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Veterinary technician's pocket partner (gnv64)

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Information about Veterinary technician's pocket partner (gnv64)
Health & Medicine

Published on February 28, 2014

Author: jhackdole

Source: slideshare.net

Description

Veterinary technician's pocket partner
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Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States

The Veterinary Technician’s Pocket Partner Marisa Bauer Vice President, Career and Professional Editorial: Dave Garza Director of Learning Solutions: Matt Kane Acquisitions Editor: Benjamin Penner Managing Editor: Marah Bellegarde Senior Product Manager: Darcy M. Scelsi Editorial Assistant: Scott Royael Vice President, Career and Professional Marketing: Jennifer McAvey © 2010 Delmar, Cengage Learning ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution, information networks, or information storage and retrieval systems, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the publisher. For product information and technology assistance, contact us at Professional & Career Group Customer Support, 1-800-648-7450 For permission to use material from this text or product, submit all requests online at cengage.com/ permissions. Further permissions questions can be e-mailed to permissionrequest@cengage.com. Marketing Manager: Erin Brennan Marketing Coordinator: Jonathan Sheehan Production Director: Carolyn Miller Production Manager: Andrew Crouth Sr. Content Project Manager: Elizabeth Hough Art Director: David Arsenault Library of Congress Control Number: 2009922556 ISBN-13: 978-1-428-35782-2 ISBN-10: 1-4283-5782-3 Delmar 5 Maxwell Drive Clifton Park, NY 12065-2919 USA Cengage Learning is a leading provider of customized learning solutions with office locations around the globe, including Singapore, the United Kingdom, Australia, Mexico, Brazil, and Japan. Locate your local office at: international.cengage.com/region Cengage Learning products are represented in Canada by Nelson Education, Ltd. For your lifelong learning solutions, visit delmar.cengage.com Visit our corporate website at www.cengage.com Notice to the Reader Publisher does not warrant or guarantee any of the products described herein or perform any independent analysis in connection with any of the product information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that provided to it by the manufacturer. The reader is expressly warned to consider and adopt all safety precautions that might be indicated by the activities described herein and to avoid all potential hazards. By following the instructions contained herein, the reader willingly assumes all risks in connection with such instructions. The publisher makes no representations or warranties of any kind, including but not limited to, the warranties of fitness for particular purpose or merchantability, nor are any such representations implied with respect to the material set forth herein, and the publisher takes no responsibility with respect to such material. The publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or part, from the readers’ use of, or reliance upon, this material. Printed in China 1 2 3 4 5 6 7 13 12 11 10 09

´Dedication To my Gramma, with her wings forever around my heart. To my darling husband Steve, You fill my life with sweet sunshine that glows within me. You’ve instilled in me a sense of worth and love that bonds our family. Thank you for all of your love and support. To my beautiful little angel Alexis, Remember, no matter how old you are or where you may be. . . . My love will always be with you. iii

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´ Table of Contents ANATOMY . . . . . . . . . . . . . . . . . . . 1 Canine Anatomy . . . . . . . . . . . . . . . . . . . 2 Feline Anatomy . . . . . . . . . . . . . . . . . . . . 3 References . . . . . . . . . . . . . . . . . . . . . . . 5 ANESTHESIA . . . . . . . . . . . . . . . . . 7 Stages of Anesthesia . . . . . . . . . . . . . . Monitoring an Animal under Anesthesia . General Considerations . . . . . . . . . Vital Signs . . . . . . . . . . . . . . . . . Reflexes to Check . . . . . . . . . . . . . Normal Anesthetic Recovery Signs . . Signs of Anesthetic Overdose . . . . . Anesthetic Machine Quality Control. . . . Set-up of the Anesthetic Machine . . Pressure Testing the Anesthetic Machine. . . . . . . . . . . . . . . . . . . Troubleshooting during an Anesthetic Emergency . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 10 10 11 11 12 12 13 13 . . 13 . . 14 . . 16 v

vi table of contents CYTOLOGY AND ENDOCRINE FUNCTION TESTING . . . . . . . . . . . 17 Common Endocrine Function Testing . . . . 18 Serum Bile Acid Test . . . . . . . . . . . . . 18 ACTH Stimulation Testing . . . . . . . . . 19 High- and Low-Dose Dexamethasone Suppression Tests in Dogs . . . . . . . . . 20 Thyroid-Stimulating Hormone (TSH) Response Test . . . . . . . . . . . . . . . . . 21 Diabetic Testing/Glucose Curve (Insulin Tolerance) . . . . . . . . . . . . . . 22 Cytology Images . . . . . . . . . . . . . . . . . . 24 Ear Cytology . . . . . . . . . . . . . . . . . . 24 Vaginal Cytology . . . . . . . . . . . . . . . 24 Sperm . . . . . . . . . . . . . . . . . . . . . . 25 Fatty Aspirate . . . . . . . . . . . . . . . . . 25 References . . . . . . . . . . . . . . . . . . . . . . 26 DENTISTRY . . . . . . . . . . . . . . . . . 27 Dental Models (Canine and Feline). . . . . . . 28 Dental Disease . . . . . . . . . . . . . . . . . . . 29 Dental Charting. . . . . . . . . . . . . . . . . . . 31 Dental Prophylaxis Procedure . . . . . . . . . 32 Common Dental Tools . . . . . . . . . . . . . . 34 References . . . . . . . . . . . . . . . . . . . . . . 35

vii table of contents EMERGENCIES . . . . . . . . . . . . . . . 37 Emergency Drugs. . . . . . . . . . . . . . . . . . ABCs . . . . . . . . . . . . . . . . . . . . . . . . . . A = Arterial Bleeding/Airway Patency . . B = Breathing . . . . . . . . . . . . . . . . . C = Cardiac. . . . . . . . . . . . . . . . . . . Cerebral Pulmonary Cardiac Resuscitation (CPCR) . . . . . . . . . . . . CPCR Procedure . . . . . . . . . . . . . . . Drug Therapy . . . . . . . . . . . . . . . . . Evaluation of Status Post Resuscitation . Electrocardiogram (ECG). . . . . . . . . . . . . Electrocardiogram (ECG) Waveforms . . Possible ECG Arrhythmias . . . . . . . . . Placing the Leads on the Patient . . . . . Triage . . . . . . . . . . . . . . . . . . . . . . . . . Triage Priority List . . . . . . . . . . . . . . Immediate Assessment . . . . . . . . . . . Patient History . . . . . . . . . . . . . . . . Cardiac Arrest . . . . . . . . . . . . . . . . . . . . Causes . . . . . . . . . . . . . . . . . . . . . . Signs and Symptoms . . . . . . . . . . . . . Treatment . . . . . . . . . . . . . . . . . . . Airway Obstruction . . . . . . . . . . . . . . . . Causes . . . . . . . . . . . . . . . . . . . . . . Signs and Symptoms . . . . . . . . . . . . . Treatment . . . . . . . . . . . . . . . . . . . 40 46 46 46 47 48 48 49 49 50 50 53 60 61 62 62 62 63 63 63 64 64 64 64 65

viii table of contents Acute Respiratory Distress . . . . . . . . . . . . 65 Causes . . . . . . . . . . . . . . . . . . . . . . 65 Signs and Symptoms . . . . . . . . . . . . . 66 Treatment . . . . . . . . . . . . . . . . . . . 66 Shock . . . . . . . . . . . . . . . . . . . . . . . . . 67 Causes . . . . . . . . . . . . . . . . . . . . . . 67 General Signs and Symptoms of Shock . . 67 Treatment . . . . . . . . . . . . . . . . . . . 67 Hypovolemic Shock . . . . . . . . . . . . . . . . 68 Causes . . . . . . . . . . . . . . . . . . . . . . 68 Signs and Symptoms . . . . . . . . . . . . . 68 Treatment . . . . . . . . . . . . . . . . . . . 68 Anaphylactic Shock . . . . . . . . . . . . . . . . 69 Causes . . . . . . . . . . . . . . . . . . . . . . 69 Signs and Symptoms . . . . . . . . . . . . . 69 Treatment . . . . . . . . . . . . . . . . . . . 69 Cardiogenic Shock . . . . . . . . . . . . . . . . . 70 Causes . . . . . . . . . . . . . . . . . . . . . . 70 Signs and Symptoms . . . . . . . . . . . . . 70 Treatment . . . . . . . . . . . . . . . . . . . 71 Septic Shock . . . . . . . . . . . . . . . . . . . . . 71 Causes . . . . . . . . . . . . . . . . . . . . . . 71 Signs and Symptoms . . . . . . . . . . . . . 71 Treatment . . . . . . . . . . . . . . . . . . . 72 Pneumothorax . . . . . . . . . . . . . . . . . . . 72 Causes . . . . . . . . . . . . . . . . . . . . . . 72 Signs and Symptoms . . . . . . . . . . . . . 72 Treatment . . . . . . . . . . . . . . . . . . . 73

