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An ailing profession PDF

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INCLUDES THE Nutrition An ailing profession CREATE A COMPLETE Canine corns PICTURE OF HEALTH Why they develop and how to treat them 61 5 pointers to cultivate Letters client compliance and Breed tendency or compulsive behavior? 44 prolong pets’ lives p70 Blue-green algae Saving pets exposed to this deadly toxin 49 Bladder rupture Guidance on using positive- contrast cystography for this hard-to-detect injury 54 Journal Scan ▸ What’s best for treating IMHA? 59 ▸ Can cats receive canine blood? 60 Idea Exchange Protecting pets’ tails and handy heartworm prevention reminders 80 February 2014 | Volume 109 | Number 2 | PEER-REVIEWED | dvm360.com mbcyyelaaallcgonkewnta ES383106_vetm0214_cv1.pgs 01.28.2014 23:35 ADV See how quickly clinical signs of bacterial skin infections can begin to improve with CONVENIA.*,† Photos: David Bird, DVM Baseline 24 hours 9 days post-injection post-injection Fast. Effective. Treatment. IMPORTANT SAFETY INFORMATION: People with known *Eleven-month-old Labrador retriever with acute moist dermatitis hypersensitivity to penicillin or cephalosporins should avoid treated only with CONVENIA® (cefovecin sodium) 8 mg/kg. exposure to CONVENIA. Do not use in dogs or cats with a history of allergic reactions to penicillins or cephalosporins. Side effects for both dogs and cats include vomiting, †Case included an initial skin cleansing with a diarrhea, decreased appetite/anorexia and lethargy. For dilute topical antiseptic. more information, please see Brief Summary of full Prescribing Information on page For more information, go to convenia.com or talk to your (SS[YHKLTHYRZHYL[OLWYVWLY[`VMAVL[PZ0UJP[ZH(cid:28)SPH[LZHUKVYP[ZSPJLUZVYZ Zoetis representative. ©2014 Zoetis Inc. All rights reserved. February 2014. AIF-00029 41461_Convenia_FrenchFold Cover_V3.indd 1 1/17/14 10:15 AM mbcyyelaaallcgonkewnta 48214020025_2824280.pgs 01.29.2014 05:51 ADVANSTAR_PDF/X-1a See how quickly clinical signs of bacterial skin infections can begin to improve with CONVENIA.*,† Photos: David Bird, DVM Baseline 24 hours 9 days post-injection post-injection Fast. Effective. Treatment. IMPORTANT SAFETY INFORMATION: People with known *Eleven-month-old Labrador retriever with acute moist dermatitis hypersensitivity to penicillin or cephalosporins should avoid treated only with CONVENIA® (cefovecin sodium) 8 mg/kg. exposure to CONVENIA. Do not use in dogs or cats with a history of allergic reactions to penicillins or cephalosporins. Side effects for both dogs and cats include vomiting, †Case included an initial skin cleansing with a diarrhea, decreased appetite/anorexia and lethargy. For dilute topical antiseptic. more information, please see Brief Summary of full Prescribing Information on page For more information, go to convenia.com or talk to your (SS[YHKLTHYRZHYL[OLWYVWLY[`VMAVL[PZ0UJP[ZH(cid:28)SPH[LZHUKVYP[ZSPJLUZVYZ Zoetis representative. ©2014 Zoetis Inc. All rights reserved. February 2014. AIF-00029 41461_Convenia_FrenchFold Cover_V3.indd 1 1/17/14 10:15 AM mbcyyelaaallcgonkewnta 48214020025_2824280.pgs 01.29.2014 05:51 ADVANSTAR_PDF/X-1a EUCALYPTUS IS GREAT FOR LOTS OF THINGS. BUT DR. GRACIE WAS WHAT SAMSON REALLY NEEDED. www.avma.org Healing animals like Samson is an amazing experience. So is studying Veterinary Medicine at AVMA-accredited St. George’s University. You’ll study alongside aspiring doctors public health professionals scientists and faculty from 140 countries in a fully integrated One Health One Medicine environment. And SGU is small enough that students get plenty of individual a� ention but large enough to o  er )& degree programs. Find out about information sessions and webinars in your area at sgu.edu/dvm US/Canada: 1 (800) 899-6337 ext. 9 1280 sgu.edu/dvm • [email protected] ©2014 St. George’s University Grenada, West Indies Untitled-2 1 17/01/14 7:42 PM mbcyyelaaallcgonkewnta 48214020022_2823680.pgs 01.18.2014 01:06 ADVANSTAR_PDF/X-1a Mission Content Group Veterinary Medicine is a peer-reviewed journal dedicated Editor/Medicine Channel Director | Mindy Valcarcel [email protected] to providing concise, credible, and essential information Medical Editor | Heather Lewellen, DVM on the most common and crucial clinical problems seen in companion-animal practice. Content Manager | Adrienne Wagner Senior Content Specialists | Alison Fulton | Heather Biele, DVM Editorial Advisory Board Assistant Content Specialist | Victoria Biondi Leading specialists who direct our content and ensure Technical Editor | Jennifer Vossman, RVT our editorial quality and integrity Consulting Technical Editor | Avi Blake, DVM Joseph W. 