Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges.

Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative.

Effect of gonadotropin-releasing hormone on clinical response and fertility in cows with cystic ovaries, as related to milk progesterone concentration and days after parturition.

We gave gonadotropin-releasing hormone (GnRH) or an analog of GnRH to 264 lactating cows with cystic ovaries. The effects of milk progesterone concentration (MPC) and days after parturition (DAP) at diagnosis on clinical response 30 days after treatment and on subsequent fertility were examined. Palpation per rectum revealed ovarian cysts in 264 cows; 118 had true follicular cysts (MPC less than 1 ng/ml). Clinicians with more than 3 years of experience reported significantly more true cysts than did less experienced clinicians. Clinical response 30 days after treatment did not differ in 3 groups of cows (divided on the basis of MPC at treatment), but fewer cows with MPC less than 1 ng/ml were bred or conceived than were cows with MPC greater than or equal to 33 ng/ml. Days after parturition at diagnosis did not affect 30-day clinical response rate, but cows treated less than 35 DAP had significantly more days to first estrus and to conception than did cows treated greater than 90 DAP. Significantly more cows treated less than 35 DAP had MPC less than 1 ng/ml at treatment.

Pyelonephritis in cows: 15 cases (1982-1986).

Medical records of 15 adult cows with a final diagnosis of pyelonephritis were evaluated retrospectively. Only 3 cows had obvious clinical signs that indicated urinary tract disease. Physical examination, including rectal and vaginal examinations, and urine chemical reagent strip screening detected abnormalities in all 15 cows and allowed subsequent confirmation by culture results of urine samples obtained using a catheter. Bacteriologic cultures of urine revealed Corynebacterium renale infection in 6 cows and Escherichia coli infection in 9 cows. Long-term treatment with antimicrobial drugs resulted in recovery in 9 of 11 treated cows. Of these, 4 of 4 cows with C renale infection and 5 of 7 cows with E coli infection recovered; the remaining 2 cows with E coli infection died.

Thrombocytopenia associated with acute bovine virus diarrhea infection in cattle.

Thrombocytopenia was observed in 15 of 146 cases of clinically acute bovine viral diarrhea virus (BVDV) infection in adult cattle. Platelet counts ranged from 2,000 to 33,000/microliters. Clinically, a bleeding tendency was manifested by bloody diarrhea, petechial and ecchymotic hemorrhage, epistaxis, and abnormal bleeding from injection sites. Coagulation testing (six cases) gave no evidence of disseminated intravascular coagulation. Bone marrow aspirates were suggestive of active marrow necrosis (two cases) or recent repopulation (three cases). Treatment, when given, was supportive and empirical in nature. Six animals experienced complete clinical recoveries; the others died or were euthanatized. Although the pathogenesis of the thrombocytopenia was not definitively determined, thrombocytopenia associated with acute BVDV infection should be considered in the differential diagnosis for cattle with bleeding disorders.

Successful management of malignant edema caused by Clostridium septicum in a horse.

The clinical course and successful therapeutic management of a horse with malignant edema caused by Clostridium septicum is described. This is believed to be the first report of a horse surviving malignant edema caused by C. septicum. A discussion of this disease syndrome, including etiology, pathogenesis, clinical signs, therapy, and diagnostic methods is presented.

A randomized double blind clinical trial of two GnRH analogs for the treatment of cystic ovaries in dairy cows.

A randomized double blind clinical trial was conducted to compare the efficacy of the gonadotrophin-releasing hormone, buserelin, to that of the hormone gonadorelin for the treatment of bovine ovarian cysts. Two hundred and sixty five cows with a clinical diagnosis of follicular cysts were included in the study. At 30 days post treatment 85% of the gonadorelin and 89% of the buserelin treatment groups no longer had a palpable ovarian cyst. No significant differences were found between treatment groups in the number of cows bred by 90 days post treatment, conception rate by 90 days post treatment, services per conception, milk progesterone at 30 days post treatment, days post treatment to first heat, and days post treatment to conception.

