Nursing Care and Procedures

1. Nursing Care and Procedures Michael Lavoie Veterinary Assistant Program Middlesex Community College March 2012

2. Common Blood Tests • During your pet’s routine wellness exam or if it is suspected that something is wrong, your veterinarian may wish to run laboratory tests using a sample of your pet’s blood, urine, skin, hair or feces. • When your pet is healthy, your veterinarian may run laboratory tests, such as a complete blood count (CBC), chemistry panel and urinalysis, to establish your pet’s “baseline” values. • Then, if your pet ever gets sick, your veterinarian will compare your pet’s current laboratory results to his previous baseline value to determine if the current values are abnormal

3. CBC- Complete Blood Count • A CBC measures the number of red blood cells, white blood cells and platelets in a sample of blood. • The numbers of each type of cell give your veterinarian information to help him diagnose anemia, infections and leukemia. • If your pet is undergoing treatment for a condition, a complete blood count can help your veterinarian monitor how your pet is responding to the treatment

4. Vet assistant role in CBCs • The vet assistant role is to help hold for the blood draw. • You can also run the blood work if you have a working idea of how the blood machines work. • If the blood is going out to the laboratory, you are allowed to set up the sheets going out to the laboratory.

5. Urinalysis (UA) • Laboratory testing of your pet’s urine will help your veterinarian detect the presence of specific substances that normally do not appear in urine, including protein, sugar, white blood cells or blood. • Measuring the dilution or concentration of urine can also help your veterinarian diagnose illness. • Urinalysis can be helpful in diagnosing urinary-tract infections, diabetes, dehydration, kidney problems and other conditions

6. Vet assistant role in Urinalysis • Your role would be to help hold for the urine collection, whether it be holding laterally for a cysto or helping to collect • You can also run a urinalysis dip stick. • Also you can run a urine specific gravity. • You can also set up the paperwork to send the laboratory.

7. Cystocentisis • A 'cystocentesis' is a way in which a veterinarian can collect a urine sample. • In a cystocentesis, a fine needle attached to a syringe is inserted into the bladder through the abdomen. • Urine is drawn into the syringe and the needle is removed. • This does not hurt the animal; if the animal demonstrates any objection to a cystocentesis, it is usually because the animal needs to be placed on his back during the procedure.

8. Blood Chemistry Panel • A blood-chemistry panel measures your pet’s electrolytes, enzymes and chemical elements of his blood such as calcium and phosphorous levels. • These measurements help your veterinarian determine how your pet’s organs, such as kidneys, pancreas and liver, are currently functioning. • Blood-chemistry panels also help your veterinarian accurately diagnose and treat illness, as well as monitor your pet’s response to treatment. • Your veterinarian may also use the results of a blood-chemistry panel to determine if further testing is needed

9. Vet Assistant Role in Blood Chemistry Panels • You are responsible for gathering the equipment. • Helping with restraint • Running the actual chemistry if you have a prior knowledge of how to run the blood chemistry machines • Be able to set up the blood to be sent out to the laboratory

10. Heartworm Testing • Your veterinarian may recommend a blood test to confirm the presence of heartworms in your pet. • Several different heartworm tests will show the presence of microfilariae (offspring of adult heartworms) in your pet’s blood. • There are other blood tests that confirm the presence of adult heartworms by detecting certain substances in the bloodstream.

12. Vet Assistant Role in Heartworm Testing • Getting the materials together. • Helping to hold for the blood draw for the heartworm test • Be able to set up and run a heartworm test

13. Fecal Examination • Your veterinarian may examine your pet’s feces under a microscope for clues about many different kinds of diseases, including difficulties with digestion, internal bleeding and pancreas disorders. • Most importantly, fecal examination will confirm the presence of intestinal parasites, including roundworm, hookworm, whipworm, tapeworm and giardia.

