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Animal Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Consideration can be given to treatment of companion animals under the guidance of the treating veterinary surgeon. The potential for dissemination of zoonotic bacteria is lower in these species than in production animals, as generally companion animals are housed in much smaller groups, and can be contained indoors, with less opportunity for dissemination of infection among numerous animals as would occur in a herd situation. However, regardless of this, the zoonotic potential of the infection should be carefully considered, and public health authorities should be notified if a diagnosis of MTBC infection is made in a cat or dog.
The art and science of surgery
Published in Lois N. Magner, Oliver J. Kim, A History of Medicine, 2017
Despite the reputation of hospitals as places where people went to die, the annual reports of some hospitals suggest a respectable success rate. For example, the 1856 annual reports of Philadelphia's Children's Hospital claimed that of 67 children admitted that first year, 41 were discharged as cured, and none had died. In contrast, in 1870, when Dr. Abraham Jacobi publicly revealed the appalling mortality rate at a children's hospital in New York, he was forced to resign. Hospital administrators refused to institute reforms suggested by Jacobi, one of the founders of American pediatrics. Physicians and surgeons knew all too well that even a pinprick opened a doorway to death. The doctor was no more immune to the danger than his patient. Minor wounds incurred during autopsies or operations could lead to death from a massive systemic infection known as pathologist's pyemia. With but slight exaggeration, doctors warned that it was safer to submit to surgery in a stable, where veterinary surgery was routinely and successfully performed, than in a hospital. When miasmata generated by ineluctable cosmic influences permeated the hospital, patients inevitably succumbed to hospital gangrene, erysipelas, puerperal fever, pyemia, and septicemia. Physicians endlessly discussed the nature of these disease entities, but all of these life-threatening infections can be subsumed by the term hospitalism or nosocomial infections.
Communicating with patients
Published in Ray Fitzpatrick, John Hinton, Stanton Newman, Graham Scambler, James Thompson, The Experience of Illness, 1984
The interview is the one thing which distinguishes medicine from veterinary surgery. Despite being the cornerstone of medical practice, it is often seen as a tiresome interface between the doctor and the disease, yet it may determine the form and content of the information provided, and may totally determine whether the advice given is heeded. Relatively little attention is paid by medical curricula to interviewing skills, the assumption being that such abilities come naturally with unsupervised practice. Yet dissatisfaction with medical communications remains the most prominent of patient complaints and a major factor in the move to alternative medicine, with its focus on good and reassuring communications and the patient as an informed participant in treatment. Patients prefer to be able to give an account of their problems in their own terms, yet these expectations of communication are often unmet. This chapter will outline the perspective which social psychology brings to the study of social interactions. It will then discuss some of the problems which have arisen in communicating with patients, will consider the interview process as a decision-making task and will then go on to study the training methods which have been employed to improve communication skills.
Histotripsy ablation for the treatment of feline injection site sarcomas: a first-in-cat in vivo feasibility study
Published in International Journal of Hyperthermia, 2023
Lauren Ruger, Ester Yang, Sheryl Coutermarsh-Ott, Elliana Vickers, Jessica Gannon, Marlie Nightengale, Andy Hsueh, Brittany Ciepluch, Nikolaos Dervisis, Eli Vlaisavljevich, Shawna Klahn
Client-owned cats with naturally-occurring peripheral soft tissue tumors were screened at the Virginia-Maryland College of Veterinary Medicine Animal Cancer Care and Research Center (ACCRC) over a 2-month period (22 September 2021 – 18 November 2021) and enrolled in a prospective, single-arm, pilot study of histotripsy treatment in cats diagnosed with peripheral soft tissue sarcoma. Feline patients with a cytologic or histologic diagnosis of peripheral, malignant soft tissue sarcoma were considered for enrollment. Study inclusion criteria included tumor diameter of ≥ 2 cm in the longest dimension, complete tumor resectability as determined by an American College of Veterinary Surgeons (ACVS)-board-certified veterinary surgeon, expected patient survival of > 4 weeks without treatment, and compliance with all scheduled treatment visits. At the time of study screening, patients were required to undergo routine laboratory bloodwork and thoracic and abdominal imaging. Patients were excluded if the tumor was non-resectable or if the recommended surgical resection was declined; if the patient had definitive therapy other than surgery within the past 3 weeks; or if they had a significant co-morbidity (significant cardiac, pulmonary, or renal dysfunction, ALT or AST values ≥ 3x the upper reference limit). The owners of eligible cats were offered standard treatment options, including palliative care, and informed consent was obtained for all enrolled cats. This study was approved by the University Institutional Animal Care and Use Committee (IACUC protocol #20-180) and the College of Veterinary Medicine Hospital Board.
Instilling Fairness in Animal Research
Published in The American Journal of Bioethics, 2018
Horrifically, for most of the history of animal research, when pain was inflicted in patently invasive experiments, it was not controlled. A 1907 veterinary surgery textbook laments that anesthesia was rarely utilized in veterinary medicine when a procedure could be accomplished by forcible restraint (known as bruticaine in veterinary circles), and that remained common practice in cattle and equine medicine (Merillat 1906). In the same vein, when I began teaching veterinary ethics in 1978, I learned that analgesia was not taught or used in veterinary medicine, even when animals were used multiply for surgery teaching to save money. When I and two veterinarian colleagues wrote the federal law to require analgesia in research animals and I was asked by Congress to prove that such a law was needed, a literature search on animal analgesia with the Library of Congress turned up only two papers, one of which affirmed that there ought to be papers. Sometimes people who studied pain in animals would incoherently deny that we could know animals felt pain! There are still no postsurgical analgesics federally approved for farm animals.
An Investigation of a Novel Tendon Transfer Surgery for High Median-Ulnar Nerve Palsy in a Chicken Model
Published in Journal of Investigative Surgery, 2019
Geoffrey R. Browning, Anthony H. Le, Jennifer J. Warnock, Ravi Balasubramanian
Surgery was performed by a board-certified veterinary surgeon on the left hindlimb of each animal. Hanging leg preparation was used along with aseptic technique. Three quarter drapes were placed around the leg, followed by a full drape. A tourniquet using sterile vet wrap was placed just proximal to the surgical site. Using a #10 scalpel blade a three-centimeter longitudinal incision was made on the dorsal surface of the tarsometatarsus. The skin was incised between the larger dorsal scales and the smaller secondary scales medially, and the medial spur was used as a midline landmark. Dissection using sharp-sharp scissors was performed to expose the EDL tendons beneath the fascia (Figure 2). The tendons were handled with Bishop Harmon tissue forceps, and implant was handled with Debakey tissue forceps. Exposure was maintained using mosquito hemostats (Figure 2). For the implant group, the implants were placed deep to the tendons approximately 5–8 millimeters distal to the EDL tendon bifurcation (Figure 3a). The implant was sutured with 5-0 polypropylene suture on a taper needle (Prolene) in each tendon longitudinally angled slightly off midline (Figure 3b). Square knots for each EDL tendon branch were oriented on the deep surface (Figure 3c). The resulting position and orientation of the implant prior to skin closure can be seen in Figure 4 and 5. For the sham group, the implant was positioned and then removed. Two single interrupted sutures were placed at the same location (Figure 6). The skin was closed in a cruciate pattern with 4-0 nylon suture on a reverse cutting needle (Ethicon). The skin was cleaned with iodine solution. Triple antibiotic ointment (bacitracin-neomycin-polymyxin B) was applied topically to the incision site. Finally, a bandage was placed over the incision using a telfa pad, cast padding, and vet wrap.