The Savvy VetTech

Veterinary technicians commonly perform or assist with ophthalmic examinations. This blog is a review on common eye tests and normal values.

A good eye exam begins with a thorough history and appreciating a patient’s signalment (age, male/female/spay/neuter status, breed). Some particular breeds may be predisposed to certain ocular diseases. Taking a good history may help the veterinarian make a proper diagnosis and treatment plan.

Eye tests should be performed in a certain order. The proper order for the most common ocular tests are Schirmer Tear Test (STT), Fluorescein stain, and Intraocular pressures (IOP).

1) Schirmer Tear Test- The STT tests for dry eye or kerratoconjunctivitis sicca (KCS). This is a decrease in tear production. A small piece of paper made for this test is inserted under the lower eyelid and held in place for 60 seconds. Normal tear production should be greater than 15 mm in 60 seconds. Most normal dogs will produce more tears than this but this is a guideline to follow.

2) Fluorescein stain- This is a yellow dye which is applied to each eye to look for a corneal abrasion or ulcer. The abrasion or ulcer is seen when highlighting the stained eye with a fluorescent blue light.

Anticoagulant rodenticide, otherwise most commonly known as “rat bait” poisoning, is a serious and potentially fatal toxicity that requires treatment. Coumarins such as warfarin and brodifacoum are the most commonly known examples. D-Con is a common rodenticide that pets ingest in the home in cases of toxicity.

Anticoagulant rodenticide is a vitamin K1 antagonist. Vitamin K is required for synthesis of clotting factors II, VII, IX, and X (2, 7, 9, and 10). Factor VII has the shortest half-life of these and will be depleted first.

Prothrombin time (PT) measures the extrinsic clotting system which contains factor VII and it becomes prolonged first. Therefore, PT measurement is helpful in determining clotting status in a pet that may have been exposed to anticoagulant rodenticide. Platelet counts in these animals are usually normal. Any time there is a history of potential exposure or an animal is showing evidence of bleeding, coagulation should be checked.

Pets that have been exposed to anticoagulant rodenticide are at risk for bleeding. They may bleed spontaneously or if they receive an injury could bleed due to their inability to clot. They can bleed from anywhere and symptoms may include melena, epistaxis, bleeding from gums, blood in urine or vomit, lameness or joint swelling, etc. Clinical signs may be seen initially within 4 to 6 days after ingestion.

If an animal is known to have recently ingested this toxin (within the last 8 hours), induction of emesis (vomiting) is recommended, followed by activated charcoal to prevent further absorption of the toxin, and supplemental Vitamin K 1 (phytonadione). It is given daily for 3 to 4 weeks. Vomit of this type of toxin is very commonly a green/blue color.

To ensure a safe workplace for pets and employees, remember a few key points regarding anesthesia safety.

For General Anesthetic Procedures:

• Always remember to ask for assistance when moving large pets from one place to another. Moving a heavy dog by yourself could cause you or the pet injury.
• Patients that are recovering from anesthesia need to be closely monitored. Sometimes they may thrash around or make sudden movements and could injure themselves or others.
• Watch for the swallowing reflex during recovery and remove the deflated endotracheal tube when the patient begins to swallow.

One of the most common reasons owners neglect dental care or other procedures for their pet is fear of anesthesia. In fact, many owners have either had a negative experience surrounding anesthesia with a previous pet or with themselves, or have a friend who had a bad experience. Veterinary medicine has come a long way in terms of standards of care and many people do not realize how advanced our anesthesia protocols and procedures have become.

Recently, a feline "Cyrano," a 9-year old male neutered cat developed bone cancer in his left hind leg. He had radiation therapy and the cancer was cured. However, due to the radiation the bone deteriorated.

Because Cyrano was a large cat at 26 pounds, amputation for him was not a great option.

Dr. Denis Marcellin-Little at North Carolina State University w

ho has had more than 10 years of experience with 3D printing (also called additive manufacturing) took on the challenge of creating an implant for Cyrano. This is a way of making a 3-dimensional object from a digital model.

They chose to manufacture a cobalt chromium knee implant for Cyrano. This was a cutting edge option, as this type of implant or surgery had never been done before.

Retrospective studies have been helpful for bringing to light information about animal health that may have not otherwise been noticed. In the past few years, there have been many research articles that have focused on spaying and neutering health risks versus benefits. A recent study from U.C. Davis found a greater occurrence of hip dysplasia, cranial cruciate ligament tears and certain types of cancer in spayed or neutered golden retrievers as compared to intact counterparts. The research suggests that health risks are generally greater for dogs that were sterilized less than a year of age. Golden Retriever Study

What is Panniculitis?

