A NewsmAgAziNe V ANd C Traumatic injuries ofA NewsmAgAziNe for VeteriNAriANs ANd their ColleAgues Inside NoVember/deCember 2011 Vol.6, No.6 Return undeliverable Canadian addresses

A NewsmAgAziNe for VeteriNAriANs ANd their ColleAgues

InsideNoVember/deCember 2011

Vol.6, No.6

Return undeliverable Canadian addresses to3662 Sawmill Valley DriveMississauga, Ontario L5L 2P6Publications Mail Agreement #41262570

The Canadian Veterinary Medical Association

Conference, Halifax, NSand the Ontario Veterinary

Medical Association Conference, Toronto, ON

In thIs IssueFocus on...

3 Canadian Vet Advisory Board

4 VetLaw

9 Nutritional assessment of the cat with cardiac disease

12 Shake That Sass – a story about believing…

13 Unlocking the secrets of a deadly heart disease

14 Zoonoses − both sides of the coin Part 3: Toxocara

15 First aid for injured wild birds

16 A team approach to managing feline hyperthyroidism

18 For Pet’s Sake

21 The do’s and don’ts of selling a veterinarian practice

22 Canine Vaccine Guidelines revised

22 2011 Ride for Farley

24 Industry News

25 Best Practices

26 Continuing Veterinary Education Calendar

26 CVMA News

Managing osteoarthritis in dogs involves teamworkTORONTO, ON − Osteoarthritis (OA) is a ubiquitous orthopedic problem in dogs, particularly in large breed dogs. It causes acute pain and, later in life, chronic pain, explained Denis Marcellin-Little, DEDV, DACVS, DECVS, DACVSMR, speaking at the Ontario Veterinary Medical Association Conference. Dogs with chronic pain become less fit, less playful, and less mobile as the disease progresses. It is critically important to manage the disease early and comprehensively to decrease, delay, or avoid the long-term consequences of OA. What causes OA in dogs?OA is also often identified in middle age and older dogs but, unlike humans, the problem has often been present for years. Dr. Marcellin-Little said that he believes the cause of OA is a developmental or genetic orthopedic disease for the overwhelming majority of dogs with OA. The most common orthopedic diseases are hip dysplasia, the various forms of elbow dysplasia including elbow subluxation resulting from antebrachial growth deformities, osteochondritis dissecans (OCD) of the humeral head, femoral

Traumatic injuries continues on page 4

Traumatic injuries of the respiratory systemTORONTO, ON − Traumatic injuries of the respiratory system are fairly common in dogs and cats, and can lead to life threatening complications. Familiarity with the clinical signs associated with these injuries will help the veterinary clinician select the appropriate interventions to aggressively treat these critical cases, explained Steven L. Marks BVSc, MS, MRCVS, DACVIM, speaking at the Ontario Veterinary Medical Association Conference.

Airway traumaAirway trauma may be a result of blunt or penetrating trauma. Blunt trauma to the trachea or larynx can lead to hemorrhage or edema of the airway which, in some cases, can lead to secondary obstruction due to swelling of the airway mucosa and/or hemorrhage.

Clinical signs include dyspnea and cyanosis, and subcutaneous emphysema is often present following

Feline infectious peritonitis TORONTO, ON − Feline infectious peritonitis (FIP) is a disease of cats caused by a virulent biotype of feline coronavirus, affecting approximately one out of every 200 cats seen at referral centres such as veterinary medical teaching hospitals. Veterinarians are often faced with a diagnostic dilemma because there are no individual tests that are reliable for the diagnosis of FIP and the clinical picture is highly variable, explained Susan Little, DVM, DABVP (Feline), speaking at a Lifelearn live seminar.

Feline coronavirus is different from other feline viruses because systemic antibodies have no protective function for the cat and actually play a role in the disease itself; antibody titres have limited usefulness for diagnosis of FIP or predicting which cats are at risk of developing FIP; and although a vaccine is available, there is no consensus on its efficacy or safety.

Biology There are two biotypes of feline coronavirus: feline enteric coronavirus (FECV) and feline infectious

Managing osteoarthritis continues on page 6 Feline peritonitis continues on page 8

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NMX AD-Canadian Vet magazine 9/29/10 8:38 AM Page 1

3november/December 2011 canaDIan vet

Canadian Vet Advisory Board

canaDIan vetA NewsmAgAziNe for VeteriNAriANs ANd their ColleAgues

Publisher Karen Tousignant [email protected] Managing Editor Shelagh Ross [email protected] Art Director Jason Praskey [email protected] Advertising [email protected] Subscriptions & Circulation [email protected]

Published six times annually by K2 Animal Health Publishing, 3662 Sawmill Valley Drive, Mississauga , Ont L5L 2P6 Telephone: 905-607-7338 Toll-free: 1-888-607-7338 Fax: 905-607-0181

Each clinical article in Canadian Vet is reviewed for accuracy by the veterinarian who presented at the meeting.Copyright 2011. All rights reserved. Printed in Canada.

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Canadian Vet is honoured to have the following veterinarians as members of our Veterinary Advisory Board. In addition to providing knowledge and expertise on animal health issues, our veterinary advisory board members will help us keep the publication useful and relevant to veterinarians in Canada.

David Francoz DVM, DACVIM

St. Hyacinthe, QC

Søren R. BoysenDVM, DACVECC

Calgary, AB

Susan LittleDVM, DABVP (feline)

Ottawa, ON

Elizabeth Bellavance DVM, CMA, MBACamlachie, ON

Joseph C. Wolfer DVM, DACVOToronto, ON

Danny JoffeDVM, DABVP (canine/feline)

Calgary, AB

Trisha Dowling DVM, MSc, DACVIM & DACVCP

Saskatoon, SK

Duane LandalsDVM, BSc.AgEdmonton, AB

Ernie ProwseDVM, BSc, BA

Truro, NS

Scott WeeseDVM, DVSc, DACVIM

Guelph, ON

John TaitBSc, DVM, MBA, CFP

Guelph, ON

Fraser HaleDVM, FAVD, DAVDC

Guelph, ON

4 november/December 2011canaDIan vet

Among the most recurring inquiries at our offices relates to seeking advice on the best protocols to adopt when faced with the unpalatable task of terminating the employment of one of your employees. These situations are often emotionally charged and tend to create levels of angst for both the employer and the employee. As such, while acknowledging that the emotional element will never be completely absent, one might consider the following five steps in approaching this business decision.

Step one: rehabilitation?The first assessment to be undertaken is to determine whether or not the conduct of the employee is such that a rehabilitation effort might be more appropriate rather than terminating the relationship. Very often a series of events leads to a consideration of firing the employee; however, given the legal exposure that an employer faces, it may be worthwhile in some cases to try to rehabilitate the employee with the help of some guidance and training. If rehabilitation is an option, then careful monitoring of the actions of the employee over a set period of time should be undertaken; if the employee does not meet the challenges of the rehabilitation effort, then the notion of termination becomes a more appropriate action. At the commencement of the correction period, a clear and unequivocal warning should be provided to the employee that failure to achieve an appropriate change will result in termination.

Of course, if the employee has engaged in conduct which otherwise would constitute “just cause” for dismissal, the employer is at liberty to implement an immediate firing without further liability; however, it is a very rare occurrence indeed that legally-justified cause for termination exists.

Step two: employment contract?If rehabilitation is not a viable option or the effort to correct fails and “just cause” for termination does not exist, then one should next consider the terms of any written employment agreement with the employee to determine whether or not its content speaks to the employer’s obligations with respect to termination. Very often the main purpose of an employment contract is to set out the protocols to terminate the relationship and will set out the amount of notice or payment in lieu of notice that the employer must comply with. If a contract exists and addresses the issue, then one merely follows the protocols set out in the document to terminate the relationship. Step three: reasonable noticeIn the absence of a written employment agreement, the employer has a legal obligation to provide the employee with reasonable

notice or payment in lieu of notice. In determining what is reasonable in the circumstances, regard must be given to the relevant provincial employment standards legislation, the age of the employee, the employee’s seniority, the quality of the employee’s work, and the likelihood of the employee successfully seeking alternative employment. Generally speaking, the “rule of thumb” for determining what constitutes “reasonable notice” is a month per year of service; this is a general rule only and there are a number of factors that will go into the determination and, as such, it is definitely an area where the employer will want to seek advice from his or her lawyer.

Step four: notice or payment in lieu?Once the appropriate amount of notice has been established, the employer has the option of determining whether or not the employer wishes to provide notice of termination or move to an immediate dismissal providing a payment in lieu of notice. The principal consideration at this stage is to determine whether or not the continued engagement of the employee through a notice period can be appropriately “policed” and the impact that the employee’s continued presence will have on the remaining staff. If one elects to give notice, then a formal written notice should be delivered to the employee providing the amount of notice determined at “Step three” above; if one elects to give a payment in lieu of notice, then one must consider whether or not the proposal will be for a lump sum payment or for “salary continuance” over the relevant notice period. Note that the employee is entitled to a lump sum payment if the employer desires to pursue immediate dismissal; given the sometimes significant negative cashflow impact that a lump sum payment might bring, providing for a slightly more generous payment over time might be preferable.

Step five: the exit interviewThe final stage of the process is to actually meet with the employee and advise him or her of your decision and to present either a letter providing notice or a proposal for payment in lieu of notice. If the latter is pursued, the employee should be invited to seek independent advice and required to sign a release absolving the clinic from any further legal action in the future.

Douglas Jack practises law in Fergus, Ontario dedicated to the legal aspects of veterinary practice. He can be reached by email at [email protected]. Visit his website at www.vetlaw.ca and his blog at www.vetblawg.ca.

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the injury. The respiratory pattern may vary depending on the level of the disease, for example whether it is extrathoracic or intrathoracic. Additional diagnostic evaluation may include radiography, contrast radiography, or tracheoscopy.

Emergency treatment includes oxygen supplementation and restoration of the airway; this may include tracheostomy and continued medical management or surgical repair in the case of tracheal disruption. Stabilization of other concurrent disorders such as shock and pneumothorax must also be a priority.

Flail chestFlail chest is a specific injury that involves multiple rib fractures. It occurs when dorsal and ventral fractures occur in two or more adjacent ribs, causing a free-floating section of the thoracic wall, resulting in a paradoxical motion or “flailing”. Pets with this degree of injury are generally dyspneic due to concurrent injury such as pneumothorax, hemothorax, or pulmonary contusions and the pain associated with the trauma. Dr. Marks said that while the administration of oxygen and analgesics is beneficial, local analgesia should be considered due to the risk of administering systemic analgesic

Traumatic injuries continued from page 1


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prior to and during thoracocentesis. Thoracocentesis can be performed with the pet standing or in sternal or lateral recumbency, using a 60 cc syringe, fluid administration extension set, and 20-22-gauge needle. Alternatively, a transvenous catheter or butterfly catheter can be used. Thoracic radiographs may be useful but should not be performed until the patient is stabilized. If thoracocentesis continues to be productive, after several attempts, thoracic drain placement may be required. Dr. Marks stressed that as with other thoracic injuries, concurrent disease may be present.

Pleural effusionThe types of traumatic pleural effusion include hemothorax and chylothorax, with the diagnosis of hemothorax being far more common than chylothorax in the trauma patient. The presence of fluid in the pleural space should be detectable on thoracic auscultation and percussion.

Oxygen supplementation is usually recommended. As well, fluid analysis should be performed as soon as possible to confirm the diagnosis. Thoracic radiographs and ultrasound should be delayed until the patient is stable. If the effusion is refractory to therapy with thoracocentesis, thoracostomy tube placement must be considered.

agents that may adversely affect respiratory function. Local infiltration with lidocaine and bupivacaine may be useful in these patients (1.5 mg/kg), as well as ventilatory support depending on the severity of the injury and evaluation of ventilation. Pulmonary contusionsPulmonary contusions are a common finding in animals with thoracic trauma and occur after hemorrhage into the pulmonary parenchyma and alveoli. There may be concurrent disease such as pneumothorax and hemothorax. The diagnosis is often made after thorough physical examination, thoracic auscultation, and review of thoracic radiographs. Negative thoracocentesis in a dyspneic pet should increase the clinical suspicion of the presence of pulmonary contusions. The clinical finding of hemoptysis is also indicative of pulmonary contusion. Dr. Marks added that since thoracic radiographs may not reveal the full extent of injury during the acute assessment of the patient, evaluation can be enhanced with an arterial blood gas analysis and pulse oximetry. He noted that the hypoxemia that is detected in these patients is generally due to ventilation perfusion mismatch and intrapulmonary shunting.

