May 2006 Issue

Featured case study: Six-year-old domestic short-haired male cat, Peanut, born FeLV-positive, April 2000 by Tonimarie Molina, RVT, Feline Medical Center, Pleasanton, California

Introduction
FIV and FeLV infections in cats are relatively common and often associated with a variety of clinical diseases and syndromes. Screening for retroviral infections is important because early detection of these diseases allows the veterinarian to positively influence the quality of life in affected patients. Advances in veterinary medicine, coupled with observant and willing pet owners, make it possible for many cats infected with retrovirus infections to enjoy long and healthy lives.

Tonimarie, Peanut’s owner, is a veterinary technician at the Feline Medical Center in Pleasanton, California, and is an advocate for FeLV-positive cats. Tonimarie’s personal mission is to facilitate awareness of FeLV and FIV among pet owners. For over 14 years, she has helped owners of affected cats understand feline retroviral infections, and has provided effective and timely management strategies to allow these cats to maintain optimal health.

History
Peanut is a six-year-old domestic short-haired male cat that was born FeLV-positive. Peanut was diagnosed at three months of age with an IDEXX SNAP® FIV/FeLV Combo Test and confirmed with an IFA test at IDEXX Reference Laboratories. After a diagnosis of FeLV infection was established, Tonimarie and her veterinarian established an appropriate management plan that consisted of neutering Peanut, routine dental prophylaxis, and semi-annual follow-up exams that included blood and serum chemistry profiles. Additionally, Peanut was vaccinated according to a nonretrovirus vaccination protocol recommended by the attending veterinarian.

Over the past six years, Peanut has had few health issues. At age three, he suffered from intermittent diarrhea. Fecal tests were performed to rule out intestinal parasites. Peanut responded favorably to a high-quality, hypoallergenic diet and he returned to a normal weight.

Recent presenting complaints
Recently, Peanut began coughing and gagging, exhibiting what is typically considered to be “pre-hairball” behavior. He was given Laxatone®, but failed to produce a hairball. The following day, Peanut’s condition worsened, progressing to gagging when attempting to eat dry food. Additionally, he exhibited increased respiratory difficulty.

The physical exam revealed nasal congestion, mild conjunctivitis and an enlarged left submandibular lymph node. Upon auscultation, lung sounds were normal, but the heart rate was slightly elevated at 200 bpm. CBC and blood chemistry values were normal. Thoracic and abdominal radiographs were obtained, as well as a sonogram of Peanut’s thorax and abdominal cavity. Lymph node and splenic cytology suggested a diagnosis of lymphoma.

Clinical case outcome
Treatment consisted of 62.5 mg of Clavamox® administered twice daily for two weeks, and supplemental vitamins. Peanut’s food bowl was elevated to neck level and moist food was added to his diet to facilitate swallowing. To confirm the diagnosis, a radiograph and a sonogram of Peanut’s thorax and abdominal cavity will be repeated in one month and collection of additional samples for cytology or histopathology will be performed if abnormalities are identified. To date, Peanut is doing well. He is eating normally and is active and alert. For the past six years, Tonimarie’s knowledge of Peanut’s retrovirus status has allowed her to offer attentive and highly effective health care. Regardless of Peanut’s final diagnosis, Tonimarie and her veterinarian are committed to providing this FeLV-positive cat with the most progressive care possible.

The recommendations contained in Diagnostic Edge educational materials are intended to provide general guidance only. As with any diagnosis or treatment, you should use clinical discretion with each patient based on a complete evaluation of the patient, including history, physical presentation and complete laboratory data. With respect to any drug therapy or monitoring program, you should refer to product inserts for a complete description of dosages, indications, interactions and cautions.

We want to hear from you. Let us know what you think about this case and tell us about any other case topics that you would like to see. E-mail us at diagnosticedge@idexx.com.

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Smaller, more convenient packaging of the IDEXX VetTrol™ Control for the IDEXX VetTest® and VetLyte® analyzers

In November 2005, we brought you the new, conveniently prepackaged Quality Control Panel for your VetTest® Chemistry Analyzer. The Quality Control Panel includes four prepackaged panels of six slides each, giving you a four-month supply of quality-control slides.

Now, to make things even easier, we’ve repackaged the IDEXX VetTrol™ Control in a convenient four-pack, making it easier to store and reducing your risk of having expired product in your freezer. Each box contains four control vials and four diluent vials, giving you a four-month supply of VetTrol Control.

The VetTrol Control is used to independently verify the accuracy of your IDEXX VetTest® and VetLyte® analyzers. For instructions on how to prepare the VetTrol Control, refer to the package insert or visit www.idexx.com/qcpanel.

As a reminder, when performing quality control on your VetTest and VetLyte analyzers, record your results on the Quality Control Log Sheet, which is included the software package. (44 KB)

For more information or to place an order, contact your local IDEXX representative, contact IDEXX Customer Support at 1-800-248-2483 or e-mail diagnosticedge@idexx.com.

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Run plasma samples three times faster
and more easily than serum on your IDEXX VetTest® Chemistry Analyzer

With the VetTest® analyzer, you can get fast, accurate results for a quicker assessment of your patient’s health and more immediate treatment decisions. In addition, using the Becton Dickinson lithium-heparin gel tube (BD™ Microtainer® tube) reduces the risk of errors or failed tests, so you can be even more confident in your results.

Running plasma on your VetTest analyzer is not only fast, it’s easy! And more accurate for certain chemistries.

Choosing a BD™ gel tube and plasma completely eliminates the need for clotting a sample, a process that takes a full 20 minutes. When plasma is introduced to the anticoagulant as quickly as possible, fibrin will not have an opportunity to begin forming. By using a BD gel tube, which contains a gel barrier, you can ensure that the plasma is quickly separated from fibrin or impurities, and that it remains separated.

