Now YOU Can Choose the Best Veterinary Lighting for Your Surgery Room

When it comes to surgeries, good lighting is crucial.

Without good quality light, it can be hard to see all the details of what you’re working on, whether that’s a spay, a wound repair, and abdominal exploratory, or anything else.

Dim or subpar lighting can make you strain your eyes while trying to place or tie your sutures. And, adequate lighting is important to accurately note the color, texture, and general appearance of tissues for your medical record—that way, nothing gets missed.

Not to mention, good visualization of your field of work keeps you from craning your neck to see better—which can be helpful for your posture and for preventing aches and pains from hunching over. 

Maybe you already understand the importance of good surgical lighting—but did you realize how affordable it is?

In the past, LED lights have been very expensive compared to halogen bulbs—and maybe that seemed cost-prohibitive.

However, new lights are available at 30-40% less (and that includes a better warranty, too).

So, considering the energy efficiency and performance of LED lights, there’s really no competition—affordable, high-quality LEDs are a great investment for your practice.

Plus, many cities, counties, states, and even electric power companies offer rebates for upgrading to LED lights, due to the decrease in power used.

Specific requirements for rebates vary by location—so be sure to check with your local municipality and utility providers to see what’s available in your area. Because it’s always great to get a cash rebate that can help cover the cost of your upgrades!

So, how do you choose the right surgical light?

When it comes to selecting the best surgical light, there are many things to consider…

• Affordability. LED lights are much more affordable now than they used to be, so shop around and be sure you’re getting a good deal (be sure to compare all the other factors on this list, too).

• Quality. Look for dependability, durability, and a good-value warranty to back up your investment.

• Range of lighting brightness, including high-intensity light, and dimming options to use as needed.

• Adjustable. The light pattern can be adjusted from a smaller, focused pattern, to a larger area of coverage, depending on your needs.

• Precision positioning. You should be able to adjust the entire head and arm of the light, and know it will stay precisely where you put it (we recommend limitless arm rotation and a drift-free design that moves easily when you adjust it, but then stays put where you want it).

• Easy to clean (and sterilizable handles are a plus).

• User-friendly, with dimming and focusing controls on or near the handle.

• Shadow-free illumination—or at least a design that minimizes shadows as much as possible.

• Mounting options that match the layout of your surgery room or suite.

What’s our recommendation?

We recommend the new Burton veterinary LED surgery light.

Why? Because this light checks all the criteria above. Plus, it has a dependable LED, is assembled in the USA, and is backed by an industry-leading 5-year warranty.

At a competitive price point that optimizes design, performance, and value, it’s pretty hard to pass up!

Is a Burton light right for you?

When it comes to investing in new equipment for your practice, maybe the lighting isn’t always the first thing on your mind…

However, surgical lighting is something you use many times every week—maybe even several times per day, depending on the nature of your practice.

That’s probably more often than you use some of the other equipment in your hospital.

So, be sure not to overlook this crucial piece of equipment. You may be surprised how better lighting can make your time in the surgery suite more comfortable and efficient.

Sell Your Used Veterinary Equipment On A Community Website

Sell Your Used Veterinary Equipment

Welcome to the other half of our series on buying and selling your used equipment on usedvetequipment.com.

If you’re looking to sell some of your equipment, you’re not alone. There are many reasons why you might pursue this option as a veterinarian…

Maybe that new in-house chemistry analyzer or the extra kennels you purchased didn’t get used as much as you expected—and you’re not seeing the return on investment you wanted… 

Maybe you want to upgrade, but you aren’t sure what to do with your current equipment. Or, maybe times are tight and you need to increase your cashflow.

Whatever your reason, selling your used veterinary equipment can put some cash in your pocket, while also helping out a fellow member of the veterinary community who needs the machine, gadget, or gear you’re selling. 

If that sounds great to you and you’re ready to get started, we recommend visiting usedvetequipment.com. Here’s why…

• List Anything! Whether you’re looking to sell an ophthalmoscope, an autoclave, an x-ray processor, or a vehicle… there’s no item too large or too small. 

• Set Your Own Price. You choose how much you’d like to sell for, and you can accept or reject any offer that comes your way. 

• We’re Here to Help. We’ve done this thousand of times—so no matter what you need to ship, we can help you with logistics and also ensure prompt payment from your buyer.

Since this is a community-based platform, you’ll find interactions to be secure, reliable, and honest.

• Affordable. There’s no cost to you to list your equipment (including unlimited photos and videos to showcase your items), and no time limit in which to sell.

• Good for Animals and the Environment. Reusing and repurposing equipment is not only a great way for the veterinary community to share resources to improve animal care everywhere—but it can also help keep materials out of landfills.

• Stellar Service. Just check the site, and you’ll find reviews from tons of happy buyers and sellers! Like this one below…

“I can’t say enough about the great job Brad did in selling our cages and floor grates. It was quick and everyone is happy. Brad found the right buyers and made all the arrangements. I highly recommend this website.”

—JS in NY

Selling is simple on usedvetequipment.com. But, we also have some tips to help you get the most success out of your listing.

For the most success when you sell your equipment, be sure to include…

• Pictures! You can include as many pictures as you’d like to on your listing, and video if that will help to show your item. 

Images will help your equipment sell—and most smartphones are perfectly capable of producing the high-quality photos you need.

Try photographing from different angles, cleaning the items before you take pictures, and removing any distracting clutter from your shot so the focus is solely on the equipment you’re selling.

• Detailed Descriptions. Include all relevant details about the brand name, manufacture date, current condition, size and weight, the reason for selling, etc. 

Also, let potential buyers know how the item has helped you in your daily practice—and how it can help them.

• A Smart Pricing Strategy. Sometimes, pricing used equipment appropriately can be difficult—you know there will be some depreciation, but what’s a fair price?

The easiest way to get a starting point is to research similar items that have recently sold.

And, if you’re hoping to sell fast—it helps to go a little under the going rate or to include shipping in your price.

And that’s it! Once your equipment is listed on usedvetequipment.com, you can easily connect with colleagues who are interested in buying.

With each sale, that’s money you can invest back into your practice for expanding, upgrading, marketing, or compensating your amazing team members.

Plus, you’d be helping out a fellow practitioner in the veterinary community—someone who really wants the equipment you don’t need anymore. It’s a win-win for both of you.

Good luck, and happy selling! 

“I had an entire Veterinary Clinic of items to sell and Brad sold them all! He is diligent in getting items sold and payment is speedy. Brad and UsedVetEquipment.com are The Best!”

—S.F. in Colorado

“Brad was able to sell my cages within a week of posting the items. He had great communication and payment was prompt. I will list my items with him again.”

—Wes Godwin - Texas

Written by: Dr. Tammy Powell, DVM

Veterinary Equipment Considerations for Non-Profits

Non-profit veterinary practices can encompass a variety of different business models, each with its own unique equipment needs and purchasing considerations. 

Here are some things to think about when planning a new non-profit or purchasing equipment for an existing non-profit organization.

Wish List

Some not-for-profit clinics help pet owners of limited financial means with basic wellness services like vaccinations, while others might include spay/neuter surgeries or even a wide range of care for illnesses. Other non-profits are rescue organizations helping dogs, cats, or other species, or even exotic animals overseas. And many other possibilities exist.

The first step is to envision the mission, goals, and practice style of the clinic. Which species will be helped? Which services will be offered—for example, are surgeries, diagnostic imaging, or dental care on the list?

If the clinic will be serving owned pets, are there eligibility requirements for the pet owners (such as proof of low income), or will everyone be able to access the facility’s care? 

The plan might need to change based on a variety of factors, including local business laws and regulations and other practical considerations like finances. But having a clear vision for the practice will help new non-profit owners focus on their goals and top priorities when tough decisions must be made.

Budget, Funds, and Regulations

A clear goal or vision is crucial to starting a non-profit that helps pets or other animals. But unfortunately, the goal must fit into a realistic business plan to become a reality and be sustainable in the long term. Keeping the doors open is the best way to help most animals.

