0 Comments
Walmart has been operating an own-branded pilot practice on the outskirts of Atlanta for about a year. Retailing giant Walmart has decided to start building own-branded veterinary practices inside its stores following the apparent success of a pilot clinic that opened last year on the outskirts of Atlanta. The company will open another five of the Walmart-branded practices over the next month — two more in Georgia and three in Arizona — with more planned to follow, it announced in a press release. "Walmart has plans to continue to expand its Pet Services centers, with ambitions to introduce the model to more communities in the future," the company said. The move indicates that Walmart still carries a torch for veterinary care, even in the wake of pet medication merchandiser PetIQ's recent shuttering of 282 practices inside the stores of partners including Walmart, Meijer and Tractor Supply Co. Walmart's decision also marks a modest win in PetIQ's turbulent six-year foray into providing veterinary care. PetIQ has operated the Walmart-branded pilot practice since its opening in September 2023, including by supplying veterinarians and support staff. Walmart said its new own-branded clinics will continue to operate "in collaboration" with PetIQ. The Walmart-branded practices — much like the shuttered PetIQ clinics that had operated under the VetIQ brand — will offer only a pared-down level of care, encompassing vaccines, wellness exams and minor medical services. PetIQ, which recently agreed to be acquired by private equity firm Bansk, pinned the closure of its wellness centers on difficulty finding enough veterinarians. Hundreds of practitioners and support staff lost their jobs as a result of its clinic closures, 149 of which had occurred by the end of 2023, and the remaining 133 by this August. Walmart indicated that it nevertheless sees potential in a model that will allow it to cross-sell existing products — such as pet food, cat scratchers, fish tanks or "Beetlejuice" dog costumes — to consumers seeking veterinary care. Elsewhere, dedicated pet supplies retailer Petco recently started slowing the rate at which it builds veterinary practices in its stores, citing difficulty finding veterinarians. Conversely, online retailer Chewy is dipping its toes deeper into veterinary care, having now opened six brick-and-mortar veterinary clinics since April. Credit: VIN Zoonotic diseases from pet fish are very rare, but rare doesn’t mean never. That can make messaging around the disease risks from pet fish challenging, because there’s a need to balance costs vs benefits, and being proactive vs paranoid.
I have a saltwater fish aquarium, and I don’t stay up at night worrying that it’s an impending source of doom. For managing the aquarium, I use some really basic and non-disruptive common sense, though. I did some work on it a couple days ago and paid attention to two things: I kept my hand with a few cuts on it out of the tank, and after I was done I washed my hands. Common sense and hygiene 101. The most commonly reported zoonotic disease issue from aquariums is probably Mycobacterium marinum infection, also known as “fish tank granuloma.” A recent paper in Emerging Infectious Diseases (Dawson et al. 2021) describes a case of another type of infection acquired from a household aquarium, caused by a bug that’s gotten some press recently for other reasons: Burkholderia pseudomallei, the cause of melioidosis. Melioidosis is a nasty and potentially life-threatening disease. In North America, melioidosis is typically associated with travel to tropical or subtropical areas where the bacterium can be found in water and soil. People are exposed through ingestion or inhalation of the bacterium, or contamination of broken skin. However, local sources in North America have been identified, such as the recent outbreak of human melioidosis cases in the U.S. that was linked to contaminated aromatherapy products. The case in the recent EID paper was a 56-year-old woman in the U.S. that was hospitalized because of fever, cough and chest pain. She had a somewhat complex medical history, and had been taking immunosuppressive drugs up until approximately 1 month before she got sick. Culture of her blood identified B. pseudomallei. Fortunately, she responded well to a few months of antibiotic treatment. The first question asked after the bacterium was isolated was likely “where have you traveled recently and when?” However, she had no history of travel. As part of the next stage of the investigation, they found out the patient had two freshwater aquaria, from which they collected samples for testing. (It’s not clear how quickly they moved from “no travel history” to “maybe the fish tanks are the source” and how many steps were in between.) There’s nice description of events as they relate to the aquaria. The patient had purchased two small aquaria about 3 months before she got sick. In one (tank A) she kept cherry barbs and in the other (tank B) she kept guppies. She also purchased some tiger barbs for tank B, but that was after she got sick. Interestingly, she reported that the water in tank B had been persistently cloudier than the other tank, and it required more cleaning, which she did with bare hands. That’s the aquarium from which B. pseudomallei was isolated. Presumably, the woman was exposed while cleaning the aquarium, either via a break in her skin, contact of contaminated water with her nose, eyes or mouth (e.g. splashes, contact with wet hands) or maybe contact with areas that got contaminated by water from the aquarium (e.g. areas around a sink down which water was poured). There were also dead fish in tank B when public health investigators came to visit. That raises the question of whether the fish might also have been sick. We’re not going to recommend testing all dead pet fish for melioidosis as a surveillance tool, but it once again illustrates the potential inter-relatedness of human and animal health. The article concludes “To prevent or reduce risk of exposure, particularly among persons who have major risk factors, simple precautions can be taken when handling freshwater fish, snails, aquatic plants, aquariums, or other materials in contact with aquarium water, such as gravel, substrate, decorations, filters, and other equipment. CDC recommends thorough handwashing with soap and water before and after handling or cleaning aquariums and feeding fish, wearing gloves to cover any cuts or wounds in the hand while handling fish or aquariums or allowing wounds to fully heal first, avoiding cleaning fish aquariums if immunocompromised or in areas where immunocompromised persons might be present, and not allowing children less than 5 years of age to clean fish aquariums.”
