Mobile Veterinary Home Services: A Comprehensive Guide

The Convenience Revolution: A Deep Dive into Mobile Veterinary Home Services

In the ever-evolving realm of veterinary medicine, mobile veterinary home services have emerged as a game-changer, offering convenience, comfort, and personalized care to pet owners and their furry companions.

If you're a veterinarian contemplating this exciting venture, this comprehensive guide will equip you with the knowledge and strategies to establish a thriving mobile veterinary practice.

The Allure of Mobile Veterinary Home Services

Mobile veterinary home services present a plethora of benefits for both pet owners and veterinarians.

Convenience for Pet Owners:

• Eliminates the hassle of transporting pets to traditional veterinary clinics, reducing stress and anxiety for both pets and owners.

• Offers in-home care, allowing pets to be examined and treated in their familiar and comfortable environment, potentially reducing stress-induced behavioral issues.

• Provides flexibility in scheduling appointments, catering to busy lifestyles, and accommodating pets with special needs.

Advantages for Veterinarians:

Enables personalized attention and relationship building with pet owners and their furry companions.

Offers a unique work environment, breaking away from the traditional clinical setting.

Provides a sense of autonomy and control over one's practice.

Essential Equipment for Your Mobile Veterinary Clinic

To ensure you can provide comprehensive veterinary care at your client's homes, you'll need to invest in the following equipment:

• Portable examination table

• Basic diagnostic tools, such as a stethoscope, otoscope, and ophthalmoscope.

• Essential medications and supplies for common pet ailments.

• Waste disposal system.

• Portable laboratory equipment for in-house blood and urine tests.

• A reliable vehicle to transport your equipment and supplies.

• Shop for used equipment. https://www.usedvetequipment.com/

Crafting a Winning Marketing Strategy

Effective marketing is crucial for raising awareness about your mobile veterinary services and attracting clients. Here are some key strategies to consider:

• Establish a Strong Online Presence: Create a professional and informative website that clearly outlines your services, location, and contact information. Utilize social media platforms to engage with potential clients, share educational content, and showcase testimonials from satisfied customers.

• Target Local Communities: Partner with local pet stores, animal shelters, and groomers to cross-promote your services. Engage in community events and pet fairs to showcase your expertise and connect with potential clients.

• Offer Competitive Pricing and Packages: Consider offering introductory packages or discounts to attract new clients. Tailor your pricing to the specific needs of your target audience.

• Emphasize Convenience and Personalized Care: Highlight the unique advantages of mobile veterinary services, emphasizing convenience, reduced stress, and personalized attention for both pets and owners.

Navigating the Regulatory Landscape

Before launching your mobile veterinary practice, it's essential to familiarize yourself with the applicable regulations and licensing requirements in your jurisdiction. These may include:
Obtaining a mobile veterinary license or permit.

• Ensuring your vehicle meets safety and sanitation standards.

• Maintaining proper records of patient care and adhering to veterinary practice standards.

Why Mobile Veterinary Home Services Are a Smart Choice

Mobile veterinary home services offer a compelling alternative to traditional brick-and-mortar clinics, providing several distinct advantages:

• Reduced Overhead Costs: Eliminates the need for expensive clinic facilities, rent, and utilities.

• Flexible Work Schedule: Set your own hours and work-life balance.

• Expanding Client Base: Reach a wider clientele, including those with mobility challenges or multiple pets.

• Enhanced Job Satisfaction: Experience the satisfaction of providing personalized care in a relaxed and stress-free environment.

Conclusion

Mobile veterinary home services present a rewarding and fulfilling career path for veterinarians seeking a unique blend of entrepreneurship, clinical expertise, and compassionate care.

By following these comprehensive guidelines and embracing the inherent advantages of mobile veterinary practice, you can successfully establish a thriving business that caters to the needs of pet owners and their furry companions.

Exploring the Benefits of Mobile Services

Beyond the Clinic: A Holistic Approach to Pet Wellness with Mobile Vets

In the dynamic realm of veterinary medicine, a transformative trend has emerged, revolutionizing the way pet owners and veterinarians experience care. Mobile veterinary services have become the go-to solution for those seeking the perfect blend of convenience, personalized attention, and a stress-free environment for pets.

If you're a veterinarian contemplating diving into the world of mobile vet services, this comprehensive guide will equip you with tips on starting a new service, effective marketing, the importance of a compelling website, and how purchasing used equipment can be a savvy financial move.

The Convenience for Customers and Their Beloved Pets
For Pet Owners:

• Stress-Free Environment: Bid farewell to the challenges of transporting pets to traditional clinics. Mobile vet services bring veterinary care directly to the doorstep, eliminating the stress associated with car rides and unfamiliar surroundings.

• In-Home Comfort: Imagine your pet being examined and treated in the cozy comfort of their own home. Mobile vet services prioritize in-home care, reducing stress-induced behavioral issues and fostering a more relaxed experience for both pets and owners.
  
  

• Flexible Scheduling: Tailor-made for busy lifestyles, mobile vet services offer flexibility in appointment scheduling. Whether it's a routine check-up or a more urgent matter, customers can enjoy appointments that align with their schedules.

For Veterinarians:

• Personalized Connections: Building relationships with clients and their pets is a cornerstone of mobile vet services. Enjoy the opportunity to provide personalized attention, forge stronger connections, and have a more profound impact on the well-being of your furry patients.

• Escape the Clinic Setting: Break free from the constraints of a traditional clinic. Mobile vet services allow you to create a unique work environment, where you can focus on individualized care without the physical boundaries of a brick-and-mortar establishment.

• Autonomy and Control: With a mobile vet service, you're not just a practitioner; you're an entrepreneur. Take control of your practice, set your schedule, and enjoy a greater sense of autonomy in steering the direction of your veterinary career.

Tips for Starting Your Mobile Veterinary Service

• Develop a Professional Website: Your online presence is crucial for attracting clients. Create a website that clearly outlines your services, service areas, and contact information. Ensure that the design is user-friendly, and consider incorporating features like appointment scheduling and informative content.

• Utilize Social Media for Engagement: Harness the power of social media to connect with potential clients. Share informative content about pet care, engage with your audience, and showcase the behind-the-scenes of your mobile vet service. Encourage satisfied clients to share their experiences on your platforms.

• Establish Local Partnerships: Collaborate with local pet stores, groomers, and animal shelters to cross-promote your services. Attend community events and pet fairs to showcase your expertise and connect with potential clients. Word of mouth within the community is a powerful marketing tool.

• Offer Competitive Pricing and Packages: Consider introductory packages or discounts to attract new clients. Tailor your pricing to cater to the specific needs of your target audience. Highlight the value of your services, emphasizing the convenience and personalized care you bring to their doorstep.

• Emphasize Convenience in Marketing: In your marketing materials, underscore the convenience your mobile vet service provides. Highlight the stress-free environment for pets and the time-saving benefits for pet owners. Showcase testimonials that speak to the positive impact of your services on the lives of both pets and their owners.

Equipment Essentials for Your Mobile Veterinary Clinic

Investing in the right equipment is crucial for delivering comprehensive care on the go. Here's a checklist:

• Portable Examination Table: Facilitate thorough examinations with a portable table that ensures comfort for pets.

• Basic Diagnostic Tools: Stethoscope, otoscope, and ophthalmoscope are indispensable for routine check-ups and assessments.

• Essential Medications and Supplies: Be equipped with medications and supplies to address common pet ailments promptly.

• Waste Disposal System: Maintain cleanliness and hygiene with a portable waste disposal system.

• Portable Laboratory Equipment: For in-house diagnostics, invest in portable equipment for blood and urine tests.

• Reliable Transportation: A well-maintained and spacious vehicle is essential for transporting equipment and ensuring you reach your clients promptly.

• 
  Considering Used Equipment to Save Costs: Exploring platforms like usedvetequipment.com can be a smart financial move for a new mobile vet service. Purchasing quality used equipment allows you to save costs without compromising on the essential tools needed for your practice. Ensure you thoroughly inspect and verify the condition of the equipment before making a purchase.

Conclusion: Paving the Way to Success in Mobile Veterinary Services

Embarking on the journey of mobile veterinary services opens doors to a fulfilling and dynamic career.

By incorporating these tips for starting your service, emphasizing the convenience for customers and their pets, and strategically investing in equipment, you're poised to create a thriving business that brings veterinary care right to the doorstep of those who need it the most.

Explore Endoscopy in Veterinary Medicine

In recent years, endoscopy has become increasingly prevalent in veterinary medicine, offering a minimally invasive approach to diagnosing and treating a wide range of conditions. Just like other advanced imaging modalities, such as veterinary CT systems and fluoroscopy, endoscopy is becoming more commonplace for use by general practitioners.

This article aims to provide an overview of endoscopy in veterinary medicine, exploring its various applications, benefits, and considerations for implementation in veterinary practices.

What is Endoscopy?

An endoscope is a specialized instrument that allows veterinarians to visualize and examine internal organs and structures without the need for surgery.

This versatile tool consists of a thin, flexible tube equipped with a light source and a camera. The endoscope is inserted into the body through a natural orifice, such as the mouth, esophagus, or anus, to provide a real-time view of the internal environment.

Common Uses of Endoscopy in Veterinary Medicine

Endoscopy offers a range of valuable applications in veterinary medicine, including:

• Non-invasive assessment of anatomy: Endoscopy allows veterinarians to examine the internal surfaces of organs and structures without making incisions. This provides a detailed view of the anatomy, enabling the detection of abnormalities, such as inflammation, masses, and foreign objects.

• Obtaining biopsy samples: Biopsy samples are crucial for the definitive diagnosis of many conditions, including inflammatory and neoplastic diseases. Endoscopes can be equipped with biopsy forceps, allowing veterinarians to collect tissue samples from the areas of interest without the need for surgical intervention.
  
  

• Removal of foreign objects: Foreign bodies can pose a significant risk to animal health. Endoscopy facilitates the visualization, localization, and removal of foreign objects from various parts of the body, including the gastrointestinal tract, respiratory tract, and urinary tract.

• Minor surgical procedures: Endoscopy can be used to perform a variety of minor surgical procedures, such as balloon dilation of strictures, hemostasis, and nasopharyngeal polyp removal.

• Exotic animal care: Endoscopy plays a valuable role in the care of exotic species, such as birds and reptiles. It can be used for gender determination, diagnostic evaluation, and minor surgical procedures.

Benefits of Endoscopy

Endoscopy offers several distinct advantages over traditional diagnostic methods, including:

• Minimally invasive: Endoscopic procedures are minimally invasive, causing minimal discomfort and tissue damage compared to open surgery. This reduces recovery time and allows animals to return to their normal activities more quickly.

• Real-time visualization: Endoscopy provides real-time visualization of internal structures, enabling veterinarians to identify abnormalities promptly and accurately.
  
  

• Versatility: Endoscopy can be used to examine a wide range of body systems, including the gastrointestinal, respiratory, urinary, and reproductive systems.

Considerations for Implementing Endoscopy in Veterinary Practices

While endoscopy offers numerous benefits, its implementation in veterinary practices requires careful consideration of several factors:

• Training and experience: Veterinarians should undergo appropriate training and gain hands-on experience in endoscopic procedures before performing them independently.

• Equipment selection: The choice of endoscopic equipment depends on the specific needs of the practice and the types of patients it serves.

• Cost-benefit analysis: Endoscopic equipment can be a significant investment, so practices should carefully assess the cost-benefit ratio before making a purchase.
  
