in this issue… - Columbus State Community College

Fall 2009NAVTAJOURNALTHEFor Members of theNational Association of Veterinary Technicians in Americain this issue…Swine Tech SecretsCorrective SurgeryIguana NutritionStudent Issue Compliments of

MemberShip InformationN A V T AJOURNALTHEFall 2009For Members of the National Association of Veterinary Technicians in AmericaYou AreNAVTA!in this issue…Swine Tech SecretsCorrective SurgeryIguana NutritionStudent Issue Compliments ofThe National Association of VeterinaryTechnicians in America (NAVTA) is madeup of people just like you… those whowant to make a difference in the livesof animals.NAVTA is a growing national network of:• Credentialed Technicians• Assistants• Veterinarians• Educators• Researchers• Industry Sales• Allied Industry• StudentsNAVTA empowers youto succeed in your career.Together, we strengthenthe veterinary servicesprofession.To learn more about whatNAVTA can do for you, visitwww.navta.net.Why NAVTA?NAVTA is a membership based non-profitassociation that acts as the national voiceof the veterinary technician profession.In addition to serving the membership,NAVTA educates the allied industry andthe general public about the role ofcredentialed technicians in the animalhealth care profession.NAVTA initiatives include:• Monitoring legislation affecting theveterinary technician profession ona national level• Continuing education and networkingthrough state and local networks[and student chapters]• Celebrating National VeterinaryTechnician Week• Strengthening relationships with alliedassociations and NAVTA sponsors• Technician Demographic andSalary Surveys• Ongoing Public Relations campaignabout the importance of credentialedtechniciansin this issue…Letter fromthe President...................................................4In Your State......................................................6Enjoying Exotics.........................................11Breaking the Mold.....................................13Lab Animal Medicine ..............................15Leadership Conference Recap..........18I Am Vet Tech, Hear Me Oink..............22Compliance....................................................26Continuing Education:Iguana Nutrition........................................28Continuing Education:Parenteral Nutrition................................33Continuing Education:PRRS...............................................................38Continuing Education:Chemotherapy..........................................44Continuing Education:Answer Form..............................................50Case Study:Corrective Surgery..................................52Calendar of Events....................................60NVTW Activities...........................................62For Members of the National Association of Veterinary Technicians in America 3

THENAVTAJOURNALNAVTAExecutive Director: Andrea BallCommunications: Sandy Sponaugle andJennifer JensenMembership: Jacquie Gulamhussein50 S. Pickett Street, Suite 110Alexandria, VA 22304Phone: 703-740-8737Fax: 202.449.8560info@navta.netwww.navta.net2009 NAVTA EXECUTIVE BOARDPresident: Cherylann GiesekePresident Elect: Denise MikitaCorresponding Secretary: Amy ButzierRecording Secretary: Catherine HollyMember at Large: Shalom MilaniMember at Large: Roxane RocksPast President: Julie LegredAdvisor: Lori Renda-FrancisTHE NAVTA JOURNALEditor-In-Chief and AdvertisingSandy Sponaugle703-740-8737sandy@navta.netManaging EditorJennifer Jensenjenn@navta.netCE EditorDr. Ellen LoganEllen_Logan@hillspet.comEditorial BoardAndrea BallKara BurnsCherylann GiesekeJulie LegredSandy SponaugleDesignKim DowKalico DesignFrederick, MD240-446-9765kim@kalicodesign.comThe NAVTA JournalEditorial DeadlinesWinter 2009 issue – October 16, 2009Spring 2010 issue – January 15, 2010Summer 2010 issue – April 16, 2010Fall 2010 issue – July 16, 2010Opinions and statements in The NAVTA Journalare those of the authors and not those of NAVTA,unless so stated. NAVTA assumes no responsibilityfor, and does not warrant the accuracy orappropriateness of, recommendations or opinionsof the authors or of any product, service, ortechnique referred to in The NAVTA Journal.Publication of ads in The NAVTA Journal is notan endorsement of any product or service.4Letter from the PresidentNAVTA Fall 2009On the CoverPhoto submitted by Columbus StateCommunity College.The NAVTA Journal | Fall 2009October 11 through 17 is National Veterinary TechnicianWeek, a week that celebrates you as Veterinary Technicians!As you have seen, our theme for this year is “Linking theVeterinary Healthcare Team,” which is a true representationof the work we do as Veterinary Technicians.As the national voice for Veterinary Technicians, NAVTAis pleased to work with the AVMA, our state associations,student chapters and our members to promote this importantweek. The NAVTA Board would like to extend a huge“thank you” to Hill’s Pet Nutrition, our National VeterinaryTechnician Week sponsor, for their continued support of ourorganizational efforts. Together, we can educate the publicand veterinary professionals about the important role we playin the veterinary healthcare team and encourage students topursue a career in this worthwhile and rewarding profession.We look forward to hearing about your National VeterinaryTechnician Week events and successes!— Cherylann Gieseke,NAVTA PresidentColumbus State Community CollegeSCNAVTA members — on internship at TheOhio State University Veterinary TeachingHospital — pose in their chapter t-shirts withtheir welcome banner, some examples of thegroup’s “Paw-casso” masterpieces, and acouple friends.Pictured front [left to right]: Koda Smith,Bernese Mountain Dog; Tara Batesole; KellyKockentiet; Katie Hedinger; Rachel Ranney;Melissa Hapney; Maddie Mills, Yellow LabradorRetriever. Back row, from left to right, RobSmith, President; Lisa Kagy; StephanieMcKinster, Vice President; Rachel Murphy,Treasurer; Julienne Calhoun; Jeannie Young,Secretary; and Amy Beyer.Learn more about Columbus State CommunityCollege on page 8 and their SCNAVTA President,Rob Smith on page 13.

IT’S TIME...Early Registration for theNAVC CONFERENCE 2010is now openCMYCMMYCYJanuary 16-20Orlando, FLTechnicians may attend EVERY generalsession, in addition to the three dailytechnician program tracks .With a variety of educational formats, the NAVCConference 2010 fits the veterinary skill level,learning style and discipline of each registrantand more to choose fromMYKRegister now at 2009 prices.Bring a colleague and save more!REGISTERNOW!www.tnavc.org© 2009 Eastern States Veterinary Association, Inc. All rights reserved. The NAVC Conference is a trademark of the NAVC.

NAVTA NEWSIn Your StateVirginia Association of Licensed Veterinary TechniciansWith the coming of the fall, that meansit is time for the VALVT Elections. Officesup for election this year are Vice President,Corresponding Secretary, Historian andPresident-Elect. The offices are two-yearterms (except for President-Elect whichleads into President and then ImmediatePast-President) and are a great way toget involved in the VALVT! Officersreceive discounts on hotel stays forconferences and get to attend VALVTconferences for free. To become anofficer, you need to be a member in goodstanding of the VALVT; even new graduateswith a paid membership can run foroffice. If you are interested, contact ourRecording Secretary, Amy Michaux, LVTat jodie4n6@yahoo.com.The VALVT would like to belatedlycongratulate the student award winnersfrom the graduating classes of Blue RidgeCommunity College and Northern VirginiaCommunity College. The winners fromBlue Ridge Community College are HeidiSchmader (on-campus), Dean Evans (RoanokeDistance Education), and Diana Sterling(Tidewater Distance Education). Thewinners from Northern Virginia CommunityCollege are Nicole Decot (on-campus)and Kathleen Knopp (Distance Education).We would also like to say “Welcome!” tothe new veterinary technology students atboth schools and “Welcome Back!” to thereturning veterinary technology studentsat both schools. Best of luck this year andremember to study hard!Lastly – mark your calendars for theVirginia Veterinary Conference, which willbe held February 26-27, 2010 at the HotelRoanoke in Roanoke, Virginia. Much moreinformation on the conference will beavailable as time gets closer.Be sure to keep an eye out on ourwebsite, www.valvt.net, for the latestVALVT news. Have a safe andwonderful fall!Amanda Sontag, LVTVALVT Immediate Past-PresidentVirginia State Representativevalvt.netPennsylvania Veterinary Technician AssociationAudrey Alt, a student at Manor College inPennsylvania received the 2009 PVTA StudentScholarship Award, sponsored by Merial.PVTA recently held their 3rd annual KeystoneVeterinary Conference in Hershey,PA. The conference was very successfuloverall, bringing excellent quality continuingeducation to veterinary techniciansfrom all areas of Pennsylvania. Two veryimportant awards were presented atthe conference. The first was the 2009Student Scholarship Award, sponsoredby Merial. Audrey Alt, currently attendingthe veterinary technician program at ManorCollege in Jenkintown, Pennsylvania,received a $500 scholarship to help fundher education. The 2009 PennsylvaniaVeterinary Technician of the Year Awardwas given to Jamie DeFazio, nursingsupervisor at UPenn’s New Bolton Center.Jamie continues to bring outstandingnursing care to her equine patients, whichincluded Barbaro after his severe injuryat the Preakness Stakes. Jamie has alsolectured for multiple organizations, is aregional contact for the American Associationof Equine Veterinary Technicians andAssistants, and an active member of bothPVTA and NAVTA. Congratulations to bothof these outstanding individuals.For the 2010 year, the newly electedPVTA officers include: President - DanielleSimmons, CVT; President Elect - JaneGruber, CVT; and Vice President - BrandyTerry, CVT, VTS (ECC). Also, new to ourBoard of Directors are Jamie DeFazio,CVT; Robin Hivner, BS, CVT (Past PVTAPresident 2008); Kendra Lapsansky, BSCVT; Ann P. McClenaghan, BS, CVT; andBarb McCullough, CVT. These individualsjoin our officers and board membersalready serving two year terms.Tara Perry, BS, CVTPVTA Board of Directorspvta.affiniscape.com6The NAVTA Journal | Fall 2009

NAVTA NewsWisconsin Veterinary Technicians AssociationThe WVTA has been busy finalizingdetails for the upcoming fall conventionin October. We are looking forwardto having Julie Legred speak to us onNAVTA's behalf during the conference.All details about the conference can befound on our website at www.wvta.com.All are welcome to attend.The Leadership DevelopmentCommittee is in the process of updatingcertain PDs and SOPs for approval bythe Executive Board. A wage survey forWisconsin CVTs is also in the works byother committee members.The Wisconsin Department of Regulationand Licensing informed WVTA thatan increase in our licensure fees wasapproved. This increased our fees from$50 for two years to $160, which is thesame amount DVMs are required to pay.A letter from our president, Teri Raffel,was sent out to members informing themof this increase and encouraging themto value credentials regardless of thisincrease.Robyn Hackett, CVTWisconsin Representativewvta.comColorado Association of Certified Veterinary TechniciansCACVT will host its first annualSpotlight Conference to kick-offNational Veterinary Technician Week atthe Arvada Center for the PerformingArts in Arvada, Colorado. The conferencewill “spotlight” the VeterinaryTechnician Specialties (VTS) ofDentistry and Anesthesia. During lunch,VTS booths will be available so participantscan get one-on-one informationabout various specialties that mightinterest them. We are looking forward tothis wonderful event.Tracy Wangler, CVT, has stepped downas Colorado’s NAVTA State Representative.While we wish her good luck as shereturns to school, she will be missed.Tracy served as our representative foreight years, attended all the leadershipconferences, and faithfully contributedto The NAVTA Journal and many CACVTevents. Perhaps someday she will havetime to devote again (fingers crossed!)Meanwhile, Colorado is actively searchingfor a new representative.Troy BowmanCACVT Administratorcacvt.comMissouri VeterinaryTechnicians AssociationThe MVTA is proud to announce theirreorganization in late 2008. The board isnearly full and has developed a strong,working relationship with the MissouriVeterinary Medical Association (MVMA).In January 2010, we will be teamingup to host a friendly academia bowlamongst the veterinary technologystudents in Missouri, at the MVMAconvention in St. Charles, Missouri.The MVTA is a voice to six veterinarytechnology schools and over 500registered technicians in the state.The organization is always seeking individualswho are interested in assistingwith website design and maintenance,newsletter, legislative issues, and continuingeducation events. Please contactdbauer@sbc-fenton.com or visit ourwebsite to learn more.Debbie Bauer, RVTMVTA Presidentmvma.usState updates continued on page 61.We want to hear your news!In each issue of The NAVTA Journal, we share state association,specialty, and SCNAVTA updates. Share news about your group byemailing updates to sandy@navta.net. The deadline for the Winter2009 issue is October 16, 2009For Members of the National Association of Veterinary Technicians in America 7

NAVTA NEWSIn Your SchoolColumbus State Community College, OhioYou Want Me toDeclaw What?!A Book Review by:Amanda Sontag, LVTYou Want Me to Declaw What?! by Dr.Matt Toia, DVM is a collection of memoriesfrom his life as a veterinarian. Eachchapter in the book is, in essence, achapter of his life with both highs andlows and some meaningful life lessons.The stories in the book had me bothlaughing (Andrew the chimpanzee’sstory) and wiping away tears (Piper thehospital cat’s story). Dr. Toia’s writingstyle makes you feel as if you are in theroom with him and he is speaking directlyto you. He does not oversimplify hisprose, or burden it with long explanationsand definitions of the veterinary termshe uses, making the chapters go by thatmuch quicker.I have been working in veterinarymedicine for over 13 years, starting asa veterinary assistant, then moving upto receptionist and now as a licensedveterinary technician. This book helpsme remember why I started working inthis profession and it is gratifying to seethat someone else has as deep a love foranimals as I do.Amanda Sontag, LVT works at the CatHospital of Tidewater in Norfolk, Virginia.She is Immediate Past President of theVirginia Association of Licensed VeterinaryTechnician, the Virginia State Representativefor NAVTA, and the new TidewaterRegional Director of VALVT.8Officers from the Columbus State CommunityCollege SCNAVTA Chapter proudly display thewelcome banner that hangs in the entryway of theVeterinary Technology building at their school. Leftto right: Jeannie Young, Secretary; Rob Smith, President;Denise Mills, Advisor; Stephanie McKinster,Vice President; and Rachel Murphy, Treasurer. Photosubmitted by Columbus State Community College.In January 2009, the Columbus StateVet Tech Student Club went national …becoming a Student Chapter of the NationalAssociation of Veterinary Technicians inAmerica. In less than one year, the ColumbusState SCNAVTA has more than doubledin size and held numerous events andfundraisers.The chapter’s inaugural event was the“Puppy Love” Valentine’s Day Walk atGlacier Ridge Metro Park, just north ofDublin, Ohio. Students, faculty, and staff (andtheir dogs) enjoyed a few hours of socializingand fun that included: hot chocolate, cappuccino,water and treats for dogs and theirpeople, and a brisk stretch in the park. Otherevents hosted by the group include behindthe-scenestours of the Columbus Zoo VeterinaryHospital and MedVet, a medical andcancer center for pets.The chapter has also held several successfulfundraisers, including numerous t-shirt andsweatshirt sales, a Vet Tech pin sale, and a silentauction featuring “Paw-cassos,” paintingscreated by various kennel dogs at ColumbusState. Some of the proceeds were used topurchase a welcome banner and portrait forthe entryway of the Veterinary Technologybuilding at Columbus State.The NAVTA Journal | Fall 2009In order to help incoming students feelmore welcome, the group has organized amentor program. This allows new studentsto have a more experienced fellow studentto help them with any problems, questions orconcerns.Upcoming chapter events include: their fallt-shirt and sweatshirt sale; various activitiescelebrating National Veterinary TechnicianWeek; a Columbus State/NAVTA informationalbooth at the Midwest Veterinary Conference,February 25 - 28, 2010; and the Annual“Beastie Ball” Banquet, June 3, 2010, whichwill include a pinning ceremony for recentgraduates.The SCNAVTA officers at ColumbusState are: Rob Smith, President; StephanieMcKinster, Vice President; Rachel Murphy,Treasurer; and Jeannie Young, Secretary. Thefaculty advisor of the chapter is Denise Mills,MS, MLT. The club has grown from a groupof only 50 students to more than 130 membersand ranks as one of the Top 10 largestSCNAVTA chapters in the country.Rob SmithColumbus State Community CollegeSCNAVTA Chapter Presidentcscc.edu/VetTech*See page 13 for student profile ofRob SmithTeachers and students help the artists create their"Paw-casso" masterpieces for the SCNAVTAfundraiser. Photo submitted by Columbus StateCommunity College

NAVTA NewsAthens Technical College, GeorgiaThe student chapter collected over$300 to benefit the Athens AreaHumane Society (athenshumanesociety.org), the Madison-Oglethorpe AnimalShelter (moaspets.org), and the GeorgiaEquine Rescue League (gerlltd.org).Pamela Mosko, SCNAVTA vice president, presentsa check to Alysen Heil, vice president of the AthensArea Humane Society and a mathematics instructorat Athens Technical College. Photo courtesy ofAthens Technical College.The SCNAVTA Chapter at Athens TechnicalCollege conducted several fundraisingevents during Spring Quarter 2009 tobenefit local animal rescue and care facilitiesthat have contributed to the students'educational experiences. Dr. Carole Miller,chair of the associate degree program inVeterinary Technology, pointed out thatall of these animal shelters and rescuegroups have been presented with anurgent need for additional funding in thistime of economic hardship.New SpecialtiesRepresentatives from the new NAVTA VeterinaryTechnician Specialty Academies (left to right):Deborah Reeder, RVT (equine specialty); AmyButzier, CVT (CVTS Chair and equine specialty);Bonnie Soule, CVT (zoological specialty); SharonKaiser-Klingler, RVT (equine specialty); and LindaMerrill, LVT (AIMVT-Neurology).The associate degree program inVeterinary Technology prepares studentsto become members of the veterinaryhealthcare team as veterinary technicians.Working under the direction of veterinarians,veterinary technicians provide medicaland surgical nursing care to large, small,laboratory, and exotic animal species.The duties of these animal health careprofessionals often include the care andhandling of animals, routine clinical laboratoryprocedures, radiography, surgicalassistance, anesthesia, dentistry, intensivecare nursing, record keeping, equipmentmaintenance, and clinical education.Melanie Parham, AAT, RVTAthens Technical CollegeSCNAVTA Advisorathenstech.eduThree new NAVTA Academies wereannounced at the AVMA Conference in July.“The NAVTA Academies give VeterinaryTechnicians recognition for having advancededucation, training and experience in an areaof specialization,” said Amy Butzier, CVTand Chair of the NAVTA Committee onVeterinary Technician Specialties (CVTS).In addition to our existing specialties indentistry, anesthesia, internal medicine,emergency and critical care, and behavior,the NAVTA CVTS is pleased to add thefollowing to our specialty academies:Mount Ida College students Christy Jefferson andRianne Eanes experienced AVMA with their SC-NAVTA advisor, Amy Butzier (center).Diary of a Vet Tech StudentBy Christy JeffersonI am a student at Mount Ida College inNewton, Massachusetts and was excited tolearn about the AVMA Convention Programfor Veterinary Technicians being held in Seattle,Washington this past summer. SinceI was one of the only students interestedand able to attend, I decided it was wellworth the long trip. Flying across the countryalone itself is a scary thought. Arrivingat AVMA and being a veterinary technicianstudent, surrounded by DVMs and certifiedveterinary technicians, is a whole other setof nerves. I wandered around for a shortcontinued on page 51Neurology sub-specialty of theAcademy of Internal MedicineVeterinary Technicians (AIMVT)Contact: Linda Merrill, LVT at linda-lvt@earthlink.net or visit www.aimvt.comAcademy of Veterinary ZoologicalMedicine TechniciansContact: Bonnie Soule, BS, CVT atbsoule@rwpzoo.orgAcademy of Equine Veterinary NursingTechniciansContact: Amy Butzier, BS, MEd, CVT atabutzier@mountida.edu; Deb Reeder, RVTat dbreeder@gmail.comFor Members of the National Association of Veterinary Technicians in America 9