With the two-minute StatSpin® spin time and six minutes to results from the VetTest analyzer, you have results in as little as eight minutes. Why wait any longer than you have to?

The BD Microtainer tube may not be available in all contries.

BD and Microtainer are trademarks of Becton, Dickinson and Company. StatSpin is a trademark of StatSpin, Inc. (d/b/a Iris Sample Processing).

For more information about the StatSpin high-speed centrifuge, BD gel tubes (IDEXX part number 98-13197-01) or the VetTest analyzer, contact IDEXX Customer Support at 1-800-248-2483 (U.S. and Canada) or e-mail diagnosticedge@idexx.com.

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Kitten season is here!
This is the second in our three-part series on quick tips for kitten season.*

Kitten quick tip 2—Explaining the importance of FIV/FeLV testing to your clients

Your clients are concerned about the health of their cats. In fact, 80% of cat owners said they would pay for a test if their veterinarians recommended it.¹ By offering each of your clients the opportunity to screen their cats for FIV/FeLV, you're giving them something they want—a comprehensive picture of their pets’ conditions.

You can educate your clients about the risk of FIV/FeLV and offer screening results during a single visit. Some ways you can improve client compliance:

• Send annual reminders for FIV/FeLV vaccinations.

• Offer an FIV/FeLV observation form and client brochure to every cat owner who enters the clinic.

• Make sure your clinic environment supports education about testing with client brochures and posters.

• Initiate a discussion with your clients about their pets' environments, personalities and habits to determine if their cats are at-risk.

Here are some FREE tools from IDEXX to help you deliver the FIV/FeLV testing message to your clients.

FIV/FeLV Observation/Consent Form (537 KB)
This form is the key to testing compliance. A complete screen for the cat owner to help identify retrovirus testing needs, it should be handed to every cat owner who walks through the door.

FIV/FeLV Client Brochure (3.9 MB)
This brochure provides a source of education on FIV and FeLV for cat owners, empowering them to make informed decisions about understanding the retrovirus status of their cats.

FIV/FeLV Management—Client Brochure (287 KB)
This educational client piece emphasizes practice/pet-owner partnership in managing retrovirus-positive cats. It should be used by veterinarians to discuss the appropriate management plan for a cat.

To order any of these FREE tools, call IDEXX Customer Support at
1-800-248-2483.

*See kitten tip 1 in our April 2006 issue and watch for tip 3 in our June 2006 issue.

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Building a strong foundation with kitten visits
by Wendy S. Myers, Communication Solutions for Veterinarians, Denver, Colorado

Do you attempt to cover every imaginable topic with a new kitten owner during the first veterinary visit? Chances are, your appointment will extend well beyond 20–30 minutes and leave the owner’s head spinning with information overload. Instead, improve client education and compliance with a checklist of items to discuss during each of the three kitten visits. Have doctors and technicians work together to create discussion topics for 6–8-, 10–12- and 14–16-week exams. Staff members should handle the majority of client education to maximize productivity and exam time.

To help guide clinics, I created puppy, kitten, adult and senior pet exam report cards with a checklist of client-education topics in my book, The Veterinary Practice Management Resource Book and CD. Discussion topics can be a mix of handouts, as well as conversations. Organize handouts and brochures in a pocketed folder with your hospital logo, name and telephone number. Label each folder “Kitten’s First Visit:8 Weeks,” “Kitten’s Second Visit:12 Weeks” and “Kitten’s Third Visit:16 Weeks.”

Organizing materials in advance helps you make the most of exam time, provide written materials for clients to reference at home, and position your veterinary hospital as the trusted resource for healthcare information. Review topics such as diagnostics, behavior and nutrition in each kitten visit because these are building blocks for a healthy lifestyle. Here are sample discussion topics for kitten wellness exams you can adapt for your hospital:

With a well-organized approach to kitten wellness exams, you’ll have better educated clients, keep appointments on time, and improve compliance for vaccinations, diagnostics and products.

Wendy S. Myers owns Communication Solutions for Veterinarians in Denver, Colorado, and provides consulting services on client service, marketing and hospital management. She is the author of two books and four videos. You can reach her at 1-720-344-2347 or visit www.mycommunicationsolutions.com.

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Education and Events

We offer a variety of training events about emerging trends and best practices in veterinary diagnostics in a forum designed to involve, educate and motivate you and your staff. Here are some of the upcoming educational events.
See a full listing.

Seminars

• The Most Commonly Misdiagnosed Diseases in Veterinary Medicine
  Fred Metzger, DVM, DABVP

• Update on Feline Retroviruses
  Susan Little, DVM, DABVP

• Diagnosing Canine Pancreatitis
  Jörg M. Steiner, med.vet., Dr.med.vet., PhD, DACVIM, DECVIM-CA

Visit the education and events calendar, click the date to view the details, fill out and submit the form to register.

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NOW with FREE CE Credit!

Can you identify the structure indicated with an arrow in this unstained urine sediment from a dog? Images represent a high-dry field of view and a magnified view of the structure.

Step up to take the Interactive Challenge—and now you can step up your CE credits, too! Earn a half-hour of FREE CE credit for each month's challenge.*

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We have made it easy for you to take the challenge! Simply complete each field in the form and submit for CE credit. You will receive an e-mail confirming your participation in the May 2006 Interactive Challenge, worth one half-hour of CE credit.*

All fields are required for CE credit records.

Thanks for taking the May Diagnostic Edge Interactive Challenge!

*Each interactive challenge meets the requirements for 0.5 hours of continuing education credit in jurisdictions that recognize AAVSB’s RACE approval; however, participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education.

AAVSB Provider Number 106

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