Queensland News - Australian Veterinary Association

AVA Queensland News - August 2009President’s WordCongratulations and many thanks to the membersof the Executive for their time and energy taken toimplement and conduct the authorised implantingcourses around the State.It is also timely to remind members of the importanceof reading material sent by the Government. Theprofession is taking on a serious responsibility anda leading role in correct animal identification andmanagement for a civil benefit.It has been somewhat mystifying that some memberscould not see past the placement of the transponderswhen the purpose is to gain an understanding of theAnimal Management (Cats and Dogs) Act 2008. Proofof understanding the Act is part of the legislation’srequirements.Our profession is well positioned to provide both themicrochipping service and the education of cat anddog owners on the benefits and legal responsibilitiesfor better pet management.While referring to Government, there has beenpositive feed back from the Infectious DiseaseControl (IDC) Seminars. There is financial supportfrom the State Government via the Department ofPrimary Industries and Fisheries and QueenslandHealth, including presentations by their staff whichare duly appreciated.It is important that veterinarians lead the way forcontinued revision of IDC because zoonotic diseasesare on the rise and affecting global health.Recently, the Queensland Division conducted a mailoutto lapsed members and we have been informedthat the response was very encouraging, so a verywarm thank you to those involved and welcome back.The AVA president Dr Mark Lawrie and the National CEOGraham Catt are presently on a fact finding missionto the American Veterinary Medical Association andcalling on the New Zealand Veterinary Association onthe way home. We look forward to hearing about thistrip at the forthcoming strategic planning weekend inTownsville. The Executive hopes to hear of ways tobring more benefits to our members.On behalf of the Queensland Division, I would remindevery one that at the Queensland office we appreciatebeneficial input from colleagues – so, whether youare in government, industry, academia, the suburbsor the paddock, please keep those e-mails coming.All the best for now.Dr Bruce PottDr Bruce Pott - PresidentEditor’s NoteIn this issue, we are fortunate to have papers fromDrs Brad Gavaghan on diagnosing the coughingdog and the situation on technology in cardiology,Ross McKenzie on poisoning of pets by commongarden plants (and big hairy spiders), and from BruceRemington on the surprising scarity of wild birdssurveyed by the booming free range meat chickenindustry.Dr Gavaghan’s papers are sourced from the annualconference of the Division held at Yeppoon 20-22March 2009. Those interested may obtain a copyof the proceedings from the Divisional office. DrsMcKenzie and Remington’s papers were given atmeetings of the South East Queensland Branch.The papers are reproduced in the News as a serviceto those members who were unable to attend themeetings and to give an idea of activities happeningwithin the Division. If other Branches or SpecialInterest Groups would like articles published in theNews you are cordially invited (exhorted) to send themin, whether they are technically or socially oriented. Iam aware that many groups run their own newsletter.The News is an opportunity to extend information tothe general membership.1

AVA Queensland News - August 2009Continued from pg. 36. Sighting numbers in the month:-Less than 5 = 85%Less than 10 = 12%More than 10 = 3% (mainly Mynahs).7. Problem species:-Pigeons: Two farms with fewer than 5 birds for one and two monthsIbis: One farm with fewer than 5 for two weeksParrots: One farm with fewer than 10 for less than a month (we speculate that there was a tree in fruit/flower).DiscussionOf great interest are the reasons why only low numbers were observed. The following are some suggestions:1. Different environment to the northern hemisphere, which is usually reported. Australia has a number ofdifferent habitats, most of which are different to those seen in the northern hemisphere. Also the type andnumbers of migrating birds are different in Australia.2. Broilers not layers. Maybe the information previously reported was on layer farms. Layer farms operateon a continuous production basis while the broiler farms surveyed operated on a batch basis wherechickens are not on the range for significant periods.3. No feed or water is allowed on the ranges of FREPA certified farms. This is probably the most importantreason. If wild birds have no reason to be on the range, then they are not attracted. Feed is only providedin the connecting housing. Also no water, either drinking or as ponds, is allowed on the ranges.4. The grass is always kept short for vermincontrol. Therefore there are no seeds orcover for wild birds. Studies at airportshave found that birds are discouraged byshort grass. Also the amount of mowingactivity may disrupt the wild birds’environment.5. All ranges are fenced to protect thechickens from predators. This may detersome wild birds.6. All of these commercial farms have almostconstant human activity during daylighthours. The presence of people workingin and around the facility may have adeterrent effect.Conclusions1. The situation in Australia with regard towild birds is different to overseas reports.2. Further work may be of benefit to findbetter ways to reduce wild bird intrusions.An example might be use of trees/bushesthat do not attract wild birds but grow inspecific environments.Most otitis externa treatmentsrequire two doses a day…With Mometamax®,it’s just one daily dose.Mometamax® is proven to alleviate clinical signs of otitisexterna in dogs and only requires once-daily administration.To help ensure your clients and their dogs receive convenient,safe and efficacious treatment against otitis externa, prescribethe simple once-daily treatment, Mometamax®.Contact your local Territory Manager directly or on1800 033 461MOMETAMAX® ONCE DAILY • NEW MOMETAMAX® ONCE DAILY • NEW MOMETAMAX® ONCE DAILY • NEW MOMETAMAX®4