Cryptosporidiosis associated with bacterial enteritis in a goat kid.

A 7-day-old male Nubian-Alpine crossbred goat was examined because of listlessness, anorexia, and diarrhea. The presumptive diagnosis was severe enteritis. Large numbers of Clostridium perfringens and a non-pathogenic heavily encapsulated Escherichia coli were isolated from the feces. Cryptosporidium parvum was identified on the qualitative fecal examination. The kid improved after treatment with fluids and antibiotics.

Cellulitis and subcutaneous abscesses caused by Rhodococcus equi infection in a foal.

Cellulitis and subcutaneous abscess formation was diagnosed in a 3-month-old Thoroughbred filly. Clinical signs consisted of a large ulcerated plaque, with satellite pustules on the medial aspect of the right hock and subcutaneous abscesses in the right inguinal and mammary gland areas. Laboratory analysis revealed mature neutrophilia. Rhodococcus equi was isolated from the cellulitis and the subcutaneous abscess. Oral administration of erythromycin and rifampin for 35 days resulted in a clinical cure.

Bovine virus diarrhea--clinical syndromes in dairy herds.

Bovine Virus Diarrhea (BVDV) was diagnosed as the major etiological agent in 10 dairy herd disease outbreaks. The outbreaks varied between herds in time of onset in individual cattle, signs, morbidity, and clinical course. A definitive diagnosis was obtained by viral isolation from whole blood samples in each herd. Each herd problem and its clinical course was described in detail. A discussion of current knowledge pertaining to BVD--the disease and the virus--follows. The importance of strain variation relative to disease production and prophylaxis was highlighted.

Whipworm (Trichuris discolor) infection in dairy replacement heifers.

Trichuriasis caused by Trichuris discolor was diagnosed in a 19-month-old Holstein heifer examined because of emaciation, diarrhea, recumbency, and oral ulceration. The heifer's problem was representative of a herd problem involving pastured replacement heifers. Euthanasia was elected due to the heifer's moribund state and poor prognosis. Gross necropsy revealed subcutaneous edema and diffuse edema of the colon, with hundreds of adult Trichuris discolor in the cecum and colon. Histologic examination revealed multifocal subacute necrotizing colitis, with many adult Trichuris discolor embedded in the mucosa. Treatment instituted on the farm consisted of levamisole hydrochloride at a dosage of 6 mg/kg of body weight. Favorable response was documented by clinical improvement and elimination of fecal shedding of trichurid eggs.

Presumptive organophosphate-induced delayed neurotoxicity in a paralyzed bull.

A case of presumptive organophosphate-induced delayed neurotoxicity in a bull is described. All signs were referable to a focal cervical or diffuse spinal cord lesion. These included recumbency with severe symmetrical paresis of all 4 limbs, the hind limb involvement being greater than the forelimbs. CSF analysis was normal. The bull was killed and necropsied. There were no gross CNS lesions. Histopathologic finds are characterized and their resemblance to lesions observed in delayed neurotoxicity caused by organophosphate compounds is discussed. The bull had been treated with organophosphate insecticide (famphur) 43 days prior to the onset of signs.

Cranial tumors in aged cattle causing Horner's syndrome and exophthalmos.

An 11-year-old Jersey cow and a 9-year-old Holstein cow were examined for complaints of progressive exophthalmos. Additionally, signs of unilateral Horner's syndrome and reduced air movement through the nasal passages on the affected side were observed. In both cases, a poor prognosis was given due to suspected neoplasia. At 2 and 6 months, respectively, after initial examination, these cows were killed and post mortem examinations of the affected tissues were performed. The diagnosis for the Jersey was sclerosing respiratory epithelial adenocarcinoma and for the Holstein was squamous cell carcinoma. The clinical signs, differential diagnosis, and the progression of the disease were discussed.