table of contents Hemothorax . . . . . . . . . . . . . . . . . . . . . 73 Causes . . . . . . . . . . . . . . . . . . . . . . 73 Signs and Symptoms . . . . . . . . . . . . . 74 Treatment . . . . . . . . . . . . . . . . . . . 74 Diaphragmatic Hernia . . . . . . . . . . . . . . 74 Causes . . . . . . . . . . . . . . . . . . . . . . 74 Signs and Symptoms . . . . . . . . . . . . . 75 Treatment . . . . . . . . . . . . . . . . . . . 75 Seizures . . . . . . . . . . . . . . . . . . . . . . . . 75 Causes . . . . . . . . . . . . . . . . . . . . . . 75 Signs and Symptoms . . . . . . . . . . . . . 76 Treatment . . . . . . . . . . . . . . . . . . . 76 Ingestion of Poisons . . . . . . . . . . . . . . . . 76 Causes . . . . . . . . . . . . . . . . . . . . . . 77 Signs and Symptoms . . . . . . . . . . . . . 77 History. . . . . . . . . . . . . . . . . . . . . . 77 Treatment . . . . . . . . . . . . . . . . . . . 78 Fractures . . . . . . . . . . . . . . . . . . . . . . . 83 Causes . . . . . . . . . . . . . . . . . . . . . . 83 Signs and Symptoms . . . . . . . . . . . . . 83 Treatment . . . . . . . . . . . . . . . . . . . 83 Doppler Blood Pressure Reading . . . . . . . . . . . . . . . . . . . . . 84 Procedure. . . . . . . . . . . . . . . . . . . . 84 Crash Kit Supplies . . . . . . . . . . . . . . . . . 85 Important Points to Remember . . . . . . . . . . . . . . . . . . . 86 References . . . . . . . . . . . . . . . . . . . . . . 87 ix

x table of contents PHYSICAL EXAMINATION . . . . . . . . 89 Patient History Questions Normal Values. . . . . . . . Restraints. . . . . . . . . . . Examinations . . . . . . . . General . . . . . . . . . Integument. . . . . . . Respiratory . . . . . . . Ears. . . . . . . . . . . . Eyes . . . . . . . . . . . Cardiovascular . . . . Gastrointestinal . . . . Genitourinary . . . . . Lymph Nodes . . . . . Musculoskeletal . . . . Neurologic . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 . 92 . 95 . 98 . 98 . 99 . 99 100 100 101 101 102 102 103 104 104 HEMATOLOGY . . . . . . . . . . . . . . 105 Sample Handling . . . . . . . . . Blood Values . . . . . . . . . . . Chemistry Values . . . . . . . . Morphology . . . . . . . . . . . . Blood Parasites . . . . . . . . . . CBC Formulas and Procedures Blood Smear Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 107 110 113 122 124 124

xi table of contents Packed Cell Volume/Hematocrit (PCV/HCT) . . . . . . . . . . . . . Total Plasma Protein (TPP) . . . 100 Count WBC Differential . . . WBC Counts . . . . . . . . . . . . . WBC Estimate . . . . . . . . . . . . Platelet Estimate . . . . . . . . . . Absolute Numbers . . . . . . . . . Reticulocyte Count . . . . . . . . . Corrected WBC Count. . . . . . . Blood Transfusions. . . . . . . . . . . . Blood Typing vs. Cross-Matching . . . . . . . . . . . Blood Types . . . . . . . . . . . . . Rules of Transfusion . . . . . . . . Blood Transfusion Supplies . . . Blood Donors . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 127 128 129 130 131 131 132 133 134 . . . . . . . . . . . . . . . . . . . . . . . . 134 134 135 136 137 138 IMAGING . . . . . . . . . . . . . . . . . 139 Radiation Safety . . . . . . . . . . . Time . . . . . . . . . . . . . . . . Distance. . . . . . . . . . . . . . Shielding . . . . . . . . . . . . . Common Sense . . . . . . . . . ALARA Principle (As Low As Reasonably Achievable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 141 142 142 142 . . . . . . 143

xii table of contents Radiographic Technique . . . . . . . . . . . . 143 Density . . . . . . . . . . . . . . . . . . . . 143 Contrast. . . . . . . . . . . . . . . . . . . . 144 Measuring and Beam Positioning Basics . . . . . . . . . . . . . . . . . . . . . 144 Evaluating Radiographic Technique . . . . . 145 Developing Film . . . . . . . . . . . . . . . . . 146 Manual Processing Procedure . . . . . . 146 Automatic Film Processing. . . . . . . . 148 Creating a Technique Chart . . . . . . . . . . 149 Quality Assurance/Quality Control . . . . . 152 Maintenance of Protective Apparel . . . . . 152 Alternative Imaging Technology . . . . . . . 153 Computed Tomography (CT) Scan or CAT Scan . . . . . . . . . . . . . . . . . 153 Ultrasounds . . . . . . . . . . . . . . . . . 154 Magnetic Resonance Imaging (MRI). . 155 Digital Radiology/Computed Radiography . . . . . . . . . . . . . . . . . 156 Digital vs. Conventional Radiography . . . . 157 References . . . . . . . . . . . . . . . . . . . . . . 157 NURSING CARE . . . . . . . . . . . . . 159 Administration of Medications . . . . . Venipuncture . . . . . . . . . . . . . . . . Cephalic Venipuncture . . . . . . . Jugular Venipuncture . . . . . . . . Lateral Saphenous Venipuncture . Femoral Venipuncture . . . . . . . . . . . . . . . . . . . . . . . . . . 160 166 166 167 168 169

table of contents xiii IV Catheters . . . . . . . . . . . . . . . . . . . . 170 General Preparations for Peripheral IV Catheter Placement . . . . . . . . . . . . 170 Procedure . . . . . . . . . . . . . . . . . . 171 Managing an IV Catheter . . . . . . . . 172 Catheter Complications . . . . . . . . . 172 Removing an IV Catheter . . . . . . . . . 173 Bandaging . . . . . . . . . . . . . . . . . . . . . 174 Important Rules when Applying a Bandage . . . . . . . . . . . . . . . . . . 174 Abnormal Findings . . . . . . . . . . . . 174 Types of Bandages . . . . . . . . . . . . . 175 Fluid Therapy . . . . . . . . . . . . . . . . . . . 181 Fluid Calculations . . . . . . . . . . . . . 181 Drip Rates . . . . . . . . . . . . . . . . . . 182 Patient Monitoring during Fluid Therapy . . . . . . . . . . . . . . . . . . . . 183 Common Fluids Used . . . . . . . . . . . 184 References . . . . . . . . . . . . . . . . . . . . . 186 NUTRITION . . . . . . . . . . . . . . . . 187 General Terms . . . . . . . . . . . . . . . . . . 189 Body Condition Scoring . . . . . . . . . . . . 190 Association of American Feed Control Officials (AAFCO). . . . . . . . . . . . . . 193 Six Components of Food . . . . . . . . . . . . 193 Life Stages Diet . . . . . . . . . . . . . . . . . . 205 Growth: Puppy and Kitten . . . . . . . . 205

xiv table of contents Large Breed Growth: Puppy . . . . . . . 205 Adult/Maintenance . . . . . . . . . . . . 205 Large Breed Maintenance . . . . . . . . 206 Senior/Geriatric. . . . . . . . . . . . . . . 206 Specialty Diets . . . . . . . . . . . . . . . . . . 207 Sensitive Stomach . . . . . . . . . . . . . 207 Hypoallergenic . . . . . . . . . . . . . . . 207 Overweight . . . . . . . . . . . . . . . . . . 208 Pregnancy . . . . . . . . . . . . . . . . . . 208 Lactation . . . . . . . . . . . . . . . . . . . 208 Enteritis . . . . . . . . . . . . . . . . . . . . 209 Kidney Disease . . . . . . . . . . . . . . . 209 Liver Disease. . . . . . . . . . . . . . . . . 209 Heart Disease . . . . . . . . . . . . . . . . 210 Diabetic . . . . . . . . . . . . . . . . . . . . 210 Nutrition for Critical Care . . . . . . . . 210 Sensitive Skin . . . . . . . . . . . . . . . . 211 Oral Care . . . . . . . . . . . . . . . . . . . 211 Active . . . . . . . . . . . . . . . . . . . . . 211 Hairball . . . . . . . . . . . . . . . . . . . . 211 References . . . . . . . . . . . . . . . . . . . . . 212 MEDICAL RECORDS AND OFFICE PROCEDURES . . . . . . . . . . . . . . 213 Veterinary Ethics . . . . . . . . . . . . . . . . . 215 Medical Record Information . . . . . . . . . 215