Month-long flea protectionin a chewable tablet To learn more about Comfortis ® , see your Elanco/Lilly representative ordistributor representative, call 1 (888) 545-5973 or visit www.comfortis4dogs.comThe most common adverse reaction recorded during clinical trials was vomiting. Other adverse reactions were decreasedappetite, lethargy or decreased activity, diarrhea, cough, increased thirst, vocalization, increased appetite, redness of theskin, hyperactivity and excessive salivation. For product label, including important safety information, see page 12.©2009 Elanco CF00417 070109

Member Profile: Melissa OrtizEnjoying Exotics –Profile of an Exotics TechnicianMeet Melissa Ortiz, LVT,NAVTA member and partof the veterinary nursingstaff at The Center forAvian and Exotic Medicinein New York City. She isa graduate of LaGuardiaCommunity College andhas her own family ofexotics at home.Pictured with Gregg, anAfrican Grey Parrot whois Melissa’s favorite birdever!What made you want to becomea Veterinary Technician? It seemedlike the perfect job for me. I've always lovedanimals and science. Veterinary technologyis a perfect combination of both! Themedicine is very intriguing and I love thenursing aspect of being a vet tech.Why did you choose to work withexotic pets specifically? I love dogsand cats, but I am so absolutely passionateabout exotics! It's the day-to-daychallenges that make it fun and exciting —like having to make your own tiny e-collarsor trying to place a splint or catheter on/in a teeny little leg. Exotics are fascinatingand they're practically wild animals.They're bred in captivity, but they are noway near being domesticated. It makesme proud to be able to educate peopleabout how to properly care for them and isexciting keeping them alive when medicalintervention is called for.Tell us about a typical day for you.My days consist of assisting the doctorsduring their exams and afterwards offeringconsultations to the clients. I’m able toeducate the clients on proper husbandry,nutrition, and behavior issues. This is veryimportant since most presenting conditionsin exotics are directly related to theway they are being raised at home. One ofmy favorite responsibilities is anesthetizingpatients for a variety of procedures. Ican honestly say I am more comfortableanesthetizing rabbits and birds than I amdogs and cats! There are around-the-clocktreatments to be done, including in-houselab work, compounding medications, andstaff training.What have been some highlightsof your career so far? The top highlightof my career so far has been becomingnot just a veterinary technician, but onethat specializes in exotic species. I owethat to Dr. Katherine Quesenberry, whoasked me to come on board her exoticmedicine service when I was employed atthe Animal Medical Center. I volunteeredwith the service for about three yearswhile I was in tech school and soon aftergraduation Dr. Q offered me a position.Everyone who knows me knows that wasthe best thing that could have ever happenedto me! It was amazing to be able towork with and learn from her. As a veterinarytechnician, I have seen things that Inever thought I'd see, and have cared forpatients that I never thought I would meet.I've had patients who need CAT scans,I’ve anesthetized a goldfish that neededsurgery to remove overgrown tissue surroundingher eyes and restore her vision,and I participated in repairing the shell ofa tortoise that took nearly a year to heal.(The shell has grown into a normal healthyshell, by the way!) I've seen a canarycome back to life from a doctor passinga breath through an airsac cannula, whenit didn't have a heartbeat just secondsbefore. Right now I am proud to be part ofa team at the Center for Avian and ExoticMedicine, a facility in which 100% of ourpatients are exotic species. The thought ofa whole hospital designed to house andtreat these critters is phenomenal and likemost of our patients, unique.Have you seen any changes in theexotic animal industry since youstarted working? Absolutely. Laboratoriesare able to produce more accuratetesting, and more and more companiesare manufacturing equipment specificallyfor exotics, like vital sign monitors thatcan read a heart rate between 10 and400. Surgical approaches are becomingmore advanced, such as spaying a birdlaparoscopically. The literature is providingmore research on diseases and options fortreatments, as well as broadening optionsin pharmacology.For Members of the National Association of Veterinary Technicians in America 11

Member Profile: Melissa OrtizMelissa intubating “Slim,” an Albino California Kingsnake, with an endotracheal tube. She ran his anesthesiaduring an hour long procedure to remove an abdominal mass.Does it take a specific type ofperson to work with exotic pets?I think you have to be a little eccentric towork with such special patients. Otherpeople may have phobias toward some ofthe patients that I find cute. You can't havethe mindset that it may not be “worth” doingtreatments on certain exotics becauseof how small they are or how inexpensivethey would be to replace. No matter howsmall or inexpensive, somebody loves thatcritter and the animal needs to be treatedwith the same amount of care and respectas a patient 10 times their size. Overall, Ithink you have to be “into” them. Caringfor them goes way beyond the medicine.It’s about knowing their husbandry, theirspecific needs, and behaviors.What would you tell anystudents or young people, or evenveterinary technicians, who mightbe interested in specializing inexotic pets? Do it! But you've got to becommitted. I wake up in the morning andwant to go to work because I know it'sgoing to be exciting. I look forward to thepatients I’m going to see and the knowledgeI'm going to be sharing. Being a vettech is more than just a job, it’s a career,and one you have to be passionate about.There's a growing demand for technicianswho are knowledgeable and comfortablewith exotics. More and more exotics areshowing up at dog and cat practices, anda technician who can provide proper carefor those species is very valuable.What are some ups and downsassociated with your job? Well, theworst thing about working with exotics,for me, is the reality that you just can'tsave everything. Exotics are delicate andit's frustrating to see them come into thehospital in poor condition, knowing thatthey may not be in this situation if theowners were properly educated. They areexcellent at masking illnesses and, moreoften than not, by the time they get to thehospital they are critical. There are peoplewho feel they should be in the wild wherethey belong, but since they are not, it'sour responsibility to educate owners onhow to make their lives as comfortableand as natural as possible while living incaptivity. On the bright side, it does makemy day when I meet clients who areon the right track and their exotic petsthriving and happy. It's a great feeling Iget from my day-to-day work, interactingwith these animals and doing everythingI can to help keep them in the bestcircumstances possible.avianandexoticvets.com12The NAVTA Journal | Fall 2009

Breaking the Mold –A Non-Traditional Student ProfileRob is a second-year student in the Veterinary Technology program atColumbus State Community College in Ohio, scheduled to graduatein March 2010. He is president of the school’s SCNAVTA chapter andowner of Hoosier Roos Bernese.student Member profile: Rob smithWhat made you choose to studyVeterinary Technology? I havehad a passion for animals since childhoodand always felt a very specialconnection with them. Throughout myyouth, I dreamed of a career in veterinarymedicine, but was discouraged frompursuing it because my highest gradeswere in English and history, not scienceand math. After graduating from IndianaUniversity in 1989, double majoring inJournalism and history, I worked as anewspaper editor for seven years. I spentthe next 10 years in sales, marketing andthe service industry, which included runningmy own landscaping company. In2006, I suffered a near fatal health crisis.At that time, my wife and I decided that Ineeded to seek a career that I was passionateabout. As a result, I decided tofollow my childhood dreams and pursuea career in the veterinary healthcare field.Several times while in school studyingto become a veterinary technician, Ihave been asked why I did not pursuebecoming a veterinarian. If I were 20years younger – and much wealthier – Imight consider that route. That said, Iam extremely proud about becoming aveterinary technician. To me, being anadvocate and caregiver for animals –whether healthy, sick, injured or merelyhelpless -- is the most important responsibilityof a veterinary technician, and thatis one of the biggest reasons I chose topursue this path.How did you become involvedwith creating a SCNAVTA chapterat CSCC? Our first-year class wasapproached by instructor Denise Millsabout getting the Vet Tech Club up andrunning again. Several of us expressedinterest and held an election. Upon beingelected president, I discovered NAV-TA and learned about the benefits thatthe association offers students. Whatsealed our decision to move forward withcreating a SCNAVTA was that NAVTA reflectsthe very same professional valuesthat are emphasized by the faculty andstaff as CSCC — professionalism, pride,and opportunity. The goal of our club isnot just have social events, but to havefun events that educate the communityas well as broaden students’ perspectivesand open their eyes to the job opportunitiesavailable in the field, includinganimal hospitals, zoos, wildlife sanctuaries,research, food, sales and marketing,communications, pharmaceuticals andmore. There are specialty areas such asoncology, neurology, dentistry, and morethat students can focus on as well.Speaking of specialties, doyou plan to pursue additionaltraining after graduation? I planto take the state exam in January tobecome a RVT (Registered VeterinaryTechnician) and have been approachedabout a possible position at The OhioState University Veterinary TeachingHospital. I would love to pursue anyadditional training possible and amespecially interested in specialty areasthat pertain to large dogs, such asorthopedics, physical therapy, nutrition,radiology, ultrasound, and responsiblebreeding. Nutrition is one of the mostimportant, and most underrated, areasin veterinary medicine today and — alongWhen you think ofstudents, you tend to thinkof young co-eds livingon campus or maybe stillliving with their parents.We’d like to introduceyou to one veterinarytechnician student whodoes not fit the typicalcollege mold:Rob Smith, age 43.Pictured with his bestbuddy Molson (CHVillairns Glory on Tap).For Members of the National Association of Veterinary Technicians in America 13

Veterinary Technology Degrees14• Associate’sdegree• Bachelor’sdegree727-341-4772www.spcollege.edu/hec/vt/16298 2/0916298 Vet Tech ad.indd 1 2/11/09 8:44:55 AMStudent Member profile: Rob smithYogi, one of the kennel dogs at Columbus State Community College, turned the tables on VeterinaryTechnician student and SCNAVTA President, Rob Smith. Photo by Julienne Calhoun.with responsible breeding — is key inpreventing most of the ailments seentoday in veterinary medicine. I am alsovery intrigued by large animal medicine.I greatly enjoy working with largeanimals and it is neat to come home andrealize that my large dogs reallyare “small animals.”What is the typical day like inthe life of a Veterinary Technicianstudent at CCSC? For daystudents, classes begin around 8:30 or9 a.m. and run throughout the day untilabout 3 p.m., depending on the particularquarter. Classes for the eveningprogram start around 5 p.m. and runto around 8 or 9 p.m. Many studentscommute from more than an hour awayto attend CSCC. All students aredivided into Patient Animal Care Teamsand required to do one hour of PACTtime each week, caring for our cat anddog patients, known endearingly as“the Beasties” in our kennel area. Thisincludes: exercise activity, grooming andbathing, and, of course, bonding time.Students are also required to come inand help care for the animals at leasttwo weekends per quarter for one totwo hours.The NAVTA Journal | Fall 2009Tell us about your life outside ofschool. I was born in Columbus andraised in Lancaster [Ohio]. I have beenmarried to my beautiful wife Jeannie for20 years and we have three children:Melanie, age 15; and twins Megan andParker, age 13. We live in the rolling hillsof southwest central Ohio, near Amandawith our 10 Bernese mountain dogs, agolden retriever and five cats. Our familyhas been involved with Bernese mountaindogs for more than 17 years andare the owners/operators of HoosierRoos Bernese, hoosierroos.com. I’vebeen the president of two regionalBernese mountain dog clubs and mywife and I founded the Ohio ValleyBernese Mountain Dog Club, which atone time had more than 100 Berner and75 human members from throughout theMidwest. We even had some membersfrom Canada and Australia.

Your CareerAn Unexpected CareerWhy I Became a Laboratory Animal TechnicianWhen I entered tech school in 2002, Iwas determined to work in private practicefollowing graduation and licensure.I was not aware there were other careerpaths for veterinary technicians. I was introducedto the field of laboratory animalmedicine through a guest speaker in ouranimal science class. He shared someof his personal experiences in biomedicalresearch and discussed some of thestudies he was involved with. I was veryvocal and remember asking him, “Howdo you sleep at night?” I could not imaginehow a veterinary technician, someonetrained to provide medical care, could dosuch horrible things to animals. Needlessto say, I immediately dismissed thisparticular career opportunity.During my second semester, I heardanother speaker and realized I was notwell-informed about the field of laboratoryanimal medicine. Her presentationprompted me to contact the first speakerand arrange an externship at the privateacademic institution in which he worked,to see for myself what really went on behindthose closed doors. I have to admit,I was very nervous about what I mightsee. I ended up spending the summerin a transgenic rodent facility, learninghusbandry of genetically engineered mice.I was told that I would have to “showerin” to the barrier facility to help maintaina “clean” colony of experimental animalsby minimizing the bugs brought in. In allhonesty, it reminded me of a sci-fi film andI remember thinking, “This is so cool!”I had the opportunity to learn aboutsome of the research being performedand was relieved to find that it was heavilyI had the opportunity to learn about some of the researchbeing performed and was relieved to find that it washeavily regulated by external and internal agencies such asUSDA, OLAW, and IACUC.regulated by external and internal agenciessuch as USDA, OLAW (Office of LaboratoryAnimal Welfare), and IACUC (InstitutionalAnimal Care and Use Committee).Some protocols even require a veterinarytechnician be assigned to a research teamto perform the more technical tasks suchas anesthesia, which is great job securityby the way. There are standard operatingprocedures for just about every task, fromproviding food and water for the researchanimals to running an autoclave load. Afteronly one day of being exposed to the “darkside,” I decided to take a career path that Inever expected.Unlike the previous clinical rotations Ihad fulfilled in shelter medicine and privatepractice, I fit in with the laboratory animalveterinary technicians. I even persuadedmy program director to allow me to completean additional rotation at a researchhospital. Looking back on my collegeyears, science was always my calling.During my laboratory animal studies, Imet folks with a variety of education andexperience, and they all had the commoninterest of overall humane care of animals.It was not at all what I envisioned. I did notFor Members of the National Association of Veterinary Technicians in America 15

your careerwitness mad scientists torturing animalslike many people imagine. We do wearwhite coats though!Now, several years later, I am workingdirectly for an investigator who studiesbrain activity in male rhesus monkeys.My responsibilities in the lab include dailyclinical rounds of our colony, administrationof prescribed treatments, recordkeeping, collaborating with attendingveterinarian for new and ongoing cases,and performing anesthesia, post operativecare and pain management. I also sit onour environmental enrichment committee. Iam fortunate to have an intricate role in theresearch, as I am involved in the developmentof standard operating proceduresrelating to anesthesia and analgesia, andto assist in the training of lab personnel.Being on the animal welfare side as opposedto the animal rights side, I have tremendousinfluence. Whether I agree withthe rationale for conducting the researchor not, I can make every effort to improvethe lives of the animals in my care.Working in this environment can definitelybe emotionally challenging. There aredays when I am performing my rounds andfind myself saddened, realizing the animalsare living in a very unnatural environment.Euthanasia, as in private practice,is another reality in the lab animal setting.Research animals are often euthanized toprovide histology for FDA approval of drugtherapies and medical devices. However,there are instances where other methods,such as MRI, can validate scientific work,as is the case in our lab. Our investigator isdedicated to retiring our animals to sanctuaries,where they will receive attentivelife-long care and will have acres to roamand trees to climb, following study. This isno easy task, as there are limited funds andsanctuaries to work with. This is currentlybeing addressed at the federal level.In the meantime, we strive to enrich animals’daily environment by providing socialcompanionship by pair housing, encouragingnatural foraging behavior, and promotingpositive interaction. We provide avariety of special treats such as ice creamcones for their birthdays and fresh fruitsand veggies strung along the topsof their enclosures. They have theopportunity to play with toys, listen toradio/CDs, and watch movies. And yes,they do get popcorn!The author has a special bond with the monkeys in her lab. Photo taken by Kelsie, Lab Manager, BS, RLATG.Being on the animal welfare side as opposed to the animalrights side, I have tremendous influence. Whether Iagree with the rationale for conducting the research ornot, I can make every effort to improve the lives of theanimals in my care.I feel so privileged to work with everymember of our colony and have a distinctbond with each one of our boys. Someanimals communicate by hooting and lipsmacking, many present their backsides fora petting session, and a few are indifferenttowards me. I admit I do have my favoritesand it changes from time to time. My boyfriendasks me periodically, “So, who’s theflavor of the month?” Roy, in particular, willalways hold a special place in my heart. Hewelcomed me to the lab five years ago bypulling my hair and stealing my glasses!At the end of the day, I feel so luckyto be a routine part of their lives, observingtheir complex, curious, and playfulbehavior, and most importantly, interactingwith them.To protect the author’s anonymity, hername and location have been withheld.Despite her pride in her profession, oneof the realities of animal research is that itis a highly controversial topic. We respectthe author's right to privacy and thank herfor sharing her story.The author is a member of theAmerican Association for LaboratoryAnimal Science Veterinary TechnicianSubcommittee. AALAS advancesresponsible laboratory animal care anduse to benefit people and animals. Theprimary goal of the Veterinary TechnicianSubcommittee is to educate their colleaguesand students about the roleof the veterinary technician in lab animalmedicine. For more information oncareers in lab animal medicine or to findout more about AALAS, visit aalas.org.16The NAVTA Journal | Fall 2009

leadership COnferenceSponsored by Hill’s Pet Nutrition“I thoroughly enjoyed the opportunity toshare ideas with other veterinary technicianassociation leaders. Fresh ideas are worththeir weight in gold.”-Cindy Dittmar, RVT from Texas18The NAVTA Journal | Fall 2009