A business plan is a great place to start. This includes important considerations such as the budget. Equipment purchases, operating costs, staff compensation, insurance, rent and overhead expenses, marketing and fundraising efforts, tax considerations, and many other financial factors can make or break any business, including non-profits. 

Compared to for-profit businesses, non-profits also have unique legal and financial requirements, which may have some variability between jurisdictions.

For example, there may be specific guidelines in terms of how the money is tracked and utilized and how (and how much) employees are compensated. And businesses might be required to hold regular member or shareholder meetings, with meeting notes submitted to a local regulatory body.

While there can be enormous tax benefits to having a non-profit business, there’s also the matter of figuring out how money will come into the business. Is there a small charge for services (low-cost versus free)? How much can be reliably raised in donations in that city or location? And are there grants or other helpful programs to apply for?

This can be quite complicated, with high stakes, so it’s smart to consult a business, legal, and financial professionals who have some familiarity with veterinary businesses.

Experts are there for a reason, and they can help create a plan for a financially feasible clinic.

Where to Buy or Source Equipment

With all of the above sorted out, a veterinarian will have a better idea of which equipment they can and should purchase for their new non-profit. At this stage—or, if searching for affordable equipment for an already-established non-profit—here are a few ideas for sourcing equipment…

• Look for used veterinary equipment. Talk to local colleagues who are looking to upgrade their veterinary digital x-ray system, anesthesia monitoring equipment, or even smaller items like Tonopens or otoscopes. They might be willing to sell at a discount. Also, look for veterinary equipment selling sites such as usedvetequipment.com or explore sites like eBay.

• Ask for equipment donations. It never hurts to ask! Perhaps other vets in the area, or even local human hospitals, are planning to get rid of old equipment when they upgrade. There could be tax benefits to them for donating, so it’s possible the exchange could be mutually beneficial.

• Establish relationships with vendors. They might have demo or loaner models, or other gently used items they are willing to part with for a reasonable cost.

• Hold a fundraiser. Explain to the local community which equipment you are looking to purchase and why, i.e., how it will help the pets you serve. 

• Look for grants. Some equipment providers or charitable organizations might be able to fund equipment for non-profit organizations. 

• Work with local veterinary clinics. Some of them might be willing to rent out their space and equipment to a non-profit or rescue organization. This could be a more economical alternative to purchasing equipment.

Besides purchase costs, consider other factors like reliability, the size of the equipment (for example, whether the new veterinary DR system will physically fit into the x-ray suite), portability if there is more than one location, and additional costs (shipping, installation, and warranties or costs of servicing/maintaining the equipment).

A little planning can go a long way toward finding equipment at a reasonable cost to help support a non-profit veterinary practice’s mission.

Written by: Dr. Tammy Powell, DVM 

Equipment Options for Your New Veterinary Practice

If you’re ready to take the leap and open the veterinary practice of your dreams—or if you’re still exploring options and seeing if practice ownership is right for you—finding the veterinary equipment you need is an important part of the process.

After all, it’s difficult to diagnose and treat patients without the proper tools.

Depending on the type of practice you open, your equipment wish list may include…

• X-ray and ultrasound machines.

• In-house bloodwork analyzers.

• Surgical lights, an autoclave, and anesthesia monitoring equipment.

• IV pumps.

• Exam room tables.

• Kennels.

• A scale to weigh patients.

• A tonometer for measuring intra-ocular pressures.

• A dental cleaning unit.

• Computers, and veterinary clinic software.

• Credit card processors for payments.

• A washer and dryer.

• Separate refrigerators for medications and for your staff to keep their lunches in, and a freezer for cadavers.

• Specialty equipment, such as a vehicle for a mobile practice, and pneumatic drills, and an MRI for a neurology practice.

Plus, there are smaller items to consider, like otoscopes, blood pressure cuffs, staff uniforms, and all your daily supplies like needles, syringes, and gloves.

With all this in mind, it’s not surprising that your equipment costs could add up to tens of thousands of dollars—or more—making your equipment a vital consideration when opening and financing a veterinary practice.

Not to worry, though, because you do have options.

Considerations for Purchasing Veterinary Equipment

Purchasing new equipment is certainly an option many practice owners pursue. It’s exciting to get the latest technology delivered to your practice’s door, and—depending on the type of equipment—installed by experts. And, the equipment should be in excellent condition because it’s brand new.

When buying new, it’s important to do your research, though. Be sure you’re getting good quality and the best value for your dollar. 

Also, check the manufacturer’s or seller’s warranty—because there would be nothing worse than investing your money only to have a malfunction (less likely with new equipment, but possible) or have something get dropped or broken during the grind of daily practice.

And finally, ask about support and training. For example, who do you call when you have a question about the machine? And, does the company offer training to your staff, to ensure the equipment is used to its maximum potential?

Purchasing used veterinary equipment can also be an excellent option. Many machines are designed to last for years, and your colleagues may want to sell relatively new equipment in order to upgrade. This can be a great benefit to you because you can catch a real bargain.

For used equipment, we recommend usedvetequipment.com, a site exclusive to veterinary professionals looking to buy or sell veterinary equipment, with guidance on shipping and a moderator for payments. But, you may find quality used equipment through other online sellers or medical equipment specialist resellers, too.

With used equipment, inquire about the condition. Also, ask if there is a warranty still in place—you don’t want to miss out if it is still in place and transferrable.

Finally, consider maintenance costs with any equipment you buy. Maintenance is crucial for keeping your equipment running for as many years as possible, potentially saving you lots of money in the long run if you can avoid replacing your machines sooner than necessary. So, these maintenance costs should be factored into your budget.

Financing for Veterinary Equipment

If you have some cash saved up, you may be able to purchase some of your equipment outright. But, chances are you’ll need to finance at least some of your purchases.

For financing new equipment, check with the manufacturer to see if they allow payments over time. Some may have monthly payment plans. These plans take away some of your initial financial pressure since the money you bring in with the equipment can fund the monthly payment (for example, your x-ray fees can support your monthly payments for a good quality x-ray machine). 

Alternatively, you could seek financing from a bank or other lender. The bank you’re working with on practice financing may include equipment costs as part of your loan, or as a separate negotiation. Or, you may reach out to another lender.

Typically, lenders refer to these loans for equipment as “capital leases,” and they may offer monthly payment plans. 

The lender would own your equipment until the loan is paid in full, but there’s usually an affordable (as low as $1 for some institutions) purchase option for you once you finish all the loan payments.

When evaluating a lender or other equipment payment plan, here are some things to look for…

• What’s the interest rate?

• What fees are associated with the loan?

• What is the loan’s term, or how long will you be paying?

• Is there a purchase option once the loan is paid in full, and how much it will cost?

• What penalties exist for late payments, paying off the loan early, or if you would like to get out of the lease?

• The reputability of your lender (if it’s not the lender you’re already working with, do they have recommendations from the equipment sales representative or other veterinarians? Do they routinely work with veterinarians?).

Also, talk to a tax professional to find out if the depreciation and interest payments on your veterinary equipment are tax-deductible.

Your Overall Financial Picture

Before purchasing any equipment, it’s important to think through what the equipment will do for your patients, and what sort of return on investment you can expect. 

For example, will you use the equipment often, or will it only be on rare occasions?

What training is required to learn how to use this equipment? What about client education on the benefit of the service? How many years is the equipment expected to perform?

A veterinary consultant, or financial professional who’s familiar with veterinary businesses, can guide you through these analyses and include these considerations in your business plan so your new practice can find the right balance of initial equipment purchases, then grow and thrive over time.

Written by: Dr. Tammy Powell, DVM

How Can Veterinary Dental Digital X-Ray Help With My Clients Daily Dental Teeth Cleaning In My Animal Hospital?

Veterinary dentistry has become advanced over recent years, particularly with the advent of oral dental radiographs.

The idea of regular dental care for our pets is new to many pet owners who are beginning to realize the importance of regular exams, teeth cleaning, and oral radiographs.

