Vol. iv Future vets club publication 2018-2019
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vol. iv Future vets club publication 2018-2019
TABLE OF CONTENTS
02 A Fishy Treatment
Joey Chan
Sea Turtle Rehabilitation
Akshaya Chandrashekar 30
06 Welfare of Feral Cats
Sydney Banton
Researching at the OVC
Emmy Luo 33
10 When Veterinarians Make Mistakes
Alison Wong
What Vet School Means to Me
D’Arcy Dykeman, OVC 2020 35
15 The Countless Colours of Hematology
Amelia Norman
Veterinary Specialization
Q&A
Drs. Valverde, Attard, &
37
Molnar
18 Probiotic Pets
Dennis Zhu
Letters To Our First-
Year Selves
FVC Executives
41
21 3D Printing in Veterinary Medicine
Arshia Nazem
A Co-President’s Journey with
the FVC
Julia Jeremic, Co-President
43
27 Canine Diet-Associated Dilated
Cardiomyopathy
Sydney Swartz
01
A FISHY TREATMENT:
Healing burns with tilapia SkiN
Bandages
Joey Chan
Winner, Omnis Animalis Best Member Submission
Do not judge a fish by its ability to climb a Further complicating the situation, they
tree but by its ability to help animal burn vic- discovered that one of the bears was preg-
tims. In the wake of massive California wild- nant and feared that the stress of birthing in
fires, two black bears and a mountain lion captivity would cause her to reject her cub. 3
were found with severe burns on their paws.1 Along with these concerns, the team wanted
An estimated recovery time of months turned to minimize the risk of accustoming the ani-
into weeks with an innovative treatment: fish mals to humans and captivity. 2 A fast recov-
skins as bandages. 2 ery was imperative.
These circumstances gave rise to an exper-
imental approach that uses tilapia skins to
cover the wounds. 2 The biological cover-
ing remained in place, only requiring to be
changed a few times over several weeks.1
Another advantage is that the skins are ed-
ible, so no harm would be caused if they
were ingested. 4 Nevertheless, the animals
Figure 1: Bear with severe third-degree are unlikely to recognize it as food, because
injuries on her paws.2 sterilization removes the fish smell. 5 Model-
ing the sterilization protocol for human skin
Once the animals arrived at the state wildlife grafts, tilapia skin was first sterilized for a
investigations laboratory, veterinarians first few days.1 Afterwards, the skin was appropri-
treated the burns by cleaning them, remov- ately cut and sutured onto the animals’ paws.1
ing dead tissue, and applying ointments.3 To A variable number of fish skins were used per
cover the wounds and provide pain relief, the wound, but each paw generally required one
use of traditional methods would have been or two.1 The animals also received integrative
challenging. Gauze bandages carry the risk of therapies, which relieved pain and enhanced
being ingested, causing intestinal obstruction; wound healing by increasing blood and lym-
they also require frequent changes involving phatic flow.2 While all the therapies assisted
sedation, compromising the health of the ani- the recovery process, majority of the healing
mals.1 In addition to this, the veterinary team occurred after the application of tilapia-skin
struggled to administer pain medication.2 bandages.2
02
Within weeks, new skin regenerated on the After the fish-skin treatment, she stood on
animals’ paw pads.2 all fours and walked around with the other
bear.9 Greater mobility was perceived as a
huge success for pain control.2 Overall, the
veterinary team believed that there was no
downside to the unconventional procedure,
because no adverse reactions to the skins
were observed.2 Following rehabilitation, the
bears were released back into the wild.3 The
mountain lion, who normally would have
Figure 2: Tilapia skin bandage on a bear stayed with his mother until about eighteen
paw.6
months of age, was too young when injured.3
Tilapia skin is a promising treatment for Therefore, he was transferred to a wildlife
burns because of its ability to promote heal- rescue center.3
ing and soothe pain.2 Similar to human skin,
fish skin contains certain collagen proteins
that are essential for scar formation.1 Due to
its abundance of collagen type 1, tilapia skin
has bioactive properties such as biocompat-
ibility, low antigenicity, and high biodegrad-
ability and cell growth potential.7 Fish colla-
gen is transferable, serving as a material that
can replicate the natural extracellular matrix.7
It organizes cells by providing environmental
signals and directing cellular regulation.7 Giv- Figure 3: Pony patient with tilapia skins
en this, the collagen in tilapia skin assists in applied to her facial burns.6
scaffolding, and thus, wound healing.2 More-
over, fish skin is resistant, tolerating more Treating burns with tilapia skin is rapidly ex-
tension than human skin and withstanding tending beyond a single application in veteri-
high moisture levels.1 Due to its moisture re- nary medicine. After its use on wild animals,
tention, fish-skin bandages stay bioactive for the procedure was performed on a pony with
a long period of time, eliminating the need to exudative wounds from third-degree chemi-
be changed frequently.1 Another advantage of cal burns on her face.6 Veterinarians cleaned
