Monday, July 27, 2015

We're sitting our memberships!

Hero's plan is to sit ON memberships, as demonstrated by his rapid insertion of himself into folders I bought to organise the reading material.
One of the aims of this blog is to promote the welfare of companion animals. It seems so straightforward: companion animals are companions, so don’t we look after them to the best of our ability?

The answer, in short, is not always. We’re people. We get it wrong. One of the fields that has grown over the last fifty years in particular is the science of animal welfare, and it has proven that occasionally our intuitions about what is best for an animal aren’t always the best thing. For example, when it comes to enclosures for guinea pigs, bigger is not always better. They need adequate space, but they’re also thigmotactic – they like to be wallflowers and the concept of a wide open space can be a bit confronting and cause significant stress.

Similarly with reptiles. They need their space, but they also need heat (more specifically, a heat gradient based on their preferred optimal temperature zone), exposure to UV light, a hide, appropriate humidity and so on). Sticking them in a big fancy enclosure might tick the space box, but if the heating isn’t right the animal ends up severely immunocompromised.

As a companion animal veterinarian I deal mostly with the welfare of individual animals (and their associated humans) on a daily basis. But welfare is one of those things we can always do better. And our views about what is good animal welfare change over time, with the advent of new evidence and sometimes in spite of it.

So, with the encouragement of a fantastic colleague who sold me when she said we could be study-buddies (years of study has taught me that a good study-buddy is worth their weight in gold), I’ve made the decision to sign up to sit membership examinations in animal welfare. 

For those who don’t know, memberships of the Australian and New Zealand College of VeterinaryScientists are exams one can sit (as long as one is at least three and a half years out of vet school) that help one hone one’s knowledge in a particular area. This is about the journey, not the destination. i.e. it’s about the period of study and mentorship ahead of time that really count.

According to the ANZCVS -
"The candidate is expected to demonstrate a high level of interest and competence in a given area of veterinary activity. This is judged by that standard of knowledge and understanding, practical skills, attitude, methodology and communication which would make the person suitable to give professional advice to veterinary colleagues not similarly qualified on problems or procedures often encountered or used in general practice, in the relevant area of veterinary endeavour."
Every year, veterinarians from Australia and New Zealand sit these formidable exams and many become members in the different college chapters – from medicine and surgery to zookeeping and unusual and exotic pets to pharmacology and pathology. (If you see a vet with the letters MANZCVS after their name, it means they’ve sat memberships in one or more of these areas).
Candidates sit two written exams and an oral exam. In animal welfare that means understanding not just the welfare of companion animals, but issues pertaining to the welfare of all veterinary species, including ethics and legislation. Not a small area.

So right now we’re in the mode of constructing a learning plan, reading papers and planning. It won’t change the emphasis of SAT, although I’m hoping to share more animal welfare information along the way.

If you’re keen to sit your memberships, the best source of information is the ANZCVS Membership Candidate Handbook which you can download free of charge here.

To get an understanding of the level of knowledge required it is helpful to review past written exam papers, which can be viewed here

Hopefully study will look something like this: reading in an exotic relaxing location. Prior experience suggests there is something of a gulf betwixt this expectation and reality but we're hoping to bridge that gulf!
Our challenge is to take a balanced approach to life and study - and we'd love to hear from SAT readers about they approach big projects and exams.


Saturday, July 25, 2015

Stress-down

Phil relaxes on his big fluffy bed.
The plan yesterday was to observe National Stress Down Day (in support of Life Line), but life had some other plans. Phil managed to get in a few hours of blissful day-napping, but it has been a very busy week here and whilst we had fantastised about talking a long scenic walk by a beautiful River, it didn’t happen.

Fellow blogger Mia Cobb did stress down and loved it. You can read her post about the importance of de-stressing, and how we destress with animals, here.