Practice standards are changing, and pet dentistry has become sophisticated and cutting edge. Similar to when humans have an oral examination and teeth cleaning, the dentist will request radiographs to check for underlying problems or concerns.

The same should be expected for pets when they go to the veterinarian for teeth cleaning. Dental radiology is at the forefront of ever changing veterinary practice standards.

With most of a tooth lying below the gum surface (think of an Iceberg), problems cannot be appreciated until a radiograph is taken and reviewed.

It is virtually impossible to practice veterinary dentistry without dental radiographs, which allow visualization of tooth roots, bone, and surrounding structures not visible otherwise.

Dental radiographs today are not taken with the conventional x-ray unit seen at most veterinary clinics. 

Today’s advanced dental x-ray units give exceptional detail and clarity. Dental x-rays are easy to use and typically located adjacent to the patient. They are made using small radiographic films or digital sensors placed inside the patient’s mouth, and can generally be accomplished within 10 or 15 minutes when performed by an experienced and trained technician.

Typically 6-8 images are taken during a routine pet dental cleaning. The radiation risk to the patient from dental radiographs is minimal and outweighs the risk of missing underlying dental problems.

Dental radiographs should be performed early to establish a baseline for future comparison.

Ideally, this can be accomplished at the same time puppies and kittens are undergoing routine spay and neutering and should be performed under anesthesia to effectively diagnose and assist in treating a patient with periodontal disease or underlying pathologic complications.

Anesthesia is important to obtain dental radiographs because the sensor or films must be placed in the pet’s mouth, which would be difficult to accomplish awake.

Studies show that without dental radiographs, up to 75% percent of significant dental problems are missed in pets undergoing routine teeth cleaning.  

In addition, the AAHA (American Animal Hospitals Association) Dental Care Guidelines for Dogs and Cats state that preoperative and postoperative dental radiographs are mandated for all tooth extractions.  

Dental radiographs taken prior to extractions ensure that a procedure can be properly planned and that no underlying issues such as developmental defects surprise the individual performing the extractions.

Post extraction radiographs ensure that all root fragments are removed and that no inadvertent damage was caused.

A pet can be left in discomfort for years if problems are missed during a dental.

Pets showing dental problems may avoid hard food, have red or bleeding gums, bad breath, have problems picking up and dropping food, make noises when they yawn, chew on one side of the mouth, excessively sneeze, express facial discomfort by pawing at the mouth, excessively salivate, exhibit ropey drool, and more.

Any pet exhibiting these signs should have a dental with oral radiographs to allow the veterinarian to make an accurate diagnosis. Once a diagnosis has been established, the proper treatment plan can then be instituted. Without dental radiographs, an accurate diagnosis is not possible, and pets may needlessly suffer. 

Indications for dental radiographs in pets:

• Periodontal Disease and Extractions: Radiographs help to determine a treatment plan, identify retained tooth roots, follow each pet’s dental progression as they age, and to assist the operator during extractions to avoid potential injury such as jaw fractures.

• Trauma: Identify a fracture or foreign body such as shrapnel or other material.

• Defects and Variations in Tooth Density: Identify cavities or resorption lesions in cats.

• Endodontic Issues: Determine if a tooth requires a root canal.

• Developmental Defects/Anomalies: Detection of supernumerary teeth, missing teeth or teeth that have failed to erupt.

• Swellings, Cysts, Tumors: Help determine the source of facial swelling and pain.

• Advanced procedures: Pets receiving advanced procedures such as crowns, braces, jaw fracture repair, oral tumor removal.

With modern medical advances in veterinary dentistry, dental radiographs should always be implemented in the complete periodontal exam and treatment of pets undergoing dental cleaning with extractions.

It is otherwise not possible to provide good quality dental care and documentation without utilizing radiographs.

Dental radiography is the number one diagnostic tool in the practice of complete pet dentistry.

Written by: Dr. Tammy Powell, DVM

Ultrasound Techniques: Evaluating the GI Tract

An abdominal ultrasound is a tool that can help you with visualizing and diagnosing a variety of conditions in your canine and feline patients.

Today, we’ll be talking about evaluating the gastrointestinal tract.

Depending on your patient, you may be doing an ultrasound exam of the stomach, small intestines, and colon to look for…

• Inflammation and wall thickening

• Foreign bodies

• Neoplasia

• Pyloric outflow obstructions

• Intussusceptions

• Enlarged mesenteric lymph nodes

This isn’t an exhaustive list…

But basically, if the patient is having GI symptoms and your x-rays haven’t provided the answer you need, an ultrasound is often a good next step.

That’s because it provides more details about tissue structure in real-time, as opposed to just the silhouette of radiographs. Often, x-rays and ultrasound work well together.

It may take a little bit of practice, but with experience you can catch on to ultrasound technique and do your ultrasound exams in-house rather than referring.

Here are a few tips for getting the diagnostic information you need during a simple ultrasound evaluation of the GI tract…

• If possible, have the patient fast beforehand. That way, you can get a clear picture of the GI tract without a lot of food or fecal matter to block your view of certain structures or create artefacts such as shadowing. You can also consider an enema if needed.

• Position the patient. Dorsal recumbency is most common, although lateral recumbency may also be used, especially for visualization of deeper structures. Use a trough for comfort, and if appropriate consider sedation (most patients don’t need to be sedated, though).

• Experts recommend having a systematic approach to look at the entire abdomen. Whichever viewing order works best for you, it’s good to be consistent so nothing is forgotten. And, the GI tract will be an important part of your evaluation.

• Choose a machine and probe that work best for your needs, then practice and develop comfort using the different settings, especially adjusting depth and gain (brightness). That way, you can focus on seeing what you want to see, rather than fussing with settings during your ultrasound exam.

• Start at the stomach by locating it just caudally to the liver. Rock and fan the probe to systematically obtain orthogonal views of the whole stomach from fundus to pylorus.

• Next, examine the intestines and cecum. 

  • The duodenum, ileum, cecum, and colon are examined individually. 

  • For the jejunum, you don’t need to follow every loop from beginning to end. Instead, scan the abdomen starting at the level of the stomach. Slide or sweep the probe from side to side, gradually moving cranially to caudally until you’ve visualized the entire field (usually you would stop at the level of the urinary bladder trigone).

• Along the way, take notes to help you prepare your report for your patient’s medical record. Be sure to include what was normal, as well as any abnormalities you found, such as masses or thickened intestinal walls. 

While scanning, you can freeze images for your records and take measurements if you feel anything may be enlarged.

When you develop your ultrasound skills, having this tool at your disposal can often give you quick information when you need it—for example, looking for a GI mass or obstruction when x-rays were inconclusive.

It’s a great way to offer an additional service to your patients and clients, and possibly to stand out from other clinics in your region.

Written by: Dr. Tammy Powell, DVM

A Beginner’s Guide to Pathology Using Ultrasound

Sometimes, radiographs just don’t show the whole picture…

That’s especially true for analyzing the details of soft tissue structures—especially in the abdomen, but in other parts of the body as well.

Limitations of radiographs

One problem you may run into with radiographs is a “silhouette sign,” which basically means that two areas with a similar opacity border one another in your x-ray views. This makes it difficult to tell where one structure begins and the other ends.

A good example of a silhouette that could cause confusion is when the abdomen is full of fluid. Since fluid is approximately the same opacity as the abdominal organs, they may blend together, making it difficult to evaluate the abdominal structures.

In cases like this, an ultrasound can provide additional information. And, ultrasound has many other uses…

What an ultrasound is especially useful for

Radiographs can provide a lot of valuable information. But, they can’t always provide fine detail about texture, small defects, or other abnormalities of soft tissue structures. That’s especially true if the abnormalities don’t result in a big change in opacity or in organ size.

Therefore, ultrasound is often superior for detecting changes within an organ, especially if the change is small, in the early stages of a disease, or otherwise difficult to view on radiographs.

This may include conditions such as…

• Nodules or masses within an organ such as the liver, which aren’t large enough to change the radiographic silhouette/size of the organ.

