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McCurnin's Clinical Textbook for Veterinary Technicians - E-Book

McCurnin's Clinical Textbook for Veterinary Technicians - E-Book

Joanna M. Bassert

(2017)

Additional Information

Book Details

Abstract

Immerse yourself in every aspect of the veterinary technology field with McCurnin’s Clinical Textbook for Veterinary Technicians, 9th Edition, covering small and large animals, birds, reptiles, and small mammals. With a new zoonoses theme threaded throughout each chapter, this comprehensive text describes how each disease affects the host, how it is spread, and how it is treated. Case presentations provide you with relevant, real-life scenarios so you can practice your critical thinking and decision-making skills.

  • Introduction to the concept of the Technician Practice Model ensures that excellent nursing care is provided to each patient.
  • Content on fluid therapy and transfusion medicine keeps you current and prepared for success in practice.
  • Thorough coverage of electrocardiography included in the Emergency Nursing chapter to teach you how to interpret, and how to examine and differentiate, normal from abnormal and dangerous from non-dangerous.
  • Case presentations provide you with real-life scenarios so you can practice your critical thinking and decision-making skills.
  • Large animal care is integrated throughout the book with medical records, dentistry, physical examination, surgical instrumentation, surgical assistance, emergency care, and euthanasia, in addition to the individual Large Animal Medical Nsing chapter, to prepare you to care for large animals.
  • A chapter dedicated to birds, reptiles, and small mammals keeps you up-to-date with care and treatment for these increasingly popular pets.
  • Comprehensive chapters on pharmacology, pain management, restraint, and veterinary oncology offer a broader understanding of the responsibilities of a technician.
  • Vet Tech Threads design emphasizes important study points and ensures you understand the content introduced to you.
  • Step-by-step instructions and photographs show you how to perform dozens of procedures, and make information readily accessible in emergency and clinical situations.
  • Evolve site with TEACH instructor resources, an image collection, and a test bank accompanies the text, and provides instructors with everything they need to successfully teach each chapter and evaluate students' progress.
  • NEW! Chapter on Veterinary Oncology contains fundamental information on veterinary cancers and current therapies.
  • NEW! Toxicology chapter provides an overview of toxic substances and treatments while helping you understand how to recognize, assess, and manage poison concerns.
  • NEW! The theme of zoonotics is threaded throughout each chapter and emphasized appropriately to increase your understanding of how each disease affects the host, how it is spread, how it is treated, and the necessary safety precautions.
  • NEW! A 2017 winner of the William Holmes McGuffey Longevity Award ("McGuffey") from the Text and Academic Authors Association (TAA). The "McGuffey" recognizes textbooks and learning materials whose excellence has been demonstrated over time.

Table of Contents

Section Title Page Action Price
Front Cover cover
Endsheets 2-3 timeline IFC2
Evolve page IFC4
McCurnin's Clinical Textbook for Veterinary Technicians i
Copyright Page iv
Dedication v
Contributors vi
Reviewers xi
Preface xii
Key Features xii
New Features xii
Organization xii
The Learning Package xiii
Student Workbook xiii
TEACH Instructor Resources xiii
Evolve Website xiii
Support xiii
Acknowledgments xiv
Table Of Contents xv
How to Use This Learning Package xvii
Textbook Features xvii
Student Workbook xvii
Evolve Website xviii
Additional Resources xviii
Coville & Bassert xviii
Clinical Anatomy and Physiology for Veterinary Technicians, 3e xviii
Brown & Brown xviii
Lavin’s Radiography for Veterinary Technicians, 6e xviii
Colville & Oien xviii
Clinical Veterinary Language xviii
Holmstrom xix
Veterinary Dentistry: A Team Approach, 2e xix
Prendergast xix
Front Office Management for the Veterinary Team, 2e xix
Studdert, Gay, & Blood xix
Saunders Comprehensive Veterinary Dictionary, 4e xix
Taylor xix
Small Animal Clinical Techniques, 2e xix
Wanamaker & Massey xx
Applied Pharmacology for Veterinary Technicians, 5e xx
1 Veterinary Technology: An Overview 1
1 Introduction to Veterinary Technology 1
Outline 1
Learning Objectives 1
Key Terms 2
Introduction 2
History of Veterinary Technology 3
The Veterinary Technician Today 4
Employment Prospects, Salaries, and Attrition 4
Education 5
Programs of Veterinary Technology 5
Two- and Four-Year Programs 5
Standard Criteria 5
Distance Education 6
Continuing Education 6
The Veterinary Technician National Examination 6
The Profession of Veterinary Technology 7
The Veterinary Technician Practice Model 7
Step 1: Gather Data 7
Step 2: Identify and Prioritize Patient Evaluations 8
Step 3: Develop Plan of Care and Implement Interventions 8
Step 4: Evaluate Patient Response 8
Step 5: Add Data 8
Scope of Practice 8
Responsibilities of the Veterinary Technician in Practice 10
Reception Area 10
Examination Rooms and Outpatients 10
Laboratory and Pharmacy 10
Radiology and Special Imaging 10
Treatment Room 11
Operating Room 12
Wards 13
Hospital Management and Communications 13
Terminology and the Veterinary Health Care Team 13
Veterinarian 13
Veterinary Technician Specialist 14
Veterinary Technologist 15
Veterinary Technician 16
Veterinary Assistant 16
Laboratory Animal Technicians and Technologists 16
Professionalism 17
Professional Appearance 18
Uniform 18
Hands and Nails 19
Jewelry, Face, and Hair 19
Professional Conduct 19
In the Workplace 19
Outside the Workplace 19
Professional Communication 20
Verbal Communication 20
Written Communication 20
Medical Records. 20
E-mail. 20
Text Messaging 20
Professional Organizations and Acronyms 21
National Association of Veterinary Technicians in America 21
Registered Veterinary Technologists and Technicians of Canada/Technologues et techniciens vétérinaires enregistrés du Canada(RVTTC/TTVAC) 21
Professional Ethics 21
Profession-Related Laws and Regulations 24
Laws (Statutes) 24
Rules and Regulations 26
Entry Into Practice 26
Licenses, Certificates, and Registrations 26
Demonstrating Good Moral Character 28
Background Checks 28
Refusal of Licensure 28
License Renewal and Continuing Education 28
Grounds for Disciplinary Action 29
Technical Violations 29
Substantive Violations 29
Fraud and Deceit. 29
Crimes of Moral Turpitude. 29
Misrepresentation. 29
Animal Abuse. 30