If you’re feeling work has been a bit stressful lately, there’s a fantastic (and very short) article by psychologist Stacie Fishell Rowan on the “Top 5 Ways to Avoid Burnout”. I don’t want to steal her thunder and give them away, so you’ll need to log in to read this article (it’s free and the article applies to non-vets as well as to vets).

The key lesson is that stressing-down in any job but especially being a vet takes planning, but also flexibility.


We’re currently working on a project relating to stress in the veterinary profession, although we’re not stressing about it! Have a great weekend, folks, and get some sleep.

Friday, July 24, 2015

Managing skin conditions in practice: tips from veterinary dermatologists

Skin lesions on the abdomen of an itchy and unhappy cat.

Skin conditions in companion animals can be a source of frustration, for the animal, the owner and even the veterinarian. If you’ve ever lived with a dog or cat that is scratching or licking 24/7, comes out in welts every time he or she goes for a walk, or has seemingly never-ending ear infections you know the pain. Owners are often at their wit’s end, and just want and end to it – but treatment can take time.

On the flip side, if you can help manage skin disease, you can improve an animal’s quality of life massively.

In today’s post, top veterinary dermatologists share their tips for veterinarians managing skin conditions in general practice. They happen to be gathering in Australia in September at the CVE’s clinical dermatology conference in Port Douglas. If you want to find out more about evidence based dermatology and current controversies in the field, while scratching your itch to travel, find out more here.

Dr Mandy Burrows BSc BVMS MACVSc (Canine Medicine) FACVSc (Dermatology)


  1. Empathise: take time to work out your client and what they can and cannot understand and can and cannot do. Ask them to tell their story.
  2. Communication: the challenge and success as well as the rewards of chronic care management for most dermatologic conditions in dogs and cats is based in the successful communication of clear expectations to clients; this does not mean that expectations should be low, but there has to be an understanding that chronic skin diseases require both short and long-term planning for successful outcomes.  Share the plan in different ways; talk about it, draw it on the white board, write it down to take home and then have your staff call and talk it over a few days later. Make sure that you have an adequate follow-up system in place so that skin cases attend their scheduled revisit appointments.
  3. Topical therapy: in many instances, topical therapy for allergic and infected skin disease is of significant value but overlooked; in areas of regional pruritus such as ears and feet, the application of modern “soft” steroids and topical antibacterial products are a valuable tool for long term management of atopic dogs with minimal adverse effects; these products are very helpful in reducing reliance on systemic antimicrobial agents, glucocorticoids and other immunomodulatory drugs. Before you prescribe, stop and think! Could I reduce my reliance on systemic drugs for this patient by combining some topical therapy?


Dr Greg Burton BVSc (Hons) MACVSc (Small Animal Surgery) FACVSc (Dermatology)


  1. Elimination diets: Don’t forget gelatin capsules may contain beef and pork and many routine oral medications (even non-flavoured ones) can contain soy, wheat, rice, milk, pork proteins. Resolve infections prior to starting the food trial and maintain with topical treatments throughout the elimination diet. This includes flea control and heartworm prophylaxis medications.
  2. Allergic conjunctivitis is often overlooked in atopic dogs as pruritus is not always present. Allergic conjunctivitis can cause tear film abnormalities and progress to corneal (vision threatening) disease. Continuous maintenance therapies with antihistamine drops can be safe and effective. Systemic absorption from ocular steroid containing drops can be clinically significant in small breed dogs. 
  3. Denial is MRSP’s (Multiresistant Staphylococcus pseudintermedius – formerly known as MRSI) best friend. Consider MRSP in every dog with persistence of bacterial pyoderma in the face of compliant beta lactam antimicrobial therapy. Culture early, specifically ask the laboratory to look for MRSP and ensure post-consultation hygiene measures are adequate in-clinic (room and staff). F10 disinfection of the room and 70% alcohol on all washable surfaces (including computer keyboards) and effective hand washing before re-using the consulation room can limit spread of MRSP within the clinic.