• Pancreatitis or certain other disorders of the pancreas.

• Calculi of the urinary bladder that are radiolucent.

• Details of the gallbladder, an organ that is often difficult to see on radiographs since it is overshadowed by the liver.

• Abnormal blood vessels, such as a portosystemic shunt.

• Detailed cardiac evaluation, including diagnosing enlargements, congenital abnormalities, neoplasia, and more.

These are just a few examples—an ultrasound has many uses clinically!

Of course, there are some lesions that are better diagnosed using radiographs rather than ultrasound, especially in areas of the body that don’t transmit sound waves well (such as the lungs).

And, by looking at your x-ray views and ultrasound study together, you’ll get more information than you would with either technique by itself. 

So, it’s not a matter of choosing between radiographs and ultrasound—instead, they work very well when used together to see the whole clinical picture.

How to use an ultrasound

It takes some experience to get the hang of directing your ultrasound probe and interpreting the images. Taking a course is often the best and fastest way to become proficient.

However, even though the process of performing an ultrasound study is different from obtaining radiographic views, some of the basic principles of interpretation remain the same for both. 

Rely on the same good practices you do when reading a radiograph, such as…

• Have a system and evaluate each organ (and spaces between the organs) in an order that works for you. Do it the same way each time, to be sure you don’t miss anything.

• Examine cross-sectional images together—meaning views that are 90-degrees apart—of each area of study. An ultrasound, like an x-ray, produces a two-dimensional image. So, you’ll want to move the probe to look at each area at different angles (just like orthogonal views provide a complete picture when taking radiographs).

• When in doubt, seek a consultation with a radiologist who can help you interpret your images.

Just like any other part of your clinical skills, ultrasound technique and interpretation will come with time.

After all, they call it clinical “practice” for a reason—practice makes perfect. 

But with a little time, you’ll likely see a good ROI on your investment, since you can diagnose in-house rather than referring—and may find your ultrasound very useful if you need more diagnostic information in a pinch.

Ask for a free demo at your hospital to learn more.

Written by: Dr. Tammy Powell, DVM

Ultrasound Techniques: Visualizing the Adrenal Glands

The adrenal glands, those tiny but very important glands, can be tricky to find and evaluate during an ultrasound exam.

However, having a system and knowing where to look can make your job much easier.

There are many reasons you want to visualize the adrenal glands on every scan, including checking for neoplasia and other masses and looking for any changes that could be associated with Cushing’s or Addison’s disease.

Here are some tips to help save you time and allow for a clearer view of these small glands…

Have a repeatable system

When you perform an abdominal ultrasound, it’s important to have a systematic approach to look at everything. And that includes keeping small structures like the adrenal glands and abdominal lymph nodes on your list, so they don’t get overlooked.

Do your scan in the same order every time—whether that’s cranial to caudal, clockwise, or some other system that works for you—and it’s much less likely that anything will be missed or any abnormalities overlooked.

Adrenal gland landmarks

The right and left adrenal glands are respectively located near the right and left kidneys. However, the kidneys are relatively large, whereas the adrenal glands are small. So, the kidneys can overshadow these small glands.

The kidneys are the first things you’ll locate because they’ll point you in the right general direction. After that…

Vascular landmarks are most helpful when it comes to locating the adrenals.

Specifically, the aorta, caudal vena cava, renal vessels, and mesenteric artery are what you’re going to be looking for.

Color Doppler can help you visualize the vessels.

Also note, if the patient allows you to apply gradual pressure, it helps to minimize the distance between your probe and the glands as much as possible.

Finding the LEFT adrenal gland

The left adrenal gland is located ventrolateral to the aorta and cranial to the left renal artery. 

Start by scanning the left dorsal mid-abdomen and visualizing the aorta in a long view. 

Find the spot where the left renal artery branches off from the aorta, and just cranial to that you’ll see the left adrenal gland.

Finding the RIGHT adrenal gland

The right adrenal gland is dorsolateral to the caudal vena cava, and just cranial to the cranial mesenteric artery. It’s also more cranial and dorsal compared to the left adrenal gland.

Scan the right cranial abdomen, with the caudal vena cava in long view.

Apply some pressure with the transducer which will cause compression of the caudal vena cava and help you visualize the right adrenal gland. The gland is right next to the vessel, slightly oblique to it.

Are the adrenal glands normal?

Evaluate the qualitative properties of the gland, and then measure the glands from their cranial pole to caudal pole. Also, measure the thickness of each pole.

Normal adrenal glands are hypoechoic to surrounding fat, and have a characteristic “peanut” shape (although the right adrenal may have more of an “arrowhead” appearance). Typically, adrenals are 4-7mm thick in dogs and 3-4mm thick in cats. 

Abnormalities may include…

• Evidence of hyperadrenocorticism. 

  • If pituitary-dependent, the adrenal glands may be normal in appearance, or they may be “plump” (symmetrically enlarged). An ultrasound exam alone is not enough to diagnose Cushing’s, but may be helpful in context with additional diagnostic tests.

  • If adrenal-tumor related, you may be able to visualize a mass. 

• Evidence of Addison’s disease or hypoadrenocorticism.

  • You may notice smaller or thinner adrenal glands. As with Cushing’s, you’ll want to use this information in conjunction with clinical symptoms and other diagnostic tests.

• Adrenal masses.

  • Many are incidental findings only.

  • Pheochromocytoma is a possibility.

  • Malignancies are possible and may lead to invasion of adjacent tissues, especially blood vessels. 

  • You’ll use your clinical judgment and the patient’s clinical signs to help you determine whether more diagnostics are needed, or to start by monitoring the growth with repeat ultrasound exams over time.

• Age-related changes.

  • Nodular changes and remodeling may be normal in old adrenal glands. Practice will help to develop clinical judgment of what’s normal and what’s not.

The ability to find the adrenal glands quickly will come with experience, and knowing the right tips and techniques will make it easier to get the information you need even when you’re first learning.

Written by: Dr. Tammy Powell, DVM

Patient Injury & Complications In Veterinary Dentistry

The nature of anesthesia brings risk in general. In veterinary medicine, during dental procedures, pets are often placed in vulnerable positions which can lead to increased risk of injury and medical complications.

These risks can be minimized or entirely avoided with careful consideration, and proper training and continuing education of staff. Listed are a few of the more common injuries that can occur during a dental procedure.

Aspiration Pneumonia

Aspiration pneumonia in pet patients occurs when the patient inhales a foreign substance and develops lung inflammation and infection as a result.

The most common occurrence during dentistry is water and debris entering an unprotected airway, hence allowing fluid and debris to enter the lungs. This can occur from an underinflated tracheal tube, or repositioning during the procedure that allows fluid to enter the airway.

Aspiration pneumonia can also occur if the patient vomits or regurgitates during anesthetic recovery.. To reduce the incidence of dental-related aspiration pneumonia, maintaining the patient on their back during the procedure, and avoiding repositioning has proven to not only lessen the risk of aspiration but also lessens the amount of anesthesia needed during the procedure.

In addition, antiemetic medications given during the premedication phase can help reduce the incidence of post-anesthetic nausea and vomiting. Caution should be taken during the recovery phase to wait until the patient is alert and responsive enough to deflate the cuff and remove the tracheal tube.

Tracheal rupture

Tracheal rupture in dogs and cats are more frequent during dental procedures than any other medical procedure. Seventy-five percent of tracheal ruptures are thought to be associated with oral surgical procedures with the incidence more common in cats than dogs.

Tracheal injury can cause symptoms such as mild dyspnea, and even death. The most likely cause of tracheal rupture is thought to be due to an overinflated tracheal cuff, as well as failing to detach the tracheal tube from the anesthesia hose during repositioning, which can cause a torque on the inflated cuff resulting in a tear of the dorsal membrane of the trachea.

Another common cause of tracheal rupture is a patient that is not adequately anesthetized and coughs or lunges upward during intubation, tearing the trachea.