Leadership ConferenceThe NAVTA Leadership Conference was held August 29 through31 in Kansas City, Missouri, in conjunction with CVC Central.Sponsored by Hill’s Pet Nutrition, the conference hosted over50 state association leaders representing 24 states, providingnetworking and educational opportunities.Our morning training session kickedoff with an energetic presentation oncustomer service form Rick Grandinetti, abusiness consultant, author and educatorwhose presentation “Succeeding Insidethe Box” provided attendees with several“take home” tips, such as:• You are responsible for how peopleperceive you• Start your day, every day, as if youjust got hired.• What gets rewarded gets repeated.• Hire for personality. Train for skill.• You can’t change what you don’tacknowledge.• Catch someone doing something right.Ricks’ presentation left attendeesinspired and energized for the networkingsession that followed and the afternoonahead. My presentation on marketing yourstate association was also well-receivedand I hope each attendee is able to takesome of our discussion points back totheir state and implement some positivechanges. After a day of workshops and fun(including the Lee Ann Womack concert),the conference concluded with a day atthe Hill’s Pet Nutrition Center. This wasan amazing experience, as we were ableto tour the facility and enjoy presentationsfrom the experts at Hill’s about a varietyof topics, such as: an introduction to petfoods and the industry; cognitive declinein dogs; and cats and carbs.Overall, the weekend was a positiveexperience for all in attendance. We wouldlike to thank Hill’s Pet Nutrition for theirsponsorship and Kara Burns for pullingout all the stops for NAVTA once again.Sandy Sponaugle,NAVTA Communications DirectorWhat did you think ofthe NAVTA LeadershipConference?“I feel privileged and honored to participatein the 2009 NAVTA Leadership Conference.It was a pleasure to meet and get to knowso many great leaders and professionalsin our field. Andrea, Julie, Sandy, Denise,Jacquie, Rebecca and Kara made a profoundpositive effect on me. I am humbled andhonored to have met them. Rick Grandinettitouched my heart and my mind, and left meenergized for the future. The entire conferencewas awesome from the great networkingresources, the open forum exchange ofideas, as we as a report on the pulse of theprofession. I hope that I can help projectthe same passion into my state technicianorganization as NAVTA has accomplishedon a national level. The tour of Hill’s was funand informative and will further solidify myendorsement of Hill’s products and theircaring employees."-Rhonda Haywood, RVT from MissouriLeft: Kara Burns, MS, MEd, LVT of Hill’sPet Nutrition; NAVTA CommunicationsDirector Sandy Sponaugle; and keynotespeaker Rick Grandinetti at the NAVTALeadership Conference.Right: John Thomas of Lange, Thomas &McMullen, LLP gave a presentation aboutassociation legal issues.For Members of the National Association of Veterinary Technicians in America 19

Leadership ConferenceWhat did you think ofthe NAVTA LeadershipConference?“I loved the networking and can’t wait to goback to my state and be the one percentchange I want to see! Bring back RickGrandinetti! I feel pumped to go back to mystate and pump them up. The Hill’s Tourwas awesome and eye opening. I loved it.-Rebecca Blatter, CVT from Wisconsin“Attending the NAVTA Leadership Conferenceprovided me with the tools to assess ourstate veterinary technician and assistant organizationand derive a path to our future goals.”-Tracy Turner from New Jersey“Your NAVTA leaders synergy was felt andexpanded upon while networking and learningabout motivation, membership benefits,and association management. Every onecame away with enlightened ideas of whowe are and where we can support eachother in the veterinary technician profession.Thanks to Hill’s generosity for offering agreat opportunity and their continued supportof veterinary technicians.”-Rebecca Rose, CVT from ColoradoDay 2 of the NAVTA Leadership Conference included a tour of the Hill’s Pet Nutrition Center, where theyparticipants learned about the pet food industry, cognitive decline of dogs, cats and carbs, animal welfare,and, of course, about the history of Hill’s Pet Nutrition.About the Hill’s Pet Nutrition CenterHill’s Pet Nutrition began in 1939 by Dr.Mark L. Morris, Sr., who believed thatmanaging nutrition could have a positiveeffect on health of companion animals.His line of therapeutic pet foods helpedspringboard the field of clinical nutrition.Dr. Morris’ tradition is carried ontoday through the Hill’s Pet NutritionCenter, a state-of-the-art, fully equippedresearch center and veterinary hospitalcertified by the American Animal HospitalAssociation. An industry-leader inproduct innovation, Hill’s employs morethan 200 veterinarians and veterinarytechnicians, board-certified specialistsin nutrition and internal medicine, andfood scientists who work to create newproducts and improve existing ones.Hill’s scientists author more than 50research papers and textbook chapterseach year and teach at leading schoolsof veterinary medicine worldwide. Hill’semploys a staff of companion pets thatput their products to the test. In return,these animals are given clean, roomyliving quarters, exercise areas, an agilitycourse, and plenty of friends, both humanand animal.Mission of Hill’s Pet Nutrition:Our mission is to help enrich andlengthen the special relationshipsbetween people and their pets.Left: Attendees of the 2009 NAVTA LeadershipConference enjoyed workshops about effectiveboard leadership and defining your purposeand goals.Right: Kara Burns, MS, MEd, LVT (left) ofHill’s Pet Nutrition and Andrea Ball, NAVTAExecutive Director, at the opening reception ofthe 2009 NAVTA Leadership Conference.20The NAVTA Journal | Fall 2009

Leadership Conference“A wonderful opportunity to network withother technicians and learn more aboutwhat other state associations are doingto grow, reach out and retain membershipthrough leadership.”-Denise Moore, LVT from Washington“The NAVTA Leadership Conferencewas an excellent opportunity to network,share issues and be inspired by otherassociation leaders. Rick’s presentationwas a great motivator to improve myselfand continue the journey toward excellencein my profession with renewed enthusiasmand passion.”-Kris Keane, LVT from Virginia“I was honored to attend the NAVTA LeadershipConference and be in the company ofprofessional colleagues so dedicated to theprofession! The Marriott rolled out the redcarpet and Kara Burns form Hill’s treatedus like royalty! Power presentations andworkshops provided invaluable information.Meeting the NAVTA board as well as otherstate representatives was fun and bonding;creating a true sense of teamwork forenhancing the veterinary technician professionacross the country. So inspiring! I’mdefinitely coming back!-Janet McConnell, CVT from New JerseyThe NAVTA Leadership Conference offered a glimpse ofmany leadership opportunities and ways to grow the professionand our organization. This concept shouldn’t be limitedto attendees, but rather, new leaders must always continueto carry the torch to keep the association strong. Leadershipcan’t be “in name only.” They must be put into practice, in your profession and inyour professional association.Some people believe that great leaders are made, not born. However, withoutpractice, drive, enthusiasm, and experience, there can be no true developmentin leadership. Talent goes to waste. People follow others when they see a clearsense of purpose. They get the same "vision" that the leader has. People will onlyfollow you if they see that you know where you are going.Being a leader is also not about what you make others do. It's about who youare, what you know, and what you do. You are a reflection of what your constituentsmust be. Trust and confidence is built on good relationships, trustworthiness,and high ethics. The way you deal with people and the relationships you build willlay the foundation for the strength of your group. The stronger your relationship,the stronger their trust and confidence will be in your capabilities and the morethey will do to help you reach goals.Remember, being a leader does take a good deal of work and time. It is notlearned overnight, it is an ongoing process. Remember that it is not all about you. It’salso about the people around you and, ultimately, the goals you are trying to reach.Do you have the drive and desire required of a leader? Do you have thedesire to work cooperatively with other people? Then start now, contactAndrea@navta.net and get involved in your national association!Andrea BallNAVTA Executive DirectorA Note From the Director“What an amazing conference! I love meetingmembers from across the country, sharingstories and comparing our challenges. Itenergizes me to be surrounded by so manycommitted and passionate professionals. Ican’t thank Hill’s enough for providing thiseducational opportunity.”-Roxane Rocks, CVT from ColoradoSponsored by Hill’s Pet NutritionFor Members of the National Association of Veterinary Technicians in America 21

A Day in the lifeI Am Vet Tech,22The NAVTA Journal | Fall 2009

A day in the lifeHear Me…Oink??By Tamara Leader, RVTI am a Veterinary Technologist, the termused in Canada. My official title is CQACoordinator/Herd Health Technician,which basically means jack of all trades.“A day in the life” of a swine herd healthtech is difficult to pin down since my jobis, as anyone in the livestock industryunderstands, subject to change on adaily basis.I’ve been a Veterinary Technologistfor seven years now, so I’ve had sometime to experiment with different fieldsand see what I like. With my job at BigSky Farms, my needs are always fulfilledand my schedule is very independent.I spend two or three days each weektraveling, and the rest of the week isspent in the office.On my traveling days, I travel aroundSaskatchewan blood sampling differentherds in the Big Sky system so our VetServices department can monitor herdhealth. I collect samples from all stagesof swine production, from 3kg weanlingsto 180kg sows and boars. We have anin-house lab that enables me to centrifugethe samples and send the serumto various laboratories, as well as keepbanked samples. All tissue and fecalsamples, culture swabs and barn watersamples are brought to our lab so I canpackage and ship them to the appropri-For Members of the National Association of Veterinary Technicians in America 23

A Day in the lifeBarn ProceduresPiglet processing: All newbornpiglets are given an iron and an antibioticinjection, have their tails docked, tattooedor ear notched as necessary, and malesare castrated.Tattooing: If the barn knows thatpiglets are going to be exported, they aretattooed before one week in age. Thetattoo identifies the specific barn andproducer (in this case, Big Sky). If theyfind out at a later time that they are goingto be exported, then the piglets aretagged instead.Ear Notching: This is another way toidentify pigs. A tiny piece(s) of the earis clipped out the same way for all thepigs in the group. Big Sky uses thisas a way to keep track of the geneticsof their pigsTreatments: All barn staff go throughthe barns daily and treat any animalsaccording to the usage plans of theveterinary department.Ridgling surgeries: Farrowing barnstaff are trained to do ridgling (cryptorchid)surgeries, when one (or both) testicleshas not descended.Scrotal rupture surgeries:Occasionally, castration results in a scrotalrupture. Farrowing barn staff are trainedto surgically correct this.Oink!Oink!ate location. In order to keep myself upto date on procedures I occasionallyassist with farrowing, vaccinating, pigletprocessing, treatments, tattooing, andother procedures. During my barnvisits, I also collect fecal samples andculture swabs, assist the barn staff withCanadian Quality Assurance (CQA)paperwork and answer any questionsthey may have.The rest of my week is spent in ourhead office – conducting training andexport scheduling, in addition to otherduties. Part of my job is to ensure thatnew employees are properly trained forCQA, the program that ensures the porkwe eat has been produced in a safe andhumane way. I train employees on howto give injections, how to treat illnesses,what to do if something goes wrong, andproper record keeping. Proper trainingis important to help avoid potential consumerrisks, such as preventing injectionsite abscesses, antibiotic residues, andbroken needles. Over time, I have beenArticle author Tamara Leader, RVT, enjoys her workand having the freedom to think on her feet in herposition at Big Sky Farms in Saskatchewan, Canada.able to put our training program online,which has simplified and streamlinedour processes.Some of my other responsibilities includeexport scheduling, barn validations,and paperwork. I coordinate the schedulesof six veterinarians (two that workout of our office and four contracted veterinarians)who do export inspections for15 different barns. This may not sounddifficult, but it entails completing exportpaperwork, scheduling around biosecuritytimes and government imposed guidelines,and solving problems with the U.S.border as issues arise. I also enter datafor water results, serologies and researchtrials into different databases; create anddistribute prescriptions, vaccine plans,dosage charts and medication usageplans according to the veterinarian’sinstructions; and answer questions thatour barns may have. I’m the first point ofcontact between the labs, our contractvets, and any export situations that arise.As Veterinary Technologists [or Technicians] , we are trainedin so many areas that we can adapt to new opportunities asthey arise…No matter what jobs we’re in, there are alwaysopportunities to expand our knowledge and skills.24The NAVTA Journal | Fall 2009

A Day in the lifeMy boss’ philosophy has always been,“If a technologist can do it and do it well,then that frees the veterinarians up fordoing things that only veterinarians cando,” such as export inspections, herdhealth visits, CQA validations, and diagnosingproblems in our herds. By freeingthe veterinarians’ time, I’m helping tomake our department more efficient. Thisbuilds the veternarians’ confidence in myabilities and helps others understand thatmy profession is just that, a profession.I feel valued as an employee and havethe freedom to make my own schedule,the confidence and knowledge to beable to address situations that arise, andthe support of our veterinary departmentbehind me.As Veterinary Technologists [or Technicians],we are trained in so many areasthat we can adapt to new opportunitiesas they arise. We are not limited to workingin small animal clinics with dogs andcats. We can branch out if that is whatwe want. No matter what jobs we’re in,there are always opportunities to expandour knowledge and skills. I encourageother technologists, technicians, andand employers to speak up when there’ssomething new to learn or to be taught.Too many times we put ourselves, orallow ourselves to be put into, the “I’mjust a vet tech” rut. You don’t have to bejust anything. If you love your profession,have confidence in your abilities, and arewilling and able to use those abilities toexcel, then you can be anything you wantto be.“I am vet tech, hear me roar!”Understanding Canadian Quality Assurance (CQA ® )What is the CQA Program? TheCQA program is an on-farm programthat assists producers in creating flexible,effective food safety-related proceduresfor their operation. CQA is based onthe seven basic principles of the internationally-recognized HACCP (HazardPrevention Critical Control Point) model.The program is administered by theCanadian Pork Council and provincialrepresentatives.How Does CQA Minimize FoodSafety Hazards? The program is comprisedof HACCP-based “best practices”for reducing or eliminating potentialhazards on farm that could result in afood safety concern in the final product,pork. Hazards can come from inputs tothe operation, such as feed, stock, or theproduction process (for example, medicationuse.) Hazards are generally classifiedin three categories: physical, such as brokenneedles; chemical, such as residuesof medications; and biological, such assalmonella. By following the recommendedprocedures, producers can reduceor eliminate potential hazards that mightotherwise occur in their operation.Every year these best practices areofficially validated by an accredited CQAValidator. They audit all aspects of eachindividual farm regarding food safetyincluding: treatment and vaccinationrecords, wash and disinfect logs, prescriptions,medication and vaccine usageplans, and feed sequencing.Nearly all Canadian processors(packers) require that the barns theyreceive pigs from are CQA validated.The Unites States has a food safety programcalled the Pork Quality Assuranceprogram (PQA), with similar requirementsand procedures to the CQA program.Recently a new initiative, Animal CareAssessment (ACA) was introduced asan addition to the CQA program. Itmainly focuses on the welfare andhumane upbringing of the pigs. This isan audit process, concentraing on feed;water; proper handling; environmentalenrichment, such as toys for the pigs;proper euthanasia procedures; and othertechniques/procedures.For more information about CQA,visit cqa-aqc.ca.By Tamara Leader, RVT; CQACoordinator/Herd Health TechnicianBig Sky Farms Inc. in Humboldt,Saskatchewan, Canada; bigsky.sk.casavt.ca – provincial association websiteTo keep her clinical skills sharp, Leader assists with piglet processing procedures when travelingto various barns.For Members of the National Association of Veterinary Technicians in America 25

COMplianceThe Basics:Who: Federal Trade Commission(FTC)What: Red Flag Rule complianceprogramWhy: Consumer identity theftprotectionWhen: Nov. 1, 2009How: Have a compliance programin place, which should include clinicpolicy, checklist, management andemployee training, vendor complianceforms and action plan foridentity theft incidents.26Regulatory IssuesRed Flag Rule Compliance DemystifiedVeterinary clinics have yet another regulatory issue to run up theflagpole! The new Red Flag Rule (RFR) compliance directive from theFederal Trade Commission has caused more panic and confusion thanis warranted by what is essentially a straight-forward regulation.A Look at the Issue(and why the FTC camedown with this ruling)Identity theft is a growing problem in thiscountry, and the FTC has added a layerof protection for consumers by decreeingthat all businesses – including veterinarypractices – must conform to the Red FlagRule program. The rule got its name fromthe fact that there are signs, or “red flags,”of identity theft for businesses that dealThe NAVTA Journal | Fall 2009with the public, from stolen credit cards tofake identification cards.All businesses must now educate employeeson the potential risks for identitytheft and take steps to protect clients’personal information. The FTC has twolevels in terms of identity theft and the RedFlag Rule:1) Inspection2) Investigation

ComplianceAn inspection will be conducted in amanner similar to random OSHA inspections,in that an inspector will arrive andpresent credentials, then request to seerecords of your RFR compliance program.Records should include the policy statement,training records for managementand employees, and applicable forms.If any deficiencies are found, you maybe subject to a fine of $500 to $1,000;however, the amount, like all fines fromgovernment entities, is negotiable oncecompliance is reached.Note: No inspector will ask for moneyup front. If someone appears at your practiceto conduct an “inspection” and wantsmonetary compensation, this is in itself a“Red Flag” alert that this is a fraudulentinspector, NOT a government inspector.With any legitimate government action theinspector leaves you with a brief writtenpreliminary report and then reports to asupervisor, who will send a letter detailingthe inspection, report and possible fineswith a timeline for rebuttal.An investigation is different from a generalinspection, and it means a consumerhas submitted a claim of identity theft. Aninvestigation will be conducted by an FTCinvestigator to help the consumer andhis/her bank or other financial institutionsgo through transactions where the theftcould have occurred. If your clinic is listedas a place where the consumer used, forexample, a credit card to pay for services,such as filling a prescription, and gavethe credit card info over the phone, thenthe FTC investigator may arrive at yourpractice to discuss the transaction withyou and how the consumer’s informationwas protected. For example, the informationshould be restricted to a client’s fileand never quickly jotted down on a slipof paper where it could easily be seen byanyone nearby. Also, when an employeeis taking the information by phone andrepeating the info out-loud, it should neverbe done in earshot of the public. Thesetypes of potential violations are whatshould be covered in covered inemployee training.Some rights you have:1) Practice owner and their managers,legal team, accountants and consultantshave the right to be present for anyinspection or investigation.2) No original records or documents areto leave the practice; the practice attorneyshould be notified if copies are requested.3) You have a right to reschedule theinspection for a time when you andyour agents and consultants can allbe available.4) You have a right to have a writtenreport of preliminary findings.To learn more about the FTC Red FlagRule program, visit ftc.gov.Dr. Chery F. Kendrick is aveterinarian regulatory specialist. Hercompany Kendrick Technical Servicesprovides regulatory consulting servicesand tools for the veterinary practice.You may also have seen “Doc Chery”at conferences or seminars nationwidetaken one of her online courses atVetMedTeam.com. For more information,visit KendrickTechServices.com or contactDr. Kendrick at DocChery@charter.netor 1-865-405-4255.For Members of the National Association of Veterinary Technicians in America 27