AVA Queensland News - August 2009Common Household & Garden Plants & Fungi Poisonous to Pets inQueenslandDr Ross A. McKenzie PSM DVScSpecialist in Veterinary Pathobiologyyapunyah.house@bigpond.comBackgroundQueensland Health was concerned about the labeling of potentially harmful plants sold in nurseries. A broadbasedcommittee was formed to assess the issue – with a particular focus on child health. Among other things,veterinary practices were surveyed to answer the question “How much plant poisoning actually happens inQueensland pet animals?”Outcome: Self-regulation by Australian nursery industry; labeling guidelines issued to members. Available athttp://www.ngia.com.au/AcknowledgementsAdvice on selecting surveyed practices: Aaron Palmer, Judy Seton.Data from responding practices: Jocelyn Birch Baker, Mary Calder, Shannon Coyne, Adrienne Easton, PeterGardiner, Tom Gradwell, Carmel Griffen, Amy Hehir, Tracy Holland, Melanie Irvine, Isobel Johnstone, Terri King,Terry King, Graham Lauridsen, Peter Lyons, Lisa Mason, Greg Muir, Dick Murray, Peter Noble, Rowan Pert,Paul Sheedy, Caroline Spelta, Angela Steenholdt, Philip Thomas, Mary Thompson, Rob van Drimmelen, KurtVerkest, Laurie Wanstall.Pet animal background dataPet population, Queensland (calculated from ABS 1995, 2001 data)Dogs = 0.5 millionCats = 0.4 millionPet birds = 0.2 millionHuman population calculated as 4 million.Pet Plant PoisoningsFifty-three major veterinary practices were contacted in major cities/towns in Queensland in 2007 for plantpoisoning of pets in the five years 2002-2006. Of these 25 (47%) responded.Patient visits data: dogs: 500,000 = 100,000/yr, cats: 175,000 = 35,000/yr, birds: 24,000 = 5,000/yr.Pet plant poisonings diagnosed: Dogs: 289 cases = 58/yr = 0.06% of patient visits. Birds: 7 cases = 1/yr =0.03% of patient visits. Cats: 19 cases = 4/yr = 0.01% of patient visits.Plant Poisonings Of DogsLife-threatening poisonings (descending order of occurrence):Brunfelsia spp. (francisia, yesterday-today-and-tomorrow) fruits [36 cases]Onions (Allium cepa) [34]Cycad seeds (Cycas revoluta) [28]Duranta erecta (golden dewdrop, cv. Sheena’s Gold, cv. Geisha Girl, cv. Alba) [12]Cardiac glycoside-containers (oleanders etc.) [8]Grapes/raisins (Vitis vinifera) [3 cases]Lilium spp. (lilies) [3]Cyanobacteria [2]Tobacco (Nicotiana tabaccum) [2]Stinkhorn fungi (Order Phallales) [2]Avocado (Persea americana) [1]Rhododendron [1]Melia azedarach (white cedar) fruit [1]7

AVA Queensland News - August 2009Continued from pg. 7Minor poisonings (very small or no threat to life, descending order of occurrence:Macadamia kernels [83 cases]Cannabis sativa (marijuana) [62]Aroids (Dieffenbachia, Zantedeschia, etc.) [5]Other plants [4]Plant Poisonings Of CatsLife-threatening poisonings (descending order of occurrence):Lilium spp. (lilies) [13 cases]Brunfelsia spp. fruits [2]Cycad seeds [1]+ Duranta erecta [1 – Scanlan et al. 2006]Minor poisonings:Aroids [2]Cannabis sativa [1]Plant Poisonings Of BirdsLife-threatening poisonings (descending order of occurrence):Avocado (Persea americana) [6]Oleander (Nerium oleander) [1]+ Duranta erecta [3 – Scanlan et al. 2006]8