  

• Referral options: It is important to have a referral network in place for cases that require specialized endoscopic expertise.

Conclusion

Endoscopy has become an invaluable tool in veterinary medicine, offering a minimally invasive and versatile approach to diagnosing and treating a wide range of conditions.

By expanding their diagnostic capabilities with endoscopy, veterinary practices can enhance patient care and provide comprehensive, high-quality services.

Additional Resources:

• * American Veterinary Medical Association: [https://www.avma.org/](https://www.avma.org/)

• * World Small Animal Veterinary Association: [https://www.wsava.org/](https://www.wsava.org/)

• * European Society of Veterinary Endoscopy: [https://www.esve.org/](https://www.esve.org/)

Mastering Detection & Treatment of Urinary Bladder Stones

Unraveling the Diagnostic Challenge: Spotting Hidden Bladder Stones

Introduction:

Embarking on the quest to identify and address urinary bladder stones in our furry companions requires a nuanced approach. This comprehensive guide is designed to navigate the intricacies of detection and treatment, shedding light on the sometimes elusive nature of these mineral-rich intruders.

Recognizing the Telltale Signs: Is It Bladder Stones?"

Is your pet showing signs of distress like blood in their urine, increased urination, or accidents at home? These could be subtle indicators of urinary bladder stones. Explore this section to decipher the signals that may prompt a visit to your veterinary clinic.

The Power of Radiographs: Shedding Light on Uroliths

Radiographs serve as the cornerstone in this diagnostic journey. Learn about capturing essential views of the abdomen and unraveling the mystery of radiopaque stones. Delve into the nuances of stone size and distribution, from sand-like grains to larger formations.

Contrast Studies: Enhancing Visibility for the Elusive Stones

When radiographs fall short, a double-contrast study becomes essential. Discover the benefits of combining positive and negative contrast agents for optimal bladder stone visualization.

Understand the role of anesthesia or sedation in administering contrast agents through a urinary catheter, ensuring patient safety and comfort.

Ultrasound Magic: Illuminating Radiolucent Stones

Explore the wonders of ultrasound in uncovering radiolucent stones that elude traditional radiographs. Dive into the fluid-filled bladder's role in providing contrast for ultrasound waves, enabling the detection of stones and other bladder abnormalities. Delve into ultrasound's capabilities in assessing the upper urinary tract, identifying issues beyond bladder stones.

Tailoring Treatment: From Diet Changes to Cystotomies

Based on diagnostic findings, discover treatment options, from recommending dietary changes for dissolvable stones to performing cystotomies for stone removal. Understand the importance of follow-up imaging to track progress and determine the effectiveness of dissolution.

Post-Op Imaging: Ensuring Success in Stone Removal

Uncover the critical role of imaging on the day of surgery, utilizing pre-op radiographs to confirm stone presence and post-op views to document successful removal. Navigate the choice between standard radiographs and ultrasound for follow-ups, ensuring the long-term health monitoring of the urinary system.

Conclusion:

Armed with a combination of imaging modalities, veterinary professionals can empower clients to proactively address, monitor, and prevent urinary bladder stones in their cherished pets.

Stay ahead in the journey of pet healthcare with crystal-clear insights into the world of diagnosing and treating these pesky intruders.

Your commitment to comprehensive care ensures a happier and healthier life for our four-legged friends.

A Vet's Guide to Safe, Conscious X-Rays for cat Patients

1: Balancing Safety and Conscious Imaging

X-rays serve as invaluable tools in feline diagnostics, offering crucial insights when executed with precision. However, coaxing a cat into a state of stillness for the procedure without resorting to sedation presents a unique challenge. In this guide, we explore the delicate balance between achieving diagnostic-quality X-rays and ensuring the well-being of both feline patients and veterinary staff.

2: When Sedation Isn't an Option: Considerations and Scenarios

Before embarking on the journey of conscious cat X-rays, veterinary professionals must assess the necessity of avoiding sedation. Safety remains the top priority for patients and staff alike, as repeated attempts due to poor positioning or movement can elevate stress levels and radiation exposure.

While short-acting sedation options exist, there are scenarios where a conscious approach is preferable, such as with cats having advanced cardiac disease or previous adverse reactions to sedation.

3: Techniques for Conscious Radiographs: A Step-by-Step Approach

Ensuring a smooth and stress-free process for conscious X-rays involves meticulous preparation and execution. This section provides practical tips for veterinary professionals to enhance the welfare of feline patients and maintain a safe environment during the procedure.

4: Preparing for Success: The Importance of Readiness

To successfully execute conscious X-rays, meticulous preparation is non-negotiable. From predicting kV and mA settings to having restraint equipment readily available, the efficiency of the procedure relies on a well-thought-out plan. Implementing feline-centric protocols, including calming voices, quiet environments, and minimal handling, contributes to a low-stress atmosphere.

5: The Art of Positioning: Tools and Techniques

Positioning a cat for X-rays demands creativity and careful consideration.

This section introduces various tools, such as Perspex boxes, sandbags, troughs, and foam wedges, to aid in achieving optimal positioning without compromising patient comfort. Emphasizing that "less is more" in cat restraint, the guide outlines methods to stabilize cats with respiratory concerns while maintaining minimal restraint.

6: Taking the Shot: Executing the Radiographs

Executing conscious radiographs requires coordination and precision. This section guides veterinary professionals through the process, from staying with the cat until the machine is ready to providing reassurance during the 'beep' or 'click' of the X-ray machine.

Tips for allowing the cat to rest between shots and recognizing signs of distress ensure a humane approach throughout the procedure.

7: Pitfalls and Prudence: Navigating Challenges

While conscious radiographs offer a non-sedative alternative, potential pitfalls exist, such as poor positioning, movement blur, or sub-optimal exposure.

This section emphasizes the preference for sedation or anesthesia whenever possible to achieve radiographs safely, underlining the importance of adaptability and recognizing when chemical restraint may be necessary.

By mastering the art of stress-free cat X-rays, veterinary professionals can enhance the diagnostic process, ensuring the well-being of their feline patients and fostering a positive experience for both cats and their human companions.

Choosing the Best Oxygen Source for Your Veterinary Practice

What Oxygen Source Does Your Veterinary Hospital Utilize: Concentrator-Generated, Cylinder-Stored, or Piped Oxygen?

Have you ever thought about what works best in your veterinary hospital?

Have you become accustomed to switching small oxygen cylinders on the regular, hoofing them about the practice, trying not to think too hard about what may result from one dropped on the ground?

Well, there are alternatives out there. So, if you’re rethinking how your practice should deliver oxygen to patients, read on; we’ve collated the pros and cons of each system so that you can make an educated judgment call for you and your colleagues.

Oxygen Cylinders for Veterinary Hospitals

One of the most traditional methods of oxygen storage and delivery within the veterinary hospital or clinic is through the use of oxygen cylinders, particularly the smaller ones designed to attach to individual anesthetic machines.

The patient caseload determines the lifespan of these cylinders, ranging from one to a few days before necessitating replacement.

However, the replacement process not only adds to the workload of the veterinary team but also poses potential dangers associated with handling and moving compressed gas.

It is crucial to equip staff with purpose-designed trolleys for safely transporting these cylinders. In the event of a drop and subsequent damage, a compressed gas leak could literally blow a hole in the operating theatre wall.

Effective administration is essential for managing small oxygen cylinders, ensuring that spares are consistently available. Ideally, anesthetic machines should feature two docks, allowing for a seamless transition from one cylinder to the next when needed.

Human error is a potential concern in this system, requiring accurate labeling of cylinders as "full," "in use," or "empty." Prompt replacement of empty cylinders is vital to maintaining a state of preparedness. Additionally, robust ordering processes must be in place to prevent running out of this critical veterinary consumable.

Considerations also extend to the cost of cylinder rental, contributing to the overall expenses of operating a veterinary practice, subsequently reflected in client bills.

Despite these challenges, there are positive aspects to using oxygen cylinders in veterinary care.

Purpose-built, portable anesthetic tables with small cylinders enable uninterrupted anesthesia for patients in transit.

Moreover, in the event of a power outage, anesthetic machines continue to function, with many modern devices equipped to be powered by compressed gas through mini-Schrader sockets during emergencies.

Piped oxygen for veterinary hospitals

Piped gas is sleek in appearance, giving a professional and ‘thought-out’ look to a clinic.

Gas outlets (sockets, usually Shrader-type) are placed at convenient spots around the practice (for example at prep room and theatre anesthetic stations, and near oxygen kennels inwards).

Hoses are secured into these outlets, extending into the room to attach to anesthetic machines.

The wall outlets are fed from an oxygen distribution line that extends outside and connects to an oxygen source, most commonly bulk supply oxygen cylinders.

These large oxygen cylinders are generally situated externally to the practice, making for convenient replenishment of supplies since gas delivery companies can be given a key or combination to a safety gas storage ‘cage’.

Oxygen concentrators can also be purchased as an alternative to bulk gas cylinders, the associated money-saving of which could well offset the cost of having a piped system installed.  

Veterinary piped oxygen tends to utilize flexible hosing for the transportation of the gas throughout the building.

These hoses are not only easy to fit retrospectively (and can therefore be fitted to existing veterinary practice fabric, not just new builds), but also allow amendments and changes to be made over time.

Veterinary practices tend not to be static entities; they grow and develop to meet the ever-changing and developing needs of pet owners, so having the ability to easily add to and amend facilities is extremely useful.

It is overall a flexible system that can be tweaked as necessary to suit the individual practice.

The list of benefits of piped gas is short but important. Many practices find piped gas to be the best option simply for the level of convenience and safety for staff; it reduces or even eradicates the number of cylinder changes compared to traditional small gas cylinders.

Even where large cylinders are used, changing empty cylinders is quick and simple since they do not need to be moved.

The downside is, of course, that the cylinder still needs to be replaced periodically. In some very cold climates, there may be a risk of the connections freezing in mid-winter – but this can easily be mitigated with good design.

Oxygen concentrators play a vital role in the operations of a veterinary hospital or clinic.

They serve as ingenious devices that harness air as a natural resource to generate medical-grade oxygen.

Functioning by extracting air from the surroundings, these concentrators meticulously filter out elements like nitrogen, producing purified oxygen readily available for patients around the clock.

Available in various sizes, they cater to diverse needs, ranging from individual anesthetic stations to comprehensive applications that serve an entire veterinary practice through a piped gas delivery system.

This method of oxygen generation proves highly convenient, requiring minimal intervention once the equipment is activated.

Veterinary practices stand to benefit in two significant ways: firstly, for environmentally conscious practices, the use of concentrators helps diminish their ecological footprint by reducing the need for oxygen delivery vans on the road.

Secondly, there's a substantial cost-saving advantage, potentially cutting gas bills by up to 90%. It is advisable, however, to maintain a spare oxygen cylinder as a precaution in case of equipment failure.

In summary, the cost-effectiveness of utilizing an oxygen concentrator in conjunction with a piped gas system makes it a valuable investment for veterinary hospitals, regardless of their size.

This holds particularly true for mid to large-sized practices, where the financial advantages are substantial.

Moreover, the convenience offered by these systems contributes to enhanced staff morale.

Even in smaller veterinary practices where the installation of a piped gas system might not be financially justifiable, the adoption of one or more compact concentrators can prove advantageous not only in terms of finances but also in promoting staff well-being and environmental considerations.

Unleashing Convenience: The Rise of In-Home Veterinary Care

Convenience Meets Care: The Evolution of Mobile Veterinary Services

For many pet owners, scheduling veterinary appointments can be a logistical nightmare.