xv table of contents Filing Systems and Organization Methods . . . . . . . . . . . . . . . . . . . Problem-Oriented Medical Records (POMR) . . . . . . . . . . . . . . Source-Oriented Medical Records (SOMR) . . . . . . . . . . . . . . Legal Rules Regarding Medical Records . . . . . . . . . . . . . . . . . . . . Telephone Communications. . . . . . . . . . Telephone Etiquette . . . . . . . . . . . . Scheduling Appointments . . . . . . . . . . . Questions to Ask the Client when Scheduling an Appointment . . . . . . . Admission and Discharge . . . . . . . . . . . Admitting a Patient into the Hospital . . . . . . . . . . . . . . . . . . . . Discharging a Patient from the Hospital . . . . . . . . . . . . . . . . . Consent Forms . . . . . . . . . . . . . . . . . . Euthanasia . . . . . . . . . . . . . . . . . . . . . OSHA . . . . . . . . . . . . . . . . . . . . . . . . OSHA’s “Right to Know” Law. . . . . . . Material Safety Data Sheets (MSDS) Book . . . . . . . . . . . . . . . . . . . . . . OSHA Tips . . . . . . . . . . . . . . . . . . Labeling . . . . . . . . . . . . . . . . . . . Handling Hazardous Waste . . . . . . . Personal Protective Equipment (PPE) Guidelines . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . 216 216 217 217 218 218 219 219 220 220 220 221 222 223 224 224 225 225 226 226 229

xvi table of contents PARASITOLOGY . . . . . . . . . . . . . 231 Specimen Collection and Handling Quality Control . . . . . . . . . . . . . Procedures . . . . . . . . . . . . . . . . Direct Smear . . . . . . . . . . . Fecal Gram Stain Smear . . . . Centrifuge Method . . . . . . . . Skin Scraping . . . . . . . . . . . Cellophane Tape/Scotch Tape Method . . . . . . . . . . . . . . . Microfilaria Test Procedures. . . . . Modified Knott’s Test . . . . . . Direct Blood Smear Diagnosis. Snap Test (Antigen/Antibody Testing) . . . . . . . . . . . . . . . Common Endoparasites . . . . . . . Common Ectoparasites . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 232 233 233 233 234 234 . . . . . . . . . . . . . . . . . . . . 235 235 235 236 . . . . . . . . . . . . . . . . . . . . 236 237 242 249 PHARMACEUTICALS . . . . . . . . . . 251 Common Measurements . . . . . . . . Liquid Measurements . . . . . . . Weight Equivalents. . . . . . . . . . Conversion Factors . . . . . . . . . . . . Unit Conversions . . . . . . . . . . . . . . Converting Percents to a Decimal or a Fraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 254 254 255 255 . . . 255

xvii table of contents Basic Drug Calculation Formulas . . . . Dosage Calculations . . . . . . . . . . Percent Concentrations . . . . . . . . Fluid Administration Calculations . Controlled Substances . . . . . . . . . . . Schedule I. . . . . . . . . . . . . . . . . Schedule II . . . . . . . . . . . . . . . . Schedule III. . . . . . . . . . . . . . . . Schedule IV. . . . . . . . . . . . . . . . Schedule V . . . . . . . . . . . . . . . . Analgesics . . . . . . . . . . . . . . . . . . . Anesthetics (General) . . . . . . . . . . . . Antibiotics . . . . . . . . . . . . . . . . . . . Anticonvulsants . . . . . . . . . . . . . . . Antifungals . . . . . . . . . . . . . . . . . . . Antihistamines . . . . . . . . . . . . . . . . Antihelmintics (Dewormers) . . . . . . . Cardiovascular Drugs . . . . . . . . . . . . Fleas and Ticks . . . . . . . . . . . . . . . . Heartworm Preventives . . . . . . . . . . . Intestinal Drugs. . . . . . . . . . . . . . . . Nonsteroidal Anti-inflammatory Drugs. Steroids . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 256 256 258 259 259 260 260 260 261 262 266 269 276 278 280 281 287 291 297 301 304 307 310 POCKET PETS . . . . . . . . . . . . . . 311 Terms to Know . . . . . . . . . . . . . . . . . . 313 Normal Values . . . . . . . . . . . . . . . . . . 314

xviii table of contents Reproduction . . . . . . . . . . . . . . Common Diseases in Pocket Pets . Mice . . . . . . . . . . . . . . . . . . . . Husbandry . . . . . . . . . . . . . Nutrition . . . . . . . . . . . . . . Behavior. . . . . . . . . . . . . . . Special Characteristics . . . . . Restraint and Handling . . . . . Administration of Medications Rats . . . . . . . . . . . . . . . . . . . . Husbandry . . . . . . . . . . . . . Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315 324 335 335 335 335 336 336 337 338 338 339 Behavior. . . . . . . . . . . . . . . . . . . . 339 Special Characteristics . . . . . . . . . . 340 Restraint and Handling . . . . . . . . . . 340 Administration of Medications . . . . . 341 Hamsters . . . . . . . . . . . . . . . . . . . . . . 342 Husbandry . . . . . . . . . . . . . . . . . . 342 Nutrition . . . . . . . . . . . . . . . . . . . 343 Behavior. . . . . . . . . . . . . . . . . . . . 343 Special Characteristics . . . . . . . . . . 343 Restraint and Handling . . . . . . . . . . 344 Administration of Medications . . . . . 345 Gerbils. . . . . . . . . . . . . . . . . . . . . . . . 345 Husbandry . . . . . . . . . . . . . . . . . . 345 Nutrition . . . . . . . . . . . . . . . . . . . 346 Behavior. . . . . . . . . . . . . . . . . . . . 346 Restraint and Handling . . . . . . . . . . 346 Administration of Medications . . . . . 347

table of contents Guinea Pigs . . . . . . . . . . . . . . . . . . . . 347 Husbandry . . . . . . . . . . . . . . . . . . 347 Nutrition . . . . . . . . . . . . . . . . . . . 348 Behavior. . . . . . . . . . . . . . . . . . . . 349 Special Characteristics . . . . . . . . . . 350 Restraint and Handling . . . . . . . . . . 350 Administration of Medications . . . . . 351 Rabbits . . . . . . . . . . . . . . . . . . . . . . . 352 Husbandry . . . . . . . . . . . . . . . . . . 352 Nutrition . . . . . . . . . . . . . . . . . . . 352 Behavior. . . . . . . . . . . . . . . . . . . . 353 Special Characteristics . . . . . . . . . . 353 Restraint and Handling . . . . . . . . . . 354 Administration of Medications . . . . . 356 Ferrets . . . . . . . . . . . . . . . . . . . . . . . . 356 Husbandry . . . . . . . . . . . . . . . . . . 356 Nutrition . . . . . . . . . . . . . . . . . . . 357 Behavior. . . . . . . . . . . . . . . . . . . . 357 Special Characteristics . . . . . . . . . . 358 Restraint and Handling . . . . . . . . . . 359 Administration of Medications . . . . . 360 Chinchillas . . . . . . . . . . . . . . . . . . . . . 360 Husbandry . . . . . . . . . . . . . . . . . . 360 Nutrition . . . . . . . . . . . . . . . . . . . 361 Behavior. . . . . . . . . . . . . . . . . . . . 361 Special Characteristics . . . . . . . . . . 361 Restraint and Handling . . . . . . . . . . 362 Administration of Medications . . . . . 362 References . . . . . . . . . . . . . . . . . . . . . 363 xix