Dr Rusty Muse DVM Diplomate ACVD MANZCVS


  1. Spend the time to take a complete history regarding the skin disease present.  The skin has limited reaction patterns so the history of a patient and its skin disease including how it started, how it has progressed, the areas affected and response to therapy will give you most of the information that you will need to know to proceed with accurate diagnostics and therapeutics.
  2. Pursue underlying primary diseases when secondary problems present.  Bacterial or Malassezia infections whether of the skin or the ear have a primary cause in most every case.  Develop a plan to pursue or manage the primary disease because if you don’t relapsing infections whether skin or ears will cause you to lose clients.
  3. There is no substitute for clear, concise and very detailed discharge instructions in managing skin disease.  Most clients will follow your instructions if they know what is expected of them. It is imperative in most cases of skin disease, that clients continue therapy until remission or control of the condition has been achieved and then a long term management plan can be instituted on follow up visits. 

Dr Wayne Rosenkrantz DVM Diplomate ACVD


  1. When dealing with the pruritic dog, keep in mind the four most common causes of pruritus (Atopic dermatitis, Flea allergy, Adverse food reactions and Scabies). Correlate the diseases by emphasis on history and physical lesion distribution.
  2. Eliminate simple things first when approaching chronic inflammatory skin disease. The most common component of pruritus in dogs with chronic inflammatory skin disease is microbial disease; therefore, this should be tested for first with cytology. In atopic dermatitis cases, secondary pyoderma is present in approximately 80% of the cases and Malassezia in 35%. It may be even more prevalent based on how aggressively one looks for secondary infections.
  3. Combined treatments (Multimodal) are more effective than monotherapy when handling chronic atopic dermatitis cases. By combining therapies you can often reduce the dosage and frequency of more potent drug therapies (glucocorticoids, ciclosporin, oclacitinib) and achieve similar results. Always attempt to utilize safer long-term options ie, allergen specific immunotherapy (ASIT), essential fatty acids and topical therapy when managing chronic atopic dermatitis.

Thank you Drs Burrows, Burton, Muse and Rosenkrantz for sharing those pearls of dermatology wisdom. If you want to meet them and review your approach to dermatology, view the program here

Wednesday, July 22, 2015

Vet's pets: Gillian Shippen introduces her toy-testing crew

These guys may look sleepy but keeping them entertained and enriched is busy work for Gillian Shippen.
Gillian Shippen is a Nursing Practice Manager for Dr Michael J Burke Vet Clinic in South Australia. She’s also the author of PetsNeed a Life Too, and founder the company with the same name – it’s all about enriching the lives of companion animals. (Here at SAT we’re very big fans of appropriate and safe environmental enrichment for animals).

I think it’s safe to say that Gillian takes her work home with her.

She shares her life with Normie (7.5 year old moggy), Diesel (10-12 year old Rottweiler cross) and Buster (a 7.5 year old Rottweiler). This crew are not only her companions, they’re also her product testers. When Gillian recommends a toy, she knows exactly how sturdy and entertaining it is.

How did you meet?

Normie came to us as a stray kitty – a friend of my stepson was working at a winery and found a litter of kittens. The owner of the winery suggested something unthinkable (drowning) so the friend brought the kittens to me. The kitten were only about 5 weeks old so as my stepson and his friends were all enamoured by the kittens I suggested they foster them until the kittens would be old enough to re-home.

Normie naps.
Stepson fell in love with Normie and begged to keep him (my sighing, knowing what the eventual outcome would be). Eventually stepson decided looking after a kitten wasn’t for him (and we had a return of another one) so they came to the clinic for re-homing, I immediately found a home for one but Normie was to stay at the clinic until I could find him a home. My partner said no, he’ll come home with us!

Diesel came from a shelter/rescue one year after I lost my first Rottie, Cole. Diesel was approximately 10 years old looking for a new home and his forlorn face looked at me from the photo reminding me of Cole.

