. The empty building was in disrepair, to the point that there were gaping holes in the roof and extensive water damage. But the bones of the building were solid and couldn’t escape his notice. During this time, Dr. McLahan worked as an associate for another practice, and was making mental notes for future practice ownership. 

When a for-sale sign popped up in front of the bank one day, Dr. McLahan pounced. He called the real estate broker persistently; finally, the broker called back to ask what Dr. McLahan wanted the building for. Apparently, the broker got multiple calls a day asking to see the building, but most were not serious or were for uses the city would not approve. Before Dr. McLahan could even see the building, the broker ran his idea past the township to see how the people would receive a veterinary facility, especially in an area not already zoned for veterinary use. 

Dr. McLahan finally toured the building, petitioned neighbors and the city council to get a zoning change, and got the support he needed to make the old bank his future veterinary practice. He closed on the building in December 2017 and fast-tracked his build process to open up a mere six months later. 

Dr. McLahan’s creative use of an existing building earned his hospital, Bridgeport Veterinary Hospital in Bridgeport, Pa., a special mention in the dvm360 2020 Hospital Design Competition.

Dr. McLahan had never owned a practice before but had worked in corporate America for a while before becoming a veterinarian and working for others. He brought his experiences into his new endeavor as a practice owner, focusing on building a stress-free facility for patients, clients and staff. Thankfully the natural features of the bank building worked to that end. 

“I used the features of the building to my advantage,” he says. “One of the main things that has been beneficial is that the original bank vaults are reinforced with concrete, making them really quiet places. One of the vaults we made into a cat ward, and another is our surgery suite.” 

Dr. McLahan also designed the practice to have a smaller reception and waiting area, instead moving clients straight into one of the four exam rooms upon arrival. A smaller waiting room forces the hand, he says, discouraging people from staying in that space. 

"The waiting room situation is very stressful for animals and clients. You mix sick animals with healthy animals, add in anxious animals or those with fear aggression, mix cats with dogs, it’s all a recipe for stress," he notes. "I wanted a design that allows us to put animals directly into exam rooms. We stagger appointment times to minimize waiting.” 

To make sure the facility is quiet for his patients, Dr. McLahan hired an animal hearing research company to survey the site. They verified that the facility does, in fact, filter out sounds that are bothersome to animals. The vault is indeed a quiet, relaxing space for the cats. The dog ward is on the other side of the building, and the boarding kennels are in the basement, giving plenty of space between noisy activities.

Dr. McLahan says his mother always told him he learns things the hard way, and building his first veterinary practice was no exception. He hopes sharing his mistakes will help others avoid them. 

His first tip: Get your initial plans as accurate as possible 

 you start building. “I learned from experience that change orders are very costly!” says Dr. McLahan. “Contractors love change orders because it makes them more money. Of course, they’re very accommodating, because it benefits them. I didn’t realize that initially.” 

His next tip: If you can’t visualize the layout based off your drawings, build a three-dimensional model of your space. “Picturing how things will work based off a drawing is really hard for me,” he says. “A table is just a square on a drawing; a countertop is just another square. To really get in and realize how things will flow, a 3-D model can make it feel more real.” 

All told, the building process went well for Dr. McLahan, despite the change orders. A mere eight months after closing on the building he opened for business, to rave reviews. 

Bridgeport Veterinary Hospital sits at a high-traffic intersection with 30,000 vehicles passing per day, plus lots of foot traffic. That helped get word out about the practice opening. Dr. McLahan held a grand opening on Labor Day weekend. The local fire company brought a ladder truck to put up the flag outside the practice. Vendors and locals came to tour the practice, with a line down the block waiting to get in and see what had become of the old, dilapidated bank building. 

“It’s exhilarating to know this is my business, in a spectacularly beautiful building,” he says. “I’m excited for our future here.”

Articles

A building as secure as an old bank, vaults and all, is sure to make for a quiet, stress-free veterinary practice.

Hospital design: Banking on a good plan

Mental health has long been a concern in the veterinary profession. According to 2018 statistics from the Centers for Disease Control and Prevention, veterinarians are at 

much discussed throughout the profession in recent years

. In an effort to prevent worsening mental health among its associates, BluePearl Specialty and Emergency Pet Hospital recently launched the Micro Steps to Wellness program.

The corporation’s goal is to provide its more than 5,900 associates with small, monthly steps that aim to help reduce elevated health risks and create healthy lifestyle habits in an effort to prevent depression, burnout and compassion fatigue. According to a BluePearl 

, each micro step is intended to be “habit stacked, meaning each action can be simultaneously practiced throughout the day, month, or year” either at home or in the hospital.

