Vet Sci 1
1.1 The Veterinary Team
Receptionist
First person to greet client
Duties include the following:
Answers phone calls
Schedules appointments
Creates and maintains charts
Cashes out clients
Handles billing
Lowest education requirement
High school diploma/GED
Duties ALSO include:
Distributes preventative medications
Educates clients
Keeps waiting room neat and clean
Assists customers with pet food purchases
Average salary is $23,800 (outdated numbers)
Modern day in Illinois it averages between $33,000-$46,000
Veterinary Assistant
Assists either the technician or the veterinarian
Duties include the following:
Restrains animals
Provides nursing care
Fills prescriptions
Bathes and exercises patients
Sanitizes and cleans equipment
Prepare equipment and supplies
Educates clients
Cleans kennels
Average salary is about $24,000 (outdated numbers)
Modern day is $29,890-$31,000 in Illinois
Certification or associate’s degree is needed (not in Illinois)
Veterinary Technician
Professional who assists the veterinarian
Duties include the following:
Educates clients
Administers medications
Administers and monitors patients under anesthesia
Performs physical exams
Assists in surgery
Duties ALSO include:
Administers boosters (not rabies)
Maintains records and legal documents
May take and develop x-rays
Collects and tests lab samples
Associate’s (two-year) degree or bachelor’s (four-year) degree is needed
Average salary is $31,000 (outdated numbers)
Modern day is $43,746-$47,860 in Illinois
Veterinarian
A doctor who is qualified and authorized to treat diseases or injured animals
Duties include the following:
Diagnoses disease
Provides a prognosis
Prescribes medication
Performs surgery
Maintains patient records
Euthanizes animals
Duties ALSO include:
Administers vaccinations, including rabies
Treats trauma-based injuries
Determines cost estimates for procedures
Takes cell and tissue samples from animals
Educates clients
Doctorate of veterinary medicine (eight-year+) degree is needed
Salary is $87,500 (outdated numbers)
Modern day is $125,000-$133,000 in Illinois
Other Possible Team Members
Kennel attendant
Cares for animals staying at hospital
Duties include:
Cleaning cages
Feeding and watering patients
Bookkeeper
Does the accounting
Duties include:
Payroll
Paying bills
Ordering supplies
Practice manager
Maintains internal workings of hospital
Duties include:
Hiring new employees
Scheduling staff
Maintaining practice manual
Maintaining inventory
Facilitating hospital meetings
Communicating with drug representatives
Maintaining hospital equipment and machines
OSHA: Occupation Safety and Health Administration
OSHA Acronym
Occupation Safety and Health Administration
A government agency of the United States Department of Labor to ensure workplace safety
Initiated by the Occupation Safety and Health Act of 1970
Under President Richard Nixon
Fatalities have dropped from 38 fatal injuries per day in 1971 to 12 per day in 2016 (OSHA 2017)
Fatalities in 2016 included the following
Crushing
Falling
Electrocution
Insect Stings
Being hit by or thrown from equipment
NIOSH
The National institute for Occupation Safety and Health
Federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness
Located in the Center for Disease Control and Prevention (CDC)
Not a legal enforcement agency
OSHA is a legal enforcement agency
Works with OSHA to make recommendations
Protection
Most private sector employers and their workers are covered by OSHA
OSHA helps by educating employers and employees about the following
Toxic chemicals
Deadly safety hazards
Job hazards of high risk jobs
Best practices through compliance assistance
Who is covered under OSHA?
Most private sector employers
Federal Government workers
Who is NOT covered under OSHA?
