Computer use and applications in veterinary medicine.

An 8-year-old neutered male cat with a history of intermittent collapse and dyspnea was evaluated. Hypertrophic cardiomyopathy was diagnosed on the basis of findings from physical examination, radiography, and echocardiography. Cardiac arrhythmias were not recorded during routine electrocardiography. Continuous ambulatory electrocardiography documented severe ventricular arrhythmias (ventricular premature complexes, ventricular bigeminy, and paroxysmal ventricular tachycardia). Continuous ambulatory electrocardiography can detect intermittent and potentially life-threatening cardiac arrhythmias.     

Flow cytometry and its applications in veterinary medicine

Flow cytometry is a technique for analysing and separating populations of cells (and subcellular components). The cells are generally stained with fluorescent markers (eg, fluorescent antibodies or DNA-binding dyes). Each cell is analysed individually, at high speed. Thus, assays may be performed on small samples (less than 10,000 cells). A subpopulation of interest can be separated from the remainder of the cells to a high degree of purity (up to 99 per cent). The application of flow cytometry to veterinary science is increasing and is discussed here.     

Trauma: physiology, pathophysiology, and clinical implications

Objective: To review the physiology, pathophysiology, and consequences of trauma. The therapeutic implications of hypovolemia, hypotension, hypothermia, tissue blood flow, oxygen delivery, and pain will be discussed. Data Sources: Human and veterinary clinical and research studies. Human and veterinary data synthesis: Trauma is defined as tissue injury that occurs more or less suddenly as a result of violence or accident and is responsible for initiating hyothalamic–pituitary–adrenal axis, immunologic and metabolic responses that are designed to restore homeostasis. Tissue injury, hemorrhage, pain, and fear are key components of any traumatic event. Trauma and blood loss result in centrally integrated autonomic‐mediated cardiovascular responses that are designed to increase heart rate, systemic vascular resistance, and maintain arterial blood pressure (ABP) to vital organs at the expense of blood flow to the gut and skeletal muscle. Severe trauma elicits exuberant physiologic, immunologic, and metabolic changes predisposing the animal to organ malfunction, a systemic inflammatory response, infection, and multiple organ dysfunctions. The combination of both central and local influences produces regional redistribution of blood flow among and within tissue beds which, when combined with impaired vascular reactivity, leads to maldistribution of blood flow to tissues predisposing to tissue hypoperfusion and impaired oxygen delivery and extraction. Gut blood flow and viability may serve as a sentinel of patient survival. These consequences are magnified in animals suffering from pain or that become hypothermic. Successful treatment of traumatized animals goes beyond the restoration of blood pressure and urine output, is dependent on a fundamental understanding of the pathophysiologic processes responsible for the animals current physical status, and incorporates the reduction of pain, stress, and the systemic inflammatory response and methods that restore microcirculatory blood flow and tissue oxygenation. Conclusions: Severe trauma is a multifaceted event and is exacerbated by hypothermia, pain, and stress. Therapeutic approaches must go beyond the simple restoration of vascular volume and ABP by maintaining tissue blood flow, restoring tissue oxygenation, and preventing systemic inflammation.     

A review of neuroendoscopy and potential applications in veterinary medicine

The endoscope was first developed over 200 yr ago. Endoscopy has since been applied to many disciplines of medicine. Its application to the nervous system was initially slow and not widely accepted and mainly involved the biopsy of tumors and the treatment of hydrocephalus. Several reasons for neuroendoscopy's limited use include inadequate endoscope technology, high skill level required, the advent of the surgical microscope, and the development of other treatments such as ventricular shunting. Over the past 50 yr, improvements in optical glass lenses, fiber optics, and electrical circuitry has led to better equipment and a revival of neuroendoscopy. Neuroendoscopy is now used in many diseases in human medicine including hydrocephalus, neoplasia, and intracranial cysts. This review presents the history of neuroendoscopy, the equipment and technology used, and the possible translation of techniques currently used in human medicine to veterinary medicine.     

Thrombin physiology and pathophysiology

Objectives – To review the role of thrombin in physiology and clinical disease and to discuss the pharmacology of antithrombosis.
Data Sources – Original research articles, scientific reviews, textbooks.
Human Data Synthesis – Thrombin and thrombin receptors are involved in a variety of physiologic and pathologic processes resulting in a great deal of interest in thrombin-related pharmacologic intervention.
Veterinary Data Synthesis – Although there is little clinical research data available on thrombin specifically in veterinary patients, some of the original research on protease activated receptors was performed at veterinary institutions and many of the human molecular biology studies have been done on animals including dogs.
Conclusion – Thrombin plays a significant role in coagulation, anticoagulation, and fibrinolysis. Antithrombotic treatment is focused on preventing thrombosis while maintaining hemostasis. Pharmaceutical agents are selected for the specific component of the coagulation pathway associated with a specific disease process, for a proven prophylactic benefit with procedures that carry a risk of thromboembolism, for rapidity of onset and ease of reversibility, for limited monitoring requirements, and for oral formulation and bioavailablity. Recent insight into other aspects of thrombin physiology presents an opportunity for pharmacologic intervention in a variety of other processes such as inflammation and sepsis, peripheral blood cell activation and chemotaxis, vascular endothelial and smooth muscle activity, cellular development and tissue repair, mitogenesis, neoplasia, and the function of nervous tissue following injury.     