Angela Calderone, vice president of people and organization at BluePearl, said, “Now more than ever, we as an organization have a responsibility to recognize the mental health and wellbeing needs of our associates and provide them easy access to the tools and professionals they need to help cope with the mounting pressures they face each day.”

Speaking to the effectiveness of wellness programs, Lori Harbert, MSW, LCSW, director of health and well-being at BluePearl, which includes more than 90 veterinary practices in 26 U.S. states, said, “This program encourages our associates to take their wellness as well as the wellness of their colleagues seriously. By implementing proven to work, positive behavioral habits in our practices, we hope to open the gateway to healthier living across the veterinary profession.”

June 1 marked the launch of the first micro step, Paws for Wellness, which encouraged associates to take brief breaks to improve their attitude, concentration and happiness, while reducing stress. Additional planned micro steps include guided meditation videos, healthy eating potlucks, participation in National Suicide Prevention Awareness Month and an introduction to gratitude journaling.

The corporate veterinary hospital chain recently launched a year-long program that aims to improve mental health and wellbeing among associates. 

BluePearl launches wellness program for associates

Ceva Animal Health, maker of the pheromone products Adaptil and Feliway, has announced the acquisition of ThunderWorks, which produces a wide range of calming products for dogs and cats, most notably the 

Abbie King, senior behavior product manager at Ceva Animal Health, said in a 

 about the acquisition, “We have always been fans of the ThunderShirt range and we are therefore delighted with the acquisition, which will further strengthen our extensive portfolio of behavioral products that work in synergy with one another to provide pet owners with comprehensive anxiety solutions.”

By acquiring ThunderWorks, Ceva hopes to expand its portfolio of anxiety-reducing solutions for cats and dogs.

The global veterinary health company will use the ThunderWorks brand to expand its line of calming products for dogs and cats.

Ceva Animal Health acquires ThunderWorks 

When news first broke that SARS-CoV-2, the virus that causes COVID-19, was believed to have originated from bats, questions quickly surfaced about the potential threat of infection from companion animals to humans and vice versa. Initially, veterinary experts found no evidence of a correlation. However, that changed when animals 

 and then in the U.S. tested positive for the virus. The first reported case in the U.S. was a tiger at the 

As human medical experts raced to identify the chain of transmission and possible cures, their counterparts in the veterinary field searched for links on how the virus could be transmitted through human-animal contact and what impact that might have on animal patients.

“We were really interested at the outset in how prevalent this spillover might be,” explained Jonathan Runstadler, DVM, PhD, a professor of infectious disease and global health at Cummings School of Veterinary Medicine at Tufts University, during a recent webinar hosted by the Massachusetts Veterinary Medical Association. “Part of the problem initially was that in late January and through February, there wasn’t information or data of any sort to look at in order to evaluate if this was a risk.”

Dr. Runstadler provided an overview of the university’s Coronavirus Epidemiological Research & Surveillance (CoVERS) study. “The study we’ve started grew from some of what we already know about viruses like SARS-CoV-2 and related viruses that have caused epidemic events in the past,” he said.

“We know that these viruses are spilling over into human populations from animal hosts. It is usually animal hosts in the wild but [it also occurs] through domestic intermediate hosts or other animals that are in semi-domestic situations. For SARS-CoV-2, that really is no different.”

Quickly shifting focus from the department’s ongoing studies, the research team started locally by sampling patients from veterinary hospitals in Massachusetts. Initially, they hoped to determine whether significant spillover was occurring in situations where close human-animal contact was common. As the study’s focus began to take shape, however, the CoVERS team established the following three key phases:

In the first phase, they screened a variety of companion and large animal species to estimate the transmission of SARS-Cov-2 to animal hosts. The subjects were chosen without regard to the COVID-19 status of owners or other humans with which the animals had contact.

In the second phase (where the team is currently focused), the investigators are screening and monitoring paired owners and animals to evaluate direct SARS-Cov-2 transmission and identify high-risk situations.

The third phase will focus on monitoring farm and veterinary school animals that are in regular contact with humans for natural SARS-CoV-2 infection as well as inter- and intraspecies transmission over the course of the COVID-19 pandemic.

The first animal to be tested for the CoVERS project was a hedgehog. The group has also tested horses, bats, a coyote and even seals, but Dr. Runstadler said most of the samples have been taken from dogs and cats.

“Based on some of what we know from experimental inoculations of animal hosts and from what has occurred naturally as well, it appears that cats may be the most interesting population in terms of domestic animals.”

