Showing posts with label veterinary. Show all posts
Showing posts with label veterinary. Show all posts

Oh, My Aching Joints

Gena sent in a question about her dog's arthritis. Apparently, little Piglet has problems with his knees bothering him. Many pets of all sizes suffer from osteoarthritis, so this is a good topic for discussion.

When most people say "arthritis", they are meaning what doctors call osteoarthritis. This is different than rheumatoid arthritis, which is a disorder of the immune system. Osteoarthritis is wearing and tearing on the joint surfaces over time. Certain breeds can be prone to this and orthopedic injuries can increase a dog's risk of it developing. Within a joint there are some basic structures: synovial fluid, which acts as a cushion and lubricant; hyaline cartilage, which covers the bone and helps with smooth, low-friction movement; ligaments and tendons, holding bones together; and the bone itself, underlying these tissues. As a joint deteriorates, the cartilage begins to wear off. As it does, it exposes the underlying bone. When bone contacts cartilage or another bone, that touch and movement causes pain and inflammation.

Once degerative changes begin in the joint, they are pretty much irreversible. Truly degenerative joint disease (DJD) will never return to normal, and can result in some extensive changes in the shape of the bone as the body tries to compensate for abnormal movement or instability. Even surgery can only do limited things to improve the condition, and are usually small changes such as removing bone spurs.

The keys to improving the lives of arthritic patients lies in helping with pain and inflammation. This can be accomplished through several means. One that most people are familiar with is prescription anti-inflammatory medications. The category of drugs is called "non-steroidal anti-inflammatory drugs" and is commonly abbreviated as "NSAIDs". You are already familiar with these products for human use as acetominophen, ibuprofen, naproxen, and many others. In veterinary medicine we have Rimadyl, Etogesic, Deramaxx, Melicam, and several others. Though they are all in the same category of drugs, they have slightly different efficacies between patients, and slightly different potential side-effects. That's why Tylenol works better for some people than Advil, or vice-versa. These medications help to reduce pain and inflammation, and can be the only thing to really help pets. They are not without potential dangers, though, especially with continual, long-term use. Currently these medications are available only by prescription (at least, in the US), and you should consult with your vet on these options. I do not recommend using human medications in dogs unless you are under a vet's instructions to do so. Dogs and cats are more susceptible to the side-effects than humans are.

Besides prescription analgesics, there are other things that can help, and I usually recommend them as a first choice unless the patient's pain is extremely bad. Glucosamine and chondroitin supplements can work wonders, and are readily available over-the-counter. They help to increase the lubrication of the joint, and can rebuild some of the cartilage. Numerous studies have shown their efficacy, and I have seen many of my patients dramaticly improve on them. They will take 2-4 weeks to show an effect, so don't give up on them after a few days. Many pet foods now have them included in the diet, especially for large breeds. There really are no side-effects, so they're a great supplement to use. Make sure to use one designed for pets, though. Even if the basic ingredients are the same as a human equivalent, we have a different digestive system and so the ingredients may not be absorbed as well if you use a human product.

Along the same lines is MSM, a natural dietary sulfur. This is another nutritional supplement, and works differently than glucosamine. MSM will act as a natural anti-inflammatory, which can help reduce discomfort. Using glucosamine and MSM together form a two-pronged approach that may eliminate or prevent the need for NSAIDs.

It is also very, very important to get your dog to a normal weight. Obesity can dramatically increase the pain of arthritis. First, there is extra pressure on the joints that the body was not designed to hold. Second, fatty tissue has been found to produce numerous hormones and biochemicals. Rather than being an inert substance, it actually is a very active one. These chemicals have been shown to increase inflammatory reponses in the body, which is one of the problems with arthritis.

If you have a pet with arthritis problems, talk to your vet. They may recommend x-rays to assess the amount of damage, and whether or not surgery is an option (as it may be in certain types of hip disease). They will also help design a management program that best suits your pet's needs.

The Slow Season

Did you know that veterinary medicine is a seasonal business? Well, at least here in the US it is. I've never completely understood why, even though I know some of the factors.