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Vice President, Legal | Michael Bernstein Permissions/International Licensing. Call Maureen Cannon at (440) 891- Vice President, Electronic Information Technology | J. Vaughn 2742. List Sales: Please contact List Account Executive Renée Schuster at (440) 891-2613. Editorial Offi ces: Write to 8033 Flint, Lenexa, KS Executive Vice President | Ron Wall 66214; or call (913) 871-3800. Visit our websites: dvm360.com; thecvc.com; industrymatter.com. Veterinary Medicine (ISSN 8750-7943 print; ISSN 1939-1919 online) is published monthly by Advanstar Communications Inc., 131 West First St., Duluth, MN 55802-2065. One year subscription rates: $60 in the United States and Possessions; $72 in Canada and Mexico; $97 in all other countries. Single issue orders: $18 in the United States and Possessions; $22 in Canada and Mexico; $24 in all other countries. Periodicals postage paid at Duluth, MN 55806 and additional mailing off ces. POSTMASTER: Please send address changes to Veterinary Medicine, P.O. 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Veterinary Medicine does not verify any claims or other information appearing in any of the advertisements contained in the publication, and cannot take responsibility for any losses or other damages incurred by readers in reliance on such content. Publisher assumes no responsibility for unsolicited manuscripts, photographs, art, and other material. Unsolicited material will not be returned. Address correspondence to Veterinary Medicine, 8033 Flint, Lenexa, KS 66214; (913) 871-3800; e-mail [email protected]. To subscribe, call toll-free 888-527-7008. Outside the U.S. call 218-740-6477. 43 dvm360.com | Veterinary Medicine | February 2014 | mbcyyelaaallcgonkewnta ES384401_vetm0214_043.pgs 01.29.2014 22:02 ADV LETTERS Brief Summary of Prescribing Information Table 2: Number of Dogs* with Adverse Reactions Reported During the Field Study with CONVENIA. Active Adverse Reaction CONVENIA Control (cefovecin sodium) (n=157) (n=163) Antimicrobial for Subcutaneous Injection in Dogs Lethargy 2 7 and Cats Only Anorexia/ Decreased Appetite 5 8 CAUTION: Federal (USA) law restricts this drug to Vomiting 6 12 use by or on the order of a licensed veterinarian. Diarrhea 6 7 INDICATIONS: Blood in Feces 1 2 Dogs Dehydration 0 1 CONVENIA is indicated for the treatment of skin Flatulence 1 0 infections (secondary superficial pyoderma, Increased Borborygmi 1 0 abscesses, and wounds) in dogs caused by *Some dogs may have experienced more than one susceptible strains of Staphylococcus intermedius adverse reaction or more than one occurrence of and Streptococcus canis(Group G). the same adverse reaction during the study. Cats Mild to moderate elevations in serum γ-glutamyl CONVENIA is indicated for the treatment of skin trans-ferase or serum alanine aminotransferase infections (wounds and abscesses) in cats caused were noted post-treatment in several of the by susceptible strains of Pasteurella multocida. CONVENIA-treated dogs. No clinical abnormalities were noted with these findings. CONTRAINDICATIONS:CONVENIA is contraindicated in dogs and cats with known allergy to cefovecin One CONVENIA-treated dog in a separate field or to β-lactam (penicillins and cephalosporins) study experienced diarrhea post-treatment lasting group antimicrobials. Anaphylaxis has been 4 weeks. The diarrhea resolved. reported with the use of this product in foreign market experience. If an allergic reaction or Cats anaphylaxis occurs, CONVENIA should not be A total of 291 cats, ranging in age from 2.4 months administered again and appropriate therapy (1cat) to 21 years, were included in the field study should be instituted. Anaphylaxis may require safetyanalysis. Adverse reactions reported in cats treatment with epinephrine and other emergency treatedwith CONVENIA and the active control are measures, including oxygen, intravenous fluids, summarizedin Table 3. intravenous antihistamine, corticosteroids, and Table 3: Number of Cats* with Adverse Reactions airway management, as clinically indicated. Reported During the Field Study with CONVENIA. Adverse reactions may require prolonged treatment Breed tendency or due to the prolonged systemic drug