november 2014 - animal health...

INSIDER | NOVEMBER 2014

In This Issue of Insider

How to Choose the Best Veterinary CT Scanner for your Practice» Page 2 & 3

How to Choose a Sustainable Site for your New Veterinary Clinic» Page 4

When your Dog Requires Surgery» Page 5, 6 & 7

Special Days This Month» Page 8

Resources From the Web» Page 9

Thoughts, Considerations and Techniqiues for Better Equine Radiographs» 0 & 11

Continuing Education» Page 12, 13 & 14

Did You Know?» Page 15

New Year Planning

H olidays, staff scheduling, client scheduling, preparations for colder weath-er—before you know it, it’s the New Year!

However busy, it’s important to find the time to think about what’s ahead for your practice, to envision what you want for 2015, and make it happen. New services you may offer, Continuing Education to plan for, whether to upgrade any (or all) of your existing clinic equipment before the year-end—all decisions you should be considering now to give you the time to plan.

This issue of the INSIDER (and the next) is geared toward practice planning, equip-ment and diagnostics, and includes some tools and information to help you make some of those critical decisions as 2014 draws to a close.

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2ANIMAL HEALTH INTERNATIONAL, INC. | www.animalhealthinternational.com INSIDER | NOVEMBER 2014

CT Scanner or “computed tomography” has been used. on animals since the 1970s. It has grown in popularity in veterinary medicine, because it

can provide high image quality and enable vets to make more definitive diagnosis. It can help you identify the best options for treating your patients. Best of all, CT Scanners have become more affordable for use in veterinary practices. Before you decide to add CT Scanning to your practice, there are some important considerations.

Veterinary CT Scanner CT Scans can be used in many situations.✓ Ideal for those with lung, nasal or ear disease

✓ Can screen the lungs for metastatic cancer prior to surgery

✓ Abdominal and some orthopedic conditions

✓ Ideal for pet patients with metal implants that can’t be imaged with MRI.

(source: Vikki Harmonay)

Professional Focus

How to Choose the Best Veterinary CT Scanner for your Practice

✓ Can guide tissue sampling of deep structures, particularly within the thorax.

✓ To further increase the differentiation of tissue, an iodine-based contrast media can be injected intravenously.

Conventional tomography or computed tomography?

While conventional radiographs can be used on animal patients, there are some drawbacks

✓ Conventional tomography depicts a three dimensional object as a two dimensional image

✓ Overlying tissues are superimposed on the image.

✓ Are unable to distinguish between two tissues with similar density, such as soft tissue and fluid.

Today’s computed tomography performs at a higher level.


The Veterinary Medicine Loan Repayment Program

✓ It provides a three dimensional viewpoint by scanning thin slices of the body with a narrow x-ray beam, which rotates around the body.

✓ It can differentiate between tissues of similar density because of the narrow x ray beam and the use of "windowing."

What CT Scanner fits your practice?

Once you’ve decided that a CT Scanner is right for your practice, it’s important to determine which one is right for you. First, answer these questions:

✓ What is the size of the animals that you treat at your facility?

✓ What is the range of weight of the animals?

✓ What studies will you be performing?

✓ Will you be treating emergencies and trauma?

✓ Do you have space to install a CT Scanner?

✓ What is your budget and time frame for purchase?

✓ Will you need to renovate your facility to house the CT Scanner?

✓ What are the HVAC, mechanical, electrical and engineering requirements?

✓ What are the installation requirements?

If you have a practice that deals primarily with smaller animals, a 1-4 slice CT scanner is a great choice. It will be affordable and a good investment. If you operate a vet trauma center, perform oncology studies or practice primarily on larger animals, a 16, 32 40 or 64 slice CT is a better option. You’ll be able to get better resolution, accurately measure margins of mass and achieve quicker scan speeds.

New, Refurbished or Used? Buy or Lease?

Because scanner quality has improved and costs are more affordable, CT scanners are being used more by veterinarians. CT Scanners can be costly to buy and to operate — but there are many refurbished and pre-owned CT Scanners on the market. These come complete with impressive warranties and service contracts are available, as well—which can drastically reduce headaches! Used or refurbished CT scanners can cost half the price of a new CT and still deliver the high quality image you want and need. And if you don’t have room to house a CT Scanner at your facility, there are Mobile CT Scanners available, which are easy to set up and affordable, as well. There are also opportunities to lease equipment instead of purchase, which can also be affordable.

The more you know, the easier it will be to determine the right choice for your practice!