Immediate family members of farm employers
Self employed individuals
People with workplace hazards that are regulated by other agencies
Mine Safety and Health Administration
The Coast Guard
Workers Rights
The right to a safe workplace
The right to raise safety or health concerns with the employer or OSHA
The right to report a workplace injury without fear of retaliation
The right to request an OSHA inspection of the workplace
The right to participate or have a representative participate in an OSHA inspection
The right to file a complaint with OSHA
Employer responsibilities include
Providing workers with a workplace free of recognized hazards following OSHA Safety and Health Standards
Finding and correcting safety and health problems
Trying to eliminate or reduce hazards through reasonable changes in working conditions
Ventilation systems
Less harmful chemicals
Displayed “It’s The Law”
The official OSHA job safety and health poster
Reporting to OSHA all work-related fatalities within eight hours and all inpatient hospitalizations, amputations and losses of an eye within 24 hours
Providing required training to all workers in a language and vocabulary that they can understand
Posting OSHA citations at or near the site of the alleged violation
Employers must…
Provide fall protection for employees
Prevent trenching cave-ins
Prevent exposure to some infectious diseases
Ensure safety of workers entering confined spaces
Prevent exposure to harmful chemicals
Put guards on dangerous equipment
Provide safety equipment, such as respirators
Provide training in an understandable language for dangerous jobs
Hazards
OSHA recognizes six main types of hazards
They include the following
Biological (bio) hazards
Composed of living organisms that pose a threat to other living organisms, usually humans
Primarily include
Viruses
Fungi
Prions
Bacteria
Parasites
Usually transmitted bodily substances
Blood
Urine
Feces
Saliva
Vomit
Protective measures
Barriers
Gloves
Gowns
Eye protection
Chemical hazards
Toxic substances that can cause a wide range of health effects when humans are exposed to them
Effects range from mild irritation to death
Methods of absorption
Absorption through the skin or membranes
Inhalation
Ingestion
Examples
Cleaners/Disinfectants
Agricultural crop chemicals
Bleach
Chlorine
Ammonia
Users of chemicals should consult a Safety Data Sheet (SDS) for safe handling, disposal and First-Aid procedures
Ergonomical hazards
Injuries usually caused by repetitive work (carpal tunnel syndrome from typing), being in an awkward position to perform a physical task (cleaning inside a cafe), lifting heavy objects (dog onto an exam table) or a combination of all these factors
Simple changes can be made by…
Using correct posture to lift
Obtaining ergonomically friendly tools
Mops that swivel
Using Personal Protective Equipment (PPE)
Wearing gloves
Requiring multiple people for a task or using tools to lift heavy objects
Electric grooming table
Physical hazards
Hazard caused by factors in the environment that can cause injury to the body without necessarily touching the body
Physical hazards may include ergonomic injuries
Examples include
Loud noises injuring the ear
Radiation
Ultra-Violet exposure
Temperature extremes
Safety hazards
Unsafe work conditions that may cause injury
Examples include
Unguarded machinery
Slips on wet floors
Electric shock injuries
Forklift injuries
Workplace hazards
Injuries from emotional and mental stressors can cause health problems, especially when the employee is exposed to them long-term
Examples include
Harassment
Workplace violence
Workload demands
Hand Washing
Good hand washing is one of the most critical parts of infection control
Alcohol-based hand sanitizers can be used occasionally, but high quality hand washing is hard to substitute
The basic hand wash can eliminate a significant number of pathogens
Hand washing should occur after working with each patient
Taking it one step further, performing a surgical scrub hand wash is critical to infection control in the operating room
Basic Hand Washing
Wet hands with water
Apply enough soap to cover all hand surfaces
Rub hands palm to palm
Rub back of each hand with palm of other hand with fingers interlaced
Rub palms with fingers interlaced
Rub back of fingers with opposing palms with fingers interlocked
Rub each thumb clasped in opposite hand using a rotational movement
Rub tips of fingers in opposite hand using a rotational movement
Rub each wrist with the opposite hand
Rinse hands with water
Use elbow to turn off tap
Dry thoroughly with a single-use towel
The entire process should take 15-30 seconds
Rabies
Dumb Rabies
Change in temperament
Progressive paralysis
Limbs
Face
Difficulty Swallowing
Coma
Death
Furious Rabies
Change in temperament
Aggression
Highly excitable
Chewing on everything
Stones
Earth
Own self
Self-mutilation symptom
Paralysis
Unable to eat/drink
Death
Working With Suspected Rabid Animals
Wear PPE
Gloves
Eye protection
Gown
Be extra cautious
A vaccinated dog bit someone and the bite was reported… Now what?
Dog has a physical exam
Day 0
Dog is placed on house arrest at owners home
On leash for potty breaks only
Dog has a physical exam
Day 10
If dog is asymptomatic dog resumes normal life
If dog is symptomatic, euthanisia (very rare)
An unvaccinated dog bit someone and the bite was reported… Now what?
