This is a veterinarian friend of mine that received a dog bite to the face just last week.  A Great Dane/Lab mix was on the radiology table and reached around and bit him on the face. It happened in the blink of an eye, and even though this dog has NEVER been aggressive or questionable in the past visits (she has been going to that clinic for years), something triggered her to react. It is a good reminder that any time you are taking x-rays, especially if the dog is painful, just put a muzzle on the dog. It often makes them more likely to hold still and prevents injury to others.

Here is a video on dog bite prevention with some good reminders:

http://www.youtube.com/watch?v=bKC7PMlTnzs&feature=youtu.be

In the veterinary profession, we must go a step further because we are working on a daily basis with a wide variety of animals and personalities, including injured, sick, and scared animals.

• Remember that ANY dog can bite.
• Approach each patient slowly and calmly and speak in a calm, quiet, and friendly voice.
• Don’t corner a dog in the exam room; have the owner bring the dog out and away from the corner or wall so you are not moving toward them but can approach from the side.
• NEVER allow an owner to restrain their own dog; this puts both you and the owner both at risk for dog bite. Many pets are protective of their owners and if they are holding their own pet, the pet may perceive that you are a threat.
• If you are concerned about the pet’s behavior and the dog is giving signs that he is scared or aggressive, place a muzzle on the dog for the exam.
• As a technician, if you are concerned that you cannot properly restrain an animal, make sure to inform the veterinarian of your concerns. Sometimes there are  pets that need chemical restraint (sedation) for examination.
• As tempting as it is to give those puppy kisses, avoid putting your face in an animal’s face. If the veterinarian is performing a task close to the dog’s face (such as an ophthalmic or otoscopic exam, make sure you have a good hold on the dog’s head. If you ever have concern that you cannot appropriately restrain the dog or if you sense that the dog is starting to resist, place a muzzle.
• If you are ever attacked by a dog or if a stray dog is approaching you, it is best to be perfectly still and “be a tree” or “be a rock”. Curl your hands into a fist to prevent your fingers from being bitten. If you have time, curl into a ball on the ground to protect your face and neck. A dog is less likely to attack if you are not perceived as a threat.  Never try to run or fight back; dogs are much faster than we are.
• For more information on dog bite prevention and resources, visit the AVMA website at: https://www.avma.org/public/Pages/Dog-Bite-Prevention.aspx

The VTNE will have several questions in which you will need to perform calculations. Here is a quick review of the most basic calculation.

“Sparky” is a 5-year old male neutered Corgi mix and is currently in the hospital. He weighs 32 pounds. The doctor asks you to give Sparky 5 mg/kg of Baytril injectable antibiotic IV. How much Baytril (in milliliters) will you give Sparky? Baytril comes in a 22.7 mg/mL solution.

Drug dosages are calculated according to body weight in kilograms and concentration of a drug (mg/mL or mg/tablet).

1) Figure the dog’s body weight in kilograms. There are 2.2 pounds in 1 kg.

If the dog is 32 pounds, then divide 32 by 2.2 pounds to get 14.5 kg

2)  If you are giving an antibiotic injection and the dose is 5 mg/kg, you will want to multiply the dose 5 mg/kg X 14.5 kg (the kg cancel out) to give you 72.5 mg total dose for the patient.

Now, you also need to know how many mg are in 1 mL of the antibiotic solution so you can give the right dose of medication. If the solution is 22.7 mg/mL, how many mLs will you give your patient?

Take your 72.5 mg total dose needed divided by the strength of 22.7 mg/mL (mg cancel out) and you get 3.2 mLs.

You will give your patient 3.2 mLs (the equivalent of 72.5 mg) of a 22.7 mg/mL antibiotic solution.

Veterinary Technician Duties

The daily duties of a veterinary technician vary. For instance, the responsibilities of a vet tech in an emergency hospital will differ from the duties of a zoo veterinary technician. In general, a vet tech is often asked to handle many of the regular activities of the office. Some of the common duties include:

• perform basic physical examinations
• take blood and urine samples
• conduct laboratory tests (such as blood tests and urinalysis)
• record and update patient records
• provide customer service in an office setting

Because the veterinary technician has been professionally trained to handle all these types of duties, the veterinarian can rely on him/her to manage the basic daily activities while he/she can provide more high quality direct care in assessing and diagnosing patients.