Getting your furry friend the care they need can feel like an insurmountable hurdle between busy work schedules, transportation challenges, and anxious pets. Thankfully, the landscape of veterinary medicine is evolving, and mobile veterinary services are emerging as a convenient and compassionate solution.

From House Calls to High-Tech Vans:

The concept of mobile veterinary care isn't entirely new. Traditionally, veterinarians made house calls, providing essential services in the comfort of a pet's familiar environment. However, with advancements in technology and veterinary equipment, mobile vet services have transformed into fully equipped clinics on wheels.

These specialized vans are outfitted with the latest diagnostic tools, allowing veterinarians to perform a wide range of examinations, vaccinations, and even minor procedures directly at your doorstep. This eliminates the stress of traveling to a clinic, especially for pets who experience anxiety in unfamiliar environments.

Benefits for Pets and Owners:

The advantages of mobile veterinary services extend far beyond convenience:

• Reduced stress for pets: Familiar surroundings can significantly decrease anxiety and fear associated with vet visits, leading to a more positive experience for both the pet and the owner.

• Increased accessibility: Mobile services cater to individuals with limited mobility, busy schedules, or multiple pets, making veterinary care more accessible than ever before.

• Personalized attention: Mobile vets often have more dedicated time with each pet, allowing for a more thorough examination and personalized care plan.

• Improved compliance: By removing logistical barriers, mobile services can encourage regular check-ups and preventive care, ultimately benefiting your pet's long-term health.

The Future of Mobile Veterinary Care:

The future of mobile veterinary services is brimming with potential. As technology continues to evolve, we can expect to see:

• Expansion of services: Mobile vets may offer more specialized services like dentistry, pain management, and even advanced diagnostics.

• Telemedicine integration: Combining mobile visits with remote consultations can further enhance accessibility and provide ongoing support between appointments.

• Focus on preventative care: Mobile services can be crucial in promoting preventative healthcare initiatives, leading to healthier and happier pets.

Short Reason for a Mobile Vet to Have a Website: Reach More Pets, 24/7

A website for your mobile vet service allows you to reach potential clients anytime, anywhere.

This is crucial as many pet owners research vets online before making an appointment.

Your website can showcase your services, qualifications, and the convenience of mobile care, attracting clients who might not otherwise consider your services.

Choosing to be a Mobile Veterinarian

Mobile veterinary services are revolutionizing the way we care for our pets.

By offering convenience, personalized attention, and reduced stress, they are making essential veterinary care more accessible and ensuring a healthier, happier life for our furry companions.

Low Flow Anesthesia in a Veterinary Practice. Do's / Don'ts

Low Flow Anesthesia in a Veterinary Practice: Key Do's and Don'ts

The Benefits of Low-Flow Anesthesia for Veterinary Practices.

There was once a time when anesthetic was all about just keeping the patient ‘asleep’ so that a procedure could be carried out.

If we are being responsible practitioners and business owners, we should be striving to reduce the use of some of these inhalants.

Using injectable anesthetic protocols eliminates the volatile gas element altogether, but there is still a carbon footprint associated with the production of the drug, the electricity needed to power the syringe driver, drug wastage, and so on.

We also need to be careful not to compromise patient safety.

Low-flow anesthesia helps to provide the compromise we need, allowing us to continue with inhalants but at lower levels than we are traditionally used to.

What is low-flow anesthesia?

Simply put, low-flow anesthesia is the minimum safe gas flow you can use during the maintenance phase of a patient’s anesthetic, that still supplies them with enough oxygen to continue with normal metabolic functions.

It is defined as a fresh gas flow (FGF) of 0.5-1 L/min. 

Minimal flow (which is 0.25 – 0.5 L/minute) or closed-circuit techniques (< 0.25 L/minute) also exist, but care must be taken to ensure your patient doesn’t become hypoxic.

This is made riskier if nitrous oxide is used, so this would not be recommended. It’s also important to remember that many general-purpose vaporizers do not operate reliably below 0.5L/min.

Many practices have conventionally used comparatively high FGF rates, usually much more than is actually required for our patients.

This has many downsides, including being wasteful of oxygen and inhalational anesthetics. This not only impacts the environment but also costs money. There is an increased risk of unnecessarily exposing the veterinary team to anesthetic agents with this method too.

For our patients, there is also the downside of having lots of unnecessary cooling gases entering the airways, which is not ideal for a small animal under anesthesia. Hypothermia is a real risk, particularly for animals under 10kg, so re-breathing warm gases in low-flow anesthesia can be very helpful.

What are the dos and don’ts of low-flow anesthesia in a veterinary clinic?

Most of the problems faced in low-flow anesthesia are due to inappropriate equipment which we will cover here.

Dos:

Do use a veterinary vaporizer that can deliver precise fresh gas flows down to 200ml/min and make sure that it has been calibrated and tested for low flow rates.

Despite claims, some vaporizers struggle with high resistance, an inability to respond quickly to setting changes, and inaccuracies in the delivery of inhalants (Kelly and Kong, 2011).

Don’t hesitate to speak to the manufacturer if you require specific advice about individual vaporizers.

Do use a precise oxygen flow meter which can be easily read and used to monitor fresh gas flow rates down to 200ml/minute.

Do use a low volume / low resistance circle absorber which can rapidly respond to changes in vaporizer settings at 200ml/min fresh gas flow. It should respond within 5 breaths ideally.

Some can be very slow (up to 20 minutes). Increasing your FGF during vaporizer setting changes can help, but may negate some of the benefits of using a low-flow system.

Do always leak-test your system before use. The soda lime in any rebreathing circuit needs daily checking too, as once exhausted the indicator can revert back to its original color if left in situ which can be misleading, severely compromising its carbon dioxide absorbing abilities.

Do use a higher FGF (2L/min) and vaporizer settings at the start of your anesthetic. Around 10-15 minutes is required to allow the anesthetic agent and oxygen concentrations to build to a sufficient level in the breathing system (Feldman, 2012).

Similarly at the end of your anesthetic increasing your FGF can help to remove any volatile agent more rapidly.

Do use appropriate analgesia and volatile agent-sparing techniques.

This includes using systemic analgesia as well as regional anesthesia techniques like epidurals, peripheral nerve blocks, and splash blocks. You could also consider total or partial intravenous anesthesia.

Do use capnography whenever you’re doing a low-flow protocol. It gives us a measure of how well a patient is ventilating and is the only reliable early measure of hypoxemia.

Don’ts

Don’t use repurposed human equipment for low-flow anesthesia in small animals. It is unlikely to be accurate enough for the patient sizes you will be dealing with.

Don’t try and use non-rebreathing systems that require high gas flows to expel expired CO2, such as Bain circuits or Ayres T-pieces.

Don’t use low-flow when nitrous oxide is being delivered unless there is in-circuit oxygen concentration monitoring. There is a risk of hypoxia in these patients.

Don’t expect staff to feel comfortable with new techniques without appropriate training, invest time in your team.

Don’t worry if you don’t have access to all the patient monitoring tools.

However, your patient will need to be observed very closely.

Most practices have a pulse oximeter though, which you should use as a minimum.

This tells us about hemoglobin saturation, which is essential in low-flow anesthesia.

Gas/anesthetic agent monitoring is ideal as it monitors inspired O2, as well as inspired and expired anesthetic agent concentrations, but this is expensive so many practices do not have access to this.

Summary

There are multiple benefits to low-flow anesthesia, and it should be considered by all veterinary hospitals. Ensuring you have the right equipment in place is key, as is spending time on staff training so that you can be sure you are providing the very best care for your patients.

References

Feldman, Jeffrey M. MD, MSE. Managing Fresh Gas Flow to Reduce Environmental Contamination. Anesthesia & Analgesia 114(5):p 1093-1101, May 2012. | DOI: 10.1213/ANE.0b013e31824eee0d

Jones, RS & West, E (2019) Environmental Sustainability in Veterinary Anaesthesia. Veterinary Anaesthesia and Analgesia 46 (4) 409-420

Kelly, J.M. & Kong, K.-L. Accuracy of ten isoflurane vaporizers in current clinical use. Anaesthesia, 2011; 66: 682–688

‘The whys and hows of low flow: an introduction to safe low-flow anesthesia’ by Simon Wheeler and Colin Dunlop, 14th June 2023

‘Low Flow Anaesthesia: Frequently Asked Questions, April 2020’ – Davies Veterinary Specialists, April 2020

‘Reducing anesthetic gas for environmental benefit’ - Ellie West MA Cantab VetMB CertVA DipECVAA AIEMA MRCVS, Clinical Anaesthetist, and Sustainability Lead at Davies Veterinary Specialists, 30th January 2020

Stainless Steel Cages for pets in Veterinary Clinics

Promoting Animal Well-Being: The Role of Stainless Steel Cages in Veterinary Clinics

Stainless steel cages are found in most veterinary clinics across the world, often being used for both canine and feline patients and some exotic species.

The perception of cages of any kind to members of the public can be poor, but using the right stainless steel cages can have a positive impact on animal welfare and be a great advantage to a clinic.

They are excellent for biosecurity as can be easily disinfected using appropriate techniques without worrying about damage to the surfaces. 

Various layouts of cages exist, which allow a certain flexibility in the clinic to fit with a practice trying to balance patient safety, hygiene, and patient welfare.

Patient welfare is at the forefront of the veterinary industry and equipment that makes this easier is always worthwhile. Members of the public assume a level of patient welfare when leaving their pets in the clinic, so it’s vital to ensure this occurs.

Safety for staff members

Stainless steel cages are much safer for staff members as they allow the behavior of a patient to be observed from a distance, without the staff having to get close and risk injuries from bites or scratches.

The initial components of pain scoring can be performed by observing the patient from outside the cage and watching their reactions.

This also means that the patient themselves is less aware of being observed and their “personal space” remains intact, so they tend to remain calmer (in an already strange situation for them away from family and familiar scents and surroundings).

The easy closure of the cages prevents damage to fingers or paws from becoming trapped within the cage. 

Safety for patients 

As the cages are smoothly finished, there is no risk of a rough edge or surface that the patient can catch themselves and cause injury on.

They are unable to get through the gaps between the metal cage bars, so cannot hurt themselves falling. They cannot affect the closing mechanisms, regardless of whether they lean or put pressure on them, so they are safe and secure inside the cage. 

Welfare of patients 

Due to the design of the cages, there is excellent airflow and ventilation which prevents airborne particles from staying for too long on surfaces. It also allows for the patients to have good airflow and prevent overheating by being too enclosed. 

As the patients can see out of the cages, they feel less enclosed and often are calmer as they can observe what is going on around them.

An unfamiliar environment can be frightening for patients, but a bright area where staff can observe the patients and talk to them to help calm can be helpful to make them feel less scared. 

Because they cannot injure themselves or others, as mentioned above, they will be safer overall and if they are vocalizing in distress staff members can hear them and come to help them. 

The cages are designed to be large enough that the patients can turn around and exhibit normal behavior which is good, but without being too big that they can cause damage by knocking themselves on the sides. 

Cleanliness

Stainless steel as a material by nature is durable and easy to clean. The cages can be wiped over, or areas submerged in cleaning products, to allow for a thorough disinfection and can even be left with disinfectant in contact for longer periods of time to prevent any diseases remaining.

This all helps prevent cross-contamination, as when the next patient is placed in the kennel it is not only visibly clean but is disinfected, allowing for the reassurance that diseases will not be passed on. 