Cage rest and oxygen supple-mentation are the main treatments. The use of antimicrobials and corticosteroids are controversial, while the use of furosemide to treat pulmonary contusions in the unstable patient is contraindicated.

PneumothoraxPneumothorax, or air in the pleural space, is most commonly seen in dogs and cats secondary to trauma. Physical examination usually indicates a restrictive breathing pattern, which is characterized by rapid shallow breathing. Thoracic auscultation reveals dull or distant lung sounds. Thoracic percussion is often a useful tool and may be hyperresonant confirming the diagnosis. Thoracocentesis should be performed immediately and prior to thoracic radiographs if the animal is dyspneic.

Oxygen supplementation via face mask may be used in these patients


Diaphragmatic herniaThe diagnosis of diaphragmatic hernia is most commonly made after survey thoracic or abdominal radiographs. These animals are often not stable due to shock, pulmonary contusions, and pain associated with the traumatic incident. The concurrent injuries should be treated and the patient stabilized prior to surgical intervention for repair of the diaphragm. Oxygen therapy may be beneficial and thoracocentesis may be performed if pleural effusion or pneumothorax is present.

SummaryDr. Marks concluded by saying that traumatic injuries of the respiratory system often cause life-threatening complications in the dog and cat. Therefore, it is important for the veterinary clinician to rely on history, clinical signs, and physical examination findings to triage these patients and provide efficient and effective care. In many cases supportive care including oxygen therapy, fluid therapy, and analgesia will help stabilize these patients. CV

Managing osteoarthritis continued from page 1

condyles, and ridges of the talus, cranial cruciate ligament (CCL) injuries, and patellar luxations.

Joints with developmental orthopedic diseasesJoints with developmental orthopedic disease have direct damage to the articular cartilage and synovitis (Table 1). Hip dysplasia, elbow dysplasia, and OCD are developmental diseases that develop during the rapid phase of growth, between 3.5 and 5 months of age. Elbow dysplasia leads to irreversible changes in cartilage within a few weeks after the onset of humero-radial or humero-ulnar subluxation. With OCD, damage to the articular cartilage occurs as soon at the osteochondral flap develops. With hip dysplasia, the first signs of disease are hip laxity and subluxation. The subluxation leads to the destruction of the dorsal acetabular rim and leads to damage to the femoral head. The development of osteophytes in subluxated hip joints generally occurs over a period of a few months. In some dogs, generally the largest dogs and the dogs with severe hip laxity, dorsal acetabular rim damage, synovitis, and OA may develop over a period of weeks. In other dogs, OA may develop over a period of years. With patellar luxation, damage to the cartilage of the trochlea and patella may or may not occur early in life based on the frequency of the luxation and the shape of the femur and tibia.

Dr. Marcellin-Little stressed that the management of OA will be much more successful if problems are identified and managed early in life, before they have a profound impact on patients’ limbs, bodies, and lifestyle.

Stage 1 − Growing dogs with developmental orthopedic diseases may have a pelvic limb lameness (with hip laxity, patellar luxation) or a forelimb lameness (with elbow subluxation, elbow dysplasia, OCD of the shoulder joint). The lameness may be intermittent or constant. The clinical signs of early joint disease are often ill defined: being generally slower, clumsier, less playful, having a “funny” gait. As OA enters its chronic phase, the clinical signs become more discrete and more intermittent.

Stage 2 − Young adult dogs with joint disease often have intermittent signs that subside after a night of rest. These signs are often associated with more intense periods of activity. The likelihood of diagnosing OA appears to vary between specific joints. Some diseases are easier to visualize than other diseases.

Stage 3 − Middle aged dogs with OA progressively become exercise intolerant. They may sit when taking a leash walk and/or hesitate or refuse to climb into a motor vehicle or to climb stairs. The changes present at that stage of OA are more profound, and involve cartilage damage, thickened joint capsule which may restrict the motion of the arthritic joint, and muscle mass loss in the affected limbs. A pain response to joint motion or to joint loading is much more likely to be present at that stage. OA flares are easier to trigger, are more severe, last longer, and are harder to control with therapy. OA is often diagnosed at that third stage because the clinical and radiographic signs are more severe.

Stage 4 − The fourth stage is most severe, and often involves geriatric dogs who are losing the ability to walk and perform activities of daily living. The changes present in limbs with OA involve loss of articular cartilage, thickening of the joint capsule, and pain when joints are loaded or when joint capsules are stretched. The loss of muscle mass is more severe. Dogs, particularly overweight dogs, progressively lose the ability to walk.

Intervention strategiesOwners, clinicians, and technicians should be proactive, and avoid waiting until problems are severe and chronic. Dr. Marcellin-Little said that the key to early intervention is education and awareness.

Therapeutic interventions should be proportionate to the severity of the disease and should focus on treatments that have proven benefits in humans or in dogs. The anticipated cost of long-term management should be discussed, including weight loss and regular leash walks.

At the first stage, dogs should be screened for developmental orthopedic diseases. Radiographs should be made of painful joints. Dogs with OA should regularly engage in low-impact activities, particularly leash walks. Nutrition should be optimized in dogs diagnosed at the first stage because slowing growth has been shown to have a profound positive impact on the rate of development of OA. Clinicians and veterinary technicians should provide perspective on the course of the disease over a lifetime.

At the second stage, owners should identify patterns of lameness that follow specific activities. Dogs should be exercising daily in ways that do not induce lameness and OA flares. Owners should normalize the dog’s weight to help reduce the progression rate of OA. Dogs should be reevaluated yearly by their clinician, who should assess their gait, fitness level, muscle mass, and other changes resulting from OA. Veterinary technicians should be in contact with owners to make sure that long-term management programs are sustained.

At the third stage, screening should involve the assessment of joint pain, muscle mass, and goniometric measurements of joint motion. Clinicians should discuss with owners the types of exercises that would allow OA dogs to maintain (or recover) their strength. They should be more specific and supervised more closely. Sustained pain management and a weight optimization program are both important to optimize the dog’s mobility and quality of life.

OA becomes a life-threatening situation at the fourth stage. Pain management is the most critical aspect of OA management at that stage. Clinicians should not hesitate to hospitalize dogs to optimize rest, provide short-term ambulation assistance, provide thorough pain management, and maximize the chances of controlling the situation.

SummaryOwners, clinicians, and technicians need to assess and monitor dogs for OA before problems become severe and chronic. Once problems are identified, management strategies should be developed, involving the entire team, to optimize mobility and quality of life. Dr. Marcellin-Little stressed that education and awareness are the key to early intervention. Early diagnosis of orthopedic diseases, he said, should be a high priority for all involved. CV

Secondary problems

Key clinical signs

Table 1 The classic causes of osteoarthritis in dogs and their consequencesClassic causes of

osteoarthritis

Hip dysplasia

Elbow dysplasia

Osteochondritisdissecans (OCD)

Patellar luxations

Cranial cruciate ligament injuries

Primary problem

Lateral femoral subluxation

Humero-ulnarsubluxation

Flap of cartilage and subchondral bone

Lack of patellar stability

Synovitis from ligament damage?

Damage to the articular cartilage Synovitis/joint capsule thickening

Damage to the articular cartilage. Synovitis/joint capsule thickening

Synovitis/joint capsule thickening

Damage to the articular cartilage Loss of stifle joint motion

Loss of joint stabilityDamage to medial meniscus

Puppies bunny hop at a gallop, around 6 months of age. Wide base stance

Forelimb lameness around 6 months of age and later in life Pain in joint flexion

Forelimb or pelvic limb lame-ness around 6 months of age

Intermittent lameness around 6 months of age. Lack of limb use in severe situations

Severe pelvic limb lamenessLoss of willingness to sit straight

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To learn more, contact your Hill’s Veterinary Account Manager, go to HillsVet.ca or call Hill’s Veterinary Consultation Service at 1-800-548-VETS (8387).1Fritsch DA, Allen TA, Dodd CE, et al. A multicenter study of the effect of dietary supplementation with fi sh oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. J Am Vet Med Assoc. 2010;236:535-539.2 Roush JK, et al. Multicenter practice assessment of the effects of omega-3 fatty acids on osteoarthritis in dogs. J Am Vet Med Assoc. 2010;236(1):59-66.3 Roush JK, et al. Evaluation of the effects of dietary supplementation with fi sh oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. J Am Vet Med Assoc. 2010;236(1):67-73.4Renberg WC. Pathophysiology and management of arthritis. Veterinary Clinics of North America: Small Animal Practice 2005;35:1073-1091.

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peritonitis virus (FIPV). FECV is a very common, highly infectious feline virus that is transmitted by the fecal-oral route. It has been estimated that in multi-cat households where FECV has been introduced, 80-90% of all the cats will be infected. In the general cat population, infection rates may reach 30-40%, and are lowest in feral cat populations.

The majority of cats with FECV remain healthy, although in a small number of cases, FECV infection is the first step in a chain of events leading to FIP. Dr. Little explained that the vast majority of cats do not “catch” FIP but become affected when their own FECV infection mutates. Therefore, cats that are ill with FIP are unlikely to be a risk to other cats, especially to adults, and may not need to be isolated.

Clinical presentation Most cats affected with FIP are between three months and two years of age. Other risk factors include living in a multi-cat home; pedigreed breeds; genetic susceptibility; concurrent diseases, especially feline leukemia virus (FeLV) infection; and stress.

FIP presents in two clinical forms: effusive (wet) and non-effusive (dry) and both may occur, usually during transition from one form to the other, in the same patient. The effusive form is traditionally the most commonly seen, although the non-effusive form appears to be increasing in prevalence in recent decades. Some clinical signs are common to both forms and include: • Lethargy • Anorexia • Weight loss • Chronic fluctuating fever non-responsive to antibiotics • Poor growth rate in kittens

Overt clinical signs may be apparent for a few days to a few months, but in retrospect may have been preceded by a long period of vague ill health and poor growth in kittens. Generally the effusive form progresses more rapidly than the non-effusive form.

Clinical signs associated with the effusive form are due to immune complex damage of small blood vessels (vasculitis) with the resulting leakage of serum protein and fluid into body cavities. The most common clinical feature is ascites; in fact, FIP is the leading cause of ascites in young cats. Typically, the abdominal distension is non-painful and a fluid wave may be palpated.

If pleural effusion occurs, the primary clinical signs may include dyspnea, tachypnea, open-mouth breathing, and cyanotic mucous membranes. Heart sounds will be muffled on thoracic auscultation. Other less common signs include ocular or central nervous system (CNS) involvement, pericardial

effusion, and scrotal enlargement due to extension of peritonitis to the tunics surrounding the testes.

Clinical signs associated with the non-effusive form are due to localized perivascular infiltrates of inflammatory cells in the parenchyma of organs. The most common clinical presentations involve the eyes or CNS. Ocular involvement may manifest as anterior uveitis with hyphema, hypopyon, aqueous flare, miosis, and keratic precipitates. Ocular disease may be the sole manifestation of FIP in affected cats, or it may be combined with CNS or abdominal involvement.

Diagnosis Dr. Little went on to say that, unfortunately, there is no single test or indicator that is reliable for the diagnosis of FIP; the diagnosis must be based on a preponderance of evidence gathered from patient signalment, medical history, physical examination, and laboratory findings. The first step should be evaluation of the patient for evidence of effusion using radiographs and/or ultrasound if necessary.

The effusive form of FIP is the easiest to diagnose, but only about 50% of cats that present with effusions will have FIP. The most common diseases that produce effusions similar to FIP include lymphocytic cholangitis and malignancies. Therefore, it is important to confirm the diagnosis by examination of the effusion. Effusions due to FIP are non-septic exudates that are yellow and viscous with a high specific gravity (1.017-1.047), high protein content (>3.5 g/dL), an albumin:globulin ratio <0.45 and low to moderate cellularity (<5,000 cells/μL).

