What does an ICU cage unit do for a critical pet patient?

A Safe Haven for Healing: Understanding the Benefits of Veterinary ICU Cages

Care of the critically ill patient can be challenging enough as it is; makeshift oxygen tents, fluctuating room temperatures, and awkward nebulization systems can make it seem like a real uphill struggle.

Vet surgeons and vet techs who have access to the latest innovations in intensive care equipment can focus their time and energy on patients and treatment plans, instead of wasting it battling environmental undesirables.  

So, what are our requirements?

Oxygen Supply

One of the primary features of all our intensive care unit (ICU) cages is the supplementation of oxygen (O2).

Traditional flow-by methods are unreliable, in no small part due lack of patient compliance. With flow-by, not only is it difficult to quantify the amount of O2 being delivered to a patient, but it is also nearly impossible to track and measure the patient’s response to the gradual removal of said supplementation.

The user-friendly control panel on our ICU cages facilitates the delivery of precise proportions of O2 into a patient’s micro-environment.

These levels can be readily adjusted in a manner to suit the patient’s needs, who can be easily viewed and monitored via the clear-view cage doors. O2 concentrators can be utilized with our ICU cages for the highly economical creation of medical-grade O2.

Vet professionals can relax in the knowledge that certain safety functions are in place to protect patients. Not only will an alarm sound should O2 concentration fall below 20%, or carbon dioxide exceed 2000ppm, but they can rest assured that intelligent technology will automatically engage the external circulation of air in these circumstances, and therefore maintain patient safety.

Nebulization

For patients requiring nebulization, our ICU cages offer an extremely exciting feature. Environmental medical nebulization is an inbuilt function, removing the need for awkward, handheld systems that are poorly tolerated by pets, with the potential to induce stress.

What is more, the efficacy of nebulization is dramatically improved and can be achieved without disturbing the patient.   

Warming

Hypothermic patients benefit from our ICU cages through the gentle, reliable, and consistent application of warm air into their environment.

Burns from heat mats and microwaveable wheat bags need to be a risk no more. Instead, it is possible to accurately monitor and adjust environmental temperature at the touch of a button, for safe and effective warming. 

Quiet, calm, and spacious accommodation

Other benefits of ICU cages include the calm, and quiet environment that they create.

There are no clattering metal cage doors. Instead, soft-closing plastic doors make for a peaceful experience for critically unwell patients who may be stressed about their condition.

The impact of anxiety on compromised patients is no secret amongst vet professionals: we all know that it can interrupt and prolong treatments and therefore recovery. For this reason, our ICU cages feature silent air conditioning systems and a 3-in-1 light system.

White light is invaluable for times of patient assessment, whilst gentle, warm light is invaluable for general monitoring, and blue light is available for therapeutic purposes.

Our cages can accommodate larger patients than some since there is a removable divider. When the divider is in place, the control panel is capable of setting individual environmental conditions for each cage, resulting in tailored care for each patient.

Infection control

When a critical patient poses the additional challenges of being either infectious, or immunosuppressed, it can be tricky to know where to house them for their safety, or that of other patients.

Our ICU cages come into their own in these circumstances, with to state-of-the-art photo-hydro-ionization technology which continuously disinfects and deodorizes the cage. An internal air circulation system further bolsters the creation of a safe and sterile environment, reducing cross-contamination between patients. 

ICU cages can have been described as life-supporting pieces of equipment, and it is easy to see why. As veterinary professionals, we not only aim to not harm, but we also strive for the best standard of care when it comes to our patients;

ICU housing facilitates exactly this for many critically unwell pets including neonates, infectious patients, critical care patients, those with cardiopulmonary diseases, those with post-operative complications, as well as geriatrics.

Struggle with makeshift oxygen & unreliable nebulization? Our ICU cages offer:

• Precise oxygen delivery with alarms & safety features.

• Built-in nebulization for improved efficacy & reduced stress.

• Safe & controlled warming to avoid burns.

• Quiet environment with silent AC & calming light options.

• Infection control with photo-hydro-ionization & air circulation.

Ideal for neonates, infectious, critical care, & more!

https://newvetequipment.com/intensive-care-unit

Veterinary Dental Cleaning Stations: Components and Their Uses

A comprehensive oral health assessment and treatment (COHAT), also known as a veterinary dental procedure, is an important consideration for any pet’s long-term health.