The USDA and the National Institute of Food and Agriculture administer a program which will repay up to $ 25,000 per year of qualified student loan

debt in exchange for three years of service in areas of the U.S. which lack adequate veterinary services. Program summary is below, but more complete information can be found at:

http://www.nifa.usda.gov/nea/animals/in_focus/an_health_if_vmlrp.html

USDA’s Veterinary Medicine Loan Repayment Program (VMLRP), authorized by the National Veterinary Medical Services Act (NVMSA) helps qualified veterinarians offset a significant portion of the debt incurred in pursuit of their veterinary medicine degrees in return for their service in certain high-priority veterinary shortage situations. The National Institute of Food and Agriculture (NIFA) will carry out NVMSA by entering into educational loan repayment agreements with veterinarians who agree to provide veterinary services in veterinarian shortage situations for a determined period of time.

If you commit to providing at least three years of veterinary services in a designated veterinary shortage area, NIFA may repay up to $25,000 of your student loan debt per year. Loan repayment benefits are limited to payments of the principal and interest on government and commercial loans you received for the attendance at an accredited college of veterinary medicine resulting in a degree of Doctor of Veterinary Medicine or the equivalent.

Be sure to review the eligibility requirements to determine if you and your loans are eligible for the VMLRP.


Some of the most important considerations you can make when planning a new clinic or additional construction is loca-tion and orientation. The following offers some sound advice and suggestions.

In the old days before modern earthmoving equipment and heating, ventilation, and air conditioning (HVAC) systems, it was necessary to construct buildings that

took advantage of breezes, natural weather patterns, the lay of the land, and the path of the sun. We can resurrect some very simple principles from the archives of our collective building history and reuse them to make more sustainable buildings. These principles fall under the category of common sense and as long as they are applied properly, they should not add to the cost of your hospital. Here are some things to consider when choosing a site for your new veterinary clinic that Mark Hafen, AIA, of Animal Arts shared during the Hospital Design Conference at CVC Kansas City.

Building orientation. This means facing the building so that the long sides are exposed to the north and south and the short sides are exposed to the east and west. This is a tried and true guideline that will ultimately have a dramatic effect on your energy costs. Orienting a building incorrectly means that the HVAC system will need to fight additional heat gain on the east and west sides of the building.

Placement of windows. Even though you may be limited by the layout of your building, consider the impact of exterior openings on the energy usage of your building. The worst exposure for solar gain is the west side of a building due to the extremes of afternoon sun in most portions of the continental United States. The best exposure is the south side, because it is possible to use overhangs that block summer sun when the sun is high in the sky but allow solar gain in the winter when the sun is low in the sky. Your mechanical engineer will take into account the placement of your windows when sizing your mechanical system. If buildings are properly oriented and properly fenestrated, mechanical systems will ultimately be smaller.

With all decisions, it is best to temper these rules of thumb with a dose of reality. For example, if orienting your building to the path of the sun creates significantly more asphalt to move cars around the building, or if it causes a

(authored by dvm360.com staff, Veterinary Economics, Dec. 2012)

How to choose a sustainable site for your new veterinary clinic

great deal more dirt to be moved, then building orientation should be balanced with other good design choices.

The following are some very good and simple principals that do not add dramatically to construction costs:

✓ Use a white or light colored roof. These roofs are ubiquitous in our industry, so it is possible to find good, affordable products. Light colored roofs reduce solar heat gain dramatically, which is both good for the building and for the site.

✓ Use deciduous plantings to shade a parking area during the summer. In the winter when their leaves are gone, they allow for greater heat gain.

✓ Reduce dark, impervious paving. Concrete is actually a better paving choice than asphalt because it is much more reflective. Check with your local construction market to see if concrete is an affordable choice for your area. If possible, also incorporate porous paving products, although these may not be affordable for many projects.

✓ People are often interested in green roofs, which grow plants on a rooftop environment. Unfortunately, green roofs are not practical or affordable for most veterinary hospitals, especially because of the need for large, rooftop mechanical equipment.


Client Focus

Your clients may not always understand the diagnostics tests that your clinic performs or orders. Share these notes with your staff—they provide a quick, clear and easy-to-under-stand explanation of some of the diagnostics you may order, and why.

The VeterinarianJust as your physician will check your vital signs, weight, and other conditions when you visit the doctor, your veteri-narian will also want to check vital signs and obtain basic medical information about your pet. In addition to check-ing your pet's weight, looking at your pet's eyes, checking its ears, routine examination of the mouth and teeth, and observing the pet's movements, there are other simple tests that are often performed.

The veterinarian will use a stethoscope to listen for ab-normal heart, lung, or digestive system sounds that may indicate problems with these organs.