15. Vet Assistant Role in Fecal Examination • Collecting or gathering the stool needed • Setting up the fecal floatation • If you are familiar with the eggs of each worm you can read the sample for the doctor. • If you are learning you can have the vet technician check your work and then present your findings to the doctor • Set up the sample to go to the laboratory

16. Skin Scrapings • Skin scraping is one of the most common tests in veterinary dermatology. • Your veterinarian will take a small scraping of your pet’s skin and examine it under a microscope to confirm the presence of certain types of fungi or microscopic parasites on your pet’s skin • These can be yeast, demodex or scabies

18. Vet Assistant’s Role in Skin Scrapings • Gather the materials for the doctor. • Restrain the animal for the scraping • Set up the slide and microscope for the doctor • Sometimes if you are familiar with what you are looking at and looking for reading the slide for the doctor. • If you are unsure you can have the veterinary technician look to make sure you have found what you needed

19. Fungal Cultures • Your veterinarian may take a few hair samples if he is concerned about the possibility of a fungal infection on your pet’s skin. • A culture test can be performed on the hair sample to detect the presence of fungi such as ringworm. • Unlike other laboratory tests, it usually takes one to two weeks to get a final result from a fungal culture

20. Vet Assistant’s role in Fungal Cultures • Gathering the materials • Holding the animal for the doctor • Setting up and sending out the culture to the laboratory.

21. Fine Needle Aspirates • If your pet has an unusual lump or bump on his skin, your veterinarian may take a sample of it using a hollow needle to withdraw cells and/or fluid from the lump. • Your veterinarian will examine the sample on a slide under a microscope to help diagnose infections or cancer. • Fine-needle aspirates also provide information about whether a tumor is malignant or benign, and if additional testing or treatment is needed

22. Vet Assistant’s Role in Fine Needle Aspirates • Gather the materials for the doctor • Restrain the animal for the doctor • Setting up the slides for the doctor to read if being read in house. • Set up the slide and send out to the laboratory for analysis

23. Common Diseases in the Vet Hospital: Addison’s Disease • Addison’s disease is an uncommon-even rare-disease that can affect any dog. • Standard Poodles, Rottweilers, Great Danes and several other breeds, however, seem to have a higher incidence of affliction. • The disease occurs when injury to or disease of the adrenal gland causes a deficiency in the gland’s ability to produce normal amounts of cortisone or the mineral-regulating hormone called aldosterone

24. Addison’s disease Continued… • Various symptoms such as weakness and gastrointestinal disorders develop. • Diagnosis can be made by measuring electrolyte levels or through specific adrenal gland function tests. • Treatment consists of hormone replacement therapy using one of several different drugs depending on the animal’s response. • The drugs may be administered in injectable or pill form. • Treatment is usually lifelong, but once regulated, the dog can live a normal life

26. Arthritis • Arthritis is a condition in which an animal’s joints become inflamed, often accompanied by pain, heat, and swelling in the joints, and it usually results in increasing stiffness and immobility. • It doesn’t have to mean a poor quality of life for your pet, however. • The signs may be hard to spot at first: your gray-in-the-muzzle Labrador retriever takes a little longer to get up in the morning, or your fuzzy Persian doesn’t jump as high as she used to.

27. Arthritis continued… • Arthritis is a condition in which an animal’s joints become inflamed. • It is accompanied by pain, heat, and swelling in the joints, and it usually results in increasing stiffness and immobility. • It doesn’t have to mean a poor quality of life for your pet, however. • There are medications, therapies, and other things that you can do at home.

28. Things that can be Done at Home • Keep litter boxes and food and water dishes at a comfortable height, easily accessible, and on a non-slip surface such as a rubber bath mat or a piece of indoor-outdoor carpet. In a multi-level house, keep them on every floor. • Supply a padded surface to cushion your pet’s joints while she sits and sleeps. Pet store dog and cat beds will work, as will bean bag chairs and old mattresses. Place the padding in a warm, draft-free spot. • Make slippery surfaces like wood or linoleum floors safer with non-skid runners, available at most home improvement and hardware stores. • If your cat’s litter box has high sides, cut a cat-sized opening in one side to let him step in and out easily, leaving one to two inches at the bottom to keep litter from spilling out.