Continuing EducationforiguanasOptimum NutritionBy: Roberta A. Avila-Guevara, CVTDenver, ColoradoThe Green Iguana has been a popularhousehold pet for many years. Eventhough there has been a period of lowinterest, this lizard remains at the top ofthe charts in the herp community. It isimportant for veterinary technicians tounderstand the dietary and husbandryneeds of the Green Iguana so that theycan educate clients on their proper care.The basic husbandry needs of the iguanainclude an enclosure that is taller than itis long or wide. These lizards are arboreal,they love to climb to great heights. As withmost reptiles, iguanas are ectothermic,meaning that their internal temperature isdependant upon their external temperature.It is important to provide high endtemperatures of 90 degrees, preferablywhere they can bask on a branch; and low28end temperatures of 70 degrees so theycan escape the heat if they get too warm.Iguanas should be fed in the late morning.They need to warm up under the warmtemperatures in order to get their digestivetract moving. Any uneaten food canbe removed in the evening after daylighthours have ceased.The Green Iguana is a strict herbivore.This means that iguanas have hindgutsadapted for fermination of dietary fiber andfeeding appropriate foods is imperativefor this pet’s health. When kept as pets,iguanas can become picky eaters. Theywill only eat what tastes good, regardlessof the nutrient value of the food; thereforeit is important to start these lizards on anappropriate diet from the beginning. Thisinsures that the iguana will get the nutri-The NAVTA Journal | Fall 2009ents he needs and keep him from dictatingwhat his diet will be.VegetablesVegetables make up the majority of theiguana’s diet and are placed into categoriesto distinguish the nutrient composition.This helps determine what vegetablesmake the best choices for the iguana.Dark, leafy greens are crucial for thehealth of the iguana, due to the higherlevels of calcium found in most of thesefoods. Calcium-rich greens include: mustardgreens, chard, collards, turnip greens,dandelion greens and the flowers, romaine,parsley, endive, cilantro, and leeks.The darker, outside leaves of all greens are

Continuing Educationlevels of phosphorus. The iguana requiresphosphorus for basic chemical reactions;however, abnormal levels of this mineralcan be detrimental. Ideally, phosphoruscompliments calcium in a balance knownas the calcium to phosphorus ratio. Foriguanas, that ratio should remain at a 2:1level. If the phosphorus levels are too high,it can result in skeletal problems, includingmetabolic bone disease.more nutritious than the inner, pale leavesand some greens have a low nutritionalcontent in general. These greens includebutter lettuce and boston lettuce andshould be provided only in small quantities.It should be noted that iceberg lettucehas no nutritional value and should not beincluded in the diet.Oxalates and phytates are naturally occurringmolecules found in some greensthat bind to calcium and prevent the iguanafrom absorbing it. Greens that containthese molecules include: spinach, chard,beets, rhubarb, beet greens, bok choy,and kale. These foods do not need to beavoided entirely; however, they should beprovided in limited quantities.Non-leafy vegetables, combined withleafy greens, should provide the remainderof the iguana’s vegetable requirements.The non-leafy group consists of categoriessimilar to the greens and those with a highnutritional content include: okra, snowpeas, snap peas, bell peppers (all colors),mushrooms, green beans, yams, andsquash. The low nutrient group includes:zucchini, olives, cucumbers, and onions.Carrots and beets contain oxalate andphytate molecules, and therefore shouldbe limited.Cauliflower, broccoli, brussels sprouts,and cabbage are vegetables that belongto a group called cruciferous. This groupof vegetables contains substances thatbind to iodine and prevent its usage by thethyroid gland. Without the availability ofiodine, the thyroid gland will become enlargedand the neck will swell. This conditionis called goiter, and leads to hypothyroidismdue to the decrease in hormoneproduction. These vegetables should alsobe provided in limited quantities.FruitsIn the wild, fruit is a seasonal hors d’oeuvrefor the iguana and therefore, makes up asmall percentage of the diet naturally. Fruitis mostly fructose and water with minimalamounts of fiber; it also contains highFruit will also dilute the necessarynutrients in the rest of the diet becauseof its high levels of water. Providing smallamounts of fruit is just as important aschoosing the right types of fruit. Figs,papaya, mango, and raspberries are highin calcium and make excellent choices.Bananas, melons, strawberries, apples,and plums (skins included) also makegood choices. Avoid fruit that is high infat, such as avocados; fruit high in acidity,such as oranges; and fruit known to betoxic to dogs and cats, such as grapesand raisins.Grain-Based FoodsIguanas can be given special treats suchas cream of wheat and bread. Thesegrains supply a minimal amount of plantbased proteins, carbohydrates, andvitamins, but they are high in phosphorusand low in calcium. They should only beoffered once or twice every few weeks.Choose whole grain bread without addedsugar and cook the cream of wheat beforeoffering it.SupplementsProduce purchased at grocery storesusually fails to provide optimum amountsof nutrients for iguanas that are kept incaptivity. Therefore, supplementation ofthe diet is important. Iguanas should beprovided with both a multi-vitamin anda calcium/vitamin D3 supplement. TheFor Members of the National Association of Veterinary Technicians in America 29

Continuing EducationIguana Nutrition, continuedmulti-vitamin provides most of the microminerals, macro minerals, and fat-solublevitamins. This supplement should beprovided to the adult iguana two times aweek, and the juvenile four times a week.This is dependent upon signalment, healthstatus, and current deficiencies or excessesin vitamins or minerals. Deficiencies incalcium and vitamin D3 are common andmay result in stunted growth, muscle tremors,seizures, softened and broken bones,and death. Ideally, the iguana producesenough of its own vitamin D3 throughultraviolet rays from the sun. This can besimulated in captivity through UV lighting;however, the lighting must provide bothUVB and UVA rays in order to producethe vitamin D3. The most common way tomeet all of the iguana’s vitamin D3 needsis through supplementation.Look for supplements that contain bothcalcium and vitamin D3, but are vitamin Aand phosphorus free. These needs will besupplied in the multi-vitamin supplement.Juvenile iguanas should be supplementedat each feeding with calcium and vitaminD3, and three times a week for themulti-vitamin. Adults need the calcium andvitamin D3 three times a week, and multivitaminsonce or twice a week.It is easy to over supplement theseanimals. An excess of one nutrient caninterfere with several metabolic pathways,and result in various medical conditions ormalnutrition.Hypothyroidism can occur when highlevels of calcium interfere with absorptionof zinc and copper. This affects iodineuptake by the thyroid gland. Renal failure,mineralization of internal organs, anddeath are seen with high levels of vitaminD3, and too much phosphorus, in relationto calcium, will result in metabolic bonedisease.30Commercially Prepared FoodsCommercial diets are available for juvenileand adult iguanas; however, these dietscan be problematic. Wheat and corn areusually the first ingredients found in thesediets. If fed in excess, these foods willlead to metabolic bone disease due to thehigh levels of phosphorus. Kidney diseasehas been seen due to the high levels ofpurines that put stress on the kidneys overtime and eventually cause them to fail.A majority of the commercial dietscontain high levels of protein. While exactprotein needs for iguanas are not known,levels above 25to 30% can contributeto many dietary and medical conditions.Gout presents itself as inflammation andstiffening of the joints. This occurs whenincreased levels of uric acid, a byproductof protein digestion, begin to build up inthe bloodstream. The crystals get lodgedin joint, lung, kidney, and liver tissue. It is adebilitating disease with a lot of pain anddiscomfort. There is no cure, so preventionis the best medicine.The primary protein source found incommercial foods comes from animals.While all proteins are the same once theyare broken down into amino acids, animalproteins have higher amino acid concentrationscompared to plant proteins.The iguana will exceed its protein needsconsuming animal proteins. This can developinto kidney damage and failure fromthe build up of protein byproducts in thebloodstream.Look for products with a crude proteincontent of 18% and fat content notexceeding 12%. Herbivores reptiles candevelop metabolic bone disease if they arefed a diet with a fat content higher than12%. High levels of fat will prevent calciumfrom being absorbed and thereforeproduce a calcium deficiency over time.The NAVTA Journal | Fall 2009HydrationIguanas maintain high levels of hydrationthrough semi-tropical environments;therefore, chronic dehydration occurs ifappropriate levels of moisture are not provided.There are several ways to providehigh moisture levels. Maintaining a pool ofwater in the bottom of the habitat raisesthe humidity. Misting the habitat severaltimes a day along with commercial mistersand foggers encourages water consumptionbecause iguanas lap water from plantleaves in their natural environment. Finally,giving iguanas time in the bath promotesmoisture absorption through the skin.Foods to AvoidThere are foods that have been offered toiguanas based upon limited knowledgeand misunderstanding of these animals.Some of the foods are a possible problemif they are fed in large quantities. Othersare dangerous and known to lead to medicalproblems and death.Dog and cat foods have been a popularfood item since iguanas have becomepopular pets. Unfortunately, these foodscan be higher in fat and vitamin D, andoften contain animal based proteins. Inaddition, if they are fed dry, it will lead tochronic dehydration.A diet that provides mostly lettuce, orconsists of iceberg and other low nutrientlettuce, leads to metabolic bone disease,deficiencies in vitamins and minerals,goiter, and hypothyroidism. It is importantto provide variety in the diet in order tomaintain the leafy greens at a healthypercentage.Adding crickets, worms, pinkies, andother ‘meats’ to the diet leads to numerousmedical conditions, including metabolicbone disease, gout, and even death due tothe inappropriate protein sources and highfat levels.

Continuing EducationOptimum Nutrition for Iguanas Quiz1. Iguanas area. omnivoresb. carnivoresc. herbivoresd. insectivores2. Oxalates and Phytatesa. Are chemicals found in supplementsthat aid in the absorption of calciumb. Are chemicals found in somevegetables that prevent theabsorption of calciumc. Are molecules found in fruit thatdilute the nutrients in vegetablesd. Are molecules found in somevegetables that prevent theabsorption of phosphorous3. Vegetablesa. Make up at least 60%-85% of theiguana’s diet, with leafy greensproviding 30%-45% and othervegetables providing 30%-40%b. Makeup at least 15%-30% of theiguana’s diet, with leafy greensproviding 10% and other vegetablesproviding 20%-30%c. Make up at least 60%-85% ofthe iguana’s diet, with leafy greensproviding 20%-30% and othervegetables providing 40%-55%d. None of the above4. Fruit should be provided inlimited quantities becausea. Phosphorus levels are too low, whichcan lead to metabolic bone diseaseb. Phosphorus levels are too high, butthere is no link to metabolic bonediseasec. Phosphorus levels are too high,which can lead to metabolic bonediseased. None of the above5. When providing grain-based foodsin the iguana’s dieta. Oatmeal can be given in limitedquantities.b. Limit them to occasional treats dueto high phosphorus levels.c. None of the above.d. Grain-based foods should never beincluded in the diet.6. Calcium and vitamin D3deficiencies are commonand can includea. Stunted growth, muscle tremors,seizures, softened and brokenbones, and death.b. Stunted growth, muscle tremors,seizures, mineralization of internalorgans, and death.c. Stunted growth, muscle atrophy,seizures, softened and brokenbones, and death.d. Increased growth, muscle tremors,seizures, softened and brokenbones, and death.7. Gout is a condition consisting ofinflammation and stiffening of thejoints. This occurs witha. Over supplementing with calcium.b. Diets with high fat levels.c. High levels of protein.d. Low levels of vitamin D3.8. Hypothyroidism is seen withdecreased hormone production. Thiscan occur when iodine is bound bysubstances found ina. grain-based foods.b. Some supplements.c. Cruciferious vegetables.d. Animal source proteins.9. The calcium to phosphorus ratiofor iguanas should remain ata. 100:1b. 10:1c. 2:2d. 2:110. What percentage of crudeprotein and fat content is idealfor iguanas?a. Exactly 18% fat and 12% crudeproteinb. Less than 12% fat and 18%crude proteinc. More than 12% fat and 18%crude proteind. More than 18% fat and 12%crude proteinThis article is worth one credit from Kansas State University and willbe accepted for grading through December 31, 2009. To receive credit,either complete the quiz online at www.VetMedTeam.com or completethe hard copy on page 50 and submit per the instructions.32The NAVTA Journal | Fall 2009

Continuing EducationAvoiding the Consequences ofMalnutrition in Hospitalized Patients –Understanding and ApplyingParenteralNutritionKara M. Burns, MS, MEd, LVTMark Brady, DVM, DACVECCHill’s Pet NutritionTopeka, KansasSick and injured animals undergo a uniquemetabolic response that puts them atrisk for malnutrition. These animals findthemselves in a catabolic state with loss oflean body mass. The problem that resultsfrom continued loss of lean body massis that the body’s protein being catabolizedis functional tissue, as compared tofat and carbohydrate. Also, loss of leanbody mass negatively impacts the overallhealing process. It is imperative thatthe healthcare team not only nutritionallysupport the hospitalized patient, but alsominimize the development of malnutritionin sick or injured patients.Parenteral nutrition (PN) can be definedas the administration of nutrients by anymeans other than the gastrointestinal(GI) tract. The focus of this discussionwill involve intravenous administration fornutritional management. PN is sometimesreferred to as total or partial parenteralnutrition and these definitions are takendirectly from the human literature. Totalparenteral nutrition (TPN) implies that allenergy and nutrient needs are met bythe intravenous solution. These solutionsare capable of maintaining a patient formonths or years, if necessary. Partial orperipheral parenteral nutrition (PPN) sup-For Members of the National Association of Veterinary Technicians in America 33

Continuing EducationParenteral Nutrition, continuedof polyurethane are recommended, as theydo not have a predetermined removal time.Veterinary technicians are critical to thesuccessful implementation and managementof PN in patients.ply a portion of the energy and nutrientneeds. These solutions are typically usedfor short durations (days to weeks). Inveterinary medicine, the strict definitionfor TPN cannot be met because solutionsthat contain the total caloric energy needsdo not meet the requirements for vitamins,macrominerals, and trace elementsrequired for long-term feeding. As veterinarytechnicians, it is important to realizethe limitations of this treatment choice inregard to the critically ill patient.There are a number of factors to considerwhen determining the appropriate timeto start nutritional support. The healthcareteam should anticipate when to start nutritionalsupport and the type of nutritionalsupport for each patient. Typically, oncethe decision has been made to institutenutritional support, enteral feeding (utilizingthe GI tract) is preferred to parenteral forseveral reasons. Enteral nutrition is morephysiologic, prevents GI tract atrophy,reduces gut stasis, and limits bacterialovergrowth to list some of the underlyingbenefits. 1,2 However, not every patient cantolerate enteral nutrition. It is imperativethat veterinary technicians identify thosepatients that may not be able to tolerateenteral nutrition. Examples of patients whomay be a good candidate for PN include:patients with intractable vomiting, those atincreased risk for aspiration, poor anestheticcandidates, and those unable totolerate the total caloric intake orally.Administration of PN is achievedthrough a central or peripheral catheter.The utilization of a central venous catheteris preferred, especially when consideringpotential complications such as phlebitisand infection. When long term PN is indicated,central venous catheters comprisedParenteral Nutrition SolutionsPN solutions are composed of carbohydrates,amino acids, lipid substrates, andother components. 3,4 The carbohydrate istypically 50% dextrose. Dextrose solutionscome in a range of 5% to 50%. The useof a central intravenous line (e.g. jugularcatheter) is necessary if the concentrationof dextrose is greater than 10% in thePN solution. Dextrose provides a readilyusable energy source for most patients.However, in critically ill patients, insulinresistance may alter the body’s ability toutilize this energy source. This is one ofthe reasons PN solutions rely on multipleenergy sources to provide nutritionalsupport. Crystalline amino acid solutionshelp maintain lean body tissue and positivenitrogen balance. They help the bodymaintain normal immune function, improvewound healing, and aid the function ofmany organs. These solutions are availablein different concentrations from 3.5% to15%. An 8.5% solution with or withoutelectrolytes is the most common preparationutilized in veterinary medicine. Thesesolutions lack taurine, but given the shortduration of treatment, this deficiency israrely a concern. Lipid emulsions providethe majority of the energy density of aThere are a number of factors to consider when determiningthe appropriate time to start nutritional support.The healthcare team should anticipate when to startnutritional support and the type of nutritional supportfor each patient.34The NAVTA Journal | Fall 2009