The veterinarian may gently press on the pet's gums with a finger and then release the pressure to determine how long it takes for the capillaries in the gums to refill. A longer than normal capillary refill time may indicate that the pet is

When Your Dog Requires Surgery(source: by Norma Bennett Woolf, for www.canismajor.com)

going into, or is already in, shock. Long refill times also oc-cur in certain heart diseases. The color of the gums can also indicate problems such as jaundice (a sign of liver disease), shock, or anemia.

Veterinarians use their hands to check for the size and loca-tion of internal organs such as the liver, spleen, kidneys, and urinary bladder. This is called abdominal palpation. They will also check for enlargement of lymph nodes located throughout the body.

Specialized TestsIf your pet has a specific problem at the time of the exami-nation, the veterinarian may perform additional tests that are not generally part of a routine physical examination. For example, examination of a dog with suspected vision problems might include tests that assess overall vision, examination with an ophthalmoscope (an instrument that allows the veterinarian to assess the interior portions of the eye) and various stains, and determination of the pressure within the eye (intraocular pressure). Similarly, examina-tion of a lame horse might include a hands-on examination of the affected leg, blood and biochemical tests, muscle biopsy, and various types of imaging techniques.


The In-house LaboratoryMost veterinary clinics have at least basic laboratory facilities within their clinic. Several laboratory tests can be carried out in these facilities after the veterinarian collects the appropriate samples or after the pet owner collects the samples and brings them to the clinic. The complexity and types of tests done will vary from clinic to clinic. The following types of tests are frequently done at an in-house laboratory.

Stool SamplesStool samples may be collected by the pet owner prior to a visit to the veterinary clinic or they may be collected by the veterinarian. A small amount of the stool sample is prepared and then examined under a microscope. In some cases, a small amount of the stool is placed in a liquid and then examined with a microscope. These steps are used to detect the presence of the cysts of various parasites such as Giardia and Cryptosporidium. The eggs of other parasites, such as roundworms, hookworms, and tapeworms, can be found in stool samples. Larval or adult worms or tapeworm segments may also be observed.

Urine SamplesAnalysis of urine samples (urinalysis) is important for de-tecting various types of urinary tract diseases. Because sig-nificant changes occur in urine if it is left at room or higher temperature for any length of time, the sample should be analyzed immediately after collection, or refrigerated and transported to the laboratory as soon as possible after collection. Urine samples should not, however, be frozen because freezing will change several important charac-teristics of the urine. The tests usually carried out on urine samples include examining the appearance, chemistry, and sediment.

Normal urine is typically yellow or amber in color and is usually transparent or clear. The presence of diseases or infections may change the color or clarity. For most pet species, normal urine has a slight odor of ammonia; however,

the urine of some pets (such as cats) normally has a pun-gent odor. A bacterial infection of the urinary tract may produce a strong ammonia odor in the urine.

Chemical analysis of urine may include determining its specific gravity (density) and pH level and measuring the amount of protein, glucose, or fragmented blood cells, all of which can indicate disease, injury, or defects. Micro-scopic examination of urine sediment (the solid part of urine) is part of a routine urinalysis. Large numbers of red blood cells in urine sediment usually indicate bleeding somewhere in the urinary tract, while large numbers of white blood cells usually indicate an infection. Other solid components of urine, known as casts, are long tubular structures formed by the congealing of protein in the kid-neys. Large numbers of casts may indicate kidney disease. Crystals may be present but are generally not considered to be a problem. Bacteria may be present in small num-bers in normally voided urine, but large numbers indicate infection. If your veterinarian suspects a bladder infection, a sample of urine to culture for bacteria may be collected directly from the bladder using a needle and syringe. This process is called cystocentesis.

Blood SamplesAnalysis of the numbers and structure of blood cells is important in the diagnosis and monitoring of disease and infection. Blood samples are usually taken by the veterinar-ian or a veterinary technician for analysis.The color of the gums can also indicate problems such as

jaundice (a sign of liver disease), shock, or anemia.


There are 3 common tests carried out using red blood cells: packed cell volume, hemoglobin concentration, and red blood cell count. All 3 are interrelated and help your vet-erinarian diagnose diseases. The packed cell volume is the proportion of the whole volume of blood occupied by the red blood cells. When the proportion of red blood cells is high, the condition is called polycythemia. Polycythemia is common when a pet has dehydration or diarrhea. A low packed cell volume may suggest anemia or bleeding. The hemoglobin concentration in the blood sample indicates the oxygen-carrying capacity of the red blood cells. The red blood cell count is the number of red blood cells in a unit volume of blood. The results of the tests on red blood cells can tell your veterinarian a lot about the way your pet's body is functioning and suggest possible health problems.

