A review of the expanding field of exotic animal oral health care--veterinary dentistry

This article reviews the clinical literature of the field of Veterinary Dentistry from its conception in the late 1960's to its rapidly expanding role today as an emerging clinical specialty practice in veterinary medicine. It defines eight dental sub-disciplines in contemporary veterinary oral health care from a practical point of view and provides information concerning standardization of key words searches, definition of terms, and use of the expanded Medical Subject Headings (MeSH) necessary for a comprehensive review of the rapidly expanding literature stored in electronic databases.     

Behavioral medicine as a part of a comprehensive small animal medical program

The rationale of incorporating behavioral medicine into veterinary practice is that it can expand the range of medical services offered, help obtain happier, more acceptable pets, and lead to longer pet ownership. In doing so, veterinarians should be able to increase their business both through an actual increase in pet ownership and retention and through increased services for individual pets. The range of services offered can differ from practice to practice but may include preventive, interventive, and ancillary services, as with other areas in contemporary veterinary medical practice. Each area of behavioral practice can be an economically feasible addition to veterinary practice from the perspective of medical services rendered, as a method of practice promotion, or as an area of public service. The choice depends on the level of competence of the practitioner, the practice philosophy, and the need for the services in a given service area.     

Small animal dentistry in Canada: 1994 survey.

Small animal dentistry is a rapidly growing area of interest and specialization internationally, offering tremendous benefits to patients, clients, and practitioners. To date, no studies have been done to determine the standard of small animal dental care in Canada. A national mail survey was designed to document the prevalence of dental disease in small animal patients, the types of veterinary dental procedures being provided by practitioners, as well as home care recommendations and compliance for 1994.     

World Small Animal Veterinary Association Global Dental Guidelines

Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.     

Dispensing law and sale of animal feed

For the veterinarian, drug sale is generally permitted by his licence of drug dispensing. According to the law on animal feed, feedstuffs are not regarded as drugs and thus they are not licensed to be sold by veterinarians. Drugs, however, may only be released for the treatment of individual animals, which are previously examined by the vet. The sale of animal feed is not regarded as part of veterinary practice. Only in case of a registered additional business, a veterinarian is allowed to sale feedstuffs. Dietetic animal feedstuffs are also regulated by the Animal Feed Act. Dietetic drugs, however, are regulated by the Drug Act and are strongly to be delineated from dietetic feed. Thus, the term "dietetic" alone does not automatically give any legitimatization for a sale of feedstuffs in veterinary practice.     

The mobile exotic animal pet practice.

Mobile practice is an exciting, interesting, and profitable means to deliver high-quality veterinary care to exotic animal-owning clients. The advantages and disadvantages should be considered carefully when considering this type of practice.     

The profile of small animal practice

The objectives, methods and results of a comprehensive survey of the work done by sixty-one veterinary surgeons engaged in small animal practice are summarized and collated.
The study was undertaken on behalf of the BSAVA Scientific Committee and took place during 1972/1973. The implications and the possible lines along which this type of practice may evolve are discussed.     

Perceptions of animal physiotherapy amongst Irish veterinary surgeons

The aim of this study was to investigate veterinary surgeons' perceptions, knowledge and use of animal physiotherapy in the Republic of Ireland. A questionnaire was developed and sent to 200 veterinary surgeons, of which 97 were returned. Results indicated that 77 (79%) of respondents were aware of animal physiotherapists. Common sources of information included veterinary colleagues, owners and professional journals, with physiotherapists themselves and undergraduate training being less commonly cited. Awareness of animal physiotherapy was greatest amongst those working in equine practice (χ2 = 5.7, df 1, p = 0.017); they were more knowledgeable about its techniques (t = 2.806, df 75, p = 0.006) and more likely to refer (χ2 = 48.36, df 1, p = 0.0001). Seventy-four respondents (96%) thought that more research was necessary to increase the evidence base for animal physiotherapy. If this branch of physiotherapy is to develop, there needs to be increased interaction and co-operation between veterinary surgeons and chartered animal physiotherapists.     

The use of information technology in large animal veterinary education

To facilitate large animal veterinary education, information technology has to connect the classroom to the farm. Technology needs to be portable, durable, and cost-effective. Dairy production medicine was one of the first areas in veterinary medicine to use computers to manage large sets of milk production-related data. Now equine practice has embraced technology in almost every diagnostic imaging methodology. The personal desktop assistant (PDA) has allowed students to take large volumes of information with them during clinical rotations. The technology is advancing so quickly that it is difficult to keep up with new software and hardware developments, let alone purchase the most current versions. This article reviews information technology as it is used in large animal practice and, consequently, in large animal veterinary education.     