Of the more than 350 animals that have been tested through CoVERS to date, there have been no cases of SARS-CoV-2. “We are glad that we have not detected positives in the population of patients that we’re looking at,” Dr. Runstadler said.

Looking ahead, the team is interested in enrolling more human-animal pairs for the home phase of the study, which they hope includes adding human samples for testing. “If we get a spillover event we will be able to look at the virus coming from the human as well as the spillover virus,” he explained. “That may be important for understanding how this virus actually does spill over, when it does in those rare instances, between humans and animals.”


So far, none of the animals involved in the CoVERS study have tested positive for the virus that causes COVID-19. 


Study examines human-to-animal transmission of SARS-CoV-2 

High-risk neonatal puppies and kittens are those that become severely dehydrated or systemically ill, or are falling behind in weight gain. A variety of factors can contribute to these circumstances, of which husbandry is the most common. Failure of passive immunity and/or infectious disease can also contribute.

Caring for these high-risk neonates requires knowledge of normal newborn parameters. Healthy puppies and kittens should be gathered in a loose pile within their enclosure (

), should have good mucous membrane coloring and should be noted to be “twitching” while asleep; they should not be extremely vocal.

A healthy puppy or kitten will twitch noticeably, almost continuously, while sleeping (

). This can even startle them awake or cause them to readjust their sleeping position. In my experience, evaluating for this twitching has been the most important factor when monitoring neonates. A significant decrease or lack of twitching could signify that the animal is not doing well and requires professional evaluation.

Several other factors should be monitored as well when caring for high-risk neonates, including environment, hydration, nutrition, excrement, weight and immunity.

In the first week of life, puppies and kittens rely solely on their external environment for warmth; they are unable to maintain their own body temperature. Environmental temperatures ranging from 75°F to 80°F will support maintaining an optimal neonatal rectal temperature of 98°F to 99°F. Only when a puppy or kitten is maintained at an appropriate temperature is it able to digest milk and thus ready to be fed.

High-risk neonates are typically solitary individuals; an entire litter of high-risk neonates is rare. Those at high risk prefer to snuggle against something warm. IV fluid bags warmed in the microwave (make sure the bag is neither too hot nor too cold) and covered with a tube sock can provide a nice substitute for littermates. A sock will be more inviting to the neonate and, because they can be changed and laundered easily, socks also help keep the area clean.

A well-hydrated puppy or kitten will have adequate skin turgor and good pigment color. Light-colored animals should have bright pink mucous membranes (

). As for adults, it can be challenging to assess mucous membranes in darkly pigmented neonates. However, there should be areas where assessment is possible, such as the belly.

Any fluids administered to a neonate, regardless of route, should be warmed. For mildly dehydrated newborns, subcutaneous fluid administration is appropriate. Crystalloid fluids should be administered at a dose of 1 ml/30 g. In cases of severe dehydration, an intravenous or intraosseous catheter is greatly preferred. Jugular intravenous catheters may be the easiest to obtain, and the femur is an excellent bone for intraosseous placement using a hypodermic 22- or 20-gauge needle. Both routes can be used to administer fluids, blood products, diluted dextrose and antibiotics. Severely hypovolemic neonates can receive approximately 60 ml/kg of crystalloid fluid total during one resuscitation event. In cases of dehydration, the rehydration process should be more gradual.

Dehydration deficits in neonates are calculated in the same way as for adults: Percent dehydration multiplied by body weight in kg will provide the total fluid deficit in liters.

 The neonate’s maintenance fluid is about 60 to 100 ml/lb/day.

 Colloids can be used in urgent circumstances and are dosed the same as in adults.

Any species-specific milk replacer or goat’s milk can be used to feed neonatal puppies and kittens. Neonates need to be fed every two hours until they are gaining weight steadily and becoming more glossy in appearance. They can be bottle fed only if they are vigorous enough to perform the task adequately. Bottle feeding should not be attempted until the neonate’s Apgar score is between 7 and 10 (

 Neonates with Apgar scores between 4 and 7 should be tube fed via a red rubber catheter (size 8-10 Fr for canine neonates and 5 Fr for neonatal kittens.)

Correct tube length is imperative when tube feeding. The tube should be aligned from the mouth and extended down to the last rib. When placing the tube in the stomach, you will feel resistance as the tube passes the lower esophageal sphincter. Place the animal in sternal recumbency and insert the tube toward the back of the throat on the left side, advancing rather swiftly. A puppy or kitten that is alert enough to be fed will also fight you to some degree during tube placement. Holding the mouth closed and the neck extended while milk is instilled will help keep the tube in place.