Future Job Outlook

Many students worry that if they begin a new career path that there won’t be any job available when they complete their training. With the veterinary technician training program, this isn’t such a problem. The United States Bureau of Labor Statistics (BLS) has projected a 52% growth in veterinary technician jobs between 2010 and 2020. That translates into over 40,000 new jobs. This growth rate is extremely high when compared with other occupations. This type of job security, matched with decent salary rates, makes the veterinary technician career enticing.

Start a Career as a Veterinary Technician

Have you ever considered a career working with animals? If so, becoming a veterinary technician may be an ideal career choice for you. Vet tech colleges can help you fast track your career. If your schedule is too busy or you don’t have many colleges in your area, you may consider an online veterinary technician program.

Exams are given on the computer at a Prometric Testing Center. To find out specifics on this facility click on the link below.

https://www.prometric.com/en-us/for-test-takers/prepare-for-test-day/Pages/overview.aspx

For March/April testing window, you will have 4 hours to complete 200 questions. There are also an additional 25 pilot questions on the test that will not be counted toward your score, but you will not know which those are.

For those sitting the exam in July/August and beyond, you will have 3 hours to complete 150 questions. There will be an additional 20 pilot questions on this exam.

You may take breaks during the exam, but the time clock will continue to run. You will be provided a count down clock.

There will be an online calculator which you may use for the math and calculations on the exam. It will be similar to the MS Windows calculator, so it may be helpful to practice prior to the exam.

You will be provided with an erasable board so that you can make notes as needed (no scratch paper is allowed).

There is a comment section for each question where you may make a suggestion or comment. These comments are later reviewed by ProExam and AAVSB. Keep in mind that it may be best to make comments at the end and not use your valuable test time.

There is no penalty for guessing, so make your best guess even if you do not know the answer.

For more detailed information regarding the exam and topics, visit the AAVSB website; under Candidate Handbook click on the applicable exam date.

http://www.aavsb.org/VTNE/

Good luck on your exam!

Is the glass half full or half empty? Are you bored of vaccination appointments, itchy dogs, and anal glands? Take an active role in your practice to keep it interesting! The great thing about this profession is that every day is different!

1) When those adorable little puppies and kittens sign up on a puppy or kitten package or come in for their first visit, take their picture and create a place on the wall for those photos. Other clients also like to look at the cute little ones and it shows that you care for your patients. Then, when they come in for their spay or neuter, send that first picture home with the owner. This is a great way to help foster a client and hospital relationship!

2) Check your local community for learning opportunities. I know of a veterinary dentist in our town who does a free dental radiography workshop a few times a year so vet techs can practice their techniques and learn new methods of dental x-ray. Further educating yourself can keep things interesting.

3) Almost any place will accept a qualified volunteer. Are you really interested in zoo medicine? Find out if you can shadow or volunteer for a day or two at the local zoo. You never know where opportunities are lurking.

4) Giving to others can really boost one’s self-esteem and outlook on the profession. Find a way to give back to the community. Volunteer at the local shelter one day a month. It looks great on a resume, and those pets who are without a home can greatly benefit from your training.

5) Check for online training courses. There are many companies that offer free continuing education classes or credits. You may need these credits for your license in some states. If not, it is still a fantastic way to keep up to date on your knowledge. Idexx has complimentary webinars on a variety of topics year-round. For other CE ideas, please visit: http://www.navta.net/membership/continuing-education

6) Talk to the veterinarian about the cases. They may not know you are interested in knowing or understanding the medicine behind some of the cases you are seeing in practice. Don’t be afraid to ask questions! You can learn as much or as little as you want, but you must take the initiative to show your interest.

7) Consider going to a convention once a year. Many jobs will cover some of the expenses. Check with your employer to see if they would be willing to send you to a conference such as this. It is something to look forward to, and is a great way to boost your knowledge and  meet other vet techs!

Remember, even though you may get bored, these things can help keep your job interesting. Your patients need you and greatly appreciate the wonderful care you give them. Your veterinarians would not be able to do their jobs without you, and for that the whole veterinary community is grateful for you.