Other laboratory tests that may be used in the diagnosis of FIP include serum chemistries and the complete blood cell count (CBC). CBC results are variable and non-specific but may include neutrophilia with a mild left shift, lymphopenia (<1500/μL), and anemia of chronic disease. Serum chemistry changes may include an albumin:globulin ratio <0.45, total protein >8.0 g/dL, globulins >5.1 g/dL, elevated liver enzymes, hyperbilirubinemia and azotemia.

Histopathology on tissues remains the gold standard for diagnosis of FIP and is underutilized by practitioners. Perivascular pyogranulomatous inflammation is the hallmark of FIP. Immunohistochemistry can be used to confirm the presence of macrophages within pyogranulomas and can be performed on formalin fixed and paraffin embedded tissues.

Dr. Little added that FIP is one of the most frequent causes of neurological disease in the young cat, especially in cases with multifocal clinical signs. Both generalized tonic-clonic and complex focal seizures may be seen as well as other neurologic abnormalities. The occurrence of seizures indicates extensive brain damage and is an unfavourable prognostic sign.

All coronavirus antibody titres are non-specific and cannot be used alone to diagnose FIP. A positive coronavirus antibody test does not rule in FIP and a negative coronavirus antibody test does not rule out FIP.

Polymerase chain reaction (PCR) is a sensitive technique for detecting minute amounts of viral RNA in blood and effusions. However, no single unique genetic sequence has been identified as associated with FIP, regardless of the claims of some commercial laboratories.

Treatment No effective treatment for FIP has been identified to date, although several have been proposed and discarded as ineffective. Some antivirals have shown promise in vitro but are limited in usefulness due to known toxicity in the cat. Oral low dose recombinant human interferon alpha is widely used, but anecdotal reports of efficacy are unconfirmed.

Polyprenyl Immunostimulant (PI) is an investigational veterinary biologic comprised of a mixture of plant-derived polyisoprenols. Limited information suggests it has low toxicity, is orally absorbed, and may upregulate

Feline peritonitis continued from page 1

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BOSTON, MA – Nutritional deficiencies and excesses are common in cats with cardiac disease. Selecting the right diet for each patient is important for providing optimal care, explained Lisa M. Freeman, DVM, PhD, DACVN, speaking at The 1st World Feline Veterinary Conference.

Nutritional assessment is a two-part process, involving screening evaluation and extended evaluation.

Screening evaluation is part of routine history taking and physical examination and should be performed on

every patient at every visit. Information such as age, body condition, muscle condition, diet, feeding management, and disease conditions are part of this screening. Based on the screening, cats that are healthy and without risk factors need no additional nutritional assessment.

Extended evaluation is performed when one or more nutrition-related risk factors are found or suspected based on the screening evaluation. In the case of a cat with cardiac disease, extended evaluation should be performed in all cases to identify suboptimal nutritional status and diet.

biosynthesis of mRNA of Th-1 cytokines. Preliminary data from treatment of a small number of cases of non-effusive FIP appears promising.

Palliative care may be appropriate for some patients, particularly those cats with mild clinical signs, that are not too debilitated and that are still eating. Traditional palliative care for cats with FIP includes prednisolone +/- cyclophosphamide or chlorambucil. Antibiotics are not justified unless neutropenia occurs as a result of cytotoxic drug therapy. Good nutritional support and avoidance of stressors are also recommended.

Conclusion Dr. Little concluded by saying that FIP can present a diagnostic dilemma due to the variety of presenting clinical signs and the lack of definitive diagnostic tests. The most important step is to identify any effusion that might be present, for diagnostic tests on effusions are more reliable than on blood or serum. She said that while various algorithms are available to aid in diagnosis, they should not be adhered to rigidly since the disease has considerable variation. Histopathological examination, with or without immunohistochemistry, remains the gold standard for diagnosis. No effective treatment is available, and while palliative care only prolongs the inevitable, it may be desired by some cat owners and be appropriate for some affected cats. CV

Nutritional assessment of the cat with cardiac disease

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The holidays are coming…so please don’t forget to support animal charities. Here are just a few:Canadian Animal Assistance Team www.caat-canada.org

Vets Without Borders www.vwb-vsf.ca

The Equine Foundation of Canada www.equinefoundation.com

Save the Manatee Club www.savethemanatee.org

your local Humane Society www.humanesociety.com

Wildlife Preservation Canada www.wptc.org

and/or the charity that’s closest to your heart. Happy holidays from all of us at Canadian Vet!


Screening evaluationStandardized diet history forms make gathering complete information more efficient and ensure that the required information is collected for each patient.

Body condition score and muscle condition scoreA consistent method and scale should be used to measure body weight (BW), body condition score (BCS), and muscle condition score (MCS) to assess current status and changes over time. The BCS evaluates body fat with a goal for most healthy cats of 5 out of 9. However, in congestive heart failure (CHF), a BCS of 5-6 may be more desirable. The MCS differs from the BCS in that it evaluates muscle mass. Evaluation of muscle mass includes visual examination and palpation over the temporal bones, scapulae, lumbar vertebrae and pelvic bones. Assessing muscle condition is important as cats with CHF lose primarily muscle compared to a healthy animal that would lose fat. Muscle loss adversely affects strength, immune function, wound healing, and, is independently associated with mortality in humans. Dr. Freeman said that early identification of subtle muscle loss, at the “mild muscle wasting” stage is valuable for successful intervention.

Extended evaluationFor an extended evaluation, additional relevant information should be collected in addition to that from the screening evaluation:

Animal factors• Changes in food intake or behaviour (e.g., amount eaten, chewing,

swallowing, nausea, vomiting)• Skin and hair condition• Diagnostic work up

– Minimum database/laboratory testing as appropriate – Specific testing might include a complete blood count (checking for anemia); urinalysis; biochemistry profile (including electrolytes, BUN, creatinine); or evaluation of other nutrient concentrations that may be low (or high) as a result of an unbalanced diet (e.g., taurine, vitamin B12, iron)

– Additional workup as indicated (e.g., ECG, blood pressure)• Current medical conditions and medications

– Assess effects of the disease and any treatment plan on pet’s nutritional status (e.g., CHF can reduce food intake, change preference for foods, and contribute to loss of lean body mass)

– Many of the cardiac medications can have important interactions with diet (e.g., loop diuretics can cause losses of potassium and magnesium; potassium sparing diuretics and ACE inhibitors can cause sodium retention; digoxin can have GI side effects)

Action plan1. If cat is underweight, assess whether this is due to insufficient food

intake, a low calorie density food, or high-energy requirements. 2. Create a monitoring plan for body condition. Teach the client to monitor

BW, BCS, and MCS. Adjust intake as needed to match changing needs over time.

3. A diet change may be needed for cats with cardiac disease if they are eating a food that is too high or low in an individual nutrient (e.g., calories, sodium, potassium).

Diet factors• Determine exact cat food – brand, specific product, flavour, form (e.g.,

wet, dry, other). • Assess the quality of the food and also check the caloric density of

current pet food, particularly if pet is below or above desired BCS, or if owner has to feed unusually large or small amounts to maintain desired BCS

• For cats with cardiac disease, it also is important to know the sodium, potassium, magnesium content of the food

• Evaluate other sources of nutrients: treats, table food, supplements, food used for administering medication

• Ask if the owner is administering any dietary supplements – if so, carefully assess for safety, efficacy, and quality control

Action plan1. Determine if current amount and type of food is appropriate, based on

life stage, activity, stage of cardiac disease, body condition, laboratory values, clinical signs, concurrent medical conditions, medications

2. If diet factors are determined to be inadequate, prepare a plan for food and treats that provides appropriate calories and nutrient content for the patient

3. Consider other food sources in total intake recommendations if necessary4. Recommend a specific feeding plan that incorporates pet food, treats,

table food, medication administration, feeding method, frequency, and location

Feeding and environmental factors• Assess feeding management, especially in cats that are over- or underweight

Action plan1. Determine any changes in feeding management and any necessary

environmental changes – Whereas some cats can maintain good body condition when fed free choice, others require meal feeding of appropriate amounts to maintain good body condition

– Confirm the use of an appropriate food-measuring device, and provide food in measured amounts

– Management changes may include provision of feeding toys, and reducing conflict and competition for food

– Create specific schedule for follow up via telephone to elicit questions and verify compliance/adherence to recommended feeding management or environment changes. Repeat examination/assessment

2. Consult with a specialist or refer any time one feels unqualified to take action and monitor a patient

Client education Dr. Freeman stressed that client communication and rapport are important for achieving desired outcomes, particularly in cats with cardiac disease. Discussion of diet, treats, table food, dietary supplements, and appropriate (and effective) medication administration is beneficial for both the owner’s and the cat’s quality of life. She recommended trying to engage the client in decision-making and defining expectations, and added that recommendations may be modified by the client’s time, lifestyle, and financial limitations. Use communication techniques that include a variety of forms based on client preferences.

Demonstrating and teaching the client to effectively administer medications and to evaluate the BW, BCS, and MCS is effective in engaging the client in their pet’s care. Expectations and goals should be specific, achievable, and include specific follow-up in order to monitor progress and compliance and to adjust recommendations.

She added that informing clients about specific foods, and potential advantages, risks and concerns is helpful. Include recommendations on amount and frequency of diet fed, accounting for snacks, treats, table food, foods used for medication administration, and dietary supplements.

SummaryDr. Freeman concluded by saying that every cat with cardiac disease should have a thorough nutritional assessment to determine whether the overall diet is optimal. Body condition and muscle condition scores should be determined for every patient with cardiac disease. She stressed that the muscle condition score is particularly important to assess in cats with heart failure. CV

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By Karen Tousignant

On January 24, 2011, a girl met a horse. “Sasquatch” was a large, dark bay horse with big feet, a remarkably beautiful face, and an oversized, barrel-like stomach. The girl is my 14-year-old daughter, Meghan. After the sudden closure of the barn where she’d been riding, Meghan followed her coach to a new riding facility. She tried riding several horses, but none was just right. She then tried “Sass”, as she fondly called him, and knew that he was the right horse for her.

Many people, myself included, doubted Sass. He had been declared “sour” and put out to pasture. When Meghan found him, Sass hadn’t been ridden for several months, and he was overweight and lacked muscle tone. Some of the barn girls jokingly called him “the pregnant gelding.” “Nobody can ride that horse” we were told. “He doesn’t like people.” But Meghan could ride him, and she rode him well. Meghan believed in him and Sass knew it!

Over the next several months, Meghan continued to work with Sass and their progression as an equestrian team was nothing short of amazing! Meg’s coach told her that she had achieved two years worth of training in six months because Sass responded to her so well. They were described to me as “poetry in motion.” People noted that Meghan and Sass seemed to be one together – in perfect unison both mentally and physically. Nobody could believe what Meghan had achieved with “that horse.” But Meghan could; she had always believed in Sass.

Show time came for Meg and “Shake That Sass.” Sass was clearly excited, standing with his head up high and his ears up. He was intently listening to and watching all of the other horses, and every now and then he would let out a series of great big neighs and whinnies! To everyone’s surprise, Meg and Sass came home with two 2nd place ribbons. Meg’s coach said to me, “I hope she realizes just how well she is doing on that horse.”

At their second show, which would be their last, Meg and Sass won the 1st place ribbon in the 2’6” speed class! Sass was a winner and he knew it! Together, Meg and Sass had shown us all the power of believing.

But it wasn’t just about winning first-place ribbons. It was about the pure joy Meghan got from simply being around this horse. It was about the way that, in response to her asking if he was a beautiful boy, Sass would enthusiastically nod his head up and down. It was about the way he would turn and hug Meghan with his head when she was grooming him. It was about the way that one could always hear Meghan saying “good boy” as Sass accomplished yet another jumping feat and about the way that she always left the arena patting Sass on the neck and praising him for his efforts – even on a bad day.