clearance (65 Active days). Adverse Reaction CONVENIA Control (n=157) (n=163) WARNINGS: Not for use in humans. Keep this and all drugs out of reach of children.Consult a Vomiting 10 14 compulsive disorder? physician in case of accidental human exposure. Diarrhea 7 26 For subcutaneous use in dogs and cats only. Anorexia/ Antimicrobial drugs, including penicillins and Decreased Appetite 6 6 cephalosporins, can cause allergic reactions in Lethargy 6 6 sensitized individuals. To minimize the possibility Hyper/Acting Strange 1 1 I am a veterinary internist and see how excited a of allergic reactions, those handling such Inappropriate Urination 1 0 antimicrobials, including cefovecin, are advised to *Some cats may have experienced more than one who has owned Labrador dog gets. Labradors make avoid direct contact of the product with the skin adverse reaction or more than one occurrence of and mucous membranes. the same adverse reaction during the study. retrievers since childhood successful assistants for PinR tEhCeA aUbTseIOnNceS :ofP are psrcorvibeinn go r asntrtoibnagclyte sruiaslp dercutegds Fsotuudry C OANLTV E(N1I Ac acsaes esw haasd emleilvdalyt eedle vpartee-ds tpuodsyt)-. and read with interest the disabled because they bacterial infection is unlikely to provide benefit to No clinical abnormalities were noted with these treated animals and may increase the risk of the findings. “Just Ask the Expert: In- can be easily trained to development of drug-resistant animal pathogens. Twenty-four CONVENIA cases had normal hibiting a Lab’s infatuation retrieve items. The safe use of CONVENIA in dogs or cats less pre-studyBUN values and elevated post-study tahnaimn a4l sm hoansth nso ot fb aegeen adnedt einrm birneeedd. inSga foert yla hcatas tninogt 6B UCONN vVaEluNeIsA ( 3c7a–s3e9s mwgit/hd Ln opromsta-ls pturdey- )a. nTdhe mreil dwlye rtoe with its toy ball” in the I think this dog just bloenegn- teesrmta belfifsehcetds ofonr iInMje cotri oIVn saidtemsi nhiasvtrea ntiootn b. Teheen Tmwood eorfa ttehleys eele cvaasteeds paolssot- shtuaddy a cnr eealetinvaintee dv apluoesst-. June 2013 issue. T is was hasn’t been trained dtheete brmodinye, da. pCpOrNoxViEmNaItAel yis 6s5lo wdalyy se liims innaeteedde fdro tmo swtuitdhy t hBeUsNe .f iNndoi ncglisn.ical abnormalities were noted immediately diagnosed properly. I’d advise the eliminate 97% of the administered dose from the body. Animals experiencing an adverse reaction One CONVENIA-treated cat in a separate field as a canine compulsive owners never to accept may need to be monitored for this duration. study experienced diarrhea post-treatment lasting CONVENIA has been shown in an experimental 42 days. The diarrhea resolved. disorder. But I think this and then toss the ball in vitrosystem to result in an increase in free FOREIGN MARKET EXPERIENCE: The following concentrations of carprofen, furosemide, doxycycline, adverse events were reported voluntarily during is a breed-related behav- from anyplace they don’t and ketoconazole. Concurrent use of these or post-approval use of the product in dogs and cats other drugs that have a high degree of protein- in foreign markets: death, tremors/ataxia, seizures, ior and quite normal in want play to occur. I binding (e.g. NSAIDs, propofol, cardiac, anticonvulsant, anaphylaxis, acute pulmonary edema, facial edema, andbehavioral medications) may compete with injection site reactions (alopecia, scabs, necrosis, Labrador retrievers. know what a slimy, dirt- cefovecin-binding and cause adverse reactions. and erythema), hemolytic anemia, salivation, pruritus, lethargy, vomiting, diarrhea, and inappetance. For generations, Labra- covered tennis ball feels Positive direct Coombs’ test results and false positive reactions for glucose in the urine have been For a copy of the Material Safety Data Sheet, reported during treatment with some cephalosporin (MSDS) or to report a suspected adverse reaction dor retrievers have been like when dropped in my antimicrobials. Cephalosporin antimicrobials may call Zoetis Inc. at 1-888-963-8471. also cause falsely elevated urine protein selected for the drive to clean lap. Even dropping determinations. Some antimicrobials, including STORAGE INFORMATION: cephalosporins, can cause lowered albumin Store the powder and the reconstituted product in retrieve, also known as the ball in disgust will values dueto interference with certain testing theoriginal carton, refrigerated at 2° to 8° C (36° to methods. 