There are 5 main types of white blood cells.

Neutrophils are the most common type of white blood cell. They engulf (“eat”) infectious particles such as bacteria. They increase in number during inflammation, infection, and short-term stress. A related type of white blood cell is the eosinophil. The number of eosinophils goes up during allergic reactions and some tissue injuries. Their number also goes up in response to certain tumors and parasites.

Basophils are the least common type of white blood cell. They are also related to neutrophils and eosinophils. An

increase in the number of basophils is associated with inflammation.

Monocytes are large cells that serve mainly as phagocytes and increase in number during chronic diseases.

Lymphocytes are the white blood cells responsible for antibody production and cell-mediated immune responses. Large increases in the number of lymphocytes often indi-cates leukemia, a type of cancer.

Platelets are cell-like particles in the blood. Another name for platelets is thrombocytes. Platelets are much smaller than red or white blood cells. They perform a critical role in the clotting process to repair damaged blood vessels. Thus, injuries often prompt a large increase in number of plate-lets. Some autoimmune diseases, blood clotting disorders, and bone marrow problems cause a decrease in the num-ber of platelets.

The Outside Laboratory or Test CenterMany of the tests the veterinarian uses to diagnose disease require highly specialized instruments or equipment. In other cases, specific training is required for the technicians performing the tests. For these reasons, many veterinarians will either send the samples to an outside laboratory or refer the patient to a special test facility. Some of the tests conducted are similar to those available in the clinic, but the availability of advanced testing equipment in a special-ized facility may offer advantages in speed and accuracy. For example, the specialized laboratory may be able to more easily spot and identify abnormally shaped red or white blood cells, both of which can help confirm a disease diagnosis, during routine tests on a blood sample.

In addition, at an outside laboratory specialized tests may be performed, such as one to detect larval stages of para-sites that are not easily found on standard tests. Because parasites also occur in samples other than stool samples, a direct smear of a pet's blood on a slide can be analyzed to detect the presence of blood parasites.

Most laboratories offer a basic group of tests, known as a basic test panel, which provides information regarding many general health problems. Having a laboratory per-form these tests can help point to a diagnosis, particularly if the animal has signs and a history that could make it difficult to determine the problem. The basic group of blood tests for pets includes total protein, albumin, globu-lin (calculated as the difference between total protein and albumin), urea, creatinine, alanine amino transferase (ALT), and alkaline phosphatase (ALP). This group of tests may be modified as appropriate for other animals. Based on the results of this group of tests, other tests maybe carried out as needed to reach a definite diagnosis.

The results of the tests on red blood cells can tell your

veterinarian a lot about the way your pet's body is functioning and suggest

possible health problems.


Special Days This MonthMonth and Week - Long Events include:

November • National Pet Cancer Awareness MonthNovember • National Pet Diabetes MonthNovember • Manatee Awareness MonthNovember • ASPCA's Adopt a Senior Pet MonthNovember 3-9 • USDA's Bird Health Awareness WeekNovember 3-9 • National Animal Shelter Appreciation Week

November Special Days include:November 17 • National Take a Hike dayNovember 17 • National Black Cat day

November 17th,National BLACK CAT Day

Month of NovemberUSDA's Bird Health Awareness Week

Coming up in the INSIDER:

✓ December - New Year Planning

Question? Comments? Suggestions for topics? Want to be on our mailing list, add a friend, or be removed from our mailing list? Please email us at [email protected]

INSIDER | APRIL 2014


April

2014


Customer Focus » Page 2

Prevention of Zoonotic Transmission » Page 4 & 5

Resources from The Web » Page 7

Continuing Education »

Did You Know » Page 10

A Focus on Endoparasites

The symptoms related to the occurrence of internal and external parasites are one of the leading reasons owners seek veterinary care and treatment for their working and companion animals. Identifying and treating the primary

cause and the associated symptoms make up a good portion of any veterinarian’s day. But how much emphasis is placed on prevention?

Despite best efforts by veterinary professionals and the larger veterinary health community, more than 21.5 million dog owners were found to be either not giving their dogs heartworm preventives or not administering them as recommended by their veterinarian. And an estimated 77 percent of veterinarians currently recom-mend year-round administration of heartworm preventives, but only half of owners report they follow these instructions.

This issue of the INSIDER will give you some tools and information to assist you in identifying and treating parasites, specifically endoparasites, and about prevention and other best practices.

INSIDER | MAY 2014


May

2014


A Team Approach to Client Compliance» Page 2

Lyme Disease in Dogs» Page 3, 4 & 5

Flea Allergy Dermatitis in no FAD » Page 6 & 7

Parasite Prevalence » Page 8

Identification and Treatment of Mange in Horses - Prevention and Control of Mange in Horses » Page 9 & 10

Continuing Education» Page 11 & 12

Did You Know?» Page 13

Mites, Ticks and Fleas…Oh My!