Keeping the mouth healthy helps protect a dog or cat’s teeth and contributes to a pet’s overall wellbeing. And, it can be a source of revenue for the veterinary practice.

Here are some of the common components of a dental cleaning station, and the roles they play during a COHAT.

The Equipment Needed for Scaling and Polishing

Even for pets who need significant extractions, the dental procedure typically also involves scaling and polishing the remaining teeth, to clean them, keep them in good health for as long as possible, and avoid further tooth loss. 

So, it’s safe to say that scaling and polishing are an important part of any dental procedure.

Dental scaling and polishing are often delegated to skilled veterinary technicians and nurses. So, when it comes time to invest in a new dental cleaning station, it’s a good idea for veterinarians and practice managers to review the equipment available and see what is required to meet their practice’s needs.

These common tools on a dental cleaning unit play a role in scaling and polishing:

• Ultrasonic scaler. Hand scalers are still used, too, especially for tight spots that need extra attention. And curettes are needed for subgingival cleaning. However, it’s hard to beat an ultrasonic scaler for speed and efficiency when removing large amounts of dental calculus above the gumline. Many include a built-in LED light for easy visualization of the area being cleaned.

• Polisher/Low-speed handpiece. This tool is crucial for smoothing over any small defects or microabrasions in the tooth enamel caused during scaling. In other words, polishing should ALWAYS follow scaling. Recent AAHA dental guidelines recommend using disposable prophy angles and individually packaged, fine-grit prophy paste with a polisher.

• Air/Water syringe. This tool is useful for flushing away bits of tartar and other debris as you’re working, for drying a tooth prior to applying a sealant, or for irrigation and inspection of any visible subgingival areas after cleaning.

• Suction tool. Weak suction can be a convenient way to remove excess water and saliva during a procedure.

Equipment for Drilling and Extractions

Many extractions require drilling into alveolar bone to expose the tooth root or divide the tooth into segments. This allows for safe and efficient extractions, with less risk of leaving root tips or fragments behind.

For this reason, a high-speed drill is an essential component of any veterinary dental cleaning station. The drill should have several burs to choose from, too, since veterinarians see patients of all different sizes and since different bur shapes (rounded or tapered, for example) serve different purposes.

In addition to the drill, hand tools—such as elevators, luxators, extraction forceps, and suture kits—will be used. 

Other Factors to Consider In a Dental Cleaning Station

In addition to the tools available on the dental station, here are some considerations that may affect a veterinarian or practice owner’s decision to make a purchase…

• The size of the unit. Practices with small spaces may prefer a compact cleaning station, while others might not have a size restriction.

• Easy storage and access to tools. No matter the size of the station, it should be easy to store and access the tools right when you need to. No veterinary team member wants to fumble while reaching for a tool or accidentally drop something because it’s difficult to put back.

• Water reservoirs. No one wants to run out of water (which is used for many of the tools, including drilling and ultrasonic scaling) during the middle of a procedure, then put things on hold as the reservoir is refilled. For that reason, it may be beneficial to look for a station with a larger distilled water reservoir capacity.

• Service, maintenance, and warranty. It’s important to protect any equipment investment and to make sure it’s easy to keep the machine running so a veterinary practice can avoid canceling procedures due to equipment issues.

Also, remember to invest in high-quality complementary equipment. In addition to the dental cleaning station and other dental tools, a complete dental procedure also involves dental x-rays, appropriate anesthetic protocols and equipment, personal protection equipment, and anything else needed to perform a COHAT safely and effectively.

Veterinary dentistry can be a rewarding way to provide excellent patient care and generate income for a veterinary practice—a win-win scenario. To make sure these procedures run as smoothly as possible, it’s important to choose the equipment that’s the best fit for your practice’s needs.

Additional resources:

2019 AAHA Dental Care Guidelines for Dogs and Cats: https://www.aaha.org/globalassets/02-guidelines/dental/aaha_dental_guidelines.pdf 

Editor’s Note:

Currently, we offer a complete veterinary dental cleaning station at an affordable price including shipping, delivery, and a 3-year warranty. 

The space-saving machine is designed for high-volume use. 

It features key tools that are crucial to any veterinary dental procedure—plus, a few exciting special features like advanced cooling for the high-speed drill, a scaler with an endodontics feature, an LED light on the polisher, and more!