Pressure from an overinflated cuff can cause pressure necrosis of the trachea, showing delayed symptoms of inflammation and scarring.

Avoiding over-inflation of the cuff, using new tracheal tubes, testing the cuff to ensure proper inflation prior to use, avoiding repositioning as much as possible, and ensuring a level plane of anesthesia prior to intubation can help minimize the risk of tracheal rupture.

Artery Damage during Tooth Extractions

Arterial damage to arteries such as the palatine artery which runs the length of the mandible can accidentally occur during routine tooth extractions where the instrument can slip from the practitioner’s hand.

These injuries can be mild to more severe requiring surgical intervention.

The most effective way to avoid this type of injury is to implement extraction techniques involving gingival flaps where the roots are exposed, and more easily undermined, and extracted. 

Written by: Dr. Tammy Powell, DVM

What Could You Miss Without Dental Radiographs?

When it comes to dentistry, sometimes teeth are like icebergs—there’s a lot going on “below the surface.” In this case, under the gumline. 

Unfortunately, the parts of the tooth you can see don’t always tell the whole story. 

That’s where dental radiography comes in.

Here are a few situations when dental x-rays could make your client communications easier, help you provide better patient care, and improve your bottom line…

Finding pesky root tips

If you’re extracting a tooth with a fractured root—whether the root splintered prior to the dental procedure or the tip happened to break off during a difficult extraction—you generally want to be sure you’ve removed each and every piece.

In many cases, root tips left behind can lead to infection, pain, or an abscess, plus another procedure to retrieve the piece and an unhappy client.

Radiographs help because you have confirmation that you’ve removed all pieces of the tooth roots.

For extractions, it can be useful to take “before and after” images that clearly document the successful removal of the tooth and its root(s).

Informing owners of the risk of jaw fractures

Sometimes, periodontal disease has caused so much bone loss that it leads to a pathological fracture in the jaw.

Or, the jaw could have so much bone loss that there’s a high risk of iatrogenic jaw fracture during a dental procedure and extraction.

You can probably imagine what could go wrong without radiographs…

When you extract the bad tooth, a jaw fracture can occur if that area of the mandible is already severely compromised due to disease and bone loss. But without radiographic proof of the underlying condition, the client may be inclined to blame your technique, rather than recognizing the severity of their pet’s periodontal disease.

Taking radiographs beforehand helps to set up realistic expectations of risk.

Discovering retained and impacted teeth

Whenever teeth are missing, dental x-rays are a good idea.

Sometimes, below the gumline, you’ll find retained or impacted teeth. Left in place, they could lead to dentigerous cysts or other problems.

Without radiographs, these “hidden” teeth can be difficult to find and treat.

Detecting damage to neighboring teeth

Maybe there’s one tooth that’s obviously bad… But, bone loss and infection have also affected the integrity of the neighboring teeth.

Dental radiographs will help you determine whether or not neighboring teeth are viable. And, the images provide tangible evidence that a neighboring tooth needs to be extracted.

This visual aid can make it easier to show a client exactly what you’re talking about, and help to reinforce your recommendations.

And more…

Dental radiographs can also help you look for oral neoplasias, feline resorptive lesions, tooth root abscesses, and more.

Sometimes this will help to confirm your clinical suspicions based on the patient’s presentation and symptoms. Other times, the findings may come as a surprise—allowing you to treat before the problem becomes worse.

With all the information dental x-rays provide, they can really help you create a thorough treatment plan that covers everything a patient needs during their dental procedure.

Your treatment recommendations can help to improve your dentistry revenue. And, importantly, your dental images can also help you provide excellent patient care and increase client knowledge and compliance.

Ask us about a free demo for your hospital, to see how dental radiography can fit into your practice space and daily appointment flow.

Written by: Dr. Tammy Powell, DVM

Take The Frustration Out Of FORLs

To extract or not to extract that tooth root?

Is a crown amputation all that’s needed?

When it comes to feline odontoclastic resorptive lesions (FORLs), these may be the questions you’re asking yourself.

FORLs can cause loss of the protective surfaces (enamel, cementum, and dentin) of both the crown and the root(s) of a tooth, resulting in pain.

These lesions come in two varieties:

• Type 1: Where the root appears radiographically normal.

• Type 2: Where the root is radiographically hard to distinguish from the surrounding bone, with loss of visibility of the periodontal ligament space.

As you know, the treatment for these lesions is different—full extraction of the root(s) for Type 1, versus just a crown amputation for Type 2.

Performing a crown amputation and leaving a root in place for Type 1 could result in problems or complications, not to mention continued pain for the patient.

On the other hand, trying to extract the root of a true Type 2 lesion could be a monumental task and a big headache.

So, it’s very important to determine what type of lesion you’re dealing with. Here’s how…

Diagnosing FORLs

Patient presentation

A client brings their pet to you because of halitosis, food dropping, and occasional jaw chattering. 

During the physical exam, you notice bright red, inflamed gums and gingival hyperplasia near one of the mandibular premolars. 

You suspect a FORL—and given that FORLs are one of the most common dental problems in cats, you’re probably right.

You suggest a dental procedure, including dental radiographs, a full cleaning, oral exam, and possible extraction. The client agrees with the plan.

The day of the procedure

After the patient is anesthetized, your technician obtains radiographic images of the entire mouth, which takes just a few minutes to perform.

Then, you look at the radiographs in conjunction with your oral exam.

While probing the tooth in question, you feel a rough patch under the gingival hyperplasia, consistent with a resorptive lesion.

The x-ray confirms your diagnosis. 

Determining the best treatment plan

In this case, the patient’s tooth is clearly Type 1, with a periodontal ligament space still visible. So, you perform a full extraction.

While evaluating the dental rads, you also notice the premolar on the opposite side is starting to show radiographic evidence of a lesion.

Even though it’s mild, you call the owner and inform them of the likelihood of progression. 

To prevent a painful lesion from developing between dentals, the owner decides to go forward with a pre-emptive extraction of that tooth as well.

Documenting the extraction

In addition to being an integral part of your treatment plan decisions, dental radiographs can also help you document that extraction was performed successfully.

A post-procedure x-ray image is a great way to document that there are no root tips left behind.

And, in cases where a crown amputation was indicated, dental rads provide visual proof that this was an appropriate treatment course.

In this way, dental radiographs not only help you to plan and implement a very high quality of medicine—but they also give you peace of mind and are a valuable part of your medical records.

Talking to clients about dental radiographs

Maybe you already know the benefits of dental radiography—but you’re concerned about discussing the additional cost with clients. 

Often, it helps to include the x-rays as part of the dental procedure package. List them on the estimate so the client understands the value they are receiving—just don’t itemize the cost of the radiographs separately. 

Be sure to adjust the estimate of the dental package accordingly, to cover your costs. And remember, with a monthly payment plan for your dental radiography system, just a couple of dental procedures per month can cover your investment.

Client education also helps. Explain how the results of the radiographs allow you to provide the best possible treatment and reduce the likelihood of future complications.

With clients who want the best for their pets, it’s a win-win for both of you.

Written by: Dr. Tammy Powell, DVM

Ultrasound-Guided Cystocentesis: How and Why to Do One

There are several ways to collect a urine sample from your patient, including free catching, using a urinary catheter, and doing a cystocentesis.

A cystocentesis—which involves obtaining a urine sample via a needle placed directly into the bladder—may be the preferred method in many cases.

This is especially true when you need a sterile urine sample, such as for culture and sensitivity testing for UTIs. And in general, a cystocentesis will provide more accurate results than a free catch urine sample, since it reduces contamination from cells or pathogens of the skin.

It’s possible to perform a cystocentesis by palpating the bladder or using anatomical landmarks alone. However, an ultrasound can make the process easier by removing the guesswork and allowing you to visualize everything.

Here’s how it works…

How to perform an ultrasound-guided cystocentesis for dogs and cats

1. Prepare for the procedure.

   • Use an appropriate size syringe (usually 3ml to 12ml) based on the size of your patient.