It is very common for neonates to grunt and vocalize while being fed. Hearing this is a sign that the tube has been placed correctly. An animal that is too lethargic to swallow the tube and provide some resistance is not quite ready for enteral nutrition. While feeding the neonate, be sure to palpate the area below the lower rib on the left side of the body to ensure you are not overfeeding. A good guideline for feeding volume is approximately 4 to 5 ml/100 g. If the puppy or kitten is showing signs of discomfort during feeding, do not proceed with the entire volume but work up to it incrementally. To prevent residual milk from dripping into the pharynx, risking aspiration, kink the tube before removing it.

Because neonates cannot urinate or defecate without assistance, they should be stimulated both before and after feedings. To stimulate urination, rub the ventral caudal abdomen/inguinal area. Urine should be almost clear in a well-hydrated neonate (urine specific gravity < 1.017). A neonate with darker urine will need a more aggressive fluid therapy plan.

Some neonates may urinate and defecate simultaneously, while others need separate stimulation to produce feces. Do not rub directly on the anus repeatedly to stimulate defecation; this can result in ulceration of the anal tissue and make defecation uncomfortable. Instead, wipe a damp, warm cloth or gauze bilaterally on either the ischium or the pelvis (or both). If ulcerations do occur, use vitamin A & D ointment in between stimulation events.

Neonatal feces should resemble varieties of mustard. It can be bright yellow or darker yellow, with or without “seed” material in it. The seeds are fatty excrement. The feces can be very wet in appearance but should not be completely liquid. The meconium is much darker and gelatinous. At-risk neonates that have not had adequate nutrition may pass meconium much later after birth.

A healthy puppy or kitten will gain about 10% of its body weight daily. High-risk neonates should be weighed twice daily using a gram scale. This will allow minor weight losses and gains to be observed more closely to allow for a necessary intervention sooner rather than later.

Neonates that have failed to nurse on their dam or queen within 18 hours of birth will not have had the opportunity to ingest colostrum. In these cases, plasma or serum can be used as a substitute. If administered within the first 18 to 24 hours of life, the plasma or serum can be given orally to the neonatal puppy. Puppies should receive 0.1 ml/g of adult dog serum.

In kittens, care should be made to ensure the serum blood type matches that of the kitten. Dosing for kittens is 15 ml non-hemolyzed adult serum/100 g of body weight. This serum should be divided into three total injections given every eight hours for the first 24 hours of life.

Newborn puppies and kittens can become compromised quickly, particularly in the first week of life. Their owners may miss early warning signs of compromise, only noticing that something is amiss when the neonate has entered a high-risk state.

Dr. Simermeyer is an emergency practitioner at Mount Laurel Animal Hospital in Mount Laurel, NJ. Her professional interests include emergency and critical care, and canine reproduction. She has been breeding Cardigan Welsh Corgis for the past 23 years.

Thomovsky EJ. How to treat the sick neonate. Presented at the Atlantic Coast Veterinary Conference; 2015.

Veronesi MC, Panzani S, Faustini M, et al. An Apgar scoring system for routine assessment of newborn puppy viability and short-term survival prognosis. 

Newborn puppies and kittens can become compromised quickly. Here’s what you need to know when caring for these fragile animals.

Neonatal nursing care for high-risk puppies and kittens

Transitioning from undergraduate to veterinary school can be tough to say the least, largely because of the massive workload and fast-paced learning, says Danny Sack, DVM, a 2020 graduate and small animal intern at the Animal Medical Center in New York. One good way for first-years to stay afloat is to understand how they learn best, he tells dvm360.

Speak to your professors, speak to different clinicians that you get along well with, and ask what worked for them in veterinary school, says Dr. Sack. Also speak to your peers, and ask how they’re studying. "But take every piece of advice with a grain of salt," he advises. "Not everybody learns the same [way]," he says. 

He also advises first-year students not to compare themselves with others. “It’s really important to stay in your lane and do what makes you be the best student you can be, and that will kind of keep you on track and limit the stress you don’t need in your life,” he says.

Finally, he emphasizes the significance of proper self-care. His advice: Try not to push yourself past your limit and make time to rest.

“Don’t grind to the point where you can’t get up the next morning, where you’re having mental breakdowns because you can’t stand it one more minute," says Dr. Sack.

Watch the video below for more of Dr. Sack’s recommendations.

Videos

Danny Sack, DVM, offers some tips to help new veterinary students navigate their most challenging year of veterinary school.

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dvm360 launches online CE center amid pandemic

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