Busta was also from a shelter/rescue group at 6 years old, a few months after we lost another one of our other dogs. He was the result of a marriage breakup.

Does anyone have any conditions that require treatment?

Busta is a strange dog and I have him on Prozac for anxiety as he is a very much over-the-top dog. I am hoping it is just to do with the re-homing and will see about weaning him off - I have already tried to wean him off (unsuccessfully) once but that would seem it was too soon. He also has unusual gastric issues which we manage.

Diesel is on anti-inflammatories for arthritis.

The dog we lost just before we got Busta had his front leg amputated due to an osteosarcarcoma. He survived 8 months before he got another one on his hind leg.

The wheelchair didn't impede this dog's enjoyment of life.
How would you describe household dynamic?

The cat is the boss of the household (after me!) with his 7.5kg frame (not fat just BIG) keeping the two Rottweilers and anyone else in the household in line. The two Rottens are good friends and play well together.

What do you do to spend time together?

Busta often goes to work with my husband, leaving Diesel and Normie behind to enjoy the creature comforts of home. The animals are all allowed on the furniture to snuggle with us.

A slightly out-of-focus snap of Gillian hanging with her two rotties, just to prove that they are allowed to snuggle on the furniture.
The dogs are taken for a walk daily and if there is something we are doing that they can attend with us, we take them. Diesel just helped me with a display stand for an Open Day at a Doggie Day Care Centre recently.

Has caring for this group taught you anything you didn’t already know about their condition or animals with this condition?

I started my Pets Need A Life Too! because I decided to bring a Rottweiler into my life at a time they were getting a bad reputation in the press. I wanted to prove that Rottweilers are a great breed of dog given the right environment.

Cole was a great ambassador (and my heart dog) he taught me about fairness and being with an awesome dog. [Cole passed away in 2012].

Then we got Chevy, he was a lovely dog but had so many issues, Chevy taught us how to manage a dog with “issues”. Diesel is just a lovely sweet old man who just gets on with everyone and Busta is a sweet handful. They all have taught me something (even Normie the cat) in their own way.

How have they changed your approach to patients?

I don’t know if they have, or if it is my obsession with learning more about how to approach patients…maybe it is because of them I have the obsession?

Any parting words of wisdom?

Treat animals with patience and kindness – they will always respond in kind. Animals need to trust and we need to earn that trust, we cannot force it on them

I often feel the problems we feel with have with animals are purely because of our own lack of understanding of the animal’s feelings. We want things to happen on our terms, we need to slow down, take our time and be patient in our dealings – things need to happen in the animal’s time.

Given the above, I think everyone might be wondering what toys you like to enrich the lives of your crew?

I particularly like the AussieDog range for Rottweilers – very hard wearing range of toys, for both just playing, as well as their food dispensing range.

Food dispensing toys:
Starmark BobALot,
Busy Buddy Magic Mushroom, Tug A Jug and Kibble Nibble,
Buster Food Cube is a an old favourite;
The Foobler is a nice new one on the market but does need careful training;
Aussie Dog tucker ball and Home Alone;
Ultra Kong is awesome too.
(all of these are good hard wearing toys)

Softies:
Hard Boiled Softie (a little difficult to get at the moment);
Kyjen Iqube, Hide A Squirrel, Hide A Bee, Hide A Bird, and the Kyjen Egg Babies range;
(Because what dog doesn’t like to unstuff things?)

Play:
Aussie Dog Enduroball (or the Staffy ball for the real hard workers), Turbo Chook, Bungy Chook and well pretty much all of their range – including some of the domestic hoof stock range, works well with the bigger dogs!
(just because they are so darn well made!...even better they are an Australian company)

I really do believe it is all in the way people introduce toys to their pets and what kind of toy they choose too (a ball is no fun unless someone is there to throw it).