fish skin is that it has antibacterial properties, her burns, removed dead tissue, applied oint-
preventing infections.8 Altogether, the nature ments, then sutured tilapia skins from the top
of tilapia skin accelerates healing time and of her forehead to the bottom of her mouth.6
reduces the need for pain medication2, deem- Extensive wounds like the pony’s would
ing it an effective biomaterial in regenerative usually require six months of recovery time,
medicine. but eighty percent of skin had already grown
back two weeks following the use of fish-skin
Prior to using tilapia skins as bandages, bandages.6 Another application of tilapia skin
the bears would sit with their paws off the has emerged in companion animal medicine
ground.2 One of them would often remain with cats and dogs.10
lying down to spare her burned paws.9
03
In one case, a kitten suffered from third-de- The innovative fish-skin treatment has the
gree burns on his paws in a wildfire, leaving potential to help solve a global public health
him without paw pads.10 Contrary to the oth- issue.6 Although burns are treatable, advanc-
er applications so far, tilapia skin was placed es in standard practice are predominantly
over the kitten’s paws, and bandages were applied in developed countries, where there
wrapped around it.10 Veterinarians did not is greater access to expensive dermal substi-
suture the fish skin on, because they feared tutes.6 In the United States, tens of thousands
that the risk of anesthetizing the kitten would of people donate tissue for transplant, so the
be too great.10 The kitten ultimately reaped need for tilapia-skin bandages is not high-
the same benefits as other species: rapid ly expressed.1 However, as an inexpensive
wound healing and pain relief.10 biomaterial12, tilapia skin could prove to be
economically significant where skin banks
The use of tilapia skin as a bandage for wild- are not as readily accessible. Considering the
life patients was adopted from its application therapeutic nature, low-cost, and widespread
on human burn victims.2 Human and pig availability of tilapia skin, fish-skin bandages
skins have long been used as grafts for burns could revolutionize the treatment of burns for
in developed countries.11 However, devel- both animals and humans.
oping countries such as Brazil lack these
References
supplies and other artificial alternatives, so
gauze bandages are normally applied.11 Along 1. Zachos E. Fish skin bandages help burned bears and cougar heal. Nation-
al Geographic [Internet]. 2018 Jan 25 [cited 2019 Jan 20];Animals:[about 6
with the painful process of changing gauze screens]. Available from: https://news.nationalgeographic.com/2018/01/califor-
nia-thomas-fire-bear-cougar-paw-burn-tilapia-fish-skin-bandage-spd/
bandage daily, the standard gauze-and-cream
2. Quinton A. Bears burned in California wildfires healed with fish skins,
dressing does not promote much healing.11 released to wild. UC Davis [Internet]. 2018 Jan 24 [cited 2019 Jan 20];Human &
Out of necessity, researchers turned to tilapia animal health:[about 8 screens]. Available from: https://www.ucdavis.edu/news/
bears-burned-california-wildfires-healed-fish-skins-released-wild/
skin, a widely-available fish-farming byprod-
3. Brulliard K. Two bears were badly burned in wildfires, and fish skin helped
uct in Brazil, and converted it into a socially heal them. The Washington Post [Internet]. 2018 Jan 25 [cited 2019 Jan 20];An-
imalia:[about 9 screens]. Available from: https://www.washingtonpost.com/
beneficial resource.12 They discovered that news/animalia/wp/2018/01/26/two-bears-were-badly-burned-in-wildfires-and-
transferable collagen and moisture retention, fish-skin-helped-heal-them/?utm_term=.2376f33d66fa
the healing properties of tilapia-skin bandag- 4. Kitaura C. Healing burned paws with fish skin. UC Davis [Internet]. 2018 Jan
9 [cited 2019 Jan 20];Human & animal health:[about 5 screens]. Available from:
es, decreased healing time and pain medica- https://www.ucdavis.edu/news/healing-burned-paws-fish-skin/
tion use in human patients.11 5. Glimour J. Watch this kitten get fish-skin mittens to heal paws burned in the
California fires. Miami Herald [Internet]. 2018 Dec 6 [cited 2019 Jan 25];Na-
tional:[about 5 screens]. Available from: https://www.miamiherald.com/news/
nation-world/national/article222700085.html
6. Quinton A. Innovative treatment could help solve global public health
crisis. UC Davis [Internet]. 2018 Sep 17 [cited 2019 Jan 25];Human & animal
health:[about 16 screens]. Available from: https://www.ucdavis.edu/health/
news/healing-animals-with-fish-skins/
7. Yamamoto K, Igawa K, Sugimoto K, Yoshizawa Y, Yanagiguchi K, Ikeda T, et
al. Biological safety of fish (tilapia) collagen. Biomed Res Int [Internet]. 2014
Apr 7 [cited 2019 Jan 22];2014:630757. Available from: https://www.ncbi.nlm.
nih.gov/pmc/articles/PMC3997882/ doi: 10.1155/2014/630757
8. Hu Z, Yang P, Zhou C, Li S, Hong P. Marine collagen peptides from the skin
of Nile tilapia (Oreochromis niloticus): characterization and wound healing
Figure 4. Physicians use tilapia skin to evaluation. Mars Drugs [Internet]. 2017 Apr 15 [cited 2019 Jan 22];15(4):102.
Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408248/ doi:
treat a child’s burned skin.12
10.3390/md15040102
04
9. The Associated Press. Burned bears treated with fish skins spotted in the wild.
CTV News [Internet]. 2018 Feb 18 [cited 2019 Jan 20];Sci-tech:[about 1 screen].
Available from: https://www.ctvnews.ca/sci-tech/burned-bears-treated-with-
fish-skins-spotted-in-the-wild-1.3808676
10. Quinton A. Dogs, cats rescued from California camp fire heal with fish
skins. UC Davis [Internet]. 2018 Dec 5 [cited 2019 Jan 25];Human & animal
health:[about 7 screens]. Available from: https://www.ucdavis.edu/health/news/
dogs-cats-rescued-california-camp-fire-heal-fish-skins
11. Sussman N. Can tilapia skin be used to bandage burns? STAT [Internet].
2017 Mar 2 [cited 2019 Jan 25];In the lab:[about 4 screens]. Available from:
https://www.statnews.com/2017/03/02/brazil-tilapia-skin-burns/
12. Whitaker P, Garcia P. Brazilian doctors use fish skin to treat burn victims.
Reuters [Internet]. 2017 May 25 [cited 2019 Jan 25];World news:[about 5
screens]. Available from: https://www.reuters.com/article/us-health-brazil-
burns/brazilian-doctors-use-fish-skin-to-treat-burn-victims-idUSKBN18L1WH
05
Feral cats:
welfare problems and solutions
Sydney Banton
2nd Place, Omnis Animalis Best Member Submission
The domestic cat has become the most popu- Welfare Problems
lar and most abundant pet in North America.
While there are an estimated 8.8 million cats When it comes to the welfare problems
that are considered household pets in Cana- associated with feral cats, the concern is not
da1, there are also up to 5.5 million feral cats isolated to the cats themselves, but also to
in Canada.2 There are varying definitions as the organisms they interact with, including
to what a feral cat is. Slater et al.3 define a humans. In particular, domestic cats are
feral cat as, “a cat that cannot be handled, is the definitive host of Toxoplasma gondii,
un-socialized (with humans), and not suit- meaning that the parasite can replicate and
able for placement in a home as a pet,” while complete its lifecycle in the cat but show no
Levy & Crawford4 refer to feral cats as, “any symptoms of infection.6 Feral cats contract
unconfined, un-owned cat, regardless of its this parasite from killing or ingesting infect-
socialization status.” If the two are combined, ed wildlife species and can then shed the par-
a feral can be described as a domestic cat that asite in their feces, where it can contaminate
is un-confined and has never been socialized the environment, other wildlife species and
with humans and is therefore unable to be humans.6 For most healthy humans, toxo-
placed in a home. plasmosis infections show mild to no symp-
toms, however, if a pregnant woman is infect-
Feral cats come from unsterilized stray, out- ed with toxoplasmosis, it can be passed to the
door or abandoned cats that give birth to fetus, causing serious neurological deficits.6
kittens outdoors.5 Those kittens then, not
being socialized with humans, are considered
feral. They can go on to reproduce and create
more and more feral cats. Their reproductive
biology contributes to this overpopulation
problem as domestic cats are sexually ma-
ture by the age of 6 months and can produce
an average of 1-6 kittens, 1.6 times a year.5
The feral cat overpopulation problem is not
unique to Canada, but is in fact a worldwide
occurrence.
06
A study by Luria and colleagues7 in Florida So, often studies report on both owned,
found that 10.9% of feral cats in a Trap-Neu- free-roaming cats and feral cats. Jessup10 ana-
ter-Release (TNR) Program were infected lyzed data from a wildlife rehabilitation cen-
with T. gondii. ter in California, over a 9-month period, and
concluded that 30.3% (1,015/3,353) of small
Another major concern is the welfare of birds, including song birds, migratory birds
wildlife that fall prey to feral cats. In 2015, and endangered birds were brought in be-
McGregor and colleagues8 fit 13 feral cats cause of outdoor/feral cat-related injuries. In
in Australia with cameras to observe their addition, 12% of mammals and 15% of rep-
hunting behaviours. These cats had to be tiles were brought in due to cat-related inju-
chased up trees by trained dogs and then ries.10 These are the animals that are fortunate
tranquilized in order to attach the cameras, enough to be found and brought to the rehab
so they were truly feral cats. The researchers center. How many others are left to suffer?