Committing or Aiding Illegal Professional Acts. 30
Working Impaired. 30
Practicing Beyond the Scope of Practice. 30
Unprofessional Conduct. 31
Malpractice (Negligence). 31
Incompetence. 31
Responsibility for Actions 32
Process of Disciplinary Action 32
Notice 32
Right to a Hearing 32
Hearings Procedures. 32
Disciplinary Sanctions 33
Revocation of a License. 33
Suspension of a License. 33
Probation of Licensee. 33
Reprimand. 33
Civil Penalty. 33
Additional Laws Governing Veterinary Practice 33
Labor Laws 33
Hostile Work Environment 34
Safety in the Workplace 34
Medical Waste Management Laws 34
Controlled Substances 34
Animal-Related Laws 34
Anticruelty Laws 34
Animals Used in Research and Education 35
Horse Protection Act 35
Endangered Species Act 35
Laws Specific to Canada 35
Criminal Code of Canada 35
Canada Wildlife Act 35
Canadian Food Inspection Agency 36
Provincial Legislation on Animal Welfare 36
Nongovernmental Animal Welfare Organizations 36
Humane Transportation of Animals 36
Canadian Meat Inspection Act 36
Recommended Readings 36
2 Veterinary Practice Management 37
Outline 37
Learning Objectives 37
Key Terms 37
Introduction 38
Types of Veterinary Practices 38
Typical Employee Positions 39
Management Personnel 40
Veterinarians 41
Veterinary Technicians and Technologists 42
Veterinary Assistants 42
Receptionists 43
Kennel, Ward, and Barn Attendants 43
Practice Facilities and Workflow 44
Small Animal General Practices 44
Facility Exterior 44
Outpatient Areas 45
Inpatient Areas 47
Surgical Area 50
Support Area 50
Small Animal House Call Practices 51
Specialty and Emergency Practices 51
Large Animal Mobile Units 51
Large Animal Haul-in Facilities 52
Clients and Client Services 53
Importance of Client Communication 54
Communication Myths 54
Six Aspects of Excellent Communication 54
Clarity. 54
Courtesy. 54
Positive Nonverbal Communication. 55
Open-Ended Inquiry. 55
Reflective Listening. 55
Empathy. 55
Dealing With Difficult Clients 55
Management of the Veterinary Practice 56
Planning 56
Human Resources 57
Hiring 57
Compensation 58
Training and Orientation 58
Employee Management and Retention 59
Addressing Employee Stress 59
Stressors. 60
Reducing Stress in the Workplace. 60
Employee Substance Abuse and Stress: Important and Not to Be Ignored. 60
Marketing 61
Internal Marketing 61
Client Relationships. 62
Practice Appearance. 62
Full-Service Care. 62
Client Reminders. 62
Personal Appearance. 62
Handout Materials. 62
Sympathy and Thank-You Communications. 63
Newsletters. 63
Targeted Mail. 64
Point-of-Sale Displays. 64
Animal Care Talks. 64
External Marketing 64
Advertising. 64
Newspapers. 65
Radio and Television. 65
Community Activities. 65
Web-Based Marketing. 65
Pet Portals. 65
Financial 66
Bookkeeping and Accounting 66
Balance Sheet 66
Income Statement 66
Statement of Cash Flows 66
Management Analysis 67
Profitability Calculation. 67
Key Performance Indicators. 67
Budgeting. 68
Price Setting. 68
Operations 68
Front Desk Management 69
Appointment Scheduling. 69
Estimates and Client Payments. 69
Inventory Management 70
Computerization of the Veterinary Practice 72
Electronic Medical Records 73
Patient Scheduling 73
Reminders 73
Billing 74
Inventory 74
Client Communication 74
Accounts Receivable 74
Doctor Production 75
Summary 75
References 75
Recommended Readings 75
Journals 75
Management Short Courses 75
Internet Sites 75
3 Veterinary Medical Records 76
Outline 76
Learning Objectives 76
Key Terms 76
Introduction 77
Functions of the Medical Record 77
Primary Purposes 77
Supports Excellent Medical Care 77
Documents Communications 77
Secondary Purposes 78
Supports Business and Legal Activities 78
Supports Research 78
Medical and Legal Requirements 78
Veterinarian–Client–Patient Relationship 78
Importance of Informed Consent 78
Consent and Authorization Forms 79
Documentation: Protection Against Complaints and Litigation 79
Ownership and Release of Medical Information 81
Format of Veterinary Medical Records 81
Source-Oriented Veterinary Medical Record 81
Problem-Oriented Veterinary Medical Record 82
Components of the Problem-Oriented Veterinary Medical Record 82
The Database 82
Client and Patient Information 82
History 83
Physical Examination 84
Laboratory, Diagnostic Imaging, and Other Pertinent Forms 87
Laboratory Diagnostic Summary and Flow Sheet. 87
Consultants. 87
Master Problem List and Working Problem List 88
Hospitalized Patient Records 90
Overview 90
Technician SOAP Notes 90
Subjective/Objective. 90
Assessment. 92
Plan. 92
Notations 93
Medication Administration/Order Record 93
Cage Cards and Patient Identification 94
Discharge and Summary Forms 98
Management of Paper Medical Records 98
Organization and Filing 98
Alphabetic Filing 99
Numeric Filing 99
File Purging 100
Lost Records 100
Management of Electronic Medical Records 100
Overview 100
Validating the Electronic Record 101
Risk of Loss 101
Advantages of Electronic Medical Records 101
Logs 103
Management of Ambulatory Practice Records 103
Recommended Readings 104
Related Associations 104
4 Occupational Health and Safety in Veterinary Hospitals 105
Outline 105
Learning Objectives 105
Key Terms 106
Introduction 106
Safety 106
Objectives of a Safety Program 106
Your Safety Rights 106
Your Safety Responsibilities 107
The Leadership’s Rights 107
The Leadership’s Responsibilities 107
General Workplace Hazards 107
Dressing Appropriately for the Job 108
Save Your Back! 108
Clean Up After Yourself 108
Everything in Its Place 109
Beware of Break Times 109
Machinery and Equipment 109
Electrical 109
Fire and Evacuation 110
Do Not Become a Victim of Violence 111
Hazardous Chemicals: Right to Know 111
Special Chemicals 114
Ethylene Oxide 114
Formalin 114
Glutaraldehyde 114
Medical and Animal-Related Hazards 114
Noise 115
Bathing, Dipping, and Spraying Areas 115
Zoonotic Diseases 115
Viral Infections 115
Bacterial Infections 116
Lyme Disease. 116
Fungal Infections 116
Internal Parasites 116
Larval Migrans. 116
Protozoal Infections. 116
External Parasites. 117
Nonzoonotic Diseases 117
A Dirty Mouth? Precautions for Dentistry Operations 117
Radiology 117
Anesthesia 118
Compressed Gases 119
Sharps and Medical Waste 120
Hazardous Drugs and Pharmacy Operations 121
Internet Resources/Recommended Reading 122
2 Patient Management and Nutrition 123
5 Animal Behavior 123
Outline 123
Learning Objectives 123
Key Terms 124
Introduction—Why Behavior? 124
The Technician’s Role in Behavior Counseling 125
Technician Specialists in Behavior 125
Taking a Behavior-Specific History 125
Learning and Animal Behavior Modification 126
Associative Learning 126
Classical and Operant Conditioning 127
Extinction 128
Addressing Respondent Fear 128