Continuing EducationPN solution. Lipid emulsions also supplyessential fatty acids and are isotonicwhich helps decrease the osmolarity ofthe solution. These solutions are availablein different concentrations from 10% to30%. A 10% or 20% solution is the mostcommon preparation utilized in veterinarymedicine. 3,5,6 Electrolytes, vitamins, andtrace elements are other components thatcan be added to PN solutions. The mostcommon electrolyte abnormalities thatoccur in patients receiving PN administrationinclude hypokalemia and hypophosphatemia.These electrolytes can be supplementedin the PN solution. However,most patients receiving PN will also havea second line for crystalloid administration.Given the fact that these electrolyteabnormalities can change rapidly, it standsto reason that supplementing them in thecrystalloid solution rather than having tocompound a new PN bag would be thebetter option.PN solutions can be compounded inhouse,via a pharmacy, veterinary referralinstitution, or human health care company.The cost of having the PN solutioncompounded at an outside facility is offsetby obtaining several days of treatment in aquick, aseptic manner. 7 Typically, all that isrequired by the outside facility is a nutritionalcalculation sheet and/or prescriptionfrom the veterinarian detailing the amountsof each substrate that needs to be addedto the solution. If it is elected to compoundthe PN solution directly at your hospital,one of three methods may be utilized. Thefirst, and least desirable, method uses asyringe to directly transfer each nutrientsolution into a sterile, empty fluid bag. Theconcern with this technique is contaminationof the system given the multipletransfers required to create the PN solution.The second option involves using a3-in-1 sterile bag and gravity flow to createthe PN solution. Each component of thePN solution can be connected to the bagand the nutrients are transferred directlyby gravity flow. This method is faster and< 2kg: RER = 70 x weight (kg) 0.75> 2kg: RER = [30 x weight (kg)] + 70 or above equation.RER = (kg x kg x kg, √, √) x 70.safer, avoiding the potential for underlyingcontamination. However, transfer ofexact quantities of nutrients is impossibleand partially unused components arewasted. The final method involves utilizinga semi automated, closed-system PNcompounder. This method allows exactquantities of solution to be created andmultiple bags can be made very quickly.The main downside of this method is thecost of the compounding machine. Oncecompounded, a PN solution can be storedfor days or weeks at refrigerated temperatures.1,2,6Route of Administration of PNAdministration of PN solutions shouldbe through a dedicated catheter placedin an aseptic manner by a credentialedveterinary technician. Whether the solutioncan be administered via a peripheralcatheter or central line is directly relatedto the osmolarity of the solution. Simplistically,this decision is directly relatedto the dextrose concentration of thesolution. As previously stated, a solutiongreater than 10% dextrose should be administeredthrough a central line to avoidthrombophlebitis. Catheters composedof silicone, polyurethane, or tetrafluoroethyleneare also recommended toavoid this complication. PN solutions aretypically administered as a constant rateinfusion over a 24-hour period. Once thesolution is warmed to room temperature,it is recommended to utilize the entiresolution in this time frame to preventcontamination and lipid particle destabilization.It is imperative that the healthcareteam reevaluate the nutritional plan everyday while administering PN. If the patientis not improving with this modality overseveral days and remains anorectic, optionsto institute enteral nutrition shouldbe considered. 5,8Calculating Caloric RequirementsIt is important for nursing care to includecalculating the patient’s caloric requirements.This is important because feedingmore of any food than necessary has thepotential for causing metabolic complications.A general rule to remember is mostdogs and cats tolerate the food or solutionthat meets the resting energy requirement(RER). The RER can be described as theenergy requirement for a healthy animal atrest in a thermoneutral environment, andis based on weight. Veterinary patientsthat are hospitalized have metabolic ratesvery near their RER. We can estimate theRER of hospitalized patients by using thefollowing equations:< 2kg: RER = 70 x weight (kg) 0.75> 2kg: RER = [30 x weight (kg)] +70 or above equation.In order to simplify the equations andapply to all sizes of canines the followingequation may also be utilized:RER = (kg x kg x kg, √, √) x 70.Feeding patients at RER is a safe andrational approach, as opposed to doublingbasal requirements. Doubling basalrequirements has been shown to result inoverfeeding and potential complicationsincluding hyperglycemia, hyperammonemia,and hyperlipidemia. 5 At minimum,For Members of the National Association of Veterinary Technicians in America 35

Continuing EducationParenteral Nutrition, continuedProper patient selection is important to ensure anacceptable outcome. Diligent nursing care and properaseptic technique are also crucial to a positive patientoutcome. Nutritional requirements of hospitalizedpatients should be carefully monitored by theveterinary technician.SummaryIn summary, PN solution is a viable nutritionalchoice for small animal patients.Combined enteral and parenteral feedingis recommended when applicable to preventintestinal hypertrophy and to facilitatehealing by promoting intestinal growth.Proper patient selection is important toensure an acceptable outcome. Diligentnursing care and proper aseptic techniqueare also crucial to a positive patient outcome.Nutritional requirements of hospitalizedpatients should be carefully monitoredby the veterinary technician. Compoundingof the PN solution is available throughoutside facilities or can be performed in aprivate practice setting. A dedicated intravenousline should be utilized to administerthe PN solution. Understanding some ofthe potential complications that can occurshould enhance the effectiveness of thistreatment option.veterinary technicians should performdaily nutritional assessments to guideany needed adjustments to the nutritionalplan of the hospitalized patient. A criticallyill patient may require more frequentassessments.Potential ComplicationsPotential complications with PN administrationcan be classified into threemain categories: mechanical, metabolic,and septic. 2,5,6 Nursing care shouldinclude continuous patient monitoringto minimize potential complications.Monitoring should include: hydrationstatus, body weight, body conditionscore (BCS), attitude/demeanor, TPRand pain assessment.Mechanical complications usually involvecatheter related problems. Examplesinclude: occlusion, premature removal,line disconnection/ breakage, and/orthrombophlebitis. These problems canbe avoided by the veterinary technician’sstrict adherence to aseptic technique andcareful monitoring of the patient. Metaboliccomplications are more likely to occur withPN solutions formulated to deliver totalcaloric requirements. The most commonmetabolic complication is hyperglycemia.Insulin therapy may be required to controlthis event. Other complications include:hypertriglyceridemia, hyperammonemia,or electrolyte changes consistent withrefeeding syndrome (e.g. hypokalemia,36hypophosphatemia, hypomagnesemia).Reformulation of the PN solution is requiredif any of these problems occur. Themost serious and potential life threateningcomplication is sepsis. Veterinary techniciansneed to use strict antiseptic techniquewhen placing a catheter. Nursingmanagement of catheters carrying hyperosmolarsolutions containing amino acidsrequires special focus because the solutiontype is an excellent medium for colonizationof bacteria. Antiseptic techniquesand focused nursing care should be thesame for all types of fluid administration,and are especially important in patientsreceiving PN. If signs of sepsis developwithout an identifiable source, contaminationof the solution and/or intravenouscatheter should be suspected. A cultureand sensitivity of both should be considered.It is due to this potential complicationthat many veterinarians recommendhaving the PN solution compounded at anoutside facility.The NAVTA Journal | Fall 2009References1. Thomovsky E, et al. Parenteral nutrition:uses, indications, and compounding.Compend Contin Educ Vet 2007;29:76-8,80-5.2. Chan DL , Freeman LM. Nutrition in criticalillness. Vet Clin North Am Small Anim Pract2006;36(6):1225-41.3. Thomovsky E, et al. Parenteral nutrition:formulation, monitoring, and complications.Compend Contin Educ Vet 2007;29:88-102.4. Proulx J. 2000. Nutrition in Critically IllAnimals. In The Veterinary ICU Book, 202-217.Jackson Hole, WY: Teton NewMedia.5. Remillard RL, et al. 2000. Assisted Feedingin Hospitalized Patients: Enteral and ParenteralNutrition. In Small Animal Clinical Nutrition4th ed, 351-386. Marceline, MO: WalsworthPublishing Company.6. Freeman LM, Chan DL. 2006. Total ParenteralNutrition. In Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice 3rded, 584-601. St. Louis, MO: Saunders Elsevier7. Remillard RL , Thatcher CD. Parenteralnutritional support in the small animal patient.Vet Clin North Am Small Anim Pract1989;19:1287-306.8. Chandler ML,et al. Use of peripheral parenteralnutritional support in dogs and cats. J AmVet Med Assoc 2000;216:669-73.

Continuing EducationParenteral Nutrition Quiz1. Patients that may benefit fromparenteral nutrition include those:a. at decreased risk for aspirationb. gaining lean body massc. able to receive daily caloric intakeorallyd. with intractable vomiting2. Which of the following is a commonelectrolyte abnormality occurringin patients receiving parenteralnutrition?a. Hyerkalemiab. Hyperhosphatemiac. Hypokalemiad. Hypoparathyroidism3. The three main categories of complicationsof parenteral nutrition areclassified as:a. Chemical, metabolic, and septicb. Mechanical, metabolic, and septicc. Caloric, hydration, and septicd. Metabolic, refeeding, and septic4. The most common preparation ofcrystalline amino acid solutions is:a. 8.5% with or without electrolytesb. 10.5% without electrolytesc. 30% with electrolytesd. 35% without electrolytes5. Lipid emulsions:a. provide the majority of the energydensity of a parental nutrition solutionb. supply essential fatty acidsc. are isotonicd. all of the above6. RER stands for:a. Resting Electrolyte Requirementb. Rapid Electrolyte Restorationc. Resting Energy Requirementd. Rapid Energy Restoration7. The equation used to determineRER for all sizes of canines is:a. (kg x kg x kg, √, √) x 30b. (kg x kg x kg, √, √) x 70c. (kg x kg x kg, √, √) 0.75 x 30d. (kg x kg x kg, √, √) 0.75 x 708. Metabolic complications withparenteral nutrition administrationinclude:a. hypertriglyceridemiab. hyperkalemiac. hyperphosphatemiad. hypermagnesemia9. Partial parenteral nutrition:a. supplies all energy and nutritionneedsb. supplies a portion of the energy andnutrition needsc. can maintain a patient for months oryearsd. provides nutrients through the gastrointestinaltract10. Central intraveneous line is necessaryin parenteral nutrition if:a. the concentration of lipid substratesis greater than 10%b. the mixture of dextrose and aminoacids is less than 10%c. the mixture of dextrose and lipids isless than 10%d. the concentration of dextrose isgreater than 10%This article is worth one creditfrom Kansas State Universityand will be accepted for gradingthrough December 31, 2009. Toreceive credit, either complete thequiz online at www.VetMedTeam.com or complete the hard copyon page 50 and submit per theinstructions.For Members of the National Association of Veterinary Technicians in America 37

Continuing EducationPorcineReproductiveand RespiratorysyndromeBy Brent Legred & Julie Legred, CVTCo-Owners – LSG HealthsystemsBricelyn, Minnesota38“There has never been a more devastatingdisease in the swine industry, and it isby far the disease with the greatest costto the industry today,” said Scott Dee,DVM, MS, PhD, DACVM, Professor ofthe Department of Veterinary PopulationMedicine, College of Veterinary Medicine,University of Minnesota. “It has put quitea few people out of business. It’s madeothers more cognizant of the disease andbetter managers. It’s completely changedherd health strategies and pig flow.”The NAVTA Journal | Fall 2009In the United States’ swine herds, therewas reporting of catastrophic outbreaksof an unknown disease in the late 1980s.Originally, the efforts of identifying thecause of these outbreaks were failing, soMystery Swine Disease (MSD) seemedappropriate terminology. Similar outbreaksstarted to be reported in Germany in1990. By 1991, the Netherlands andthe United States identified the causativeagent and established the name asPorcine Reproductive and Respiratory

Continuing EducationSyndrome (PRRS). Today commonlyPRRS, commonly pronounced and called“purrs”, is endemic in most of the world’sswine population, although some countriesincluding Sweden, Norway, Finland,Switzerland, Oceania, New Caledonia,New Zealand and Australia, claim to bedisease free.Porcine Reproductive and RespiratorySyndrome (PRRS) is caused by a small,enveloped, single-stranded, positive RNAvirus that is about 50 – 60 nm in diameter.It is classified in the order Nidovirates, belongsto the family Arteriviridae and genusArterivirus. This virus is closely related tothe Equine Arteritis Virus, Simian HemorrhagicFever Virus and Lactate Dehydrogenase-ElevatingVirus of mice.CharacteristicsPRRS causes a persistent and chronicinfection in pigs. The most significant characteristicof PRRS infection is the virusreproduction in cells of non-clinical carrierpigs for many months. Persistent infectioncan occur with exposure in utero, in young,or in adult animals. PRRS outbreaks canbe seen as: reproductive failure; lactationfailure; increased still births and abortions;poor growth; and respiratory disease includingpyrexia, anorexia, cough, dyspneaand skin discoloration. In highly infectedherds, the immunosuppressive characteristicsof the disease can cause hardshipin fighting the herd’s previous pathogensthat were under control before the PRRSinfection. Death occurs in many of theyoung pigs, often due to secondaryinfections like Haemophilus parasuis andStreptococcus suis. Preceding abortions,respiratory symptoms may be evident ingilts. In some strains there may be anemialeading up to pneumonia. Bruising mayalso occur at iron injections sites due tothrombocytopenia. Clinical signs of PRRScan vary greatly in intensity among herds.They can be asymptomatic or catastrophicdepending on the virus strain, managementfactors, host immune status, hostsusceptibility and reoccurring infections.After pigs have been exposed, the virusreplicates in susceptible macrophagesand rapidly spreads to lungs and lymphoidorgans. Virulent strains have been knownto cause viremia as early as 12 hours insome individuals and in all pigs within 24hours of infection. Titers increase quicklyand peak in lung, lymphnodes and semenin seven to fourteen days.ResearchPRRS is one of the most significant viraldiseases of pigs in modern times and hascaused economical hardship to the swineindustry in all sectors. The disease affectssmall farms, as well as large swine productionsystems. It affects all phases of porkproduction from the breeding herd all theway through the grow/finish phase. Datacollected by a study done by the NationalPork Board and Iowa State Universitydemonstrated that PRRS costs the UnitedStates pork industry $560 million to $762million annually.Research for the National Pork Boardand Iowa State University shows a farrowingrate reduction of nearly 11 percent ona PRRS affected sow herd, 1.5 fewer pigsweaned and 10 percent fewer litters persow per year compared to a PRRS negativefarm. The study concluded a significantnegative net economic impact of thedisease affected farms to be $74.16 perlitter compared to PRRS negative farms.This is just the beginning. Nursery pigsaffected by PRRS have a mortality rateincrease of 10.65 percentage points, whichis nearly six times greater than normal.PRRS infected nursery pigs have beenshown to have a feed conversion drop of11.69 percent and take up to 25 percentlonger to grow from 12 to 50 pounds. Addingthese costs, it is estimated that PRRScosts about $6.01 per pig just in the nurserythan if pigs that were non- infected.In the grow/finish phase of production,PRRS infected pigs have 6 percent higherdeath loss, feed efficiency was 7 to 8percent worse, while growth and averagedaily gain suffered by a whopping 12 percentfrom 50 to 260 pounds. This combinationof negatives adds up to a contributionof an extra $7.67 per pig in costs forPRRS infected pigs versus non-infectedgrow/finish pigs.The most significant reason PRRS hasbecome such an insurmountable challengefor the pork industry has been the ability ofthe virus to continually mutate and take onmultiple strains with little to no cross protectionfrom the previous strain immunity.This has caused tremendous frustration,because just when a producer has stabilizedthe virus, a new strain could mutatewith devastating effects. Strain variationand lack of cross protection has made itdifficult to eradicate PRRS, especially fromlarger systems and hog dense areas.TransmissionPigs infected with PRRS can shed thevirus through saliva, urine, feces, semen,blood, and aerosols. Pregnant femalesexposed in late gestation can shed thevirus through milk and colostrum. Becauseof the wide usage of artificial insemination,it is a huge worry of the virus being shedthrough of semen. It has been reportedthat the infected virus can be shed in semenfor 43 to 92 days after exposure.Transmission of PRRS can occur byseveral routes of exposure including: oral,intramuscular, intrauterine, vaginal, andintranasal. Most data shows that pigsare highly prone to infection by way ofparenteral exposure. Possible parenteralexposure can be routine husbandry practices,such as teeth clipping, injectionsFor Members of the National Association of Veterinary Technicians in America 39

Continuing EducationPRRS, continuedwith medications and vaccines, ear notching,or tattooing and because the PRRSvirus can be found in saliva. Common pigbehavior can produce parenteral exposureby means of cuts, scrapes or bites fromaggressive behavior between the pigs. Inaddition, the infected risk can come laterallyfrom older pigs harboring the PRRSvirus in the same air space. A few “TyphoidMarys” carrying and leaking the virus tosusceptible pigs can cause mortality ratesto sky rocket and average daily gains todrop by a tenth of a pound or more.Indirect transmission routes include:fomites and inanimate objects or substancessuch as instruments, equipment,water, food, coolers, needles, coveralls,boots and hands. Since the virus can beshed by way of urine, feces and saliva, theenvironment can be contaminated andcaution must be taken as to the possibilityof transmission occurring through fomites.Transport vehicles, such as trucks andtrailers, are potentials for mechanical transmission,as are mosquitoes and houseflies.PRRS can be infective for long periods oftime under the right temperature, pH andmoisture conditions.Vertical transmission occurs when infectedsows or gilts transplacentally pass the virusto fetuses. Fetal death or birth of infectedpiglets can occur and these piglets maybe weak or appear perfectly normal. Moststrains of PRRS only efficiently cross theplacental in the last trimester of pregnancy.Epidemic PRRS infections of herdsinitially during the first phase, last two ormore weeks and most of the time showanorexia and lethargy in the majority of theanimals. It can affect animals at any ageand can enter into one or more stagesof production and advance to all stageswithin a week’s time. During the secondphase, reproductive failure, high mortalityin the piglets occurs and can last upto four months once a herd has beeninfected. With PRRS, it almost alwaysbecomes endemic. Usually endemicallyinfected herds are mostly seen as regularor occasional outbreaks in susceptiblenursery or grower/ finisher pigs.It has been observed that PRRStransmission within a herd continuallycirculates. There are pigs that are persistentlyinfected and can be negative onseveral tests while still harboring the virus.It should not be assumed that pigs becomeless of a risk just because they havecleared the virus, as some are constantlyviremic and carrier animals.The most significant source of PRRSintroduction into farms is the entry of aninfected pig. Semen and aerosol transmissionfrom neighboring farms in recentyears have proven to play major roles. Ithas also been demonstrated that equipmentand items moved between positiveand negative farms, especially when theseitems are wet and cold, has also beena mode of transmission between farms.Location to positive herds has proven tobe a risk factor. There is a higher risk ofherds becoming infected where there arepositive herds close in proximity. This riskdecreases with herd distance.PreventionThe goal for the prevention of PRRS is toprevent the entrance into negative herdsor prevent the entrance of new strains intoalready positive herds. Bio-security playsa key role in prevention and control. In aperfect world, production units would belocated in isolated areas, but no matterwhat, extreme importance should beplaced on all bio-security efforts put forthinvolving everything going into and outof the farms. Any replacement breedingstock coming into a PRRS negative herdshould come from breeders known to be40The NAVTA Journal | Fall 2009