Periodontal disease. Therapy and prevention

Success in veterinary dentistry lies in good home care and regular, thorough dental prophylaxis. The removal of supragingival and subgingival calculus must be accomplished before periodontal disease can be controlled. When gingival sulcus depths exceed 4 or 5 mm, the gingivae must be excised or reflected to allow proper treatment of the pocket area. Antibiotic therapy should be instituted in the extensively involved veterinary dental patient.     

ACVIM small animal consensus statement on safe use of cytotoxic chemotherapeutics in veterinary practice

The purpose of this report is to offer a consensus opinion of ACVIM oncology diplomates and technicians on the safe use of cytotoxic chemotherapeutics in veterinary practice. The focus is on minimizing harm to the personnel exposed to the drugs: veterinary practitioners, veterinary technicians, veterinary staff, and pet owners. The safety of the patient receiving these drugs is also of paramount importance, but is not addressed in this statement. Much of the information presented is based on national recommendations by Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, United States Pharmacopeia, and other published regulations. These directives reflect an abundance of caution to minimize exposure to medical personnel, but large‐scale studies about the consequences of long‐term occupational exposure are not available in veterinary medicine. Challenges in the delivery of optimal treatment safely and economically to veterinary patients in general practice without access to a veterinary oncologist or other specialist, because of costs or proximity, remain.     

Analysis of a practice management computer software program for owner compliance with recall reminders

The purpose of this study was to describe clients' level of compliance with reminders that are computer generated and to identify factors associated with owner response to a recall. Client response to a recall notice revealed that clients responded to reminders for vaccination about 3 times less often than for the other recall codes combined (dental procedures, laboratory tests, medical progress examinations, and neutering). These results suggest that veterinarians need to move away from annual vaccination reminders and toward the promotion of preventive veterinary services, such as annual wellness examinations, screening laboratory testing, and routine dental procedures. Once a practice has committed to and set up the required computer systems to promote preventive veterinary care, the stage is set for the implementation and monitoring of recommendations and reminders. This type of practice philosophy and marketing coincides perfectly with an approach to maximizing compliance in all aspects of veterinary medicine.     

Orbital penetration associated with tooth extraction

Three cats and 2 dogs were evaluated for ophthalmologic complications associated with tooth extraction procedures. Orbital penetration leading to ocular and, in one case, brain trauma was secondary to iatrogenic injury from a dental elevator. Outcomes included enucleation of the affected eye in 3 cases, and death from brain abscessation in 1 case. Early treatment or, preferably, referral to a veterinary ophthalmology specialist may prevent such outcomes. Awareness of the anatomical proximity of caudal maxillary tooth roots and the orbit, appropriate interpretation of diagnostic intraoral dental radiographs, and technical proficiency in tooth extraction techniques will minimize these complications in veterinary dental practice.     

Assessment of companion animal quality of life in veterinary practice and research

O bjectives : Quality-of-life (QOL) assessment is a novel field in veterinary medicine. It shares similarities with the more established fields of human QOL assessment and animal welfare science and could prove similarly useful.
M ethods : This paper draws on existing literature on human QOL assessment, animal welfare, philosophy and animal QOL assessment.
R esults : It provides practical recommendations for QOL assessment in veterinary practice and in veterinary research on what should be assessed, how it should be assessed and who should assess it.
C linical S ignificance : These should assist veterinarians intending to develop their use QOL assessment.     

Veterinary drug legal situation for oral medication in animal facilities in Germany

Oral medication of animal stocks can be administered via oral ready-to-use veterinary medicinal products or by using medicated feedingstuffs. The regulations contained in the German Drug Act (Arzneimittelgesetz - AMG) and the ordinances derived from the AMG are applicable to both types of medicinal product. The legal requirements relating to the manufacture, authorisation, marketing, dispensing and proper use of these medicinal products in respect of oral medication are dealt with in detail. Pursuant to Section 13 AMG, companies that manufacture medicated feedingstuffs require a manufacturing licence. To take into account the special features of these medicinal products, specific stipulations have been laid down regarding the manufacture and dispensing of medicated feedingstuffs by these companies. The use of medicated feedingstuffs is for various reasons in steep decline, while oral ready-to-use medicinal products are, according to reports on practice in the relevant sector, increasingly being used to treat animal stocks as well. When dispensing veterinary medicinal products, the veterinarian must comply with the state of the art and make sure that the animal keeper is able to use the drugs properly. In order to react to doubts regarding compliance with these legal requirements, recommendations for use of oral medication should be developed which provide veterinarians with an aid to assist them in deciding which type of drugs are most suited for the respective case, and what is to be complied with in their use. The recommendations for use are intended to facilitate the correct application of oral medication in respect of both types of veterinary medicinal product.     