For Sass’ 8th birthday Meghan found a recipe and made him a birthday cake with oats and molasses. I have never in my life seen such a happy horse

as Sass was when he devoured that cake. He had a happy birthday alright. He had Meghan and a molasses cake. What more could a horse ask for?

I’ll never forget the way Meghan took the time to figure out Sass and learn to work with that “impossible” horse. Initially, he would run away from her when she went out in the field to bring him in for her lesson. It was like a game that he played. He would let her walk up close enough to him to almost be able to catch him, and then he would dart away and hide behind another horse, looking at her as if to say “Haha…you didn’t catch me.” Even food

did not work, as Sass was smart and he would grab the apple and run! But Meghan was patient with Sass, and she had an uncanny understanding of him. She learned that if she went up to the horse standing beside Sass and patted it, then Sass would come right over to her! He didn’t want Meg paying attention to any horse other than him.

One time, Meg fell off Sass as they were going over a jump. Spooked by the fall, Sass dashed madly around the outdoor arena. He darted away from the girls who tried to catch him, and we were all thinking that he was going to be a challenge to round up. Then Meghan stood up and calmly called “Sass,” and that wildly running horse stopped in his tracks, looked, and walked straight over to her!

Sadly, on Thursday, August 25, Meg went to the barn to ride Sass and noticed that he was acting out of character. Her coach had a look at him and recognized the signs of colic. Despite valiant efforts to save him, Sass’ life ended later that night when the veterinarian advised that the kindest option would be to put him down.

Meghan lost her riding partner and the love of her life. The heartache was unbearable. I cried with her until we could cry no more, or so we thought. But Meghan showed me just how strong a young woman she is. She stopped crying, and she accepted that Sass was in a better place where he was no longer in pain. In Meghan’s words, Sass will always be her favourite horse no matter what, and she will love him forever. In a note alongside his picture, she wrote, “Happy you’re out of pain and in a great place buddy, have fun up there for me.”

One has to believe that this horse and rider found each other for a reason. They taught each other a great deal about love, and about the power of believing!

RIP Shake That SassMarch 31, 2003 – August 26, 2011

Shake That Sass – a story about believing…


Doberman friends live longer and healthier lives,” said Sinclair. “If you have a Doberman that is being euthanized, or any other breed of dog suspected of having DCM, please consider contacting us.”

“We will do everything we can to support the owners’ needs during such a difficult time as

saying goodbye to a best friend,” she said. “I am happy to answer questions, facilitate immediate or planned donations, and address any concerns about how things will work and what to expect.”

For more information, contact Sinclair at [email protected].

Unlocking the secrets of a deadly heart diseaseBy Barry Gunn,OVC Communications Officer

Scientists at the Ontario Veterinary College (OVC) are reaching out to pet owners and veterinarians to help with a research project aimed at eliminating a fatal heart disease that affects up to 60% of Doberman Pinschers.

Dilated cardiomyopathy (DCM) is an incurable disease that leads to congestive heart failure. While the disease is not completely understood and its genetic basis in dogs is unknown, researchers hope to identify new biomarkers that will help identify dogs with DCM before they begin to show symptoms.

“The goal of identifying a novel biomarker is to develop a rapid, affordable and non-invasive screening test to help front-line clinicians diagnose DCM in dogs,” said Dr. Elizabeth Sinclair, a veterinarian who is pursuing a PhD in the Department of Biomedical Sciences. Sinclair is a member of the DCM research group, which also includes Drs. Glen Pyle and Gordon Kirby, Biomedical Sciences, and Lynne O’Sullivan, Clinical Studies.

The research group is also investigating the causes of DCM by looking at changes in the myofilament proteins – involved in contraction of the heart muscle – in Dobermans that have died of the disease.

“In humans, DCM is a multi-genetic disease, and this is likely the case in dogs with DCM,” said Sinclair, whose work is supported by the OVC Pet Trust Fund and an OVC Fellowship. “Genes that can be investigated as a cause of DCM could lead to screening/breeding programs and one day an elimination of this fatal disease.”

The team is asking for help from veterinarians and owners who are considering euthanasia for dogs due to medical reasons. They are asked to contact the researchers for information on becoming a tissue donor. Sinclair said this offers one way for pet owners to ease the pain of their loss by helping others.

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Danny Joffe, DVM. Diplomate ABVP (Canine/Feline Specialty) and A. Mark Joffe, MD, FRCPC (Internal Medicine, Infectious Diseases), presented the animal and human implications of toxocariasis at the Saskatchewan Veterinary Medical Association Conference.

SASKATOON, SK − Toxocaral larval migrans, the most common pet-associated zoonosis in industrialized countries, is an infection caused by parasitic roundworms found in the intestines of dogs (Toxocara canis) and cats (T. cati). Symptoms generally affect children, who often play in dirt or eat dirt (pica) contaminated by dog or cat stool containing embryonated eggs. The fact that humans have surrounded themselves with various domestic animals, particularly dogs and cats, has ensured a worldwide distribution for Toxocariasis.

Dr. Mark Joffe explained that the degree of host damage in humans depends on which tissue has been invaded and the number of migrating worms and extent of host response. Toxocara infections can cause ocular larva migrans (OLM), an eye disease that occurs when a microscopic worm enters the eye. This can lead to unilateral visual impairment, retinal detachment, and blindness. Heavier, or repeated Toxocara infections, while uncommon, can cause visceral larva migrans (VLM), a disease that causes swelling of the body’s organs (liver, lungs, or central nervous system).

Although veterinarians generally recognize the potential risks associated with T. canis and T. cati, according to a survey1 of 545 veterinary clinics in western Canada, only 13% of puppies and 39% kittens were dewormed in accordance with the recommendations set out by The Companion Animal Parasite Council (CAPC), a group of veterinarians, parasitologists, and infectious disease experts who have developed recommendations to help veterinarians control parasites that threaten the health of pets and people. While 68% of clinics had

deworming protocols in place, only 78% followed their own protocols. Only 44% of veterinarians routinely discussed the zoonotic risks of canine and feline roundworm disease with their clients. The survey also showed that there was no difference between new graduates and more experienced clinicians in their compliance with the recommendations. Dr. Danny Joffe said that these results indicate that practicing veterinarians have significant room for improvement in both their strategic deworming protocols and in their client education on the zoonotic hazards of these diseases. He stressed that every clinic should have a well-used protocol in place, ideally matching the CAPC recommendations.

Life cycleT canis females produce up to 200,000 eggs daily, which can lead to massive environmental contamination if a significant number of canines in a region have patent infections. The prevalence rates of canine Toxocara infections and of soil contamination with T. canis eggs vary regionally, and range from about 3% to 27% contamination.

Toxocara eggs are not infective when excreted from the host; eggs take about two weeks (depending on environmental conditions) to become infective. Direct contact with fresh dog or cat feces is not a risk factor; contact with feces after a period of time is the source of human infection. It has been shown that dogs can carry aged fecal debris in their coats that could conceivably be a source of human exposure. Cats are more fastidious. Although studies on T cati have not been performed, a study on Toxoplasma gondii showed a total absence of oocytes in the fur of cats a week after massive shedding.

T. canis larvae are commonly present in the mammary glands of infected bitches, allowing for early transmission to puppies; but the most common route of canine infection is transplacental. Larvae from the infected bitch migrate through the placenta into the developing fetus, and the pup is born infected. T cati can be also be contracted by kittens by suckling, but transplacental transmission does not occur. Clinical signs of Toxocara infection in puppies and kittens are usually mild to nonexistent.

The intestinal phases of canine and feline roundworm infections are very easy to treat, with many prescription and non-prescription vermifuges being effective. Unfortunately, there is no medication currently available to treat the hypobiotic larvae in tissues, as these larvae are almost completely metabolically inactive, and since most parasiticides act on some phase of parasite metabolism. As a result, even bitches that have had multiple negative fecal samples and multiple proactive dewormings can still give birth to infected puppies, as these hypobiotic larvae “wake up” at 42 days of gestation and move to the placenta and on into the developing fetus.

As toxocariasis is a zoonotic disease it is an important role of veterinarians to educate owners on how to decrease environmental contamination by Toxocara eggs.

Strategies should include decreasing the number of patent canine and feline infections via strategic deworming. Owners should be counselled not to allow pets to defecate in public places, especially places frequented by children. Picking up after pets prior to incubation of eggs, both on and off the owner’s property, is very important. As well, the zoonotic potential of roundworms should be discussed with each and every pet owner.

Preventive treatment in animalsOne of the key recommendations of the CAPC for controlling toxocariasis is the year-round use of antiparasiticides with activity against intestinal parasites of zoonotic potential in dogs and cats, even in areas without endemic heartworm disease. Such products for dogs would include milbemycin oxime, ivermectin with pyrantel pamoate, and moxidectin with imidicloprid. In cats such products would include the above and selamectin. It should be noted that these products would also control Baylisascaris infections in dogs and help prevent zoonotic transmission of this extremely dangerous parasite.

Reference1. Stull, JW and Carr AP, et al. Small animal deworming protocols, client education, and veterinarian perception of zoonotic parasites in western Canada. Can Vet J 2007;48(3): 269-76.

Zoonoses − both sides of the coinPart 3: Toxocara


CAPC recommendations• Puppies and kittens should be routinely dewormed beginning at 2 weeks

of age, with deworming repeated every 2 weeks, until the animals are placed on a monthly control product with efficacy against ascarids at 4 to 8 weeks of age.

• To treat potential newly acquired infections, dogs and cats should be maintained on monthly intestinal parasite-control products with efficacy against ascarids.

• Efficacy of the initial deworming, the monthly control product, and client compliance should be monitored by performing a fecal examination 2 to 4 times in the first year and 1 to 2 times per year thereafter, depending on the age of the animal and its prior history of infection.

• Prevention of predation and scavenging activity by keeping cats indoors and dogs confined to a leash or in a fenced yard will limit the opportunity for cats and dogs to acquire infection with ascarids via ingestion of

vertebrate hosts or from an environment contaminated with feces from untreated animals.

• Prompt removal of feces from the yard or the litterbox will also help prevent ascarid eggs from becoming infective as the fecal material decomposes or is dispersed into the environment.

• Enforcing leash laws and requiring owners to remove feces deposited by their dogs can protect public areas from contamination with ascarid eggs.

• To avoid contamination with eggs of B. procyonis, raccoons should not be kept as pets and should be discouraged from defecating in areas frequented by people or dogs. CV

Sourcewww.capcvet.org/recommendations/ascarids.html

First aid for injured wild birdsHALFAX, NS – People who find ill or injured wild birds will often look to their local veterinarian to act as the first responder. The first principle is to do no harm, explained Guylaine Séguin, DVM, IPSAV, DÉS, speaking at the Canadian Veterinary Medical Association Conference. Intervention, prior to sending the bird to a rehabilitation centre, should only be attempted if the veterinarian is confident and comfortable with the procedure.

Case history and animal descriptionWhen a wild bird is brought in for treatment, contact information should be noted, the date first observed and captured, the location with a description of

the area, whether the bird was held captive prior to its arrival, and its condition. Dr. Séguin said that trauma is often the primary reason for admission. As well, starvation, ingestion of toxic agents, and infectious diseases are all possible reasons for intervention.

Species identification requires a certain degree of ornithological knowledge and can drastically alter the management of the case. At minimum, the genus of the wild bird should be determined. Age determination can be difficult and it is often impossible to determine the gender, as many species present no sexual dimorphism and there are no external organs.

First aid for injured wild birds continues on page 19

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By Kara M. Burns, MS, MEd, LVTAcademy of Veterinary Nutrition Technicians Hyperthyroidism is recognized as the most common endocrinopathy of middle-aged to older cats. The pathogenesis of feline hyperthyroidism remains unclear, although hyperthyroidism is seen in cats throughout the world. Traditionally, the management of feline hyperthyroidism has included thyroidectomy, anti-thyroid medications, and radioactive iodine. Surgery and radioactive iodine therapy are intended to provide long-term solutions, whereas oral anti-thyroid drugs are used to control hyperthyroidism and must be given daily to achieve and maintain their effect. The healthcare team should be familiar with these modalities as well as nutritional management – a new way to manage hyperthyroidism in cats. Recently reported studies reveal that feeding a limited-iodine food normalizes thyroid hormone concentrations and alleviates clinical signs in hyperthyroid cats.1-4 Now managing hyperthyroidism can be as safe and easy as feeding the cat a special pet food.