xx table of contents REPRODUCTION . . . . . . . . . . . . . 365 Quick Reference . . . . . . . . . . . . . . . . Canine Reproduction . . . . . . . . . . . . . The Estrous Cycle of the Canine. . . . Pseudopregnancy . . . . . . . . . . . . . Pyometra . . . . . . . . . . . . . . . . . . Breeding Considerations . . . . . . . . . . . Canine Pregnancy . . . . . . . . . . . . . . . Delivery and Postpartum Complications and Interventions. . . . . . . . . . . . . Dystocia . . . . . . . . . . . . . . . . . . Cesarean Section . . . . . . . . . . . . . Eclampsia (Milk Fever) . . . . . . . . . Mastitis . . . . . . . . . . . . . . . . . . . Feline Reproduction . . . . . . . . . . . . . . The Estrous Cycle of the Feline . . . . Pyometra . . . . . . . . . . . . . . . . . . Feline Pregnancy . . . . . . . . . . . . . . . . Neonatal Care for Puppies and Kittens . . . . . . . . . . . . . . . . . Physical Examination . . . . . . . . . . Caring for Orphan Neonates. . . . . . . . . Milk Replacer for Puppies . . . . . . . Milk Replacer for Kittens . . . . . . . . Homemade Formula Recipe . . . . . . Caring for Ill Neonates . . . . . . . . . . . . Reference . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367 368 368 370 370 371 371 . . . . . . . . . 375 375 376 376 377 377 377 378 379 . . . . . . . . 379 379 381 381 381 382 382 383

table of contents xxi SURGERY . . . . . . . . . . . . . . . . . 385 Aseptic Technique . . . . . . . . . . . . . . . . 387 Rules of Asepsis . . . . . . . . . . . . . . . 387 General Surgical Hand Scrub Procedure . . . . . . . . . . . . . . . . . . 387 Drying Hands after Scrub. . . . . . . . . 389 Gowning . . . . . . . . . . . . . . . . . . . 389 Open Gloving . . . . . . . . . . . . . . . . 389 Closed Gloving . . . . . . . . . . . . . . . 390 Instruments . . . . . . . . . . . . . . . . . . . . 391 Scalpel Blades . . . . . . . . . . . . . . . . 391 Scissors . . . . . . . . . . . . . . . . . . . . 392 Thumb Forceps . . . . . . . . . . . . . . . 393 Hemostatic and Tissue Forceps . . . . . . . . . . . . . . . . . . . . 395 Needle Holders . . . . . . . . . . . . . . . 397 Towel Clamps . . . . . . . . . . . . . . . . 397 Spay Hooks (Snook Hook) . . . . . . . . 398 Prepping the Animal for Surgery . . . . . . . 399 Surgical Clip and Scrub . . . . . . . . . . 399 Patient Positioning . . . . . . . . . . . . . 400 Single Drape . . . . . . . . . . . . . . . . . 400 Four Corner Drape . . . . . . . . . . . . . 400 Hanging Leg or Appendage Drape . . . . . . . . . . . . . . . . . . . . . 401 Induction and Recovery. . . . . . . . . . . . . 401 Potential Intubation Problems . . . . . 401

xxii table of contents Intubation Procedure . . . . . . . . . . . . . Confirmation of Endotracheal Tube Placement . . . . . . . . . . . . . . . . . Patient Recovery . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . 402 . 403 . 404 . 404 URINALYSIS . . . . . . . . . . . . . . . 405 Handling and Storage . . . . . . Methods of Collection . . . . . Free Catch/Void. . . . . . . Express Bladder . . . . . . . Catheterization . . . . . . . Cystocentesis . . . . . . . . Gross Exam . . . . . . . . . . . . Chemical Analysis . . . . . . . . Urine Sediment Exam . . . . . . Procedure. . . . . . . . . . . Labeling Sediment Values References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406 406 407 407 407 408 408 409 410 410 410 413 VACCINES AND DISEASE . . . . . . . 415 Vaccine Risk Assessment . . . . . . . . . . Questions to Ask Clients regarding Patient’s Lifestyle . . . . . . . . . . . . Possible Vaccine Reactions. . . . . . Locations to Vaccinate . . . . . . . . . . 416 . . 416 . . 416 . . 417

table of contents xxiii Vaccines and Disease . . . . . . . . . . . . . . 418 References . . . . . . . . . . . . . . . . . . . . . 428 ZOONOSIS . . . . . . . . . . . . . . . . 429 References . . . . . . . . . . . . . . . . . . . . . 443 APPENDIX . . . . . . . . . . . . . . . . 445 Glossary. . . . . . . . . . . . . . . . . . . . . . . 446 Websites . . . . . . . . . . . . . . . . . . . . . . 449 Notes. . . . . . . . . . . . . . . . . . . . . . . . . 451

´ Preface The goal of this book is for students and technicians to have access to an easy-to-follow, quick, and comprehensive reference guide that they can literally fit into their pockets. It is designed to be an “on-the-go” guide that veterinary students and technicians can access when attempting to do a quick calculation, locate medication side effects, etc., in situations where time is of the essence. This book is targeted for veterinary technology students, veterinary technicians, and veterinary clinics. As a veterinary technician instructor, I have worked hands on with students that try to create simple versions of this guide on several occasions, but each situation ended in less than satisfactory results. The main reason for this was the immense time, effort, and research that a book like this requires, none of which is easily available to veterinary technicians and tech students in today’s fast-paced world. Generally speaking, veterinary technicians are expected to have a working knowledge of nearly every aspect of the veterinary field (e.g., common lab procedures, nursing procedures, terms and abbreviations, pocket pet topics, reception and administrative topics, legal and OSHA topics, emergency procedures and situations, etc.). For example, we are expected to identify parasites and blood abnormalities, figure out fluid drip rates, and maybe even know the gestation of a guinea pig! The simple fact is that there is too much to memorize without sacrificing clinical skills and technique, two necessary tools every technician must possess. (I do realize that technicians should know how to perform multiple procedures, but there are many xxiv

PREFACE xxv that are not done on an everyday basis and can easily be forgotten.) Unlike the human health profession, where nurses generally deal with specific interests, such as pediatrics or radiology, in the veterinary field technicians must be well versed in all aspects of their field of medicine. A primary goal of this book is to ensure that it is easy to read and contains quick-access information with the simple flip of a page. Some of the features included in this book are: • Color coded tabs for easy reading and easy access • Sub-categories are bulleted at the beginning of each chapter for easy reading and reference • A size that can easily be carried in a pocket, spiral bound • Wipe-free waterproof pages • Many easy to read charts and bulleted information • Illustrations and color photos • Notes pages and helpful Web sites • Ruler on the inside back cover After countless hours researching the information needed to complete this book to its fullest potential, I began debating with myself about seemingly irrelevant topics, such as what chapter should go first? What should I call each chapter? What can I leave out and what must to be in the book? But after finishing this project, I am so very excited to have published something that future and current fellow veterinary technicians can use to help them feel confident and prepared to excel even under the most pressure-packed situations!

´ Acknowledgments I am grateful to many people for their help, opinions, ideas, and encouragement about this project. • My husband, with his boundless patience who gave me his keen insights and comments during the creation of the book, and who also altered his schedule on many occasions to be with our little girl while I spent my evenings at the coffee shop. I love you! • Thank you to my Senior Product Manager, Darcy Scelsi, for her patience and assistance with my many questions and my efforts to complete, polish, and proficiently edit my manuscript. • My past editor at Delmar Cengage Learning, Dave Rosenbaum. He was always there to answer my questions, as simple or pesky as they may have been. Thanks, Dave! • If it weren’t for my past supervisor at MSB I would never have had the opportunity to even put a proposal together to publish this book. Thank you, Lisa Travers, from the bottom of my heart! • To my confidant, Ken Traen. Your words and wisdom have brought me strength and comfort within myself. I can’t thank you enough. Without your motivation and inspiration this project would never have become what it is. • I would also like to thank the Minnesota School of Business Blaine Campus, many of my past students, the staff at Bass Lake Pet Hospital, and my rock stars at Anderson Lakes who helped me collect the many images needed to make this book as helpful as possible. xxvi

´ Reviewers Tracy Blais, BS, CVT, MEd Mount Ida College Newton, Massachusetts Terry D. Cannerdy, BS, DVM Murray State University Murray, Kentucky Gail Hartman, BS, DVM Becker College Worcester, Massachusetts James Q. Knight, DVM Becker College Worcester, Massachusetts Mary O’Horo Loomis, DVM SUNY Canton Canton, New York Karl M. Peter, DVM Foothill College Los Altos Hills, California Jamie Schoenbeck-Walsh, RVT, RN Purdue University West Lafayette, Indiana xxvii

´ About the Author Marisa is a graduate of Argosy University with an Associate’s Degree in veterinary technology. She is also a state and nationally certified veterinary technician. Marisa has been in the animal field for more than a decade, and in the veterinary field for nine years. She taught at the Minnesota School of Business for three years, worked as an ICU technician at the University of Minnesota’s Small Animal Hospital, worked in a laboratory setting, and has experience in a variety of small animal practices. She taught many of the classes offered in the veterinary technology program at the Minnesota School of Business with a curriculum she created herself. Marisa is currently Emergency supervisor at Florida Veterinary Specialists (Brandon, Florida) and Off-site HR director at Anderson Lakes Animal Hospital’s (Eden Prairie, Minnesota). xxviii