Summer is the busy time for us. We see more frequent skin and ear infections, flea problems, and allergy issues. These are complaints that happen more frequently in warm weather than in other times of the year. However, we also see more pets for routine preventative care. The increased number of clients is likely because of several influences besides medical need. Many parents have summers with more free time because they are home with the kids and don't have to worry about school schedules. People need to have their pets ready for boarding, getting them up to date on vaccines in preparation for taking them to kennels while the human family goes on vacation. There also seems to be more discretionary income available.

By contrast, the winter months are very slow for us. Extra money is spent on Christmas rather than the pets, and people tend to get into a greater financial crunch around this time of year. Cold, dry air isn't good for fleas, and is more forgiving to skin problems, so these issues tend to go away for the most part (depending on the part of the country). And since we are now in December, yes, we're becoming much slower and I am getting caught up on some reading that I didn't have time to do in the Summer.

We as a profession have learned how to deal with this seasonality. While many businesses hire seasonal help during November and December as the Christmas shopping season happens, we hire Summer workers to aid in the extra business. Sometimes we'll plan building or cleaning projects for January or February when we know there won't be many clients around. We hate having to reduce employees' hours as the holidays approach, but it's also necessary in order to stay in business.

Apparently, seasonal variations happen in other non-retail businesses. I spoke to my kids' pediatrician once, and she said that because of colds and flu their client flow is seasonal also, but with the height during the winter months. I'm curious as to whether non-American veterinary practices see a similar pattern.

Just another view behind the scenes of a veterinary practice!

The Weather Outside Is Frightful

Winter is coming, and that means we need to be aware of the weather changes with our pets. Here in the US there are huge differences in weather, from Maine to the Dakotas, Florida to Oregon, California to Georgia. But regardless of where you live there are some guidelines to remember. Most of our pets, especially dogs, aren't really well designed for living outside. We've bred them to be dependent on us, and often have bred coats that don't do well in cold weather. Smaller breeds are especially at risk for this.

Most dogs can do well outside, though long-haired breeds are much more likely to have problems with matted fur. However, dogs that aren't arctic breeds shouldn't be outside in cold weather. A dog house with fresh straw or hay is needed to help keep them warm and well-insulated. The bedding should be changed regularly to keep it clean and hygenic and to prevent insects and parasites from growing. Outside dogs should also have shelter from rain or other precipitation. Don't use heaters in dog houses, as they are a potential fire risk, and we definitely don't want that to happen!

As a rule of thumb, I tell my clients that if the weather is going to dip to freezing or below, pets should be brought inside. Certain breeds, such as huskies, malamutes, St. Bernards, and other thick-furred dogs can do well outside in cold weather with appropriate bedding and insulation. But most breeds cannot tolerate these temperatures, especially small dogs or breeds with short hair. I know that many people have kept dogs outside year-round, so I can't completely argue that. But often that is in warmer climates, or they have very well insulated dog enclosures. The average pet owner likely isn't going to have good preparations for that.

What if your dog is large, or messy, or particularly rowdy and you simply cannot or are not willing to bring it inside your house? Well, a garage is always an option, and is going to be warmer and have better conditions than being outside. If you still can't or won't do that, I'd have to be blunt and ask why you have a dog (again, I can be more direct here than with my own clients). As a pet owner, you have a responsibility to provide them with proper care. Pets can also be extremely rewarding, and bring a lot of joy, fun, comfort, and companionship. If a dog is simply going to be outside all of the time, you might want to seriously think about why you have it.

Now, those of you who have kennels with many dogs for breeding or hunting, I'm not really talking about you. I know plenty of people with these circumstances that interact with and train their dogs daily, and give them excellent care. Admittedly some people simply have so many dogs that it's impossible to bring them all inside. In that situation, make sure they have appropriate places to stay when outside.

The weather is getting colder, and we need to think about our little fuzzy friends. Take care of them and think about whether or not you would want to sleep outside during the winter.

Pet Peeve #1

I'm going to go ahead and get this off my chest as an early post. Please forgive me if I step on anyone's toes, but this is a big pet peeve of mine, and one I deal with almost daily. I never get to say this directly to my clients, so pardon me if I vent a bit.