The typical presentation of hyperthyroidism in the cat includes weight loss with polyphagia, tachycardia, polyuria and polydipsia, nervousness or agitation, alopecia or unkempt coat, increased vocalization, heat intolerance and less often, vomiting, anorexia, and lethargy. A palpable thyroid is identified in many cats.5 It is imperative that the healthcare team performs a thorough history of the cat with the owner. Owners may think that an inability to groom or increased agitation is a normal aging process; however, these behaviours may be attributable to a disease process. Diagnosis is generally based on the presence of one or more typical clinical signs, increased serum thyroxine (T4) concentrations, and a palpable thyroid nodule.

Each method of managing feline hyperthyroidism has advantages and disadvantages and healthcare team members should discuss these with owners so they can make an informed decision for their cat.

Anti-thyroid medicationsThe thioureylene antithyroid drugs (e.g., methimazole, carbimazole) are the most common medical management for feline hyperthyroid patients due to their reliable ability to inhibit the synthesis of thyroid hormones and lower serum thyroid hormone concentrations. They are widely recommended to stabilize hyperthyroid cats prior to surgery and are the only drugs that can be used chronically for management of hyperthyroidism.6

Chronic administration of antithyroid medications has the advantage of being readily available, requiring no special facilities, and at least initially, being reasonably inexpensive. In addition, anesthesia and hospitalization are avoided. However, daily administration of medication is required, and this may be challenging for some cats and owners. While many cats have been successfully managed long term with oral therapy, the potential for adverse reactions should be considered. Most adverse reactions associated with methimazole or carbimazole occur within the first three months of therapy and include vomiting with or without anorexia and depression, self-induced excoriations of the head and neck, and mild to serious hematologic complications. These hematologic complications include agranulocytosis and thrombocytopenia either alone or concurrently and more rarely immune-mediated hemolytic anemia.6 Because of these side effects, long-term monitoring is appropriate. It’s been recommended to assess results of complete blood count, serum chemistries, and total T4 concentrations before treatment and three and six weeks afterwards, and then every three months with the dose adjusted as necessary.7

Surgical thyroidectomySurgical thyroidectomy is a relatively simple procedure that may be curative unless the patient has affected thyroid tissue located outside the thyroid gland. However, to decrease the cardiac and metabolic complications associated with anesthetizing hyperthyroid cats, prior medical management and control of the thyrotoxicosis are required. Once euthyroidism has been achieved, the main surgical considerations are whether to perform a unilateral or bilateral thyroidectomy, the type of technique to use, and the potential postoperative complications.6 Owners will often present concerns regarding potential anesthetic risks associated with surgery as well as cost vs. medical management.

Radioactive iodineRadioiodine treatment is often considered the best option for many cats since it has the potential to cure the thyroid nodule with a single treatment, is not dependent on the location of the hyperfunctional thyroid tissue, no general anesthesia is required, and side effects are minimal. Markedly increased pre-treatment T4 concentrations, increasing size of the thyroid nodule, and the severity of clinical thyrotoxicosis as well as pre-existing kidney disease, all may potentially adversely affect the response to this therapy.6

The aim of therapy is to restore euthyroidism with the smallest possible single dose of radiation while avoiding the development of hypothyroidism.6 Approximately 30% of cats are estimated to become hypothyroid greater than three months after radioactive iodine therapy. As previously mentioned, therapy for asymptomatic hypothyroidism may decrease the risk of progressive chronic kidney disease. Owners should be advised of this possibility particularly if the motivation for radioactive iodine therapy was to avoid the need for long-term oral medication.

The main limitation to widespread use of radioactive iodine is the requirement for special licensing and the isolation of the cat for variable periods after treatment. This can range from several days to several weeks depending on state or local radiation regulations and, particularly, the dose. 6

Nutritional management of feline hyperthyroidismBecause thyroid hormone production requires uptake of iodine by the thyroid gland, it was hypothesized that limiting dietary iodine intake could decrease thyroid hormone concentration and control hyperthyroidism. Subsequently, there is now another option for managing hyperthyroid cats - feeding a limited-iodine pet food. Recently published findings document the safety and effectiveness of this food as the sole management for cats with naturally occurring hyperthyroidism.1-3 The results confirmed that feeding ≤ 0.3 ppm (mg/kg) iodine on a dry matter basis (DMB) provides an effective and safe therapy for cats with naturally occurring hyperthyroidism. Serum total thyroxine concentrations decreased within three weeks and returned to the normal range within eight weeks in most cats (and within 12 weeks in some cats) when consuming the limited-iodine pet food as the sole source of nutrition. Approximately 90% of hyperthyroid cats maintained on foods with ≤ 0.3 ppm iodine DMB as the sole source of nutrition remained euthyroid. In studies to date, indicators of renal function (serum creatinine and blood urea nitrogen) have remained stable in hyperthyroid cats when fed the limited-iodine pet food, and no other biochemical abnormalities were observed.

Managing cats with persistent hyperthyroidismThe most likely challenge for nutritional management is the need to feed the limited-iodine food as the only source of nutrition. It’s important to discuss this initially, when the owner is considering all therapeutic options for their hyperthyroid cat. If a cat does not respond as expected, veterinary technicians should first consider that persistently increased T4 concentrations are most likely due to poor adherence to the healthcare team’s nutritional recommendation of a limited iodine food as the sole source of nutrition. Discovering an additional source of dietary iodine intake can be a challenge for the veterinary healthcare team. In keeping with the principles of client-centered communications, owners should be questioned in an open-ended, non-threatening manner with the end result focusing on ascertaining potential sources of nutrition the cat could be receiving.

Feeding healthy cats in a hyperthyroid householdHealthcare teams are faced with nutritional questions from owners of multiple cats daily. Feeding limited iodine pet food is not recommended as the sole source of nutrition for healthy adult cats. However, if a client with a hyperthyroid cat chooses to feed a limited iodine food to healthy cats in the household, veterinary healthcare team members should recommend that the owner supplement the healthy cat(s) with at least one tablespoon of regular maintenance cat food (wet or dry) daily to provide additional iodine. It is critical, however, that the hyperthyroid cat receives only the limited-iodine food and no other food or treats.

A team approach to managing feline hyperthyroidism

Feline hyperthyroidism continues on page 18

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For Pet’s Sake

House-soiling in cats – the proof is in the puddlingFeline inappropriate elimination is the most common behavioural complaint of cat owners and a major risk factor for relinquishment. Therefore, while many kittens virtually train themselves, practitioners should take a pro-active role in discussing kitten litter box training and asking owners to report problems as soon as they arise.

When a cat is marking, the cat backs up to a vertical surface, raises its tail, which may quiver, treads with its back feet, and directs a stream of urine backwards. Most marking can be eliminated by neutering, but this is not always the case. Soiling is on horizontal surfaces and generally the entire bladder is emptied in the inappropriate location. Yet, despite the fact that these are different diagnoses with different treatment requirements, almost one-third of veterinarians do not ask whether the cat is spraying, or soiling.1

Is it medical or behavioural? Medical conditions that might incite soiling include lower urinary tract diseases that cause pain or discomfort, systemic diseases (e.g. renal) that might cause increased frequency or volume, and diseases that might cause decreased control (e.g. neurological, cognitive dysfunction), or ability to access the box (e.g. sensory, mobility problems). However, urinary tract disease is not commonly associated with marking. On the other hand, diseases that increase irritability (e.g. hyperthyroidism) or lower the cat’s ability to cope with stress or change (e.g. pain, age) could lead to marking.

Although medical problems can cause soiling, even when health issues have been resolved or controlled, the problem may still persist since new sites and surface preferences have been learned. The behavioural history then becomes the key element for identifying the cause and developing a treatment plan. Information that needs to be collected includes details about a) the home environment, litter type, box type, number, maintenance, and locations, b) the problem itself including onset, frequency, duration, and what the owner has done to date, c) relationships between household cats, other pets and family members, and d) where and on what surfaces the cat is soiling. Determine if there has been a change that might have occurred when the problem arose, the number and placement of boxes and whether there is anything about the litter, location, or box that might be causing avoidance.

Building a better litter boxBasic suggestions to treat soiling include addressing why the cat might be avoiding the litter, including: the box, location, substrate (litter) and cleanliness, or anything that might limit access or cause the cat to avoid the area such as other cats, a family dog, or even the owners. Try offering a smorgasbord of litter substrates and types of litter boxes (bigger is often better), in a few different locations to help determine what might be the cat’s “ultimate litter box”. Clumping litters are often preferred and are easier to keep clean. In multi-cat households start with one box per cat plus one, and space them out to avoid conflicts (location, location, location!). Scoop daily, change the litter weekly, and use odour-neutralizing products anywhere the cat has soiled. If these general guidelines do not solve the issue, then focus on re-establishing regular litter pan use by confining the cat to its own play room with one or two litter boxes any time it cannot be supervised until regular use is re-established.

What about drugs?When the problem is soiling, drugs are not the answer since the goal must be to find a litter and location that appeals to the cat while preventing the use of other sites. Since marking, on the other hand, is often related to underlying stress or conflict, drug therapy with fluoxetine or clomipramine or the use of Feliway might be effective. However, until the cause is identified and the source of stress resolved, drugs may provide control but are not a cure. For example, if outdoor cats are stimulating the cat to mark, it might be possible to change the cat’s perching spot to a different window, or keeping the other cats off the property (consider a motion detector sprinkler).

This article was co-authored by Dr. Landsberg (northtorontovets.com) and Dr. Colleen Wilson (osgoodevet.com). It was first published in the OVMA’s September-October 2011 issue of Focus magazine and is reprinted with permission.

1. Bergman L, Hart BL, Bain M, et al. Evaluation of urine marking by cats as a model for understanding veterinary diagnostic and treatment approaches and client attitudes. J Am Vet Med Assoc 2002; 221, 1282-1286.

G.M. Landsberg BSc, DVM, DACVB,

dip ECVBM-CA

Implementing nutritional management of feline hyperthyroidism in your practiceNutritional management of feline hyperthyroidism is appropriate for newly diagnosed patients as well as those patients currently being managed with antithyroid medications or in patients with recurrence of hyperthyroidism post thyroidectomy. While the method of therapy is straightforward, as with any therapeutic regimen, appropriate monitoring is necessary.

ConclusionHyperthyroidism is a common disease in older cats; while the pathogenesis remains unclear, a variety of therapeutic options are available. Traditional methods of managing feline hyperthyroidism include thyroidectomy, antithyroid medications, and radioactive iodine. Veterinary healthcare team members should be able to discuss all modes of therapy for feline hyperthyroidism with pet owners. Now healthcare teams have a new tool for managing feline hyperthyroidism that’s as safe and easy as feeding your cat.

References1. Melendez L, Yamka R, Forrester S, et al. Titration of dietary iodine for reducing serum thyroxine concentrations in newly diagnosed hyperthyroid cats. J Vet Intern Med 2011; 25:683 (abstract).2. Melendez L, Yamka R, Burris P. Titration of dietary iodine for maintaining normal serum thyroxine concentrations in hyperthyroid cats. J Vet Intern Med 2011;25:683 (abstract).3. Yu S, Wedekind K, Burris P, et al. Controlled level of dietary iodine normalizes serum total thyroxine in cats with naturally occurring hyperthyroidism. J Vet Intern Med 2011;25:683-684 (abstract).4. Data on file, Hill’s Pet Nutrition, 2011.5. Thoday KL, Mooney CT. Historical, clinical and laboratory features of 126 hyperthyroid cats. The Veterinary record 1992;131:257-264.6. Mooney CT. Hyperthyroidism In: Ettinger SJ,Feldman EC, eds. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. Seventh Edition ed. St. Louis, MO: Saunders 2010;1761-1779.7. Dechra Veterinary Products, Technical Brochure www.dechra-us.com accessed October 2011.