Learn more, and contact us with any questions, here: https://newvetequipment.com/cleaning-station 

Written by: Dr. Tammy Powell, DVM

Radiographing Reptiles

If you work with lizards, snakes, tortoises, or other reptiles, x-rays are an important diagnostic tool for these patients.

So, how does the process of radiographing reptiles differ from dogs and cats? Here are some helpful tips for reptile x-rays…

Considerations for Reptile Radiographs

Many reptiles are small in size compared to the average dog or cat. Thus, good quality radiographs with sufficient detail are required for images to be diagnostic. High detail films such as those used for mammography can be beneficial here.

At the same time, many reptiles have highly keratinized scales, or, in the case of chelonians (turtles and tortoises), a shell. These coverings can mean a higher power beam is required, which can also mean loss of detail for internal body structures. Fortunately, motion blur is not a common issue, though.

As with other species of pets, good general rules of radiography apply. This means taking a minimum of two orthogonal views to get a complete picture of the part(s) of the body being radiographed.

Indications for Reptile Radiography 

With reptiles, clinical symptoms are often subtle, and exam findings are often non-specific. So, diagnostic tools such as radiographs are important for figuring out what’s going on and providing the best treatment.

With this in mind, full-body radiographs are beneficial for any reptile who is showing symptoms of illness.

Additional common indications may include evaluating…

• Bone lesions, such as osteomyelitis, traumatic injuries, or metabolic bone disease such as nutritional secondary hyperparathyroidism.

• The digestive tract, including looking for ingested foreign bodies or other digestive ailments.

• Reproductive issues, such as dystocia, egg binding, or yolk coelomitis.

• Abscesses and other soft tissue swellings.

• Lung disease.

• Urinary issues such as bladder stones.

• Problems with other organs such as the heart or liver, although these organs may be difficult to evaluate in detail for many types of reptiles.

• Assessing if intraosseous catheters are placed correctly.

Restraint for Reptile X-Rays

Fortunately, many reptiles hold still without restraint, or with limited restraint, for certain x-ray views. But it’s still important to have a plan in place to ensure quality, diagnostic images are obtained.

A few examples of restraint for different reptile species may include…

• For snakes, allowing them to crawl inside a plastic tube. This also prevents coiling (which may interfere with radiographic interpretation) and ensures the snake is evenly extended for their radiographs.

• Cardboard boxes or other radiolucent containers for smaller species, especially small lizards. Note that this may result in a minor reduction in details/image quality.

• Vagal response in large lizards, which means placing pressure over the eyeballs when the lizard’s eyes are closed. This stimulates the vagus nerve, resulting in a lower heart rate and a calmer lizard. A vagal response could be accomplished with gentle digital pressure, or by placing cotton balls over the eyes and holding them in place with VetWrap wrapped around the head. Dimming the lights and avoiding any noise stimulation will also help.

• Chemical restraint if indicated. This could mean sedation or general anesthesia, depending on how challenging the patient is to work with, what information needs to be obtained from radiographs, and the health status of the patient. Be sure to check the best sedative drugs and doses for the particular reptile species you are working with.

Common Radiographic Views for Reptiles

As mentioned above, it’s important to obtain orthogonal x-ray views. Often, due to the smaller size of many reptiles, this means orthogonal views (a lateral and a DV) of the entire body. 

It’s important to remember that reptiles don’t have a diaphragm. They have a coelomic cavity, rather than separate abdominal and thoracic cavities like mammals have. Because of this difference, placing a reptile (except for snakes) in lateral recumbency may result in coelomic contents shifting, which can confound radiographic interpretation.

To prevent this issue and view organs in their natural position, many veterinarians obtain lateral radiographs of reptiles using a horizontal beam while the animal is standing. 

For chelonians, it helps to place them on some type of stand by balancing the plastron on a block, overturned bucket, etc. This facilitates the horizontal beam view and encourages the patient to hold still and extend their limbs and head from their shell.

Additionally, the horizontal beam can be used to obtain a craniocaudal view in chelonians. This allows comparison of the right and left lung fields.

Contrast agents, such as barium or iodine-based contrast, may be used, especially when evaluating the GI tract. However, it’s important to keep in mind that digestive transit times are highly variable (within a day at the shortest, and weeks at the longest) depending on the species, their nutritional status, and environmental conditions such as temperature and season.