Systematic Desensitization 128
Counter Conditioning 129
Flooding 129
Preventing Behavior Problems 129
Step 1: Elicit and Reinforce Appropriate Behavior 130
Step 2: Prevent or Minimize Inappropriate Behavior 130
Crate Training 130
Step 3: Meet the Pet’s Behavioral and Developmental Needs 131
Step 4: Use the “Take Away” Method (Negative Punishment) to Discourage Inappropriate Behavior 132
Step 5: Minimize Discipline (Positive Punishment) and Use It Correctly When Necessary 132
Habituation to Handling 133
Choosing a Pet 133
Medications and Treating Behavior Problems 134
Canine 134
Development 134
Social Behavior 137
Reading Canine Body Language 139
Coping With Behavior in the Clinic 140
Introducing a New Dog 141
Common Behavior Problems 142
Unruly Behaviors 142
Fear, Phobias, and Anxiety 142
Destructive Behavior 143
Canine Aggression 144
House Soiling 145
Cognitive Dysfunction 146
Feline 147
Development 147
Social Behavior 147
Reading Feline Body Language 148
Coping With Feline Behavior in the Clinic 148
Introducing a New Cat 149
Common Behavior Problems 149
Unruly Behaviors 149
Destructive Behavior 149
Feline Aggression 150
Inter-Cat Aggression. 150
Aggression Toward People. 150
House Soiling 151
Cognitive Dysfunction 154
Equine 154
Communication and the Senses 154
Social Behavior 156
Prey Behavior 157
Sexual Behavior of the Mare 157
Sexual Behavior of the Stallion 158
Maternal Behavior 159
Foal Rejection 159
Common Behavior Problems 160
Repetitive Behaviors (Stable Vices) 160
Equine Aggression 160
Inter-Horse Aggression. 160
Aggression Toward Humans. 161
Cattle and Small Ruminants 161
Species-Typical Behaviors 161
Dominant/Aggressive Behaviors 162
Submissive Behaviors 162
Sexual Behavior 162
Maternal Behavior 163
Common Behavior Problems 163
Buller Steer Syndrome 163
Aggression Toward Humans 163
References 163
Recommended Readings 164
6 Restraint and Handling of Animals 165
Outline 165
Learning Objectives 165
Key Terms 166
Introduction 166
Indications for Restraint 166
The Approach 167
Observing the Pet Before Approaching 167
Approaching the Pet 168
Capture 169
Capturing a Dog 169
Capturing a Cat 170
Removing a Pet From a Hospital Cage 171
Canine Restraint 171
Options for Restraining a Well-Behaved Dog 171
Options for Restraining an Uncooperative Dog 172
Muzzle 172
Towel 173
Chemical Restraint 174
Feline Restraint 174
Options for Restraining a Well-Behaved Cat 174
Options for Restraining an Uncooperative Cat 174
Towel 174
Scruffing and Alternative Holds 174
Muzzle 174
Gloves, Cat Bag, and Other Devices 175
Chemical Restraint 176
Restraining Dogs and Cats for Specific Procedures 176
Restraint for Venipuncture 176
Restraint for Nail Trimming 177
Introduction to Equine Restraint 178
The Approach 179
Capture of the Equine 180
Adult Equine Restraint Techniques and Devices 181
Juvenile Equine and Foal Restraint Techniques 183
Equine Restraint: Special Circumstances for Specific Procedures 185
Capture and Restraint of Cattle 187
The Approach 187
Low-Stress Handling 187
Capture 188
Restraint Techniques and Devices 190
Additional Head Restraint 191
Tail Restraint 191
Foot Control and Restraint 191
Casting Cows 192
Capture and Restraint of Swine 193
Observation 193
Approach 193
Capture and Restraint Techniques 194
Pet Pigs 195
Capture and Restraint of Small Ruminants 195
Observation 195
Approach 195
Capture 196
Individual Restraint 196
Restraint Techniques for Camelids 197
Capture and Restraint of Avian and Exotic Species 197
Restraint of Avian Species 197
Psittacines 197
Observation and Approach. 198
Restraint Techniques. 198
Chemical Restraint. 200
Passerines 200
Birds of Prey 200
Restraint of Small Mammals 200
Rabbits 200
Restraint 200
Chemical Restraint. 201
Guinea Pigs and Chinchillas 201
Ferrets 201
Restraint 202
Chemical Restraint. 202
Hamsters, Mice, Hedgehogs, Sugar Gliders, and Gerbils 202
Handling and Restraint of Reptiles 203
Lizards 203
Snakes 204
Turtles and Tortoises 205
Recommended Readings 205
Canine and Feline Restraint and Handling 205
Equine Restraint and Handling 205
Equine-Related Websites 206
Cattle, Swine, Small Ruminants, and Camelids 206
Restraint and Handling of Exotic Species 206
7 History and Physical Examination 207
Outline 207
Learning Objectives 207
Key Terms 208
Introduction 208
History and Physical Examination of Small Animals 208
History 208
The Role of the Veterinary Technician 209
Developing Rapport With the Client 209
Asking the Questions 209
Documenting the Information 209
The Information 210
Signalment 210
Background Information 210
General Management. 210
Preventive Medicine. 210
Behavioral Information. 210
Household Information. 210
Allergy History. 210
Reproductive History. 210
Pertinent Past Medical History 210
Presenting Complaint 211
Last Normal 211
Progression 211
Systems Review 211
Medications 211
Physical Examination 211
Documenting the Information 213
Surroundings 213
Temperature, Pulse, and Respiration 213
Systems Review 214
Oropharyngeal System 215
Eyes 215
Ears 216
Respiratory System 218
Cardiovascular System 219
Gastrointestinal System 221
Rectal Examination 222
Urogenital 223
Integument 224
Lymph Nodes 224
Musculoskeletal System 225
Nervous System 226
History and Physical Examination of Large Animals 227
History 228
Owner/Agent Information 228
Signalment of the Animal 228
Individual History and Chief Complaint 228
Medication and Treatment History 229
Herd Health History 229
Physical Examination of Large Animals 230
Physical Examination of the Equine 230
Getting Started 230
Body Temperature 231
Pulse Rate and Heart Rate 232
Respiratory Rate 234
Heart Auscultation 234
Lung Auscultation 235
Abdominal Auscultation 235
Mucous Membranes 236
Hydration Status 237
Height and Weight Measurement 237
Physical Examination of Ruminants 238
Recommended Readings 240
8 Preventive Health Programs 241
Outline 241
Learning Objectives 241
Key Terms 241
Introduction 242
Preventive Health Programs for Dogs and Cats 242
Lifelong Wellness 242
Wellness in Puppies and Kittens 242
Wellness in Adult Dogs and in Adult and Mature Cats 243
Senior and Geriatric Animal Wellness 243
Grooming 244
Immunity 244
Active Immunity Versus Passive Immunity 244
Vaccine Types 245
Storage, Reconstitution, and Dosing 245
Routes of Administration 246
Core Versus Noncore Vaccines 247
Onset and Duration of Immunity 247
Feline Immunizations 252
Rabies Vaccine (Noncore Vaccine). 252
Feline Herpesvirus Type 1 and Feline Calicivirus Vaccines (Core Vaccines). 252
Feline Panleukopenia Virus Vaccine (Core Vaccine). 252
Feline Leukemia Virus Vaccine (Noncore Vaccine). 252
Feline Immunodeficiency Virus Vaccine (Noncore Vaccine). 253
Chlamydophila felis Vaccine (Noncore Vaccine). 253