Feline hyperthyroidism continued from page 16


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General handling principlesInjured wild birds should be captured using a blanket or towel and secured in a robust ventilated cardboard or plastic box with shredded paper and a sealed lid. For the bird’s safety, no water, food, or perch should be provided during transportation. The box should be kept in a dark and quiet room.

Dr. Séguin noted that stress alone can be lethal to a bird, and treatment should be done quickly and quietly. She added that temperatures above 42°C can cause hyperthermia. Ice packs and alcohol applied to the feet can be used as cooling agents, and during this time any manipulation should be postponed.

Before removing the bird from the transportation cage, the bird’s behaviour should be noted. For example, is it bright, alert and responsive, or lethargic? Is it ambulatory, or is it upright, does it hold its wings correctly, is the head position normal? Is it breathing normally? Based on the conclusions of the initial observation, all necessary materials should be gathered, including means of heating or cooling, fluids, and wound treatment material. The bird should also be weighed while still in the transportation medium.

Physical examinationThe physical examination should be performed in a room that has been bird-proofed (no fans, open windows, fly traps, etc.). The veterinarian should wear adequate safety equipment, including sturdy gloves, face shield or latex gloves, depending on the potential of injuries or disease transmission.

Capturing a wild bird with a towel can be useful because many birds will stop struggling once their heads ares covered and they are dorsally recumbent. Since the feathers can conceal wounds and swelling, the feathers should be gently blown aside to inspect the body. Maintaining the feathers integrity should remain a priority. It is important to avoid applying pressure to the bird’s keel (breastbone).

Body condition scoring is done on a scale from 1 (emaciated) to 5 (obese). The skin will stick

to the underlying musculature if dehydrated and this can also be determined by the ulnar vein size and flow quality (refill time should be less than one second). Body temperature, which is normally 39-42°C, should be monitored if hypo- or hyperthermia is suspected.

The skull, neck, and clavicula should be palpated to check for fractures, and the beak and nares for integrity. The oral mucosa colour varies with species and age so unless there is expertise this may not always help identify problems. The presence of mucoid filaments at the beak opening indicates dehydration, and oral nodules or plaques can indicate trichomonas, capillaria, poxvirus, vitamin A deficiency, etc.

Feather quality should be inspected for burns, electrocution, chemical/oil staining, and/or inadequate captivity/transportation conditions. Dr. Séguin said that wrist wound(s) are typical in very nervous birds, or where inadequate captivity/transportation conditions existed. Wing extension should be examined for any restrictions.

Palpation from hip to toes should take place as well as leg and digit extensions. “Bumblefoot” on the plantar surface is typical in Falconiformes and Anseriformes. It may be caused by inadequate housing, substrate or perches, unbalanced weight bearing, and/or obesity.

A wing and tail carriage test should be done only if fractures to the wing or leg are absent. Abnormal wing

First aid for injured wild birds continued from page 15


posture can indicate coracoid fracture, brachial plexus avulsion, or soft tissue damage. Abnormal tail movement can be caused by a caudal neurologic disorder.

Dr. Séguin stressed that if the bird is lethargic the exam should be minimal and should include body condition, hydration status, and temperature. Once this has been done the bird should be transferred to a dark, quiet and warm place, with supplemental oxygen if necessary. The patient should be observed closely and frequently.

“Temporary” husbandryIt may be easiest to keep the bird in the transportation cage during its initial recovery. Metal cages should be avoided and the bird should be allowed to rest, with minimal contact with the caretakers.

Feeding options include commercial bird-feeding seeds and corn, pet shop mice (dead) and/or worms, greens, and fish – depending on the species of bird. Feeding should take place following manipulation and never before, to avoid regurgitation if the crop is full.

Before allowing a bird to consume whole prey or whole seeds, hydration status and body temperature should be stabilized. Small quantities of highly digestible food and small quantities of oral fluids can be offered. Antibiotic therapy is also recommended to control bacterial growth if GI tract stasis is suspected. Water should be available only if the patient is alert and neurologically sound, because drowning could occur.

Procedures and treatmentsOral administration of fluids is recommended for cases of mild dehydration. The bird must be able to hold its head up correctly (to avoid regurgitation and pneumonia), and be free from any beak injuries. The feeding technique depends on the species and its size – a flexible urinary catheter can be used to reach the proventriculus and a metal tube to reach the crop.

Subcutaneous administration is used in cases of moderate dehydration, and the preferred site is the inguinal fold.

Intraosseous administration is used in cases for cases of severe dehydration and/or shock. The preferred sites are the distal ulna or proximal tibiotarsus.

Intravenous administration is rarely used.

Tube-feedingEven though large predator birds can survive for several days without eating if their body condition is normal, most wild birds will have to be tube-fed if they refuse to consume what is offered to them. The technique is similar to the oral hydration technique.

Wound treatmentAny wounds should be cleaned briefly using water, the feathers around the wound plucked gently (never shaved), and necrotic tissue debrided. Disinfectant and ointment should be applied, the wound covered, and reassessed within 48 hours. Dr. Séguin said that if a cat attack is documented, or is highly suspected, antibiotic therapy should be initiated immediately, even if no wound is found.

Fracture (and/or dislocation) stabilizationWing• Digits, carpometacarpus, radius, ulna:

figure of 8 bandage• Humerus: figure of 8 bandage AND body wrap

From: Beaulieu D. and G. Fitzgerald (1996). Emergency Action Guide for Oil Spills - Rehabilitation of Contaminated Birds. Union québécoise de réhabilitation des oiseaux de proie (UQROP) and Canadian Wildlife Service. St-Hyacinthe, Québec, Canada. Reprinted with permission.

LegDigits, tarsometatarsus, tibiotarsus: employ a modified Robert-Jones or a tape splint (for smaller species ≤ 150 g)• Femur: environmental immobilization only

Coracoid• Environmental immobilization only

Special care for baby birds Whenever possible, the orphan should be returned to where it was found, or a foster family (bird) found as soon as possible to help with the imprinting process. Chicks are often dehydrated and may require subcutaneous fluids, additional humidity, and heat.

The bird’s weight should be recorded each day and it should be fed as much as it will eat so that the crop is filled to capacity, if possible. However, the crop should be nearly empty before the next meal and should be allowed to completely empty at least once each day. The frequency of feeding depends on the age and species. CV

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By Timothy A. Brown, A.L.A., Jon J. Walton, M.Sc, and Dr. Jeff Williams BSc, DDS, MBA

Many clients ask what steps to take when selling a practice. Our experience suggests that a little planning yields big results if the practice owner commits to the succession planning process.

If the correct steps are taken, even within a year or less of the anticipated sale, the result will be a higher sale price and a dramatically smoother transaction.

A veterinarian planning to sell his/her practice should seriously consider the following:

Do’s1. Consult with your accountant about incorporationThe large majority of today’s veterinarians have incorporated prior to sale. While brokers are familiar with the incorporation process, your accountant is the best person to assess your particular situation. Incorporation may provide substantial tax savings to a veterinarian.

2. Prepare your financial recordsBuyers want to understand the unique nature of a practice they are buying. Often, they ask to see a procedure analysis to determine if their skill set is compatible with that of the owner. If you do not have computerized records (about 20 percent of veterinary offices are still using Visi record systems) then at least retain the day sheets for six months minimum to demonstrate your practice protocols and procedures.

3. Protect your practice from employee fraudSadly, a growing trend in business is employee theft and the veterinary industry is no exception to this problem. Increasingly, staff are discovering methods of exploiting the inherent weaknesses of veterinary practice management systems. Longstanding, trusted employees have been involved in reported cases of practice fraud, including associates and even partners! Employee fraud is very damaging to the value of your practice’s goodwill. Here are a few ways to help ‘fraud-proof’ your practice:• Request a copy of each day-end report and examine the billings and

deposits• Cross-check the daily billings with appointed patients indicated on the

day-sheets• Examine the deposit book for cheques received and compare to the bank

or computer deposit slips• Randomly examine patient charts and compare the procedures recorded

with those found on the patient ledger• Day-end reports may be changed at any time — so crosscheck them with

month-end reports to verify no backdating or reversals have been made.• Keep detailed drug logs, not only for controlled substances• Keep track of your inventory! Veterinary practices carry many foods,

accessories, anda wide variety of over-the-counter medications. Since many employees have animals of their own, expensive items often go missing

Today’s sophisticated software has accidentally provided a means to hide or erase data and make employee theft easier. Major software companies are diligently modifying their programs to prevent fraudulent changes to financial records. To date no foolproof system has been developed and veterinarians who do not know how to use their software properly remain vulnerable. To protect your investment it may be necessary to hire a professional fraud examiner. 4. Review and update contracts and agreementsPurchasers demand accurate details of the contracts you have in place. Ask your associate(s), partner(s), landlord and any other suppliers for a current version or copy of your agreement(s). We often receive copies of important contracts that are not signed, current dated or valid. Owners often enjoyed a positive working relationship with the other party or parties and no one

thought to revisit the agreement(s) to be sure it accurately reflected the current relationship(s).

In some cases, lawyers, accountants and bankers have reason to be more skeptical, and thus more protective, of their clients. A lack of up-to-date contracts may substantially reduce the sale price of a practice, and even prevent a sale altogether.

5. Confirm your premise lease renewal option(s)Most leases contain an option to renew once the current term expires. The tenant must confirm the presence of such an option or risk facing the following scenario.In this case, the tenant failed to notice that the landlord had intentionally deleted the option to renew clause. The office location was superb and moving it was not in the veterinarian’s best interest. The practice was put up for sale, but the veterinarian had yet to approach the landlord to discuss the matter of the renewal option. When an offer was presented, the buyer insisted that the landlord confirmed, in writing, that the lease could be renewed.

The buyer’s demand was met but only after a long delay, increased costs and much frustration for all the parties involved. This situation could have been avoided if the tenant had carefully reviewed the first lease he signed (five years earlier) — an easy and relatively inexpensive task. In the event the landlord was not as co-operative, this condition may not have been satisfied, resulting in a failed offer.

Today’s buyers (or more often, their bankers) demand the right to remain in the existing premises for a minimum of seven or eight years. Banks are reluctant to finance a practice sale if the office has to be moved on short notice. If your lease does not include adequate renewal options, contact your landlord and request written confirmation that the lease will be able to be renewed upon the end of the term. You may want to consult with your appraiser or lawyer before doing so.

The do’s and don’ts of selling a veterinarian practice

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Since the last time the American Animal Hospital Association’s (AAHA) Canine Vaccination Guidelines were revised in 2006, new vaccines have been licensed, others have been withdrawn, and new information has led to the revision of previous recommendations. The 2011 AAHA Canine Vaccination Guidelines offer a comprehensive review of canine vaccines currently available in North America, updated recommendations for core versus non-core vaccines, and revised recommendations for shelter-housed dogs.

Developed in a manner consistent with best vaccination practices, the 2011 Guidelines include expert opinions supported by scientific study, published and

unpublished documents, and encompass all canine vaccines currently licensed in the U.S. and Canada. The task force that developed the guidelines included experts in immunology, infectious diseases, internal medicine, law, and clinical practice.

To help address common questions heard by members of the task force about canine vaccination issues asked by practicing veterinarians, a Frequently Asked Questions (FAQs) section was added to the Guidelines. Since scientific studies and referred journal publications are not available to support all of the vaccination recommendations included within the FAQ section, some answers are based on unpublished studies, current knowledge of immunology, and the experiences of experts in the field.

Also new to this edition:- Updated recommendations on serologic testing- Expanded discussion on vaccine adverse events- Review of the legal implications associated with administering vaccines in clinical practice- Full consideration of both U.S. and Canadian canine vaccination regulations

To view the 2011 AAHA Canine Vaccine Guidelines, please go to: www.aahanet.org/PublicDocuments/CanineVaccineGuidelines.pdf.

On Saturday, September 10, 40 veterinarians and veterinary health professionals from across Ontario embarked on a cycling journey through the Milton area, raising more than $55,000 for the Farley Foundation, a charitable organization that assists low-income seniors, disabled persons and women at risk of abuse* with necessary veterinary care for their pets.