What are these lesions?

If you perform or assist with dentals in your practice, you have seen or heard about Feline Odontoclastic Resorptive Lesions (FORLs), also called line lesions, neck lesions, or cervical line erosions.

These lesions can occur in dogs but mostly occur in cats. In fact, up to a third of all cats may be affected by these lesions. The cause is largely unknown. Teeth that have one of these lesions require extraction.

FORL’s are extremely painful. Many cats don’t show outwardly signs of pain, but the teeth are in fact painful. If these teeth are touched or probed, it often results in chattering of the jaw. This is why good oral examination and routine dental cleanings are needed to detect these lesions. Some cats with more advanced disease may present with decreased appetite or especially refusing hard food, drooling, and foul breath.

What do these lesions look like?

The tooth looks like it has a hole or divot or may look like the enamel is cracked at the gumline. The lesion starts in the cementum, invades into the dentin and the the enamel chips off leaving a defect in the tooth. Sometimes they are below the gumline and can only be found with probing. Sometimes the tooth has a pink fleshy gingival piece growing up or attaching to the tooth as in the image below. In some cases, there may be a bulge over the tooth at the gumline, or there may be bony proliferation (this is more common over the maxillary or upper canine teeth).

How are these diagnosed?

A true diagnosis of tooth resorption is achieved with use of radiographs. Sometimes the tooth may be resorbing and the exam is outwardly normal. This is why dental radiographs are important and are now considered standard of care. It is always best to extract all roots of these teeth. Crown amputation (where the crown is removed and the roots are left behind) is not recommended, since leaving these roots behind can lead to continued pain or become infected. Only in cases where there is radiographic evidence that the root is resorbed and ankylosed to the bone should this be performed.

Post-operative Care:

These cats should receive pain medication post-operatively. Buprenorphine has become a commonly used analgesic for cats and can be given orally. Also, antibiotics are recommended for about a week following the procedure. Clindamycin is a good choice, or alternatively, Convenia (a long-acting injectable antibiotic) may be used in cats that are hard to medicate.

Follow-up considerations

The patient should be re-checked 2 weeks after the procedure to make sure that the mouth has been healing properly. Client education about at-home dental care is important. Brushing, dental treats or diets, water additives, or oral rinses may be discussed as part of a longer term plan.

Symptoms: Owners may report some of the following symptoms. These symptoms are not always present, or if a cat has been hiding and is ill from this problem, the owner may not recognize the signs. If an owner calls and describes any of the following symptoms, you should recommend the cat be seen by a veterinarian immediately.

• Vocalizing in the litterbox or frequent trips to the litterbox
• Straining to urinate (often mistaken as constipation)
• Blood in the urine
• Posturing to urinate and no urine is coming out
• Licking at the genital area excessively
• Extreme weakness or lethargy, agitation

Causes: The cause of Feline Lower Urinary Tract Disease is largely unknown. It is thought to be triggered by stress, and in many cats diet may play a role. Underlying infection is rare. Sometimes struvite crystals may be seen. These crystals, along with mucus or other debris may form a urethral plug and can obstruct the urethra.

The Emergency: If a cat can’t urinate, it can’t excrete potassium. Potassium builds up in the peripheral blood and can lead to a life threatening hyperkalemia and can ultimately cause the heart to stop. The bladder may feel like a hard lemon on palpation of the abdomen.

Treatment: The obstruction must be immediately relieved by placing a sterile urinary catheter. Sometimes a cystocentesis is performed for immediate relief or if there is initial difficulty placing the urinary catheter. The bladder is drained completely and a urinary bag is attached after the urinary catheter is secured. These patients are treated with IV fluid diuresis (fluid of choice is 0.9% NaCl). Pain medication (buprenorphine) is needed to control the discomfort in these cats.

Labwork: Other than hyperkalemia (increased potassium), often the BUN and creatinine (the kidney values) are elevated. This is a “post-renal” azotemia. After the hydration status is corrected and the obstruction is relieved, these values often normalize. Follow up labwork is necessary to make sure the renal values return to a normal level. Sometimes medications (such as phenoxybenzamine) are sent home initially to help ease urination and to relieve urethral spasm after the urinary catheter is pulled.