Anatomy OUTLINE: ´ ´ ´ Canine Anatomy / 2 Feline Anatomy / 3 Reference / 5

2 The Veterinary Technician’s Pocket Partner ´ Canine Anatomy Skull Cervical vertebrae Maxilla Thoracic vertebrae Lumbar vertebrae Mandible Pelvis Scapula Humerus Ribs Ulna Radius Tibia Carpus Sacral vertebrae Femur Fibula Tarsus Metacarpus Metatarsus Phalanges FIGURE 1–1 Canine Skeleton Lumbar muscles Lateral head of Triceps FPO Biceps Femoris Semi-Tendinosus FIGURE 1–2 Canine Muscles

3 anatomy Diaphram Kidneys Trachea Ureters Large intestine Anus Bladder Esophogus Lungs Urethra Heart Liver Spleen Stomach FIGURE 1–3 Canine Body Cavity ´ Feline Anatomy Lumbar vertebrae (7) Floating rib Thoracic vertebrae (13) Maxilla Sacrum (3) Mandible False rib Coccygeal vertebrae Femur Fibula Patella Tarsals Carpals Metatarsals Phalanges Tibia Metacarpals Cervical vertebra (7) Scapula True rib Sternum (sternebrae) Humerus Olecranon process Radius Ulna Phalanges FIGURE 1–4 Feline Skeleton

4 The Veterinary Technician’s Pocket Partner Lumbar muscles Biceps Femoris Triceps SemiTendinosus FIGURE 1–5 Feline Muscles Trachea Diaphram Kidneys Ureters Esophogus Anus Large intestine Lungs Urethra Heart Bladder Liver Spleen Stomach FIGURE 1–6 Feline Body Cavity

anatomy 5 ´ Reference McCurnin, D. M., & Bassert, J. M. (2006). Clinical textbook for veterinary technicians. (6th ed.).

´ Notes 6

Anesthesia OUTLINE: ´ ´ Stages of Anesthesia ´ Anesthetic Machine Quality Control / 13 • Set-up of the Anesthetic Machine / 13 • Pressure Testing the Anesthetic Machine / 13 ´ Troubleshooting during an Anesthetic Emergency / 14 ´ References / 8 Monitoring an Animal under Anesthesia / 10 • General Considerations / 10 • Vital Signs / 11 • Reflexes to Check / 11 • Normal Anesthetic Recovery Signs / 12 • Signs of Anesthetic Overdose / 12 / 16

8 ´ Stages of Anesthesia STAGES OF ANESTHESIA STAGE OF ANESTHESIA DEPTH CARDIOVASCULAR EYEBALL FUNCTION POSITION PUPIL REACTION MUSCLE TONE REFLEX RESPONSE Normal; increased if nervous Normal Central Normal Good All present Irregular respirations (breath holding) Tachycardia Central Possible dilation Good Exaggerated reflexes BEHAVIOR RESPIRATION Stage 1 Not Disoriented anesthetized Stage 2: Excitatory Stage Not Chewing anesthetized Yawning Vocalization Vomiting Defecation The Veterinary Technician’s Pocket Partner TABLE 2-1

Anesthetized Respiration rate 12–20 (ideal) Heart rate 90–120 (ideal) May alter per size of animal Eyes central Stage 3, Plane 2: Moderate Surgical Plane Anesthetized Respiration rate regular, 12–16 rpm (ideal) > 90 bpm Medial Mild dilation rotation of eye Stage 3, Plane 3: Deep Orthopedic Stage Anesthetized Decreased respiration, shallow < 12 rpm 60–90 bpm CRT < 2 sec. Weakened pulse Eyeball central Pupil response Significantly All reflexes reduced absent to light diminished, moderately dilated Stage 3, Plane 4 Anesthetized Respiration is < 60 bpm irregular and Pale MM, shallow prolonged CRT, End of plane 4 weak pulse is respiratory arrest Central Pupil is widely Muscles are dilated flaccid All reflexes absent Central Widely dilated Flaccid All reflexes absent Overdose Stage 4: Terminal Dying or death Death Stage Apnea Cardiac collapse Normal Good Reflexes all present, but diminished Relaxed Palpebral and pedal reflexes are gone Anesthesia Stage 3, Plane 1: Light Restraint Anesthesia, Plane of Intubation 9

10 ´ The Veterinary Technician’s Pocket Partner Monitoring an Animal under Anesthesia GENERAL CONSIDERATIONS • Species variation: (i.e., Dogs are more likely than cats to have a seizure on ketamine.) • Breed variations: (i.e., Sighthounds are very sensitive to barbiturates.) • Individual variations (i.e., Each animal can have an individual reaction.) • Poor physical condition (i.e., body condition score, underlying illnesses) • Age: The very young and very old have lower anesthetic requirements (metabolic rate). • Sex: Dose a pregnant female according to ideal weight, not pregnant weight (body size increased, the brain did not). • Disposition: Fear will increase anesthetic requirements. • Smaller breeds: Require more drug per pound than larger breeds (higher metabolic rate). • Brachycephalic breeds: Have elongated soft palate; leave them intubated as long as possible during recovery.

Anesthesia 11 VITAL SIGNS TABLE 2-2 NORMAL ANESTHETIC CHANGES IN VITALS VITAL SIGN NORMAL UNDER ANESTHESIA Respirations Dog: 10–30 rpm Cat: 25–40 rpm Dog & Cat: 8–20 rpm No less than 8 rpm May see up to 50 rpm Tidal volume 10–20ml/kg Decreased Heart rate Dog: 60–180 bpm Cat: 110–220 bpm Dog & cat: 60–120 bpm Monitor if any deficits. CRT Dog & cat : < 2 sec. Dog & cat : < 2 sec. MM Pink Pink REFLEXES TO CHECK 1. Palpebral: Check eyes for blinking; if no reflex, patient is in stage 3, plane 2 (surgical plane). 2. Pinna: Ear tickle 3. Jaw tone: Any resistance when opening jaw 4. Pedal: Pinching the toe; if no reflex, patient is in stage 3, plane 2 (surgical plane) or higher. 5. Corneal (not commonly used): Tap the patient’s eyeball. (You don’t want to lose this reflex; loss of this reflex means that the animal is too deep.)

12 The Veterinary Technician’s Pocket Partner NORMAL ANESTHETIC RECOVERY SIGNS • Increased respiratory rate and depth to normal range • Rotation of eyeball to central position • Return of all reflexes • Shivering • Chewing, swallowing, and tongue movement — Tracheal tube is not removed until the animal is swallowing. — Brachycephalic breeds are not extubated until they are practically standing (monitor closely). • Attempting to stand SIGNS OF ANESTHETIC OVERDOSE • Decreased respiratory rate and tidal volume or apnea • Cyanotic MM and/or prolonged CRT • Decreased heart rate — Before the animal goes into cardiac arrest, the heart speeds up. • Hypothermia • Decreased pupil response to light, widely dilated pupils • Reflexes not returning • Abnormally prolonged recovery

Anesthesia ´ 13 Anesthetic Machine Quality Control SET-UP OF THE ANESTHETIC MACHINE • • • • • • • • Turn on the oxygen tank. Check the oxygen levels (should be over 200 psi). Make sure the vaporizer is full. Assemble the correct circuit to be used for the patient. Connect the scavenger to the system. Attach the correct size reservoir bag. Pressure test the machine for leaks (see below). Check the carbon dioxide absorber canister (soda lime) during and post surgery for color change. PRESSURE TESTING THE ANESTHETIC MACHINE 1. Close pop-off valve. 2. Occlude circuit with finger and fill bag by pushing the flush O2 button. 3. Take pressure to 25 cm or until bag is full. 4. Pressure should hold in machine. 5. Set O2 flowmeter at 200 cc. If pressure is still falling, you must find the leak. 6. Do not forget to reopen the pop-off valve after testing!

14 The Veterinary Technician’s Pocket Partner Places to look for leaks include: • Inspiratory and expiratory valves • Around the absorber • Pop-off or relief valve • Around the vaporizer • Hole in bag or hoses ´ Troubleshooting during an Anesthetic Emergency • If the animal does not stay asleep: — Check vaporizer (too low %, empty). — Check ET tube placement (too far, not far enough, in esophagus). — Is the patient holding his or her breath? — Are the respirations too shallow (bag every 5 sec.)? — Is the machine assembled correctly? — Consult with DVM. • Animal too deep: — < 8 rpm, HR < 70 bpm for small dogs — < 60 bpm for large dogs — < 100 bpm for cats — Is the vaporizer too high? — Decrease or turn off vaporizer. — Bag with pure O2 every 5 sec. — Consult with DVM.