   • Choose a needle size and length based on your patient size. A 22g needle works well for many patients.

   • Use a towel, trough, or other cushioning to make your patient more comfortable during the procedure. This may help minimize their movement.

2. Use appropriate patient restraint.

   • For some dogs and cats, this could mean having a trained team member hold them. For very anxious or fractious patients, this might mean chemical restraint.

   • Dorsal recumbency is generally the best way to position your patient.

   • Be sure to clean the area of skin where you’ll be performing the cystocentesis. If needed, consider clipping the fur, too. 

3. Estimate the bladder location.

   • You’ll use your ultrasound to see the bladder, but anatomical landmarks will give you a good starting point for where to place the probe. Try one of these methods…

     • Locate the caudal four mammary nipples and mentally draw an ‘X’ between them. The bladder will often be near the cross point of the ‘X’.

     • Place a small amount of alcohol on the caudal abdomen so it pools. Often, the bladder is located directly under where the alcohol naturally pools on the midline.

4. Visualize the bladder.

   • Place your probe onto the caudal abdomen. You should be able to see the urinary bladder on the screen—it’s a fluid-filled structure that has the appearance of a ‘black balloon’ with gray or white walls.

5. Check for any abnormalities.

   • You could focus on just doing the cystocentesis. However, while you’re visualizing the bladder, it may help to do a cursory exam (or even a more in-depth evaluation, if indicated) to look for any problems contributing to the patient’s urinary symptoms. 

     • For example, note if you see any thickenings, masses, calculi, or other issues in the urinary bladder.

6. Obtain the urine sample.

   • Place the needle directly through the abdominal wall, just in front of the ultrasound probe.

   • Aim the needle slightly caudally.

   • You should see the needle on your ultrasound screen. Use this visual to guide you, to be sure you get a good, clean sample rather than aspirating part of the bladder wall.

7. Prepare your sample for analysis.

   • Right after the cysto, replace the needle on the syringe with a sterile one.

   • Then, divide and prepare the sample in a timely manner (the fresher the sample, the better for testing) for any tests you need to perform, whether that’s in-house or at an outside lab.

In many veterinary hospitals, cystocentesis is safely performed several times per day, and complications are very rare. However, as with all medical procedures, some risks exist.

These may include…

• Hematuria (usually mild and transient).

• Much rarer complications such as bladder injury, leakage of urine into the abdomen, puncture of internal organs or blood vessels, or vagal reactions (retching, panting, hypersalivation, collapse). 

• Seeding of tumors.

  • If you suspect your patient has a bladder tumor such as transitional cell carcinoma, it may be best to avoid a cystocentesis. Otherwise, the needle could ‘seed’ the tumor as you withdraw your sample from the bladder, allowing cancer to spread into the abdominal cavity.

An ultrasound may help you to notice abnormalities such as bladder tumors during the procedure, in which case your recommendation to the client may change.

Fortunately for most pets, a cystocentesis is a quick outpatient procedure that provides a lot of valuable information. And many dogs and cats don’t show any side effects at all.

For patients with urinary symptoms, a cystocentesis is often the way to go for the most accurate diagnostic testing results and to get to the bottom of the issue faster for healthy pets and happy clients.

Written by: Dr. Tammy Powell, DVM

5 Tips for Radiation Safety During Uncertain Times

Your x-ray unit is something you use frequently—probably every day, or multiple times per day—in your practice.

You know radiation safety is important. But recently, if you’ve had to reduce the number of team members in the building at any given time, maybe it feels like there aren’t enough hands on deck for patient restraint and positioning.

The good news is, some of the same principles that reduce radiation exposure can also help your team operate more efficiently.

Here are some tips to maintain safety, even when you’re shorthanded…

A.L.A.R.A.: A Brief Reminder

A.L.A.R.A. stands for “As Low As Reasonably Achievable,” and it’s the guiding set of principles that help you reduce radiation exposure to yourself, your staff, and your patients.

This is important because ionizing radiation from x-rays can damage cells, and cumulative exposure can lead to health risks such as cancer and genetic damage to reproductive cells.

To minimize exposure, there are 3 principles to keep in mind:

• Time

• Distance

• Shielding

Decreasing exposure times, increasing the distance between your team and the x-ray source, and using PPE, all can help to decrease radiation exposure.

Tips for Radiography Safety and Efficiency

Hands-Free Restraint

Increasing the distance between your team members and the x-ray source is one of the most effective ways to decrease x-ray exposure.

Think of the inverse square law, which states that doubling your distance away from the x-ray source results in ¼ of the dose of x-ray radiation.

That’s a significant decrease!

Also, scatter radiation comes from the patient—so by not touching the patient, you’re reducing your exposure.

This can be accomplished by using:

• Chemical restraint.

• Positioning aids such as sandbags and tape.

• A combination of both.

In addition to contributing to safety, hands-free restraint also increases staffing efficiency.

Especially for large or wiggly patients, it takes fewer staff members to position the patient when hands-free restraint is used.

Patient Comfort

A patient who wiggles at the last moment can lead to a crooked radiographic image—and thus, the need to retake that view.

The more shots you take, the higher the x-ray exposure to your team members.

Keeping a dog or cat’s comfort in mind can help you get the shot you need the first time—and decrease the need for retakes.

Here’s how you can do this…

• Minimize fear and pain (for example, pain from stretching a sore leg to get the right position) by using chemical restraint. 

• Use a trough or other aid for comfort. Lying with their back on a cold, hard table can cause even the most cooperative of pets to squirm. Giving them a cozy place to settle into can really help.

• Play white noise or background music. This helps make the big buzzing and beeping sounds from the x-ray machine less startling to a dog or cat.

In addition to a better patient experience and less x-ray exposure, these methods help save your staff time by getting your views more quickly.

Getting Things Right the First Time

The fewer images you take, the less radiation exposure there will be.

In addition to the measures listed above, here are some ideas for taking the fewest views possible…

• Good planning. Be sure to know exactly which views you need ahead of time and what position the patient needs to be in for those views. Communicate these expectations clearly with your staff.

• Proper measurement. Measure the patient in the position they will be in during the shot (lying down rather than standing).

• Have a technique chart, or use appropriate settings in your digital unit. Teach team members how to make quick and accurate adjustments in settings, too.

• Use collimation. In addition to producing a higher-quality image, collimation decreases scatter radiation.

A thorough understanding of x-ray positioning and machine settings will save your staff time and headaches—in addition to minimizing radiation exposure.

Who Should Be in the X-Ray Suite?

Only the team members taking the radiographs should be near the machine. Clients shouldn’t be in the x-ray suite, and other team members should be fulfilling other duties—especially when you’re shorthanded.

Rotating the staff you have on x-ray duty can also help minimize their cumulative exposures. 

So, it’s smart to invest in training multiple team members. That way, you’ll also avoid delays if your “go-to” x-ray staff member ever needs to call out sick or otherwise miss a day.

PPE Care and Use

Even though the nature of your daily practice may have changed, it’s still important to keep up with x-ray safety measures, such as making sure your PPE is in good condition.

Experts recommend checking PPE every six months, and this includes radiographing your aprons, gloves, and thyroid shields to check for cracks. Of course, check and replace sooner if there are any notable defects.

Uncertain times may be stressful, but you and your team can continue to help the patients who need you while keeping yourselves safe.

Written by: Dr. Tammy Powell, DVM

Your Autoclave: Equipment Sterilization Is More Important Now Than Ever

In 2021, you’ve probably thought more about sterilization and disinfection than you ever have before.

Of course, you’ve always practiced safely and hygienically. But, this year’s pandemic brought the need for drastic measures like curbside service, face masks during everyday interactions, and washing your hands even more frequently…

… and, you and your staff probably feel like you’re cleaning, cleaning, cleaning all day long!

Best practices for cleaning surfaces and equipment

According to many experts, the best way to avoid viral exposure is the elimination of the risk. 

This is where isolation and social distancing protocols come in. Your distancing measures of curbside service, telemedicine, and a limited number of people inside your hospital can all help.