reported that an average of 7.2 wild animals
were killed per day, per cat, including frogs, The final concern is the welfare of the feral
snakes, quail, geckos, rats and mice.8 They cats themselves. Feral cats are exposed to the
also reported that 28% of the wildlife killed elements, predation, vehicles, starvation, dog
were not eaten.8 In comparison, Hernandez attacks, anemia due to parasites, injury and
and colleagues9 fit a provisioned colony of disease.10 Luria et al.7 reported that 3.3% of
feral cats (fed once a day by colony keepers) feral cats that were trapped as part of a TNR
in Jekyll Island, USA with cameras. Despite program were positive for Feline Leukemia
regular feeding, the cats in this colony killed Virus (FeLV), 5.2% were positive for Feline
an average of 6.15 animals per day, per cat, Immunodeficiency Virus (FIV), 18.3% were
including invertebrates, amphibians, reptiles, positive for Feline Coronavirus, 12.9% were
birds and mammals.9 They also reported that heartworm positive, 33.6% were positive for
17% of the wildlife killed were not eaten.9 So, cat scratch disease, and 20.5% were positive
even being fed by humans does not stop a for mycoplasma infection (a bacteria respon-
feral cat from killing wildlife, meaning their sible for urinary tract infections and pneu-
prey drive may be instinctual, rather than monia). Akucewich et al.11 reported that 37%
hunger driven. of 200 feral cats had ear mite infestations,
92.5% of feral cats were infested with fleas
and 15 of these individual cats had an under-
lying skin disease, possibly associated with
the flea infestation. To address some of the
more difficult factors, such as predation, vehi-
cles and starvation, Gunther and colleagues12
analyzed almost 88,000 phone complaints
from 2007-2011 in 5 cities in Israel. They re-
ported that of these 88,000 complaints, 55.3%
of them were related to cat carcasses and 16%
were related to injured cats, including sick
cats, cats hit by a car and distressed cats.12
This data is difficult to acquire, as fitting a
feral cat with a camera is quite challenging. 07
Welfare Solutions A similar study by Bissonnette et al.15 in Que-
bec, Canada, assigned 10 known cat colonies
The most widely enacted control strategy to undergo TNR and 10 colonies as control.
for feral cats today is Trap-Neuter-Release At 7 months post-TNR, the 10 colonies that
(TNR). TNR groups are community based underwent TNR had fewer adults than the
and not funded by the government. They control group, however, 1-year post-TNR,
manage populations of feral cats by trap- there was no difference in population size.15
ping, sterilizing, vaccinating and releasing Although the TNR did work in controlling
them back to where they were found. Some numbers, this effect was short-lived and
colonies are then monitored by humans, overall, not effective at controlling population
where they are fed once a day and others are numbers.
free-roaming, independent colonies with
no human supervision.13 However, as the In Australia, a study by Lazenby and col-
above studies have shown, feeding feral cat leagues16 looked at the effect of low level
colonies once a day does not prevent them culling on a feral cat population of about 350
from killing wildlife.9 In addition, Castillo & individuals. They trapped and euthanized
Clarke14 reported that the cat food in the two 26 adult cats over a period of 13 months and
provisioned colonies they studied actually reported that despite the loss of 26 individu-
attracted other stray cats and wildlife species, als, the population continued to rise over the
including skunks and raccoons, therefore course of the study. The authors concluded
increasing risk of disease transmission and that a low level of culling may have unwanted
conflict between species. The population size effects on population size and culling may
of the colonies also increased over time, even need to be done at higher levels or combined
with neutering.14 The authors suspect that with other tactics.16
the new additions to the colony were other
stray cats attracted to the food, and they also It is unrealistic and unsustainable to pre-
observed people illegally abandoning their sume that TNR alone can eliminate feral
owned pet cats in the colony.14 As a result, cat populations as it is costly and clearly not
they concluded that TNR is not only ineffec- effective in keeping population numbers
tive at controlling population size, but also steady. We must consider implementing
promotes the illegal abandonment of owned Trap-Neuter-Euthanize programs where
cats. kittens and cats that are friendly, are neutered
and rehomed and cats that are aggressive and
unable to be rehomed, are euthanized. An
earlier study by Gibson et al.17 trapped 185
feral cats and kittens, euthanized any that
tested positive for FeLV or FIV (23 cats) and
neutered and released the rest (158). Unfor-
tunately, no follow up study was reported, but
this seems to be the start of efforts to control
numbers via euthanasia and prevent infec-
tious disease from spreading to other colony
members.
08
Conclusion 7. Luria BJ, Levy JK, Lappin MR, Breitschwerdt EB, Legendre AM, Hernandez
JA, et al. Prevalence of infectious diseases in feral cats in Northern Florida.
Journal of Feline Medicine and Surgery, 2004 Oct; 6(4): 287-296.