We need to understand that some pets need to be taught how to play and or play a new game (just like humans do), they need to be supervised at least initially to ensure they understand the “rules” of the game (i.e. no destroying) and then at the end of the day people need to recognise toys are meant to be played with and ultimately be wrecked.

It is up to us as to how long the toys last by the way we teach our furred friends. And we also have to recognise that even within breeds every dog is an individual and what works for one may not work for another.

Thanks Gillian for sharing. You can follow Pets Need a Life Too on Facebook
Vet's Pets is a new series we're running weekly about the animals sharing their lives with veterinarians, nurses and technicians and veterinary students. To find out more click here.

Monday, July 20, 2015

Why dogs should avoid the hor d'oeuvres: the tale of a migrating toothpick

Devils on horseback
These, I am told, are "devils on horseback". A plate like this, left unattended, can easily turn into "devils inside a dog".
Reading a decent case report is like reading a great detective story, with the added bonus of learning something you might use in practice.

In this month’s issue of the Australian Veterinary Practitioner there is a case report, modestly entitled “Toothpick as a perforating splenic foreign body in a dog: ultrasonography diagnosis and surgical treatment”. Some of you might have tuned out half way through the title, but this little tale contains some very important lessons for dogs and those who live with them – as well as their vets.

Let me paint the picture for you. A five-year-old, 8.5kg male dachshund, kept indoors with another dachsy, is a much loved companion. The owner dotes on the dogs and I would imagine these dogs are the kind who are ever-present when one is preparing meals or hor d’oeuvres for special occasions.

But this poor dog develops diarrhoea, which continues for about two months. There is occasional vomiting and abdominal pain. It’s one of those cases where they have good days and bad days, the signs are occasionally subtle, sometimes more dramatic, but nothing to write home about.

The regular vet, concerned there might be something more sinister going on (perhaps pancreatitis) refers the dog for an abdominal ultrasound. The dog has peritonitis – an inflamed abdomen containing free fluid, which was sampled and contained bacteria and inflammatory cells. Ultrasound is very good for detecting fluid, but when there is a lot of fluid it can mask some things that would otherwise be visible.

No diagnostic test is 100 per cent perfect, none guarantees a definitive diagnosis and far too often in a veterinary context we’re reluctant to repeat a test, instead moving up the diagnostic ladder. Fortunately, after some fluid was drained, the ultrasound was repeated. The culprit, previously hidden by a volume of fluid, was immediately visible: a toothpick sitting in the spleen.

How does a toothpick get into a spleen? One of two ways. One either falls on that toothpick with such force that it is rammed through the skin and lodges into the organ, although you’d imagine there would be an obvious wound or tract. OR one swallows the offending toothpick which, with its pointy tips, simply perforates the stomach and goes a-wandering around the abdomen until it lodges somewhere else.

Pointy foreign bodies can migrate, I found this kebab tip in a skin abscess in a dog that had nibbled on a kebab several months prior. 
Once the toothpick was sited, the owner vaguely recalled a possible window during which the dog might have ingested the toothpick – around two months ago. That explains the chronic signs.

Foreign bodies – particularly those that don’t obstruct the gastrointestinal tract – can be very tricky to diagnose. They can cause intermittent, waxing and waning clinical signs. Bloodwork may be unremarkable. Wood and plant material, including toothpicks, don’t show up very well on radiographs.

There are several morals to the story.
  1. Be very wary when using toothpicks or those sharp wooden kebab skewers anywhere in the vicinity of a canine (and remember that dogs don’t mind going through the trash after you have a party, and toothpicks are the sort of thing that perforate garbage bags so are easily sited and removed by dogs).
  2. If you detect evidence of inflammation in the thorax or abdomen, consider a migrating foreign body as a possibility.
  3. Ultrasound is an important diagnostic step for identifying the cause of abdominal pain, but it might have to be repeated.