Anesthesia 15 • Pale mucus membranes: — Check for bleeding disorders, hemorrhage, anemias, and drugs or inhaled agents. — Assess anesthetic depth. — Monitor vitals. — Consult DVM. — Fluids or transfusion may be necessary. • Prolonged CRT: — > 2 sec.: • Hypotension, blood loss, shock. — Check pulse pressure and blood pressure. — Consult DVM. — Check for tachycardia: • Tx: IVF, warm patient, etc. • Dyspnea: — Usually seen with cyanosis. — Ensure O2 delivery to patient. — Tx: Bag with pure O2, IVF, consult DVM. • Respiratory arrest leads to cardiac arrest. • Cyanosis: — Same as dyspnea. • Abnormal heart rate and rhythm: — Tachycardia: • > 120 bpm in large dog or > 160 bpm in small dogs or cats in stage III • Caused by ketamine, atropine, epinephrine • Common in hyperthyroid cats, shock, CHF • Also caused by surgical stimulation. — Bradycardia: • < 60 bpm in large dogs; < 70 bpm in small dogs; < 100 bpm in cats

16 The Veterinary Technician’s Pocket Partner • Caused by xylazine, opioids, intubation (parasympathetic system) • Tx: Bag with pure O2, consult DVM, check CRT and pulse. — Cardiac arrhythmia (dysrhythmia): • Dropped beats, PVCs (premature ventricular contractions), episodes of tachycardia • Caused by: drug induced, induction (common), CV disease, GDV, hypercarbia (high O2) • Tx: Check CO2 absorber; consult with DVM. • Respiratory arrest: — Leads to cardiac arrest within 5 minutes! — Tx: Monitor 1–2 min. before assuming a serious condition exists, consult DVM, bag patient. • Cardiac arrest: — Consult DVM. — CPR (see Emergency tab). — Permanent brain damage in 3 min. ´ References McCurnin, D. M., & Bassert, J. M. (2006). Clinical textbook for veterinary technicians. (6th ed.). McKelvey, D., & Hollingshead, K. W. (2003). Veterinary anesthesia and analgesia. (3rd ed.)

OUTLINE: ´ Common Endocrine Function Testing / 18 • Serum Bile Acid Test / 18 • ACTH Stimulation Testing / 19 • High- and Low-Dose Dexamethasone Suppression Tests in Dogs / 20 • Thyroid-Stimulating Hormone (TSH) Response Test / 21 • Diabetic Testing/Glucose Curve (Insulin Tolerance) / 22 ´ Cytology Images / 24 • Ear Cytology / 24 • Vaginal Cytology / 24 • Sperm / 25 • Fatty Aspirate / 25 ´ References / 26 Function Testing Cytology and Endocrine Function Testing

18 The Veterinary Technician’s Pocket Partner ´ Common Endocrine Function Testing SERUM BILE ACID TEST Indication: Assess hepatic function in dogs and cats. Test Procedure 1. Animal must have fasted for 12 hr. prior to initial blood draw. 2. Draw 3 mL of blood (1 mL of serum) and place in a red-top tube.* 3. Serum must be separated from cells within 1 hr. of blood draw and placed in a new red-top tube; then place sample in the refrigerator. 4. Feed standard meal right after initial blood draw. 5. Draw another 3 mL of blood (1 mL of serum) and place in a red-top tube 2 hr. postprandial (after eating).* 6. Serum must be separated from cells within 1 hr. of blood draw and placed in a new red-top tube; then place sample in the refrigerator. 7. Clearly label each serum sample with pre- and post-collection times. * See your laboratory for details. Normal Values • Postprandial ranges: 0.0–25.0 μmol/L (canine) • Postprandial ranges: 5.0–15.0 μmol /L ( feline)

Cytology and Endocrine Function Testing 19 • Fasting ranges: 0.0–12.0 μmol /L (canine) • Fasting ranges: 0.0–5.0 μmol /L ( feline) These values are based on Marshfield Clinic Laboratories ranges. ACTH STIMULATION TESTING Indication: Assess the function of the adrenal glands (adrenocortical function). Test Procedure If the animal is overstressed or nervous at the clinic it is recommended that the client bring the animal home; stress can alter the test results. 1. Draw 1 mL of serum or plasma (3 mL whole blood).* 2. Administer 5 μg/kg (dog) or 125 μg/cat of synthetic ACTH cosyntropin IV or IM.* 3. Collect another 1 mL of serum or plasma 30 min. (if given IV) or 60 min. (if given IM) post ACTH administration.* You may have to collect a third sample 60 min. (if given IV) or 90 min. (if given IM) post ACTH administration in cats.* * See your laboratory for details. Normal Values • Canine baseline cortisol: 1–5 μg/dL • Canine ACTH post stimulation: 10–20 μg/dL • Feline baseline cortisol: 1–5 μg/dL • Feline peak ACTH post cortisol: 5–15 μg/dL These values are based on Marshfield Clinic Laboratories ranges.

20 The Veterinary Technician’s Pocket Partner Meaning of Abnormal Results • Values above 20 μg/dL in the post ACTH cortisol assay are suggestive of hyperadrenocorticism. • Values below the baseline ranges are suggestive of hypoadrenocorticism. HIGH- AND LOW-DOSE DEXAMETHASONE SUPPRESSION TESTS IN DOGS High-dose indication: Differentiate pituitary-dependent from adrenal tumor hyperadrenocorticism. Low-dose indication: Test for hyperadrenocorticism (Cushing’s disease). Test Procedure If the animal is overstressed or nervous at the clinic it is recommended that the client bring the animal home; stress can alter the test results. This test will take most of the day. It is recommended that the animal have the initial blood draw run in the early morning. 1. Draw 1 mL of serum or plasma (3 mL whole blood).* 2. Immediately give dexamethasone. low-dose test dosage: 0.015 mg/kg given IV high-dose test dosage: 0.1 mg/kg given IV 3. A second blood collection can be taken 4 hr. post dexamethasone administration.* 4. The last blood collection will be taken 8 hr. post dexamethasone administration.* * See your laboratory for details.

Cytology and Endocrine Function Testing 21 Normal Values • Baseline cortisol: 1–5 μg/dL These values are based on Marshfield Clinic Laboratories ranges. Meaning of Abnormal Results High-dose testing: • If the 4-hr. and/or 8-hr. cortisol levels are < 50% baseline: pituitary-dependent hyperadrenocorticism. • If the 4-hr. and/or 8-hr. cortisol levels are > 50% baseline: either adrenal-dependent or pituitarydependent hyperadrenocorticism. Low-dose testing: • The 8-hr. post cortisol is > 1 μg/dL: supports hyperadrenocorticism. The 4-hr. test is used to differentiate adrenal-dependent from pituitary-dependent hyperadrenocorticism. • The 4-hr. post cortisol is < 1 μg/dL: pituitary-dependent hyperadrenocorticism. • The 4-hr. post cortisol is > 1 μg/dL: additional tests are needed to differentiate adrenal-dependent from pituitary-dependent hyperadrenocorticism. THYROID-STIMULATING HORMONE (TSH) RESPONSE TEST Indication: Measures the amount of thyroid-stimulating hormone in the blood, which reflects the function of the thyroid.

22 The Veterinary Technician’s Pocket Partner Test Procedure 1. Collect 3 mL whole blood (1 mL serum) and place in a red-top tube.* 2. Administer bovine 0.1 IU/kg TSH (bTSH) IV, IM, or SQ.* (Do not give more than 5 IU/dog or 1 IU/cat).* 3. Collect a second sample (same as above) 4–6 hours after the bTSH was administered. * See your laboratory for details. Normal Values Canine: 0.03–0.32 ng/mL These values are based on Marshfield Clinic Laboratories ranges. Meaning of Abnormal Results • Elevated TSH is consistent with primary hypothyroidism. • Significance of a low TSH concentration is uncertain. DIABETIC TESTING/GLUCOSE CURVE (INSULIN TOLERANCE) Definition: a visual representation of the patient’s blood glucose level over the course of a day. Test Procedure 1. Owner feeds animal a normal meal. 2. Owner gives insulin (dosage per DVM recommendations).