Conclusion

Stainless steel cages have many benefits to both the patients and staff in the clinic.

As well as the above, they are durable and hard-wearing so last for a long time due to their high quality.

They can be customized to allow them to stack on top of others or for various sizes and configurations which makes for a highly useful system for many years. 

Comfort & Hygiene Stainless Steel Cages for Veterinary

Balancing Comfort and Hygiene: Stainless Steel Kennels in Veterinary Care

Stainless steel kennels are a mainstay in many veterinary clinics for the housing of our patients. These kennels are a careful balance between excellent biosecurity and hygiene while still maintaining patient comfort during their hospitalization.

Comfort - Bedding

Bedding is clearly an important consideration in the comfort of a patient, as stainless steel is hard and non-porous, which is ideal for hygiene but is not appropriate to house animals on directly. 

Species consideration

Bedding should be used according to species – veterinary hospitals see everything from dogs and cats to birds and rodents; all have very different husbandry requirements. Species-specific husbandry and bedding provision can help in stress reduction in hospitalized patient, allowing them to display their natural behaviors.

Bedding, particularly when discussing canine and feline patients, should be non-slip and durable. Rodents, lagomorphs, avians, and reptiles all will require the provision of very specific bedding and husbandry. 

Life stage consideration

The age/life stage of the patient needs to be considered.

Many geriatric animals will benefit from a padded orthopedic mattress in the kennel for extra support as a high percentage of geriatric animals will have some degree of osteoarthritic changes, or muscle atrophy.

Young patients, particularly dogs, maybe a foreign body risk and therefore the bedding provided must be durable and unable to be torn into small pieces which could be inadvertently ingested.

However, neonatal and juvenile animals may require more sleep/rest periods, and therefore provision of suitable bedding is essential. 

Disease process consideration

Furthermore, animals with certain diseases can experience cachexia and will need extra padding to support them. Other disease processes can cause patients to be unable to thermoregulate well, which will result in staff needing to warm or cool their environment and provide bedding appropriate to their specific needs.  

Orthopedic mattresses, useful in both geriatric and sick patients, can be obtained once kennels have been measured. A waterproof and durable outer layer is important to maintain hygiene.

Laundry

Soiled hospital laundry and animal bedding may be considered a potential source of infection to both staff and patients and may cause cross-contamination of the environment.

All reusable linens and bedding that have been contaminated with blood, urine, feces, or any other bodily fluids or exudates must be subjected to a decontamination process.

All bedding should be checked for soiling regularly and changed whenever there has been contamination. Using single-use absorbable sheets may help in cases of incontinence, hemorrhage, diarrhea, or vomiting, to help protect the bedding. 

Biosecurity and Hygiene

Compelling evidence has accumulated in human medicine to confirm the important role of the environment in pathogen transmission.

Infection prevention and biosecurity are an essential part of patient care to avoid hospital-acquired infections (HAIs), therefore should play an important role in daily practice – with several team members involved in ward and kennel cleaning and hygiene and all team members be educated and aware of the importance.

There is a real financial risk of failure to ensure biosecurity – with potential losses to the veterinary hospital and the client. Careful and strategic evaluation of disinfectants, implementation of thorough cleaning practices, and environmental swabs of the veterinary hospital can prevent these kinds of HAIs and the added cost of treating and controlling them.

To aid in this process, it is desirable that surfaces in animal housing and clinical spaces are cleanable and nonporous, such as stainless steel in the kenneling areas. 

Common factors that can lead to poor hygiene measures include, not following the dilution instructions on the disinfectants, failing to reach designated contact time, incorrect storage or use beyond the disinfectant’s shelf life, and mixing inappropriate cleaning chemicals which can result in dangerous interactions (such as the release of chlorine gas).

Furthermore, if the team does not adequately remove gross debris prior to the application of the disinfectant, it may render the chemicals ineffective.

Quality Control

Environmental swabs can be taken to monitor and audit the effectiveness of current hygiene protocols. This should be done throughout the veterinary hospital but should include kennels, including monitoring the cleaning of the bars and openings to ensure specific ‘touch points’ aren't getting missed. 

Conclusion

Consideration of comfort and hygiene in hospitalized patients is essential.

It takes a whole-team approach to maintain veterinary practice hygiene, and education should be on a systemic level so all people within the organization are aware of why protocols are used.

Particularly in kenneling areas, stainless steel units provide an excellent non-porous material for decontamination and disinfecting – but care should also be taken to furnish the kennel with appropriate bedding to maximize patient comfort and experience while still allowing excellent hygiene measures to be undertaken.

References

AAHA (2017) ‘Infection Control and Biosecurity in Veterinary Medicine’ Available Online: https://www.aaha.org/globalassets/05-pet-health-resources/virox_booklet24.pdf

Anderson, K.L., O’Neill, D.G., Brodbelt, D.C. et al. Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Sci Rep 8, 5641 (2018).

Traverse M, Aceto H. Environmental cleaning and disinfection. Vet Clin North Am Small Anim Pract. 2015 Mar;45(2):299-330, vi. doi: 10.1016/j.cvsm.2014.11.011. Epub 2014 Dec 30. PMID: 25555560; PMCID: PMC7114656.

Kerrigan, L. (2015) ‘Care of ageing patients: general considerations for nursing’ Available Online: https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/care-of-ageing-patients-general-considerations-for-nursing.pdf

Mark A. Mitchell, (2009) CHAPTER 2 - PREPARING YOUR HOSPITAL FOR EXOTIC PETS, Editor(s): Mark A. Mitchell, Thomas N. Tully, Manual of Exotic Pet Practice, W.B. Saunders.

Enhancing Patient Safety with Stainless Steel Cages

Patient Safety First: The Role of Stainless Steel Cages in Veterinary Care

There are a variety of different veterinary practices across the globe, from converted old buildings to purpose-built referral centers. No matter the type of veterinary practice, patient safety should always be at the forefront of our minds.

The type of cages used within the veterinary sector could have a direct impact on the health of our patients, with some cage materials being described as superior to others. There are many different factors that could affect the quality of patient care, but the quality of cages within kennels and catteries is well within our control. 

Let’s have a look at 10 reasons to invest in, or make the switch to, stainless steel cages for your veterinary practice.

Durability 

Stainless steel is durable, making it the perfect material for an animal cage. Stainless steel has an important component - chromium - which gives the steel its durable nature. (Anderson, 2022)

We see a variety of different temperaments at the veterinary practice, from the sweet and innocent to the bold and brash and it is important for a kennel to withstand a beating (or gnawing) when an animal may not be too happy about being in a cage. 

Some kennels can be manufactured with materials such as glass and plastic, however, these are often easily damaged by warping, bending, or even smashing.

Fully customizable 

Veterinary practices come in all different shapes and sizes and it is important that you don’t have to change your current space to be able to upgrade your kennel design. Many stainless steel kennels can be made to order, allowing them to fit the area that you already have. 

Hygienic 

All types of kennels and cages found within the veterinary practice should be easy to clean and maintain. After all, the clinic should be as sterile as possible to avoid post-operative, zoonotic, and inter-species infections. 

Stainless steel cages are easily cleaned and disinfected. Not only that, but they are unlikely to become damaged by the cleaning chemicals or being wet.

Traditional kennels, which include ceramic tiles, offer the possibility of harboring bacteria, either in cracked tiles or the grouting. Materials such as plastic and perspex are easy to clean and maintain, however, once they are scratched or damaged in any way, this also offers a chance for bacteria to accumulate. 

Hypoallergenic properties 

Stainless steel is hypoallergenic and it is unlikely that an animal would have a reaction to it. In fact, that’s why jewelry for humans is often made from steel as it is unlikely that we will have an allergic reaction.

Similarly, many pet food bowls are made from stainless steel - mainly because it has the same benefits that stainless steel kennels do! Harmful bacteria, pollen, and allergens are unable to enter stainless steel due to its non-porous surface, making it a safer option for our patients. (Americat Company, 2023)

Eco-friendly

In a world where sustainability and global warming are hot topics, it’s only fair that veterinary practices do their bit to contribute towards a greener future. Veterinary practices produce a substantial amount of waste, so why should we further implicate the environment by investing in plastic kennels?

Stainless steel is environmentally friendly, fully recyclable, and toxic chemicals are not usually used in its production. When you compare this to plastic kennels, which are not normally recyclable, it’s easy to see why stainless steel is superior. 

Aesthetically pleasing

No matter what cages you have at the veterinary practice, you want them to be safe, easy to clean and look smart. If you’re employing new staff, the appearance of the practice says a lot about a company.

Stainless steel cages look sleek, smart, and clean. They make a kennel or cattery environment look clean, professional, and functional.

Strong and safe

Stainless steel is a strong material. In fact, stainless steel is so strong that it is often used to build bridges, skyscrapers, and vehicles.

Stainless steel cages offer the best security and protection for our patients. Whilst plastic and perspex are strong, they can be more likely to break and crack. Some kennels offer glass frontages which are perfect for observing patients, but may not be the best material for an angry canine that we want to stay where it is!

Resistant to rust 

A massive perk to stainless steel kennels is that they are corrosion-resistant. This makes them a brilliant addition to the veterinary practice as they can be easily cleaned or left to soak in disinfectant in severely soiled cases.

Stainless steel cages are also brilliant to be used outside, as they are weather resistant and so are suitable for housing injured wildlife. 

Aids in odor control 

Unfortunately, there’s always a less desirable smell or two at the veterinary practice. From diarrhea to vomit - we’ve seen it all.

Stainless steel cages offer an easy-to-clean surface and thankfully do not hold on to unpleasant odors. 

Most other materials, including perspex, are easy to clean but can sometimes hold on to smells.

Perspex can scratch more easily, allowing odors to penetrate into the material.

Some kennels can have ceramic tiles that line the walls and floor of the kennels; These are easy to clean initially, but aged and worn tiles can crack and deteriorate over time, harboring smells.

Resistant to extreme temperatures 

Whilst a veterinary clinic is usually temperature-controlled and is unlikely to experience extreme temperatures, stainless steel is resilient against hot and cold temperatures.

Plastic can easily warp under hot conditions or become brittle in extreme cold. Likewise, glass can easily crack and smash in high or low temperatures.

Final thoughts on stainless steel cages

Stainless steel kennels have many perks and seem to be one of the most versatile and durable kennels available within the veterinary industry. Each veterinary practice is different and what might suit one practice may not suit another. If you want a cage that is secure, durable, hygienic, and eco-conscious you can’t go wrong with a stainless steel kennel.

The benefits of stainless steel cages in Veterinary clinics

Advantages of Stainless Steel Cages in Veterinary Clinics

Stainless steel cages are now being widely used in veterinary practices across the world. Stainless steel is an iron-based alloy that is well known for its resistance from rusting and corrosion. 

Stainless steel cages have gained popularity over the years because of their ease of maintenance, along with their smart appearance. These types of cages can also be used to comfortably and securely accommodate many species including dogs, cats, and exotics.

Therefore, they can be incorporated into many different types of practices. The following points will discuss the benefits of stainless steel cages in veterinary clinics, and we’re going to really focus on the hygiene benefits. 

The importance of hygiene

Infection control and hygiene are of great importance in veterinary practices. The main reasons that practices have strict hygiene protocols are to prevent the spread of zoonotic and contagious diseases between patients or from patients to staff and to reduce the risk of antibiotic resistance.

Good hygiene provides a line of defense against harmful organisms and standard operating procedures are in place to set these protocols.