Track 1
Dog has a physical exam
Day 0
Dog is impounded at the vet clinic for 10 days
Dog has a physical exam
Day 10
If dog is asymptomatic, dog receives Rabies Vaccine and is sent home
If dog develops symptoms, dog is euthanized (Track 2)
Track 2
Dog is euthanized
Dog is decapitated
Head is sent to the state lab
Tissue samples are removed from 2 locations
Brainstem and Cerebellum
Several tests performed to diagnose
Histology/histopathology
Direct fluorescent antibody test
Immunohistochemistry
2.1 Veterinary Laws and Ethics
Veterinary State Practice Acts
States have laws or codes that tell what skills and procedures each of the veterinary professionals may legally perform in each specific state
The Veterinary State Practice Act also tells the following
How individuals apply for licenses and are licensed
What continuing education is required
Rules of professional conduct that veterinarians must follow
Record-keeping rules
Duties and makeup of the State Board of Veterinary Medicine
Veterinary Careers
Veterinary State Practice Acts: laws that define what tasks each veterinary professional may perform
Veterinarian
DVM (Doctor of Veterinary Medicine)
VMD (Veterinary Medicine Doctor (UPenn))
Veterinary Technologist
Has their bachelors
Veterinary Technician
Has their associates
Veterinary Assistant
Certification
Malpractice
In order for litigation - must prove 3 elements
Vet agreed to treat patient
Vet failed to exercise the necessary legal obligation of skill and diligence in treatment
Negligence caused injury to the patient
Veterinarian-Client-Patient-Relationships
Veterinarians must establish relationships with clients to be able to practice veterinary medicine according to most veterinary state practice acts
Reporting Abuse and Neglect
Most Veterinary State Practice Acts require veterinarians to report animal abuse and neglect to local authorities
Many states protect veterinarians from any legal action stemming from such reports
Recordkeeping and documentation are important parts of reporting
Veterinarians should educate their clients about humane care and treatment of animals
Veterinary Medical Ethics
Ethics
Moral principles that govern one’s behavior
There is a fine line between legal and ethical violations
Animal owners desire more procedures and techniques to change and manage their animals
Veterinarians must consider if they ethically agree with what they are being asked to do
Procedure examples
Tail docking
Debarking
Ear cropping
Declawing
Abbreviations
AVMA
American Veterinary Medical Association
Accredits Vet Tech programs & acts as collective voice for veterinarians
NAVTA
National Association of Veterinary Technicians in America
Accredit Vet Assistant programs & acts as collective voice for vet techs
AVA
Approved Veterinary Assistant
Title of certificate after passing the AVA exam and successful completion of CHS Vet Science program
AAHA
American Animal Hospital Association
Sets standards & guidelines for veterinary hospitals
VETMEDTEAM
1st website offering continuing education for entire vet team
Definition
Medical Record
A legal document that records sequential health events each time the patient is seen by the veterinarian
Summarizes the patient's medical history
Illness
Symptoms
Past treatments
Medications
Purpose
Provides continuity
Current veterinarian
Multiple veterinarians
Offers quick, easy access to information
Vaccinations
Master problem list
Gives financial history
Receipts from past visits
Serves as a legal document
Confidential
Legal Documentation
Medical records are owned by the veterinary practice
The attending veterinarian is authorized to release medical information only to other practices
Hand written with blue or black ink
Maintaining files
Inactive files are removed and stored
Purging files
Eliminate hard copies after seven years
Filing Systems
Numerical Filing
Each fluent or specific patient is assigned and filed by a specific account number
Color Coding
A color is assigned to numbers 0 to 9
Alphabetical Filing
Each client is filed alphabetically by owner’s last name, first name, middle initial and patient name
Color Coding
Color is assigned to specific letters
Creating Medical Record
Client Information
Name
Address
Telephone Number
Patient Information
Name
Species
Breed
Age
Gender
Reproductive Status
General Physical Description
Organization of Medical Information
Source-Oriented Medical Record (SOMR)
Data kept in chronological order
Data organized based upon subject matter
Normally written in narrative format
Problem-Oriented Medical Record (POMR)