29. Continued • Ramps can help animals make it up and down stairs, on and off the porch, on and off the couch, and anywhere else where the jump may be too far for their sore joints. You can construct your own ramp with a sheet of heavy plywood covered in indoor-outdoor carpeting. Just make sure that both ends are completely secure when your pet is on the ramp, and be sure that the angle is not too steep • Some pets that are too stiff to use the stairs will try to use them regardless, possibly falling and hurting themselves in the process. Supervise your pet when she is using the stairs, and use a baby gate or sheet of plywood to keep the steps off limits the rest of the time

30. Continued • If you have large dog, a homemade sling can help you support a little of her weight as she tries to move around. Slip a long, wide strap made of leather, canvas, or a thick, durable fabric under her chest and hold one end in each hand. You can pull up on the ends to help her stand up and get her balance; you can also use the sling to help your dog into the car and up the stairs. • A little warmth can help a sore animal get through a long night. Consider wrapping a hot water bottle in towels or tucking a microwaveable heating pad into your pet’s bed. • If your pet is used to spending time alone in the yard, be sure you have a clear view to keep an eye on her. Pets with arthritis are vulnerable to attacks from other animals, they can fall and injure themselves easily, and they can become very stiff in cold or damp weather. Stay by the window and watch them when they’re outside; even better, sit outside with them

31. Continued… • Groom your pet regularly. As animals lose flexibility in their joints, they can’t reach around to scratch or groom themselves the way they used to. Cats, particularly, may develop matted or dirty fur—very upsetting to a finicky feline! Regular brushing will help your pet feel comfortable and allow you to spend some quiet, affectionate time with her

32. Cancer: How to treat: Surgery • Veterinarians will perform surgery on a tumor when it can be removed from a pet’s body without damaging other tissue. • It is not a viable option if the cancer is large enough to endanger the animal if removed, if the cancer has spread, or if the animal is too weak to survive anesthesia

33. Chemotherapy • This is a process in which an animal is given toxic chemicals, usually intravenously, that are intended to kill the out-of-control, rapidly reproducing cancer cells, without damaging the slower-dividing healthy cells. • The good news is, animals often respond to chemotherapy better than humans. • They usually don’t have the severe side effects like nausea and hair loss that people can experience

34. Radiation Therapy • In this treatment, high doses of radiation are aimed directly at the tumor to shrink it or arrest its growth. • This can be done either with a narrow beam of radiation, or with radioactive implants placed next to the tumor. • It’s a completely painless procedure

35. Canine Distemper • Canine distemper virus can cause a variety of symptoms related to the central nervous system. • It is spread from dog to dog in secretions like saliva, urine and tears. • It affects a variety of systems within the dog, such as the immune system (by suppressing the ability to make white blood cells and fight off infection), the central nervous system (resulting in seizures and erratic behavior), the gastrointestinal system (resulting in vomiting and diarrhea), and the respiratory system (resulting in coughing).

36. Canine Distemper Continued • Canine distemper affects puppies and dogs that have not been vaccinated against it. • Most dogs are presented to the veterinarian for depression, lethargy and thick green eye discharge. • Some dogs will come in for seizures. • Dogs that recover initially from the disease may have seizures or other central nervous system disorders later in their old age

37. Cushing’s Disease • Cushing’s disease is the common name for a disease called hyperadrenocorticism that most commonly affects people, dogs, cats, and ferrets. • It’s caused by a hyperactive adrenal gland that pumps too many steroids and other hormones into the bloodstream. • It can be caused by a growth in the adrenal gland or the pituitary gland

38. Cushing’s Continued… • Some of a dog’s muscle to break down, giving him a thin-legged, potbellied look. • It can also hurt a dog’s ability to concentrate urine, making him drink a lot and produce a lot of urine. • The steroids can suppress the immune system, as well, so dogs can sometimes get secondary infections. • And the pancreas can be affected, causing vomiting and often diarrhea. • Other symptoms include hair loss, calcified lumps under the skin, increased appetite, panting, and high blood pressure