Hospital-associated infections sadly occur in both veterinary and human medicine and control is based on hygiene and environmental factors.

In veterinary practices, the more common diseases that can be easily transmitted between ward patients include urinary tract infections, viruses such as parvovirus or calicivirus, and multi-factorial syndromes such as pneumonia, infectious diarrhea, and kennel cough.

In already very vulnerable patients contracting these diseases during a hospital stay can be detrimental to their health. 

Stainless steel cages – the benefits

Easy to clean

Stainless steel cages encourage and allow a good level of hygiene in the patient wards.

As stainless steel is a highly durable material with high chemical resistance, it is able to withstand and handle a wide range of different types of cleaners and disinfectants, as well as repeated application of these.

Plastic kennels can be relatively easy to clean but are often less resilient at withstanding repeated disinfectant applications.

Wooden kennels are an even poorer disinfectant, with microscopic pores that allow pathogens to evade the surface clean, and trapping organic debris that can inactivate many disinfectant agents.

Remain clean

The smooth and bright surfaces of stainless steel also allow the surfaces to be virtually free from bacterial retention after cleaning.

This high level of cleanliness is why places such as restaurants and hospitals also utilize stainless steel surfaces throughout their businesses.

Smooth surfaces mean that it is less likely that cracks and crevices appear that can harbor dirt and bacteria. 

Time saved

Furthermore, the easier that something is to clean the less time that it takes. This means that more time can be spent focusing on looking after your hospitalized patients and delivering gold-standard care. 

Strong and durable

Additionally, stainless steel cages are also extremely secure and safe. This is a feature that is vitally important in Veterinary practices as nobody wants an escapee patient!

Stainless steel is hard-wearing, and it is therefore able to withstand a lot of force even from the strongest of dogs.

Its robust physical properties also mean that, once they are installed, they are likely to be used for many years without needing to be replaced.

Smart looks

How aesthetically pleasing something is definitely is an important factor when planning any workplace environment. Stainless steel cages do give a professional appearance and the shiny polished surfaces provide a beautiful finish.

Hygenic separation

Often stainless steel kennels are positioned side by side or are stacked which helps to prevent the transmission of airborne pathogens to the patient next door. 

To conclude, stainless steel is now a popular choice of material for cages in many types of Veterinary practices. Not only does stainless steel provide patient security and safety, but it also maximises hygiene which greatly benefits the health of both the patients and the hardworking veterinary staff. 

Uncover the Advantages of Endoscopes in Veterinary Medicine

Shrinking Surgeries: The Advantages of Minimally Invasive Endoscopic Procedures

Endoscopy is a fantastic, minimally invasive tool that is now widely used throughout the veterinary field, both in small- and large animal medicine. You may or may not have access to endoscopy in your current veterinary clinic but even so, it is really handy to know when to reach or refer for this modality!

What is endoscopy?

Let’s begin by reviewing how endoscopy actually works. Endoscopes are often described as “cameras'' which are used to view internal organs.

In reality, of course, we do not routinely place a camera into the patient; instead, we use an optical waveguide, typically in the form of fiber optics, which transmits light from the insertion tube and umbilical cord into the patient. The reflected light is sent back to the processor for image visualization

These optical devices rely on the principle of total internal reflection, a phenomenon whereby light can be reflected continually along an optical fiber or rod lens. The image can then either be viewed directly or projected onto a camera and displayed on a screen (as is increasingly common). 

There are two major types of endoscope: rigid vs flexible

These are selected based on the area of interest. For example, if you wanted to examine the colon, bronchioles, oesophagus, or stomach then you would opt to use the flexible endoscope.

Flexible endoscopes are made up of moveable and easy-to-manipulate insertion tubes, containing one or more bundles of optical fibers.

Whereas fixed rigid endoscopes are better suited to procedures such as arthroscopy and laparoscopy, and comprise a steel sheath containing delicate rod lenses.

In either case, the insertion tube must be connected to an umbilical cord, which supplies light (it’s dark inside a patient, remember!), distilled water (for cleaning the lens), and in many cases the camera mount and other mechanisms.

In the case of flexible endoscopes, there will usually also be a handpiece on the end of the insertion tube that mounts the control wheels, for lateral and vertical flexion and extension of the scope. In many scopes, there is an instrument channel through which instruments can be passed such as surgical instruments, biopsy forceps, or grasping instruments.

The benefits:

There are many benefits of endoscopy in small animal procedures in particular which can enhance your clinical practice, improve patient outcomes, and reduce the requirements for referral to alternative or secondary providers.

Diagnostics:

Endoscopy is now a well-recognized diagnostic tool in the management of gastrointestinal disorders in dogs and cats (Rychlik and Kaczmar, 2020). Endoscopy and endoscopically guided biopsy have a high sensitivity to diagnosing mucosal disorders within the gastrointestinal tract.

Additionally, the endoscopic biopsy of the intestine is regarded as the gold standard in the diagnosis of IBD in dogs and cats in veterinary hospitals (Rychlik et al, 2007).

As well as gastrointestinal diseases being explored via endoscopy, the respiratory system can also be explored in this way too.

Rhinoscopy, bronchoscopy, and tracheostomy can all be performed to investigate pathology associated with these areas. Focusing on rhinoscopy, this technique allows direct visualization of the nasal mucosa, allowing samples to be obtained in a less traumatic way than direct surgery.

This is particularly relevant when nasal masses are present and require diagnosis (neoplasm or mycosis, for example)  or where tumors require staging with minimal destruction of the overlying bony structures. 

Minimally invasive surgery:

Whatever it is used for, endoscopy is always described as ‘minimally invasive.’ This is due to the small incision size and minimal exposure of the body cavity.

Consequently, because of the smaller surgical wounds with endoscopy compared to conventional surgical approaches, the healing process is quicker than with traditional surgical wounds.

Quicker healing times are of particular importance in dogs with working, competition or service duties, because of their rapid return to normal function. 

Many clinics are now offering laparoscopic (keyhole) ovariohysterectomies or ovariectomies as an alternative to the traditional ventral median celiotomy technique.

As stated above, this spay technique is not only less invasive but it has also been associated with fewer postoperative complications (William et al, 2009).

Post-operative pain scores in dogs were found to be significantly higher in cases using the traditional technique versus the laparoscopic technique (Devitt et al, 2005). Other surgeries which can now be performed via endoscopy include gastropexy, cryptorchidectomy, and abdominal organ biopsy. 

Foreign bodies:

Unfortunately, as we are all well aware, foreign bodies are common presentations in small animal practices. Whether endoscopy can be offered is dependent on the nature of the foreign body and its location within the gastrointestinal tract.

Endoscopy is currently the superior treatment of choice for the majority of gastric or oesophageal foreign bodies (Poggiani et al, 2020). Without the aid of endoscopy, in most circumstances, the alternative option is invasive surgery to physically remove the foreign object.

Endoscopy is greatly beneficial in the majority of these cases because it offers a less invasive and less costly option to the pet owner.

Additionally, endoscopy is associated with a much shorter hospitalization time which is beneficial for the patient. 

To summarise, endoscopy has many benefits in small animal Veterinary medicine.

Whether you’re already a pro at endoscopy or a budding novice endoscopist, the movement is happening, and it is becoming widely available within the veterinary field worldwide. 

Advancing Veterinary surgery: Exploring the benefits of endoscopes in small animal procedures

References

Devitt, C, M. Cox, R, E. Hailey, J, J. 2005. Duration, complications, stress and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. Journal of American Veterinary Medicine Association. 227: 921- 927. 

Rychlik, A. Kaczmar, E. 2020. Endoscopic biopsies and histopathological findings in diagnosing chronic gastrointestinal disorders in dogs and cats. Vet Med Int. 9. Rychlik and Kaczmar

Rychlik, A. Nieradka, R. Kander, M. Depta, A. Nowicki, M. Sarti, K. 2007. Usefulness of endoscopic examination for the diagnosis of inflammatory bowel disease in the dog. Polish Journal of Veterinary Sciences. 10: 113-118. 

Poggiani, F, M. Duarte, R, P. Santana, M, S. Galera, P, D. 2020. Endoscopic removal of foreign body in upper gastrointestinal tract in dogs: Success rate and complications. Sci Vet. 48: 1735.

William, T, N, C. Mayhew, P, D. Brown, D, C. 2009. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. Veterinary Surgeon. 38: 811-817. 

Veterinary Dental Care: Digital Radiology at the Forefront

Transforming Veterinary Dentistry with Digital Radiology

Dental disease is the most prevalent condition in dogs and cats presenting to small animal primary care veterinarians.

Periodontal disease is listed as the most common oral issue observed.

In recent years, digital radiology has revolutionized dental procedures in veterinary practice.

Accessing detailed images of what is lingering below the gingival surface at the click of a button can prove crucial in time-dependent clinical decision-making.

Digital dental radiology can vastly increase procedure efficiency, reduce serious complications, and improve the welfare of many veterinary patients. 

Dental radiographic equipment is considered essential in the U.S. veterinary hospital according to the WSAVA global dental guidelines.

However, to appreciate the importance of dental radiology, it is essential to understand its clinical application in treating different dental conditions.

This article explores the use of digital dental X-rays in practice through specific clinical examples and how this technology might benefit your team and your patients.

Periodontal disease

Periodontal disease occurs when subgingival plaque and bacteria cause inflammation of the soft tissue and alveolar bone supporting the tooth.

Common sequelae include oronasal fistulae, abscessation, osteomyelitis, pathological mandibular fractures, and ocular disease.

Evidence is also growing to support the notion that periodontal disease contributes to systemic conditions in some patients.

Periodontal disease is most easily identified in anesthetized patients and has been observed in 44-100% of dogs as young as the age of two years in various studies.

The condition is identified by probing for periodontal pockets around each tooth. However, for teeth with a tight interproximal space (e.g., molars), pathological pockets cannot be reached with a probe and will only be detected via dental radiographs.

Without radiology, several teeth affected by periodontal disease could be missed entirely, with serious consequences for that patient.

Additionally, dental X-rays must be performed in small-breed and toy-breed dogs.

Their mandibular molars occupy a larger area of the jaw than other breeds and severe periodontal disease can cause areas of bone lysis that dramatically weaken the mandible, causing pathological fractures in some cases.

Dental extractions without radiographs risk iatrogenic mandibular fractures in these dogs and cats.

Feline resorptive lesions

Dental radiology is integral to determining the appropriate treatment in cases of TR or tooth resorption.

Where roots are retained without evidence of replacement resorption (dentoalveolar ankylosis), the roots remain painful, and there is a risk of an endodontic infection developing.

However, where a dental X-ray identifies roots that are completely resorbed and replaced by bone, infection is unlikely to occur, and extraction is not recommended.

In these cases, crown amputation is an acceptable treatment. For those feline patients with resorptive lesions where some evidence of the root and periodontal ligament remains, or signs of infection or stomatitis, coronectomy is unsuitable, and surgical extraction may be necessary. 

Without dental radiographs, it is impossible to determine the condition of the tooth root and the appropriate course of action.

Performing coronectomy inappropriately can lead to extensive oral pain, root infections, and the requirement for revision dentistry.

In addition, identifying the best approach for extracting affected teeth can save considerable time during a dental procedure and avoid the need for salvage procedures. 

PDT or persistent deciduous tooth

Deciduous teeth that fail to exfoliate can lead to overcrowding, malpositioning of permanent adult teeth, and increased plaque build-up, with all the consequences that this entails.