Fortunately for this patient the diagnosis was the tricky bit. Once that was achieved the surgery was (relatively speaking) a piece of cake. The toothpick was easily located and very gently extracted from the spleen by simply pulling it out. There was no major haemorrhage and certainly no need to remove the spleen. The abdomen was lavaged (washed with sterile saline) and he made a complete recovery.

Reference


Silva DM, Pavelski M, Govoni VM, de Oliveira ST and Froes TR (2015) Toothpick as a perforating splenic foreign body in a dog: ultrasonography diagnosis and surgical treatment. Australian Veterinary Practitioner 45(2):91-93.

Saturday, July 18, 2015

Date with your cat: feline case reports, animal welfare strategy and why we don't approve of the Twinkletush

Hero. His middle name should be trouble!
If you’re stuck for something to do this weekend, it’s not a bad one for hanging at home with your feline friends. Heaven knows mine seem to be craving attention. Last night I came home from work and a certain three-legged beast greeted me. Nothing unusual about that. Except he had pole-vaulted onto the roof to do it. Not a place one wants to find one’s three-legged cat. Thence followed much cajoling, rattling of tins, jiggling of bags of cat food and crying out his name into the dark until he’d had enough fun and decided he would accept a lift down.

If you’re a vet with an interest in companion animals and feline patients, you might want to consider submitting a case report to the new Journal of Feline Medicine and SurgeryOpen Reports. As with the Journal ofFeline Medicine and Surgery this is a journal of the International Societyfor Feline Medicine and the American Association of Feline Practitioners.

It’s aimed not only at academic high-flying types, but also practitioners who want to share their cases, case series and short communications about regional prevalence of certain conditions. Check it out here. http://jor.sagepub.com/

The Australian Veterinary Association is conducting a survey of veterinarians in relation to animal welfare and animal advocacy, specifically in regards to whether there should be a 2016 AVA Animal Welfare strategic program and whether the AVA should be promoting the use of analgesia in livestock. To have your say complete the survey here.

One new product had us hurling cushions at the computer this week and that is the so-called Twinkletush, promoted as “bling” for those who don’t like the sight of their cat’s bum (easy solution: avert your gaze).

The manufacturers intend this as a joke but my concern about a product like this is that – despite warnings on the website – cats will be left with these things on for prolonged periods, or unattended.
It doesn’t take a PhD in microbiology to appreciate that this object is the ultimate fomite – i.e. it is likely to become contaminated very quickly. It’s also likely to upset cats. 

We wince about giving such products air time but we also understand that some people might think it’s a harmless bit of entertainment. It isn’t. It could easily cause injury to a cat, either at the tail end or via ingestion of the bling or the linear object that attaches it (think linear foreign body). We don't recommend it.

Friday, July 17, 2015

Vet's pets

We want you!
Tell us about your best friend...
Are you a veterinarian, technician or nurse? Do you cohabit with critters of the non-human variety? Smallanimaltalk.com wants to hear your story!

There’s often an assumption that there is a divide between pet owners and those who treat their animals– but what if they’re the same thing?

There’s the old adage that plumbers have leaky taps, sparkies have bad wiring and vets have neglected pets – but is that really the case?

Is there a difference between the way that non-veterinary types bond with animals versus the way veterinary types do?

Has a non-human companion taught you something valuable about being a veterinarian, or a human being in general?

SAT is seeking to profile veterinarians (including those working outside of practice), technicians, nurses and others about the animals they live with.

What do we want from you?

  1. A few photos (high res! Please no 5KB tiny, tiny phone photos that pixelate if enlarged beyond 2cm: go for 300dpi, usually over 1MB and less than 10MB shots) – preferably of your companion/s, even better if you are with them!
  2. A few answers to some easy-peasy questions.

What’s in it for you?

  • World fame on smallanimaltalk.com
  • The chance to show off your best friend.



If you can do this, drop me an email and I’ll send you the questions. Simple as that! anne [at] smallanimaltalk.com - I'll keep it open til October 31 2015, unless there's an overwhelming response in which case...bring it on.