In an ideal world, to control pet overpopula- 8. McGregor H, Legge S, Jones ME, Johnson CN. Feral cats are better kill-
ers in open habitats, revealed by animal-borne video. PLoS ONE [Internet].
tion, there would be laws in place making it 2015 Aug [cited 2019 Jan 14] Available from: https://doi.org/10.1371/journal.
mandatory to have your pet sterilized. Since pone.0133915.
this is unlikely to happen in the near future, 9. Hernandez SM, Loyd KAT, Newton AN, Carswell BL, Abernathy KJ. The use
of point-of-view cameras (Kittycams) to quantify predation by colony cats (Felis
we need to address the root cause of the catus) on wildlife. Wildlife Research. 2018 July; 45(4): 357-365.
problem through education, sanctuaries and 10. Jessup DA. The welfare of feral cats and wildlife. Journal of the American
humane euthanasia. Education on the im- Veterinary Medical Association. 2004 Nov; 225(9): 1377-1383.
portance of cat sterilization by veterinarians, 11. Akucewich LH, Philman K, Clark A, Gillespie J, Kunkle G, Nicklin CF, et
al. Prevalence of ectoparasites in a population of feral cats from north central
shelters, pet stores and even breeders may Florida during the summer. Veterinary Parasitology. 2002 Oct; 109(1): 129-139.
help stop the current population from grow- 12. Gunther I, Raz T, Berke O, Klement E. Nuisances and welfare of free-roam-
ing. Enclosed, outdoor sanctuaries to house ing cats in urban settings and their association with cat reproduction. Preventive
Veterinary Medicine. 2015 May; 119(3): 203-210.
feral cats could help prevent them from kill-
13. Cats in Canada 2017: A five-year review of cat overpopulation. Ottawa
ing wildlife and protect their own well-being. (ON): Canadian Federation of Humane Societies; 2017. 51 p. Report No.: 2.
14. Castillo D, Clarke AL. Trap/neuter/release methods ineffective in controlling
However, given the numbers of feral cats in domestic cat “colonies” on public lands. Natural Areas Journal. 2003; 23(3):
Canada alone (up to 5.5 million), it may be 247–253.
unrealistic to provide enough sanctuaries for 15. Bissonnette V, Lussier B, Doize B, Arsenault J. Impact of a trap-neuter-return
event on the size of freeroaming cat colonies around barns and stables in Que-
all feral cats. Therefore, combining education bec: A randomized controlled trial. Canadian Veterinary Medical Association.
2018 July; 82(3): 192-197.
and sanctuaries with humane euthanasia may
be the only way to address all of these issues 16. Lazenby BT, Mooney NJ, Dickman CR. Effects of low-level culling of feral
cats in open populations: A case study from the forests of southern Tasmania.
including the welfare of wildlife and the cats Wildlife Research. 2014 Feb; 41(5): 407-420.
themselves. However, euthanasia is not likely 17. Gibson KL, Keizer K, Golding C. A trap, neuter, and release program for
feral cats on Prince Edward Island. The Canadian Veterinary Journal. 2002 Sept;
to be well received by the general public. So, 43(9): 695-698.
it is clear that a solution to the welfare prob-
lem of feral cats is not going to be straight-
forward, and more research into the effec-
tiveness of current tactics is warranted, in
addition to starting to look at a combination
of tactics, such as TNR and euthanasia.
References
1. Latest Canadian Pet Population Figures Released. Guelph (ON): Canadian
Animal Health Institute; 2017. 1 p.
2. Cats and Birds [Internet]. Canada: Nature Canada; 2018. What about the feral
cats; 2018 [cited 2019 Jan 14]. Available from: http://catsandbirds.ca/blog/what-
about-the-feral-cats/.
3. Slater MR. The welfare of feral cats. Dordrecht, Netherlands: Springer; 2005.
pp. 141-175.
4. Levy JK, Crawford PC. Humane strategies for controlling feral cat popu-
lations. Journal of the American Veterinary Medical Association. 2004 Nov;
225(9): 1354-1360.
5. Nutter FB, Levine JF, Stoskopf MK. Reproductive capacity of free-roaming
domestic cats and kitten survival rate. Journal of the American Veterinary Med-
ical Association. 2004 Nov; 225(9): 1399-1402.
6. Esch KJ & Petersen CA. Transmission and epidemiology of zoonotic proto-
zoal diseases of companion animals. Clinical Microbiology Reviews. 2013 Jan;
26(1): 58-85. 09when veterinarians make
mistakes
Alison Wong
3rd Place, Omnis Animalis Best Member Submission
You are only human. Everyone makes mis- Mistakes can occur for a variety of reasons
takes. We have all heard these sayings be- including fatigue, miscommunication, lapse
fore and yet society holds veterinarians to of memory, inattention, lack of experience
a different standard. This is because being a and lack of training. Most mistakes can be
professional bear meaning in society. It is an attributed to human error, so it comes as no
indication that one has received advanced surprise that mistakes have considerable im-
education and training to acquire specialized pacts on veterinarians. Multiple studies have
skills and expertise. As such, veterinarians are described a higher than average rate of sui-
well-respected members of the community. cide within the profession. When faced with
They are expected to conduct themselves in difficult decisions and the demanding nature
a competent and ethical manner that reflects of the job, it is not uncommon for veterinar-
the values of the profession. According to a ians to forego their own needs to meet the
recent survey published in the Ontario Veter- needs and expectations of others. Working
inary Medical Association’s Focus magazine, at the expense of personal wellbeing contrib-
a whopping 95% of pet owners trust that their utes to compassion fatigue and occupational
veterinarians had their pet’s best interest at burnout. In combination with personality
heart! traits such as perfectionism, every mistake,
regardless of cause, can feel like a failure.