If you have a pet, set aside the money to take care of it! Pet ownership is NOT a right. If you have a pet, you have a great responsibility to care for it. Yes, this costs money. Sorry, but that's the reality. If you take shortcuts (not getting vaccines, not using heartworm prevention, etc.), you are putting your pet's health at risk, and will possibly face some very expensive treatments. As a responsible pet owner, you need to set aside several hundred dollars per year for veterinary care, good quality food, and preventative medicines (flea and heartworm prevention). I also recommend to set up a separate fund of about $500 just for any emergencies.

Let me give you a couple of examples. Virtually every day I have a client come in just for a rabies vaccine. They do that because it's required by law, and grooming facilities require at least this one vaccine. Depending on your location, it's only about $10-20. However, the client will decline any other vaccines (for diseases that are MUCH more common than rabies), and will decline heartworm prevention. The excuse is usually that they don't have the money for it. Yet within a couple of days, they'll go to a groomer and spend $30-60 to have their dog bathed and trimmed.

Don't get me wrong. I do believe in proper hygine and care of pets, and think groomers overall do a great job. But if it's a choice between spending $40 to prevent a fatal disease and spending $40 to get rid of mats, which is the best choice for the pet?

Priorities, people!

Example #2. I'll often see a pet for an injury that may require radiographs (x-rays). That can cost $150-200. Some people have to decline it because they don't have the money. The pet is really the one who ends up suffering. That's why I recommend having a savings account just for situations like this.

So to summarize...If you're going to have a pet, please make the decision to actually take care of it. Work the costs of veterinary care into your budget. Be prepared for emergencies. Listen to your vet's recommendations and actually do them. And if you can't afford all of this, don't have a pet!

Okay, now that I have that off my chest, I'll make sure my next entry is a bit more helpful and upbeat.

Tentang Veteriner

ada ekonomi VETERINER
ada politik VETERINER
ada VETERINER sebagai terjemahan bahasa Idonesia dari bahasa Inggris Veterinary
ada Masyarakat Kesehatan VETERINER
ada otoritas VETERINER
ada orang yang mengklaim VETERINER adalah domainnya sehingga merasa harus berkuasa atasnya.

apakah VETERINER itu?

ada orang bilang VETERINER adalah segala hal tentang hewan dan penyakitnya

padahal, VETERINER yang dalam bahasa Inggris Veterinary, menurut kamus Inggris ke Indonesia, veterinary adalah berkenaan dengan penyakit hewan


Jadi orang yang mau memperjuangkan otoritas VETERINER berarti memperjuangkan segala hal yang berkenaan dengan penyakit hewan itulah maka VETERINARIAN dalam bahasa Indonesia disebut sebagai orang yang ahli tentang segala hal yang berkenaan dengan penyakit hewan yang sudah tentu untuk disembuhkan alias DOKTER HEWAN.

lalu apa makna ekonomi veteriner, politik veteriner, kesehatan masyarakat veteriner dll itu? jelas semua terkait dengan ekonomi, politik, kesehatan masyarakat veteriner yang bersebab akibat oleh VETERINER alias segala hal yang berkenaan dengan penyakit hewan.

maka domain VETERINER oleh veterinarian atau dokter hewan sebetulnya terbatas pada segala hal yang berkenaan dengan penyakit hewan.

Sedangkan untuk kepentingan-kepentingan hal lain yang bersebab akibat dengan VETERINER, maka veterinarian atau dokter hewan tidak dapat menjalankannya sendiri.

Oleh sebab itulah pilihan tergantung pada veterinarian atau dokter hewannya sendiri:

- Mau menutup diri soal VETERINER dan segala hal bersebabakibat dengannya, atau

- Mau membuka diri soal VETERINER dan segala hal bersebabakibat dengannya.