AVA Queensland News - August 2009Summary by Major Poisonous Plants and Toxins, Life-Threatening Poisonings:Brunfelsia spp. PoisoningBrunfelsia spp. (about 40 species; South American origin; Family Solanaceae).Known toxic species Brunfelsia australis (francisia, yesterday-today-and-tomorrow) in Australia, Brunfelsiapauciflora in North America & Australia, Brunfelsia latifolia in Australia.Conditions of poisoning: Fruits are toxic. Dogs attracted to ripe fruit will eat large amounts (April-June), fatalcases have had 40-100 fruits in stomach.Clinical signs: vomiting, diarrhoea, urination, ataxia, muscle tremor, convulsions (extensor rigidity, opisthotonus).Signs may also include excitement, nystagmus, stomatitis, haematuria.Pathological signs: gastroenteritis, fruits in faeces/stomach.Organosulphur compoundsAllium cepa (onion) toxic doses reported for dogs: 600-800 g raw onion (single dose) = 3-5 large onions (eachlarge bulb weighs about 170-200 g); or 15 + g raw onion/kg (400 + g for a 25 kg dog = 2 large onions) daily for2-3 days causes anaemia of sudden onset; or 11 g raw onion/kg (275 g for a 25 kg dog = about 1.5 large onions)daily for several days causes anaemia of gradual onset. Cooking does not destroy toxicity.Allium cepa (onion) toxic doses reported for cats: 28 g raw onion/kg (112 g for a 4 kg cat = about 1 mediumsizedonion) once daily for 3 days.Allium sativa (garlic) toxic doses reported for dogs: diet containing 7% raw garlic toxic to dogs; fed for 50 days;time to onset of anaemia not stated.Sources: kitchen and barbecue scraps; human meal residues; Chinese cuisine, pizza; baby food (onion powder).Syndrome: Heinz body haemolytic anaemia, haemoglobinuria.Cycad Seed PoisoningToxicant: Methylazoxymethanol (MAM), a glycone of cycad glycosides cycasin and macrozamin.Sources: any coning female cycad (dioecious taxa).Syndrome: Liver and alimentary necrosis.Duranta erecta Poisoning (Garden Or Hedge Shrubs)Dogs, cats, birds, cattle, kangaroos, humans.Fruits, leaves.Toxin unknown: large amounts required for toxicity.Dogs - clinical signs: depression (drowsiness, drooped eyelids), gum pallor; excessive salivation, bradycardia,melenic diarrhoea + plant fragments, tetanic convulsions from external stimuli, ± coma & death.Dogs - clinical pathology (2 dogs): no liver or kidney dysfunction.Dogs - necropsy (1 pup): plant material (fruits, leaves) in gastro-intestinal tract, stomach haemorrhage.Cardiac Glycoside PoisoningNerium oleander toxic dose:Dog: fresh leaf fatal at 50-220 mg/kg; cat: fresh leaf fatal at 40-50 mg/kg (1 fresh leaf = 1.5 g); 20 kg dog fataldose = 1-3 leaves, 4 kg cat fatal dose =

AVA Queensland News - August 2009Continued from pg. 9Clinical signs continue for several days to 3 weeks after ingestion, vomiting within hours of ingestion in allcases: vomitus contained partly-digested grape/raisin, anorexia (60% of cases), diarrhoea (50%), oliguria oranuria with or without isosthenuria (50%), lethargy (40%), signs of abdominal pain (30%), ± ‘uraemic’ odour ofexhalations.Lilium (lily) & Hemerocallis (day lily) poisoningToxicant unknown, possibly 3-methoxy-2(5H)-furanone.Sources: all parts of the plants (including flowers); gardens, potted plants, cut flowers.Toxic dose: Cat: < 1 leaf.Syndrome: nephrosis.Clinical signs: vomiting and hypersalivation, onset 0-3 hours after ingestion and may persist 4-12 hours,anorexia and depression continue and intensify 24-72 hrs after ingestion, ± polyuria; evident 12-30 hours afteringestion, ± anuria in untreated cats 24-48 hours after ingestion.Untreated cases die within 5 days.Tremors and seizures were reported in 8 (36%) of 22 cats ingesting Hemerocallis spp.Cyanobacterial toxinsMany algal blooms are non-toxic to animals, but all should be considered potentially toxic. Gene probes arebeing developed to differentiate toxic from non-toxic Microcystis.Cyanobacterial Peptide PoisoningSources: Microcystis aeruginosa and others.Syndrome: acute liver necrosis.Cyanobacterial Alkaloid NeurotoxinsToxicants (Australian cyanobacteria): paralytic shellfish toxins = sodium channel blockers. Anatoxin-a andhomoanatoxin-a are post-synaptic depolarising neuromuscular blocking agents which mimic acetylcholine;act at both nicotinic and muscarinic receptors. Toxicity causes paralysis of skeletal muscle and paralysis ofbreathing.Sources: Anabaena spp. and others.Syndrome: sudden death ± dyspnoea.Stinkhorn fungus poisoningSyndrome is variable – range of signs have included: vomiting and diarrhoea (± blood), ± miosis (pin-pointpupils), ± clotting defects (transient), ± liver damage (increased AST), collapse, respiratory and circulatorydepression, cyanosis.Death cap fungus poisoningToxicants: amatoxins (bicyclic octapeptides).Sources (Australia): Amanita phalloides under oak trees, some other Amanita species, Galerina, Lepiota.Syndrome: acute liver necrosis.Avocado poisoningToxicant: persin.Sources: All avocado parts except seeds; all cultivars in Australia.Toxic doses: Budgerigar ripe fruit lethal dose 50-100 g/kg (Hass & Fuerte) or 3-6g/bird (60g adult). Canary ripefruit lethal dose 100 g/kg (Hass); 2.5g/bird (25g adult).Syndrome: cage birds - sudden death; dogs – cardiac dysfunction (large repeated doses only).Azalea poisoningToxicant: andromedotoxin (grayanotoxin).Sources: Rhododendron species, other plants in Family Ericaceae.Toxic dose: lethal dose of leaves is as little as 0.2% body weight.10