In addition, fractures and pulp exposure of deciduous teeth can cause endodontic disease and osteomyelitis, damaging the adjacent adult teeth in the process. Retained deciduous teeth, similar to FT, should be assessed for root resorption before extraction.

In many cases, where the root is partly resorbed, a surgical extraction approach is required. Non-surgical extraction without radiography risks tooth fracture and retained roots, leading to painful endodontic infections.

Where the root is entirely ankylosed, the clinician can be confident in their decision to amputate the crown, saving them time and stress and eliminating any unnecessary trauma to the patient.

Tooth trauma

Crown fractures with Dentin exposure can be painful and lead to root infections in the same way that pulp exposure can.

But, due to the subtle presentation, clients often chose to ignore these innocuous injuries.

In these cases, dental radiographs can assess the deeper structures for signs of inflammation and infection and demonstrate to the client when further action is warranted. Interventions include root canal therapy or tooth extraction.

However, when the tooth is viable, the exposed dentine can be sealed, and regular dental radiology can be used to monitor for future issues.

Similarly, where teeth are worn down due to excessive chewing, the viability of each tooth can only be assessed through dental radiology.

Other dental anomalies

The application of dental radiology is extensive.

Other uses include the assessment of ‘missing teeth’ for retained roots or unerupted teeth, dentigerous cysts, oral tumors (where CT is not available as a first-line assessment), and in cases of persistent oral pain. 

In addition, digital dental radiology can be useful in cases of dental trauma where advanced imaging is not available.

Conclusion

Visual dental assessment is no longer acceptable to assess the extent of dental disease a patient is suffering.

And in many veterinary clinics, it is hard to imagine the future of veterinary dental care without digital radiology.

The WSAVA advises that dental radiographs are essential before and after all dental extraction procedures, allowing rapid assessment of whether tooth extraction is required, the most suitable technique, and the potential risks the clinician might face.

Through dental radiology, complications are reduced, vets work more efficiently, reasons for clinical decisions are evidenced, and the outcome of a procedure is visually documented.

But, most importantly, patient welfare is prioritized in therapeutic planning, and dental radiology is a huge step forward in reducing life-long dental disease and oral pain in veterinary patients.

References:

Fulton, A.J., Fiani, N., Verstraete, F.J. (2014). Canine pediatric dentistry. Veterinary Clinics of North America Small Animal Practice 44(2), 303-24

Gorrel, C. (2015). Tooth resorption in cats: pathophysiology and treatment options. Journal of Feline Medicine and Surgery 17(1), 37-43

Lund, E.M., Armstrong, P.J., Kirk, C.A. (1999). Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. Journal of the American Veterinary Medical Association. 214(9), 1336-41

Niemiec, B., Gawor, J., Nemec, A., et al. (2020). World Small Animal Veterinary Association Global Dental Guidelines. Journal of Small Animal Practice. 61(7), E36-E161

O'Neill, D.G., James, H., Brodbelt, D.C., et al. (2021). Prevalence of commonly diagnosed disorders in UK dogs under primary veterinary care: results and applications. BMC Veterinary Research 17(1), 69

Wallis, C., Holcombe, L.J. (2020). A review of the frequency and impact of periodontal disease in dogs. Journal of Small Animal Practice 61(9), 529-540

www.rvc.ac.uk/vetcompass/news/the-cat-s-out-the-bag-the-most-common-diseases-in-pet-cats-revealed

Revolutionizing Veterinary Care: Digital Dental Radiology

Exploring the Impact of Digital Dental Radiology in Veterinary Care

Since the discovery of X-rays over a hundred years ago, radiography has proved an invaluable tool in both the human and veterinary medical fields.

But it wasn’t until the mid-1980s that the technology made such a huge leap forward, that it turned the whole discipline upside down.

This is when digital radiography came along. 

Up until this point, the process of obtaining radiographs was time-consuming, laborious, and at times, messy and potentially dangerous.

By using X-ray film and manually developing each image, practitioners were able to obtain an image, but if the alignment was wrong, or the settings were incorrect, they had no option but to repeat the whole process again.

With digital radiography, the image obtained can be instantly adjusted and manipulated to aid diagnosis and then stored digitally, allowing rapid recall of previous studies and saving vast amounts of physical space. 

Where digital radiography has really come into its own though, is in the field of dentistry. 

Veterinary dentistry has undergone a similar transformation in recent decades

Our understanding of the intricacies of how to provide a high-quality service has improved drastically, all aided by being able to look ‘under the surface’. When teaching dentistry, emphasis is placed on the areas below the gum line as often being the source of dental problems.

Therefore, it should be the required focus of treatment, much more so than the visible crown. We are now able to complement this knowledge with the ease and detail that digital dental radiology allows in order to provide a first-class, thorough treatment process for all our patients. 

Teeth are regularly likened to icebergs 

What you can see is only a small portion of the whole - and with teeth, it’s what is below the gum line that we need to focus on.

What we see on the crowns of the teeth, such as tartar or discoloration, and what we see on the gums, such as recession or gingivitis, are just markers for the damage we cannot see.

As with most things in veterinary medicine, it is always best to treat the source of a problem, rather than just manage the symptoms. 

Scaling the tartar off the visible surface will give a good cosmetic appearance, but the bacteria and plaque – the origin of the tartar – will be in the gingival sulcus. If this isn’t cleaned as well, the problem can spread down into the periodontal space and tooth root.

The only way to thoroughly evaluate this area is to use radiography. 

More complex pathologies really benefit from radiographic examination

Digital dental radiography can also bring huge advantages to the treatment of one of the most common, yet frustrating, aspects of feline dentistry – the feline resorptive lesion.

By utilizing dental radiographs, we can determine if the lesion is a type one or type two and therefore which of the two diametrically opposite treatment options – full extraction or crown amputation – is appropriate.

If radiography shows that only a crown amputation is needed, we have saved not only time and stress for the surgeon but also prevented unnecessary pain and trauma for the animal which would have occurred had the option chosen been to attempt full extraction.

Without the radiography, we only have half a diagnosis, and the treatment option chosen would be a ‘best guess’. 

Imagine working like this in any other aspect of veterinary medicine!

Other things that can only be detected by radiography include:

• bone loss

• supernumerary teeth (especially if non- or incompletely erupted)

• supernumerary roots

• abnormally shaped roots

• periapical disease

• pulp diameter

It’s clear to see how the use of radiography in veterinary dentistry can yield huge benefits. And using digital dental radiography maximizes these benefits and brings its own. 

With practice, a full-mouth series of digital radiographs can take a matter of minutes

This speed means that anesthetic time can be drastically reduced – a huge advantage, especially in fragile patients. 

From an operator's point of view, digital radiography can provide vastly superior image quality and the ability to enhance certain features and correct radiographic faults.

This will all lead to improved diagnostic ability and treatment of patients.

The images can also be easily shared between practitioners and even sent to imaging specialists without the need to transfer the patient.

A key benefit that is also often overlooked is that digital imaging requires up to 80% less radiation to produce an image than traditional film radiography.

The big advantage in today’s market is a digital system is very reasonable in price.

The integration of digital dental radiography can revolutionize a veterinary practice. 

See our complete package system - Click Here

References:

1. Lommer MJ, Vertraete FJ. Prevalence of odontoclastic resorption lesions and periapical radiographic lucencies in cats: 265 cases (1995-1998). J Am Vet Med Assoc 2000;217(12):1866-1869.

2. Heney CM, Arzi B, Kass PH, Hatcher DC, Verstraete FJM. The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats. Front Vet Sci. 2019 Feb 21;6:42. doi: 10.3389/fvets.2019.00042. PMID: 30847347; PMCID: PMC6393352. 

3. Mupparapu M. Digital dental radiography - a review of the solid-state and semi-direct digital detector. Orofac J Sci2011;3(1):40 

Veterinary Dental Care with Digital Radiographic Imaging

Elevating Veterinary Dentistry: The Power of Digital Radiographic Imaging

Dental radiography is considered an essential part of human dentistry to aid diagnosis and treatment of dental disorders. The veterinary world is catching up rapidly and dental radiography is fast becoming the standard of care for our veterinary patients.

The production of high-quality dental radiographs requires a number of specific pieces of equipment. First, specific dental X-ray plates should generally be used.

These are small and specifically designed to fit within the oral cavity, minimizing the superimposition of structures within the skull and simplifying radiographic positioning.

They come in a range of sizes from 0 to 4, with size 4 being the largest. Sizes 2 and 4 are the most commonly used. Secondly, a specific dental X-ray generator, either handheld or wall mounted, allows accurate and easy positioning for the various views required.

Traditional analog radiography uses X-ray films with an intensifying screen, set within a light-proof cassette.  After exposure to an X-ray beam, this film is then processed using either manual or automatic techniques to provide a high-quality diagnostic image.

The use of digital imaging systems first introduced in the early 2000s  has revolutionized dental radiography and has many advantages over older analog systems.

There are two types of digital X-ray set-up - Digital Radiography (DR) and Computed Radiography (CR). DR, or direct, systems use a solid-state sensor plate in place of an X-ray film.

This is linked directly to a computer via either a wire or wirelessly via Bluetooth. CR, or semidirect, systems use a photo-stimulative phosphor (PSP) plate which stores the X-ray exposure.

These are then scanned and translated into a digital image on a computer. Both have advantages and disadvantages, but DR systems are most commonly used in dental radiography systems and are generally accepted as superior.

The advantages of digital dental radiography 

While there are many advantages, the most notable include:

• Speed - DR systems will produce an almost instant image  and the sensor can be left in place making any repositioning for repeat exposures quicker and easier

• Reduced number of exposures - Digital radiography systems can adjust for suboptimal exposure settings, meaning repeat exposures due to faults are less likely

• Ability to manipulate and magnify images - This allows easier viewing and interpretation of radiographs, picking up more subtle pathologies as the images are more easily interpreted

• No degradation over time if stored correctly 

• No requirement for toxic developing and fixing chemicals

• Less space required 

• Access to telemedicine services

• Lower exposure settings - reducing radiation doses to patients and personnel by an estimated 50-80%

Initial problems were reported with reduced image detail compared with analog films, however, these have now long since been resolved.

Another commonly reported disadvantage of digital radiography set-up is that initial costs are somewhat higher than analog systems.

This is certainly true, however, it has been estimated that in a busy veterinary clinic, it would take less than a year to make up for these costs thanks to significantly lower running costs. Recent cost-benefit analyses have shown the investment is worthwhile.

Full-mouth dental radiographs

There are demonstrated benefits of full mouth X-rays as standard for all new patients, or where a clinical condition has significantly changed. 

It has been suggested that around 40% more pathology will be detected compared with clinical examination alone. 

Radiographs are much more sensitive to detecting periodontal pockets that may be missed by probing alone. They also allow assessment of the thickness and quality of the surrounding bone, reducing the risk of iatrogenic fracture if extractions are attempted, especially in small breed dogs.

Dental radiographs can detect any unusual anatomy such as a curved root that may make extractions more difficult, and post-extraction radiographs can be used to check that no root fragments are remaining.

Especially in cats

Dental radiography is essential when assessing feline mouths where resorptive lesions are present.  Without it, it is impossible to differentiate Type 1 lesions that require complete extraction from Type 2 lesions that are better treated with crown amputations.

Diagnosing the lesion type before treatment improves patient outcomes and reduces procedure times. Deciduous teeth, in both cats and dogs, which may have undergone partial resorption can also be properly assessed.

