extra-hepatic portosystemic shunts.

0 What are the prognostic indicators for this

Most portosystemic shunts in cats are extra- hepatic and are therefore potentially amenable to surgical correction. Intra-hepatic shunts are usually managed medically with low protein diets, daily lactulose dosing and antibiotic ther- apy. The aim of this therapy is to reduce the production of neurotoxins from protein diges- tion by enteric bacteria and their subsequent uptake into the portal circulation. Early recogni- tion of the condition greatly assists subsequent

kitten?

management. The cat’s condition improved using the combination therapy described above so that it was able to return home to its owners. However, within one week fitting episodes start- ed and the cat was euthanased without further treatment.

Further reading BLAXTER, A., HOLT, P. E., PEARSON, G. R., GIBBS, C. & GRUFFYDD- JONES, T. J. (1988) Congenital portosystemic shunts in the cat: a report of nine cases. Journal of Small Animal Practice 29,

RUTGERS, C. (1993) Diagnosis and management of porto- systemic shunts. In Practice 15, 175-181

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BOOK REVIEW Clinical Textbook for Veterinary Technicians, 3rd edn. Edited by D. McCurnin. Published by W. B. Saunders, Philadelphia. Price E42.00. Hardback. 655 pages. 1993.

AS with so many books, this is a multi-author publication with 48 authors including four tech- nicians. With over 600 pages and a very compre- hensive index, unlike our own textbook for veterinary nurses, which covers small animals only, this covers all species, including horses, cattle, pigs, and sheep plus dogs, cats and the many very small animals we handle such as ferrets, rabbits, guinea pigs and birds.

I found it fascinating and enjoyed the chapters on Restraint and Handling - especially of species with which I have limited experience. Both chemical and physical restraint are fully dis- cussed for each species and a later chapter on Transportation and Shipping again covers all species. This will be invaluable in practice.

Medical records follow an established, well- tried format but this is still a useful revision chapter. The very detailed chapter on Clinical Pathology had clear explanations of procedures, equipment and reasons for undertaking such pro- cedures. Parasitology and Public Health covered conditions such as heartworm which do not usu- ally occur in the UK but with the importation of more animals that do not need to be quarantined, this may well change. Clinical Microbiology is seldom undertaken except in large practices but the chapter gives a good background for veter- inary nurses and explains interpretation of the results.

For me the section on Diagnostic Imaging was superb and reference is included to Nuclear Medicine and Computed Tomography. Veter- inary nurses studying for the Diploma in Advanced Veterinary Nursing (Surgical) will find

this section invaluable. Small Animal Emergency Care - the difference

between critical and emergency care - may not be clearly defined in some situations and the author of this chapter explains the difference in perception of the situation from the point of view of the owner and the veterinary practice. Empha- sis is placed on the avoidance of stress, ie, unnecessary diagnostic procedures should be avoided. I could not agree more.

Medical and Surgical Nursing are covered in great detail and there is a separate chapter for Equine Medical and Surgical Nursing and also for Birds, Reptiles, Ferrets, Rabbits and Rodents.

Other chapters in this very comprehensive book cover Anaesthesia, Instrumentation and Aseptic Techniques, Dentistry, Pharmacology, Oncology and Hospital Practice Management plus Computer Applications and, of course, Ani- mal Behaviour.

I was pleased to see good coverage of Euthana- sia, Bereavement Counselling and Preventive Health Programmes but even more so, a complete chapter on Pain Management - an area to which more attention needs to be given although in the UK the need for pain control is well understood, probably because of the high standard of nursing in our practices.

Recommended reading is generally for books available in the USA but many of the more popu- lar ones are widely available in the UK and on practice bookshelves.

This is an extremely comprehensive book and very good value for money. It is well illustrated throughout with black and white pictures and charts where these add clarity to the text.

Had I not received this review copy, I would certainly have purchased it.

JEAN TURNER

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