AVA Queensland News - August 2009Continued from pg. 10Syndrome: emesis, cardiac dysfunction.Clinical signs: drooling saliva, vomiting, retching, diarrhoea, tenesmus, abdominal pain, cardiovascular effects(bradycardia, hypotension through vasodilation, atrioventricular block), ± sudden death, ± dyspnoea, ± paresis/semi-paralysis.Meliatoxin (white cedar fruit) poisoningSyndrome: dog (1 Australian case): lethargy, mild ataxia, increasing muscle weakness, recumbency, jaw paresis(mouth open, tongue protruding, difficulty lapping fluids), recovered slowly over 48 hours.Syndrome: dogs (North America): vomiting, hypersalivation, abdominal pain, diarrhoea, bradycardia, seizures.Ricin poisoningSource: Ricinus communis (castor oil plant) seeds.Toxic dose: dog ricin oral lethal dose = 1 ± g/kg. One R. communis seed = 0.25 g and contains about 0.25 mgricin, therefore 1 seed is potentially lethal.Syndrome: severe enteritis ± dysentery.Summary of Major Poisonous Plants which Pose Very Small or No Threat to Life:Cannabis PoisoningToxicant: Tetrahydrocannabinol.Toxic dose: dog: lowest toxic dose = 84.7 mg/kg. Death from Cannabis is not expected (dog oral lethal dose> 3g/kg).Syndrome: central nervous system depression.Clinical signs: onset usually within 1-3 hr; duration 30 min to 36-48 hr with a maximum of 96 hr; first 6-8 hoursmost intense for dogs, depression (somnolence) (60% of cases), ataxia / incoordination and sudden falling(58%), rapid arousal to normal from somnolence common, anxiety manifest as being “head shy” is common,± behavioural disorders.Macadamia kernel poisoning - raw or roasted kernelsToxin: unknown.Toxic dose (Australian clinical cases): 0.7 – 4.9 g/kg (mean 3.0 g/kg), 5-40 kernels for a 20 kg dog. US experimentalreproduction of toxic signs with 20 g/kg.Clinical signs: posterior paresis, ataxia, muscle tremor (weakness), depression, recumbency, ± joint pain andswelling, vomiting, hyperthermia.Spontaneous recovery in 12-24 hours.Aroid poisoning‘Toxicant’: calcium oxalate raphide (needle-shaped) crystals.Syndrome: buccal irritation, transient.Addendum:Theraphosid spider venomSources: barking, whistling, bird-eating spiders or “tarantulas”.Animals affected: dogs.Mode of action: neurotoxic.Poisoning circumstances: undescribed for dogs.Main effects: flaccid paralysis; death within hours in all dogs known to have been bitten.Pathology, diagnosis, therapy: undescribed.Prevention: prevent access if possible.11