Panniculitis is a rare disease in which the fat layer beneath the dermis becomes inflamed. It can be caused by an infection with bacteria, fungi or other organisms, but it is more commonly a sterile nodular panniculitis (the descriptive term for an inflammation of the fat cells that does not involve an infectious agent). It is usually an idiopathic disease, meaning we don't know what causes it. In some cases there may be a trigger such as a vaccine, trauma, Vitamin E deficiency, a drug reaction, or systemic autoimmune or infectious disease.

The inflammation in the fat layer causes bumps on the skin that can be soft or firm. The nodules can rupture and release a discharge that may resemble an abscess and be bloody or yellowish in color. These nodules are sometimes painful and most often appear around the head, neck, or abdominal region. Treatment involves corticosteroids, and in some cases antibiotics. It is helpful to culture these lesions to rule out the infectious agents as discussed above. Vitamin E has been shown to be helpful in this condition. In chronic cases, cyclosporine may be the best option for control. In single lesion cases, surgical excision may be warranted.

Diagnosis

What is it?
Stomatitis/pharyngitis is an inflammatory condition of the mouth. The oral tissues including the gums and tissues in the pharyngeal and faucal areas are swollen, inflamed, and painful. This disease is most common in young cats.

Causes
There may be several causes of this condition. The disease is often thought to be brought on by viral exposure, especially calicivirus. FIV and FeLV may also be underlying pre-dispositions. Tooth eruption may also cause an inflammatory response and occurs when the permanent teeth are coming in. The tooth eruption inflammation may be temporary, but severe stomatitis, especially viral induced, requires treatment.

What is Canine Cognitive Dysfunction?
Dogs that are getting older may start to show some signs of what we would call dementia in humans. It is a degenerative condition in the brain. It is progressive and is not curable, but there are a few treatment options. The cause is not known but it has been thought to be related to some imbalances of nervous system compounds, such as acetylcholine, serotonin, norepinephrine, and dopamine.

We know that the risk of a cat developing a vaccine-induced or related sarcoma is around 1 in 10,000. However, these sarcomas are extremely aggressive and are difficult to treat. Some veterinary schools have already started implementing tail vaccines in cats. The idea is that if the cat develops a sarcoma in the tail, the tail can be amputated, thus making it easier to cure the cancer.

You may have heard of acromegaly, but do you know what it is?

Acromegaly is a disease caused by a tumor (usually a functional adenoma) in the pituitary gland. It causes an excessive amount of growth hormone (GH) release which is produced in the anterior lobe of the pituitary gland. Because of the tumor, the pituitary cannot respond to negative feedback and continues to overproduce the GH.

It is inevitable that you will encounter a methicillin-resistant staphylococcus (MRSA) case in practice. It is also likely that you will have a client with MRSA and be asked about transmission of this type of bacteria to their pet. Because these infections are becoming more common, knowledge of this subject is important to the health of your patients.

DIAGNOSIS OF RESISTANT INFECTIONS
If the doctor has a patient with pyoderma that is responding poorly to treatment, he/she will likely want to perform a culture of the affected area, which you as a veterinary technician may be asked to perform.

PROSE

P = palatability- enhancing taste, texture, scent, and/or color to heighten compliance

R = route of administration- fine-tuning or changing the route of administration to make dosing easier, to potentially avoid side effect(s), and/or to provide local versus systemic action

O = off market but FDA approved (drug shortages, etc.)-compounding a pharmaceutical that is on temporary back-order or is manufacturer discontinued

S = strength- altering strength for dosing sensitivity, patient size, and/or possibly different therapeutic effect at commercially unavailable strength

E = elimination of allergens and/or irritants- reformulating to eliminate inactive ingredients that are irritants and/or allergens

After reviewing heat stroke in the last blog, here is a real case study about a dog that actually survived a severe case of heat stroke. It is a good example of how intensive these cases can be and what is involved in treatment.

Since this is National Dog Bite Prevention week, it is a good time to remind ourselves to be careful in the workplace and take the precautions needed to prevent injury from dog bites. It is also a good time to educate your children, family, and friends about how to avoid dog bite injury. More than 4.7 million people each year are bitten by dogs, and up to 1 million individuals seek medical treatment for dog bites.