The 2011 Ride for Farley was generously sponsored by Summit Veterinary Pharmacy, Inc. The event began in 2005 when one OVMA member veterinarian decided to cycle through northern Ontario to raise money in support of the Farley Foundation. In 2009, the Ride for Farley was moved to Southern Ontario, and has raised more than $200,000 for people and pets in need over the past three years.

Don’ts1. Don’t load up on high technology and major equipment Since most practice sellers are older than the buyers, sellers are advised to refrain from buying and installing expensive upgrades just prior to the sale of the practice. Buyers want systems in place and equipment that is fully integrated into the practice.

2. Don’t subscribe to the kitchen and bathroom conspiracy theoryWhen selling a residential property, vendors are frequently advised to make upgrades to these two areas of their homes – because that is what homebuyers deem to be important. However, no realtor will deny that there is very often much less than a 100 percent ‘return’ on this investment. Therefore, while a veterinarian may decide to spend $100,000 on new equipment and/or leasehold improvements, there may only be a corresponding increase in the appraised value of the practice in the order of only $75,000. And once again, the improvements or additions may not be what the buyer would have chosen.

3. Don’t put your practice into debtWhile there are proponents of ‘equity take out’ schemes (essentially entering into a reverse mortgage situation), there are risks to this strategy that also act as detractors to potential buyers. Essentially, in order to free up some cash from the practice, lenders (leasing companies and/or banks) will offer to lend you money against the equity built up in the practice. This is accomplished by promising to repay the borrowed money by means of an equipment lease. In support of these strategies,

the advocates of such ideas will tell you that the resulting leases are transferable. However, not every buyer wants to be bound to the terms of an agreement made by someone else. Further, there can be unanticipated transfer fees and early payout penalties should the buyer not wish to take over the lease. Besides, if money is needed, a line of credit is often an easier and cheaper way to access funds.

Conclusion: Does a practice need to be prepared for sale? YES, absolutely.

Bottom line: If the preceding low cost/high-effort advice is followed, veterinarians will be rewarded with a smoother transaction and in most instances, an increased sale price of their practice.

Timothy A. Brown is the President & C.E.O. of ROI Corporation & ROI Capital, a company that specializes in practice appraisals, brokerage, consulting, locum placements, associateships and practice financing across Canada. Timothy can be reached at [email protected].

Jon J. Walton is a national associate at ROI Corporation and head of the veterinary division. Jon can be reached at [email protected].

Dr. Jeff Williams is ROI Corporation’s associate for Atlantic Canada dental division and its director of corporate affairs and development. Jeff can be reached at [email protected]

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Veterinary professionals raise more than $55,000 for sick and injured pets during the 2011 Ride for Farley

Canine vaccine guidelines revised


To learn more about Ride for Farley or the Farley Foundation, please visit www.farleyfoundation.org, or contact Julia Hayes, Communications Coordinator at [email protected].

* For more information about OVMA’s SafePet program, please visit www.ovma.org.

Western College of Veterinary Medicine University of Saskatchewan

DIRECTOR – VETERINARY MEDICAL CENTRE

The Western College of Veterinary Medicine (WCVM) invites applications for the position of Director of the Veterinary Medical Centre (VMC).

The Veterinary Medical Centre: The VMC has undergone substantial expansion and renovation, and it is currently an outstanding state-of-the-art facility serving western Canada as an accredited hospital and referral centre through the American Animal Hospital Association. Recent equipment and diagnostic enhancements include a new MRI, a 16 slice CT scanner, nuclear scintigraphy, linear accelerator, surgical suites and examination rooms, an Equine Performance Centre and a dedicated MRI. The VMC employs approximately 100 people and interacts with over 60 faculty in two clinical departments. Each year the hospital cares for 13,000 animals, and an additional 30,000 animals are treated through 3,800 field service visits. The annual expenditure operating budget is approximately $9.7 million. The VMC is a critical part of the College’s service, research and teaching mission.

The Western College of Veterinary Medicine: The WCVM is western Canada’s regional college of veterinary medicine. Approximately 80 students per year from the four western provinces and the northern jurisdictions begin studying toward the DVM degree. The College also includes 140 graduate students, interns and residents. It is part of a comprehensive academic health sciences group on the university campus, with access to facilities including the Canadian Light Source and the Biomedical Beamline. For further information, please visit www.usask.ca/wcvm.

The WCVM is located in Saskatoon, Saskatchewan’s largest city – one of the sunniest cities in Canada. For more information on Saskatoon, please visit www.tourismsaskatoon.com.

Duties: Reporting to the Dean, the Director will play a key leadership role in the College through administration of the VMC, particularly in the areas of financial, client and human resource management. The Director will be instrumental in playing an important role in supporting the integration of the VMC’s clinical service and business requirements with the academic objectives of the College. In addition, the Director will also manage varied infrastructure and facility enhancements.

Qualifications: This position requires an individual with excellent interpersonal and communication skills, demonstrated skills in human resource and financial management, and experience in a clinical veterinary medical environment. Ideally, applicants should possess a DVM or equivalent degree plus experience or formal training in administration or business management.

Salary: Commensurate with qualifications and experience.

We will begin reviewing applications in early November. Interested persons should submit a letter of intent, curriculum vitae, and the names and contact information of three references to:

Office of the Dean Western College of Veterinary Medicine University of Saskatchewan 52 Campus Drive Saskatoon SK S7N 5B4 Email: [email protected]; phone: 306-966-7454

The University is committed to Employment Equity. Members of designated groups (women, aboriginal people, people with disabilities and visible minorities) are encouraged to self-identify on their applications.

The following participants cycled 50 km, 100 km or 160 km: Tristan Smit, Aurora, ON; Greg Stewart, Barrie, ON; Chris Stewart, Barrie, ON; Dr. Dave Heaton, Bobcaygeon, ON; Kathy Holden, Brantford, ON; Beverley Dungey, Brantford, ON; Dr. Albert Wimmers, Burlington, ON; Nancy Lester, Caistor Centre, ON; Emmalena Hurst, Caistor Centre, ON; Dr. Jonathan Uyede, Cambridge, ON; Dr. Richard Bennett, Cambridge, ON; Dr. Devin Hunt, Chesterville, ON; Kadri Uukkivi, Dunnville, ON; Dr. Bob Perry, Dunnville, ON; Elaine Perry, Dunnville, ON; Dr. David C. Gay, Fonthill, ON; Dr. Johnathan McTaggart, Fort Erie, ON; Dr. Michelle Cline, Grimsby, ON; Philip Cline, Grimsby, ON; Dr. Mark Gemmill, Guelph, ON; Nadine Vogt, Guelph, ON; Dr. Renee Bourque, Hamilton, ON; Mike Woodward, Hamilton, ON; Barbara Bacon, Merrickville, ON; Jen Haley, Merrickville, ON; Dr. Dale Scott, Mindemoya, ON; Dr. Jim Fairles, Mount Forest, ON; Dr. Stephanie Marquette, North Bay, ON; Dr. Kristin Baird, Oakville, ON; David Schleifer, Paris, ON; Michael Robertson, St. Catharines, ON; Dr. Emily Jansen, Sturgeon Falls, ON; Dr. Matthew Richardson, Toronto, ON; Dr. Robert Jones, Toronto, ON; Dr. Oscar Albarracin, Toronto, ON; Dr. Edison Barrientos, Toronto, ON; Dr. Nigel Skinner, Toronto, ON; Dr. Kevin Kieffer, Walkerton, ON

Established by the Ontario Veterinary Medical Association (OVMA) in 2001, the Farley Foundation assists seniors and disabled persons on limited incomes and women at risk of abuse (who are participating in OVMA’s SafePet program) to access non-elective veterinary medical treatment for their pets. In 2011, the Foundation expanded its eligibility criteria to include pets in long-term care facilities for seniors. To date, the Foundation has disbursed more than $1.2 million to assist over 3,000 people in Ontario by covering the unexpected veterinary costs for their pets; and in many cases saving the lives of these beloved companions.


RespiSure-ONE® now registered for use in day old pigletsCanadian swine producers can now vaccinate for mycoplasma pneumonia when they process baby pigs. A new label claim makes RespiSure-ONE the only vaccine approved for administration at one day of age.

RespiSure-ONE is the only vaccine labeled to aid in reducing the severity of colonization and shedding of Mycoplasma hyopneumoniae. In addition, studies have shown that a single 2 mL dose of this vaccine administered within the first week of life delivers up to 25 weeks of immunity.

Efficacy at one day of age has been demonstrated in Pfizer Animal Health challenge studies. Pigs receiving a single dose of RespiSure-ONE at one day of age were challenged with M. hyopneumoniae at two weeks of age and had significantly lower lung lesions and concentrations of M. hyopneumoniae in the lungs, plus reduced shedding of M. hyopneumoniae during four weeks post-challenge period.

For more information contact Simon Grudzien, at [email protected].

Pfizer Animal Health launches a new porcine circovirus vaccineNearly every pig in Canada receives a vaccine for protection against porcine circovirus (PCV), and now swine producers have a new option for efficacious protection with the registration of Fostera™ PCV from Pfizer Animal Health.

Fostera PCV is labeled for use as an aid in preventing viremia and an aid in the control of PCV2 related lymphoid depletion for pigs three weeks of age and older. The vaccine provides four months of immunity against PCV in a single 2 mL dose.

For more information, contact Simon Grudzien at [email protected].

Director - Veterinary Medical CenterThe Western College of Veterinary Medicine at the University of Saskatchewan is accepting applications for the position of Director of the Veterinary Medical Centre. For more information, see page 23 of this issue of Canadian Vet, or visit www.usask.ca/wcvm.

Equine business management strategies symposiumThe Equine Business Management Strategies (EBMS) symposium, a targeted business education program developed for equine veterinarians and practice professionals, took place recently for the second time in Europe in Cadnam (United Kingdom). This intense, 5-day course, which is supported by Merck Animal Health, has been proven very successful in recent years in the United States as well as in Europe.

A group of forty European equine practitioners gathered in August 2011 to discuss and learn how to apply business principles in their day-to-day work. Workshops and field excursions dug deep into personnel management, the use of social media and internet to promote the practice and retirement strategies for the equine veterinarian.

Roberto Ragni-Alunni, DVM, Global Technical Lead Equine at Merck Animal Health noted: “To run a successful practice, business skills are just as important as medical ones, but young graduates come out of veterinary school without any training on such subjects. At MSD Animal Health we believe that offering these additional tools can improve our bond with equine veterinarians and will help them to run a successful and sustainable business.” International specialists on strategic planning, benchmarking, branding and change management created an environment in which the course participants were challenged to work on a strategic plan for their practices and to share their knowledge, experience and ideas. to improve key areas of practice management.

For more information, visit www.equinebusinessmanagement.com.

New Hill’s® Prescription Diet® y/d™ feline thyroid health pet food Hill’s Pet Nutrition recently introduced Precription Diet y/d, a daily, low iodine nutrition solution designed to manage hyperthyroidism in cats, that is clinically proven to improve thyroid health. Treatment protocols can now include Prescription Diet y/d Feline as an integral part of managing hyperthyroidism in cats.

Hill’s recently released results from three studies conducted to determine the impact varying iodine concentrations have in cat food. The studies revealed what levels of iodine are necessary to normalize a hyperthyroid cat. They concluded that if the iodine content can be kept below 0.32 ppm, hyperthyroidism in cats can be controlled through nutrition therapy alone. This is also dependent on pet owner compliance in providing the cat only Hill’s Prescription Diet y/d Feline Thyroid Health without interruption of outside iodine-rich dietary products. Through this effort, the cat’s thyroid levels can be kept in the normal range.

For more information about Hill’s Pet Nutrition Inc. and Hill’s Evidence-Based Clinical Nutrition™ visit HillsPet.com or search for Hill’s Pet Nutrition on Facebook.

AVENTIX turns 10!For over a decade, AVENTIX has been supporting veterinary practices across Canada through the provision of exceptional animal health products. The company recently marked its 10th anniversary in the veterinary pharmaceutical and instrumentation industry. Through continued partnership with international suppliers and successful development under private labels, AVENTIX has specialized in the pharma and instrumentation divisions, and wishes to thank the Canadian veterinary community and each of the veterinary buying groups for over 10 years of support.