46° F). Use theentire contents of the vial within 56 prey drive: Get the bird, reinforce the retrieving days of reconstitution.PROTECT FROM LIGHT. Occasionally, cephalosporins and NSAIDs have After each use it is important to return the unused been associated with myelotoxicity, thereby creating portion back to the refrigerator in the original bring it back, get the next behavior. Balls should not a toxic neutropenia4. Other hematological reactions carton. As with other cephalosporins, the color of seen with cephalosporins include neutropenia, the solution may vary from clear to amber at bird, bring it back. T is be allowed in the house if anemia, hypoprothrombinemia, thrombocytopenia, reconstitution and may darken over time. If stored prolonged prothrombin time (PT) and partial as recommended, solution color does not adversely behavior is easily trans- that is of -limits. Playtime thromboplastin time (PTT), platelet dysfunction affect potency. and transient increases in serum aminotrans- ferred to toys. In fact, should take place in an ferases. HOW SUPPLIED: ADVERSE REACTIONS: cCoOnNtaViEnNinIgA i8s0 a0v amiliallbigler aams sa 1o0f mceL fmovueltci-iuns ea sv iaal dog trainers seeking good acceptable location, and Dogs lyophilized cake. A total of 320 dogs, ranging in age from 8 weeks candidates for search- then the ball should be to 19 years, were included in a field study safety NADA# 141-285, Approved by FDA analysis. Adverse reactions reported in dogs and-rescue and drug or put away until next time. treated with CONVENIA and the active control are summarized in Table 2. Distributed by explosive detection get Clever Labradors may Zoetis Inc. January 2013 Kalamazoo, MI 49007 PAA035845A&P out a tennis ball, toss it, go of and select an- 44 | February 2014 | Veterinary Medicine | dvm360.com mbcyyelaaallcgonkewnta ES384466_vetm0214_044.pgs 01.29.2014 22:04 ADV mbcyyelaaallcgonkewnta ES381156_VETM0214_045_FP.pgs 01.27.2014 17:22 ADV LETTERS CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: NEXGARD™ (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5- [3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N-[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl. Indications: NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of American Dog tick (Dermacentor variabilis) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month. Dosage and Administration: NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg). Dosing Schedule: other item (e.g. stick, toy, the characteristics that Body Afoxolaner Per Chewables Weight Chewable (mg) Administered shoe) to play with, but if distinguish a compul- 4.0 to 10.0 lbs. 11.3 One 10.1 to 24.0 lbs. 28.3 One ignored the behavior will sive disorder from these 24.1 to 60.0 lbs. 68 One 60.1 to 121.0 lbs. 136 One become extinct. Using breed inclinations is Over 121.0 lbs. Administer the appropriate combination of chewables a crate to enforce “time the degree to which the NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose, and ttrheaatt aendy a onfi mthaels d sohsoeu hlda sb bee oebns elorsvte do rf oifr vao mfeiwtin mg ioncucteusrs t ow eitnhsinu rtew toh ahto puarsrt o off a tdhme idnoisster aisti onno,t rleodsot soer rweiftuhs eadn.o Itfh ietr i sfu sllu dspoesect. eIfd out” can be helpful. animal engages in the a dose is missed, administer NEXGARD and resume a monthly dosing schedule. Flea Treatment and Prevention: T is case also illus- behavior and the ease Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly treatment with NEXGARD should continue the entire year without interruption. trates the need for vet- with which the behavior To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product. Tick Treatment and Control: erinary guidance on our can be redirected. Treatment with NEXGARD may begin at any time of the year (see Effectiveness). Contraindications: clients’ breed selections. In the case of a true There are no known contraindications for the use of NEXGARD. WNoat rfnoirn ugsse: in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a Labradors want to get compulsive disorder, physician immediately. Precautions: wet and retrieve. Border the behavior will occur The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures (see Adverse Reactions). collies want to stare, nip, often—to the point where Adverse Reactions: In a well-controlled US field study, which included a total of 333 households and 615 treated dogs (415 administered afoxolaner; 200 administered active control), no serious adverse reactions were observed with NEXGARD. and herd. Gordon setters most other day-to-day Over the 90-day study period, all observations of potential adverse reactions were recorded. The most frequent reactions reported at an incidence of > 1% within any of the three months of observations are presented in the following table. The want to run. Border ter- activities are excluded— most frequently reported adverse reaction was vomiting. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses in both groups. Five treated dogs experienced anorexia during the study, and two of those dogs experienced anorexia with the first dose but not subsequent doses. riers want to dig. Beagles and it can be dif cult to Table 1: Dogs With Adverse Reactions. Treatment Group want to bark. stop it. I think Labs that Afoxolaner Oral active control N1 % (n=415) N2 % (n=200) For dogs with true engage in retrieval as Vomiting (with and without blood) 17 4.1 25 12.5 compulsive disorders, the described in the article Dry/Flaky Skin 13 3.1 2 1.0 Diarrhea (with and without blood) 13 3.1 7 3.5 article was otherwise great! are beyond normal in this Lethargy 7 1.7 4 2.0 Anorexia 5 1.2 9 4.5 degree of the behavior. I 1Number of dogs in the afoxolaner treatment group with the identified abnormality. 2Number of dogs in the control group with the identified abnormality. Autumn Davidson, DVM, think that your approach In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the first dose arencde oivnin tgh eth sea mtheir dd adyo saeft.e Trh ree cdeoigv irnegm tahien esedc eonnrdo ldleods ea nodf NcoEmXGplAeRteDd. tThheis s dtuodgy e. xApneortiheenrc eddo ga wthiitrhd as ehiizsutorery o onfe s weiezeukre asf theard a MS, DACVIM to managing the behavior seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study. A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study. UC-Davis School of closely resembles how To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at 1-888-637- 4co2n5t1a octr FwDwAw a.tm 1e-r8i8a8l.-cFoDmA/-nVeExTgSa rodr. oFnolri naed daitt ihotntapl: /i/nwfowrmwa.ftdioan.g aobvo/Autn aimdvaelVrseete drrinuagr ey/xSpaefreietnyHcee areltpho/rPtriondgu fcotrS aanfeimtyaInl fdorrumgsa,t ion. Veterinary Medicine a compulsive disorder Mode of Action: Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine ligand-gated Davis, Calif. would be approached. chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA), thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes. Prolonged afoxolaner-induced hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines. The selective toxicity of afoxolaner Remember also that between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors. Dr. Ciribassi responds: behavior is never black- Effectiveness: In a well-controlled laboratory study, NEXGARD demonstrated 100% effectiveness against adult fleas 24 hours post- infestation for 35 days, and was ≥ 93% effective at 12 hours post-infestation through Day 21, and on Day 35. On Day 28, T ank you for the and-white or of -and-on. NEXGARD was 81.1% effective 12 hours post-infestation. Dogs in both the treated and control groups that were infested wtreitaht eflde adso gosn, Danady -41- 9g0e neegrgast eadn dfl e0a-1 e1g8g esg agts 1 i2n- tahned c 2o4n-throolu drso gpso,s at-tt 1re2a- tamnedn 2t 4(0-h-1o1u resg, gress apnedc t1iv-1e7ly )e. gAgts s iunb tsheeq NueEnXtG ARD thoughtful response. I It is always several shades evaluations post-infestation, fleas from dogs in the treated group were essentially unable to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs). agree that certain behav- of grey (no reference to a In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively. iors can be breed-specif c popular book intended), Collectively, the data from the two studies (one laboratory and one field) demonstrate that NEXGARD kills fleas before they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations. In well-controlled laboratory studies, NEXGARD demonstrated >97% effectiveness against Dermacentor variabilis 48 hours in terms of tendencies to and the challenge with post-infestation for 30 days. Animal Safety: engage in the activity. An this specialty is deter- In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to example is cattle dogs that mining what end of the treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar revert to biting owners’ spectrum the patient is incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment. In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed