There are a ton of options out there when it comes to dog food, and not all of them are created equal. This week, Dr. Andy shares 5 things you can’t afford to get wrong when it comes to feeding your pooch.
By: Tasha McNerney BS, CVT
Recently I had the privilege of running the anesthesia on my friend/coworker’s dog, Maggie, undergoing surgery to repair an ACL tear. The anesthesia itself was uneventful and – dare I say it? – even boring.
(Side note 1: It’s a good thing when the anesthetic event is boring; that means no complications to get your heart racing!)
(Side note 2: I’m allowed to say it was boring after the fact, and if you were in that room for 5 hours staring at that perfect ECG, you might say the same thing too)
The epidural even went in so beautifully I joked about taking pictures for a textbook I’m putting together. Everything about this case was textbook: from the induction, epidural, intra-op monitoring parameters to the smooth recovery from anesthesia. I figured everything was going to go smoothly in this case, including the recovery period, so we set Maggie up for the usual post op analgesic regime that every ACL repair gets (fentanyl patch and tramadol tablets). I thought I wouldn’t hear much from Maggie and her owner.
And that’s when Maggie reminded us that not every patient reads the pain management handbook and some people’s (or dog’s, in this case) pain tolerance is different than others.
[tweetthis]Maggie reminded us not every patient reads the pain management handbook -[/tweetthis]
Maggie’s owner called me 48 hours after her procedure and said that Maggie seemed to be in a lot of pain, not wanting to get up from sitting, and toe touching on the rear leg. I knew the fentanyl patch had been in place for about 72 hours at that point, so it should have still been in her system. Also, she was on tramadol, so that seems to be a pretty good combination, right? Unfortunately, while we were effectively using an opioid analgesic (the fentanyl, which is related to morphine), there were other ways the body experiences pain (pain pathways) that were NOT being treated in Maggie, and we had to re-evaluate our usual plan.
Taking the Power Ranger Approach to Pain and Healing
We had Maggie come back over to the clinic to start low level laser therapy every other day. Low-level laser therapy is an alternative method of treatment where the injured body part is exposed to lasers of low intensity, which stimulate the cells and tissues and quicken the healing process.
The increased blood circulation to the area also quickens the healing process. We also put Maggie back on her previous doses of carprofen (a non-steroidal anti-inflammatory or “NSAID”) to help with the inflammation. I asked Maggie’s owner how she felt about the tramadol and fentanyl combination and she replied that Maggie had used tramadol in the past for stiffness and it had appeared to be ineffective. So, we took the tramadol away and added in a medication called gabapentin.
The beauty of gabapentin is that it works on the neuropathic aspect of pain (i.e. “nerve pain”). It also works beautifully together with NSAIDs. Gabapentin helps to control nerve pain, thus helping to prevent the “wind-up phenomenon” that can lead to chronic maladaptive pain. Often patients develop chronic pain conditions as a result of ineffective pain management therapy in the post op period.
So, we took Maggie’s previous pain management plan, which was only covering one or two of the ways she might be experiencing pain and expanded her analgesic plan to cover three different pain pathways.
I like to think of the analgesic plan and the therapies as Power Rangers. One Power Ranger battling one pain pathway is usually not enough to control the pain monster, however multiple Power Rangers can work together and combine their powers (pathways) to totally defeat that pain monster.
[tweetthis]Taking the Power Ranger Approach to Pain and Healing -[/tweetthis]
Maggie’s owner called me the next day (only 24 hours later) to say she was noticing a huge improvement. She was now trying to keep Maggie from jumping up on the bed and zooming around the house when the mailman visited. Just tweaking her pain management protocol resulted in a dramatic difference in the quality of her recovery.
Often as with many other facets of veterinary medicine, we find ourselves relying on a “cookbook” approach to post-operative pain management. We get so used to every patient doing “just fine” with carprofen and tramadol that we often don’t look to see what works best for each patient as an individual. So, take the time to follow up with your patients. If that pain management plan isn’t defeating the pain monster, re-assess and start a new plan. Your patients will bounce back faster and your clients will know you truly care about the health and comfort of your pet.
And, if you are a pet owner: trust your instinct. If your pet seems unusually uncomfortable, talk to your veterinarian. Together you can come up with a pain management plan that gets your best friend back in action sooner.
[tweetthis]If you are a pet owner: trust your instinct #painmanagement[/tweetthis]
**Hopkins, J. T., McLoda, T. A., Seegmiller, J. G., & David Baxter, G. (2004). Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study. Journal of Athletic Training, 39(3), 223–229.