39. Cushing’s Disease Continued… • Treatment varies, based on how severe symptoms are and the general health of the animal. • Two options are removing the growth that stimulates the hormone and prescribing medications that slow down production in the adrenal gland

40. Diabetes Mellitus • Diabetes mellitus is a disease involving glucose (sugar) in the blood and insulin. • Insulin is a hormone produced by the body to regulate blood glucose. • Diabetes occurs when your pet’s body has too much blood glucose because he either doesn’t produce enough insulin or is insensitive to the available insulin in his body

41. Diabetes • Type I diabetes results from a deficiency of insulin in the body due to an insufficient number of insulin-producing cells. • Type I diabetes is the most serious form of the disease and most often develops in young pets. • Type I diabetes is not preventable. • Type II diabetes is more common, resulting from a body’s resistance to the effects of insulin. • Older, obese pets are more susceptible to type II diabetes because fat cells may become resistant to insulin. • Weight control through diet and exercise may help prevent the onset of type II diabetes

42. Treatment • A combination of oral medication and a special veterinarian recommended diet. • A diet high in protein for diabetic cats and a high-fiber diet for diabetic dogs. • Proper weight management consisting of diet and regular exercise. • Spaying in female diabetic pets

43. Dry Eye • KeratoconjunctivitisSicca (KCS), or "dry eye," involves inflammation of the cornea due to decreased tear production. • The disease usually affects middle-aged or older dogs and has been reported in cats, as well. • The watery part of the tears is no longer made, so only the mucous remains. • One or both eyes may have a mucous type of discharge in or around the eye

44. Heart Disease • Heart valve problems are the most common cause of heart disease in dogs. The heart valves thicken and then leak when the heart pumps. • Inflammation (myocarditis) is caused by an infection of the heart muscles or lining of the heart. • Heartworm disease is caused by worms, which actually lodge in the heart. This disease is transmitted by mosquitoes. • Arrhythmia or irregular heart beats are caused by malfunctions of the heart’s electrical control system known as the pacemaker. • Blockages of the heart arteries cause the death of part of the heart muscle. This disease is not common in pets. • Other heart diseases may be caused by birth defects

45. Kidney Failure • Chronic kidney failure occurs when the kidneys can no longer excrete waste products, produce hormones and regulate the chemical composition of body fluids, all of which are crucial functions for your pet’s health. • Chronic kidney failure will cause kidney function to decrease slowly over a long period of time so physical symptoms will appear gradually

46. Kidney Failure • Acute kidney failure is characterized by a sudden decline in kidney function that causes changes in body chemistry such as alterations in fluid and mineral balances. • These abrupt changes will negatively affect almost every body system. • Because kidney function declines so quickly, the physical symptoms are more dramatic with acute kidney failure.

47. Physical Signs of Kidney Failure • Excessive drinking • Increased urination • Lethargy • Vomiting • Bad breath • Not eating for more than one day • Weakness or lack of coordination when walking • Depression • Weight loss or wasting of muscle tissue

48. Treating Kidney Disease • Intravenous fluids • Special diet to decrease protein and salt consumption • High blood pressure medication • Control of vomiting and gastrointestinal problems with diet and drug therapy • Anemia (decreased red-blood cell production) medication • Potassium supplements • Hospitalization and supportive care

49. Osteosarcoma • Osteosarcoma is a common and serious form of bone cancer. • It typically occurs in large and giant breed dogs. • Leg pain, swelling, and limping are usually the first noticeable signs. • Unfortunately, by the time symptoms begin to show, this disease may have spread to other parts of the body

50. Parvovirus • Parvovirus is a serious, deadly threat to the unvaccinated dog population. • It is so infectious that virtually anyone or any moving object can become a parvovirus carrier simply by coming in contact with an infected dog’s feces (bowel movement). • The virus can survive searing heat and subzero temperatures for long periods of time, and so the virus might remain long after the feces has been removed