Bordetella bronchiseptica Vaccine (Noncore Vaccine). 253
Feline Coronavirus Vaccine (Noncore Vaccine). 253
Giardia lamblia Vaccine (Noncore Vaccine). 253
Canine Immunizations 253
Rabies Vaccine (Core Vaccine). 253
Canine Distemper Virus Vaccine (Core Vaccine). 253
Canine Adenovirus Type 2 Vaccine (Core Vaccine). 254
Canine Parvovirus Vaccine (Core Vaccine). 254
Canine Parainfluenza Virus Vaccine (Noncore Vaccine). 254
Leptospirosis (Noncore Vaccine). 254
Bordetella bronchiseptica (Noncore Vaccine). 255
Borrelia burgdorferi Vaccine (Noncore Vaccine). 255
Canine Influenza Vaccine (Noncore Vaccine). 255
Canine Coronavirus Vaccine (Noncore Vaccine). 255
Adverse Vaccine Events 255
Parasite Prevention 256
Preventive Health Program for Horses 256
Physical Examination 257
Vaccinations 257
Tetanus Vaccines 265
Western, Eastern, and Venezuelan Encephalitis Vaccines 265
Equine Herpesvirus Vaccines 266
Equine Influenza Vaccines 266
Strangles Vaccines 266
Equine Viral Arteritis Vaccine 266
Potomac Horse Fever Vaccines 266
Botulism Vaccine 266
Anthrax Vaccine 266
Rabies Vaccines 267
West Nile Virus Vaccines 267
Parasites 267
Dental Care 267
Hoof Care 268
Nutrition 268
Preventive Health Programs for Livestock Species 268
Swine 268
Birth to Weaning 268
Growing Pigs 268
Breeding Animals 269
Cattle 269
Birth to Weaning 269
Growing Cattle 270
Breeding Animals 270
Small Ruminants: Sheep and Goats 271
Newborn and Growing Animals 271
The Breeding Herd 272
Summary 273
Recommended Readings 273
Dogs and Cats 273
Horses 273
Livestock 273
9 Companion Animal Nutrition 274
Outline 274
Learning Objectives 275
Key Terms 275
Introduction 275
Nutrients 275
Water 276
Protein 276
Fat 276
Carbohydrate 277
Fiber 277
Vitamins 277
Minerals 277
Supplements 278
Energy 278
Food Intake and Regulation 278
Energy Units 278
Energy Partitioning 278
Metabolizable Energy Measurement 278
Atwater Factors 279
Energy Density 279
Measurements of Energy Expenditure 279
Protein 280
Dietary Requirements 280
Protein Quality 281
Fat 281
Structure 281
3 Clinical Sciences 367
12 Hematology and Cytology 367
Outline 367
Learning Objectives 367
Key Terms 368
Introduction 368
Hematology 368
Complete Blood Count 368
Automated Hematology Analyzers 369
Packed Cell Volume 369
Red Blood Cell Count 370
Hemoglobin Concentration 371
Red Blood Cell Indices 371
Red Cell Distribution Width 371
Plasma Protein Concentration 371
White Blood Cell Count 372
Platelet Count 373
Preparation of Blood Smears 373
Blood Smear Evaluation 374
Platelets 376
Red Blood Cells 377
White Blood Cells 381
Neutrophils. 383
Eosinophils. 383
Basophils. 383
Lymphocytes. 384
Monocytes. 384
Other Cells. 384
Coagulation Testing 384
Cytology 386
Solid Tissue Masses and Enlarged Organs 386
Thoracic and Abdominal Effusions 387
Synovial (Joint) Fluid 387
Stains, Immunophenotyping by Flow Cytometry, and DNA-Based Testing 388
Submission of Samples to a Reference Laboratory 388
Otic Cytology 389
Recommended Readings 390
Hematology 390
Cytology 390
13 Clinical Chemistry, Serology, and Urinalysis 391
Outline 391
Learning Objectives 391
Key Terms 391
Introduction 391
Clinical Chemistry 392
Preanalytical Factors 393
Analytical Factors 394
Chemistry Analyzers 394
Quality Control 395
Serology 396
Types of Serologic Tests 397
Urinalysis 398
Equipment and Collection 398
Color and Turbidity 398
Specific Gravity 398
Chemical Evaluation 399
pH 399
Protein 399
Glucose 400
Ketones 400
Bilirubin 400
Blood or Heme 400
Microscopic Examination 400
Cellular Elements 401
Casts 402
Crystals 402
Microorganisms 404
Recommended Readings 404
Chemistry 404
Quality Control 404
Serology 404
Urinalysis 404
14 Parasitology 405
Outline 405
Learning Objectives 405
Key Terms 406
Introduction 406
The Veterinary Technician’s Role in Educating Clients Regarding Zoonotic Parasitic Diseases of Small Animals 407
Trematodes (Flukes) of Zoonotic Importance 407
Paragonimus kellicotti (Lung Fluke of Dogs and Cats) 407
Species Affected 409
Key Clinical Signs of Infected Animals 409
Abbreviated Life Cycle 409
Laboratory Test(s) Used to Diagnose the Infection 409
Zoonotic Potential for Clients 409
Treatment 409
Prevention and Control Techniques 409
Avian Schistosomes (Causative Agent of Schistosome Cercarial Dermatitis) 409
Species Affected 410
Location of Parasite Within Host 410
Key Clinical Signs of Infected Animals 410
Abbreviated Life Cycle 410
Laboratory Test(s) Used to Diagnose the Infection 411
Zoonotic Potential for Clients 411
Treatment 411
Prevention and Control Techniques 411
Cestodes (Tapeworms) and Metacestodes (Larval Tapeworms) of Zoonotic Importance 411
Dipylidium caninum (Cucumber Seed Tapeworm, Double-Pored Tapeworm) 411
Species Affected 411
Key Clinical Signs of Infected Animals 412
Abbreviated Life Cycle 412
Laboratory Test(s) Used to Diagnose the Infection 413
Zoonotic Potential for Clients 414
Treatment 414
Prevention and Control Techniques 414
Echinococcus granulosus/Echinococcus multilocularis 414
Species Affected 414
Key Clinical Signs of Infected Animals 414
Abbreviated Life Cycle 415
Laboratory Test(s) Used to Diagnose the Infection 415
Zoonotic Potential for Clients 415
Treatment 415
Prevention and Control Techniques 415
Spirometra mansonoides 416
Species Affected 416
Location of Parasite Within Hosts 416
Key Clinical Signs of Infected Animals 416
Abbreviated Life Cycle 416
Laboratory Test(s) Used to Diagnose the Infection 417
Zoonotic Potential for Clients 417
Treatment 417
Prevention and Control Techniques 417
Nematodes—Roundworms of Zoonotic Importance 417
Toxocara canis, Toxocara cati, and Toxascaris leonina (Ascarids and Roundworms)—Visceral Larva Migrans and Ocular Larva Migrans 417
Species Affected 417
Key Clinical Signs of Infected Animals 418
Abbreviated Life Cycle 418
Laboratory Test(s) Used to Diagnose the Infection 418
Zoonotic Potential for Clients 418
Treatment 419
Prevention and Control Techniques 419
Baylisascaris procyonis—Neurologic Larva Migrans 419
Species Affected 419
Location of Parasite Within Host 419
Key Clinical Signs of Infected Animals 419
Abbreviated Life Cycle 419
Laboratory Test(s) Used to Diagnose the Infection 420
Zoonotic Potential for Clients 420
Treatment 420
Prevention and Control Techniques 420
Ancylostoma caninum, Ancylostoma braziliense, and Ancylostoma tubaeforme; Uncinaria stenocephala (Hookworms)—Cutaneous Larva Migrans (Creeping Eruption, Plumber’s Itch, Sandworms) 420
Species Affected 420
Key Clinical Signs of Infected Animals 420
Abbreviated Life Cycle 421
Laboratory Test(s) Used to Diagnose the Infection 421
Zoonotic Potential for Clients 421
Treatment 422
Prevention and Control Techniques 422
Trichuris vulpis (Whipworms)—Trichuriasis 422