Alfred Lord Tennyson’s poem “Locksley Hall” contains the oft-quoted line “In the Spring a young man’s fancy lightly turns to thoughts of love”. In most veterinary clinics and hospitals, Spring causes veterinary practitioner’s

fancy to lightly turn to other, less romantic, thoughts: Mites, Ticks and Fleas.

While year-round prevention and treatment is the standard of care (particularly in the warmer climes of the U.S. south and west), springtime is the right time to advise your clients on just what’s bugging their furry friends.

In this issue of the INSIDER, we look at these common exoparasites and provide your practice with some topical information, tools, and tips on Mite, Tick and Flea prevalence, prevention and treatment.

INSIDER | JUNE 2014


June

2014


Discussing Small Animal Dental Exams with Clients» Page 2 & 3

Special Days This Month» Page 3

Malocclusions and Orthodontics in Dogs and Cats » Page 4

AAHA Dental Care Guidelines for Dogs and Cats » Page 5

Feline Dental Care and Treatment » Page 6 & 7

Resources From the Web » Page 8

Equine Dental Needs Change Over Time» Page 9 & 10

Continuing Education» Page 11 & 12

Did you Know?» Page 13

A Focus on Small Animal and Equine Dentistry

O ver 80% of dogs and 70% of cats develop some degree of periodontal disease by the age of three years, making dental disease the number one disease entity affecting small pets. And yet many pet owners are unaware

of the importance of regular dental health checkups.

The veterinary practitioner, veterinary technicians and front-office staff should all take a role in discussing regular dental care and annual exams with each client. One fact that is usually a good way to open the discussion (and is quite the eye-opener): The average cost to prevent dental disease in pets is $171.82, while aver-age cost for treatment of dental disease is $573.71!

In the issue of the INSIDER, we’ll offer additional discussion points to help explain the companion animal dental examination and care process, some thoughts on feline dentistry, the 2013 AAHA Dental Care Guidelines for Dogs and Cats, and the changing dental needs of your equine patients over time.


Book

mark This Page!

Resources From the Web

For More Information...

The organizations that advocate for veterinarians and other animal health professionals have terrific websites that are chock-full of information useful

to you and your staff’s career development, current events and topics, official guidelines, procedures and protocols related to animal care, and much, much more.

Bookmark those of most interest to you and your practice, and visit regularly!

American Veterinary Medical Association (AVMA): www.avma.org

American Association of Equine Practitioners (AAEP): www.aaep.org

American Association of Feline Practitioners (AAFP): www.catvets.com

American Animal Hospitals Association (AAHA): www.aahanet.org

American College of Veterinary Surgeons (ACVS): www.acvs.org

American College of Veterinary Surgeons (ACVS): www.navta.net

November 17th,National BLACK CAT Day


Equine Focus

Thoughts, Considerations and Techniqiues for Better Equine Radiographs

One of the biggest mistakes veterinarians make when buying digital imaging equipment for their equine practice is not taking the time to learn the

software and the accompanying image processing and tools.

That’s according to J.K. Waldsmith, DVM, president of Vetel Diagnostics and owner of The Equine Clinic, a full-service hospital, both in San Luis Obispo, Calif.

Dr. Waldsmith and other professionals place lack of under-standing before and after making a digital radiography equipment purchase on top of the list of possible mistakes equine practices can make.

Failing to ensure the following are also errors, Waldsmith said: a good environment for radiographs; proper electrical service where needed; proper staff; proper patient restraint; not having high speed Internet to transmit images and get technical support.

Another misstep is neglecting to check in with practice insurance providers about the new equipment, he said.

“Make sure you are covered [before] the DR system gets dropped,” Waldsmith advised. “Make sure your policy covers the cost of loaner systems while yours is being repaired.

“In my experience there is a greater need for the veterinar-ian to take the time to understand the technology, and how it can benefit their particular practice,” he said.

Waldsmith also said there’s need for more information from sources without a motive behind pitching one technology over another—there’s a need for a vendor-neutral product comparison provider like Consumer Reports.

“The profession has not seen the [needed] amount of lead-ership from the experts in terms of unbiased information both in the technology as it evolves, and also the impact on the utility and work flow it provides in the veterinary practice,” he said.

Still, there are ways to get information on products, Wald-smith said, such as asking vendors for a list of 10 references and personally asking radiologists and other experts their opinions as to the diagnostic quality of a product.