If more detailed radiographs of the skull or extremities must be obtained, it’s important to collimate. For some species, veterinary dental films may provide better detail. Anesthesia may be needed for chelonians to fully view the skull or extremities outside of the shell.

Conclusion

Radiographs are a key tool when assessing reptiles for disease or injuries. But it’s important to understand the wide range of species variations in anatomy and become familiar with what’s normal and what’s not for each type of patient. This could mean having a good reference text, obtaining additional CE, or radiographing a healthy patient of the same species for comparison.

Once the best strategies and techniques are incorporated, diagnostic images can help a practitioner evaluate these unique pets and form an appropriate treatment plan. 

Written by: Dr. Tammy Powell, DVM

Radiographing Exotic Pets: avian patients

When it comes to avian patients, many general principles of radiology still apply, just as they would for a dog or a cat.

For example, proper technique and a systemic method for looking at the entire image are important.

However, birds also present unique challenges. For example, their small size means that fine details must be visible on radiographic images. And a bird’s rapid breathing rate can create motion artifact and blurriness, which can compromise radiographic details.

Here are a few strategies and tips for radiographing an avian patient…

Restraint of Birds for Radiographs

Appropriate positioning and stillness of the patient are both crucial for obtaining x-ray images with enough detail to be diagnostic. Because of this, sedation or anesthesia are usually necessary, with appropriate patient monitoring.

Of course, the decision to administer anesthesia depends on the stability of the patient and whether they can handle anesthesia. But even with ill birds, light sedation may still be beneficial to reduce stress, discomfort, or injuries that could be caused by physical restraint. 

When administering sedation or anesthesia, be sure to check the best medications and doses for birds, as these may vary from those used for dogs and cats.

Radiographic Technique for Avian Patients

It’s ideal to use the shortest possible exposure time. This helps minimize motion blur due to a bird’s fast respiration rate.

For small patients, tabletop technique is used. A grid is not needed, thanks to a bird’s air sacs which don’t cause significant x-ray beam attenuation or scatter radiation. However, a grid may be considered when radiographing an area wider than 10 cm.

Also, appropriate collimation should be used.

Positioning Avian Patients for Radiographs

Whether a patient is canine, feline, or avian, orthogonal x-ray images are more useful and accurate than single-view x-ray studies. So, whenever possible, try to obtain both a lateral and VD view.

A common view for studies is a “whole bird” radiograph for small or medium-sized birds, which means a head-to-tail view including the coelom, pectoral limbs, and pelvic limbs. However, it’s beneficial to focus on areas of interest, too—whether that’s examining organs in the coelom, evaluating a fractured limb, etc.

To visualize the coelom, it’s best to pull the wings and legs away from the body. That way, there’s nothing overlying the coelomic cavity that could complicate interpretation or cover up important details.

When positioning, it’s best to be gentle, especially with small birds that can be fragile. Pulling the wings too much can cause pain or injury, or lead to over-rotation and improper patient alignment. Tape may be used, but it should have minimal adhesive in order to avoid pulling feathers. Other positioning aids made from clear plastic can also be very useful.

For patients in poor condition, it may make sense to first do a “screening” x-ray via a horizontal beam. For this shot, the bird could be standing on a perch on the x-ray table. Sometimes, this gives enough information to rule out certain conditions (such as egg binding or heavy metal ingestion) and develop a preliminary treatment plan. Then, if needed, more detailed imaging could be pursued once the patient is more stable.

A Few Tips for Bird X-Rays

Here are a few more things to keep in mind when it comes to bird radiographs…

• If possible, it’s helpful to fast a patient prior to radiographs of the GI tract. This allows better visualization, and it reduces the risk of regurgitation and aspiration pneumonia. However, keep in mind a bird’s fast metabolism. For very small patients, fasting beyond two hours may be detrimental.

• Have a good reference guide available to use as a point of comparison for your patient’s images. This will help not only with distinguishing what’s normal and what’s not for an individual bird, but also for anatomic variations between species.

• Consider a referral or consult as needed. There’s nothing wrong with referring a patient to an avian and exotics specialist. Or, if you take the radiographs yourself, consider sending the images for a teleradiology consult.

X-rays can be a very important part of the diagnostic plan for birds. With knowledge and some practice, bird radiographs may become faster and easier for the team, leading to prompt diagnosis and treatment of ailments and excellent avian care. 

Written by: Dr. Tammy Powell, DVM