Investigating the opinions of donkey owners and veterinary surgeons towards pain and analgesia in donkeys

The aim of this questionnaire‐based study was to identify which analgesics are currently prescribed to donkeys in clinical practice and to collect opinions from veterinary surgeons and donkey owners on the importance of different pain‐related behaviours in donkeys. Questionnaires were completed by 143 veterinary surgeons and 93 donkey owners. Phenylbutazone, flunixin, detomidine and butorphanol were reported as the most frequently used analgesics in donkeys. Most veterinary surgeons reported administering these drugs at the horse dose rate and dosing interval, which may be inappropriate in the donkey. Four pain‐related behaviours were identified as very important by veterinary surgeons and owners: dullness for colic‐associated pain, keeping the foot lifted, and lameness for foot and limb pain and inability to chew properly for head and dental pain. This is a more limited behavioural repertoire than has recently been identified to be associated with pain in the donkey and suggests that the respondents were reporting perceived wisdom as to what people think are the behavioural signs associated with pain or were not interpreting pain‐related behaviours correctly.     

Communication in production animal medicine: modelling a complex interaction with the example of dairy herd health medicine

Background

The importance of communication skills in veterinary medicine is increasingly recognised. Appropriate communication skills towards the client are of utmost importance in both companion animal practice and production animal field and consultancy work. The need for building a relationship with the client, alongside developing a structure for the consultation is widely recognised and applies to both types of veterinary practice.

Results

Veterinary advisory practice in production animal medicine is, however, characterised by a more complex communication on different levels. While the person-orientated communication is a permanent process between veterinarian and client with a rather personal perspective and defines the roles of interaction, the problem-orientated communication deals with emerging difficulties; the objective is to solve an acute health problem. The solution - orientated communication is a form of communication in which both veterinarian and client address longstanding situations or problems with the objective to improve herd health and subsequently productivity performance. All three forms of communication overlap.

Conclusions

Based on this model, it appears useful for a veterinary practice to offer both a curative and an advisory service, but to keep these two separated when deemed appropriate. In veterinary education, the strategies and techniques necessary for solution orientated communication should be included in the teaching of communication skills.     

Effective bibliographic searching for animal alternatives in veterinary medical education: the UC Davis web site

To prepare students in just four years to enter veterinary practice, veterinary medical educators offer an array of laboratory and clinical experiences coordinated with didactic instruction. Recent curricular changes have reduced the numbers of animals involved in painful or terminal procedures. For each use of animals, veterinary educators are required by the USDA's policies 11 and 12 to complete animal-use protocols that include questions on alternatives to procedures causing more than momentary pain or distress. Veterinary medical educators seeking improved teaching resources and methods or completing animal-use protocols may find it frustrating to locate the relevant information, which is dispersed across many databases. This paper addresses a gap facing veterinary educators by presenting user-friendly searching tools that are targeted toward (a) locating teaching resources and (b) conducting effective bibliographic searches on standard teaching laboratory procedures, as required for animal-use protocols. These tools simplify searching by providing streamlined access to the resources being sought. Facilitating efficient and effective searching by users can improve teaching and simplify compliance with USDA requirements.     

Animal health in organic agriculture: new guidelines and perspectives for food animal practitioners

In the last decade, the organic agriculture in Switzerland has been substantially increased due to the interest of consumer and financial incentives of the federation. Ruminants take directly or indirectly the largest part from grassland used within the organic managed surfaces. As the contacts between veterinary practice and organic agriculture has increased, the potential for veterinary activity in this area has developed considerably. The organic agriculture guidelines stipulate that all the preventive measures should be taken in feeding, keeping and breeding to insure animal health safety. This requires veterinary services for herd management. The organic status of a farm affects veterinary practice also in the form of alternative therapy/drugs administration and measures like dehorning and tail-docking. An important point in organic managed herds requests that treatment of animals should depend on alternative medical preparations or procedures based on veterinarian's experience and also on the therapeutic effect on the animal species concerned as well as on the disease. However, there are no restrictions on the veterinarian to use registered drugs as long as no alternative therapy, according to experience and possible success, is available to treat the animals. The prophylactic administration of allopathic veterinary drugs is not permissible. Further features in organic farms regarding the use of drugs are the keeping of withholding/withdrawal time, the documentation and the treatment frequency tolerated by organic marketing. Despite the above measures, the animal health has a priority regardless of its organic status. Although management of organic farms represent a unique responsibility, there are still obvious deficits in the education of veterinary practitioners for this new situation. However, in the future the extension of veterinary activity to include the alternative medical therapy should be regarded for the practitioner as a challenge and an opportunity at the same time.