Not using physical markers on the plate is a common mis-

(source: source: Veterinary Practice News, June 2014; Don Jergler)

take seen by Carter E. Judy, DVM, Dipl. ACVS.

Making it a habit to use a physical marker helps reduce the risk of inappropriately labeling radiographs, said Dr. Judy, a staff surgeon at Alamo Pintado Equine Medical Center in Solvang, Calif.

“Almost all systems come with a digital marking system that attempts to identify the laterality of a radiograph,” Judy said. “However, those digital marking systems rely on hold-ing the imaging plate in a certain position. If that position is changed, then the digital marker may very well be in an inaccurate location and can hamper the proper identifica-tion of a specific problem.”

A simple solution: When buying a digital system, don’t throw out the old one’s physical markers.

Figure A is Navicular DP view, also known as a 65-degree DP view of the foot. It is of the same foot on the same horse as Figure B (below), and demonstrates the difference in image quality and diagnositic value between a DR system that isn’t working properly and a high-quality system.

“Use them just like the old radiographic techniques and tape them onto the plate in the correct laterality,” said Judy, who spoke at the American Association of Equine Practitio-ners “Focus on the Sport Horse” conference in Louisville, Ky., July 20-22.

Improper positioning, over-interpretation and human radiation exposure are all common problems and con-cerns identified by Steve Trostle, DVM, MS, Dipl. ACVS, Dipl. ACVSMR (Equine).

Dr. Trostle recommends proper positioning to optimize the area or areas that are to be evaluated; understanding DR anatomy, like the finer details of cortical and trabecular


bone patterns; practicing radiation safety, such as wearing protective gear and wearing a monitoring badge.

“On-demand interpretation” is another trouble spot, said Dr. Trostle, who works with Blue Ridge Equine Clinic in Earlys-ville, Va.

He pointed to instances in which DR images are acquired with the owner standing there, which can create a situa-tion in which interpretation is often expected on the spot. “In some scenarios the acquisition monitor is not of high-quality resolution and the reading monitor and some edge detail might be overlooked,” he said.

He suggested setting client expectations regarding inter-pretation of images, reading images on high-quality moni-tors and minimizing distractions during interpretation to help avoid errors.

One of the biggest mistakes Kent Allen, DVM, with Virginia Equine Imaging in Middleburg, Va., sees practices make is buy-ing poor-resolution CR or DR equipment. Dr. Allen’s mindset is that expedience is a nice advantage, but quality is key.

“You can buy the new wireless plates which make the radio-graphic shooting process go much quicker,” he advised. “Or you can buy the now older or used direct DR plates with wires at a much cheaper price. Make sure you get high-quality radiographic resolution either way.”

TechniquesAvoiding buying inferior equipment in the first place, Allen said. “Compare the image quality to some of your col-leagues’ radiographs that you admire or talk to practitioners who do radiographs on an everyday basis,” he said.

Another of his suggestions is to consider shooting a larger number of radiographs around a horse’s body.

Figure B is Navicular DP view, also known as a 65-degree DP view of the foot. It is of the same foot on the same horse as Figure A (above), and demonstrates the difference in image quality and diagnositic value between a DR system that isn’t working properly and a high-quality system.

“You need to do quality control on the radiographs as you’re shooting, not when you return to your clinic,” said Al-len, who is certified in equine locomotor pathology.

Waldsmith noted that there are various ways to digitally image a horse, but that “The biggest difference is the vari-ability of the X-ray dose,” he said. “This is dependent on the X-ray machine’s capability, and also age. Many times as X-ray generators age the X-ray dose that is actually produced is less than what the settings indicate.”

Another variable is focal film distance. This is fixed in companion animal DR systems, and brings greater predictability to what is expected when using a technique chart, Waldsmith said.

“One practice tip for equine practitioners, especially those using 80 kVp/15 mA X-ray generators, is to shorten your focal film distance if you feel your image lacks subject pen-etration,” he said.

Another Waldsmith tip is that if images appear dark enough but have a grainy appearance, cut the kVp 15 percent and increase the mAs at least 20 percent.

“This will provide better saturation of the DR panel and also decrease scatter radiation, producing a much more pleas-ing and diagnostic image, especially when it comes to soft tissue detail,” he said.

Digital ThoughtThinking that digital is always better is a misconception, said Myra Barrett, DVM, MS, Dipl. ACVR. “There is a large range in the quality of products on the market and many lower end —and some higher priced—digital units are poor quality,” said Dr. Barrett, an assistant professor at Colorado State University’s College of Veterinary Medicine & Biomedical Sciences. “Good screen/film radiography remains superior to low quality digital imaging. Consulting with a radiologist prior to purchase can help eliminate this problem.”

