Select modalities

Physical rehabilitation modalities such as therapeutic ultrasound (TU), transcutaneous electrical neuromuscular stimulation (TENS), neuromuscular electrical stimulation (NMES), cold or low-level laser therapy (LLLT), and pulsed magnetic field therapy (PMF) can all, when used properly, assist in treating orthopedic injuries, neurological conditions, and chronic conditions brought about by normal aging in our small animal companions. TU uses sound waves to produce both thermal and nonthermal effects that aid in tissue healing, repair, and function. TENS uses different frequencies of electrical current to decrease pain and inflammation. NMES also uses an electrical current to stimulate muscle contraction to assist in normal neuromuscular function in postorthopedic and neurological injuries. LLLT uses light energy to reduce pain, decrease inflammation, and stimulate healing at a cellular level. PMF uses magnetic field to stimulate normal cellular ion exchange and oxygen utilization and promote generalized healing of tissues. These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol.     

Analgesia of small mammals.

Small mammals receive analgesics much less frequently than more familiar species such as dogs and cats. This is probably related to the greater difficulty of recognizing pain in these species, and the uncertainty as to the most appropriate analgesic regimen to implement when the presence of pain is suspected. However, the same principles of pain assessment and analgesic use that are applied when dealing with other companion animals can be used to manage pain effectively in small mammals. All of the commonly used analgesic agents can be used safely and effectively in small mammals, although the size of many of these animals limits the use of techniques such as epidural administration or transdermal drug delivery systems. As with other species, it is important to integrate an analgesic regimen with the overall scheme of perioperative care, and to try to implement preemptive and multi-modal analgesic therapy.     

Pain mechanisms and their implication for the management of pain in farm and companion animals

Over the last two decades there has been a dramatic increase in the literature relating to the mechanisms and management of pain in domestic animals. Understanding the mechanisms of pain is crucial for its effective management. This review highlights the current understanding of the neurophysiology of nociception and the plastic changes involved in chronic pain states. Additionally, we describe a range of novel molecules and pathways that offer opportunities for the development of mechanism-based analgesic therapies. Pain management in animals is limited by pain assessment which remains highly subjective, with clinicians relying on indirect measures of pain, using rating scales and (less frequently) quantifiable physiological and behavioural parameters. The need for a systematic approach which would assess different pain components is well justified. Species-specific issues on pain assessment and management in mammalian companion and farm animals are addressed in the later part of this review.     

Local and regional anesthesia.

Local anesthetics have the unique ability to produce complete blockade of sensory nerve fibers and prevent or pre-empt the development of secondary (central) sensitization to pain. For this reason, local and regional anesthetic techniques are often used with opioids, alpha 2-receptor agonists, dissociatives, and anti-inflammatory drugs as part of a multimodal strategy to manage pain. Lidocaine and bupivacaine are the local anesthetics used most commonly in dogs and cats. Lidocaine has a fast onset (10-15 min) and an intermediate duration of action (60-120 min), and is used for short diagnostic and surgical procedures. Bupivacaine has a slow onset (20-30 min) and a long duration of action (240-360 min), and is used to control pain both preoperatively and postoperatively. Local anesthetics are relatively safe if they are administered correctly. Administration of an excessive dose and accidental intravenous administration are probably the most common causes of systemic toxicity in small animals. Doses of local anesthetics, especially those for cats and small dogs, should always be calculated carefully. In many animals, the most simple and elegant way to control pain perioperatively is to perform a local or regional anesthetic block. Veterinarians should not hesitate to incorporate local and regional anesthetic techniques into their pain management strategies for dogs and cats.     

Hospice in a zoologic medicine setting

Forty years ago, Dr. Elizabeth Kubler-Ross in her landmark book On death and dying observed "maybe at the end of our days, when we have worked and given, enjoyed ourselves and suffered, we are going back to the stage that we started out with and the circle of life is closed." Just as human life expectancy has steadily increased over the last 4 or 5 decades, animal life expectancy has increased, including that of zoologic species. With this has come a need for humans to openly and frankly deal with end-of-life issues for themselves and for their animals, including those in zoos. By necessity, zoos have been dealing with problems such as aggressive pain management and triage, and efforts to incorporate end-of-life care into zoologic medicine. But these efforts have yet to include formal acknowledgment that they are a basic form of hospice. Hospice for humans, and now for companion animals, includes much more than pain relief and geriatric care. This article reviews the concepts and basic practices of hospice and the closely related field of palliative care, their relatively recent application to companion animal care, potential applications to zoologic medicine, and the ways this could provide opportunities for personal growth of zoo visitors and staff, including veterinary staff.     