Other considerations: Radiographs may be helpful to make sure that there is not a stone in the bladder or urethra. Also, even though a concurrent urinary tract infection is rare, it is best to culture the urine to rule it out.

Most cats have the urinary catheter in place for 48 hours or more. The catheter is then pulled and the cat is monitored closely to make sure it can urinate on its own before going home. A urinary diet is often recommended to help prevent the formation of struvite crystals and to help maintain a balanced urine pH.

Recurrence: Cats usually do well with the dietary change and trying to minimize stress in the home. Recommend 1 litterbox per cat plus 1 extra. Feliway spray or plug-ins can be helpful to reduce stress. A perineal urethrostomy surgery should be considered for cats that have recurrent episodes of obstruction.

1) Ask your employer about a duress button. This is an alarm panic button that can be pressed to immediately alert the police that the hospital needs immediate help. It can be helpful to have a few around the hospital- at the reception desk, near the drug box, or in an office. They are placed in areas that are hidden so only the employees know where they are located. Pushing a button silently contacts the police so the intruder doesn’t know they have been contacted.

2) Know all of the building exits and windows. Believe it or not, many people work in large buildings and do not know all of the exits. You should know these for escape routes, but also in case of a fire.  Ask your manager what the evacuation plan is for the pet patients during a fire and how you can help get them out efficiently.

3) Don’t panic. If someone has a weapon or gun and asks for money, give them all of the money. Just give them what they want and try to plan an escape depending on what their demands are.  In veterinary hospitals, intruders are often looking for drugs.

4) If someone walks into the hospital with a gun, it can be helpful to turn on the  speakerphone at the desk so the rest of the hospital can hear what is going on and they can prepare.

5) Think of a few places you could hide. If you knew someone had entered the building with a gun and you could not get out or didn’t know where they were, where could you hide that you would not be found?

6) If you work near a window or at the front desk and you see a suspicious person outside or see someone with a weapon, immediately lock the doors and call the police. It is best to be safe and pro-active.

7) If there is a client that is upset and the situation seems to be escalating and you are concerned about your own well-being and safety, call the police immediately. If anything, they can help diffuse the situation and escort the client out of the building.

Because these types of situations are unexpected and each is unique, it is hard to plan ahead. Hopefully nothing like this will happen. Should it occur, sometimes thinking of these few things can prepare you.

We wish all of you a safe and Happy Holiday season!

The VTNE domains starting July 15th will be:

Pharmacy and Pharmacology 12%

Surgical Nursing 11%

Dentistry 7%

Laboratory procedures 12%

Animal Care and Nursing 22%

Diagnostic Imaging 7%

Anesthesia 16%

Emergency Medicine/Critical Care 6%

Pain Management/Analgesia 7%

For more detailed information on these changes, please visit the AAVSB website at: https://www.aavsb.org/vtne/newspecs/qanda

(See blog on Taking a Patient History here: http://www.vettechprep.com/blog/?p=108 )

There are also other questions you should specifically ask for pets that are over 7 years of age. As pets age, they may start to show symptoms of arthritis or dental disease. Many times these symptoms are overlooked by pet owners, or they assume that signs of aging are just a normal part of life. While these signs are part of aging, there are some things that can be done to keep the pet comfortable and potentially slow down this process.

Additional questions to ask about the aging dog:

1) What type of diet are you feeding? Many times owner will make comments such as, “I used to feed him dry food but now he will only eat wet food.” These types of comments may suggest that the dog is having oral pain or periodontal disease.

2) Is he having problems getting up and around? Is he more stiff when he gets up in the morning? Have you noticed any limping? Are you giving your dog any joint supplements or medications currently?

3) Is your pet having any vomiting? If so, is this a new problem or is it happening regularly?

4) How is your pet’s vision? Can he see ok? Any problems in the dark or bumping into things?

5) How is his/her hearing?

6) Have you noticed any new lumps or bumps on your pet recently? Are there any that have changed? If there are, make a note of where they are located for the exam.

Make a note in the chart about any concerns the owner has and let the doctor know before they go into the exam room. This will help communication and focus on the pet’s current needs. As a veterinary technician, you make all the difference!