While digital imaging provides greater latitude with radio-graphic technique than traditional radiography, there is still the potential for over and underexposure, Barrett said, adding that proper technique is important.

“Also, many units have too strong an edge enhancement,” she said. “While this contrasting appearance can be pleas-ing to the less trained eye, the risk is of increased mock lines and over-diagnosis of fractures and other osseous patholo-gy. Most units allow you to modify the algorithm; choosing a smoother algorithm can decrease this problem.”

And with digital, positioning and labeling are still equally important, because positioned or unlabeled images are not adequately diagnostic, she cautioned. “In fact, some people are less attuned to positioning with digital because they just keep reshooting, which is easier with digital, thereby increasing the exposure to personnel and the patient,” Bar-rett said.

Courtesy of Kent Allen, DVM, with Virginia Equine Imaging in Middleburg, VA


®

Continuing Education Events

Continuing Education

Animal Health International strives to bring you the very best in Continuing Education, presented in a meaningful, practical way which allows you to bring new skills, techniques and knowledge to your practice and your patients right away. To learn more about our Continuing Education Events, please visit

http://www.animalhealthinternational.com/eventsAnimalHealth.html , or contact Animal Health International’s Director of Customer Solutions, Tom Knutson, at [email protected] .

In this issue of the INSIDER, please meet one of our instructors, Dr. Jack Easley.

Dr. Jack Easley, DMV, MS, ABVP

Jack Easley received a DVM degree from Tuskegee University in 1976. After completing a Large Animal Internship at Oklahoma State University, he served as an Associate Professor of Surgery at Kansas State University from 1978 to 1980 where he completed an Equine Surgical Residency and received a Masters Degree in Surgery. He was an Associate Professor of Surgery at the Virginia Polytechnic Institute, Virginia-Maryland College of Veterinary Medicine, 1980-1982. For the past 30 years, Dr. Easley has resided in Shelbyville, Kentucky where he owns a private practice emphasizing equine dentistry, oral and maxillofacial surgery, medicine and reproduction.

Easley is an active member of The American Association of Equine Practitioners (AAEP) having served on various committees, as an executive board member, dental committee chair and lecturer. Presently, he is a board member for the AAEP Foundation and Ethics Committee, Kentucky Veterinary Medical Association and member of the American Veterinary Dental Association, Kentucky Veterinary Medical Association, Kentucky Association of Equine Practitioners (past president), Shelby Co. Chamber of Commerce (board), and Shelby Co. Community Foundation.

For over 40 years, Dr. Easley has lectured extensively on and promoted equine veterinary dentistry throughout the world. He has written hundreds of articles for publication in professional as well as lay equine journals, textbooks, and periodicals. He serves on the editorial review boards for Equine Veterinary Education, Equine Veterinary Journal, and the Veterinary Dental Journal. Dr. Easley is the co-editor and major contributor of Equine Dentistry, first published in 1999 by Harcourt-Brace Publishing (Saunders) being the first equine dental textbook in recent times. This textbook was ultimately printed in Spanish and German; the 2nd edition published in October 2004 and the 3rd edition co-authored with Drs. Paddy Dixon and Jim Schumacher released in 2010. The guest author of Veterinary Clinics of North American, Advances in Equine Dentistry, released August 2013, Dr. Easley and colleagues have again added to current literature with the most recent data and up-to-date research in equine dentistry.

Dr. Easley is currently a member of the AVMA’s American Board of Veterinary Specialists Specialty Organizing Committee for a new American College of Veterinary Dentistry-Equine Specialty. On February 21, 2014, the American Board of Veterinary Specialists (ABVS) recognized Equine Dentistry as a specialty under the umbrella of the American Veterinary Dental College.

Dr. Easley currently resides in his hometown of Shelbyville, KY, with Sydney his wife of 43 years. They have three grown children and five grandchildren.


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“Everything we learned can be directly applied to a clinical or classroom setting. The information was interesting and the speakers were engaging. Being able to network and see others from the veterinary community was also a bonus. The hands-on practice cannot be beat!”--Rebecca Lange, veterinary technology program chair at Globe University-Appleton

“Hi Tom! Thanks for sharing the pictures. This weekend was a great value for learning. I am glad I had the opportunity to attend and definitely got my money's worth.”--Sherry L. Walters BS, DVM

Animal Health International is very proud of the quality of the Continuing Education programs we offer, and we’d like you to join us! Here is some feedback we’ve received:

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2014/2015 Orthopedics Lecture and LabsComprehensive Stifle Disease February 5-7, 2015 Oquendo Center, Las Vegas, NV