Species Affected 422
Location of Parasite Within Host 422
Key Clinical Signs of Affected Animals 422
Abbreviated Life Cycle 423
Laboratory Test(s) Used to Diagnose the Infection 423
Zoonotic Potential for Clients 423
Treatment 423
Prevention and Control Techniques 423
Strongyloides stercoralis and Strongyloides cati; (Threadworms)—Strongyloidosis Aelurostrongylus Abstrusus (Feline Lungworm) 423
Species Affected 423
Key Clinical Signs of Infected Animals 423
Abbreviated Life Cycle 424
Laboratory Test(s) Used to Diagnose the Infection 424
Zoonotic Potential for Clients 424
Treatment 424
Prevention and Control Techniques 424
Enterobius vermicularis (Human Pinworm)—Enterobiasis 425
Species Affected 425
Location of Parasite Within Host 425
Key Clinical Signs of Infected Animals 425
Abbreviated Life Cycle 425
Laboratory Test(s) Used to Diagnose the Infection 425
Zoonotic Potential for Clients 425
Treatment 425
Prevention and Control Techniques 425
Dirofilaria immitis (Heartworm)—Human Dirofilariasis 426
Species Affected 426
Key Clinical Signs of Infected Animals 426
Abbreviated Life Cycle 426
Laboratory Test(s) Used to Diagnose the Infection 427
Zoonotic Potential for Clients 427
Treatment for Animals 427
Prevention and Control Techniques 427
Arthropods of Zoonotic Importance 427
Acarines (Mites and Ticks) 427
Sarcoptes scabei 427
Species Affected. 427
Key Clinical Signs of Infected Animals. 427
Abbreviated Life Cycle. 427
Laboratory Test(s) Used to Diagnose the Infection. 427
Zoonotic Potential for Clients. 427
Treatment. 427
Prevention and Control Techniques. 427
Otodectes cynotis (Oh-toe-DECK-teez sigh-an-OH-tiss) 428
Demodex canis (DEE-moe-decks KAY-niss) 428
Cheyletiella parasitivorax 428
Species Affected. 428
4 Medical Nursing 540
18 Diagnostic Sampling and Therapeutic Techniques 540
Outline 540
Learning Objectives 541
Key Terms 542
Introduction 542
Basic Guidelines 543
Administration of Medication in the Small Animal 543
Oral Administration 543
Orogastric Intubation 544
Transdermal Administration 545
Topical Ophthalmic Administration 545
Aural Administration 546
Intrarectal Administration 546
Intranasal Administration 546
Intradermal Administration 546
Subcutaneous Administration 547
Intramuscular Administration 547
Intravenous Administration 547
Intravenous Catheter Placement 548
Peripheral Vein Catheterization 548
Jugular Vein Catheterization 551
Intravenous Catheter Maintenance 553
Intravenous Chemotherapy Administration 554
Intratracheal Administration 555
Intraosseous Administration 556
Intraperitoneal Administration 556
Sampling Techniques in the Small Animal 556
Blood Sample Collection 556
Cephalic Venipuncture 558
Jugular Venipuncture 558
Lateral Saphenous Venipuncture 558
Medial Saphenous or Femoral Venipuncture 559
Marginal Ear Venipuncture 560
Arterial Blood Sample 560
Dorsal Metatarsal Artery Sample 560
Femoral Artery Sample 560
Arterial Catheter Placement 561
Urine Sample Collection 561
Voided Collection 561
Manual Bladder Expression 562
Cystocentesis 562
Catheterization 563
Male Dog 564
Female Dog 565
Male Cat 565
Female Cat 566
Fecal Sample Collection 566
Thoracocentesis 566
Materials Needed 566
Procedure 566
Abdominocentesis 567
Diagnostic Peritoneal Lavage (DPL) 568
Materials Needed 568
Procedure 568
Transtracheal Wash 568
Percutaneous Technique 569
Method 1: Two-Catheter System 569
5 Emergency and Critical Care 818
25 Fluid Therapy and Transfusion Medicine 818
Outline 818
Learning Objectives 818
Key Terms 818
Introduction 819
Fluid Therapy 819
Indications for Fluid Therapy 819
Body Fluid Compartments 819
Types of Intravenous Fluids 820
Crystalloids 820
Colloids 821
Specifics of Fluid Administration 821
Phases of Fluid Therapy 821
Resuscitation Phase. 821
Replacement Phase. 822
Maintenance Phase. 823
Routes of Administration 823
Intravenous Route. 823
Subcutaneous Route. 826
Intraosseous Route. 827
Enteral Route. 827
Fluid Additives 827
Potassium 827
Dextrose 828
Sodium Bicarbonate 828
Monitoring Fluid Therapy 829
Resuscitation Phase 829
Replacement Phase 829
Complications of Fluid Therapy 830
Transfusion Medicine 830
Indications for Blood and Plasma Transfusion 830
Blood Donors 831
Pretransfusion Testing 831
Blood Typing 831
Antibody Screen 833
Cross-Matching 833
Blood Collection 833
Blood Products 835
Blood Product Administration 835
Determination of Volume and Rate 836
Monitoring and Transfusion Reactions 836
Recommended Readings 838
26 Emergency and Critical Care Nursing 839
Outline 839
Learning Objectives 840
Key Terms 840
Introduction 841
Emergency and Critical Care Nursing: Small Animal 841
Triage 841
Telephone Triage 841
In-Hospital Triage 841
Respiratory System 842
Cardiovascular System 843
Neurologic System 843
Completing the Initial Triage Examination 844
Assessment of Hydration and Hypovolemia 844
Initial Diagnostics 845
Basic First Aid 845
The Emergency Care Station and Resuscitation Area 846
Crash Cart 846
Shock and Systemic Inflammatory Response Syndrome 847
Reperfusion Injury 848
Advanced Emergency Techniques 848
Abdominocentesis 848
Thoracocentesis 848
Thoracic Drain Placement 849
Tracheostomy Tube Placement 849
Respiratory System Support and Oxygen Therapy 849
Cardiopulmonary Arrest 851
Cardiopulmonary Resuscitation 852
Basic Life Support 852
Advanced Life Support 853
Care of the Postarrest Patient 855
Patient Monitoring 856
Central Venous Pressure Monitoring 856
Arterial Blood Pressure Monitoring 856
Care of the Recumbent Patient 858
Airway and Endotracheal or Tracheostomy Tube Care 858
Patient Comfort 858
Intravenous Catheter Monitoring and Care 858
Nutrition and Hydration 858
Ocular Care 858
Oral Care 858
Range of Motion 858
Urinary Catheter Placement and Care 858
Standards of Care and Emergency Protocols 858
Common Emergencies 858
Respiratory Distress 858
Trauma 859
Acute Abdomen 859
Gastric Dilatation–Volvulus 859
Urethral Obstruction 860
Toxin Exposure 860
Canine and Feline Electrocardiography 860
Principles of Electrocardiography 860
Acquisition of the Electrocardiogram 860
Basic Cardiac Conduction and ECG Waveforms 861
Indications for Electrocardiography 862
Electrocardiographic Analysis 863
Cardiac Arrhythmias 866
Normal Rhythms 866
Normal Sinus Rhythm 866
Sinus Arrhythmia 866
Sinus Bradycardia 866
Sinus Tachycardia 866
Disturbances of Supraventricular Impulse Formation 867
Atrial Premature Complexes 867
Atrial Tachycardia 867
Atrial Flutter 868
Atrial Fibrillation 868
Disturbances of Ventricular Impulse Formation 868
Ventricular Premature Complexes (VPCs) 868
Ventricular Tachycardia 869
Ventricular Fibrillation 869
Ventricular Asystole 870
Disturbances of Impulse Conduction 870
Atrial Standstill 870
First-Degree Atrioventricular Block 870
