AVMA guide for veterinary medical waste management

Lawmakers have enacted a variety of laws and regulations to ensure proper disposal of certain potentially infectious or otherwise objectionable waste. The veterinary medical profession supports scientifically based regulations that benefit public health. In 1988, Congress passed the Medical Waste Tracking Act, a federal program that mandates tracking certain regulated waste. Several types of waste generated in the typical clinical veterinary medical practice are considered regulated veterinary medical waste. Discarded needles, syringes, and other sharps; vaccines and vials that contained certain live or attenuated vaccines; cultures and stocks of infectious agents and culture plates; research animals that were exposed to agents that are infectious to human beings and their associated waste; and other animal waste that is known to be potentially harmful to human beings should be handled as regulated veterinary medical waste. Regulated veterinary medical waste should be handled with care. It should be decontaminated prior to disposal. The most popular, effective methods of decontamination are steam sterilization (autoclaving) and incineration. Chemical decontamination is appropriate for certain liquid waste. Waste should be packaged so that it does not spill. Sharps require rigid puncture- and leak-resistant containers that can be permanently sealed. Regulated veterinary medical waste that has not been decontaminated should be labeled with the universal biohazard symbol. Generators retain liability for waste throughout the entire disposal process. Therefore, it is essential to ensure that waste transporters and disposal facilities comply with state and federal requirements. Veterinary practices should maintain a written waste management program and accurate records of regulated veterinary medical waste disposal. Contingency planning and staff training are other important elements of a veterinary medical waste management program. The guide includes a model veterinary medical waste management program; however, it does not address all the variations in state and local regulations. Veterinarians should obtain copies of state and local laws and regulations and modify AVMA's model plan to create an individualized practice plan that complies with federal, state, and local laws and regulations. State and local veterinary medical organizations should monitor state and local regulation to influence decisions that affect veterinarians and to keep their members informed of changing requirements. Veterinarians and veterinary medical organizations must stay involved so that regulations do not unfairly burden the veterinary medical profession.     

Towards a philosophy of veterinary medicine

The question of animal rights is looked at from a new perspective: animals of similar sentence should be entitled to the same quality of veterinary care and ought not to be treated differently, some more or less humanely than others. The ethical inconsistencies in the moral status of animals in society, and the veterinarian's role and responsibilities, are explored in an attempt to reconcile the dialectic of animal exploitation and animal rights and of the extrinsic and intrinsic worth of animals. The veterinary profession is in the centre of this issue, which necessitates an examination of our profession's ethics and the formulation of a veterinary philosophy. The importance of empathy in the art and practice of veterinary medicine is also discussed.     

Antimicrobial drug use in veterinary medicine

Recognizing the importance of antimicrobial resistance and the need for veterinarians to aid in efforts for maintaining the usefulness of antimicrobial drugs in animals and humans, the Board of Regents of the American College of Veterinary Internal Medicine charged a special committee with responsibility for drafting this position statement regarding antimicrobial drug use in veterinary medicine. The Committee believes that veterinarians are obligated to balance the well-being of animals under their care with the protection of other animals and public health. Therefore, if an animal's medical condition can be reasonably expected to improve as a result of treatment with antimicrobial drugs, and the animal is under a veterinarian's care with an appropriate veterinarian-client-patient relationship, veterinarians have an obligation to offer antimicrobial treatment as a therapeutic option. Veterinarians also have an obligation to actively promote disease prevention efforts, to treat as conservatively as possible, and to explain the potential consequences associated with antimicrobial treatment to animal owners and managers, including the possibility of promoting selection of resistant bacteria. However, the consequences of losing usefulness of an antimicrobial drug that is used as a last resort in humans or animals with resistant bacterial infections might be unacceptable from a public or population health perspective. Veterinarians could therefore face the difficult choice of treating animals with a drug that is less likely to be successful, possibly resulting in prolonged or exacerbated morbidity, to protect the good of society. The Committee recommends that voluntary actions be taken by the veterinary profession to promote conservative use of antimicrobial drugs to minimize the potential adverse effects on animal or human health. The veterinary profession must work to educate all veterinarians about issues related to conservative antimicrobial drug use and antimicrobial resistance so that each individual is better able to balance ethical obligations regarding the perceived benefit to their patients versus the perceived risk to public health. Specific means by which the veterinary profession can promote stewardship of this valuable resource are presented and discussed in this document.     

Ethical dilemmas in veterinary medicine.

Veterinarians frequently encounter situations that are morally charged and potentially difficult to manage. Situation involving euthanasia, end-of-life care, economics, and inadequate provision of care create practical and moral dilemmas. Ethical tension may be attributable to differences in beliefs regarding the moral value of animals, client and veterinary responsibilities, and deciding what is best for an animal. Veterinarians can employ communication skills used in medical situations to explore the reasons underpinning ethical dilemmas and to search for solutions with clients, staff, and colleagues.     