Vitamin D and Ultraviolet B Radiation Considerations for Exotic Pets

Vitamin D is an essential hormone that regulates many different functions in vertebrates and can have a protective effect against various disease conditions. Providing exotic pets appropriate access to vitamin D, through the diet, ultraviolet B (UVB) exposure, or a combination of both, is important for veterinarians and exotic pet owners to consider. Although it is commonly thought that most animals derive the vitamin D they need through their diet, there are a number of species that appear to benefit more from UVB exposure. In addition, there has been minimal study to investigate appropriate dietary levels of vitamin D for many of our exotic pets. Although the recommendation of providing UVB lighting has been primarily limited to captive reptiles, research with other species (e.g., birds and small mammals) suggests that these animals may also benefit from this type of lighting. However, the provision of UVB is not without its potential side effects. The purpose of this article is to review the important roles of vitamin D in animals, the different methods animals use to acquire this hormone, the potential clinical signs associated with hypovitaminosis or hypervitaminosis D, the role of artificial UVB lighting in the synthesis of vitamin D, and the potential side effects associated with UVB radiation.     

Sertl shelf arthroplasty (BOP procedure) in the treatment of canine hip dysplasia.

The BOP/Sertl shelf arthroplasty procedure is not difficult or lengthy. It uses minimal metallic fixation. It is quite physiological with minimal morbidity because there is no change in the bony anatomic pelvis except to create an extension of the lateral rim of the acetabulum. The animal is able to walk the day after surgery. The procedure can be performed bilaterally the same day, thus creating good bony stability and decreasing stretching of the joint capsule, which in turn prevents further subluxation and pain in the hip joint. The aim of this procedure is to return the animal to a satisfactory lifestyle through an effective but less complicated surgical procedure as compared to other available options. This procedure is straightforward and can be done by a surgeon who is familiar with orthopedic surgical techniques and has been trained in this procedure. To date, more than 150 veterinarians have had hands-on training to perform this operation. We are not claiming that this procedure is a cure for CHD; rather, it is a procedure that dramatically slows down the progress of this malady and allows the dog to lead a more normal lifestyle and avoids euthanasia. After 51 months, our study of 200 hips has had a success rate of 99% on the animals available for follow-up as evidenced by returning those animals to a satisfactory lifestyle with stable hips.     

Neurophysiological techniques to assess pain in animals

Neurophysiological techniques are widely applied to animals, both in the search as a monitor for adequacy of anaesthesia, and studies to assess the efficacy of analgesic agents. Laboratory animals have been extensively used in models to investigate pain in man. However a substantial number of studies have also used neurophysiological techniques to increase knowledge of pain in specific animal species, with the aim of improving animal welfare. This review provides an overview of neurophysiological techniques involving the brain that have been used in the assessment of pain in animals. An explanation of the methodology of EEG recording, with particular emphasis on veterinary studies, is given. Neurophysiological models developed to assess pain in different species are described, and their relevance to advancements in animal welfare or best clinical practice indicated.     

Liposarcoma in the nasal cavity of a cow

Liposarcomas are rare neoplasms in domestic animals, but have been reported to occur in many species. In humans, liposarcoma is one of the most common malignant mesenchymal tumors. Classification of liposarcomas in humans has been well established and categorization by type can be of prognostic value; no such unique classification scheme has been established for liposarcomas in animals. Liposarcoma of the head and neck in humans are uncommon, and are rarely reported in the nasal cavity, sinuses, and nasopharynx. To our knowledge, a liposarcoma has never been reported in the nasal cavity of a domestic animal. In this report we describe a liposarcoma that developed in the nasal cavity of a cow, with local invasion into the oral cavity.     

兽用非甾体抗炎药的应用现状

动物疼痛和炎症可影响其健康状况、养殖场经济效益等,预防和治疗动物疼痛、炎症具有重要意义。非甾体抗炎药可以减少动物疼痛和炎症的发生。近几年对非甾体抗炎药在动物中的应用研究越来越多,同时非甾体抗炎药的一些新功能被发现。论文对兽医常用非甾体抗炎药物的应用研究进展做一综述,以期为非甾体抗炎药在动物中的合理使用以及进一步研究提供参考。     