Second-Degree AV Block 870
Third-Degree AV Block 870
Bundle Branch Block 871
Disturbances of Impulse Formation and Conduction 872
Sick Sinus Syndrome 872
Escape Beats and Escape Rhythms 872
Equine Emergency Nursing 872
Gastrointestinal Tract 872
General Physical Examination 873
Nasogastric Intubation 874
Abdominal Palpation Per Rectum 875
Abdominal Ultrasonography 875
Abdominocentesis 875
Abdominal Radiography 875
Specific Conditions 876
Abdominal Exploration 876
Respiratory Tract 876
General Physical Examination 877
Thoracic Ultrasonography 878
Radiography 878
Upper and Lower Airway Endoscopy 878
Thoracocentesis 878
Transtracheal Wash 879
Oxygen Administration 880
Tracheotomy 880
Musculoskeletal System 881
Fractures 881
Distal Forelimb Fracture 881
Distal to Mid-Forelimb Fracture 882
Mid-Forelimb Fracture 882
Elbow Fracture 882
Proximal Forelimb Fracture 882
Distal Hindlimb Fracture 882
Distal to Mid-Hindlimb Fracture 882
Mid-Hindlimb Fracture 882
Proximal Hindlimb Fracture 882
Soft Tissue Injury 882
Wounds 883
General Examination 883
Arthrocentesis 883
Wound Management 883
Radiography 884
Ultrasonography 884
Wound Closure 884
Emergency and Critical Care Nursing: Food Animal 884
Patient Restraint and Safety 884
Considerations for Drug Use in Food-Producing Animals 884
Gastrointestinal System 884
General Physical Examination 884
Ancillary Diagnostics 885
Emergency Intervention 885
Specific Gastrointestinal Conditions 885
Diarrhea 885
Parasitism 886
Emergencies Involving the Rumen 886
Ruminal Tympany 886
Rumenostomy 886
Choke 887
Rumen Fluid Analysis and Transfaunation 887
Respiratory System 888
Respiratory Distress 888
Tracheostomy 888
Musculoskeletal Injuries 888
Orthopedic Emergencies and Downer Animals 888
Fractures and Joint Luxations 889
Down Animals 889
Dog/Wild Animal Attacks 890
Dystocia and Obstetrical Emergencies 890
Dystocia Box and Equipment 891
Examination 891
Epidural Anesthesia 892
Vaginal Delivery 892
Cesarean Section 892
Uterine Torsion 892
Small Ruminant Dystocias 893
Uterine Prolapse 893
Toxic Metritis and Toxic Mastitis 893
Urolithiasis in Small Ruminants 893
History and Physical Examination 893
Treatment 894
Recommended Readings 896
Recommended Websites 896
27 Toxicology 897
Outline 897
Learning Objectives 897
Key Terms 898
Introduction 898
Managing Poison Emergencies 898
Assessment of the Patient’s Condition 899
Stabilization of Vital Functions 899
Decontamination 899
External Exposure 899
Ocular Exposure 899
Dermal Exposure 899
Oral Ingestion 900
Dilution 900
Emesis 900
Activated Charcoal 901
Cathartics 901
Enemas 901
Gastric Lavage 901
Enterogastric Lavage 901
Supportive Care 901
Household Hazards 902
Dangerous Food Items 902
Moldy Food 902
Chocolate 902
Onions 902
Macadamia Nuts 903
Bread Dough With Raw Yeast 903
Grapes and Raisins 904
Xylitol 904
Household Cleaning Agents 904
Acids 904
Alkalis 904
Bleaches 904
Detergents 904
Miscellaneous Household Items 905
Zinc 905
Lead 905
Nicotine 905
Silica Gel Packets 906
Toilet Tank Drop-Ins 906
Glow-in-the-Dark Products 906
Batteries 906
Ice/Snow Melts 906
Dangerous Plants 906
Rhododendron Species 906
Cardiac Glycoside–Containing Plants 906
Castor Beans 907
Cycad Palms 907
Lilies 908
Insoluble Calcium Oxalate–Containing Plants 909
Pesticides 909
Ant and Roach Baits 909
Flea/Tick Products 910
Methomyl 911
Metaldehyde 911
Rodenticides 911
Anticoagulants 911
Bromethalin 912
Cholecalciferol 912
Zinc Phosphide 912
Antifreeze Products 912
Ethylene Glycol 912
Methanol 912
Propylene Glycol 913
Human Medications 913
Acetaminophen 913
Nonsteroidal Anti-Inflammatory Drugs 913
Aspirin 913
Pseudoephedrine and Amphetamines 913
Isoniazid 913
Calcipotriene 913
5-Fluorouracil 913
Drugs of Abuse 914
Marijuana 914
Cocaine 914
Ethanol 914
Methamphetamine 914
Recommended Reading 915
28 Wound Management and Bandaging 916
Outline 916
Learning Objectives 916
Key Terms 917
Introduction 917
Wound Healing 917
Phases of Wound Healing 917
Factors Influencing Wound Healing 919
Patient Factors 919
Wound Factors 919
Concurrent Treatment Factors 919
Small Animal Wound Management 919
Wound Management 919
Immediate Wound Care 919
Wound Debridement 920
Wound Closure 921
Wound Drainage 922
Wound Infection 922
Types of Wounds 923
Abrasions and Lacerations 923
Degloving Injuries 923
Bite Wounds 923
Burns 923
Decubitus Ulcers and Pressure Sores 924
Principles of Bandaging 924
Adherent Primary Layer 924
Nonadherent Primary Layer 925
Bandage, Cast, Splint, and Sling Application in Small Animals 926
Distal Limb Bandages 926
Casts and Splints 930
Slings 931
Bandages for Other Locations 934
Aftercare for Bandages, Splints, Casts, and Slings 936
Large Animal Wound Management 937
Wound Care in Horses 937
Preparing the Wound 937
Local Versus General Anesthesia 938
Exuberant Granulation Tissue in Open Wounds 938
Bandage, Splint, and Cast Application Techniques for Horses 938
Bandages 939
Lower Limb Wound Bandage 939
Lower Limb Support Bandage 939
Splint Application 940
Cast Application 941
Preparation of the Foot 942
Preparation of the Limb Before Cast Application 942
Application of the Cast Material 944
Cast Removal 946
Bandage, Splint, and Cast Application Techniques for Cattle 946
Application of a Claw Block 946
Modified Thomas Splint 946
Recommended Readings 951
Small Animal 951
Large Animal 951
6 Anesthesia, Analgesia, and Pharmacology 952
29 Pharmacology and Pharmacy 952
Outline 952
Learning Objectives 952
Key Terms 953
Introduction 953
Types of Drugs 954
Drug Administration 955
Dosage Terminology 955
Basic Pharmacokinetics 956
Drug Absorption 956
Drug Distribution 956
Drug Metabolism 957
Drug Elimination 957
Basic Pharmacodynamics 957
MECHANISM OF ACTION 957
Side Effects and Adverse Drug Reactions 958
Impact of Disease on Drug Pharmacokinetics 958
Cardiovascular Disease 958
Kidney Disease 958
Liver Disease 959
Aging and Drug Pharmacokinetics 959
Drug Nomenclature 959
Systemic Approach to Drug Classification 960
Antimicrobial Drugs 960
Antibacterial Drugs 960
Antifungal Drugs 962
Antiparasitic Drugs 962
Endoparasitic Drugs 962
Ectoparasitic Drugs 963
Endocrine Drugs 964
Thyroid Supplementation and Antithyroid Drugs 964
Drugs to Treat Adrenal Disease 966
Insulin 966
Gastrointestinal Drugs 967
Cardiovascular Drugs 967
Diuretics 967
Inotropic Agents 969
Antihypertensives 969
Antiarrhythmics 969
Anticoagulants 970
Respiratory Drugs 971
Anticonvulsants 971
Immunosuppressants 972
Anti-Inflammatory Drugs 972
Dietary Supplements/Nutraceuticals 972
Regulatory Pharmacology 973
Drug Laws and Regulations 973
Extra-Label Drug Use 973
Drug Residues and Withdrawal Times in Food-Producing Animals 974
Drug Compounding 975
The Veterinary Pharmacy 976