· If you would like to find a pet pain specialist in your area, or learn more about preventing animal pain, check out the International Veterinary Academy of Pain Management at www.ivapm.org
· If you want to hear and see more from Tasha McNerney BS, CVT check out her video series on veterinary technician career development for Firstline magazine called “Coffee on the Couch”. Each episode Tasha interviews technicians in different career fields and explores the secrets of their success. Check out the first episode here: http://veterinaryteam.dvm360.com/coffee-couch-conversation-with-veterinary-technician-mary-berg
About Tasha McNerney BS, CVT
Tasha McNerney attended Michigan State University and obtained a bachelor’s of science in 2002 majoring in wildlife biology. After graduation she worked in the field of wildlife rehabilitation in the Florida Keys working with shore birds specifically.
In 2003 Tasha moved to the Philadelphia area and began her veterinary technician training at Manor College in Jenkintown, PA.
Tasha has worked at Rau Animal Hospital in Glenside, PA for ten years as an O.R. / Anesthesia technician. Her areas of interest include sighthound and brachycephalic anesthesia as well as pain management. Tasha has been a featured speaker on various anesthesia and pain management topics at conferences such Atlantic Coast Veterinary Conference, Wild West Veterinary Conference and the American Veterinary Medical Association. Tasha has authored several articles for the NAVTA journal, Firstline magazine, and “Fetch” a blog dedicated to pet parents. Tasha was also a contributing author for the new “Pain Management for Veterinary Technicians” textbook. Tasha is currently working on obtaining her CVPP and VTS (Anesthesia)
In 2013 Tasha created the Facebook group Veterinary Anesthesia Nerds, which has over 4,000 members participating in education and exchange of ideas in all aspects of veterinary anesthesia and pain management.
Since pets can’t just speak up and tell us when they’re experiencing pain, we have to keep a lookout for clues. This week, Dr. Andy shares 8 subtle signs that your fur baby may be struggling.
In the winter of 2010, I was living in Leesburg, Va., with my wife and our 2-year-old daughter. When a snowstorm blanketed the area, my wife and I decided it was time for our daughter’s first snow experience.
First time parents that we were, we bundled her up like a little Michelin man, wrapped in layer upon layer of padded clothing to ensure absolutely no harm – or cold – would come to her. Did our efforts keep her warm? Oh, yes. Did they keep her safe? Well, not exactly. When she fell down, as toddlers eventually do when set free outdoors, she rolled around helplessly in the snow. She was so heavily insulated that she couldn’t use her arms or legs to get up. Whoops. We had acted very deliberately to do what we thought was best and had created an entirely new problem.
Still, aside from her face, I’m certain she was never cold.
Last year, in a much-discussed New York Times article titled “Let’s (Not) Get Physicals,” a physician reporter named Elisabeth Rosenthal argued that annual physical examinations for human patients are pointless. She cited a Canadian government task force recommendation to abandon annual physical examinations because they are “nonspecific,” “inefficient” and “potentially harmful” (in that they may lead to unnecessary tests). The task force said examinations should be replaced with intermittent screening tests for age- and risk-specific conditions (mammograms, Pap tests, etc.). Dr. Rosenthal argued that this logic is sound in the United States as well.
Scrutiny of annual physical examinations for people does not come as a surprise. Health care costs are soaring, and research consistently shows annual physicals don’t save lives. Most treatment is started because a patient feels sick and comes to the doctor — not because of findings in a routine examination.
So, do these human-side rumblings mean that we should re-evaluate the annual or biannual examinations that veterinarians recommend for pets? Are those trips to the vet with seemingly happy, healthy pets really worth the stress and effort for all involved? I’ve asked myself those questions repeatedly. Here are the key points I always return to.
[tweetthis]Are annual exams necessary? [/tweetthis]
Originally Published: Vetstreet.com – April 25, 2013 [Republished on Yahoo.com]
Mrs. Griffith sighed as she gently separated her youngest daughter and oldest Labrador Retriever. She stepped between them and over a discarded pacifier to look me directly in the eye. “Really?” she asked. “Do you brush your dog’s teeth every day?”
It was a moment of truth. She didn’t ask me what I recommend. She asked me what I do.
The best thing for her dog’s dental health is a daily tooth brushing with pet-safe enzymatic toothpaste. Unfortunately, the problem with my being a real person — one with a working spouse, young children, two jobs and a few hobbies — is that what I know to be “the best thing” and what I actually do at home are occasionally not the same. Mrs. Griffith had a lot on her plate at home, too, and when she asked me for honesty, my credibility was on the line. I wasn’t going to lie to her, and I’m not going to lie to you either.
I know exactly how dental disease affects pets. I know that the dental tartar you see slowly building up on your pet’s teeth is about 80 percent bacteria and that it damages the gums, the bone beneath and the ligaments that hold teeth in place. This bacteria can gain access to the blood stream and infect vital organs like the heart, lungs and kidneys. I also know that advanced dental disease hurts; it makes pets feel sick. Daily brushing is the best deterrent.
But like 95 percent of pet owners, I don’t regularly brush my dog’s teeth, even though I know it’s the best thing for his health. Still, that doesn’t mean dental health isn’t on my mind. Here’s what I do instead:
Originally Published by Vetstreet.com.