Continuing EducationPRRS naïve, meaning never been thereand confirmed, by regularly scheduled herdtesting. New animals coming in should alsobe isolated or quarantined for at least 30days and then tested before introducingto a herd. Semen purchased for artificialinsemination should also be obtained froma PRRS naïve source that is routinelyblood serum tested by reverse transcriptionpolymerase chain reaction (RT PCR).This method has proven to be the best andearliest detection diagnostic tool.It is important to pay close attentionto disinfection and fomite management.Data has shown that modified potassiummonopersulfate and quaternary ammoniumchloride have been the most effectivecompounds in eliminating PRRS fromsurfaces. PRRS virus does not remainviable outside of the pig for extended periods.Routine cleaning and disinfecting bycomplete drying of the surfaces should beadequate to prevent transmission betweengroups of pigs.Consideration should be made inpersons entering and/or exiting the herd.PRRS transmission can be drastically reducedwith changing or using disposableboots, coveralls and gloves or by usingdesignated clothing for specific rooms,barns or areas. Bleach footbaths, washingof hands and having a downtime period of12 hours away from pig contact. Showerin/shower out protocols have also aided inreducing transmission of PRRS.Contaminated transport vehicles havealso been known to play a big part intransmission of PRRS. Washing, disinfectingand drying have proven to be a veryeffective way of getting rid of the PRRSvirus from these vehicles. The additionof thorough drying for 120 minutes afterwashing and disinfecting has proven mosteffective.PRRS is one of the most significant viral diseasesof pigs in modern times and has caused economicalhardship to the swine industry in all sectors. Thedisease affects small farms, as well as large swineproduction systems.One of the most significant developmentsin the prevention of PRRS introductionin recent years has been the evolutionof air filtration to prevent the possibility ofaerosol transmission in hog dense areas.Air filtration systems have proven effectiveon reducing risk of PRRS contaminatedaerosols from entering pig buildingsand facilities. It is also highly recommendedto control insects such as mosquitoesand houseflies, as well as rodent populationsto aid in reduction of transmission.As previously stated, the PRRS virustends to circulate in endemically infectedherds. To interrupt the cycle in the breedingherd, bring in replacement animals thathave already been through infection andhave developed immunity before enteringthe herd. By doing this routinely, the signsof PRRS will even out and production willstart to improve. The most difficult item athand is the ideal timing of PRRS infectionon just the right schedule.There is no treatment plan specificallyavailable for PRRS. The most definitiveplan for PRRS control is to try and minimizethe detrimental outcomes PRRS hasthroughout production stages. Despite allof these efforts, there will no doubt be illeffects from the virus.There have been great strides made inthe last few years to improve and outlineprotocols to improve the outcome towardsIt affects all phases of porkproduction from the breeding herd all the waythrough the grow/finish phase.removal of PRRS from positive herds.Some of the protocols being used arepartial depopulation, total depopulationand repopulation, herd closure, segregatedearly weaning, and test and removal.To eliminate PRRS, you need a plan thatincludes strict bio-security and introductionof replacement at a time when PRRSis no longer circulating.Total depopulation and repopulation is aproven technique, but is extremely expensive.This technique may be the only hopefor farrow to finish herds that have had nosuccess in eliminating the virus using anyof the other techniques or protocols.Partial depopulation can be successfulwhen used to achieve elimination fromgrowing pigs when the breeding animalsno longer are infective. This technique isalso usually only successful for small farms.Large farms may elect to use this techniquein combination with other techniques.The closed herd technique is when allanimals are exposed to the virus, the herdis closed and no replacement animalsfrom outside the herd are brought in. Exposedanimals will eventually clear of thevirus, but this can take about six months ormore to achieve. Eventually serologicallystable replacement animals retained fromwithin the herd should be brought in andpreviously infected animals can be culledFor Members of the National Association of Veterinary Technicians in America 41

Continuing EducationRecently, the use of scheduled orplanned exposure by way of injections ofserum from pigs infected with the virus hasbeen utilized. This has come about fromthere being not enough protection for crossprotection against be strains and mutationsof the virus. However, this techniquehas big risks and requires precise timing ofadministration and high quality control.Without question, PRRS has changedthe face of the United States pork industryand completely changed herd healthstrategies and pig flows.on a routine schedule with acceleratedculling of immune compromised and olderanimals, as these animals can be a sourceof re-infection.The test and removal protocol or bloodtesting the entire herd and removing thepositive animals has achieved limitedsuccess. This technique should only beconsidered for herds where 12 monthshave passed since the last sign of PRRSthrough diagnostic observation, and whohave segregated production. Again, specialattention should be given to acceleratedculling of immune system compromisedand older animals.There are several modified live virus(MLV) and inactivated or killed vaccineproducts for PRRS on the market that42have proven to be effective in protectiveimmunity. Overall, the MLV vaccine hasshown to be the most effective in bringingon immune responses, but safety is a concernwith some of the products available.Vaccine virus acts in somewhat the sameway as field PRRS virus for transmission,so more studies need to be conductedto find a more safe and effective productto utilize for controlling PRRS. In additionthere are so many different strains andmutations of PRRS that cross protectionwill need to be a consideration as well.The NAVTA Journal | Fall 2009References1. Bassert J, McCurnin D: “McCurnin’s ClinicalTextbook for Veterinary Technicians”, SaundersElsevier, 20102. Kyriazakis I, Whittemore C: “Whittemore’sScience and Practice of Pig Production”,Blackwell, 20063. Cockcroft P, Jackson P: “Handbook of PigMedicine”, Elsevier, 20074. D’Allaire S, Straw B, Taylor D, Zimmerman J:“Diseases of Swine”, Blackwell, 20065. Dee, S: “PRRS: A Review and Update”, MinnesotaAssociation of Veterinary TechniciansConvention Proceedings, 20086. Kelley T: “Paying the Price of PRRS”, PorkMagazine, July 20047. “PRRS – Is Your Farm Safe?”, Iowa PorkProducer, September 2003, Volume 40, No.8-98. “Assessing PRRS Protection in Grow-FinishPigs” Boehinger Ingelheim’s Insight, Volume 6,Issue 19. “Once PRRS Positive Always PRRS Positive”Boehringer Ingelheim’s Insight, Volume 6,Issue 1Without question, PRRS has changed the face of theUnited States pork industry and completely changedherd health strategies and pig flows.

Continuing EducationPRRS Quiz1. In what year was the causativeagent of PRRS determined?a. 1989b. 1990c. 1991d. None of the above2. Pigs shed PRRS virus by which ofthese?a. Fecesb. Urinec. Semend. All of the above3. PRRS transmission can drasticallybe reduced by using all of theseexcept?a. Disposable bootsb. Disposable hair netc. Changing coverallsd. Washing hands4. These countries all claim to be freeof PRRS except?a. Norwayb. Netherlandsc. New Zealandd. Australia5. The PRRS virus is closely relatedto this virus.a. Equine Arteritis Virusb. Severe Acute Respiratory Syndrome(SARS)c. Avian Influenzad. Bovine Spongiform Encephalitis6. What phase of swine productiondoes PRRS affect?a. Nurseryb. Growerc. Finisherd. All of the above7. What is the biggest challenge indealing with PRRS?a. The virus can continually mutateb. There is little to no cross protectionc. There are many strains of PRRSd. All of the above8. How much has PRRS proven tocost the United States Swine Industryannually in a recent study?a. 100 - 260 million per yearb. 270 - 550 million per yearc. 560 - 762 million per yeard. 780 – 950 million per year9. Being PRRS naïve means:a. Chronically infectedb. Herd exposure, but serologicallynegativec. PRRS has never been in the herdd. Vaccinated against PRRS10. Washing, disinfecting and dryinghave been proven effective in removingvirus from transport vehicles.Which statement is not true?a. Water temperature must be greaterthan 180 degreesb. Modified potassium monopersulfateand quaternary ammonium chloridehave been most effective compoundsin eliminating PRRS fromsurfacesc. Thorough drying for at least 120 minutesafter washing and disinfectingd. All debris and fecal material must beremoved from the surfacesThis article is worth one creditfrom Kansas State Universityand will be accepted for gradingthrough December 31, 2009. Toreceive credit, either complete thequiz online at www.VetMedTeam.com or complete the hard copyon page 50 and submit per theinstructions.For Members of the National Association of Veterinary Technicians in America 43

Continuing EducationChemotherapyin Small Animal Practice ©SafetyBy Stacy L. Fielding DVM and CharlotteLacroix DVM, JDVeterinary Business Advisors, Inc.Flemington, New JerseyChemotherapy is becoming more widelyavailable in companion animal practice.This is in part due to the strengthening ofthe human-animal bond. Pets have nowreached family member status, and as aconsequence, pet owners wish to prolongcancer patient survival time and preservequality of life. However, chemotherapyagents are cytotoxic and thus have associatedhealth risks in both the occupationaland family settings. A preliminary survey of13 questions addressing chemotherapysafety in companion animal practicewas distributed to a number of oncologypractices in the United States. The surveyrevealed key areas of strength and weaknesspertaining to chemotherapy safetyin companion animal practice. This articlesummarizes chemotherapy safety issuesand provides guidelines for the implementationof a safe chemotherapy protocol.In recent years, companion animals areliving longer lives and playing more significantroles in family life. For these reasons,pet owners have become more willing toexplore various cancer treatment optionsfor their animals. It is now known that anincreasing number of companion animalveterinarians are offering chemotherapyin the small animal practice setting .1 It isalso known that cytotoxic agents have a44The NAVTA Journal | Fall 2009

Continuing Educationvery narrow margin of safety and thereforecarry a relatively significant occupationalhazard. Short term effects of exposure tocytotoxic agents have been studied and includelightheadedness, headache, nausea,hair loss, and skin irritation.2 Long termeffects of exposure have not been extensivelystudied, but it is generally suspectedthat cytotoxic agents are mutagenic,teratogenic, cause fertility impairment, andare included on lists of known or suspectedhuman carcinogens.1Exposure to cytotoxic agents can occurthrough the inhalation of aerosols, byaccidental ingestion, and by absorptionthrough the skin and mucus membranes.In an occupational setting, accidental exposureoccurs mainly through drug preparation,administration, and handling ofpatient waste. From a public health standpoint,clear guidelines are necessary foreach stage of cytotoxic drug handling inorder to protect the health of the humansinvolved in each of these procedures. Inthe United States, these guidelines are developedby the National Institute for OccupationalSafety and Health (NIOSH) andin Canada they are governed by Canada’sNational Centre for Occupational Healthand Safety (CCOHS).Preparation of Cytotoxic Agents• Always wear proper personal protectiveequipment when handling/preparingchemotherapy drugs• Store drugs in their original packaging• Store drugs in a dedicated fridge• Prepare drugs in a biological safetycabinet or low traffic area• Label prepared drugs appropriatelyThere are a number of important safetyguidelines to follow when receiving, storing,and preparing chemotherapy drugs.Two pairs of latex gloves must be wornwhen unpacking drugs upon receivingthem in the clinic, as it has been found thatpackaging material may contain harmfuldrug residues. For this reason, drug packagesshould also be stored in sealed plasticbags. Ideally, cytotoxic agents shouldbe stored inside their original packaging ina dedicated refrigerator away from otherdrugs and animal feed.4Drug mixing and compounding shouldbe carried out by a trained professionalwithin the confines of a class II or IIIbiological safety cabinet if at all possible.The unit should ideally have a laminar flowpattern and a HEPA filtration system, preferablyvented to the outdoors. The cabinetshould also be located in a low-traffic areaand away from strong drafts that may aidin aerosolization and dispersion of fumes.If a biological safety cabinet is not availabledue to financial constraints, the use ofa respirator mask containing a HEPA filteris strongly recommended.5Hazardous drugs should be preparedaseptically by a staff member wearing personalprotective equipment including twopairs of unpowdered latex gloves or specialchemotherapy gloves, a long-sleevedwaterproof gown fastened in the back, eyeprotection, shoe and hair coverings, and arespirator (HEPA) mask. Ordinary surgicalmasks do not offer sufficient protectionagainst aerosolized compounds.5 It hasalso been recommended that gloves bechanged every 30 minutes during batchcompounding.3Drug preparation should take place on adisposable plastic-backed absorbent padwithin the biological safety cabinet, andthis should be changed with each use. Anumber of sources advise that syringesonly be filled two-thirds full, in order toreduce the likelihood of spills if the plungerbecomes separated from the syringe.3,6When the drugs are ready for use, theyshould be labeled with appropriate patientinformation and biohazard stickers.Administration of CytotoxicAgentsBefore administering a chemotherapeuticagent to an animal, most sources recommendthat a dosage calculation be recheckedby at least two individuals withinthe private practice setting.1 This is mainlydue to the very narrow therapeutic windowof antineoplastic agents.A number of cytotoxic drugs, especiallydoxorubricin and vincristine are vesicantsthat cause extensive tissue necrosis if extravasationoccurs, or if the drug accidentallycomes into contact with skin.4 It is forthis reason that administration equipmentshould be primed and examined for leaksprior to treatment. Intravenous lines andcatheters must also be flushed with salinefollowing administration in order to removedrug residues.2 In addition, plastic-backedabsorbent pads and alcohol-dampenedgauze pads should be placed near theinjection site to catch any drips that mightseep out of the needle hole.1The potential routes of exposure are thesame for both preparation and administrationof cytotoxic drugs; therefore protectiveequipment must be used by hospitalstaff during drug administration. Recommendedprotective clothing includes along sleeved waterproof gown, two pairsof powder-free latex gloves worn over thegown cuffs, eye protection, and a respiratormask containing a HEPA filter.6 Inorder to lessen the likelihood of accidentalspills and leaks, administration of chemotherapydrugs should be carried out in arelatively low traffic area where there willbe minimal interruptions.Following drug administration, usedsyringes should be disposed of uncappedand needles left in place to minimizeFor Members of the National Association of Veterinary Technicians in America 45

Continuing Educationthe risk of accidental exposure throughneedlestick injuries. Syringes and needlesshould be placed directly into a sturdysharps container that has been specificallyset aside for cytotoxic waste.4 Also,all used IV tubing, gauze, absorbent pads,gowns, and gloves should be sealed inclearly labeled plastic bags. All contaminatedwaste must be disposed of accordingto the hospital’s hazardous wastemanagement plan.6Nursing CareIt is important to note that the hospital staffmembers preparing and administeringcytotoxic drugs are not the only personswho may be exposed to these agents.Kennel staff as well as pet owners andtheir families also incur a significant riskfor exposure. Following a chemotherapytreatment, an animal may excrete toxicdrug metabolites for a period of severaldays. The main route of excretion for thesecompounds is through the urine or feces.2It is therefore imperative that recommendationsbe followed when dealing withpatient bodily waste.Within the hospital setting, the cagesof patients receiving chemotherapy shouldbe clearly labeled with an identificationtag. Feed bowls and bedding should bewashed separately to reduce contaminationof other hospital supplies. It has beensuggested that laundry be washed twicewith regular detergent. Also, gowns andtwo pairs of unpowdered latex glovesshould be worn when cleaning the cagesof animals that have received chemotherapydrugs during the previous 48 hours.4Dogs that have received chemotherapymay also be walked outside in an areaaway from other hospital patients.Hazardous drugs should be prepared aseptically by astaff member wearing personal protective equipment.If an animal is to be discharged shortlyafter treatment, guidelines for safe handlingof patient waste should be clearlycommunicated to the pet owner. Ideally,these guidelines should be in a writtenformat so that the client and his or herfamily can refer to the information at home.The veterinarian should stress the importanceof wearing gloves when cleaningup after the pet, as well as proper handwashingand waste disposal. Some goodadvice to give pet owners, for instance, isto “contain and absorb rather than diluteand distribute pet waste.”4 A follow-upcall by a technician would be a thoughtfulgesture in order to answer any questionsor concerns the client may have.Accidental Exposure and SpillsEven if a small animal practice followssuggested guidelines closely and carriesout chemotherapy treatments withextreme caution, there is always a risk foraccidental exposure. If cytotoxic agentscome into contact with the skin, the areashould be immediately washed with soapand copious amounts of water. If thereis accidental exposure to the eyes, it isrecommended that the eyes be floodedcontinuously for at least five minutes. Dueto the fact that chemotherapy is usuallygiven intravenously, needlestick injuries area concern to the personnel administeringthe drug. In these circumstances, the areashould be washed immediately and bleedingshould be encouraged by squeezing.6Any incident involving a hazardous drugcoming into accidental contact with theskin or mucus membranes should be welldocumented, and medical advice shouldbe sought at the earliest convenience.Any facility using cytotoxic agents on aregular basis should be in possession of acommercial spill kit with clear instructionslocated near drug preparation and administrationareas. If a spill were to occur, personalprotective equipment including a wa-46The NAVTA Journal | Fall 2009

Continuing Educationterproof gown, double latex gloves, splashgoggles, and a respirator are to be wornby the person cleaning. Before decontaminatingthe area, it is necessary to containthe spill. If it is a liquid spill, this may becarried out by a plastic backed absorbentpad. A spill of solid material requires theuse of damp absorbent gauze pads inorder to decrease aerosolization. After thespill is contained, the entire area must bedecontaminated. Household bleach hasbeen suggested as a cost-efficient andsuitable agent for decontamination of anumber of cytotoxic drugs currently usedin companion animal medicine, includingvincristine, carboplatin, and cisplatin.3 It isimportant to note that before any type ofdecontamination is carried out, one shouldconsult the appropriate MSDS informationfor the hazardous drug in question. Followingdecontamination, the spill area shouldbe washed well with detergent and water.Any used cleaning materials should thenbe disposed of in the appropriate “cytotoxicwaste” receptacle.1Chemotherapy Safety in SmallAnimal PracticeA preliminary survey of 13 questions wasdeveloped in order to assess the existenceof chemotherapy safety measures withincompanion animal practice in the UnitedStates. The surveys were sent by electronicmail to 13 board-certified veterinaryoncologists that were offering chemotherapytreatments on a daily basis within theirpractices. The questions were presentedin a “yes/no” and short answer format,and addressed a number of safety issuesconcerning the storage, preparation, andadministration of cytotoxic agents. Nursingcare of chemotherapy patients as wellas client education was addressed. Ofthe13 surveys that were distributed, nineresponses were returned. The resultswere not statistically significant due to asmall sample size. However, the survey dididentify areas of strength and weaknessSample instructions to provide to clientsChemotherapy Safety at HomeWe are happy to tell you that __________________ (name) is ready to return home with you andyour loved ones. __________________ (name) has received chemotherapy today as part of his/her cancer treatment plan, and further treatments may be required in the near future.Chemo drugs: Some things to considerChemotherapy drugs are meant to destroy cancer cells, but they are capable ofharming healthy cells in the process. Chemo drugs are cleared from the body throughthe urine and feces. This occurs for a period of time following each treatment. If healthyhumans and animals are repeatedly exposed to chemotherapy drugs or their breakdownproducts, we can become sick.In order to protect yourself and your loved ones, we recommend that you handle(name) ‘s bodily fluids with care for 2 days following each chemotherapy treatment. Itis important to wear protective gloves when cleaning up urine or feces, or when handlingsoiled bedding or toys. Latex or nitrile gloves may be used and disposed of right away,followed by careful handwashing. It is also a good idea to make sure that any soiledbedding and /or toys are washed separately with plenty of hot water and detergent.Accidents may be safely cleaned up using a household bleach solution (1 part bleachto 10 parts water) while wearing your protective gloves. You may also want to considerwalking __________________ (name) in an area away from other animals during the two daysfollowing his/her chemotherapy treatment.We wish you and __________________ (name) the best during this time. If you have any furtherquestions, please do not hesitate to give us a call. __________________ (name) is a wonderfulpatient, and we look forward to seeing you again!Sincerely,Doctor Name and the staff of __________________ Animal Hospital**Note: If the instructions are for a cat, tips for safe litter box cleaning can besubstituted for dog walking tips.For Members of the National Association of Veterinary Technicians in America 47