腹腔镜技术在小动物中的应用

腹腔镜手术具有术中腹腔脏器显露充分、对施术动物损伤小、手术切口小、出血量少、术后痛苦轻、恢复快和组织粘连少等优点。腹腔镜技术从20世纪80年代就普遍应用于人医临床,在兽医领域国外早就有腹腔镜技术在动物中应用的报道,而国内腹腔镜技术在动物上的应用则相对较少。腹腔镜技术在小动物中的应用主要包括在活组织检查中的应用、在消化系统中的应用,在泌尿系统中的应用及在生殖系统中的应用。     

Vaccine side effects: fact and fiction

The debate over adverse reactions associated with companion animal vaccination has considerably exercised the veterinary profession internationally over the past decade. A range of suspected adverse reactions to vaccines is reported including the onset of inflammatory, allergic, autoimmune or neoplastic diseases. Lack of efficacy, interference with diagnostic testing and other occasional suspected product-related issues are also reported. Available data suggest that the overall prevalence of true adverse reactions is exceedingly low and that vaccination does not significantly contribute to ill-health in companion animals. There is increasing public interest in vaccination issues with transfer of focus from publicity over human vaccine side effects to those perceived to occur in animals. We must not lose sight of the fact that vaccination is a safe procedure that has impacted significantly on infectious disease control. Reduced population uptake of vaccination leads to re-emergence of disease in both humans and animals. Nevertheless, there have recently been a series of practical recommendations produced to ensure reduced 'vaccine load' on our companion animals and vaccine manufacturers are moving towards developing non-adjuvanted products with an extended duration of immunity. These measures will further reduce the very small current risk of any adverse consequences to vaccination in our pet population.     

Skin diseases of rodents and small exotic mammals.

Small exotic mammals and rodents are becoming popular pets in the United States. Like most other exotics, the popularity of these animals has vastly preceded the accumulation of practical husbandry and veterinary information available about them. Several dermatologic conditions have been described in most rodents and small exotic mammals; however, the practitioner can assume that more exist that have not yet been diagnosed or documented. It is not unreasonable to assume that rodents and small exotic mammals could be affected by many of the same dermatologic conditions well described in other animals. Veterinarians are encouraged always to apply the same diagnostic protocols used to work up skin problems in dogs and cats when presented with an exotic pet with a dermatologic disease.     

Clinical Anesthesia and Analgesia in Invertebrates

Invertebrates are an expansive and diverse group of animals that have had little attention regarding anesthesia and analgesia. Economic use, environmental awareness, laboratory research, and increasing demand for invertebrates as pets has lead to a greater desire for knowledge for these animals in the veterinary medical community. With the increasing number of animal welfare regulations, various scientific studies have improved the overall knowledge of invertebrate medicine, but much more research is required to fully understand anesthesia techniques in the different species treated by veterinarians. Analgesia is a controversial and often neglected topic with invertebrates because of the common belief that invertebrates do not feel pain. Recently, the idea that invertebrates do not feel pain has been challenged with the discovery of nociceptive pathways similar to those in vertebrates. This article presents a general overview of anesthetics and analgesics used in selective invertebrate taxa.     

Inherited metabolic disease in companion animals: searching for nature's mistakes

Inborn errors of metabolism are caused by genetic defects in intermediary metabolic pathways. Although long considered to be the domain of human paediatric medicine, they are also recognised with increasing frequency in companion animals. The diagnosis of diseased animals can be achieved by searching for abnormal metabolites in body fluids, although such screening programmes have, until now, not been widely available to the small animal clinician. A comprehensive battery of analytical tools exists for screening for inborn metabolic diseases in humans which can be applied to animals and serve not only for the diagnosis of affected patients but also to detect asymptomatic carriers and further our understanding of metabolic pathways in dogs and cats. Moreover, naturally occurring animal models of inherited metabolic diseases provide a unique opportunity to study the biochemical and molecular pathogenesis of these disorders and to investigate possible therapeutic options.     

An abdominal teratoma in a yearling Irish Cob with a strangulating obstruction of the small intestine

A yearling Irish Cob stallion was presented to De Morette Equine clinic for severe acute abdominal pain, nonresponsive to analgesics and sedatives. Rectal palpation and a limited transabdominal ultrasonographic examination led to the presumptive diagnosis of a strangulated obstruction of the small intestine. The painful behaviour of the pony did not allow conservative treatment and surgical exploration was denied by the owners for financial considerations. On necropsy, a large cystic mature teratoma was adhered to the ventral body wall, the mesenteric root, omentum and intestines. Teratomas are rare in man and animals, and an extragonadal intraperitoneal location has not previously been reported in the equine species.     