Drug Procurement 976
Drug Storage and Disposal 976
Prescribing and Dispensing Drugs 977
Prescription Writing 977
Drug Calculations 978
Converting Between Units of Measure 978
Calculating the Correct Drug Dose 978
Using Percent Solutions 979
Constant Rate Infusion 979
Recommended Readings 980
30 Pain Management 981
Outline 981
Learning Objectives 981
Key Terms 981
Introduction 982
The Role of the Veterinary Technician as a Patient Advocate 982
Communication 982
Patient Assessment 982
Signs of Pain 983
The Science of Pain Management 984
Pain Is Bad 984
Physiology of Pain 985
Nociception and the Pain Pathway 985
Neuropathic Pain and Wind-Up Phenomenon 987
Treatment of Pain in Small Animals 988
Environmental and Emotional Care 988
Principles of Administering Analgesia 988
Administration of Analgesics and Analgesic Techniques 989
Take-Home Analgesia. 991
Local and Regional Anesthetics 991
Routes of Administration 991
Topical Analgesia. 991
Local Infiltration. 991
Circumferential Ring Block. 991
Dental Nerve Block. 992
Intra-Articular (Joint Space) Anesthesia. 992
Pleural Space. 992
Epidural Nerve Block. 992
Intravenous Analgesia. 992
Opioids 993
Severe Pain 993
Morphine Sulfate (Pure Opioid Agonist). 993
Hydromorphone (Pure Opioid Agonist). 993
Fentanyl Citrate (Pure Opioid Agonist). 993
Moderate to Severe Pain 993
Buprenorphine (Buprenex) (Partial Mu Agonist). 993
Mild Pain 993
Butorphanol Tartrate (Torbugesic) (Mixed Agonist–Antagonist). 993
Opioid Reversal 994
Naloxone Hydrochloride (Pure Opioid Antagonist). 994
Butorphanol Tartrate (Torbugesic) (Mu Antagonist). 994
Alpha2 Agonists 994
Advantages of Alpha2 Agonists Over Other Sedatives. 994
Constant Rate Infusion 995
Drugs Commonly Administered via CRI. 995
Morphine–Lidocaine–Ketamine. 995
Dexmedetomidine. 995
Neuropathic Pain Reliever. 996
Nonpharmacologic Treatment Options 996
Treatment of Pain in Large Animals 996
Identifying and Anticipating Pain 997
Treating Pain in Large Animals 998
NSAIDs 1002
Opioids 1002
Alpha2 Agonists 1002
Local Anesthetic Drugs 1003
Miscellaneous Agents 1003
Ketamine. 1003
Antispasmodic Agents. 1003
Joint Supplements and Chondroprotective Agents 1003
Alternative and Complementary Therapy 1003
Good Husbandry 1004
Species-Specific Information 1004
Horses 1004
Cattle, Sheep, and Goats 1005
Drug Residues in Meat and Milk 1005
Camelids 1006
Pigs 1006
Summary 1006
Recommended Readings 1007
31 Veterinary Anesthesia 1008
Outline 1008
Learning Objectives 1009
Key Terms 1010
Introduction 1010
What Is Anesthesia? 1010
Patient Preparation 1011
Fasting Recommendations 1011
Patient Stabilization 1012
Physical Status Classification 1012
Anesthetic Agents 1012
Agonists, Partial Agonists, Mixed Agonist–Antagonists, and Antagonists 1012
Anticholinergics 1012
Tranquilizers and Sedatives 1013
Phenothiazine Tranquilizers 1013
Benzodiazepine Tranquilizers 1013
Alpha2 Adrenergic Drugs 1014
Opioids 1015
Propofol 1016
Alfaxalone 1016
Dissociatives 1017
Barbiturates 1017
Etomidate 1017
Guaifenesin 1018
Inhalant Anesthetics 1018
Halogenated Anesthetics 1018
Anesthesia Equipment 1018
Endotracheal Tubes 1018
Laryngoscopes 1019
Supraglottic Airway Devices 1019
Masks 1020
Anesthetic Chambers 1020
The Anesthesia Machine 1021
Preparing the Machine 1021
Machine Assembly 1022
Checking for Leaks 1022
Setting the Pop-off Valve 1022
The Carrier Gas Supply 1022
Anesthetic Vaporizers 1024
Precision Vaporizers 1025
Nonprecision Vaporizers 1026
Vaporizer Inlet Port and Outlet Port and the Fresh Gas Inlet 1026
Breathing Circuits 1026
Rebreathing Circuit Parts 1027
Scavenging System 1029
Maintenance of the Anesthesia Machine 1029
Principles of Endotracheal Intubation 1030
Selecting a Tube 1030
Preparing the Tube 1030
Intubation Procedures 1030
Intubation Procedure for Small Animals 1030
Intubation Procedure for Horses 1031
Intubation Procedure for Adult Cattle 1032
Intubation Procedure for Small Ruminants and Small or Young Cattle 1032
Checking for Proper Placement 1032
Cuff Inflation 1033
Laryngospasm 1033
Complications of Intubation 1033
Monitoring the Anesthetized Patient 1033
Stages and Planes of Anesthesia 1034
Stage I—Period of Voluntary Movement 1034
Stage II—Period of Involuntary Movement 1034
Stage III—Period of Surgical Anesthesia 1034
Stage IV—Period of Anesthetic Overdose 1034
Principles of Monitoring 1035
Vital Signs 1035
Indicators of Circulation 1035
Indicators of Oxygenation 1037
Indicators of Ventilation 1037
Reflexes and Other Indicators of Depth of Anesthesia 1039
Response to Surgical Stimulation 1039
Monitoring Equipment 1040
Mechanical Indicators of Circulation 1040
Mechanical Indicators of Oxygenation 1042
Mechanical Indicators of Ventilation 1043
Small Animal Anesthesia 1045
Selecting a Protocol 1045
Equipment Preparation 1045
The Preanesthetic Period 1045
Induction of Anesthesia 1046
Intravenous Induction 1046
Propofol. 1047
Ketamine-Diazepam or Ketamine-Midazolam. 1047
Alfaxalone. 1047
Intramuscular Induction 1047
Mask Induction 1047
Chamber Induction 1048
Maintenance of Anesthesia 1048
Patient Positioning, Comfort, and Safety 1048
Recovery From Anesthesia 1049
Preparation for Recovery 1049
Monitoring During Recovery 1049
Signs of Recovery 1049
Extubation 1049
The Postanesthetic Period 1049
Equine Anesthesia 1049
Selecting a Protocol 1049
Equipment Preparation 1050
The Preanesthetic Period 1050
Induction of Anesthesia 1051
Intravenous Induction 1051
Maintenance of Anesthesia 1051
Recovery From Anesthesia 1052
Preparation for Recovery 1052
Monitoring During Recovery 1053
Signs of Recovery 1053
Extubation 1053
The Postanesthetic Period 1053
Ruminant Anesthesia 1053
Selecting a Protocol 1054
Preanesthetic Fasting 1054
Equipment Preparation 1055
The Preanesthetic Period 1055
Induction of Anesthesia 1055
Intravenous Induction 1055
Maintenance of Anesthesia 1056
Recovery From Anesthesia 1056
Preparation for Recovery 1056
Monitoring During Recovery 1056
Signs of Recovery 1056
Extubation 1056
The Postanesthetic Period 1056
Manual and Mechanical Ventilation 1057
Anesthetic Problems and Emergencies 1057
Inadequate or Excessive Oxygen Flow 1057
Saturation of Carbon Dioxide Absorbent Granules 1058
A Patient That Will Not Stay Asleep 1058
Excessive Depth of Anesthesia 1058
Apnea and Hypoventilation 1058
Hypotension 1058
Cyanosis 1058
Vomiting or Regurgitation 1059
Prolonged Recovery 1059
Rough Recovery 1059
Acknowledgments 1059
Recommended Websites 1059
Recommended Readings 1059
7 Surgical Nursing 1060
32 Surgical Instruments and Aseptic Technique 1060
Outline 1060
Learning Objectives 1061
Key Terms 1061
Introduction 1061
Instrumentation 1062
General Surgery Instruments 1062
Scalpel 1062
Electrosurgery 1062