Staphylococcal control in the veterinary hospital

Staphylococcal infections are common in veterinary dermatology patients, as are patients whose health status places them at increased risk of staphylococcal infection. The rapid emergence and dissemination of meticillin-resistant staphylococci has had significant impacts on management of infections and also increased concerns about transmission of staphylococci between animals, from animals to humans and from humans to animals. The increasing incidence and implications of staphylococcal infections, particularly meticillin-resistant staphylococcal infections, is leading to more interest in infection control in veterinary hospitals as a means to help reduce the impact of these significant pathogens. Infection control is a series of principles and practices that can and should be implemented by every veterinary hospital to improve patient care, protect personnel and meet the increasing expectations. Fortunately, general concepts of infection control are both simple and practical, and application of a basic infection control programme requires limited time, effort or training. With an understanding of some basic concepts and use of available resources, development of an effective infection control programme is within the reach of any facility.     

Evaluating the economic and noneconomic impacts of the veterinary medical profession in Michigan

This study reaffirms the diversity and breadth of the veterinary profession. As it turns out, some of the furthest-reaching impacts of the veterinary medical profession were largely non-quantifiable. The veterinary medical profession had a substantial direct economic impact in Michigan during 1995. The total economic contribution of the veterinary medical profession to Michigan during 1995 that was attributable to expenditures on salaries, supplies, services, and their multiplier effect was approximately $500 million. In addition, the profession was associated with nearly 8,500 jobs (combined professional and lay positions). The veterinary medical profession was also considered to have an impact on the prosperity of the live-stock, equine, and pet food industries in Michigan, even though the economic contribution in these areas could not be directly quantified. Economic well-being of the individual businesses in these industries is directly related to the health and productivity of the associated animals, and improvements in output or productivity that accompany improved animal health likely carry substantial economic benefits in these sectors. In addition, progressive animal health management provides a crucial method of managing risk in the animal industries. Similarly, although the economic contribution could not be quantified, the veterinary medical profession enhances the safety and quality of human food through research, regulation, and quality assurance programs in livestock production, minimizing the risk of drug residues and microbial contamination. During 1995, approximately 5.3 million Michigan residents benefitted from the physical, psychological, and emotional well-being that accompanies companion animal ownership. By preserving the health and longevity of companion animals, veterinarians sustain and enhance these aspects of the human-animal bond. As Michigan enters a new century, it is likely that the state's veterinary medical profession will continue to make a highly valued societal contribution. Pets, equines, and food animals will continue to have prominent roles in Michigan for the foreseeable future, as will the human-animal bond, food safety, and medical research. Clearly, for economic and noneconomic reasons, it will be in the interest of the people of Michigan to seek opportunities to maintain and enhance the vitality of the state's veterinary medical profession. It was our hope that results of this study would provide university administrators, legislators, MVMA executives, and others with information needed to justify the ongoing provision of public support for the veterinary medical profession. In addition, we expect that the results will supply useful material for public relations and marketing campaigns by the MVMA and the Michigan State University College of Veterinary Medicine and will provide the media with public interest stories to promote the veterinary profession. Although this study considered the economic and noneconomic impacts of the veterinary medical profession only in Michigan, the results can provide an important reference point for educators, policy markers, and legislators in other states. In addition, this study could serve as a methodologic model for veterinary organizations in other states, or at the national level, to emulate.     

Use of complementary veterinary medicine in the geriatric horse.

The use of complementary and alternative veterinary medicine continues to grow within the veterinary community. As more clients seek out complementary and alternative medicine for their own health care, they begin to seek out these forms of therapy for their animals. For the equine practitioner, this includes those clients with geriatric animals. It is hoped that this article provides some insight into what conditions may be helped with CVM (complementary veterinary medicine) and when an equine practitioner may want to consider CVM as a form of therapy for the geriatric horse.     

Perspectives on academic veterinary administration

It is important for veterinary administrators to apply knowledge bases from other fields to their own unique administrative needs. For example, although some resources are written for business managers, the discussions of four key management competency areas, guidelines for mastering these skills, organizational assessment tools, and other self-help tools may provide interesting food-for-thought for veterinary administrators.(76) In developing their own administrative styles, administrators should seek to apply those principles that seem to intuitively fit with their personal research styles, work situations, managerial styles, administrative preferences, and unique organizational culture. Through strengthening their liaisons with community and university business programs, counseling agencies, employee assistance programs, and psychology researchers, administrators can continue to be exposed to and benefit from new paradigms for consideration in veterinary medical environments. Through these liaisons, the unique needs of veterinary medical environments are also communicated to individuals within the fields of psychology and business, thus stimulating new research that specifically targets veterinary medical environment leadership issues. Each field has unique contributions to help veterinary administrators work toward creating veterinary medical environments that are creative, energetic, visionary, pragmatic, and highly marketable in order to help administrators recruit and nurture the best and brightest veterinary researchers, teachers, and clinicians.     