heels in an attempt to pre- leaning toward. from the concomitant use of NEXGARD with other medications. Storage Information: vent them from leaving Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F). HNoEXwG SARuDpp ilsi eavda:ilable in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each chewable home; border collies can John Ciribassi, DVM, size is available in color-coded packages of 3 or 6 beef-flavored chewables. herd in the same context. DACVB NADA 141-406, Approved by FDA MDualrukteht, eGdA b y3:0 F0r9o6n-t4li6n4e0 V UeSt ALabs™, a Division of Merial Limited. While I agree that Chicagoland Veterinary M10a50d-e4 4in9 3B-0ra0zil. these tendencies do tend Behavior Consultants Rev. 7/2013 ™LNAEBXSG aArReD t raandde mFRaOrkNs ToLfI NMEe VriEaTl. to follow breed lines, Carol Stream, Ill. ©2014 Merial. All rights reserved. 46 | February 2014 | Veterinary Medicine | dvm360.com bcyyelaallconkw ES384465_vetm0214_046.pgs 01.29.2014 22:04 ADV NEW! It’s a soft chew. Kills BOTH fleas and ticks. It’s prescription only. NexGardTM (afoxolaner) is the protection you asked for, and patients will beg for. NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill the American dog tick. NexGard is available only with a veterinarian’s prescription, and features anti-diversion technology monitored by Pinkerton® Consulting & Investigations. IMPORTANT SAFETY INFORMATION: For use in dogs only.  The most ®FRONTLINE is a registered trademark, and common adverse reaction is vomiting.  Other adverse reactions TMNEXGARD and FRONTLINE VET LABS are reported are dry/flaky skin, diarrhea, lethargy, and anorexia.  The trademarks, of Merial. ®PINKERTON is a registered trademark of Pinkerton Service safe use of NexGard in pregnant, breeding, or lactating dogs has not Corporation. ©2014 Merial Limited, Duluth, GA. been evaluated. Use with caution in dogs with a history of seizures. All rights reserved. NAX14TRADEAD (01/14). See brief summary on page 46. mbcyyelaaallcgonkewnta ES381152_VETM0214_047_FP.pgs 01.27.2014 17:22 ADV LETTERS New heartworm Clarifi cation guidelines and In the article “DIY physical therapy for patients incidence survey with patella and cruciate injuries” in the De- cember 2013 issue, we should not have used the term physical therapy to apply to veterinary T e American Heartworm Society patients since this term is only applicable to li- recently updated their guidelines for censed physical therapy professionals and usually preventing and treating heartworm only used for human patients. Instead, we should disease in dogs and cats. Get the de- have used the term veterinary rehabilitation. tails at dvm360.com/AHS2014. Also be on the lookout for the AHS We apologize for any confusion this error may heartworm incidence survey coming have caused. And we thank Janet Van Dyke, to your clinic mailbox. T e deadline DVM, DACVSMR, president of the American for f lling out the survey is Feb. 28, Association of Rehabilitation Veterinarians, for 2014, so make sure you participate to pointing out the error. get the true scope of the current inci- dence rates through the country. Seeking participants for mast cell tumor drug trial T e University of Exclusion criteria Tennessee Veterinary 1. Pretreatment with che- Medical Center Oncology motherapy or radiation Department announces a 2. Tumor recurrence new clinical trial for the after surgery evaluation of masitinib 3. Dogs with history of pro- mesylate for nonresect- tein losing-enteropathy able grade II and III mast 4. Dogs with history cell tumors in dogs. Dog of renal disease with owners must bring their proteinuria or protein- dogs in for a screen- losing nephropathy ing visit to determine 5. Dogs with concomitant whether the dogs can be serious disease (life ex- enrolled in the study. pectancy < 3 months) Eligibility For more informa- Dogs weighing more than tion, contact Dr. Olya 6.9 kg diagnosed with a Smrkovski, DACVIM nonresectable mast cell (oncology), by e-mail tumor measuring > 1 cm ([email protected]) or in the longest diameter. phone (865-974-8387). 48 | February 2014 | Veterinary Medicine | dvm360.com mbcyyelaaallcgonkewnta ES384479_vetm0214_048.pgs 01.29.2014 22:04 ADV

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Senior Vice President | Tracy Harris By Philip I. Allen, DVM; David S. Biller, DVM, DACVR; and Michael S. T sure, tachycardia, pale mucous.
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