Soal ekonomi VETERINER, jelas akan sangat terkait dengan peternak.
soal politik VETERINER, jelas akan sangat terkait dengan pemerintah
misalnya
soal kesehatan masyarakat VETERINER, jelas akan sangat terkait dengan pemegang domain kesehatan masyarakat yaitu dokter dan segala profesi terkait kesehatan

Dengan semua hal terkait ini, sebetulnya yang sangat dekat hal VETERINER adalah dokter hewan, paramedis veteriner, sarjana kedokteran hewan, ahli madya kedokteran hewan/ veteriner.

sedangkan yang lain kaitannya tidak secara langsung namun dunia VETERINER tidak akan punya manfaat apa-apa bila tidak melibatkan mereka, sehingga bicara soal keluarga VETERINER sebetulnya ada:

1. keluarga inti (anggota biasa): Drh, SKH, AMd Veteriner
2. keluarga tidak inti (anggota luar biasa): peternak, pemerintah, pebisnis, dll yang bidangnya bersebab akibat dengan VETERINER (segala hal yang berkenaan dengan penyakit hewan).
inilah bahasa lain yang ingin saya katakan terkait hal tsb..


Milis Dokter Hewan


Anggota milis dokter_hewan ini sangat bervariasi, bukan hanya dokter hewan. kita di sini memang tidak membicarakan profesi dokter hewan dari kaca mata dokter hewan semata. Namun dari kaca mata manusia, meski manusianya itu mungkin juga dokter hewan.

ketika menyadari bahwa kita manusia dan mempunyai ketergantungan dengan semua orang dan sesama, maka kita akan bisa melihat permasalahan bukan hanya dari kepentingan kita sendiri.

sejak berdiri tahun 2000, milis ini tidak dimaksudkan untuk semata-mata membela kepentingan dokter hewan. kita menempatkan dokter hewan sebagai pihak yang dipercaya untuk mengelola kehewanan sesuai pendidikannya di bidang kesehatan hewan.

pendidikan dokter hewan di Indonesia sampai saat ini lebih pada pendidikan kesehatan hewan, dan dokter hewan lebih berkompeten di bidang kesehatan hewan

ketika saat ini PDHI mendengungkan cakupan otoritas meliputi:

veterinary medical authority
dan
veterinary authority

menurut saya terjadi suatu bias cakupan yang ingin dikerjakan oleh dokter hewan terutama yang di bidang veterinary authority. Sebab ternyata terjadi ketidakjelasan pengertian Veterinary atau veteriner. sehingga PENGERTIAN TENTANG VETERINARY atau VETERINER HARUSLAH DIEPRJELAS, sesuai postingan saya terdahulu

veterinary lebih luas dari medical veterinary. itu pasti. veterinary mencakup semua hal bidang veteriner, kesehatan hewan, terkait penyakit hewan, BUKAN KEHEWANAN

pada kenyataannya bidang ini sudah begitu banyak pihak yang terlibat. dan melihat dari kepentingan semua orang yang punya hak azasi yang sama.. terjadilah irisan-irisan dengan bidang-bidang lain di luar bidang kedokteran hewan sendiri.

Sekali lagi, kedokteran hewan bukanlah kehewanan, sebab kehewanan pengertiaannya jauh lebih luas melibatkan pihak-pihak lain


Analog dengan Kedokteran


sebuah ANALOGI yang memudahkan kita memahami veteriner:

KEMANUSIAAN ---- lingkupnya sangat luas, yang ngurusi berbagai departemen: hukum, ham, pendidikan, sosial, dll, yang menyangkut kehidupan kita MANUSIA

KEHEWANAN ---- lingkupnya sangat luas terkait hewan, bukan hanya veteriner atau kesehatan hewan saja

KESEHATAN (MANUSIA)/ KEDOKTERAN UMUM ---- otoritas profesi pada Dokter Umum (Manusia)

KESEHATAN HEWAN/ KEDOKTERAN HEWAN / VETERINER---- otoritas profesi pada dokter hewan

Itulah mengapa selalu saya tidak sejalan dengan teman2 (setidaknya di milis dokter_hewan) yang menganggap wilayah profesi dokter hewan adalah semua bidang kehewanan, melebihi batas wilayah otoritas di bidang veteriner (yang terkait penyakit dan kesehatan hewan).

2 tulisan saya terdahulu dengan topik ini menguraikan wilayah DOKTER HEWAN (VETERINARIAN) bukan KEHEWANAN tersebut..

ya, semua ada tempatnya...

kita semua di milis ini sudah berdialog sejak tahun 2000, tentu kita harus memperoleh kemajuan (dalam konteks ini pengertian soal VETERINER)

sehingga jalan kita 'lurus'.

 
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