Continuing EducationConclusionWhen carried out in a safe manner, chemotherapyis a viable option for certaintypes of cancer seen within the smallanimal practice setting. It is imperative thatanimal hospital employees are properlytrained in the handling of these hazardouscompounds, ensuring guidelines areconsistently followed. Client education onthe hazards of cytotoxic agents in the formof readily available, written materials is alsoparamount. Ongoing education will alsobe necessary for veterinarians as researchuncovers more of the long term effects ofexposure to chemotherapeutic drugs andother cytotoxic agents.If an animal is to be discharged shortly after treatment,guidelines for safe handling of patient waste should beclearly communicated to the pet owner.pertaining to chemotherapy safety in thesmall animal practice setting.The majority of practices surveyed haddedicated refrigerators for the storage ofcytotoxic agents, as well as dedicated areasfor chemotherapy drug administrationsituated away from high-traffic areas ofthe facility. Most practices also containeda biological safety cabinet with a complianthood for the preparation of cytotoxicdrugs. Personal protective equipment (ie.chemotherapy gowns, gloves, and eyeprotection) was offered in all practices,but there was some variation in whichitems were worn in various situations. Forexample, the class of drug being handledsometimes warranted the use of morepersonal protective equipment. Almost allof the practices surveyed had access toa commercial chemotherapy spill kit, andappropriate disposal methods for cytotoxicwaste were in place at most facilities.A few potential areas for improvementwere also identified. Written informationfor clients on the hazards of cytotoxicdrugs was offered in some clinics, but notall. This is extremely important because clientsmay be exposed to drug metabolitesin the bodily secretions of chemotherapypatients for several days following treatment.Written policies for kennel staff andother hospital assistants concerning therisks of coming into contact with cytotoxicwaste should also be made more widelyavailable. Finally, hospital staff memberscan benefit from specialized trainingprograms about handling chemotherapydrugs and cytotoxic waste.References1. Lucroy, M.D. Chemotherapy Safety inVeterinary Practice: Hazardous DrugAdministration. Compendium 2002;24(2):140-1442. Hahn, K.A. & Morrison, W.B. Safety guidelinesfor handling chemotherapeutic drugs.Veterinary Medicine 1991; pp. 1094-1099.3. American Society of Health-SystemPharmacists. ASHP guidelines on handlinghazardous drugs. American Journal ofHealth-System Pharmacists 2006; 63:1172-934. Hayes, A. Safe use of anticancerchemotherapy in small animal practice.Companion Animal Practice 2005; 27:118-27.5. Lucroy, M.D. Chemotherapy Safety inVeterinary Practice: Hazardous DrugPreparation. Compendium 2001;23(10):860-67.6. McKelvey, D. (1999). Safety Handbook forVeterinary Hospital Staff. USA: AAHA Press.48The NAVTA Journal | Fall 2009

Continuing EducationChemotherapy Safety Quiz1. Which is not a short term affect ofexposure to cytotoxic agents?a. Lightheadednessb. Teratogenic affectsc. Headached. Skin Irritation2. How often should gloves bechanged during compounding?a. Every 30 minutesb. Every 60 minutesc. It isn’t a necessary precaution.d. Every 15 minutes3. What should be worn whilecompounding?a. Long sleeve waterproof gownfastened in the backb. Eye protectionc. Shoe and hair coveringd. Respirator (HEPA)e. Unpowdered latex glovesf. All of the above4. How many pairs of unpowderedlatex gloves are suggested to beworn when compounding, administering,and dealing with wastefrom an animal recently exposedto cytotoxic drugs?a. 1 pairb. Gloves are not recommendedc. 4 pairsd. 2 pairs5. What is something that shouldbe done in the case of a needlestickinjury where the syringe has beenexposed to cytotoxic drugs?a. Rinse and stop the bleedingimmediately.b. Rinse well and encourage bleedingby squeezing.c. Clean with an alcohol wipe andallow injury to stop of its own accord.d. Clean with an alcohol wipe and stopthe bleeding immediately.6. What household agent has beensuggested as a cost-efficient andsuitable agent for decontaminationof a number of cytotoxic drugs?a. Laundry Detergentb. Windexc. Hand Sanitizerd. Bleach7. From the oncologist who respondedto the survey in this article, whatsuggested safety procedures weremost board-certified oncologistlacking?a. Proper protective gearb. Proper storagec. Proper client educationd. Proper administration of cytotoxicagents8. Within what time frame areanimals that have been exposedto cytotoxic chemicals still likely toexcrete toxic drugs’ metabolites?a. 48 hoursb. Several daysc. 24 hoursd. 78 hours9. In what ways can accidentalexposure to cytotoxic drugs occurin an occupational setting?a. Preparation of drugsb. Administration of drugsc. Handling of patient wasted. All of the above10. When discharging an animalshortly after treatment, in what waysshould the pet owner be informed?a. Verbal onlyb. Verbal and writtenc. Written onlyd. The pet owner can look it up onlineThis article is worth one creditfrom Kansas State Universityand will be accepted for gradingthrough December 31, 2009. Toreceive credit, either complete thequiz online at www.VetMedTeam.com or complete the hard copyon page 50 and submit per theinstructions.For Members of the National Association of Veterinary Technicians in America 49

Continuing EducationPlease type or print legibly—this is the name that will appear on the letter fromKSU verifying your CE credit. No new letters can be issued if misspellings aremade due to illegible writing.Name:Address:City: State: Zip:Phone:Email:Credit Card (check one): ❏ Visa ❏ MasterCardTotal # of Tests Taken: ___________Card NoName on CardSignatureAmount enclosed: $___________Exp. DateV-code (3 digits on card back)NOTE: CE credit requirements vary from state to state. Check with your accrediting agencyto verify that these CE hours will be accepted.AnswersContinuing education credits areavailable in each issue of TheNAVTA Journal. Credits are issued byKansas State University.To Apply for CE Credit:• You must be a NAVTA memberto receive CE credit.• Send this completed answersheet with $5.00 per article toNAVTA/CE, 50 S. Pickett Street,Suite 110, Alexandria, VA 22304• Questions can also be answeredonline at VetMedTeam.com.Select “course catalog” from menuand then click on NAVTA OnlineExam Portal.• Make check payable in U.S. fundsto NAVTA OR Fax the completedtest with your credit card informationto 202-449-8560• Answer the questions on thechosen article• Choose only one answer foreach question• Mark your choice for each question in INK• All questions must be answered correctly toreceive the CE credit• There will be no refund of fees for thearticle if 10/10 questions are notanswered correctly• Letters verifying the amount of CE creditearned will be issued by Kansas State Universityand forwarded to the above address• Please allow 8 weeks for processingArticle 1: Optimum Nutrition for Iguanas(1 credit)1. a b c d2. a b c d3. a b c d4. a b c d5. a b c d6. a b c d7. a b c d8. a b c d9. a b c d10. a b c dArticle 3: PRRS(1 credit)1. a b c d2. a b c d3. a b c d4. a b c d5. a b c d6. a b c d7. a b c d8. a b c d9. a b c d10. a b c dArticle 2: Parenteral Nutrition(1 credit)1. a b c d2. a b c d3. a b c d4. a b c d5. a b c d6. a b c d7. a b c d8. a b c d9. a b c d10. a b c dArticle 4: Chemotherapy(1 credit)1. a b c d2. a b c d3. a b c d4. a b c d5. a b c d6. a b c d7. a b c d8. a b c d9. a b c d10. a b c d50The NAVTA Journal | Fall 2009

NewsVetMedTeamUpcoming CEVetMedTeam offers a series of free RACEapproved courses in multiple topics. Freecourses begin the 1st and 15th of every monthand address topics, such as fecal diagnostics,immunology, dentistry, zoonotic diseases,pain management and more.VetMedTeam hosts the NAVTA Online ExamPortal. Via the Portal NAVTA members areable to take article examinations online.Our upcoming fee-based courses:October 1 – Basic Principles of Endocrinology; BasicPrinciples of Pharmacology; Finance: Cash vs. Accrual& Accts Payable and ReceivableOctober 15 – Basic Principles of Emergency Response;Basic Principles of Hematology; Advanced Conceptsin Abdominal Radiology; OSHA: The Safety Officer;Beyond Customer Service;November 1 – Developing Puppy and KittenKindergarten; Basic Principles of Surgical Assisting;Advanced Concepts in Veterinary Anesthesia;November 15 – Basic Principles of UrinalysisDecember 1 – Basic Principles of OSHA ComplianceEnjoy the holiday season and we will seeyou at the 2010 North American VeterinaryConference!Diary, continued from page 9period of time and then settled in on a lecture about BART, an organizationthat trains rescue personnel on resuscitating animals andsafely moving them out of harm’s way. This lecture was so interestingand uplifting, it settled my nerves and made me eager to learn aboutthe different topics many veterinary professionals came to teach andfelt passionate about. The remainder of my time spent at the conferencewas spent learning about lots of diverse and important aspectsof the veterinary technician profession that I have chosen to becomepart of. I was able to meet many influential people in the industryand became even more excited to start my career. After four dayslistening to all kinds of speakers and lectures, I flew home to Bostonas sure as ever that I was headed down the right career path. Iencourage every veterinary technician student to attend at least oneof these conferences, not only to learn about the different careerchoices you have with your veterinary technician degree, but to getexcited about the technician world you are about to enter into.For Members of the National Association of Veterinary Technicians in America 51

Case study1Ulnar-CarpalArthrodesis:Corrective SurgeryFor A SevereThoracic LimbDeformityby Jessica Comolli, LVTThe author is a graduate of Tri-County Technical Collegeand recently became a Licensed Veterinary Technician in theState of South Carolina.Figure 1: Simon was supported on his hind limbs with a harness.Simon, a two year old , male neutered,Pit Bull Terrier was referred to CascadeVeterinary Referral Center (CVRC) forbilateral thoracic limb deformities thathad been obvious since he was a puppy.He was a very active inside dog that wasambulating by bearing his weight on acallus that had developed on the carpusof his right front limb. His owner helpedhim move about on his hind limbs by supportinghis upper body with a harness(Figure 1). Simon did not use his leftthoracic limb at all.52Physical examination revealed thatSimon was bright, alert, and responsive,and that he was adequately hydrated.His heart rate was normal (130 bpm)with adequate pulses and no murmurs.His temperature was normal (102.0°F),and his mucous membranes were pinkwith a capillary refill time of one second.He was panting and his lungs were clearupon auscultation. Visual assessment ofhis thoracic limbs revealed marked elbowand antebrachial deformities with rotationalmalalignment of the distal limbs(Figure 2).Radiographs of Simon’s thoracic limbsdepicted bilateral radial hemimelia, orabsence of the radius in both limbs. 1The radiograph of his right limb disclosedcomplete radial aplasia with a shortenedulnar deformity, as well as an ankylosingelbow and a supination deformity ofthe paw (Figure 3). It appeared to havereasonable bony length to possibly allowweight bearing with more proper alignment.Corrective surgery involving anulnar-carpal arthrodesis was suggestedto the client, and possible complicationsincluding implant failure, vascular or nervecompromise, infection, disuse of limb, andfailure to fuse were acknowledged.Simon presented to CVRC four weekslater for corrective surgery of his right thoraciclimb deformity. His pre-surgery temperaturewas normal (102.3°F); his heartrate was normal (120 bpm); and he waspanting. His mucous membranes wereThe NAVTA Journal | Fall 2009pink with a capillary refill time of one second.He was pre-medicated with 0.48ml(0.96mg) hydromorphone subcutaneously.A 20 gauge catheter was placed in hisright saphenous vein and he was inducedwith .90ml (90mg) ketamine and 2mlFigure 2: Simon had marked deformities of thedistal limbs.2

Case Study3 4 5Figure 3: Pre-operative radiographs revealed complete radial hemimelia and a shortened ulnar deformity. Figure 4: Simon was intubated and prepped for surgeryFigure 5: The distal ulna and the artiular cartilage were rongeured before ESF placement.(10mg) diazepam. He was then intubatedwith a size 10 cuffed endotracheal tube(Figure 4). Anesthesia was maintainedwith isoflurane for a total duration of fourhours. He received Normosol ® -R at a rateof 215 ml/hour intravenously throughoutthe procedure.The right thoracic limb was shaved andprepped with chlorhexidine scrub andalcohol. Monitoring equipment includedan electrocardiograph, an indirect bloodpressure monitor, a pulse oximeter, anda capnograph. Three doses of 4.3ml(430mg) cefazolin and a second dose of0.48ml (0.96mg) hydromorphone wasslowly given intravenously during theprocedure.The initial incision was made through alateral approach to the distal ulna continuingdorsally to the carpal/metacarpalregion. There was moderate-markedbleeding encountered intermittently duringthe dissection. Difficulty exposing theulna, carpus, and metacarpal bones wasnoted due to the severity of the deformity.The orientation of the blood vessels andtendons were abnormal, and excessivefibrous tissue was present. The distalulna was rongeured and a vestigial smallcarpal bone was removed to allow forreduction and realignment of the distallimb. Corticocancellous bone fragmentswere saved for later grafting. The articularcartilage between the carpal bonesand the ulna was rongeured to permitfusion of the bones, and a type 2 externalskeletal fixator (ESF) was applied withtwo full pins and one half pin in the ulna,one full pin in the carpus, and four halfpins in the metacarpus (Figures 5-7).Difficulty achieving optimal alignment wasencountered and slight external rotationpersisted, despite a significant amount ofscar tissue release and dissection. Thesurgical site was lavaged with warmedsaline solution and the previously savedbone autograft was applied to the ulnarcarpalfusion site. The large fibrous callusfrom the previous weight-bearing surfaceat the distal end of the ulna was excised,while preserving the overlying skin forclosure. A Jackson-Pratt (JP) continuoussuction drain was placed in the palmararea, and all layers were closed with 3-0Monocryl suture (Figure 8).Prior to Simon’s recovery from anesthesia,he was given a third dose of 0.48ml(0.96mg) hydromorphone intravenouslyfor pain, and post-operative radiographswere taken (Figures 9-10). Upon extubation,his IV flow rate was reduced to 50ml/hour of Normosol ® -R, and a morphineconstant rate infusion at 0.1 mg/kg/hourwas started. Later that evening, Simonwas moving about his cage. Canned foodwas offered, but he showed no interestin eating. Four hours after surgery, warmcompresses were applied to the operatedlimb. Simon began to vocalize, and afourth dose of 0.48ml (0.96mg) hydromorphonewas given intravenously for pain.His JP drain, which was being expressedevery 30 minutes, was nonproductive untilseven hours post surgery when 17 mlof fluid were removed. Simon’s appetitereturned the next morning. Physicalexamination revealed a moderate amountof soft swelling in the foot. The digits werewarm with good sensation, and the ESFwas stable. More warm compresses wereapplied and his foot was massaged forten minutes to encourage circulation. TheFigure 6: A type 2 ESF was applied6For Members of the National Association of Veterinary Technicians in America 53

Case StudyCorrective Surgery Case Study, continued7 8Figure 7: Two full pins and one half pin wereplaced in the ulna, one full pin in the carpus, andfour half pins in the metacarpus.Figure 8: A JP drain was placed.JP drain was pulled, as it was no longerproductive, and external coaptation (asplint bandage) was applied to the limb foradditional protection.Simon was discharged to go home thatafternoon with an Elizabethan collar andmedications that were to be given at home(Figure 11). These included carprofentablets 50mg PO BID as needed forpain; tramadol tablets 50mg PO TID asneeded for pain; and cephalexin 500mgPO BID, which he was to continue takingthroughout his recovery period to helpprevent possible infection. His ownerswere instructed to keep him strictlyconfined for 6-8 weeks during which theyshould also monitor his fixator pins andwatch for excessive drainage, swelling, orcolor change. They were also encouragedto continue the warm compresses andto massage the foot as much as the dogwould allow. The owners called the nextday reporting that Simon was eating anddrinking without any problems, but wereconcerned that the dog was in pain, especiallywhen his foot was being massaged.The dosage of tramadol was increased to100mg TID and acepromazine (12.5mgTID as needed for sedation) was alsoprescribed.were cleaned with diluted chlorexadinescrub in warm saline and a new splint bandagewas placed. A significant decreasein swelling was noted three weeks aftersurgery, and swelling was absent fourweeks after surgery.Six weeks after surgery, Simon returnedto CVRC for a re-check examination andpost- operative radiographs. A slightdischarge coming from a small ulcer thathad appeared distal to the previous footpad was noted. There was also a mildserosanguineous discharge coming fromthe dorsal mid-incision. Sensation in thelimb was present, and there was no significantdischarge in the pin insertion sites.Prior to having craniocaudal and lateralradiographs taken of his right forelimb,0.5ml (1mg) hydromorphone and 0.02ml(0.2mg) acepromazine were administeredintravenously. The radiographs revealedcallus bridging in the lateral aspect of theulnar-carpal site, and when compared toimmediate post surgical radiographs, theapparatus, apposition, and alignment wereFigure 9 & 10: Post-op craniocaudal and lateral radiographs were taken of the front right limb.910Simon returned weekly for re-checkappointments during which his operatedlimb was cleaned and his bandagewas changed. He was sedated with0.5ml (1mg) hydromorphone and 0.05ml(0.5mg) acepromazine intravenously priorto bandage removal. The pins and skin54The NAVTA Journal | Fall 2009