Cytology and Endocrine Function Testing 3. 4. 5. 6. 23 Owner brings the patient to the clinic. Take initial blood sample and determine glucose value. Take blood samples at 1 to 2 hr. intervals for the next 12 hr. Once completed, the insulin dose, dosing interval, and type of insulin used are evaluated. Normal Values • Canine: Maintain blood glucose between 100–200 mg% for at least 20–22 hours per day. • Feline: Maintain blood glucose between 100–300 mg% for at least 20–22 hours per day. • The highest blood glucose value will be the sample just before the insulin was given: < 300 mg/dL. • The time from the insulin injection until the lowest glucose result is between 5 and 8 hr. • The lowest point should be > 100 mg/dL. • Midpoint should be 150–250 mg/dL. Meaning of Abnormal Results • If the lowest point is reached in less than 5 hr., the insulin is given more often, or a longer-acting insulin is used. • If the time when the lowest point is reached is greater than 8 hr., the insulin is given less often. • If the lowest point falls below 100 mg/dL, or the midpoint is below 150 mg/dL, the patient’s insulin dose is usually decreased.

24 The Veterinary Technician’s Pocket Partner ´ Cytology Images EAR CYTOLOGY FIGURE 3–1 Yeast Found in the Ear VAGINAL CYTOLOGY A B FIGURE 3–2 Vaginal Cytology: (A) Cornified Epithelial Cells; (B) Noncornified Epithelial Cells

Cytology and Endocrine Function Testing SPERM FIGURE 3–3 Sperm FATTY ASPIRATE FIGURE 3–4 Fatty Aspirate 25

26 The Veterinary Technician’s Pocket Partner ´ References Hendrix, C. M. (2002). Laboratory procedures for veterinary technicians (4th ed.). St. Louis, MO: Mosby. Marshfield clinic laboratories veterinary diagnostic services 2004 directory of lab services. (2002). Marshfield, WI: Marshfield Clinic Laboratories. Plumb, D. C. (1999). Veterinary handbook. Ames, IA: Iowa State University Press. Sink, C. A., & Feldman, B. F., (2004). Laboratory urinalysis and hematology for the small animal practitioner. Jackson, WY: Teton NewMedia. Tilley, L. P., & Smith, W. K., Jr., (2004). The 5-minute veterinary consult: Canine and feline (3rd ed.). Baltimore, MD: Lippincott Williams & Wilkins.

Dentistry OUTLINE: ´ ´ ´ ´ ´ ´ Dental Models (Canine and Feline) Dental Disease Dental Charting / / 29 31 Dental Prophylaxis Procedure Common Dental Tools References / 35 / 28 / 34 / 32

28 ´ The Veterinary Technician’s Pocket Partner Dental Models (Canine and Feline) To read the dental formula for dogs and cats: • The first number refers to the mandible. • The second number refers to the maxilla. • “2 X” refers to both sides of the mouth. • I = incisor, C = canine, PM = premolar, M = molar Canine deciduous teeth: 2X (3I/3I, 1C/1C, 3PM/3PM) = 28 Canine adult teeth: 2X (3I/3I, 1C/1C, 4PM/PM, 2M/3M) = 32 A B FIGURE 4–1 Canine Dental Model: (A) Mandible; (B) Maxilla

Dentistry 29 Feline deciduous teeth: 2X (3I/3I, 1C/1C, 3PM/2PM) = 26 Feline adult teeth: 2X (3I/3I, 1C/1C, 3PM/2PM, 1M/1M) = 30 A B FIGURE 4–2 Feline Dental Model: (A) Mandible; (B) Maxilla ´ Dental Disease There is no universal dental grading system. The information provided is generalized information that can be used to help identify the disease level. See your clinic protocol for details or differences.

30 The Veterinary Technician’s Pocket Partner TABLE 4-1 LEVELS OF DENTAL DISEASE PERIODONTAL ATTACHMENT MOBILITY Normal, healthy gingiva No odor No attachment loss No tooth mobility Mild gingivitis Mild inflammation No bleeding on gentle probing Gingivitis only No attachment loss Possible tooth mobility Advanced Moderate gingivitis Gingivitis Inflammation and Some May bleed on gentle Periodontitis probing Less than 25% attachment loss Slight tooth mobility Severe Advanced gingivitis Gingivitis Inflammation with Bleeding Moderate Periodontitis 25% to 50% attachment loss Moderate tooth mobility Severe Severe gingivitis Gingivitis Inflammation with Severe Bleeding Periodontitis Greater than 50% attachment loss Severe tooth mobility LEVEL GINGIVA No Disease Reversible Gingivitis

31 Dentistry A B C D FIGURE 4–3 (A) Dental Disease Stage/Grade 1; (B) Dental Disease Stage/Grade 2; (C) Dental Disease Stage/Grade 3; (D) Dental Disease Stage/Grade 4 ´ Dental Charting TABLE 4-2 POSSIBLE CHARTING NOTES CE CERVICAL EROSION D Discoloration E or E/D Enamel defect continues

32 The Veterinary Technician’s Pocket Partner CE CERVICAL EROSION FX or # Fractured tooth ONF Oronasal fistula PE Pulp exposure O or * Missing tooth X Extracted tooth RD Retained deciduous tooth W Worn tooth F1, F2, F3 Grade 1,2,3 furcation GR Gingival recession M1, M2, M3, M4 Grade 1, 2, 3, or 4 mobility PN Pulp necrosis FORL (feline only) Feline odontoclastic resorptive lesion ´ Dental Prophylaxis Procedure Steps to follow when performing a dental prophylaxis once the animal is anesthetized: 1. Tilt the animal’s head at a slight incline (nose down). 2. Technician should be fully protected: gloves, mask, and goggles or glasses. a. The bacteria in an animal’s oral cavity can cause serious infection.

Dentistry 33 3. Thorough examination of the oral cavity: a. Check for missing or loose teeth, discoloration, fractured teeth, foreign objects, pus, etc. b. Check gums for disease, lesions, ulceration, tumors, etc. c. Check the tongue, nose, tonsils, and pharynx. d. In younger animals check for any retained deciduous teeth to be removed. e. Chart all findings. 4. If there are large pieces of calculus, remove them with calculus removing forceps. 5. Scale all teeth. a. If a mechanical scaler is used, do not keep the scaler on the tooth for more than 10 sec. b. Make sure to scale lingual and palatal portions of the teeth 6. A curette should be used to remove any subgingival calculus from the teeth. 7. Once all teeth are properly cleaned, the next step is to polish the teeth. 8. Rinse the animal’s mouth to remove any leftover calculus and paste. 9. A periodontal probe should be used to check all teeth for deep pockets. 10. Apply medicated oral rinse or fluoride treatment. (Dry teeth prior to applying any fluoride treatments.)

34 ´ The Veterinary Technician’s Pocket Partner Common Dental Tools A B(a) B(b) C(a) C(b) D FIGURE 4–4 (A) Mouth Gages; (B) Curette and Curette Tip; (C) Tooth Extraction Forceps and Tooth Extraction Forceps Tip; (D) Various Hand Scalers; (continued)

Dentistry E 35 F FIGURE 4–4 (continued) (E) Left to Right: Jaquette Supragingival Tip; Measuring Probe Tip; Sickle Scaler; (F) Left to Right: Sickle Scaler Tip; Explorer Tip; Subgingival Curette Hand Tip ´ References McCurnin, D. M., & Bassert, J. M. (2006). Clinical textbook for veterinary technicians (6th ed.). St. Louis, MO: Elsevier Saunders. McKelvey, D., & Hollingshead, K. W. (2003). Veterinary anesthesia and analgesia (3rd ed.). St. Louis, MO: Mosby.