Data kept in reverse chronological order
Data organized based upon progress notes for each visit
Normally written in note/list format
Problem-Oriented Medical Record
Contains the following
Master Problem List
Contains dates associated with health issues that the client reported or that the veterinarian observed
Progression Notes
In SOAP format
Subjective, Objective, Assessment, Plan
Subjective Information
Non-measurable clinical impressions of the patient
Objective Information
Factual, measurable data
Assessment
Diagnosis compromised from diagnostic testing and physical examination
Plan
Treatment that is recommended
Behavior
An internal or external change (stimulus) that excess a threshold
Stimulation of nervous and/or endocrine systems
Ethology
Study of animal behavior
Behavior is genetic (instinct) and learned (conditioned response
Conditioned Responses
Classical or operant
Imprinting
Pattern of behaviors that bonds animals to caretakers
Dogs and cats
3-12 weeks of age
Preventing Behavior Problems in Companion Animals
It is easier to prevent than to correct a behavior problem
Common behavior problems
Destruction
Aggression
House soiling
Avoid anthropomorphism
Attributing human traits to a non-human creature/thing
Destructive Cat Behavior
Scratching posts can prevent destructive cat behavior
Why cats scratch
Mark territory
Stretch muscles and tendons
Remove worn outer sheaths from claws
Scratching objects
Proper location
Proper height, orientation and texture
Scratching Objects
Physical characteristics
Height
Tall enough for full height stretch
Weight
Sturdy enough to hold cat’s weight
Orientation
Horizontal or vertical
Texture
Depends on cat’s preference
Long strokes or short picking motion
Location
Where the cat likes to scratch
Attach a toy or spray with pheromone or catnip
Destructive Dog Behavior
Destructive behaviors that are self-rewarding
Digging
Chewing
Tearing
Scratching
Moving objects
Trash diving
Reasons with underlying causes
Separation anxiety
Noise phobia
Developmental reasons
Teething
Play
Investigation
Preventing Destructive Dog Behavior
Appealing toys
Start with young dogs
Reward when toy is played with
Elicit preferred play action
Shaking
Chewing
Tearing
Take away unacceptable items
Replace with acceptable toy
Booby trap unacceptable items or areas
Digging
Provide a specific area to dig
Loose soil or sand
Bury items to encourage digging in area
Preventing Aggressive Behavior Problems
Aggressive behavior intends to harm another individual
Agonistic behavior
Submission
Avoidance
Escaping
Offensive or Defensive Threats
Offensive or Defensive Aggression
Types of aggression
Fearful
Maternal
Interfemale
Play-related
Territorial
Intermale
Predatory
Redirected
Determine type of aggression being displayed
Dogs
Most commonly toward people
Especially children
Cats
Most commonly toward other cats
Prevention techniques
Puppy test
Match owner’s activity level and lifestyle
Castration
Prepubertal or postpubertal
Socialization
Sensitive socialization period
Dogs: 3-12 weeks old
Cats: 2-7 weeks old
House-training
Dogs
Take outside frequently
When it wakes up
After it eats
If it appears to be sniffing around the house
Crate training when puppy is left alone
Proper size
No longer than 4-6 hours in 8-week-old puppies
Teach the desired location for elimination
Reinforce correct behavior immediately
Do not use physical punishment after “accidents”
Cats
Readily trained to use litter box
Clean, easily accessible litter box
1 per cat and 1 extra
Acceptable substrate (litter)
Soft
Fine-grained
Acceptable level of litter in box
Provide privacy
Clean box regularly
Remove clumps daily
How to Check Your Patient’s Vitals
Mentation, Temperature, Heart Rate, Pulses, Respirations, Mucus Membranes, Capillary Refill Time and Weight
What’s Your Canine Patient Doing
Mentation is how your patient is acting
Are they…
Bright
Alert
Responsive
Tail Wagging
Happy to See You
Maybe they are…
Quiet
Alert
Responsive
Not as Happy
Still Interested in Seeing You
Or maybe they are…
Dull
Not Alert
Still Respond When You Talk to Them
Not Wagging Their Tails or Getting up at All
Only Lift Their Head to See Who is Talking
Mentation Status is reported as BAR, QAR or DR
BAR
Bright, Alert, Responsive
QAR
Quiet, Alert, Responsive
DR
Dull, Responsive
You take a temperature HOW?
Done rectally
What is a normal temperature?
100.5-102.5 degrees fahrenheit
Heart rates, Just a little beat of the heart
What do you listen with?
Stethoscope
Where do you listen to hear the heartbeat?
Left side of their chest
What does it sound like?