Credit: VIN Published: December 10, 2021 By J. Scott Weese, DVM, DACVIM Lizards like Chamillionaire, a veiled chameleon, need ultraviolet B light to produce the vitamin D needed for their intestines to absorb calcium.When Dr. La'Toya Latney first met Chamillionaire, the youngster was suffering from serious bone damage.
The 6-month-old veiled chameleon, a species native to Saudi Arabia and Yemen, had been relinquished by his owner at the veterinary hospital where Latney works in New York City. Chamillionaire hadn't been getting the right type of light, hindering his body's ability to absorb calcium. "I adopted him from an owner who did not know better," Latney said. In the hands of a more knowledgable owner, Chamillionaire lived to a respectable 4 years old. Now, a new rule in the United States has increased the chance that, even with owners who know better, numerous species of captive animals may not get the heat and light they need to be healthy. A ban on inefficient "general service lamps" was announced by the U.S. Department of Energy in 2022 and went into effect on July 3 this year. The rule is intended to encourage the use of more efficient lighting sources, such as LED lamps, that are better for the environment. The problem is that some of the banned bulbs emit a particular spectrum of light, ultraviolet B (UVB), that readily activates the production of vitamin D needed to facilitate calcium absorption in the intestines. Calcium is a vital mineral for all animals, including humans, that's involved in bone structure, muscle contraction and several cellular processes. "The ban should be a concern of animal caretakers for many species," said Latney, a senior veterinarian at the Schwarzman Animal Medical Center who also is chair of the Association for Reptile and Amphibian Veterinarians (ARAV). "This is particularly true for captive reptiles, amphibians, birds and mammal species that have limited exposure to natural, unfiltered sunlight." In brief * Veterinarians are warning that a ban introduced in the United States last month of certain inefficient light bulbs could harm pets with limited exposure to natural sunlight. The welfare of reptile and amphibian species is of particular concern. * The ban encompasses UVB bulbs that help animals produce vitamin D needed to facilitate calcium absorption, and basking bulbs that warm ectothermic animals dependent on external heat sources. * Legal alternative sources of heat and light, such as LED lamps and heating pads, are available, but none are ideal, practitioners maintain. * A U.S. Department of Energy spokesperson said the agency is working with the American Veterinary Medical Association and the Association of Zoos and Aquariums "to find solutions to their needs." Still, practitioners like Latney are especially concerned for reptile and amphibian species that are more dependent on artificial lighting and therefore overrepresented when it comes to calcium-related diseases. Calcium production isn't their only concern. Reptiles and amphibians are ectothermic, meaning their body temperature depends on external heat sources. So-called basking bulbs that provide a controllable heat source, whether via ultraviolet A or infrared radiation, also have been caught up in the ban. "The new rules could definitely negatively affect the welfare of a lot of animals in captivity," said Dr. Kimberlee Wojick, the director of veterinary services at Roger Williams Park Zoo in Rhode Island. Although alert to the potential impact on the zoo's small reptile and amphibian collection, Wojick worries more about animals kept in people's homes. "Professional places such as zoos and aquariums are going to be able to pivot and modify things a little bit more easily than a reptile hobbyist," Wojick said. "So I think the animals and the people that will suffer the most are just the regular consumers that would be buying these lamps and lights from pet stores." Do legal alternatives exist? A U.S. Department of Energy spokesperson told the VIN News Service that the agency is "actively working" with the American Veterinary Medical Association and the Association of Zoos and Aquariums "to find solutions to their needs" amid growing calls by veterinarians, zookeepers and pet owners for an exemption for animal husbandry. Numerous alternative sources of heat and light remain available, but none are ideal, according to practitioners contacted by VIN News. Whether heating, lighting or both are needed depends on the animal; some species are more sensitive to a lack of heat or UVB than others. Snakes, for example, typically don't require special UVB bulbs, just basking bulbs for warmth. On the heating side, alternatives such as ceramic heating pads simply aren't as effective as basking bulbs, said Dr. Brad Lock, a reptile consultant for the Veterinary Information Network, an online community for the profession and parent of VIN News. "Things like heat emitters, heat pads and radiant heat panels do not provide the best heat sources and are very drying to the animal and the enclosure environment," he said. They can also cause injuries, according to Latney. "Heating pads have been reported to cause severe and even fatal thermal burns in reptiles," she said. "The hobbyist shift from heating pads to heating lamps