Lactate in veterinary critical care: pathophysiology and management

The measurement of blood lactate in people has proven to be a useful tool in the diagnosis, monitoring, and prognosis of a wide range of clinical syndromes. Its use in small animals is increasing, and several studies have been completed that demonstrate its potential role in critical care. This article summarizes the current state of knowledge regarding the physiology and pathophysiology of lactate production and lactic acidosis; current indications and the utility of measurement in a critical care setting are described; novel applications in the evaluation of cavitary effusions are highlighted; and a guide to the therapy of lactic acidosis is presented.     

Intensity-modulated radiation therapy and helical tomotherapy: its origin, benefits, and potential applications in veterinary medicine.

Intensity-modulated radiation therapy (IMRT), especially image-guided IMRT as represented by helical tomotherapy, is a novel approach to therapy and is rapidly evolving. Both of these forms of therapy aim to allow targeted radiation delivery to the tumor volume while minimizing dose to the surrounding normal tissues. Adaptive radiation therapy and conformal avoidance are possible with intensity-modulated therapy and helical tomotherapy, which offer opportunities for improved local tumor control, decreased normal tissue toxicity, and improved survival and quality of life. Human and veterinary patients are likely to benefit from the continued development of this radiation delivery technique, and data over the next several years should be crucial in determining its true benefit.     

Use of biochemical markers of bone metabolism in veterinary medicine

Effective, non-invasive bone assessment methods for screening, diagnosis and follow-up of the skeleton are more and more requested in veterinary medicine. In contrast to clinical parameters, invasive methods and imaging techniques, indices of bone turnover is a tool for bone metabolism evaluation of the whole skeleton. Biochemical bone markers therefore provide a more real-time assessment of the bone status with simple blood- or urine-analysis. This article surveys currently available biochemical marker of bone metabolism used in veterinary medicine. Additionally, information is provided about physiological and pathological, as well as therapeutic variations of biochemical bone marker concentrations in various species.     

An update on cardiovascular adrenergic receptor physiology and potential pharmacological applications in veterinary critical care

Objective: To review the recent human and veterinary literature on current adrenergic receptor physiology/pathophysiology and potential applications in veterinary critical care. Data sources: Human and veterinary clinical studies, reviews, texts, and recent research in receptor molecular biology. Human data synthesis: Recent development of molecular cloning and other biological research techniques has advanced the field of adrenergic physiology. The past decade of research has made available new knowledge of adrenergic receptor subtypes as well as their locations and functions. Many of the diagnostic compounds used in biochemical research to distinguish between α‐ and β‐receptor subtypes may emerge as important additions to the arsenal of cardiovascular pharmaceuticals. Veterinary data synthesis: Veterinary adrenoceptor research is typically directed at investigating the effects of commercially available medications. Such studies demonstrate important species differences in addition to potential side effects and new indications for therapy. Many of the human molecular biology studies are performed on animal species, which can have direct application to veterinary medicine. Conclusions: Proper cardiovascular responses are essential to maintaining tissue perfusion and cellular homeostasis. α‐ and β‐adrenergic receptors play a vital role not only in the pathophysiology but also in the therapy of diseases involving the cardiovascular system. For adrenergic pharmacotherapy to be successfully used, a thorough understanding of the mechanisms underlying adrenoceptor physiology is necessary. Recent research has illuminated various subsets within the α‐ and β‐receptor classifications. Awareness of currently available and emerging adrenoceptor subtype‐specific treatment options allows precise pharmacologic targeting of disease processes in critical illness.     

Evidence-based veterinary medicine: evolution, revolution, or repackaging of veterinary practice?

Over time, evidence-based veterinary medicine (EBVM) should integrate with normal clinical practice. Also, clinical knowledge increases with EBVM, reducing the need for information in one area and allowing veterinarians to explore new areas of specialty or cutting-edge advances in the profession. Textbooks, journals, veterinary conferences, and web sites provide nearly unlimited information about EBVM for the practicing veterinarian to help with the transition to EBVM use in daily practice life. EBVM should continue to change and improve how we, as veterinarians, provide the best available care to our clients and patients.     

Food-supply veterinary medicine and veterinary medical education: an Australian perspective

Food-supply veterinary medicine has been an essential part of veterinary degree programs in Australia since the first veterinary school opened in the late nineteenth century. Australian veterinary schools, like others internationally, are being challenged by the relevance of material in current curricula for modern food-supply veterinary medicine. Additionally, student aspirations are a major issue, as curriculum designers balance companion-animal training with the herd/flock-based issues that focus on productivity and profitability. One of the challenges is to examine the relative balance of education in generic skills (self-knowledge, change management, teamwork, leadership, negotiation) with more technically or scientifically based education. An ongoing process of curriculum review and renewal, which involves input from both external and internal stakeholders and allows regular review and assessment, is needed to ensure continuing curriculum relevance.     

Maggot-therapy in veterinary medicine

Maggot-therapy is the application of disinfected fly larvae to chronic wounds to debride the wound bed of necrotic tissue, reduce bacterial contamination and enhance the formation of healthy granulation tissue. Interest in the use of maggot-therapy in human medicine is growing as a result of the prevalence of antibiotic resistant bacteria. Maggot therapy, however, is used relatively little in veterinary medicine. Nevertheless, concern over antibiotic resistance and the increase in demand for organic husbandry and residue-free meat and milk, suggest that it is an option which merits further consideration.