What is a “mistake”? The Canadian Journal From a UK survey, loss of confidence, elevat-
of Surgery defines a medical error to be “an ed stress, feelings of guilt or depression and
act of omission or commission in planning or the consideration of a change in career were
execution that contributes or could contrib- sentiments shared by many recent veterinary
ute to an unintended result”. Mistakes don’t graduates after making a mistake.
always amount to much and can be inconse-
quential to the outcomes of a case. According Dr. Marie Holowaychuk is one such veteri-
to one study, inconvenience to the client was narian who made a mistake. Her remorse is
the most common negative outcome of an evident in her account of a horrible mistake
error. For example, clients had to schedule for that happened over 10 years ago. During
another appointment or wait for delayed test her third-year residency at an intensive care
results. It is the mistakes that do lead to sub- unit, she was reviewing x-rays to confirm the
optimal, adverse and even fatal outcomes that placement of a nasal feeding tube for a dog
will remain the topic of discussion. called Laci.
10The first x-rays showed correct placement services were contacted and ultimately, wide
with a kink at the end of the tube. A techni- surgical excisions of the injected area were
cian was asked to fix the kink by pulling the taken to save the patient. Unfortunately, not
tube slightly back and to repeat the x-ray. all patients are so lucky. Dr. Sarah Boston
Unknown to Dr. Holowaychuk, the tube had recalls a cancer patient of hers who went to a
been removed entirely and replaced. In re- board-certified ophthalmologist for the re-
viewing the second x-ray, she failed to realize moval of a painful, non-visual eye. It wasn’t
that the tube was now placed in the trachea until after that the veterinarian became aware
and not the esophagus. The patient ended that the normal eye had been removed. De-
up having food fed into her lungs, suffered spite efforts to rehabilitate, the blind (and
cardiopulmonary arrest and died. She recalls deaf) dog didn’t adjust and was ultimately
berating herself and the fear of interpreting euthanized.
x-rays in the months to follow. Today, Dr.
Holowaychuk lectures other veterinarians on When it comes to dealing with mistakes,
the importance of disclosing errors to clients. honesty really is the best policy. Some vet-
Additionally, the hospital has since imple-
erinarians will offer to waive any fees for the
mented a “Laci Rule” where proper placement
procedures that led up to the mistake and/or
of feeding tubes is confirmed by a radiologist
prior to any feedings through the tube. cover the costs of any follow up procedures
to remedy the situation. This may be enough
The types of mistakes vary widely and reflect depending on the severity of the mistake
the diverse roles and responsibilities veter- and the nature of the veterinarian-client-pa-
inarians assume. Misdiagnosis, overdosing, tient relationship. But compensation, how-
failure to run the appropriate diagnostic tests ever well-intentioned, isn’t always enough
and retained surgical sponges are some ex- to address a client’s concern and recover the
amples. Of these, surgical mistakes appear true costs of medical errors. A survey from
to be most common accounting for 57% of an internal medicine outpatient clinic re-
treatment claims made to the UK’s largest vealed that 98% of all patients wanted some
veterinary professional indemnity insurer in acknowledgement of even minor mistakes by
2015. Second to surgery are errors involving their physicians.
drugs, specifically inappropriate drug choice
and overdose. Note that all these figures are Acknowledgement is important for multiple
reliant on voluntary reporting systems and reasons. It demonstrates accountability and
very likely underestimate the true prevalence transparency which in turn helps to build and
of mistakes. At times, a veterinarian might reinforce trust. Clients don’t want to be writ-
not even know they’ve made a mistake! ten off for the intense emotions they experi-
ence and value empathy. A genuine apology
Relative to human medicine, the nature and should be offered because it’s the right thing
frequency of mistakes in veterinary medicine to do and can go a long way to mitigating
aren’t as well documented or researched. A some of their pain and anger. Clients also
quick google search yields many anecdotes want full disclosure to understand how and
from both pet owners and veterinarians. Dr. why mistakes were made. They are concerned
Patty Khuly recounts a misunderstanding about the standards of care and want reassur-
that led a staff member to administer a “cata- ance that measures are taken to prevent
strophic” dose of subcutaneous medication to
a patient. Upon realization, toxicology 11t
the same mistake from happening to another Studies also suggest that an apology and ex-
animal. planation can help reduce the likelihood of
litigation.
