Clinical skills and knowledge used by veterinary graduates during their first year in small animal practice.

OBJECTIVE: To determine the clinical skills and areas of knowledge used by veterinarians in small animal practice during their first year after graduation and the degree of assistance and supervision they received while developing these skills. DESIGN: A postal survey was sent in December 1999 to 59 veterinarians who completed their training at Murdoch University in December 1998. PROCEDURE: The first part of the survey asked for information on veterinary work patterns since leaving university. The second part consisted of a list of diagnostic and therapeutic skills of varying complexity and the graduates were asked to indicate whether they had used these skills in practice and whether they had been assisted or supervised while doing them. The respondents were also asked if they had had the opportunity to practise these skills as undergraduates at university or during extramural experience. In the third part the areas of knowledge used in practice were assessed by analysis of a series of consecutive cases. RESULTS: Forty replies were received but since three graduates had done no small animal work the analysis of the skills section is based on 37 responses. Thirty graduates supplied information on 994 canine cases and 308 feline cases. The distribution of the mean work time was dogs and cats 69%, horses 13%, farm animals 11%, birds 3% and others 4%. Skills used by over 90% of graduates included general anaesthesia, examination of the tympanic membrane, taking and interpreting an abdominal radiograph, catheterising a male cat, fine needle aspiration of a mass, neutering dogs and cats, tooth scaling and extraction and treating an aural haematoma. The survey also identified the opportunities for undergraduates to practise some of these skills during extramural experence and the extent of assistance given to new graduates during their first year in practice. The areas of knowledge used in over 10% of the cases included vaccination, anaesthesia/sedation, skin/coat problems, general advice on pet health, neutering and musculoskeletal diseases. CONCLUSION: Veterinarians, in their first year after graduation, use a wide range of complex diagnostic and therapeutic skills. Although many of these skills are acquired during the undergraduate training, a significant contribution is made by extramural practical work undertaken during the clinical years of the undergraduate course and in the first year following graduation. Practising veterinarians play an important role in providing opportunities and supervision for clinical training.

Surgical repair of fracture of the os penis in a dog.

An eight-year-old male Australian cattle dog cross was presented with complete urethral obstruction secondary to fracture of the os penis which had occurred two years earlier. Obstruction was associated with callus and fibrous tissue proliferation compressing the urethra at the fracture site. The problem was satisfactorily resolved by removing excess bone and fibrous tissue and stabilising the fracture with a stainless steel finger plate.

Long-term survival of four dogs with disseminated Aspergillus terreus infection treated with itraconazole.

Four dogs with disseminated aspergillosis caused by Aspergillus terreus were treated with oral itraconazole for 190 to 1095 days. Infection was eliminated in 1 dog. Two dogs were treated for 1000 and 1095 days but were eventually euthanased 572 and 485 days after treatment was stopped. At necropsy both dogs had widespread aspergillosis. The fourth dog was euthanased for other reasons after 190 days of treatment when it was showing a good clinical response although there was radiographic evidence that the disease was progressing.

Coping with blindness: a survey of 50 blind dogs.

A telephone survey of 50 owners of blind dogs was made in order to assess how well visually deprived dogs can cope within their environment. Ten of the 50 dogs surveyed died or were euthanased as a direct result of their blindness or ocular disease. Three owners were unable to come to terms with their pet's visual loss. Two dogs died as a result of accidents directly associated with blindness and five dogs were euthanased due to pain caused by glaucoma. Twenty-seven owners reported permanent behaviour or temperament changes in their pets. Behavioural changes included a more cautious approach to the environment and closer contact with the owner. Owners were aware of an obvious compensatory reliance on the senses of hearing and smell. Permanent temperament changes were reported in only two dogs both of whom became more aggressive. Only six of the surveyed dogs were unable or unwilling to find their way around in familiar surroundings. The most consistent measures undertaken by owners to ensure the dogs' safety was to prevent access to roads and to ensure that there was minimal movement of furniture within the home. Six dogs lost interest in exercise after the onset of blindness but a further six were still allowed to roam at large. Of the 32 owners who accompanied their dogs eight reported that restraint on a lead was unnecessary. Twenty-eight owners had encountered people who had suggested it was unkind to keep a blind dog.

Complement C4 allotype association with and serum C4 concentration in an autoimmune disease in the dog.

Serum C4 concentrations and C4 allotypes were determined wherever possible on eight dogs with an autoimmune disorder characterized by antinuclear antibody (ANA) positivity, pyrexia, and seronegative arthritis. Three of the six dogs tested serially showed hypocomplementemia at disease onset with return to normal concentrations with clinical remission following steroid therapy. All five dogs C4 allotyped were phenotypically identical. The phenotype (C4-4) was significantly increased in the diseased dogs. Thus C4 allotype may provide a marker for susceptibility to development of an autoimmune disorder in the dog. Serum C4 concentrations may help in disease diagnosis and monitoring the effectiveness of therapy.

New declotting catheters for arterio-venous shunts.

Clotting is a serious problem in patients with A-V shunts. Balloon Embolectomy catheters or irrigating devices are frequently unsuccessful in declotting shunts, resulting in surgical revision of the shunt. Frequent surgical revisions reduce sites of vascular access, making it difficult to perform adequate hemodialysis. New instruments, constructed mainly of stainless steel, have been devised and used to declot A-V shunts. The instruments have been devised for specific purposes and labeled as follows: (1) Explanding Mesh, (2) Helix and (3) Rotating Cutter. These instruments will dislodge and remove organized clots, snare and cut fibrin "flaps", open and enlarge the vessel lumens. They have been used successfully in removing vascular obstructions adjacent to the vessel tips of the shunt or at the site of anastamosis of the shunt and vessel. These are the most common sites of obstruction. By prolonging shunt life we have been able to decrease the number of shunt revisions.

Dynamic pulmonary compliance as a measurement of lung function in dogs.

Measurement of the dynamic pulmonary compliance was carried out on 27 normal dogs weighing 11-8 to 26-4 kg Variations in the results of repeated observations and difficulties in allowing for differences in lung size between dogs limited the usefulness of the measurement as a test of lung function. Pulmonary compliance was found to correlate better with trunk length than with bodyweight or chest circumference. The mean value for dynamic pulmonary compliance measured during inspiration in 27 normal dogs was 0-117 litre/cmH20 with a standard deviation of 0-046 litre/cmH2O. Measurements were made on six dogs with clinical respiratory disease.