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AVA Queensland News - August 2009A Practical Guide To The Use Of Today’s TechnologyIn Cardiac PatientsDr Brad Gavaghan BVSc MACVSc FACVSc (cardio)Veterinary Specialist ServicesCnr Logan and Lexington Roads, Underwood, Brisbane Q 4119gavaghan@bigpond.net.auThe following discussion will cover those topics below:1. SpO2 - Pulse oximetry2. Blood pressure assessment - Doppler3. Central venous pressure assessment4. End-tidal gas analysis - capnography5. Urine output6. Electrocardiography1. How to record an ECG2. Systematic ECG assessment techniques3. The normal ECG4. Recognition of some common arrhythmias.1. SpO2 - Pulse OximetryThe pulse oximeter measures the percentage saturation of haemoglobin with oxygen. It works by emittingtwo wavelengths of light and measuring the amount of light that is reflected. The probe is usually placed onunpigmented mucosa (eg lip), or, in anaesthetized patients, it is placed on the tongue.Valuable information is given about both cardiac and respiratory function. If the patient’s ventilation iscompromised enough (e.g. pulmonary oedema), or if the percentage of inspired oxygen drops (poor oxygencage set-up), this will be reflected in a drop in SpO2. Equally important however is the fact that if the cardiacoutput drops and the tissues continue to remove oxygen at a constant rate, the SpO2 will drop.The pulse oximeter continually displays the SpO2 as well as the pulse rate. The SpO2 should remain > 93%.2. Blood Pressure Assessment - DopplerDefinitions and pathophysiologyIn humans, systemic arterial hypertension (SAH) may be defined as either:an increase in systemic arterial blood pressure (BP) above normal rangeor a BP that results in clinical or pathological sequelae.There is insufficient data in veterinary patients to define a strict ‘cut-off’ BP that accurately separates normalversus abnormal patients, particularly with reference to the likelihood of clinical sequelae, therefore whenassessing the clinical relevance of a blood pressure reading, it is important that the clinician takes intoaccount the:• patient’s age, breed, species, body condition• physiological state – agitated versus calm• presence of predisposing systemic disease (e.g. renal disease)• presence of clinical sequelae (e.g. ocular manifestations).Systolic arterial blood pressure is determined by the combined influences of :• diastolic arterial blood volume (ie fluid intake versus secretion, i.e. via influences of anti-diuretic hormone,angiotensin II)• amount and rate of flow into that space with each beat (i.e.stroke volume, contractility, preload, afterloadetc)• arteriolar vascular resistance (ie vasodilation vs vasoconstriction)• aortic compliance (influenced by age, disease, autonomic innervation and hormones e.g. angiotensin II).13

AVA Queensland News - August 2009Continued from pg. 13Given that diastolic blood pressure is more difficult to measure in our patients, it is fortunate that isolateddiastolic hypertension is not thought to be common in veterinary patients.AetiologySystemic Arterial Hypertension may be divided into:• essential (primary) hypertension (common in humans)• secondary hypertension (common in veterinary patients).The most common causes of SAH are:In dogs: renal disease (↑ BP in 60%);In cats: renal disease (↑ BP in 61-73%) and hyperthyroidism (↑ BP in up to 87%).Other causes include:hyperadrenocorticism (↑ BP in 60% dogs); diabetes mellitus (↑ BP in 50-70% dogs); pheochromocytoma(episodic ↑ BP in 50% dogs); acromegaly; hypothyroidism (atherosclerosis); hyperaldosteronism; obesity;chronic anaemia; polycythemia; hypergammaglobulinaemia (ie increased viscosity).DiagnosisThe clinical diagnosis of hypertension should never be established on the basis of asingle blood pressure measurement in the absence of overt clinical disease consistentwith the diagnosis (Cowgill LD, ACVIM 2001)This statement supports the balanced clinical approach to the diagnosis of hypertension, rather than onlytreating a BP measurement, taken on only one occasion.What is normal BP?Dog:Cat:By consensus, a systolic BP between 160-165 mmHg and a diastolic BP between 90-95 mmHgare considered to be the upper thresholds for normotension in the dog.The Veterinary Blood Pressure Society (VBPS) proposed a mild elevation (systolic/diastolicmmHg) at > 150/95, moderate elevation > 160/100 and severe elevation at 180/120.Sighthounds tend towards higher normal pressures at approx 145-150 mmHg (systolic).Similar to the dog, but perhaps 5 mmHg less.For adequate perfusion of the central organs BP must be above:Direct: systolic >70 mmHg, mean >50 mmHg;Indirect: systolic > 90 mmHg, mean > 70 mmHg.Moderate hypotension is: Indirect: systolic 80-90 mmHg, mean 60-70 mmHgSevere hypotension is: Indirect: systolic < 75 mmHg, mean < 60 mmHgMeasurement TechniquesDirectDirect arterial puncture – with measurement via either an aneroid manometer or a pressure transducer.IndirectDoppler – (e.g. Parks Medical)Oscillometric – (e.g. Dinamap)Plethysmography – (e.g. Finapress).14