´ Notes 36

Emergencies OUTLINE: ´ ´ Emergency Drugs ´ Cerebral Pulmonary Cardiac Resuscitation (CPCR) / 48 • CPCR Procedure / 48 • Drug Therapy / 49 • Evaluation of Status Post Resuscitation / 49 ´ Electrocardiogram (ECG) / 50 • Electrocardiogram (ECG) Waveforms / 50 • Possible ECG Arrhythmias / 53 • Placing the Leads on the Patient / 60 ´ Triage / 61 • Triage Priority List / 62 • Immediate Assessment / 62 • Patient History / 62 ´ Cardiac Arrest / 63 • Causes / 63 • Signs and Symptoms • Treatment / 64 / 40 ABCs / 46 • A = Arterial Bleeding/Airway Patency / 46 • B = Breathing / 46 • C = Cardiac / 47 / 63

´ Airway Obstruction / 64 • Causes / 64 • Signs and Symptoms / 64 • Treatment / 65 ´ Acute Respiratory Distress / 65 • Causes / 65 • Signs and Symptoms / 66 • Treatment / 66 ´ Shock / 67 • Causes / 67 • General Signs and Symptoms of Shock • Treatment / 67 ´ Hypovolemic Shock / 68 • Causes / 68 • Signs and Symptoms / 68 • Treatment / 68 ´ Anaphylactic Shock / 69 • Causes / 69 • Signs and Symptoms / 69 • Treatment / 69 ´ Cardiogenic Shock / 70 • Causes / 70 • Signs and Symptoms / 70 • Treatment / 71 ´ Septic Shock / 71 • Causes / 71 • Signs and Symptoms • Treatment / 72 ´ / 71 Pneumothorax / 72 • Causes / 72 • Signs and Symptoms / 72 • Treatment / 73 / 67

´ Hemothorax / 73 • Causes / 73 • Signs and Symptoms • Treatment / 74 / 74 ´ Diaphragmatic Hernia / 74 • Causes / 74 • Signs and Symptoms / 75 • Treatment / 75 ´ Seizures / 75 • Causes / 75 • Signs and Symptoms • Treatment / 76 / 76 ´ Ingestion of Poisons / 76 • Causes / 77 • Signs and Symptoms / 77 • History / 77 • Treatment / 78 ´ Fractures / 83 • Causes / 83 • Signs and Symptoms • Treatment / 83 / 83 ´ Doppler Blood Pressure Reading • Procedure / 84 ´ Crash Kit Supplies / 85 • Important Points to Remember ´ References / 87 / 84 / 86

40 ´ Emergency Drugs EMERGENCY DRUGS DOSAGE (WITH ROUTE OF ADMINISTRATION) DRUG WHEN GIVEN Epinephrine (Adrenaline) Initiate heartbeat Increase blood flow during CPCR Increase contractility Anaphylactic shock Atropine When bradycardia is seen Canine and feline: (CPCR dose) as an antidote to 0.05 mg/kg IV or 1 mg/kg organophosphate intratracheal poisoning CONTRAINDICATIONS Canine and feline: 0.05–0.5 mg Hypersensitivity to epinephrine, shock (0.5–5 mL) of 1:10,000 solution due to non-anaphylactoid causes, intratracheally or intravenously during general anesthesia with May need to repeat every 5 min. halogenated hydrocarbons, during (Wingfield, in Plumb, 1999) labor, cardiac dilatation, patients with narrow-angle glaucoma Contraindicated in conditions where anticholinergic effects would be detrimental The Veterinary Technician’s Pocket Partner TABLE 5-1

After prolonged CPR to correct metabolic acidosis Canine and feline: 1 mEq/kg IV bolus; add 3 mEq/kg to IV drip Incompatible with several solutions; consult product insert Should not be added to solutions containing calcium Dexamethasone (Dexasone, Dexamethasone Solution) Many uses; some include: Prolonged CPR Unconscious > 30 min. Shock Craniocerebral/spinal trauma Intracerebral pressure and edema Thrombocytopenia Canine and feline: shock: 5–10 mg/kg IV 0.25–1 mg q24h IV, IM When administered IM in patients with idiopathic thrombocytopenia and in patients hypersensitive to a particular compound. Other than with “burst” therapy, should be tapered off the drug. Patients who have received the drugs chronically should be tapered off slowly because ACTH and corticosteroid function may return slowly. In systemic fungal infections Prednisolone Sodium Succinate (Solu-DeltaCortef) Many uses, some include: Prolonged CPR Unconscious > 30 min. Endotoxemic or septic shock Neoplasms Respiratory disorders Liver disorders Canine: 5–30 mg/kg IV q4–6h Feline: 1–3 mg/kg IV q4–6h Same as dexamethasone Emergencies Sodium Bicarbonate 41 continues

Mannitol Reduce intraocular pressure After prolonged CPR Unconscious > 30 min. Cerebral edema Hemoglobin Increase systemic oxygen Glutamer-200 content if animal is (Oxyglobin) anemic DOSAGE (WITH ROUTE OF ADMINISTRATION) CONTRAINDICATIONS Canine and feline: 100–1000 mg/kg IV (20% = 0.5–5 mL/kg) Anuria secondary to renal disease, severe dehydration, intracranial bleeding, severe pulmonary congestion, or pulmonary edema Canine: 15–30 mL/kg IV Feline: 5–20 mL/kg IV, given in 5 mL/kg IV increments Advanced cardiac disease, renal impairment with oliguria or anuria Dopamine Adjunctive treatment of Canine and feline: 20 mg in acute heart failure and 250 mL LRS IV at a rate of renal failure 2–8 μg/kg per minute Supportive treatment of shock Lidocaine Ventricular arrhythmias Pheochromocytoma, ventricular fibrillation, and uncorrected tachyarrhythmia Canine: 2–4 mg/kg IV or 4 mg/ Known hypersensitivity to the amide-class kg intratracheal local anesthetics, severe degree of SA, Feline: 0.25–1 mg/kg slow IV AV, or intraventricular heart block (if not being artificially paced) Caution: Do not use in patients with liver disease, congestive heart failure, shock, hypovolemia, severe respiratory depression, or marked hypoxia, in patients with bradycardia or incomplete heart block having VPCs The Veterinary Technician’s Pocket Partner WHEN GIVEN 42 DRUG

Opioid reversal Respiratory stimulant in narcotic overdose Canine and feline: 1.01– 0.04 mg/kg IV, IM, SC If hypersensitive to it Caution: Do not use in pre-existing cardiac abnormalities or opioid dependent Yohimbine Xylazine reversal Respiratory stimulant in xylazine overdose Dogs: 0.11 mg/kg IV slowly Hypersensitive to it Caution: Do not use in renal disease, seizure disorders Heparin Anticoagulant used primarily Canine and feline: 5–75 U/kg for treatment of DIC and IV, SC q6–8h thromboembolic disease Known hypersensitivity, severe thrombocytopenia, or uncontrollable bleeding (caused by something other than DIC) Oxytocin Induction or enhancement of uterine contractions at parturition, postpartum retained placenta, and metritis Known hypersensitivity, dystocia due to abnormal presentation of fetus(es) unless correction is made. When used prepartum, oxytocin should be used only when the cervix is relaxed naturally or by the prior administration of estrogens Canine: 5–20 units IM, IV, repeat q30–45min. (2 U/kg up to 20 U) Feline: 0.5–3.0 units IM, IV continues Emergencies Naloxone 43

Canine and feline: status epilepticus 0.5–3 mg/kg IV or 2.5–20 mg intratracheal Hypersensitivity to benzodiazepines, cats exposed to chlorpyrifos, significant liver disease (especially in cats) CNS stimulant Used to stimulate respirations in newborns Canine and feline: 2–10 mg/kg slow IV Neonate: 1–5 mg SC, IV, or sublingual Hypersensitivity, seizure disorders, head trauma, heart failure, severe hypertension, respiratory failure secondary to neuromuscular disorders, airway obstruction, pulmonary embolism, pneumothorax, acute asthma, dyspnea Canine and feline: 2–5 g/kg (6–12 mL/kg) PO q2–6h Ineffective against mineral acids or caustic alkalis, ethanol, methanol, or iron salts Diazepam Dopram Activated Charcoal To prevent or reduce the systemic absorption of certain drugs or toxins The Veterinary Technician’s Pocket Partner CONTRAINDICATIONS Anxiolytic Muscle relaxant Hypnotic Appetite stimulant Anticonvulsant WHEN GIVEN 44 DOSAGE (WITH ROUTE OF ADMINISTRATION) DRUG

Causes emesis Canine and feline: 1–2 mL/kg PO, maximum of 2 tbsp. (30 mL); repeat half of the dose once if no emesis within 15 min. Where emesis is contraindicated; ingestion of alkalis, acids, corrosive agents, or hydrocarbons. Preexisting condition of the animal also determines the indication for using an emetic. Emesis should not be induced in an animal that has a history of epilepsy, cardiovascular disease, or is debilitated Diphenhydramine Anaphylactic shock Antihistaminic effects Prevention of motion sickness Sedative Antiemetic 1 mg/kg q8–12h IM, SC, IV (Do not exceed 40 mg total dose.); 2–4 mg/kg q8–12h PO Hypersensitive to it or others in class Dosages from Plunkett, 2005 and Plumb, 1999. Emergencies Hydrogen Peroxide 45

46 The Veterinary Technician’s Pocket Partner ´ ABC S ABCs: A good method of assessing a treatment strategy for victims of acute trauma. A = ARTERIAL BLEEDING/AIRWAY PATENCY Arterial bleeding: • If arterial hemorrhage is present, direct pressure should be applied to the wound immediately. If the vessel is easily visualized, cla

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