Social distancing within the practice and avoiding the sharing of spaces and equipment as much as possible can also help.

Then, there’s PPE to help minimize any potential exposures—as well as your cleaning and disinfection protocols.

You wear gloves and face masks, you wash your hands and use hand sanitizers, and you clean the surfaces and equipment in your practice.

During your cleaning efforts, don’t forget about a powerful piece of sterilization equipment you probably use frequently…

Maximize your use of this key piece of veterinary equipment…

If your own or work at a veterinary practice, there’s a good chance you have at least one autoclave available for use.

Autoclaves use steam under pressure to kill microbes and are one of the most powerful disinfecting tools you have in your arsenal.

Surgical equipment—and beyond!

An autoclave is a tried and true method of sterilization for surgical packs, drapes, and tools.

But, maybe there are a few more items you don’t always think of that could be put into an autoclave for quick, thorough disinfection.

Things your autoclave can be used for include…

• Gowns for surgery, isolation, or general use as an extra layer of protection.

• Cloth caps.

• Cloth face masks.

• Surgery light handles.

• Nitrile exam gloves or surgical gloves (ideally these would be single-use, but there are procedures described to maximize the lifespan of your PPE during shortages).

• Dentistry tools.

• Wound care items such as Penrose drains.

• Cones/specula for otoscopes.

• Pipette tips.

• Certain muzzles.

• Certain nail clippers.

• Biological waste—in case you suspect viral contamination and want to sterilize waste prior to disposal.

There may be other items you can sterilize, too—so get creative! 

Just be sure to check the manufacturer’s guidelines before you sterilize a new item—they’ll guide you on what’s safe or not safe to go in your autoclave.

But, once you get into the habit, this will save you time and do a more thorough job of eliminating microbes than most hand cleanings could ever do.

Why invest in a top-of-the-line autoclave?

In modern times, we can’t help but think of an autoclave as a potent killer of coronavirus!

But really, a good autoclave is useful to you all the time, pandemic or no pandemic. It ensures your equipment is properly sterilized from all microbes prior to use.

A good quality autoclave is dependable and makes your life easier via the simplicity of use. Here’s what we recommend you look for…

• Several setting options including solid or liquid items, and wrapped or unwrapped items.

• The option to choose a preset that suits your needs.

• Large water reservoir so you don’t have to refill as often.

• A tabletop model with a large chamber capacity so you can fit more items per cycle.

• Locking mechanisms for safety.

• A strong warranty and excellent customer service.

Our pick is this Full-Size Veterinary Autoclave because it meets all of these criteria, and has an industry-leading 3-year warranty (which includes a loaner autoclave if yours ever needs to be serviced).

How to keep your autoclave healthy

It’s always important to protect your investments by caring for your equipment—and that’s even more true during times when the business may be slower due to social distancing.

Here are a few tips to keep your autoclave in tip-top shape…

• Use distilled water, not tap water.

• Post guidelines for routine maintenance (otherwise, it’s easy to forget!).

• Look for debris when the autoclave is cool, and clean it as needed.

• Wipe the trays clean weekly.

• Note any water or steam leaks.

• Listen for any unusual sounds.

• Observe the tape indicator each time, to ensure the autoclave is functioning as it should.

With a little attention and care, your autoclave will stay healthy—and in turn, it can help keep your equipment pathogen-free!

Clave 23+ Steam Sterilizer With Drying Compressor

Full-Size Veterinary Autoclave

Click here to see the one we sell

Good Exam Room and Dental Lighting: Why It Matters

When it comes to upgrading your veterinary practice, maybe the first things that come to mind are new exam tables, high-tech anesthesia monitoring equipment, or an in-house chemistry analyzer.

Was a new LED exam room light also on your list? If not, it should be. Here’s why…

While lighting is often overlooked, just think about how many times per day a good, strong light could make your life easier.

Times, when a high-quality LED light could come in handy in your exam room, include the evaluation of…

• Lesions and wounds.

• Dental disease or oral lesions.

• Ocular health (you’ll use your ophthalmoscope and other equipment for a more detailed exam, but good room lighting can help you pick up subtle lesions during a routine checkup).

• Paw pads and the spaces between the paw pads.

• External ear structures.

• Dander, fleas, and other skin and coat issues.

These are a few good examples—but really, good lighting can help with much of the physical exam by making it easier for you to accurately document tissue colors, textures, lesions, and other notable abnormalities in your medical record.

Good lighting is essential for dental procedures and surgeries

In our last blog post, we gave some advice on how to pick a good surgical light.

And along those same lines, don’t forget about dental procedures!

The mouth is like a dark cave, making it difficult for you and your staff to see what you’re working on if you don’t have good lighting.

Some things a good light will help you visualize include…

• Calculus that needs to be cleaned—and verifying that all calculus was removed.

• Enamel defects and small chips or fractures. 

• Staining, or other color changes such as pulpitis.

• Subtle bleeding or mild gingivitis.

• Oral abnormalities such as masses or inflammation.

• Pharyngeal or tonsillar abnormalities.

• Extraction sites—before, during, and after the extraction.

• Placement and manipulation of small sutures.

Not to mention, a good overhead light can aid your laryngoscope light during intubation. 

How affordable are good LED lights?

In the past, LED lights were very expensive compared to halogen bulbs—so it’s understandable if you’ve not purchased one before.

However, some brands are now 30-40% less than previous LED prices.

So, LEDs don’t have to be expensive anymore. And considering their performance and efficiency, a good LED light can be a great addition to your practice.

Plus, many cities, counties, states, and even electric power companies offer rebates for upgrading to LED lights, due to the decrease in power used.

Specific requirements for rebates vary by location—so be sure to check with your local municipality and utility providers to see what’s available in your area. Because it’s always great to get a cash rebate that can help cover the cost of your upgrades!

How do you choose a good exam room or dental light?

When it comes to selecting the best lighting, there are many things to consider…

• Affordability. LED lights are much more affordable now than they used to be, so shop around and be sure you’re getting a good deal (to be sure you’re comparing apples to apples, check for the other factors on this list, too).

• Quality and dependability. Plus, a good-value warranty helps to back up your investment.

• Lighting adjustability in terms of intensity and dimming options, as well as area of focus.

• Precise positioning. The light head and arm should be easy to move and manipulate—but then, stay right where you put it without drifting. 

• Easy to clean.

• User-friendly, with simple controls on or near the handle.

• Shadow-free illumination—or at least a design that minimizes shadows as much as possible.

• Mounting options that match the layout of your rooms.

• Comfortable and safe for pets, with adjustable settings you can change as needed, and low heat output.

Here’s what we recommend…

We recommend the new Burton veterinary LED exam light because it checks all the boxes listed above.

Plus, it has a high-quality LED (virtually heat-free and with a 75% energy savings compared to halogen), is assembled in the USA, and is backed by an industry-leading 5-year warranty.

At a competitive price point that optimizes design, performance, and value, it’s pretty hard to pass up!

Why invest in new lighting?

As we said, lighting is often overlooked in terms of equipment upgrades…

But, just think of how many times per day you’ll use a good-quality light in your exam rooms or dental area.

In terms of cost per use, that can make new lighting a great investment—something you’ll benefit from using many times per day.

And if your new light makes your life easier in terms of visualizing the patient and making accurate medical notes… that’s an investment that could save you time and headaches, and be well worth it!

Positioning Tips for Dental Radiographs

When it comes to evaluating a pet’s teeth, dental x-rays are the best way to see what’s happening “under the surface.” That is, under the gumline.

Dental radiographs help you obtain a full picture of tooth roots, evaluate for periodontal disease and damage, differentiate between different types of FORLs, and look for any other defects that may not be visible with your eyes alone.

Even though the value of dental radiographs (to both your patients and your practice) is hard to deny, there can be a learning curve when your team first begins to use them.

This is important, because in order for your x-ray images to be diagnostic, they need to be good quality.

Fortunately, with practice, dental x-rays become simple and routine—a process your team can quickly replicate for each patient.