AVA Queensland News - August 2009Continued from pg. 14This discussion will mostly look at the Doppler technique as this is the most popular ‘in practice’ method ofBP measurement.DopplerUses a piezoelectric crystal to send and receive an ultrasound signal that detects blood flow in an arterydistal (usually superficial palmar or plantar arterial arch or the coccygeal artery e.g. tail in cats) to an inflatablecuff.Accurate assessment requires:• good, repeatable operator technique• correct cuff size (cuff width to be 40% of circumference of limb [dog], or 30-40% of circumference [cat])• calm patient.Averaging of approx 5 measurements is ideal.Only reliably measures systolic BP (not diastolic BP).Oscillometric – (e.g. Dinamap)Measures the magnitude of arterial pulsations produced in an air-filled cuff: these are inaccurate withpatients that are moving, have arrhythmias, hypotension or bradycardia.3. Central venous pressure (CVP) assessmentCVP is a simple way to evaluate right ventricular function.CVP is a measure of the right atrial pressure, which is the chamber of the heart into which venous returnfrom the all of the body (except the lungs) occurs.This is measured via the placement of a long catheter into the entrance of the right atrium, via the jugularvein.CVP is particularly useful for regulating the volume and rate of IV fluids that are administered to a patient. Ifthe CVP is low despite fluid therapy, the rate of fluid therapy can be increased, provided there is no left heartfailure. If the CVP is elevated, fluid therapy can be discontinued and possibly re-commenced at a slowerrate when the CVP is at an acceptable range.Procedure: extension tubing is attached to the CVP/jugular catheter, then a water manometer is attachedto the extension tubing via a 3 way stopcock. An administration drip set and bag of fluids is attached to theother port of the three way tap. The manometer can be attached to the cage with the zero marking at the leftof the right atrium (i.e. at approximately the point of the shoulder in sternal recumbency, or mid-sternum inlateral recumbency).Normal range is 3-7 cm of water.Some reasons for a high CVP: occlusion of the jugular vein; over-administration of fluids; right ventricularheart failure.If the CVP is low, patient has reduced blood volume.4. End-tidal gas analysis – capnographyA capnograph measures infra-red absorption to determine the concentration of CO2 (carbon dioxide) inexpired gases. It gives a digital report of the inspired and expired CO2 concentrations during each ventilatorycycle.It is therefore only of use in the anaesthetized patient.It can assist in rapidly diagnosing airway and breathing failure.In patients breathing supplemental oxygen the capnograph can detect ventilation problems earlier than apulse oximeter. It measures the CO2 directly at the endo-tracgheal tube through an adaptor.Normal peak CO2 expiratory is 30-50 mmHg.15

AVA Queensland News - August 2009Continued from pg. 155. Urine outputProvides indirect information regarding cardiac output and the overall state of the circulation.Adequate kidney perfusion = adequate urine production ie 1-2 mls/kg/hr = likely to have adequate wholebody perfusion.Bladder catheterization is indicated if patient cannot be moved or is unable to urinate (e.g. spinal patients).A closed collection system is preferred, with the urine weighed for accuracy (ie 1 gm=1ml).The urine specific gravity may also provide information regarding hydration status ie Urine Specific Gravity< 1.008 if overhydrated, USpG > 1.030 if underhydrated. Other factors such as systemic disease (e.g.Cushings Disease), renal disease etc can alter these measurements.6. Electrocardiography6.1 How to record an ECGPlace the patient in right lateral recumbency, with the proximal limbs perpendicular to the body/trunk.The patient should be placed on a blanket or rubber matting to reduce interference with metal tables.Depending on the country, 50 or 60 Hz (cycle) interference is the most likely artifact affecting ECG recordings.This alternating current (AC) may come from electrical supply in the room, including supply to the ECG.50/60 cycle interference and other artifacts can be reduced:• by good contact between electrode and patient, including wetting of the site with alcohol or ECG pastesand the use of clean/free-of-rust alligator clips (ideally a pair of pliers can be used to flatten the alligatorteeth to improve patient comfort);• avoid excessive wetting of the electrode site;• turn-off flourescent lights, unplug unnecessary appliances;• use the most ‘ECG-friendly’ room in the clinic;• insulation under the patient as mentioned above;• avoid clips touching each other;• avoid clips touching more than one site on the patient;• correct use of in-built ECG filters;• ensure ECG machine has a grounding electrode;• close animal’s mouth if necessary for 3-4 seconds to record each lead if panting/respiratory motion isa problem.Electrodes should be placed on both stifles and elbows, according to the colour or letter code for thesystem.The limb leads (three electrodes plus a grounding electrode), will allow the recording of 6 leads (or traces)in the frontal plane. These are the bipolar leads I, II, III and the unipolar or augmented leads (aVR, aVL, aVF).In addition to these frontal plane leads, electrodes can be placed directly onto the chest wall, resultingin explorer or V (voltage ) leads. In real terms, this allows ‘viewing’ of the electrical signal from a differentviewing angle. This is helpful with assessment of mean electrical axis (MEA), particularly as it pertains toright ventricular enlargement and for detection of ‘p’ waves (especially with the left-sided chest leads) andother deflections in more complex arrhythmia presentations.The three most commonly used V leads are:CV 5RL : (V1) fifth right intercostal space near the edge of the sternumCV6LL : (V2) sixth left intercostal space near the edge of the sternumCV6LU : (V4)sixth left intercostal space near the costocondral junction.6.2 Systematic ECG assessment techniquesIn order, assess:• Heart rate• Heart rhythm• Measure complexes and intervals.16