Case Study11Figure 11: Simon was sent home with an e-collar.static. Simon’s owners were instructedto begin allowing slight controlled use ofhis operated limb. His prescription forCephalexin was increased to 750 mg BID,and he was to continue returning to theclinic for his weekly cleanings/bandagechanges.Seven weeks post surgery, Simon wasbeginning to use his operated limb, andby eight weeks he was using it for ambulation.Slight discharge in the medialproximalsecond pin insertion site wasnoted on the ninth week after surgery. Tenweeks after surgery, Simon presented tothe clinic for additional radiographs andpossible ESF removal. Physical examinationrevealed normal vital signs. Slightdischarge in the medial-proximal third pininsertion site was noted, and the small ulcerdistal to the previous pad continued toemit a slight discharge. He was sedatedwith 0.13ml Domitor ® intravenously priorto having craniocaudal and lateral radiographstaken of his right forelimb (Figures12-13). The radiographs revealedcontinued callus bridging in the lateralaspect of the ulnar-carpal site, which wasmore noticeable in the craniocaudal views.In comparison to immediate post surgicalradiographs, apposition, alignment, andthe apparatus remained static with somelucency around the distal pins. 0.49ml(0.97mg) hydromorphone was then givenintravenously for ESF dynamization whichwas achieved by removing the third fullpin, one proximal half pin, and one distalhalf pin. The bandage/splint was reappliedand sedation was reversed with0.13ml Antisedan ® intramuscularly. Theowners were advised to continue confinementand controlled walks.Simon was reluctant to use his operatedlimb after falling the morning of his11 week post-operative re-check. Duringphysical examination, it was noted that thesmall ulcer distal to the previous pad wascompletely healed, and there was a slightdischarge coming from the most distal pininsertion site. The next week Simon wasdoing well and using the operated limbin ambulation again. The most distal pinwas loose and therefore removed. Thesite was cleaned and a new bandage wasplaced; this time without a hard splint.Thirteen weeks after surgery, Simon presentedto the clinic for additional progressradiographs and possible ESF removal.He was given 0.96ml (0.48mg) hydromorphoneintravenously prior to receivingcraniocaudal and lateral radiographsof his operated limb. The radiographsrevealed incomplete bony healing. WithFigure 12 & 13: 10 week post-op craniocaudal and lateral radiographs were taken of the front right limb.1213For Members of the National Association of Veterinary Technicians in America 55

Case StudyCorrective Surgery Case Study, continued1417indicated. Simon’s owners were advisedto take him on controlled short walks andfurther encourage him to use his operatedlimb. A recheck appointment in 6-8 weekswas recommended unless deterioration infunction was noted.Figure 14: The ESF was removed 13 weeks after surgery. Figure 17: Simon is now using his front rightlimb to walk.the distal aspect of the ESF no longereffective in providing significant stability,it was removed from the operated limb(Figure 14). 0.25ml Domitor ® was givenintravenously for sedation prior to removal.A palmar splint/bandage was applied andthe sedation was reversed with 0.25mlAntisedan ® intramuscularly.Simon was reluctant to bear weighton his operated limb after removal of theESF. His owners had removed his splintbandagethree days prior to his scheduledre-check due to the limb appearingswollen and irritated. Seventeen weeksafter surgery, Simon’s elbow had limitedrange of motion and there was very slightmotion at the level of the carpus, suggestingpseudoarthrosis. His radiographsshowed static apposition and alignmentand an incomplete ulnar-carpal interface(Figures 15 & 16). The importance oftraining Simon to use his operated limb inorder to further strengthen its support wasSimon returned to the clinic for a recheckexamination 28 weeks after correctivesurgery of his right thoracic limb deformity.His owner stated that he has beenconsistently utilizing the operated limb forsupport and is progressively getting betterat using it in ambulation (Figure 17). Althoughsome complications did arise fromSimon’s surgery, the functional outcomewas good. His right limb, which wasonce being dragged across the ground,is now supporting the weight of his bodyin a tripedal stance, allowing him to moveabout quite efficiently. Simon is currentlyreturning for recheck exams every six totwelve months to monitor his improvement.References1. Saunders Comprehensive Veterinary Dictionary.3rd ed. Philadelphia: Saunders Ltd., 2006.1516Figure 15 & 16:17 week post-opcraniocaudal and lateralradiographs were takenof the front right limb.56The NAVTA Journal | Fall 2009

In today's economy when every penny counts, it is important to educate your clients about which services are critical for their pet.Microchipping pets is money well spent.Shelters are understaffed and overcrowded, so lost pets can only be kept for a short period of time. It is critical to have yourpets identified to facilitate their quick return and microchipping is the best way to identify them. Everywhere your pet goes, themicrochip is there … real protection that can't fade or fall off. Your belief and recommendations are welcomed by your clients.Please discuss microchipping with them. It really does save pets lives!Consider Facebook, Twitter, newsletters, email or letters (ask“How would you like to be contacted?”) to educate clients onthe following:• Microchips are a one-time lifesaving gift for pets …consider a “Chip & Weigh Event”• One-time national microchip registration with correctinfo and ID tags are important• Microchipping is as important as all your other preventivemedicine recommendation• Consider a clinic-sponsored dog wash or open houseas an opportunity to educate your clients, or try a“Chip & Snip” campaign.Over 75% of pet owners consider their pets as family. Yourrecommendations are important so please recommendmicrochipping … it could save their pet's life.Special Advertising SectionCaring For Pets When Every Penny CountsPhotos submitted by an Avid customer. Daisy, theirAustralian Shepherd, is a healthy, happy microchipped pet.ad indexAlley Cat Allies.....................................61Avid.............................................................57Eli Lilly ...........................................10, 12Hills.................................Back CoverMerial.............................................................2National Vet Tech Week ................63NAVC ............................................................5NAVTA Call For Authors.................58St. Petersburg......................................14VetMed Team........................................51VSPN ........................................................59Wild West Vet Conf ............................17Advertising SalesIf you are interested inadvertising in The NAVTAJournal, or would like torequest an Advertising SalesKit, please contact:Sandy Sponaugle,Communications Directorsandy@navta.netMailing Address50 S. Pickett StreetSuite 110Alexandria, VA 22304phone: 703.740.8737 x102fax: 202.449.8560For Members of the National Association of Veterinary Technicians in America 57

SEE YOUR ARTICLE IN PRINT!Do you have experience in a particular disease or procedure? Have youparticipated in an interesting case that could be a learning experience forothers? Do you have special expertise that you’d like to share with yourfellow NAVTA members? No matter the subject, we would love to includeyour articles and photos in The NAVTA Journal. Each quarterly journalcontains several general articles and four Continuing Education articlesthat can be used to earn CE credits through Kansas State University.NAVTAJOURNALTHEin this issue…Remembering BarbaroAmerican Associationof Equine VeterinaryTechnicians and AssistantsNestlé Purina – HelpingGastrointestinal ConcernsBlood Gas AnalysisNAVTAJOURNALTHEin this issue…Spring 2009For Members of the National Association of Veterinary Technicians in AmericaFor Members of the National Association of Veterinary Technicians in AmericaSuccessful Dental HomecareAcademy of VeterinaryDental TechniciansWays to Celebrate NVTW2009 Convention IssueCompliments of Hill’s Pet NutritionGuidelines for CE articles 2500-3000 words 10 multiple choice questions andanswers for CE quiz minimum of two references cannot have been published in anyother trade publication authors must have recognized expertisein subject matterPhoto Guidelines minimum of 300 dpi digital photos onlyVisit navta.net for full guidelines.Case StudyOn occasion, a Case Study will be includedin the issue. The Case Study depicts an unusualor extraordinary case that a veterinarytechnician was involved with.Guidelines for Case Studies 600-750 words, depending on numberof photos photos must be used to illustrate points technical information on symptoms,laboratory tests, surgery and outcomesmust be included with the studyGeneral Editorial DeadlinesWinter 2009 10/16/2009Spring 2010 01/15/2010Summer 2009 04/16/2009Fall 2010 07/16/2010Continuing Education articles are due 6-8months in advance.For more information about submittinga general editorial article, CE articleor Case Study, contact Sandy Sponaugleat sandy@navta.net. The Editor reservesthe right to edit articles and print articlesin the issue of her choice, based on spaceavailability and editorial focus.

NewsVSPN Fall 2009Continuing EducationWhat is VSPN?The Veterinary Support Personnel Network is for veterinary support staffworking with, for, or in the field of veterinary medicine, under the directionof a licensed veterinarian. VSPN offers to its members high-quality educationalcourses in a cooperative effort with VIN (Veterinary InformationNetwork). Courses are held online and are taught by specialists in the field.Oct. 4, 2009 - Dec. 20, 2009DIAG207-1009:Quality Management for theVeterinary Clinical PathologyLaboratory, Part II9 CE CreditsOct. 12-Nov. 16, 2009TECH125-1009:Transfusion Medicine6 CE hoursOct. 14-Nov. 6, 2009TECH155-1009: ReptileHematology3 CE hoursOct. 27-Nov. 25, 2009STAF116-1009: VA Module 3:Overview of Diagnostic Procedures4.5 CE hoursOct. 28, 2009 - Nov. 11, 2009EXOT311-1009:Avian Anatomy and Physiology4 CE CreditsOct. 28-Dec. 4, 2009TECH160-1009:Large Animal Parasitology6 CE hoursOct. 29-Nov. 28, 2009STAF111-1009: Challenges Facingthe Front Desk Module 24.5 CE hoursNov. 2, 2009-January 20, 2010TECH120-1109: PracticalReview for Veterinary Technicians:VTNE Preparation Class12 CE HoursNov. 9-Dec. 1, 2009TECH168-1109:Reptile Parasitology3 CE hoursNov. 17, 2009 - Dec. 1, 2009EXOT312-1109: Avian Handling,Restraint and Behavior4 CE CreditsNov. 23-Dec. 31, 2009STAF121-1109: VeterinaryMedical Terminology4 CE hoursNov. 24-Dec. 23, 2009STAF117-1109: VA Module 4:Basic Concepts of Anesthesia,Elective Surgery, and EmergencyMedicine4.5 CE hoursFor Members of the National Association of Veterinary Technicians in America 59

upcoming eventsCalendar of EventsOctober 11 – Vermont VeterinaryTechnician Association CE Meetingwith a focus on cytology [vtvets.org]October 14-18 – Wild WestVeterinary Conference in Reno,Nevada, with four Core Modules,lectures and workshops for VeterinaryTechnicians [wildwestvc.com]October 17-18 – CanineAggression CE Event in Atlanta,Georgia, with 13 CE credits available[northcoastdogs.com]October 18 – Angell-BostonAnnual Seminar for VeterinaryTechnicians, worth 6 CE credits[mspca.org/techseminar]November 7 – AlabamaVeterinary Technician AssociationCE Conference in Birmingham,Alabama, with eight hours of CEoffered [alabamavettech.com]November 8-12 – 60th AnnualAALAS National Meeting in Denver,Colorado [nationalmeeting.aalas.org]October 17-18 – TennesseeVeterinary Technician AssociationContinuing Education Program inGatlinburg, Tennessee [tnvta.org]Celebrate!National VeterinaryTechnician WeekOctober 11-17, 2009The annual celebration of VeterinaryTechnicians from around the world!For fundraising, awareness, andprofessional development ideassurrounding National VeterinaryTechnician Week, turn to page 62.Veterinary Technicians—Linkingthe Veterinary Healthcare Team!For more information, visit navta.net.Sponsored byOctober 20-23 – InternationalSociety for Anthrozoology 18thAnnual Conference in Kansas City,Missouri [rechai.missouri.edu]October 21-25 – Association ofPet Dog Trainers Annual Conferenceand Trade Show in San Francisco,California [apdt.com]October 22-25 - Research Centerfor Human-Animal Interaction1st Human Animal InteractionConference in Kansas City, Missouri[rechai.missouri.edu]November 4 – DC Academy ofVeterinary Medicine Technician’sProgram in Behavior in Fairfax, Virginia[dcavm.org]November 6-7 –North Carolina VeterinaryConference in Raleigh, North Carolina,featuring a Veterinary Technicians track[ncveterinaryconference.com]November 6-9 – CVC San Diego,offering 48 technician-specific seminars[cvcwest.com]November 13-15 – SaskatchewanAssociation of Veterinary TechniciansAnnual Conference [savt.ca]December 6 – Tufts UniversityCummings School of VeterinaryMedicine Internal Medicine CEin North Grafton, Massachusetts[tufts.edu/vet/ce]January 16-20 – NAVCConference in Orlando, Florida,featuring a comprehensive VeterinaryTechnician program with hands-onlaboratories [tnavc.org]Please visit www.navta.net and clickCalendar of Events for additional detailsand direct links to the event websites.All events listed have been submittedto our online calendar of events ande-newsletter. If you would like to add anevent, please contact Sandy Sponaugleat sandy@navta.net.60The NAVTA Journal | Fall 2009

NAVTA 2010ElectionsNAVTA NewsIt’s time for the 2010 NAVTA Executive Board elections.Positions available beginning in January 2010 include:President-Elect, Treasurer, and Member-At-Large (two year).Below are descriptions of these positions and the nominees.President ElectTerm would begin in 2010 with succession to the office ofPresident in 2011 and Past President in 2012. Nominees haveexperience with previous association officer or committee chairpositions (either with a state association or with NAVTA), publicspeaking, group dynamics, teamwork, and leadership.Nominees:Julie Legred, CVT, Bricelyn, MNTracey Nowers, CVT, Athol, MARebecca Rose, CVT, Gunnison, COTreasurerTwo year term. Nominees have experience with financialaccounting review and are able to make recommendationson the monetary affairs of the association.Nominees:Julie Urban, LVT, Mount Vernon, WAMember At LargeOne year term. Nominees must be willing to advocate and workfor the veterinary technician profession.Nominees:Jennifer Limon, MA, BAS, RVT, Hammond, LADennis K. Lopez, M.Ed., LVT, Las Vegas, NVShalom Milani, BS, CVT, VTS (ECC, SAIM), East Greenwich, RIVicky Orgrain, MBA, RVT, Topeka, KSAmy Weiss, LVMT, CAHT, Hixson, TNBallots were mailed to NAVTA members in mid-September.If you have not yet received yours, please contactus as info@navta.net.She’s Not Your Average Client.Feral cat protocols available at alleycat.org/Veterinarian.WWW.ALLEYCAT.ORGEducation Advocacy ActionKansas Veterinary TechnicianAssociationKVTA has been very busy in the last few months.Membership numbers have doubled and continue togrow; which is very exciting news for the current boardmembers! KVTA has upgraded the website and also hasplans for a Facebook page. Our President, Kara Burns,is excited with the changes to the organization and looksforward to hearing from the technicians in Kansas regardingwhat KVTA can do for them.KVTA was very fortunate to have three Executive Boardmembers and one active member attend the NAVTALeadership Conference held at the Central VeterinaryConference in Kansas City in August. KVTA PresidentKara Burns, MS, MEd, LVT; NAVTA Liaison Bridget Keesling,BA, RVT; KVTA Secretary/Treasurer Cheryl Hermann,BA, RVT; and Mary Berg, BS, RVT, VTS (Dentistry) allparticipated in a very motivational lecture given by RickGrandinetti.Upcoming CE opportunity in Colby, Kansas is scheduledfor October 2, 2009.Bridget Keesling, BA, RVTKansas Representativekvta.netFor Members of the National Association of Veterinary Technicians in America 61

NVTWWays to celebrateNational Veterinary Technician WeekOctober 11-17, 2009We want each of our members to get the most out of National Veterinary Technician Week. In order to generateawareness about animals’ veterinary needs, we came up with a few ideas that could either be used in a clinicalsetting, through a local SCNAVTA chapter, or both. We hope you will find these suggestions fun and helpful (andpossibly even lucrative as a fundraiser for your SCNAVTA Chapter or a local nonprofit.)Feel free to use these ideas in whatever way you can, or come up with your own. If you do come up with a greatidea, we would love to hear about it!Fundraising andAwareness:• Have a “Dog Wash”A spin on the traditional car washfundraiser. Invite dog owners to bringtheir pooches in to get shampooed for adonation.• Pet Spa DayPamper your pup with grooming, massageand even a Mani/Pedi!• Canine Kissing BoothGive a buck for a “Pooch Smooch.”• Gift BasketsSell gift baskets geared toward differentpets, like apples and carrots for horses,catnip and cat treats for kitties, and dogtreats and raw-hide bones for dogs.• Pet Photo ShootGet the local high school’s photographyclub to take pictures of pretty pets andsplit the donations.• Horseback RidesAn oldie but a goodie.• Organize a Dog Walk-a-Thon and getsponsors, or just get a group of friendsand neighbors together for a communitydog walk.• “Take Your Pet to Work Day”Talk to your office and see if they’d bewilling to allow pets to join the workforcefor a day.• Throw a Pet Birthday Party (or maybean Un-birthday party) and serve petfriendly goodies.• Arrange to have a Pet Parade so proudpet parents can show off.Professional Development:• Conduct client workshops to help petowners manage a difficult dog, workthrough pet sibling rivalry, or just providegeneral useful information about pethealth.• Partner with other clinics in the area tohave a seminar or launch continuingeducation initiatives.• Invite a speaker to address the mostcurrent clinical advances.• Arrange to have your own in-houseexperts share their knowledge with coworkers.“Take Your Pet to Work Day”—Just one of the many great ways to celebrate NVTW!62The NAVTA Journal | Fall 2009

Celebrate!N1A4VTA8AVMAA1023S O L U T I O N SE5E T E R I N A R I A N SE6DC W E L L N E S S7H T RN E SN I M A L H9C M H I L L SI PANS S I S T A N T SAcross2. NAVTA provides _____________4. Part of the veterinary healthcare team6. Complete animal care8. A companion and friend9. Sponsor of National VeterinaryTechnician Week10. Support for Veterinary TechniciansDown1. Organization that promotes animalwellness through our members3. A trait all NAVTA members possess5. Linking the veterinary healthcare team7. Made up of Vets, Technicians and Assistants8. Organization that advances the veterinarymedical professionVeterinary Technicians –Linking the VeterinaryHealthcare TeamNAVTA presents:National Veterinary Technician WeekSponsored byOctober 11-17, 2009www.navta.net

N U T R I G E N O M I C SClinical studies show that themetabolic profile for overweightdogs is different from that oflean dogs 1Change his future bychanging his metabolismThe nutrition in Hill’s ® Prescription Diet ® r/d ®changes a pet’s metabolism from fat storingto fat burning■ Overweight dogs fed Hill’s ® Prescription Diet ® r/d ® Canine Dry petfood lost weight and their metabolic profile shifted from “fat storing”to more closely resemble the “fat burning” profile of lean dogs 2■ Hill’s ® Prescription Diet ® r/d ® Canine Dry pet food is clinically provennutrition that reduces body fat by 22% in two months 3OverweightdogsOverweight dogsafter eating Hill’s ®Prescription Diet ® r/d ®LeandogsUp-regulated gene expressionDown-regulated gene expressionFor more information call Hill’sVeterinary Consultation Service (VCS)at 1-800-548-VETS (8387) or contactyour Hill’s Territory Manager.1Yamka RM, Friesen KG, Al-Murrani S, et al. Identification of genesrelated to obesity in dogs. FASEB J 2007;21(5):28.4(A4).2Yamka RM, Friesen KG, Gao X, et al. The effects of weight loss ongene expression in dogs. J Vet Intern Med 2008;22:741 (Abstract).3Data on file. Hill’s Pet Nutrition, Inc.®/ Trademarks owned by Hill’s Pet Nutrition, Inc. ©2009 Hill’s Pet Nutrition, Inc.