occurred largely due to this continued welfare concern." On the lighting side, alternative bulbs providing UVB for calcium absorption include LED lights and mercury vapor bulbs — the latter providing a combination of UVB and heat. But it's unclear whether LEDs, a relatively new technology, provide sufficient UVB for many species, Latney said, and mercury vapor bulbs could emit unhealthy levels of either UVB or heat. "When heat and UVB emittance are coupled in the same unit, you lose the balance needed for species that may have inverse requirements for UVB exposure levels and environmental heat," Latney said, offering the example of leopard geckos suffering toxic reactions to extreme UVB exposure. Amphibians, for their part, have sensitive skin that puts them at more risk of overheating, especially if kept in small enclosures. Wojick in Rhode Island agrees the bulb ban will make it harder for carers to mimic the natural sunlight conditions they're trying to recreate for their animals. "We have such a wide variety of reptiles and amphibians that we're using these lights for," she said. "We really need to have a lot of tools in our arsenal, and having this big group of them suddenly taken away will have unintended consequences." Animals could be exposed to natural light outdoors, but Latney cautions: "UVB radiation worldwide varies. For example, studies have shown that the amount of UVB exposure in North Carolina is not as strong as Northern Australia, so bearded dragons are at risk without additional UVB support …" She also cautions against giving oral vitamin D supplements to herbivores and omnivores, "and honestly even some carnivores," explaining that even seemingly inoccuous over-the-counter products found in pet stores "can be dangerous if administered at unknown amounts to captive species." An X-ray of Chamillionaire, taken when he was 6 months old, shows a severe reduction in bone density (osteopenia) and a folding fracture of his left femur, which healed in an abnormal position. The damage was caused by inadequate exposure to UV light.The clock is ticking None of the sources contacted by VIN News told of any animals falling ill because of the bulb ban. That may be because the ban has been in place for fewer than two months, and the bulbs, depending on type and use, can last for three to six months, perhaps longer. Moreover, animal owners and pet shops have been stockpiling bulbs, according to Phil Goss, president of the U.S. Association of Reptile Keepers (USARK), a nonprofit advocacy group. "I've heard stories of people buying as many cases as they could afford," he said. Although the ban applies to the manufacture, distribution and sale of specified bulbs, Goss said the DOE doesn't appear to be taking an active enforcement approach — at least not yet — leaving room for pet shops to continue selling stock on hand. He said he's aware of at least one manufacturer that has stopped making the banned bulbs and entered into discussions with the DOE to push for an exemption for animal husbandry. Bulb manufacturers in the U.S. include Zoo Med, Fluker's and Hagen, said Lock, the VIN reptile consultant. "I have been buying a lot of bulbs to have them in case this does actually start affecting availability," he said. "The prices, of course, have already started increasing." Financial barriers may hamper keepers from obtaining alternative products. For instance, the compact incandescent UVB bulbs being banned cost roughly $20 to $30 each, compared with around $80 and upwards for LED UVB bulbs, Goss said. LEDs typically last longer and consume less electricity than incandescent lights, but Goss said their design is another concern. "Compact [incandescent] bulbs spread light more widely because of the way they're made with the curved glass — they shoot UVB all over the place," he said. "The LEDs are more a focused-type bulb, so if you've got a bigger enclosure you might need three or four LED bulbs, and then your expense is going up almost 20 times." Goss also worries about fire hazards, should animal owners start running multiple electrical cords to their setups. Whether animals successfully adapt to alternative sources of heat and light might be hard to tell, especially with those belonging to hobbyists who don't seek regular veterinary care — and even with those who do. Wojick and Goss noted that reptiles can be good at masking illness. "It's crazy what they can handle," Goss said. "Someone might try an alternative they think is OK, but they might not notice outside symptoms for a year or more." The ARAV and USARK have been encouraging members and nonmembers alike to write to lawmakers requesting an exemption. Latney said hobbyists, herpetologists and organizations including zoos, universities and animal welfare groups, have expressed concerns about the ban, which have been presented to the AVMA Animal Welfare Committee. "I think the Department of Energy is trying to do good things," said Wojick, who has been leading the lobbying effort for the ARAV. "We obviously need energy conservation. We don't want to waste our resources. But this is such a niche market, and it would be great if an exemption is eventually made for animal husbandry." Credit: VIN Published: August 29, 2024 By Ross Kelly Who Goes First in the ER?