Biosecurity of veterinary practices.

Hospitalization of sick animals tremendously increases their risk of acquiring infections as this congregates animals that are most likely to be shedding infectious agents with animals that often have enhanced susceptibility. In order to provide the best veterinary care possible, veterinarians have an underlying responsibility to minimize the risk of additional harm that might unintentionally befall a patient because of their interventions. This includes minimizing the risk of exposing patients to infectious agents. It is therefore incumbent upon veterinarians to actively manage the risk of nosocomial infections. Nosocomial infections in veterinary hospitals are not solely a patient-care concern; the spread of infectious agents can also significantly impact normal hospital operations, revenue, client confidence, public image, and can even affect the morale of hospital personnel. In some cases nosocomial agents can also be zoonotic. This paper discusses the need for biosecurity programs in veterinary practices, and describes a practical approach for developing biosecurity practices that are tailored to individual facilities.     

A veterinary approach to spiders

Spiders are kept as pets, for scientific study and for display. The veterinary profession is increasingly being consulted for advice on their care. The basic biology and management of spiders are outlined, together with information on physical and chemical restraint. These animals are particularly susceptible to managemental problems but other diseases may also occur. A certain amount of medical and surgical attention is possible.     

Veterinary medical education and veterinary involvement in aquatic-animal health and aquaculture in Mexico

This article analyzes curriculum offerings related to aquaculture and/or aquatic-animal health taught in veterinary medical schools or colleges in Mexico. The information database of the Mexican Association of Schools and Colleges of Veterinary Medicine and the Web sites of veterinary institutions indicate that 60% of veterinary colleges include courses related to aquaculture in their curriculum, but most of these are optional courses. There are few specialized continuing education programs or graduate level courses. There is also a lack of veterinary participation, in both public and private sectors, in aquatic-animal health. It is evident that there should be a greater involvement by the veterinary profession in Mexico's aquaculture to ensure food production in a safe and sustainable manner; to achieve this, veterinary medical institutions must include more aquaculture and aquatic-animal health courses in their curricula.     

Phosphorus and phosphate metabolism in veterinary patients

Objective: To review phosphorus and phosphate metabolism and the importance of phosphate abnormalities in veterinary patients. Data sources: A review of recent human and veterinary medical literature. Human data synthesis: There is a significant amount of original research on human patients with phosphate abnormalities. Hypophosphatemia has been studied in patients with diabetic ketoacidosis (DKA), head trauma, refeeding syndrome, hypothermia and in ventilator patients that fail to wean. Hyperphosphatemia has been studied in patients with renal failure and malignancy. Phosphate levels have also been evaluated for prognostic value in sepsis and acute liver failure. Veterinary data synthesis: Although animal models were used in early experimental research, fewer studies have been published on the effects of phosphate abnormalities in veterinary patients. Hypophosphatemia has been studied in animals with DKA, with refeeding syndrome and with hyperparathyroidism. Hyperphosphatemia has been studied in animals with renal failure and with secondary hypoparathyroidism. Conclusion: Phosphorus and phosphate are important in many biological functions. This paper is a review of their role in normal metabolism and the clinical importance of phosphate imbalances for our emergency and critical care patients.     

Application of Campylobacter molecular classification and typing techniques in veterinary medicine: old-established methods and new perspectives

In this review the application and usefulness of Campylobacter genotypical classification and typing in veterinary medicine will be discussed.While there is a large area of overlapping applications between the veterinary and the medical field, several differences exist, as the spectrum of veterinary pathogens is different from the human and contaminated food of healthy animal origin may cause disease in man. In general, genotyping in the veterinary field can be applied in three different areas: (a) purely diagnostic purposes for classification of Campylobacter species and subspecies, (b) typing methods useful for monitoring or surveillance of animals as well as food products of animal origin, and (c) typing methods that can be applied during outbreaks and for source tracing. In addition, typing methods applied in areas (b) and (c) should be distinguished in regard to local short-term and global long-term epidemiology, respectively. While a whole plethora of discriminative typing methods are available, classification tools of certain species and subspecies are still missing. Perspectively, as the genomes of many relevant Campylobacter species have now been sequenced, this will help to identify several species specific loci, the products of which should be available to develop easy and fast applicable diagnostic tools. Global cooperation, sharing of strains and databases should close the currently existing gaps in Campylobacter identification tools.     