“We continuously search the world over for innovative products that enhance the practice of veterinary medicine and underscore efforts to provide quality animal care,” said Vince Bellavia, CEO of AVENTIX.

Over the years AVENTIX has partnered with established suppliers, including Dechra Veterinary Products (DermaPet), Candioli Pharma, LDCA, CLC Medica, Alcon® Canada, Meridian™ Animal Health, Heine, PetKingBrands, Paw (Blackmores), Dioptrix, Provizor Ltd., HW Veterinary Nutrition Inc., Heska®, Abaxis Inc., Imagework and Sound-Elkin™. The growth of these relationships resulted in the division and specialization of efforts into Pharma and Instrumentation, enabling AVENTIX to provide the veterinary community with targeted solutions to specific needs.

“Our success and growth is the result of solid support from the Canadian and US veterinary communities, as well as the veterinary buying groups throughout Canada and our distributor partner in the USA,” said Vince Bellavia. “In addition, the dedicated employees of AVENTIX have provided excellent support to our customers and worked tirelessly to inform our customers about the unique products we sell. To all of these groups, AVENTIX extends our sincere thanks and gratitude.” He concluded by saying, “We will continue with our promise to provide exceptional products, tools and customer care to the veterinary community.”

For further information, visit www.aventix.ca or e-mail [email protected].

Industry News

The AVENTIX team1st row (seated/kneeling) Mike Bates, Barb Hardy, Louise Bennett, Vince Bellavia, CEO Behind: Dwayne Harthun, Vivian Tate, Tracey Bennett, Joyce Bellavia, Jenn Fox, Georgina Craig


Buyers and sellers can disagree about price when a business is offered for sale. There are various scenarios that may lead to a large price gap between the buyer and seller of a business; however, the most common scenarios involve a difference in opinion regarding the future performance of a business.

Consider the following scenarios: Scenario 1: A practice is offered for sale that has been experiencing double digit growth in the past two years. The seller believes this growth will continue while the buyer believes the growth period is over.

Scenario 2: A practice is offered for sale in an area where new competition is opening down the street. The seller believes the practice will not be adversely affected by the new competition while the buyer believes the practice will be adversely affected by the new competition.

Scenario 3: A single doctor practice is offered for sale. The seller believes there is a significant amount of commercial goodwill in the practice while the buyer believes the practice is mostly made up of personal goodwill that will vanish upon the transfer of ownership and retirement of the seller.

If a significant gap exists in price between the buyer and the seller, the gap may be best managed using a contingent consideration. A contingent consideration is more commonly referred to as an earn-out. An earn-out involves a “consideration” transferred from the buyer to the seller at some point in the future. The consideration may be in the form of assets (cash), or equity (shares) in the business. The future consideration is “contingent” upon the business achieving certain performance criteria as designated and agreed upon by the buyer and seller. The performance criteria are usually financial in nature and may include revenue targets or profit targets.

An example of a simple earn-out would be if a buyer pays a seller $500,000 for the practice upfront and the buyer agrees to pay the seller an additional $100,000 if a 5% increase in revenue is attained in one year from closing.

There are pros and cons to using an earn-out as part of a sale transaction.

Pros• Facilitates the sale of a practice when a sale would not otherwise

occur due to a price gap

• Motivates the seller to play a role in the business post-closing to ensure financial targets are met and to ensure the continued success of the business

• Creates a win-win for both the buyer and the seller; protects buyers from over-payment and protects sellers from under-payment

Cons• Can be complex• Not always cost-effective for small businesses to structure and implement• Still requires buyer and seller to reach a consensus regarding price;

buyer will want most of price in the form of an earn-out while seller will want most of price realized up front at closing; buyer and seller must agree to terms

• Seller must rely on the purchasers’ business competence to receive the earn-out if seller is uninvolved in the business post-closing

Consideration should be given to the amount of the earn-out, the timing of the earn-out, the probability of achieving targets, whether or not partial earn-outs are permitted, etc. The length of time over which the earn-out is structured should be between one and three years. Longer terms are much too complex and are probably best handled as business partnerships. The majority of the price should be paid up front with a minority of the price structured as an earn-out; however, there are exceptions where this may not be appropriate. An example would be the purchase of a single doctor practice in which the doctor ceased to practice for a period of time due to disability or death. The earn-out should form the majority of the price in this scenario.

The terms of the earn-out agreement require careful consideration, and purchasers and sellers of a practice should seek professional advice on structuring and implementing this type of transaction.

Elizabeth Bellavance, DVM MBA CMA CEPA, is a member of the Board of Directors of VetPartners™, a member of the Veterinary Valuation Resource Council (VVRC), and a member of the Canadian Institute of Business Valuators. Dr. Bellavance can be contacted at [email protected].

Best PracticesContingent considerations – bridging the price gap between buyer and seller

Elizabeth Bellavance, DVM, MBA, CMA

Sponsored by Merck Animal Health

Canadian Compendium of Veterinary Products, 12th edition (English), for iPhone, iPod Touch, iPad and Android

North American Compendiums announces that the 12th edition of the Canadian Compendium of Veterinary Products (CVP) (English) is now available to download free (compliments of Pfizer Animal Health) to your iPhone, iPod Touch or iPad or Android.

This indispensable collection of veterinary drug labels is the most complete and concise reference available. The CVP features over 2,200 pharmaceutical, biological, feed medication, diagnostic, dietary supplement and parasiticide product monographs with over 120 manufacturers/

distributors and their contact information. Dosing information is provided at the product label level.

Product comparisons can be accomplished by viewing the Product Use and/or Product Category Indices. Improved navigation for mobile versions of the specie-specific Biological and Anthelmintic and Parasiticide Indices are included. Withdrawal Times are presented as ‘All species’ or as separate specie-specific charts.

This application requires an Internet connection.Owners of a Canadian account with iTunes and Google Marketplace can

download a copy for free, compliments of Pfizer Animal Health. Search for ‘CVP Vet’.

For more information visit www.naccvp.com.


october 30-november 2 toronto, onAntimicrobial Stewardship in Canadian Agriculture and Veterinary Medicine Conference [email protected] www.antimicrobialcanada.com

november 4-7albuquerque, nmVeterinary Cancer Society Conferencewww.muconf.missouri.edu/vetcancer2012

november 5mIssIssauga, onLaser Therapy in General Veterinary PracticeDr. Joanne Klingelewww.lifelearn.com

november 10-13 saInt-hyacInthe, qc 125th Anniversary of French Veterinary Education Convention www.omvq.qc.ca

november 12guelph, onPractical Aspects of Emergency and Critical Care MedicineDr. Karol Mathewswww.lifelearn.com

november 12-13guelph, onSurgical OphthalmologyDrs. Nick Whelan and Tara Richardswww.lifelearn.com

november 18-22san antonIo, tXAmerican Association of Equine [email protected]

november 19mIssIssauga, onVeterinary Dermatology in the 21st CenturyDr. Edmund R. Rosserwww.lifelearn.com

november 20eDmonton, abOncologyDr. Glenna [email protected]

December 3-4toronto, onComprehensive Clinical CardiologyDrs. Sonya Gordon and Michael O’Gradywww.lifelearn.com

December 9-11 baltImore, mDOral Surgery 1, Oral Pathology, and Radiology 3-Day Series [email protected] www.animaldentalcenter.com

January 14-18orlanDo, FlNorth American Veterinary Conferencewww.navc.com

January 19-21calgary, abWestern Canadian Association of Bovine Practitioners Conferencewww.wcabp.com

January 21-22baltImore, mDFundamentals of Dentistrytraining@animaldentalcenter.comwww.animaldentalcenter.com

January 26-28toronto, onOntario Veterinary Medical Association Conferencewww.ovma.org

February 10-12baltImore, mDOral Surgery 1, Oral Pathology and radiologytraining@animaldentalcenter.comwww.animaldentalcenter.com

February 19-23las vegas, nvWestern Veterinary Conferencewww.wvc.org

march 1-3parIs, FranceWorld Veterinary Cancer Congresswww.worldveterinarycancer.org

march 15-18Denver, coAmerican Animal Hospital Association Conventionwww.aahanet.org

march 28-aprIl 1baltImore, mDDiscovering Dentistrytraining@animaldentalcenter.comwww.animaldentalcenter.com

may 30-June 2new orleans, laAmerican College of Veterinary Internal Medicine Conferencewww.acvim.org

June 7-9saskatoon, skSaskatchewan Veterinary Medical Association Conferencewww.usask.cawww.svma.sk.ca

July 11-14montréal, qcCanadian Veterinary Medical Association [email protected]/profes-sional-convention.aspx

July 24-28vancouver, bcWorld Congress on Veterinary Dermatologywww.vetdermvancouver.com

Continuing Veterinary Education Calendar

Canadian Veterinary Medical Association (CVMA) NewsBy Kristin McEvoy, Communications Manager

CVMA award nominations are open!Nominations for the 2012 CVMA Awards program are officially open! Here’s your chance to shine the spotlight on a colleague who has gone the extra mile in support of the profession and the wellbeing of animals. Nominations for 2012 CVMA Awards will be accepted until January 30, 2012. All CVMA members are invited to nominate deserving candidates for the following awards and honours: • CVMA Humane Award • CVMA Industry Award • Merck Veterinary Award • Small Animal Practitioner Award • Life Membership• Honourary Membership

Awards will be presented during the 2012 CVMA Convention, taking place in Montreal from July 11-14. Visit the News & Events section of the CVMA website (www.canadianveterinarians.net) for details on creating and submitting a nomination package.

CVMA to partner with Care for Cats in 2012Tackling the cat overpopulation crisis and raising the value of cats is the vision of the Care for Cats group, led by PetLynx Corporation and Dr. Liz O’Brien, a feline practitioner from Hamilton, Ontario. The group, which declared 2011 as the Year of the Cat, will turn its focus to “routine veterinary care” in 2012. To raise awareness of this important issue, the CFC and the CVMA will be teaming up to promote veterinary care for cats. CVMA’s involvement in this initiative will help address two key feline issues – reduced veterinary visits and cat overpopulation. Visit www.careforcats.ca to learn more about the campaign.

Newly approved position statements Five CVMA position statements have recently been updated and approved by CVMA Council. The following position statements can be accessed in the Publications section of www.canadianveterinarians.net:• Keeping Native or Exotic Wild Animals as Pets• Animal Abuse • Ownership and Selection of a Pet • Transportation of Pets in Motor Vehicles • Veterinary Dentistry

Vet 2011: World Veterinary Year comes to a closeAs World Veterinary Year comes to a close, so too does Vet 2011 campaign and the veterinary profession’s celebration of its 250th birthday. Throughout the year, Vet 2011 activities have raised the profile of the veterinary profession and connected veterinarians with other colleagues from around the world. Vet 2011 has been a truly remarkable movement that illustrated the many different roles of veterinarians and enhanced knowledge of veterinary history.

In honour of Vet 2011, a series of scientific and academic events, as well as promotional and media events, took place in several countries. Many of these activities were granted official Vet 2011 event accreditation. Here in Canada, a total of 10 Vet 2011 Accredited Events took place: • AAHA & OVMA Conference (March 24-27)• Regional Summits for Urban Animal Strategies (4 events held in April 2011)• Ontario Veterinary College Symposium “Changing Roles of Animals in

Society… The Human and Animal Bond” (May 28, 2011)• CVMA Summit of Veterinary Leaders “Ecosystem Health – A Wake-Up

Call To Veterinarians“(July 5, 2011)• Animal Health Week “Protecting the Health of All Species” (Oct. 2-8, 2011)• International Summit for Urban Animal Strategies (October 19-22, 2011) • Congrès du 125e (November 10-14, 2011)

Photos from Vet 2011 events can be viewed on the Vet 2011 website at www.vet2011.org.

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NOBIVAC is a registered trademark of Intervet International B.V., used under license.Merck Animal Health, operating in Canada as Intervet Canada Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.MERCK is a trademark of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.Copyright © 2011 Intervet International B.V., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. All rights reserved

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