It may not be who you think Despite the world going all potty of late, most of the clients I have dealt with recently in the veterinary ER have been nice folks. At the very least, they just come and go, but most have been appreciative and kind. I have even had some truly top-tier folks who I have kept in touch with and communicated with by text, phone, or email about their pet's progress. There's a lot of buzz about the wearing down of social graces, but I have been lucky enough to have avoided the worst of it. One situation does stand out. Let's start with a scenario: What would you think if you went into a deli and, instead of taking a number and waiting for it to be called, the person behind the counter held up a giant log of bologna and started shouting “Who needs this delicious, highly processed, lunchmeat the most? Who is just dying for this salty log of fatty nitrates?” My guess is you'd think you stepped into an episode of Black Mirror or you would start looking for the hidden cameras. It's just not the way the deli works. But it is the way the ER works, with one exception. The situation goes like this: Saturday night in the ER, lobby full, staff working at max capacity. We have advised folks that the expected wait is 3-4 hours to be seen, and most are OK with it. A few people have left, some harrumphing about how we don't care about pets (false) and some figuring they can wait until their regular vet is open (hopefully true), or maybe they can find another ER with a shorter wait time (also hopefully true, but unlikely). One of the waiting patients is a dog with a broken toenail. This is painful, but not life-threatening, so after being given something for pain they are shuffled near the bottom of the priority list. Doors bust open and technicians wheel in a large dog on a gurney with the panicked owners in tow. The dog is flat out and crying in pain. He is rushed to the treatment area for evaluation and stabilization. Most of the waiting pet owners know what this means – this dog is in a crisis and will probably:
“Hey! My dog was here first!” I wish I was making this up – this really happens. The ER is the anti-deli. In the ER, the delicious bologna log becomes medical care, and we give it to the worst first, not the first who show up. Sure, if it's a slower night and everyone is equally sick, we take care of the patients in the order they come in. But when it's hopping, we attend to the life-threatening stuff first, and everyone else sits (hopefully) patiently until it's their turn. It usually works just fine, until entitled Mr. Toenail shows up and must have the concept of triage (taking care of the most seriously ill first) explained to him by our patient and caring receptionist. There is one exception, though, and this one doesn't happen in human ERs (or delis, either). We do everything we can to move euthanasia cases to the front of the line. (If there's ever euthanasia in a deli, then you truly have entered the Black Mirror universe.) It's not a medical priority, but it is a humane priority. People waiting for hours to have their beloved pet put to sleep just doesn't sit well with most veterinarians, and we do our level best to accommodate. Sometimes I literally can't get away, for example, if I am doing CPR or involved in a procedure, but my staff and I try to get to these cases and help the family as quickly as we can. It usually involves multitasking, something I am good at after 30 years of ER work, and efficient staff. In some cases, if the family does not want to be with their pet when the final injection is given, it's easier to get done. But it can take time to place an IV catheter, sign the required authorization form, and time for a last visit. Time is not a commodity that is in abundant supply in the ER. But we make it work. One thing that I have recently learned is that it is legal for credentialed technicians to give the euthanasia injection (an overdose of an anesthetic, often accompanied by a sedative) and this can help streamline the process if the owners are OK with it. Most are. So, if you are waiting in the ER, try your best not to be like Mr. Toenail. He upsets everyone: the other owners, the receptionist, and the health care team. Understand that in this world of entitlement, at this particular moment, someone else may be more entitled than you. If it's your pet who needs to be euthanized right now to eliminate suffering, you would not want a broken toenail to be seen ahead of your beloved pet in severe distress. Perhaps pop down to the deli for a delicious bologna sandwich and try and be thankful that the big, crying dog on a gurney or the red-eyed family emerging from the exam room with a blanket-draped parcel was not you and your dog. Credit: VIN Published: July 07, 2023 By Tony Johnson, DVM, DACVECC |
The PAW Blog...
For the LOVE of Pets The goal of this blog is to help educate pet owners by sharing pet health facts and pet news articles...and ... sometimes put a smile on your face with a cute or funny pet story! Categories
All
Archives
October 2024
Search for any topic...
|