Dr. Elkins is an experienced board-certi-
fied surgeon with the American College of An important role of the College of Veteri-
Veterinary Surgeons and he too is not im-
narians of Ontario (CVO) is to receive, inves-
mune to making mistakes. He performed a
tigate and act on any complaints made against
complete excision of a large anal tumor on
Sassy, a Boston Terrier, who was subsequent- veterinarians. The CVO oversees all licensed
ly discharged. Six weeks post-operation, a individuals practicing veterinary medicine
radiograph revealed that Dr. Elkins had left and serves to protect the public interest. For-
a surgical sponge in the incision. He had the mal complaints are typically made when an
option to make up an excuse to retrieve the informal approach to resolve matters prove
sponge and cover up his mistake. However, unsuccessful. An average veterinarian can ex-
he opted for honesty for the sake of the vet- pect to receive one or two formal complaints
erinarian-client relationship and communi- in their career. It is also worth noting that the
cated what had happened. After a heartfelt Complaints Committee has no jurisdiction to
apology and explanation, the clients were award damages.
understanding of the problem. Dr. Elkins
now counts all surgical sponges to prevent
the same mistake from happening again. Ac-
knowledging that this is a common mistake,
the medical profession is also taking initia-
tives to combat the unintentional retention
of surgical items using technology. One study
utilized radio-frequency (RF) tagged spong- Figure 1. Number of complaints and
es (like clothing tags used in retail) where a veterinarians involved in 2016-2018.8
nurse runs a wand over a patient to detect
readings from the RF tags. X-ray detectable Majority of complaints tend to be of “no con-
gauze sponges are also available in the mar- cern”. These cases are closed either because
ket. However, manual sponge count and the veterinarian did nothing wrong or the
surgical checklists remain the most common nature of the complaint was found to be friv-
methods used. olous and vexatious. When the Complaints
Committee identifies some concerns, the
Although open communication is ideal, the veterinarian may be required to take remedial
reality is that not every veterinarian will actions like re-education or training. Verbal
disclose every mistake made to clients and or written advice may also be given in place
colleagues. In a society of naming and sham- of remedial actions. In situations of serious
ing, there is a general reluctance to talk about concerns, the case is referred to the Disci-
medical errors. Admitting a mistake can be pline Committee for a hearing. Disciplinary
daunting. It does not come naturally to veter- hearings are open to the public and matters
inary professionals who are expected to make usually relate to allegations of professional
no mistakes. However, the timely admission misconduct or serious neglect. The College
of mistakes can prove to be essential for the
discloses the names of those found guilty of
patient’s best interest and subsequent correc-
professional misconduct and when a limita-
tive actions.
tion is applied on a veterinarian’s license. 12Both the complainant and veterinarian can References
request appeals to the committee’s decision 1. Boston, S. (2015). The Realities of Human Error in Veterinary Surgery. Ac-
cessed from https://drandyroark.com/human-error-in-veterinary-surgery/
if desired. New information for consider-
2. Cardinal Health. (n.d.). X-ray detectable gauze sponges (sterile). Accessed
ation can be submitted to the committee for from https://www.cardinalhealth.com/en/product-solutions/medical/skin-and-
a second file review. Alternatively, one can wound-management/traditional-wound-care/x-ray-detectable-gauze-sponges-
sterile.html?fbclid=IwAR0dryCi4ygl_GGDMiSFzbtkBoOSBwlYJZAjLTkgmyX-
appeal the decision to the Health Professions hzH8xxkHeZ6uIvpE
Appeal and Review Board, an independent 3. Colman, S. (2017). Wrongful Pet Deaths and Empathy for Your Vet. Accessed
from https://www.whole-dog-journal.com/issues/20_5/features/Empathy-for-
tribunal for all health professionals in Ontar- Your-Vet_21641-1.html
io. According to CVO, most complaints arise 4. CVO. (n.d.). Registration Committee Appeals. Accessed from https://cvo.org/
from miscommunication between clients and For-Applicants/Registration-Committee/Registration-Committee-Appeals.aspx
veterinarians. This represents an opportunity 5. CVO. (n.d.). Discipline Orders. Accessed from https://cvo.org/For-the-Pub-
lic/Investigations-Resolutions/Discipline/Discipline-Proceedings.aspx
for veterinarians to improve communications
and address concerns before a complaint is 6. CVO. (2003). Regulation of the Veterinary Profession in Ontario. Accessed
from https://cvo.org/CVO/media/College-of-Veterinarians-of-Ontario/Re-
even lodged. sources%20and%20Publications/INFO%20Sheets/ISRegulationoftheVeterinary-
Profession.pdf
7. CVO. (2018). Guidance on Professionalism for Veterinarians. Accessed from
Mistakes are inevitable and represent a https://cvo.org/getmedia/29e4c106-6785-4552-8673-4911c5364c11/Guidan-
learning opportunity. It is one thing to make ceonProfessionalism.pdf.aspx
a mistake and another to repeat the same 8. CVO. (2019). CVO Annual Report 2018. Accessed from https://cvo.org/
getmedia/c59f2adf-33ae-4431-b59c-8a13b119182c/AR2018final.pdf.aspx
mistake. Instead of pointing fingers, efforts
9. Elkins, A.D. (2011). Veterinary medical errors: Tell the truth, do it quickly.
should be placed on understanding why they Accessed from http://veterinarynews.dvm360.com/veterinary-medical-er-
occurred and how to prevent it in the future. rors-tell-truth-do-it-quickly?id=&sk=&date=&pageID=3
When they do occur, one should apologize 10. Grober, E. D., & Bohnen, J. M. (2005). Defining medical error. Canadian
Journal of Surgery, 48(1), 39.