Lub-dub (1 heart beat)
What is a heart rate?
The number of times a heart beats in 1 minute
It’s measured in beats per minute (bpm)
To get a heart rate, listen for 15 seconds and multiply the number by 4
If you listen for 10 seconds, multiply by 6
What’s a pulse got to do with it?
The pulse is the tactile arterial palpation of the blood moving through the artery
The rate of the pulse should match the heart rate
Where is the most common place to find a pulse on a dog?
Femoral artery is the most common and easiest place to find the pulse
How to obtain a pulse rate is the same as getting a heart rate
You feel the rate and count the number of times you feel the “bump” of the pulse against your finger
Count for 15 second multiply by 4 OR count for 10 seconds multiply by 6
Normal Heart and Pulse Rates are…
Dogs
80bpm-140bpm
Smaller dogs can have a higher heart rates
Larger dogs can have lower heart rates
With every breath they take…
A breath is how much air is taken into the lungs and pushed back out of the lungs
When we are checking respiration rates, we also want to look at the effort too
If abdominal muscles are used that can mean that there is more than average effort being used to breathe
The video we watched is a normal rate and effort
Respiration rate is measured in breaths per minute, brpm
Normal respiration rate is 10brpm-30brpm
Panting can be given as a respiration
Dogs that are hot, nervous or tired can pant and it can be considered within normal respiration limits
Mucus membranes and Capillary refill time
Mucus Membranes (MM)
Mucus Membrane is also the “gum” color
They should have a bubble gum pink color or black (if pigmented)
Concerning colors may include
White
Circulation issues with red blood cells
Brick red
Severe infection (septic), high fever (heatstroke)
Yellow
Liver failure (Jaundice)
Blue/Purple
Lack of oxygen
Muddy
Lack of oxygen, going into shock, struggling to move blood
Capillary Refill Time (CRT)
This assesses how the blood flows through the peripheral tissues
To get a CRT we take a finger and press on the MM then release
The tissue should look white or pale when we remove our finger
We then count the umber of seconds it takes for the tissue to return to its original color
Now we get to WEIGHT
We always want to get an accurate weight on our canine patients every time they come into the clinic
Sometimes the first sign of something wrong is a change in weight
Believe it or not, this is sometimes the hardest thing to get in our vitals
Euthanasia
The Euthansia Experience
Consider time of day for appointment scheduling
Collect any fees for services prior to euthanasia of pet
Prepare the room prior to client arrival if possible
Maintain a private area for client and pet
Inform the client that the veterinary staff is available for support
Ensure the pet is comfortable and presented well to the client
Allow time for owner to say goodbye, grieve and regain composure
Provide information regarding all available support systems
Hotlines
Support groups and forums
Counselors
Memorialize the Pet
Ideas for how to memorialize the pet
Urns with ashes
Clay paw print
Hanging collar on mantle
Picture frame with picture and collar
Sympathy cards
Post Mortem Care
Set Up For Euthanasia
Supplies
Hair clippers
Alcohol and gauze squares
IV catheter
IV catheter plug
Bandaging tape
Vet wrap
Catheter flush
Sedation drugs
Not always needed
Euthanasia drug
Supplies sometimes needed
Tourniquet
Muzzle
E-collar
Extra hands
Patient Preparation for Euthanasia
Clip hair
Clean skin
Place catheter (technician or DVM)
Sedation may be given before catheter placement or after or not at all
Depends on the situation
Tape catheter
Flush catheter
Present patient to client
When client is ready, inject euthanasia solution
Listen to heart to ensure death
Leave patient with client until client leaves
Post Mortem Care
Treat animal with respect
Remove any medical devices
IV catheter
Feeding tubes
Bandages
Etc
Collect any memorabilia for the client
Clay paw print
Ink paw print
Hair clippings
Collar
Etc
Bag and tag
Owner name
Pet name
Weight
Place in freezer
Crematorium pickup
Cremation Options
Communal
Pet is cremated along with other pets and ashes are not returned to owner
Red tag
Partitioned
Pet is cremated with other animals but partitions are placed between animals
Owners will get ashes, but the ashes may have other pets mixed in
Yellow tag
Private
Only one pet is cremated and ashes are only of that pet
Ashes are returned to the owner
Green tag
Make sure you place the correct tag on the animal’s bag!