Mainstreaming alternatives in veterinary medical education: resource development and curricular reform

Veterinary medical educators are charged with preparing students to enter practice in veterinary medicine during a four-year, intensive, professional education program. This requires giving students in laboratory training that involves dead, anesthetized, or conscious animals, so that they become proficient in the expected range of veterinary knowledge, skills, and abilities. Undeniably, experience with animals is essential to prepare students for a profession in which animals comprise the total domain. However, the consumptive use of animals for teaching students, especially in laboratories, is increasingly subject to regulatory requirements, while also being scrutinized by animal protection groups, and has become a common focus of contention among veterinary students. Not surprisingly, the use of animals in teaching has sharply declined over the past few decades, as new teaching resources and methods, involving less consumptive use of animals, have been incorporated. This change in veterinary medical education has occurred on such a wide scale, in almost all veterinary schools and colleges, that the educational approach can serve as a model for further developments within the veterinary educational community and, indeed, for animal-related material in secondary schools and undergraduate higher education. This article highlights examples of the leadership provided by veterinary educators in developing alternative teaching resources and methods, while maintaining the high level of proficiency expected from traditional educational approaches.     

Providing stewardship and leadership for the future of veterinary medical research: a responsibility of the veterinary colleges

As we contemplate responsibilities as well as opportunities in research, it is fair to begin by considering why research is, or should be, important to veterinary schools and colleges, to our profession, and to society. Veterinary research is conducted in many venues, such as colleges of veterinary medicine, veterinary science departments, comparative medicine departments, medical schools, and many other university departments, as well as in industry laboratories, governmental agencies, and other organizations. But schools and colleges of veterinary medicine have a unique and historic responsibility to ensure that our veterinary medical research programs are sufficient in quality, capacity, and depth to meet the research needs of our society. Consequently, my comments will be oriented toward veterinary schools and colleges.     

The scope of a laboratory animal program needed at a veterinary school.

The discipline of laboratory animal medicine is one of the most rapidly expanding specialties within the veterinary profession. Veterinary schools should fully accept the responsibility for introductory instruction in laboratory animal medicine in the professional curriculum. Such instruction should articulate the varied opportunities that exist for the laboratory animal veterinarian within the biomedical research community, and provide an overview of the normal biological characteristics and pathologic conditions of the common laboratory animal species. In addition, the opportunity should exist within the veterinary school for graduate and undergraduate students utilizing experimental animals to receive a comprehensive introduction to laboratory animal biology, care, and management. Instructional responsibility for such courses should be accepted by faculty veterinarians with advanced training in laboratory animal medicine. Veterinarians with advanced training in this specialty are uniquely qualified to make substantial contributions to biomedical research by promoting the health and welfare of the research animal.     

Attitude of Swedish veterinary and medical students to animal experimentation

Nearly all veterinary and medical students (94 per cent) found it morally acceptable to use animals in research and believed it to be a necessity in order to treat human diseases. In contrast with the medical students a substantial proportion of veterinary students (40 per cent) considered themselves animal rights activists. Unlike the medical curriculum, the veterinary curriculum contains a two-week course in laboratory animal medicine, and a higher proportion of the students who had not been through this course was opposed to the use of animals in research than of the students who had completed the course. The course modified the views of half the students; more than 26 per cent of them became more positive towards animal use in research after the course, whereas 3 per cent became more negative.     

Methodologic aspects of quality assurance in veterinary epidemiological studies]

In planning and conducting epidemiological studies the quality of the investigation should be sufficient to take care that all possible conclusions are correct. In this paper we deal with these parts of epidemiological studies which are related to quality and therefore have to be under control. This is done in the view of veterinary medicine.     

Managing stress in veterinary students

The process of obtaining a veterinary medical education creates a number of potential cognitive, emotional, physical, interpersonal, and developmental stressors for veterinary students. Although most universities offer stress management interventions for their students, these programs are often directed toward undergraduate students or non-veterinary graduate students, whose educational programs differ significantly from those of veterinary students. There is a need for specific stress management programs tailored to the needs of veterinary students. This article summarizes research drawn from the psychology, medical, and veterinary medical literature about the causes of stress that veterinary students experience. Interventions are discussed, and several Oregon State University (OSU) programs and liaisons are described. Stress management resources are suggested.     

Current economic trends affecting the veterinary medical profession.

This article explores the economic trends affecting the future of the veterinary medical profession. Key aspects of demand and supply are considered, as are several broad-based institutional factors. Demand for veterinarians and veterinary medical services is demonstrating a definitive upward trend across the profession, led by a remarkable in-crease in consumers' willingness to spend on animal health care.Supply is also expanding through increased enrollments at colleges and schools of veterinary medicine and increased productivity and efficiency in private practice. Veterinarians' incomes are increasing, and some sectors of the profession offer outstanding financial opportunities.Provided that critical needs are met for 1) increased diversity and 2) continued improvement in the nontechnical capabilites of veterinarians, the outlook for the economic future of the veterinary medical profession is strong.