In Practice Latest Issue

Liver disease in rabbits

Meredith, A. — 2013-06-17T02:56:51-07:00

Many disease conditions of the rabbit can affect the liver, and a variety of clinical signs may indicate a diagnosis of liver impairment, either as a primary or secondary condition. However, clinical signs are often non-specific and it may be difficult to make an accurate diagnosis of liver disease in practice. This article describes the clinical signs and diagnostic tests used in making a diagnosis of liver disease in rabbits, and discusses specific liver diseases and their management.

Acute kidney injury in dogs and cats 2. Management, treatment and outcome

Li, R., Mugford, A., Humm, K. — 2013-06-17T02:56:51-07:00

Acute kidney injury (AKI) is a commonly encountered emergency in small animal practice. Dogs and cats with AKI are mostly presented in the maintenance phase of the disease, by which point renal function has been severely compromised and clinical signs are apparent. The first article in this two-part series, which was published in the May issue of In Practice discussed the pathogenesis and diagnosis of AKI. This article considers both specific therapy and general supportive treatment in dogs and cats.

Diseases in camelids 1. Common presentations

Whitehead, C. — 2013-06-17T02:56:51-07:00

An increasing number of practitioners in the UK are being asked to see South American camelids (mainly llamas and alpacas). There are now just under 28,000 registered alpacas in the country, mostly concentrated in the south, although they are scattered across the regions. It is the veterinary surgeon's responsibility to take steps to familiarise themselves with any species under their care. This article considers some of the more common disease presentations that are seen in camelids in the UK. A second article, to be published in a subsequent issue of In Practice, will focus on common disease presentations seen in young camelids.

Current concepts of navicular syndrome: diagnosis and treatment

Coomer, R., Thomas, H., McKane, S. — 2013-06-17T02:56:51-07:00

Navicular syndrome is a complex of degenerative processes arising from many types of injury to structures in the heel area of the foot. Although classically presenting as a chronic forelimb lameness, the clinical signs of horses with navicular syndrome can vary widely, leading to difficulties in making a definitive diagnosis. The recent increase in availability of advanced imaging techniques such as computed tomography and magnetic resonance imaging has not only improved our understanding of the disease, but also our ability to localise lesions within the foot that may not be evident on radiographs. Due to the multiple aetiologies that may contribute to any one case, treatment and management of the condition is rarely straightforward and often requires a combination of strategies. This article reviews the current concepts of navicular syndrome and outlines a practical approach to its diagnosis and management.

Applying digital photography in general practice

Fawcett, A., Norsworthy, G. D. — 2013-06-17T02:56:51-07:00

The widespread availability of digital cameras means that most vets have access to a camera capable of producing high quality clinical images. Photography can be a powerful tool in practice. Anne Fawcett and Gary Norsworthy explore how it can be used to document clinical cases, enhance communication with colleagues and specialists, as well as share information with a wider audience.

Creating bonds and engaging with the local community

Boland, Z. — 2013-06-17T02:56:51-07:00

Having strong bonds with the local community can be an incredibly valuable resource for a practice; such a relationship fosters loyal clients and can help bring in new customers through word-of-mouth recommendations. Zara Boland discusses strategies for engaging clients with activities and initiatives both inside and outside the practice.

Search engine optimisation to improve your visibility online

Samuel, S. — 2013-06-17T02:56:51-07:00

Search engines are a fundamental part of the way most people use the internet, so search engine optimisation, which improves a website's position in the search results, can have a huge impact on the online visibility of a business. Susie Samuel explains how search engine optimisation works and how it can increase the volume and quality of traffic to a vet's webpage.

Being a badger's advocate

Cousquer, G. — 2013-06-17T02:56:51-07:00

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved. In addition, a possible way forward is suggested; however, there is rarely a cut-and-dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Being a badger's advocate’, is presented and discussed by Glen Cousquer. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘Anaesthetic death: who pays?’, which was published in the May issue of In Practice, appears on page 351.

The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.

Comments on the dilemma in the May issue: 'Anaesthetic death: who pays?'

Gray, C. — 2013-06-17T02:56:51-07:00

The May issue's dilemma dealt with a distraught owner who refused to pay following the unexpected death of his cat during a routine ovariohysterectomy. (In Practice, May 2013, volume 35, pages 286-287). Anne Fawcett argued that taking the time to explain what steps were taken in monitoring and addressing complications during the procedure was vital, as clients often don't realise how much effort vets and support staff put into reviving an animal, or how upset they might be when an animal dies in such circumstances. She proposed that, although owners were expected to pay for services rather than outcomes, a possible way forward might be to offer a ‘compassionate discount’; this would show empathy for the client's distress while also being charged in a way that ensured that the practice did not lose money. The vet might also suggest performing a postmortem examination (also at cost), as obtaining a definitive diagnosis could help provide closure for the owner.

Do you know your client?

2013-06-17T02:56:51-07:00

I OFTEN feel that when we register new clients at our practice we should ensure that the receptionist, as well as getting basic facts such as name, address and animal details, asks people what they do for a living. A client yesterday exemplified why this is important. She had presented her cat, which had a badly infected bite on its foreleg. Fortunately, although she wasn't wearing a nurse's uniform, an ID card that dangled from the lanyard around her neck proclaimed her to be staff sister for the infection unit at the local hospital. Not only did this ensure that I didn't waste (mine or her's) valuable time describing the basic underlying problem, it also meant I didn't patronise her with simplistic management advice, which she would have regarded as kindergarten-standard in her area of expertise. I also wasn't thrown when she asked intelligent questions about antibiotic...