Establishing a Dental X-Ray Routine

To make the dental radiograph process easy for you and your team—and as quick as possible for your patients—it’s best to establish a repeatable routine.

This means taking the same shots, in the same order, each time. 

You may need a larger number of views depending on the patient’s size and the angle of their mouth, but in general you can start in the same place each time and move through your views systematically until images of all teeth and their roots are captured.

Use your digital software to set up the views in the order you prefer. 

Once you establish a routine, it will only take a few minutes to shoot all views for a small patient. And large dogs should take a maximum of 15-20 minutes.

Positioning the Patient

Your patients will be under general anesthesia for their dental procedure, including dental x-rays.

After intubation, leave the patient in sternal recumbency, and simply place a towel under their chin to keep their maxilla parallel to the table. Then obtain your views of the maxillary teeth. 

When you finish the views of the maxilla, move the patient to dorsal recumbency, this time using a towel or other prop under their neck to keep the mandible parallel to the table as you obtain your views of the mandibular teeth.

You can use a trough or sandbags to stabilize the patient and keep them from tilting to the side, if needed.

Adjust this plan if you find that another method better suits your needs. For example, you may find that lateral recumbency works best for you for some views. 

Whatever system you choose, we recommend repeating the same steps each time and using a method that minimizes the number of times you need to move the patient.

Sensor or Film Placement

Select the right size sensor or film for your patient. For most veterinary patients, this would be either a size 2 (for small dogs and cats, or views focusing on a single tooth) or a size 4 (for large dogs, or for full-mouth/whole quadrant radiographic views).

Whether you’re using a sensor for digital x-rays, or regular dental film, placement is important to ensure you can see all of each tooth root. Remember the roots are much longer than the crowns (twice as long with canine teeth), so position your sensor accordingly. 

Finally, determine which side of the sensor or film should be positioned toward the x-ray beam. This may be indicated by a small dot or “dimple” on films. If you have a digital sensor, the cord side should face away from the tube and the cord should exit the front of the patient’s mouth.

Beam Placement

A parallel angle is used for the mandibular premolar and molar teeth. For many pets, this part of the mouth allows the sensor to be placed parallel to the teeth, and the beam to be shot straight forward (perpendicular) into the sensor.

The rest of the mouth, however, prevents this placement (the palate and mandibular symphysis get in the way). So, you’ll need to use a bisecting angle for the rest of your shots (and possibly for the rostral mandibular premolars).

A bisecting angle might seem complicated, but it’s important—choosing the correct angle prevents distortion (lengthening or shortening of the tooth root in your image).

Here is how to determine the bisecting angle:

• Position the sensor within the mouth behind the teeth you want to x-ray, as if the patient is biting on it (use gauze or other aids to hold the mouth open so there is no pressure from the teeth that could damage the sensor). 

• Estimate the angle between the tooth root and the plate.

• Divide this angle in half, and draw an imaginary line with your mind. 

• Position the x-ray beam perpendicular (at a right angle, or 90 degrees) to this line you’ve just imagined.

If the tooth root is too long on your image, raise the angle of the tube relative to the sensor. If the root is too short, lower the angle of the beam (move it more parallel toward the sensor). 

Developing a Simplified Technique

Using a simplified technique can allow you to skip the bisecting angle measurement. For example, one described technique uses just three angles for all oral views…

• 90 degrees for mandibular molars/premolars.

• 70 degrees for maxillary molars/premolars.

• 45 degrees for canines and incisors.

Since you can position these angles on your tube head without measuring (many units have predetermined angles marked by the tube head), this makes positioning much easier and faster for you and your staff.

Exceptions, Views of Specific Teeth, and Further Training

These guidelines are a good starting point for many patients. But, you may find you need to adjust your views to accommodate certain dogs and cats, depending on the shape of their mouth and tooth roots.

Cats in particular may need steeper angles than dogs to minimize interference from the zygomatic arch. And some patients will have tooth roots that curve significantly.

For all of these reasons, and for the benefit of hands-on experience, it helps to schedule a demo of your equipment, or to find an in-person training opportunity for your staff. That way, you can maximize your return on investment by using your dental radiography unit to its fullest potential.

Any time spent developing the proper technique for positioning will be well worth it, as you’ll be able to quickly take views that aid your treatment decisions and deliver value to your clients.

Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.

Written by: Dr. Tammy Powell, DVM

How and Where To Buy Used Veterinary Equipment

During the economic fallout of this unprecedented global pandemic, it’s more important than ever for businesses to stretch their dollars as far as they will go. 

Buying used equipment is a budget-friendly way to purchase high-quality machines and supplies—so you can operate and upgrade your practice the way you want to. 

More importantly, you can buy on a friendly, community-based platform that removes all headaches about negotiating, shipping, and payments—so you can securely get the equipment you need without taking time away from your busy schedule.

In case you’re not already familiar with it, we recommend you visit: usedvetequipment.com. 

This website was started because veterinarians needed a marketplace just for their industry—somewhere to easily buy and sell quality used veterinary equipment from trusted colleagues. 

Here’s what one happy buyer had to say:

“I purchased a digital x-ray system through usedvetequipment.com. The transaction was smooth. I would not have taken the chance without the third party mediator. Brad did a great job and the sellers were great to work with. I would not hesitate to use this service again.”

—Mark Robinson, DVM Montana

Here are a few advantages that usedvetequipment.com offers to you as a veterinarian buyer…

• Quality. On the site, you’ll find products from top manufacturers such as Abaxis, Shoreline, Heska, SurgiVet, Cardell, Welch Allen, Idexx, and much more.

• Choices. Whether you’re looking to invest in something as large as a full radiology unit, or something as small as a laryngoscope or warming pad, you can find it on usedvetequipment.com. 

There are far too many examples to list here, but other items recently sold include endoscopes, Dopplers, stem cell therapy equipment, surgical tools, cages and floor grates, exam lift tables, and much more.

• Easy Payment Options. You’ll be emailed an invoice for convenient online payment.

• Good for Animals and the Environment. Reusing and repurposing equipment is not only a great way for the veterinary community to share resources to improve animal care everywhere—it can also help keep materials out of landfills.

• Safety and Security. We’ve found the veterinary community to be honest in their descriptions of the equipment they are selling—and the standard buying process lets you inspect the equipment upon arrival before your payment is processed.

• Stellar Service. Just check the site, and you’ll find reviews from tons of happy buyers and sellers!

If you’re ready to get started, head over to usedvetequipment.com. 

Here are some things to keep in mind as you shop…

• Compare your options. If there’s more than one listing for the equipment you need (a common scenario), search around and make obligation-free offers. And if you’re not in a big hurry, search over time to see what else pops up.

• Ask Questions. This isn’t a big, faceless online store—instead, it’s all about community! You’re free to reach out to sellers with any questions you may have and to ask us about the details of shipping and payments. 

• Expect the Best Experience. The goal is for you to feel comfortable (and very happy!) with your purchase.

More interested in SELLING equipment rather than buying? Check out our next article, which will have detailed suggestions for how to successfully sell on usedvetequipment.com.

Until then, take a look around the site to browse what’s available, and be sure to bookmark usedvetequipment.com in case you need to come back to it to make a purchase in the future.

Wishing you good luck in your search—we’re sure you’ll find just the right equipment you need for all the services you’d like to offer at your practice. 

A community marketplace like this is the perfect place to buy and sell with colleagues as you build the practice of your dreams.

“… 10,000 times better than any eBay / Amazon kind of purchase! We will definitely look here 1st for future purchases.”

—Sandy Pamplin, Manager Pleasanton Road Animal Hospital San Antonio, Texas

“I recently purchased a film processor through Used Vet Equipment. I was very impressed with the website- pics and descriptions. I received a quick response to my questions. Brad was very professional and thorough in handling the transaction through delivery and tracking info. He made sure I was completely satisfied with the product. I would definitely do business here again! 5-star rating!”

—D Davis, Colorado

Written by: Dr. Tammy Powell, DVM