AVA Queensland News - August 2009Continued from pg. 16Heart rateIf rhythm is regular, use:Divide 3000 by the number of small boxes (each represents 20 ms at a 50 mm/sec paper speed) within theR-R interval (or 1500 divided by number of small boxes if using the 25 mm/sec paper speed) (see Figure 1)Or use a heart rate calculator ruler.If rhythm is irregular:Count how many complexes (or R-R cycles) occur within a 6 or 10 second time frame as marked on thepaper. e.g. 9 complexes in 6 seconds, multiply this number by 10 (ie 6s x 10 = one minute) to calculate therate per minute (e.g. 9 x 10 = 90 bpm).Heart rhythmGeneral inspection:Is it a normal sinus rhythm? Are any deviations from normal occurring in a repetitive sequence? (e.g.respiratory sinus arrhythmia); are they occasional, frequent or continuous? Regular (some forms of ventriculartachycardia) or irregular (e.g. atrial fibrillation).P wave identification:Are they present, are they regular or irregular?QRS complex recognition:Are all QRS complexes uniform in appearance? Are they likely to be ectopic ventricular complexes (wideand bizarre) in origin or are they derived from a supraventricular mechanism (normal in appearance)?Figure 1: Normal canine P-QRS-T complex.Time intervals areas for a paper speed of 50 mm/sec.Amplitude as for 1 cm= 1 mVRelationship between P wave and QRS complexes:Usually a long lead II rhythm strip is used. Use calipers or a card with marks placed on it to record the durationof P-P wave intervals, P-QRS intervals, and QRS-QRS intervals for evidence of rhythm abnormalities.Measuring Complexes and IntervalsUse the lead II rhythm strip.Measurements are made in terms of width or interval length measured in milliseconds (ms) or seconds (sec)by measuring the number of small boxes, with each box measuring 20 ms (or 0.02 sec) at a paper speed of50 mm/sec.17

AVA Queensland News - August 2009Continued from pg. 17The height of each deflection is measured in millivolts (mV). The ECG machine will have a calibration switchthat will demonstrate the height of a 1mV deflection. This is usually set at 1 cm = 1 mV.6.3 Some examples of common arrhythmias:Figure 2: Supraventricular Premature Complexes (SVPCs). P denotes the premature complex. Each sinus complex isfollowed by a premature complex, in a bigeminal rhythm.Figure 3: Atrial FibrillationThis rhythm is present in a dog with dilated cardiomyopathy. The ventricular rate has been slowed to an average of 160bpm with digoxin.Figure 4: Ventricular Premature Complexes (VPCs)This ECG is from a dog with pancreatitis and associated myocarditis. The second complex is a VPC, the fifth complexis a fusion complex.Figure 5: Ventricular Tachycardia (VT)Multiform VT at 180 bpm from a dog with gastric dilation.Acknowledgements:Thanks to Dr Fiona Campbell, Anita Parkin VN, Michelle Kleinschmidt VN, Penny Murphy VN, Rebecca SmartVN for assistance with preparation of these notes. ECG Traces from Tilley: Essentials of Electrocardiographyof the Dog and Cat.18

AVA Queensland News - August 2009AVA Members HR Advisory ServiceProviding Members with expert advice and support onemployment mattersHR MattersAVA Members HR Advisory ServiceSerious Misconduct and TerminationPractice owners are often faced with a level of conduct from an employee that justifies instant dismissal ratherthan giving a written warning or following standard disciplinary procedures. There is no strict definition of whatconstitutes serious misconduct, however instances of serious misconduct can be described as follows;• Theft from the business• Fraud• Assaulting someone in the workplace• Being intoxicated or under the influence of drugs at work• Severe breaches of OH&S legislation• Conduct that poses serious risk to the reputation, viability or profitability of the business.Serious misconduct is generally wilful or deliberate behaviour and consists of one single incident where severemisconduct was present as opposed to the cumulative effects of a number of actions by the employee overtime. When an employee is terminated for reasons of serious misconduct they forfeit the applicable notice oftermination period contained in their industrial instrument.If you feel an employee has committed serious misconduct and you are looking to terminate them, pleasecontact one of the HR Hotline team to discuss the matter first. Given the lack of clear definition as to what isand is not serious misconduct it is best to be entirely sure that the dismissal is justified otherwise the employeemay be able to access remedies such as unfair dismissal as the onus of proof is on the employer to prove thatthe misconduct was serious enough to warrant an instant dismissal.Subsequent Pregnancies and Eligibility for Parental LeaveQuestion: We have an employee who is currently on maternity leave with two months to gountil she returns. She has recently called and advised that she has fallen pregnant again.Although she will still be returning to work, she will be in the workplace for around 6 monthsbefore she goes on maternity leave again.I have looked at the Standard and it says that an employee must have completed 12 monthscontinuous service with the employer prior to going on leave.Does this mean that she does not receive a second lot of parental leave?Answer: In short, the answer is no. An employee must have completed the initial 12 month qualifying withthe employer before being entitled to take unpaid leave, after this point the employee is able to claim unpaidparental leave at any time provided the employee complies with the necessary notice and documentationrequirements.Question: Our employee has just gone on parental leave. She is now pregnant again; this means that theemployee will give birth before her expected return to work date.Answer: In these circumstances, provided the employee complies with the notice and evidentiaryrequirements, it is possible for the employee to claim a second period of unpaid maternity leave withouthaving to return to work.For more information, contact the team at the AVA Members HR Advisory Service on1300 788 977 or email avahrhotline@whr.com.au.The Hotline is open from 8.30am – 5.00pm Mon – Fri AEST.19