What acupuncture can and cannot treat

Acupuncture has been used for over 2000 years to treat a variety of diseases. It is safe and effective, especially for conditions such as pain, geriatric diseases, and exercise-related diseases. There are 361 acupuncture points located throughout the body on meridians. Meridians are the energetic channels that connect all the points to each other. These points are stimulated by various means to produce a physiological effect in the body. All points have various functions throughout the body that can be used to treat different diseases. Certain precautions must be taken when treating weak, debilitated, or pregnant animals.     

2022 WSAVA guidelines for the recognition,assessment and treatment of pain

Animal sentience refers to the capacity of animals to feel both positive and negative emotions including that of pain. As veterinary health professionals, we have a medical and ethical duty to mitigate suffering from pain to the best of our ability. In 2014, the first Global Pain Council World Small Animal Veterinary Association (WSAVA) Guidelines for the Recognition, Assessment and Treatment of Pain was published and remains to this day one of the most relevant and widespread documents of its kind. The 2022 WSAVA Global Pain Management Guidelines evolves from the first document with updated scientific information reflecting major advances in veterinary pain medicine in the last decade. This document is designed to provide the user with easy-to-implement, core fundamentals on the successful recognition and treatment of pain in the day-to-day small animal clinical practice setting. It provides basic and practical information with an extensive reference list to guide those who want to further their knowledge on pain management. The 2022 WSAVA Global Pain Management Guidelines should be easily implemented regardless of practice setting and/or location for the promotion and advance of pain management and animal welfare.     

Acute respiratory distress syndrome in dogs and cats: a review of clinical findings and pathophysiology

Objective: To review the clinical and pathophysiologic aspects of acute respiratory distress syndrome (ARDS) in dogs and cats. Data sources: Data from human and veterinary literature were reviewed through Medline and CAB as well as manual search of references listed in articles pertaining to acute lung injury (ALI)/ARDS. Human data synthesis: Since the term ARDS was first coined in 1967, there has been a abundance of literature pertaining to this devastating syndrome in human medicine. More complete understanding of the complex interactions between inflammatory cells, soluble mediators (e.g., tumor necrosis factor, interleukin (IL)‐6, IL‐8, platelet activating factor) and the clinical patient has provided for timely recognition and mechanistically based protective strategies decreasing morbidity and mortality in human patients with ARDS. Veterinary data synthesis: Although little is known, ARDS is becoming a more commonly recognized sequela in small animals. Initial case reports and retrospective studies have provided basic clinical characterization of ARDS in dogs and cats. Additionally, information from experimental models has expanded our understanding of the inflammatory mechanisms involved. It appears that the inflammatory processes and pathologic changes associated with ARDS are similar in dogs, cats, and humans. Conclusions: Unfortunately, current mortality rates for ARDS in small animals are close to 100%. As our capability to treat patients with advanced life‐threatening disease increases, it is vital that we develop a familiarity with the pathogenesis of ARDS. Understanding the complex inflammatory interactions is essential for determining effective preventative and management strategies as well as designing novel therapies for veterinary patients.     

Application of a Composite Pain Scale to Objectively Monitor Horses with Somatic and Visceral Pain under Hospital Conditions

Pain recognition and management in animals has advanced considerably in the last decade and currently animal welfare is receiving increasing public interest. However, the comprehensive assessment of pain has been inadequately addressed in horses and till recently composite pain scales (CPSs) have hardly been validated for use in patients. We investigated the reliability and clinical applicability of a CPS, originally developed under experimental conditions for assessing pain in horses with various acute soft-tissue and orthopedic conditions before and after general anesthesia and/or (non)elective surgery. These clinical cases (n = 94) were scored by means of the CPS twice daily. Horses without painful conditions and horses admitted for nonpainful diagnostic procedures under general anesthesia were compared with those that were admitted with either acute or chronic surgical and nonsurgical painful conditions of both visceral and somatic origin. Scores of observer 1 were compared with observer 2 to study inter-observer reliability. Composite pain scores showed low baseline values in healthy animals with nonpainful conditions and were not affected when general anesthesia was the only intervention. Inter-observer reliability was very high (n = 23 horses; weighted kappa correlation coefficient, κ = 0.81). Horses with painful conditions responding well to analgesic treatment could be discriminated from horses that had to be euthanized on humane grounds because of painful nonresponsive conditions. We found the CPS to be a promising tool that has the potential to provide a good basis for direct day-to-day assessment of pain status in equine patients with various painful conditions in the future.