Dental radiographs are useful when assessing fractured or worn teeth for subtle evidence of infection.  They are vital in helping to determine whether “missing teeth” are truly missing, fractured crowns with roots remaining or impacted teeth that may lead to serious complications such as dentigerous cysts.

They can also be used to help assess oral masses.

How to make the best use of your dental X-ray system

To make the best use of a dental X-ray system there are a few important considerations;

• Correct exposures should be used for different-sized patients and teeth. Some machines will have settings for different teeth programmed in others, others will require the use of a manual exposure chart.

• Dental X-ray plates or sensors and correct plate sizes should be used to minimize exposures and allow easier positioning

• Good radiation safety should be adhered to at all times following ALARA (as low as reasonably achievable) guidelines

• The use of a specific dental X-ray generator is recommended to allow easier and more accurate positioning

• Correct radiographic techniques should be utilized - generally, images should be obtained using either a parallel or bisecting angle technique, depending on the teeth and species being imaged.  For cats, a near parallel (intra- or extraoral) will be required for maxillary cheek teeth.

• Standard views should be obtained for full-mouth radiographs

• Dental radiographs should be performed under general anesthesia

• All radiographs should be assessed to ensure they are of diagnostic quality

• Good training of personnel is vital for both positioning and radiographic interpretation

Digital dental radiography is rapidly emerging as an essential tooth in modern veterinary practice

The whole team should be educated on its benefits to both pets and their owners.  Digital radiographic imaging allows early detection of dental disease, simplifies treatment, and improves patient outcomes enhancing veterinary dental care, as well as providing an additional income stream for veterinary businesses.

https://newvetequipment.com/dental-xray-equipment

References:

[1] Niemiec, B. A., Gawor, J., & Viadimír, J. (2017). Practical Veterinary Dental radiography. In CRC Press eBooks. https://doi.org/10.1201/b20288

[2] Niemiec, B. A., & Wright, M. (2011). Digital Dental Radiology. Clinician’s Brief., https://www.cliniciansbrief.com/article/digital-dental-radiology . Accessed 02/08/2023

[3] Bailey, M. (2021). Veterinary dental radiology – an overview. Royal Canin - VetFocus. https://vetfocus.royalcanin.com/en/scientific/veterinary-dental-radiology-an-overview . Accessed 02/08/2023

[4] Haws IJ. The evolution of oral radiography in veterinary medicine. Can Vet J. 2010 Aug;51(8):899-901.

[5] Van Der Stelt, P. F. (2005). Filmless imaging: The uses of digital radiography in dental practice. The Journal of the American Dental Association, 136(10), 1379–1387

[6] DuPont GA. Radiographic evaluation and treatment of feline dental resorptive lesions. Vet Clin North Am Small Anim Pract 2005;943-962.

[7] Niemiec, B. A. (2015). The importance of dental radiography. Today’s Veterinary Practice. https://todaysveterinarypractice.com/dentistry/dental-radiography-series-the-importance-of-dental-radiography/ Accessed 02/08/2023

[8]  Niemiec, B. A. (2015). Dental Radiology Series: Techniques for Intraoral Radiology. Today’s Veterinary Practice. https://todaysveterinarypractice.com/dentistry/practical-dentistry-dental-radiology-series-techniques-for-intraoral-radiology/ Accessed 02/08/2023

Feline Radiograph Techniques for Sedation-Free Imaging

X-rays are a commonly used diagnostic tool in many veterinary clinics for our feline patients. Radiographs can provide a wealth of diagnostic information, as long as they are of good quality and well-positioned.

However, cats aren’t known for their trainability, or their propensity to lie perfectly still for periods of time in a veterinary hospital, to allow veterinarians and technicians to work around them! So how do you get an X-ray of good diagnostic quality in a cat without sedation?

Do you need X-rays without sedation?

The first question to be asked is if the radiographs really need to be taken without sedation or anesthesia. Safety is paramount – for both patients and veterinary staff.

Taking X-rays conscious is not worthwhile if the process ends up having to be repeated multiple times due to poor positioning or movement blur, increasing both stress and levels of radiographic exposure to the patient and staff alike.

In many cases, a short-acting sedation or anaesthesia is the safest option to gain radiographs.1 There are many protocols now in use for a variety of situations, including drugs which are more cardiac-safe, those which avoid either renal or hepatic metabolism, and those with short half-lives for those quick X-ray procedures.

However, there are scenarios in which a veterinarian may prefer to attempt a conscious X-ray. These may include:

• Cats with advanced cardiac disease

• Cats with severe renal or hepatic impairment 

• If a cat has eaten recently and there is concern for aspiration, but needs urgent X-rays

• A known previous reaction to sedation or anesthesia

• A moribund patient who requires urgent assessment but is clinically unstable

Techniques for conscious radiographs in cats

If you have a feline patient requiring X-rays in your veterinary hospital, there are a few ways to make the procedure safer and less stressful for all involved.

The welfare of the cat, and the safety of all involved, should always be at the forefront of decision making in a veterinary clinic.

Preparation

When taking X-rays conscious, it’s hugely important to be prepared – time is of the essence. Use an exposure chart to predict your kV and mA settings,1 have restraint equipment ready to go and veterinary staff primed as to their roles. Have a plan of which order the radiographs will be taken in, and how positioning is going to be achieved. 

The process with be smoother if both staff and patient are relaxed. Practice feline-centric protocols: calm voices, quiet areas, pheromone diffusers, and minimal handling. Speed is helpful, but not to the detriment of calm handling and a low-stress environment.

Positioning

Firstly, keep the X-ray area secure by closing or locking doors: as well as being a distraction, doors opening suddenly can be an escape route for a stressed cat!

Positioning aids will be required

These may include:

1. Perspex box – if it is not possible to restrain the cat in a specific position, or the cat is very sick and/or recumbent, a clear Perspex box can be used to gain rapid radiographic assessment. Specific positioning will not be achieved, but a radiographic overview of a certain area – or even a full ‘catogram’ – can be achieved very quickly without the need for chemical or more aggressive physical restraint. Some boxes also allow oxygen to be piped in for those cats with respiratory concerns.  

2. Sandbags, troughs, and foam wedges – cats who are mobile will require physical restraint. Wedges can be used to elevate anatomic areas, or to ensure correct alignment. Sandbags are useful mostly for limb restraint – they are heavy, so avoid placing them across the thorax as this can affect respiration. Always try and ensure positioning is comfortable for the patient, as this will aid them to lie still and not panic. 

Be aware that “less is more” when restraining cats; and that cats with dyspnoea are brittle and require minimal restraint. In these patients, initial stabilization, thoracic ultrasonography, and general anesthesia for radiography (if cardiac failure can be excluded) is often the most appropriate approach.3

Taking the radiographs

A veterinary team member can stay with the cat until the machine is ready to go and the positioning is perfect, providing reassurance and extra restraint. Once the area is safe, personnel can exit and take the radiograph. The ‘beep’ or ‘click’ of the X-ray machine can cause cats to move, so you may need some background music or white noise to distract from this. 

Allow the cat to rest and hide in a covered box in between X-rays. Provide reassurance, and reward (if clinically appropriate). If the patient is becoming distressed, consider moving to chemical restraint or postponing the radiographs. 

There are many potential pitfalls when taking conscious radiographs, and it is more likely that these X-rays will be affected by poor positioning, movement blur or sub-optimal exposure. Wherever possible, sedation or anesthesia is preferable to achieve radiographs safely. 

References

1. Larson, M. Feline Diagnostic Imaging. Published 2020 John Wiley. Ed. Holland & Hudson. ISBN:9781118840948

2. Lavin L: Small animal soft tissue, in Lavin L (ed): Radiology in Veterinary Technology, ed 3. Philadelphia, WB Saunders, 2003

3. Borgeat, K. and Pack, M. (2021), Approach to the acutely dyspnoeic cat. In Practice, 43: 60-70. https://doi.org/10.1002/inpr.15

The Art of Cat X-ray Imaging: Techniques and Interpretation

Introduction to Cat X-ray Imaging: Importance and Basics

Radiography is one of the most common diagnostic tools utilized in veterinary clinics. It can provide vital information about structures inside the body and can be used to identify pathologies in both bone and soft tissues.

Cats differ from dogs and other pets in many ways, including their propensity to hide pain and illness. As a result, radiographs can be an excellent method of collecting vital diagnostic information for these patients in a non-invasive manner. 

Techniques

Safety for both patient and veterinary staff should be paramount when using X-rays. Veterinary clinics and hospitals should have effective radiation safety protocols in place and clinical staff should wear monitoring equipment.

Radiographs also need to be of good diagnostic quality to allow for accurate interpretation of injury and disease for cats presented to the veterinary clinic. 

When a feline patient requires X-rays, certain procedures should be followed.

Be cat-friendly!

Taking X-rays of a fractious cat is no veterinarian’s idea of a good time! Keep these feline-centric principles in mind to reduce stress for all involved:

• Quiet areas

• Calm handling

• Pheromone sprays/diffusers
  
  
  

  Restraint

Cats must be adequately restrained for radiographs, to ensure correct positioning and to minimize motion blur. Even small movements can cause unacceptable blurring in the X-ray.

This can be minimized by adjustments to the exposure time and mA settings, but sufficient restraint is still the most desirable. 

Sedation or brief anesthesia is usually required, but physical restraint using equipment such as sandbags and tape is also possible if necessary.

There are various sedation and anesthesia protocols that are suitable for cats, including cardiac-friendly combinations and short-acting sedatives.

Wherever possible, chemical restraint is preferred to physical in fractious animals.

Positioning

Depending on the body area requiring radiographic examination, the cat will need to be carefully positioned. Proper positioning is necessary to achieve X-rays of diagnostic quality in your veterinary clinic. 

Take more than one radiograph

Multiple views are always necessary for radiography! A good example of this is in thoracic radiographs in cats: when in lateral recumbency, fluid accumulates in the down-side lung, and there is a degree of atelectasis (lung collapse).

This leads to an increased opacity of this lower lung field, which can obscure soft tissue nodules. Orthogonal views are also needed, as X-rays are two-dimensional images of a three-dimensional patient, therefore opposing views are needed to visualize the patient as a whole. 

Interpretation

Radiographs require expertise and attention to detail for accurate interpretation. In a veterinary hospital, veterinarians should be encouraged to view X-rays in a quiet, darkened room and should not be rushed for a diagnosis. 

When interpreting feline X-rays, it is best to proceed in a logical and step-wise manner, to avoid anything being missed.

Assess positioning and exposure

Before leaping to any diagnostic conclusions, first, evaluate the basics. 

Is the X-ray:

• Of the correct patient?

• Clearly marked as to the positioning of the animal and the area exposed (i.e., left vs right markers)?

• Is the X-ray well positioned and collimated correctly, and is the exposure adequate? A cat X-ray that is improperly positioned or exposed is difficult to interpret and reduces the amount of available information.

• Are there orthogonal views available? X-ray images are two-dimensional representations of a three-dimensional subject (the patient), requiring some mental reconstruction of an anatomical image, using two radiographs taken at right angles to each other.

• Are any exposure, positioning, or rendering artifacts visible? If so, note them at this point so as not to be distracted by pseudopathological changes later.

Assess the X-ray

A logical and systematic approach should be used to evaluate X-rays in a veterinary clinic. Clinicians should choose an approach that works for them – for example, evaluate from outside in, or from left to right, or whatever system suits them and allows a thorough assessment of the whole radiographic area. 

