One can usually find many sources of information about drugs: FDA website, drug company websites and technical reports, VIN, journals, trade magazines, and so on. The important skill required of veterinarians is to assess that information to determine its usefulness in your daily practice. Below are some principles of evaluating drug information, with the goal of improving treatment and the practice of medicine.
Endoscopy is a wonderful diagnostic tool that allows exploration and biopsies of areas without invasive surgery. Given the option, many clients may prefer endoscopy instead of surgery. What types of cases are suited to endoscopy? How do you prepare a cat for endoscopy?
Following the trends in human medicine, there is an ongoing effort to adapt and develop minimally invasive therapeutics for the management of various problems facing veterinary patients. Minimally invasive therapeutics offer the advantages of smaller incisions, decreased pain, shortened anesthesia times and shorter length-of-stay compared to traditional open surgical approaches.
Drug-induced injury is an important cause of hepatic disease in dogs and cats. The incidence of drug-induced hepatic disease is unknown but is probably underestimated. Many drugs have been suspected of causing hepatic injury in dogs and cats. Most adverse hepatic drug reactions are associated with acute hepatic injury.
An increase in serum alkaline phosphatase (ALP) activity is a common laboratory finding in dogs. It is typically used as a diagnostic marker for cholestatic liver disease. However, increased ALP activity has a high sensitivity (86%) but poor specificity (49%) for canine liver disease.
Despite recent technological advances in dialysis and transplantation, conservative medical management remains the most practical and accessible approach to the treatment of chronic renal failure (CRF) for most cat owners and veterinarians.
Veterinary transfusion medicine practices have evolved considerably over the last 10 years as we have come to better understand immunology, infectious disease, and the appropriate use of blood and blood products. Some of our biggest advances in ensuring the provision of a safe blood product has come as a result of our errors including, but not limited to acute immunologic transfusion reactions and delayed non-immunologic transfusion reactions (infectious disease transmission).
Whether you call these patients geriatric, or "mature", special considerations are required in evaluating, examining, hospitalizing, and generally caring for older felines. Veterinarians and owners must understand that OLD AGE IS NOT A DISEASE, IT IS A STAGE OF LIFE.
Hemograms consist of both quantitative data (total cell counts, differential cell counts, red cell indices, etc.) and qualitative data (blood film morphology). Proper interpretation depends on the integration of both.
Fluid therapy is supportive. The underlying disease process that caused the fluid, electrolyte, and acid-base disturbances must be diagnosed and treated appropriately.
Identification and correction of the underlying causes of arrhythmias are key to their long-term, successful management. For instance, in a cat with atrial standstill as a result of hyperkalemia from urethral obstruction, the arrhythmia is best addressed by correction of the underlying problem, hyperkalemia, as primary antiarrhythmic therapy is generally unsuccessful when such electrolyte abnormalities are present.
Traumatized small animal patients represent a population in which a standardized approach to diagnosis centered on thorough background knowledge of traumatic injuries coupled with a complete physical examination will allow for rapid therapeutic interventions and optimization of patient care.
Human and canine exposure to potentially toxic mushrooms is relatively common. In 2007, the American Association of Poison Control Centers (AAPCC) reported a total of ~ 7700 calls related to mushroom exposure. The difficulty for the clinician is that rapid and proper identification of ingested mushrooms occurs infrequently.
Giardia, Clostridium perfringens enterotoxin, and Cryptosporidium are important causes of diarrhea in dogs and cats. Tritrichomonas foetus is an important problem in cats. These disorders should be investigated early in the course of diarrhea, whether it is persistent or intermittent, along with evaluation for dietary causes of GI signs, nematode parasites, bacterial and viral causes, and acute idiopathic colitis.
Glucocorticoids are the most commonly used drugs for immunosuppression of dogs and cats with immune-mediated diseases because they induce rapid, non-specific inhibition of the immune system by reducing inflammation-associated gene transcription, inhibiting intracellular signaling pathways, down-regulating cell membrane expression of adhesion proteins, and slowing cell proliferation.
Close to 30% of pet owners have used or considered the use of novel ingredients (eg, nutraceuticals and herbs/botanicals) in their animals. In the USA, approximately 90% of veterinarians sell some type of novel ingredient and the current market of veterinary novel ingredients is between $20 and $50 million per year.
Hepatoprotective agents are receiving attention for their role in the ancillary treatment of liver disease in dogs and cats. These products include both prescription drugs and dietary supplements (vitamins, minerals, herbs, nutraceuticals). A drug is defined as "any substance, food, or nonfood that is used to treat, cure, mitigate, or prevent a disease and any nonfood substance that is intended to affect the structure or function of man or animals".
Puppies and kittens are generally considered to be neonates from birth to two weeks of age although some references consider the neonate period to extend to four weeks of age. Neonates pose special problems in husbandry and health care due to their small size and developing organ systems.
Over 90% of the potassium in the body is located within cells. External balance for potassium is maintained by matching output to input. Internal balance is maintained by translocation of potassium between intracellular and extracellular fluid. Any change in plasma potassium concentration must arise from a change in intake, distribution, or excretion.
A number of factors need to be considered in deciding the best approach to decontaminating a toxicant-exposed patient. In animals orally exposed to toxicants, these factors include consideration of the substance and amount ingested, whether multiple agents were ingested, the time since ingestion, whether attempts at decontamination have been undertaken prior to presentation, the species of animal involved, number of individuals exposed and whether there is any known underlying organ dysfunction, especially affecting the liver or kidneys.
Antimicrobials are amongst the most commonly prescribed medications by veterinarians. Understanding how to properly employ these powerful drugs is the key to a successful outcome.
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