AVA Queensland News - August 2009SHORT BITS…Stupeed, Breed or DeedThe Scottish Parliament is considering a Bill which will make it an offence by the “proper person” toallow any dog to be dangerously out of control, anywhere in Scotland. In summary, a dog is defined asdangerously out of control if (1) it is not being kept under control effectively and consistently and (2) itsbehaviour, size or power give rise to reasonable alarm and apprehension on the part of any individual.Dr Andrew Easton kindly drew the article reporting the Bill (in the Veterinary Record,4 July 2009:2) to the attention of the News. Those wishing to read the Bill may visitwww.scottish.parliament.uk/s3/bills/29-dogControl/index.htmIt certainly is sensible for legislation to address the “proper person”, because it seems reasonable toexpect that such persons are able to read, and that the dogs can not.Smart but Forgetful State?The Queensland Horse Council is amazed that the Department of Primary Industries and Fisheries isconsidering terminating the position of Horse Industry Development Officer, created after the seriousoutbreak of Equine Influenza less than two years ago.In the June 2009 eQuiNEWS, the Council also draws the attention of members to halting the spread ofClass 2 plant pest Fireweed. Fireweed has small, yellow, daisy like flowers about the size of a $2 coin. Itcontains an alkaloid which is toxic for herbivores, causing liver damage and other signs. The toxin cancause sudden death or cumulative toxicity.Divisional StrategyOn 29 and 30 August, Division and Branch representatives will meet in Townsville to draw up a StrategicPlan for the coming year. National AVA will be represented and the strategic plan will dovetail with thenational strategy. The meeting is an annual event and is being held in Townsville to spread the ease ofrepresentation.The strategy will have the following broad aims: develop and improve member benefits; advocate policysolutions to government, industry and veterinary schools; engage branches; communicate Divisionachievements to members and non-members.Members’ inputs are welcomed and encouraged. Please address any comments to the Queensland officeor your Branch representative.ArthritisOur tireless Executive Officer, Mr Steve McMaster, has brought to the attention of the News a pressrelease by the Australian National Kennel Council dated 21 July 2009. A new type of stem cell technologyis being used successfully in dogs in Australia to relieve painful joint problems such as arthritis.The technology is called Regenerative Stem Cell Technology and involves harvesting fat cells from thedog, processing and purifying them, and re-injecting them into the affected joint. Improvement in qualityof life and in movement of the joint is claimed to be as high as 80 percent.The technology has been practised in Australia for less than 12 months. Readers interested in followingup this Short Bit may contact Dr Peter Higgins at publicrelations@ankc.org.au20

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Join the AVAand see the differenceThe vision of the Australian Veterinary Associationis for a global community that respects and valuesthe benefits of enhanced animal health, welfareand production.The Queensland Division mission is to be the stateorganisation representing and serving the interestsof the veterinary profession in Queensland toact and speak with a single voice on matters ofimportance to our members. Why not spread theword about the benefits of AVA membership toyour non member colleagues?AVA membership provides:• Substantial discounts for AVA annualconference registration• Subscription to the monthly AustralianVeterinary Journal• AVA eLine – monthly electronic newsletter• Access to AVA Online, our extensive website• A special bond with your professional peers• Access to local branches and Special InterestGroups (SIGs)• Pets & People Education Program• Practice Rewards• Practices of Excellence Award in communityservice• Accredited Microchip Centres• National Cattle Pregnancy Diagnosis Scheme• Hospital Accreditation Scheme• New Graduate Friendly Practice Scheme• AVA Vet Ed – Continuing Education SchemeThe AVA also provides free telephone helplines:• HR Advisory Service• Telephone Counselling Service• Accounting, Finance and SuperannuationHelpline• Legal HelplineWith added benefits such as:◊ GE Money CareCredit Client Finance Plans◊ Manchester Unity Health Insurance◊ British Veterinary Association Journals – InPractice and The Veterinary Record◊ New Zealand Veterinary Association Journals– NZVJ and VetScript◊ Diners Club◊ Mitsubishi Motors Australia◊ Qantas Club◊ Car rental with Thrifty, Hertz and AvisFor more information contact AVA memberservices on 1300 137 309or email members@ava.com.au