All organs and structures should be assessed, and findings should be categorized by radiologic (or Roentgen) signs:

• Number

• Size

• Shape

• Position

• Opacity/architecture

• Margination

If possible, normal function can also be assessed, for example through contrast studies or through the use of physiological changes such as inspiratory vs expiratory thoracic radiographs. 

Evaluate the X-ray

Once the radiograph has been thoroughly assessed and described, the findings can be evaluated for abnormalities and a radiographic diagnosis.

There is a wide range of ‘normal’, which can make this assessment of pathologies more difficult, and X-rays should be used alongside other clinical findings when making a list of differential diagnoses. 

Radiography is a commonly utilized tool in veterinary clinics and has a wide range of indications in cats. However, taking good radiographs – and interpreting them correctly – is indeed an art form, requiring practical skills, study, and experience. 

Achieving Diagnostic Images in Veterinary Radiography

 What do kV and mA and mAs mean in veterinary X-ray and what are the best settings for a small cat, medium dog, and large dog? 

Since 1895, when X-rays were first discovered, radiography has proven an invaluable asset in both human and veterinary medicine.

Over a hundred years later, nearly every veterinary clinic has an X-ray machine and it’s hard to imagine how we could ever be without one now. But just like with professional photography, it’s one thing simply taking a picture; it’s another to create an image.

And for us, as vets and veterinary technicians, we are all too aware of how the way a radiograph is taken can affect our decision-making process. 

In order to take a ‘good’, or diagnostic X-ray, we must appreciate the exposure settings of the machine. Typically, there are three factors we, as the operators, can adjust – the kV, the mA, and the exposure time (s). Nowadays, most set-ups are digital, and both the X-ray generator and the processor will have presets for certain areas of the body.

We may also only be able to adjust the kV and the mAs (a combined milliamp-seconds control). However, it’s important that we are able to understand and fine-tune all the settings as required to get the image we desire. 

The kV (kilovoltage) 

This affects the amount of energy given to the X-ray photons. The higher the kV, the higher their energy and therefore their penetrating power into the patient. Adjusting the kV will allow for adjustments in both the contrast and exposure of the image produced.

But as the kV increases, so does the risk of scatter which not only can be dangerous to the operator but also leads to an image with poor contrast. Because of this, as kV is increased, the mAs ought normally to be lowered.

The mA (milliamperage) 

This affects the amount of current, thus electrons, passing through the X-ray head. Raising the mA will increase the temperature of the filament from which the electrons are produced and subsequently, increase the number of electrons that are released. This will increase the number of X-ray photons produced, and thus the overall exposure. 

The s (seconds) 

This is simply the exposure time; the amount of time during which the X-ray photons are released, and the patient is exposed to them. The actual exposure time, in seconds, is equal to the mAs divided by the mA.

The mAs (milliampere seconds)

In many machines, as both mA and time control the number of X-ray photons, they are combined into a single control, the mAs.

In order to get the image required, we need to balance these three factors

How we do so will depend on several things

• the size of the animal

• which area of the body is being imaged

• the depth of the area of the body being imaged

For example:

- imaging the abdomen of a large dog will require generally higher kV and mAs than imaging the abdomen of a cat, as you would need more electrons with higher energy levels in order to penetrate through to the X-ray plate.

- imaging an area of movement such as the chest will require as short an exposure time as possible to eliminate movement blur – this can be achieved by increasing the mA because of the equation exposure time = mAs ÷ mA.

Exposure charts can be very useful to give a guide as to the likely appropriate settings to use for a particular body area on a particular-sized animal. Recommended exposures will vary depending on the machine used, therefore it can be difficult to suggest exact settings that can be used across the board.

However, the following gives a good example of how factors will change depending on the size of the patient. These assume a film focal distance of 80cm.

Compared to these figures for an abdominal radiograph, thoracic radiographs will require lower mAs to reduce motion blur, so the kV may need to be slightly higher, especially if the exposure time cannot be controlled independently.

Radiographs of extremities will require a lower kV and lower mAs, as the depth of the area of interest is smaller.

If the image requires high kV settings, it can be useful to use a grid to help absorb scatter and therefore improve image quality.

As a general rule of thumb, a grid is beneficial for body parts over 10cm in depth – however, with digital systems, there is more leeway due to post-exposure filtering. 

When thinking about radiation safety, both the patient and the operator, always use the lowest possible settings needed to gain the diagnostic image.

It can also be helpful to record the settings used for each exposure, either on the system or by hand, so with time, we can begin to understand our machine and what settings work well for certain images.

In many jurisdictions, this is a legal requirement and is always “best practice” for reflection and continual quality improvement.

As a rule of thumb, if you see these effects on a digital image consider these adjustments:

• If you notice a dark image, particularly of soft tissue or extremities, it is generally recommended to decrease the kV.

• Conversely, if you come across a light image, especially of bone, it is advisable to increase the kV.

• In the case of motion blur, you should consider increasing the kV and decreasing the mAs.

• If you find poor contrast on the abdomen or thorax, increasing the kV is typically recommended.

• On the other hand, if you observe poor contrast on an extremity, it is generally advisable to decrease the kV.

1. Radiography in Veterinary Technology (Fourth edition) by Lisa M. Lavin. Pg. 6

2. https://www.msdvetmanual.com/clinical-pathology-and-procedures/diagnostic-imaging/radiography-of-animals

3. Lo, W. Y., Hornof, W. J., Zwingenberger, A. L., & Robertson, I. D. (2009). Multiscale image processing and antiscatter grids in digital radiography. Veterinary Radiology & Ultrasound, 50(6), 569-576.

The Impact of Over-Exposed X-Rays in Animal Radiography

What is an over-exposed X-ray and how can I avoid that in my animal clinic's X-ray room?

X-rays are a vital and commonly used tool in every animal hospital. However, they are only of use if the X-ray image is of good diagnostic quality. If radiographs are of poor quality, for example through inadequate positioning or incorrect exposure, this can lead to errors in interpretation.

If X-rays taken in the animal clinic are over-exposed, this can be very frustrating to veterinary staff. The radiographs may need to be repeated, leading to increased exposure to X-ray beams for patients, and higher time and cost penalties.   

X-rays being over or under-exposed is a common problem in veterinary clinics. In this blog, we’ll go through over-exposure, why it happens, and how to help. To learn more about the opposite problem, under-exposure, check out our blog here.

What is exposure?

Exposure is the term used to describe the number of X-ray photons present at a certain point. Over-exposure to animal X-rays happens when the concentration of these photons is too high, leading to excessive darkening of the film. 

Four radiographic factors affect exposure:

1. Kilovoltage (kV) – the voltage applied across the X-ray generator, affecting the energy of the X-ray, and therefore the penetrating power of the beam

2. Milliampere (mA) – the current applied to the cathode to generate X-rays, affecting the number of electrons and thus of X-ray photons

3. Exposure time

4. The distance from the X-ray source to the patient (FFD – focus-film distance) – as distance decreases, the intensity of the beam increases.

The exposure of the X-ray is determined by changes to any of these four factors.

Why does an over-exposed X-ray matter?

A radiograph should be properly exposed so that all structures in the targeted anatomical region can be visualized.

In a film-based radiograph, over-exposure makes an X-ray very dark, making it hard to interpret but easy to detect. Using an over-exposed X-ray as a diagnostic tool may lead to subtle lesions being missed, or to artifacts being seen.

However, in a DR system, there are very few signs of over-exposure, as the computer will automatically filter the image and return an “optimal” radiograph.

If the exposure is massively excessive, however, there may be other artifacts generated, in particular, blocky or geometric shapes superimposed over the image.

This is more apparent in some systems than others but seems to be due to the local vs regional adjustment patterns generated by the filtering software.

So, an over-exposed DR radiograph rarely leads to a non-diagnostic image. However, over-exposure is also a safety concern, with animals and potentially staff being exposed to unnecessary levels of X-rays.

Correctly exposed X-rays are important for accurate diagnosis but above all for safety in the animal hospital.

 "Exposure Creep” is a common problem with digital radiography, and with our increasing knowledge of the health concerns associated with cumulative X-ray exposure, something that all clinicians need to work to minimize – even in jurisdictions with relatively relaxed radiation safety limits, such as the USA.

Why is my X-ray over-exposed?

It can be frustrating to have an over-exposed X-ray, and difficult to determine the underlying problem. Here are some common reasons for over-exposure in animal radiography.

A common issue when struggling with exposure is non-deliberate changes in the distance between the film and the X-ray generator.

A small change in distance can have a huge effect on exposure, as the relationship between FFD and exposure is an exponential function.

If your X-ray is overexposed, the FFD may be too small, and require adjustment – or a corresponding change to the mAs.

In animal hospitals, moveable and adjustable X-ray tables can make changes to the FFD a common problem. 

Technical errors in the choice of kV and mA levels are also common. If the kV setting is too high, the X-rays will have more power and penetrate straight through the patient, leaving a film that is overexposed and too dark to interpret.

Over-exposed X-rays require a decrease in the kV level and mAs. The omission of a grid when one is needed – or accounted for in the exposure chart - can also affect exposure. 

Tips for avoiding an over-exposed X-ray

Interpreting X-rays requires films of high quality, excellent positioning, and good exposure. 

A simple response to avoid over-exposed radiographs in the animal clinic is to ensure the kV and mA settings are correct. Over-exposure implies the settings are too high.

The use of an exposure chart can be invaluable to ensure accurate levels. A comprehensive chart, with suggested settings for all different species and sizes of animals, as well as differing anatomical locations, can help avoid mistakes when calculating appropriate settings. 

It should be remembered that X-rays need to be of good quality and exposed correctly for the anatomical area. Different bodily areas have varying needs for good interpretation.
For example, the thorax has both soft tissue and bone which all need to be detailed whereas the abdomen contains high volumes of soft tissue structures, requiring excellent contrast.

Understanding this principle may lead to small adjustments to kV and mAs to maximize the quality of the X-ray. 

Most DR systems are now equipped with Exposure Indicators, and these are invaluable for detecting higher-than-optimal exposures.

Ensure that you are familiar with how this works on your system and that you know how to interpret the numbers generated. LINK?

Remember to keep X-ray machines well-maintained and regularly serviced, for optimal performance.

Summing up

One of the reasons for observing overexposed X-rays is the failure to make necessary adjustments to the imaging technique when transitioning from film to CR to DR, or between different DR panels.

X-rays are a regularly used tool in animal clinics and have great diagnostic value. However, accurate interpretation relies upon good-quality X-rays.

Over-exposure rarely leads to a non-diagnostic radiograph but does lead to excessive radiation exposure to the patient and, potentially, staff.

​​Over-exposure can be caused by changes to the exposure factors: kV, mA, time, and distance.

Using accurate settings for the size, species, and anatomical location of the desired image, and knowing how to interpret the Exposure Indicator, are essential for optimal exposure and good quality X-ray. 
​
Many instances of under or overexposure can be attributed to doctors failing to measure animals or consult the technique chart.
​
The DynaVue Duo x-ray machine for veterinarians automatically adjusts the exposure based on animal size, optimizing imaging and reducing radiation exposure.

​​This feature saves time, minimizes errors, and enhances diagnostic quality, improving veterinary care.

References

Mattoon, J. (2006) ‘Digital Radiography’ Vet Comp Orthop Traumatol 19(03) pp.123-132

Kirberger, R. (2005) ‘Radiograph quality evaluation for exposure variables – a review’ Veterinary Radiology and Ultrasound 40(3) pp.220-226