Are these clinical-focused tools at your fingertips handy, or should you even bother?
(Shutterstock)Wondering what new apps are available to help you in veterinary practice, or which ones are worth purchasing? I wondered the same thing, so I downloaded several on my iPhone 5s with a current iOS 10.2 update. (Yes, I have an old phone with a cracked screen. Don't judge.)
Who remembers having a PDA in vet school? I do! This app is from the University of California, Davis, and it is legit. Since the app is backed by my alma mater, practitioners can feel confident in this app.
Pro: Lots of good stuff here for five bucks. I find that this app saves me from having to run and grab my books to look up fluid rates, constant-rate infusion (CRI) dosages and energy requirements, among other things. As I practice mostly outpatient, I find the energy requirement tool invaluable in counseling owners and creating nutrition plans, and the fluid plan is helpful so I don't have to go searching for the perpetually misplaced fluid wheel.
There are also all sorts of calculators that would be beneficial for technicians and doctors working in critical care and anesthesia, such as osmolality, blood gas analysis, anion gap, transfusion, bicarbonate dosing, alveolar to arterial (A-a) gradient and more.
Con: The first con I see is the notification that pops up on screen when I go to open the app: “Calcs may slow down your iPhone-the developer of this app needs to update it to improve its compatibility.”
The anesthesia drug calc is beneficial for single-agent inductions, but it is missing some newer agents (alfaxalone and Simbadol) as well as multiagent intramuscular sedation drug combos such as dexmedetomidine/butorphanol and the ever useful kitty magic (dexmedetomidine/ketamine/butorphanol or buprenorphine-a GP's best friend). Also, why isn't acepromazine on the list of anesthetic drugs?
I would like to see those combinations added and the anesthetic drugs updated.
Purchase-worthy? For the on-the-go practitioner, this handy app can be a big time saver, but Davis does need to update it. For five bucks, I am a fan.
A Vet Tool-$6.99
A Vet Tool has five tabs: formulary, hematology, x-rays, calculators and a notes section so you can create your own swipe file for things like the Colorado State University aural hematoma protocol or other handy tips.
Pro: The insulin formulary is nice to have on hand. The hematology tab has the reference ranges for several species, but I am not sure how useful this is, since most complete blood count and serum chemistry profile machines give you the ranges. I suppose if your machine was calibrated only for dogs and cats, then it would be useful to have turtle or ferret reference ranges available-which this app has.
The gestation calculator has 10 species! If you need the gestation period for anything ranging from cattle to gerbils, this app has it! (Can you tell this was the most exciting feature of this app for me?)
Con: This app lists only generic drug names in the formulary, so if you can't remember the active ingredient in Temaril (trimeprazine), you cannot look the drug up by the trade name, which is a big con for me. The formulary is also missing some big drugs such as cefovecin sodium, robenacoxib, oclacitinib and trazadone. I'm not sure why ibuprofen is listed in the formulary with the notation “safe dose not established.” Is that for pet owners who might purchase the app? Also, I'm not sure how I feel about having a dose for acetaminophen in dogs when safer analgesia is available. That feels like a no-no.
The x-ray tab is mostly useless. There are three comparable joints-knee, shoulder and hip-and you can swipe between normal and arthritic. Methinks this tab is for pet owners. Why else call it “x-ray”? The only benefit is to have a handy visual to show pet owners.
This app also needs an update to make it work better on updated platforms.
Purchase-worthy? For the price, I would pass, unless you want to wow your friends with that super sweet gestation calculator.
Pet Poison Help-$1.99
This app has a moderately comprehensive list of possible toxins to dogs and cats, the clinical signs associated with each and a description of the toxin or poison. There are four tabs: poisons, instructions on what to do if a pet is exposed, an “About” tab that is basically a sales pitch for the helpline, and a “Call now” button, which will call the helpline.
Pro: This is a handy app for pet owners that raises awareness of possible toxins around the house and provides them with two calls to action if the animal is exposed: call the helpline, and call your veterinarian.
Con: This app doesn't really help veterinarians treat toxicoses. It does not provide any antidotes, dosages or treatment plans, so if you're looking for this app to do that, don't. Whether you have this app or not, you will likely still be calling the Pet Poison Helpline or the ASPCA Animal Poison Control Center for treatment recommendations.