Cora-Based Tibial Leveling Osteotomy (CBlO) February 8-9, 2015 Oquendo Center, Las Vegas, NV

Basic Orthopedics March 21, 2015 Midwest/High Plains - IWCC

Basic Orthopedics April 25, 2015 New Orleans, Louisiana

Basic Orthopedics May 16, 2015 Roanoke, Texas

Juvenile Hip Dysplasia (JPS, DPO, TPO, FHO) June 13-14 Oquendo Center, Las Vegas

2015 Equine Lecture and LabsEquine Anesthesia w/Dr. Victoria Lukasik October 3-4, 2015 Site TBD

Advanced Equine Dentistry w/Dr. Jack Easley September 19-20 Elk River, Minnesota

2014/2015 Small Animal Dental Lecture and LabsDental - Level 1 - 2014Dental Lecture & Lab w/ Dr. Brook Niemiec November 22-23, 2014 Pomona, California

Dental - Level 2 - 2014Dental Lecture & Lab w/ Dr. Brook Niemiec December 13-14, 2014 Napa Valley, California

Dental - Level 1 - 2015Dental Lecture & Lab w/Dr. Brook Niemiec March 28-29, 2015 El Paso, Texas

Dental Lecture & Lab w/Dr. Brook Niemiec April 11-12, 2015 Nashville, Tennessee

Dental Lecture & Lab w/Dr. Brook Niemiec June 13-14, 2015 Tampa, Florida

Dental Lecture & Lab w/Dr. Brook Niemiec August 22-23, 2015 New Orleans, Louisiana

Dental Lecture & Lab w/Dr. Brook Niemiec September 26-27, 2015 Atlanta, Georgia

Dental Lecture & Lab w/Dr. Brook Niemiec October 17-18, 2015 Houston, Texas

Dental Lecture & Lab w/Dr. Brook Niemiec November 21-22, 2015 Midwest - IWCC

Dental Lecture & Lab w/Dr. Brook Niemiec December 5-6, 2015 Site TBD

2014/2015 Anesthesia Lectures and LabsAnesthesia - Level 1 - 2014Advanced Anesthesia w/Dr. Victoria Lukasik November 15, 2014 Austin, Texas - SOLD OUT

Anesthesia - Level 1 - 2015Advanced Anesthesia Level-1 w/Dr. Victoria Lukasik June 6, 2015 Denver, Colorado

Anesthesia - Level 2 - 2015Advanced Anesthesia Level-2 w/Dr. Victoria Lukasik April 18-19, 2015 Midwest/High Plains - Sioux Falls

Advanced Anesthesia Level-2 w/Dr. Victoria Lukasik May 30-31, 2015 Houston, Texas

Advanced Anesthesia Level-2 w/Dr. Victoria Lukasik September 12-13, 2015 Austin, Texas


Did you know that Animal Health International launched our new website? We did! Animal Health International is always looking to provide new and useful tools to help our customers succeed, and our new website is one of those tools. Visit www.AnimalHealthInternational.com to view our latest event calendar (including Wet

Lab and Lecture Continuing Education opportunities), links to important sites such as the USDA, Outbreak Alert (for an updated, resource rich map of outbreaks of equine and other animal diseases), the Compendium for Veterinary Products, and more!

From our website, you can also link to our online ordering site, for convenient, 24-hour ordering.

OTHER HELFUL TOOLSEVENTS CALENDERClick on the EVENT button, located on the main menu, to learn more about upcoming shows and learn more about our educational courses.

SERVICESAnimal Health International offers a broad range of services to help you manage your business. Click on a SERVICE button to see what we have to offer you.

PROMOTIONSAre you interested in seeing what promotions we have to offer as a company? Visit the promotions page to register for an account and see which manufacturers are offering promotions!

Comprehensive Stifle Disease February 5-7, 2015 Oquendo Center, Las Vegas, NV

Cora-Based Tibial Leveling Osteotomy (CBlO) February 8-9, 2015 Oquendo Center, Las Vegas, NV

Basic Orthopedics March 21, 2015 Midwest/High Plains - IWCC

Basic Orthopedics April 25, 2015 New Orleans, Louisiana

Basic Orthopedics May 16, 2015 Roanoke, Texas

Juvenile Hip Dysplasia (JPS, DPO, TPO, FHO) June 13-14 Oquendo Center, Las Vegas

822 7th Street, Suite 630Greeley, CO 80631

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animalhealthinternational.com822 7th Street, Suite 740Greeley, Colorado 80631

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Shop online now to:• Access your past orders, invoices, statements and more!

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november 2014 - animal health...

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