Biomedical Lasers and Laser Safety 1062
Laser Properties 1062
Types of Lasers 1063
CO2 Laser. 1063
Nd : YAG and Diode Lasers. 1064
Laser Safety 1064
Laser Hazard Classification 1065
Laser Safety Protocol for Personnel 1066
Laser Plume Control 1066
Laser Safety Protocol for the Patient 1067
Scissors 1067
Needle Holders 1068
Thumb Forceps 1069
Tissue Forceps 1069
Hemostatic Forceps 1070
Retractors 1071
Suction Tips 1071
Stapling Equipment 1072
Vascular Sealing Devices 1073
Ophthalmic Instruments 1073
Orthopedic Instruments 1073
Periosteal Elevators 1073
Rongeurs 1074
Curettes 1074
Bone-Holding Forceps 1074
Osteotomes and Chisels 1075
Gigli Wire 1075
Trephines and Jamshidi Needles 1076
Power Equipment 1076
Orthopedic Implants 1076
Bone Pins 1076
Interlocking Nails 1077
Orthopedic Wire 1077
External Fixators 1077
Bone Screws 1079
Bone Plates 1079
Total Hip Prosthesis 1080
Arthroscopic Instruments and Equipment 1080
Arthroscope 1080
Ancillary Arthroscopic Equipment 1081
Sharp Trocar and Sleeve 1081
Blunt Obturator 1081
Light Cable, Light Projector, and Video Camera 1081
Fluid Delivery Systems 1082
Pressurized Bag System 1082
Automated Pump System 1083
Hand Instruments for Arthroscopic Surgery 1083
Blunt Probe 1084
Rongeurs and Grasping Forceps 1084
Elevators and Osteotomes 1084
Curettes 1084
Motorized Burrs 1084
Radiofrequency Arthroscopic Probes 1084
Laparoscopic Instruments and Equipment 1085
Laparoscope 1085
Laparoscopic Trocars and Cannulas 1085
Sharp Trocars and Cannulas 1085
Blunt Trocar 1086
Light Cable, Light Projector, and Video Camera 1086
Insufflator 1086
Hand Instruments for Laparoscopic Surgery 1086
Instrument Packs 1086
Instrument Care 1088
Drapes and Gowns 1089
Aseptic Technique 1089
Physical Methods of Sterilization 1091
Filtration 1091
Radiation 1091
Heat 1091
Autoclave Sterilization 1093
Sterilization Quality Control 1095
Care and Handling of Sterile Packs 1095
Chemical Methods of Sterilization 1095
Ethylene Oxide 1096
Hydrogen Peroxide Gas Plasma 1096
Chemical Disinfection 1096
Antiseptic and Disinfectant Compounds 1097
Chlorhexidine 1097
Iodine 1097
Alcohols 1097
Phenols 1097
Quaternary Ammonium 1097
Chloride 1097
Aldehyde 1099
Cold Sterilization 1099
Sterilization of Arthroscopic/Laparoscopic Equipment 1099
Operating Room Preparation 1099
Small Animal Patient Preparation 1100
Skin Preparation—Surgical Clip 1100
Skin Preparation—Surgical Scrub 1100
Small Animal Positioning 1101
Equine Patient Preparation 1102
Patient Positioning 1102
Skin Preparation 1103
Surgical Team Preparation 1104
Attire 1104
Hand Scrub 1105
Gowning and Gloving 1108
Maintaining Sterility 1113
Scrubbed-in Personnel 1113
The Patient 1113
Opening Sterile Items 1114
Recommended Readings 1115
33 Surgical Assistance and Suture Material 1116
Outline 1116
Learning Objectives 1116
Key Terms 1116
Introduction 1117
General Concepts in Veterinary Surgical Assisting 1117
Role of the Surgical Assistant 1117
Preoperative Preparation 1117
Preparation of the Surgical Patient 1117
Assessment of Clipping and Surgical Scrub 1117
Positioning and Draping 1117
Abdomen. 1119
Thorax. 1119
Extremity. 1119
Spine. 1121
Perineum. 1121
Oral Surgery. 1122
Operating Room Sterility 1122
Surgical Instruments and Instrument Table Organization 1122
Intraoperative Techniques and Duties 1123
Surgical Lighting 1123
Instrumentation Cords and Tubing 1123
Scalpel Use 1124
Instrument Passing 1124
Retraction 1124
Hemostasis 1125
Suture Cutting 1125
Lavage and Suction 1125
Camera Manipulation 1125
Tissue Manipulation, Retraction, and Organ Positioning 1126
Skin 1126
Abdomen 1126
Thorax 1127
Musculoskeletal System 1127
Vascular and Nervous Systems 1127
Surgical Implants 1127
Permanent 1127
Temporary 1127
Passive Drains. 1127
Active Drains. 1128
Suture Material 1128
Considerations When Choosing Suture 1129
Wound Type 1129
Construction 1129
Size and Strength 1129
Handling 1129
Knot Security 1129
Suture Classification and Examples 1129
Absorbable 1129
8 End of Life 1268
37 Geriatric and Hospice Care 1268
Outline 1268
Learning Objectives 1268
Key Terms 1269
Introduction 1269
Geriatric Cats and Dogs 1269
Life Stages Guidelines 1269
Integrating Geriatric Care 1269
Common Problems in Aging Pets 1270
Oral Problems 1270
Cardiac Disease 1270
Respiratory Disease 1270
Neoplasia 1270
Kidney Disease 1270
Urinary and Fecal Incontinence 1271
Neurologic Abnormalities 1271
Orthopedic Disease 1271
Endocrine Conditions 1271
Hyperthyroidism 1271
Hypothyroidism 1271
Diabetes Mellitus 1271
Hyperadrenocorticism 1271
Changing Nutritional Needs of Aging Pets 1272
Hospice Care for the Aged and Dying Cat and Dog 1273
Pain Medications 1274
Nursing Care 1274
Decubital Ulcers 1274
Subcutaneous Fluids 1275
Bladder Expression 1275
Urine Scalding 1275
Appetite Stimulants 1275
Feeding Tubes 1276
Carts and Slings 1276
When Is the Right Time for Euthanasia? 1276
Geriatric Horses 1277
Physical Examination 1277
Common Problems in Aging Horses 1277
Oral and Nasal Health 1277
Vision 1278
Cardiac Disease 1278
Respiratory Disease 1278
Gastrointestinal Disease 1278
Kidney Disease 1278
Skin Disorders 1278
Neurologic Abnormalities 1279
Orthopedic Disease 1279
Chronic Diseases of the Geriatric Horse 1279
Equine Cushing Disease (Pituitary Pars Intermedia Dysfunction) 1279
Heaves (Recurrent Airway Obstruction) 1280
Laminitis (Founder) 1281
Dental Problems and Sinusitis 1282
Equine Recurrent Uveitis (ERU, or Moon Blindness) 1282
Neurologic Deficits 1282
Musculoskeletal System 1282
Management, Nutrition, and Nursing Care of the Geriatric Horse 1283
End of Life Issues 1283
Summary 1284
Recommended Readings 1284
Geriatric Cats and Dogs 1284
Geriatric Horses 1284
38 The Human-Animal Bond and Euthanasia 1285
Outline 1285
Learning Objectives 1285
Key Terms 1285
Introduction 1285
The Human–Animal Bond 1286
The Attachment Between Animals and Humans 1286
Benefits of Attachment 1287
Pet Loss and Veterinary Medicine 1287
When the Bond Is Broken 1287
Pet Loss and the Grief Process 1288
The Normal Grief Process 1288
Denial and Bargaining 1290
Anger 1290
Depression 1292
Resolution or Acceptance 1293
Grief and the Veterinary Professional 1295
Euthanasia 1295
The Decision 1295
As the End Draws Near: the Beginning of the End 1296
At the End 1298
The End as a Beginning … After the End 1299
The Stress of Euthanasia 1300
Euthanasia in the Shelter and Research Facility 1301
Euthanasia of Large Animals 1301
Summary 1304
Reference 1304
Recommended Readings 1304
Glossary 1305
Index 1327
A 1327
B 1329
C 1330
D 1335
E 1337
F 1340
G 1341
H 1342
I 1344
J 1346
K 1346
L 1346
M 1347
N 1349
O 1351
P 1351
Q 1354
R 1354
S 1356
T 1360
U 1361
V 1361
W 1362
X 1363
Y 1363
Z 1363
Endsheets 6-7 timeline IBC2