Purchase-worthy? For your helicopter-err, discerning, tech-savvy clients (read: millennials)-this is a fairly low-cost app that will bring them some peace of mind and increased awareness. It is a good app for them to have.
DVM Calc is from WestVet Emergency & Specialty Center in Boise, Idaho. There is a lot going on in this little gem.
Pro: The enteral feeding and CPR drug calculators are fabulous-when an animal is arresting, the last thing you want to be doing is scrambling for drug dosages. The CPR drug calculator for dogs and cats gives you low and high doses of epinephrine, atropine, lidocaine and sodium bicarbonate-all you have to do is put in the weight. It also has shock fluid doses available with a similarly easy calculator for isotonic, colloid and hypertonic fluid doses. To a working mom like me whose brain is fried by juggling children and career, this feature is gold.
The app includes a limited toxins calculator for dogs and cats, where you put in the weight of the patient and it determines the minimum lethal dose when you put in the patient's weight. Yes, chocolate (white, milk and dark) is on there. Very helpful, I think.
Not that I would ever use it, but for you busy orthopods the app features a tibial plateau leveling osteotomy (TPLO) rotation calculator-all you need to input is the tibial plateau angle and the saw blade length. Also included is a surgical blood loss calculator.
Though the gestation wheel features more specific methods of predicting gestation (vaginal cytology, day one, transabdominal ultrasound, estimated mating date, preovulatory P4), it only covers one species (dogs) and will not wow your friends at a party like the gestation tool on A Vet Tool app. However, if you do a fair amount of canine reproduction, this app may be of use.
Con: The maintenance fluid rate tool requires you to estimate your dehydration deficit in milliliters instead of percentage. Who does that?
Purchase-worthy? For five bucks I think this app is a useful investment for veterinarians and give it two thumbs up.
This app is from the CDC and is a free quick reference guide for doctors and other healthcare providers.
Pro: It's free! This elegant app has a wonderful pictorial guide of ticks found in the United States, which is great for tick identification. Each tick comes with a geographic distribution guide, the diseases that are transmitted by said tick and some fun facts about each species.
Con: The tickborne disease list, while comprehensive, only lists signs seen in people and treatments for people. While this is great for disease surveillance in people, it doesn't help us as much in veterinarian medicine.
Purchase-worthy? Since this app is free, I would say go ahead and download it. It could be helpful in several ways, including tick identification and client education.
Small Animal DDx Lite FREE (full version $49.99)
This app is created by Fabrizio Oddone and Dr. Andrea Vercelli, who has a Cicero quote at the top of his biography that when translated reads, “But memory is impaired if you do not exercise it, or even if you are by nature somewhat dull.” What is he trying to say here?
These two created the Small Animal DDx Lite, which is free, and the full version, which is $49.99. I only downloaded the lite version.
In this app Vercelli lays forth mnemonics that help practitioners work through diagnostic algorithms. For example, for seizures the mnemonic is FITS: functional (idiopathic epilepsy), intracranial disease, toxicity or systemic disease.
On the same page there is a second mnemonic: THE BRAIN: trauma, hematoma, embolism, blood chemistry and toxins, real epilepsy, anomaly, inflammatory and neoplasia.
I don't know about you, but I think that when you're in front of a hysterical client and a dog in opisthotonos, having mnemonics on your smartphone is a handy way to stay clinical during the whole ordeal.
Pro: This app gives you a classical way to formulate plans we all learned in vet school. Think 10,000-foot view of the problem; sometimes old school is the best school. Plus, it's free, and there are quotes in Latin!
Con: If you are looking for the latest drugs or dosages for treatment, this app will not help you.
Purchase-worthy? The lite version is free-give it a try! If you like it and purchase the full version, shoot me a message and tell me what you think.
Dr. Sarah Wooten graduated from UC Davis School of Veterinary Medicine in 2002. A member of the American Society of Veterinary Journalists, Dr. Wooten divides her professional time between private practice at Sheep Draw Veterinary Hospital in Greeley, Colorado, and writing articles and filming video content for various media outlets. A “veterinarian in the trenches,” she's passionate about bringing the associate's voice to the table and speaks on leadership and practice management. In addition to her adventures in veterinary medicine, she also owns a tea tavern. She enjoys camping with her family, skiing, SCUBA, and running.