and own up to their actions. It can help those
11. Holowaychuk, M. (2017). I’m a veterinarian and I make mistakes…. Ac-
affected to find closure and bring to light the cessed from http://www.criticalcarevet.ca/im-veterinarian-make-mistakes/
flaws in existing protocols and systems. Final- 12. Jarvis, S. (2018) Learn to deal with mistakes well. Veterinary Record 183,
ly, making a mistake can be an awful feeling. 633.
It is important to practice self-forgiveness 13. Jeun, S. (2018, September/October). Giving to others without giving our-
selves away. Focus Magazine, pp. 10-11.
and reach out to others for support. After all,
how you navigate and recover from mistakes 14. Khully, P. (2016). When veterinarians make mistakes. “They don’t call medi-
cine ‘a practice’ for nothing. Accessed from https://www.veterinarypracticenews.
is what truly defines an individual, not the com/when-veterinarians-make-mistakes/
mistakes in itself. 15. Kinnison, T., Guile, D., May, SA. (2015) Errors in veterinary practice:
preliminary lessons for building better veterinary teams. Veterinary Record 177,
492.
16. Mellanby, R. J., & Herrtage, M. E. (2004). Survey of mistakes made by recent
veterinary graduates. Veterinary Record, 155(24), 761-765.
17. Morrison, S. (2019, January/February). The survey says. Focus Magazine, pp.
16-17.
18. Nett, R. J., Witte, T. K., Holzbauer, S. M., Elchos, B. L., Campagnolo, E. R.,
Musgrave, K. J., & Pride, K. R. (2015). Risk factors for suicide, attitudes toward
mental illness, and practice-related stressors among US veterinarians. Journal of
the American Veterinary Medical Association, 247(8), 945-955.
19. Oxtoby, C., Ferguson, E., White, K., Mossop, L. (2015). We need to talk
about error: causes and types of error in veterinary practice Veterinary Record
177, 438.
20. Rogers, A., Jones, E., & Oleynikov, D. (2007). Radio frequency identification
Figure 2. Outcomes of complaints filed (RFID) applied to surgical sponges. Surgical Endoscopy, 21(7), 1235-1237.
against veterinarians in 2016-2018.8
21. Stevens, J. (2018, March/April). You received a CVO complaint. Now what?
1322. Tomasi, S. E., Fechter-Leggett, E. D., Edwards, N. T., Reddish, A. D., Crosby,
A. E., & Nett, R. J. (2019). Suicide among veterinarians in the United States from
1979 through 2015. Journal of the American Veterinary Medical Association,
254(1), 104-112.
23. UNC. (2010). No sponge left behind. Accessed from http://www.med.unc.
edu/www/newsarchive/2010/october/no-sponge-left-behind
24. Wallis, J., Fletcher, D. J., Bentley, A., & Ludders, J. W. (2019). Medical errors
cause harm in veterinary hospitals. Frontiers in veterinary science, 6, 12.
25. Witman, A. B., Park, D. M., & Hardin, S. B. (1996). How do patients want
physicians to handle mistakes?: A survey of internal medicine patients in an
academic setting. Archives of Internal Medicine, 156(22), 2565-2569.
14The Countless Colours
of Hematology
Amelia Norman
Red. The colour of love and war. It is associ- transition metals since these elements find it
ated with passion and power, raw emotions easy to take and donate electrons, therefore
and strength in ability. Surrounded by all this making it easier for them to bind and unbind
symbolism, it is often forgotten to look fur- oxygen.1 Different transition metals are able
ther down the road of reasoning and wonder to absorb and emit different wavelengths of
why the colour red stands for certain con- light, thus displaying a variety of colours.
cepts in society. Why is it so attached to life This creates the range of blood colours seen
and human emotion? The heart, in a human, among different animals today.
pumps blood around the body, and when this
blood is oxygenated, it appears red. Therefore, The respiratory pigment in an animal’s
the colour red is often associated with human blood decides the colour of that species.1
existence. It is humanity’s lifeline. Red blood, Humans, as well as some other mammals,
however is not the usual among all animals. have hemoglobin as their respiratory pig-
Whereas humans bleed red, other species ment.1 Hemoglobin binds oxygen and trans-
bleed a variety of colours from blue to green ports it throughout the body, allowing for
to purple to, in some cases, colourless. Blood cellular respiration to occur and energy to be
colour is not a random event, there is a rea- made. Within hemoglobin there is an iron
son as to why not everything has red blood. atom, and this atom absorbs blue light and
Over time the world has changed, shaping emits red light.1 Therefore, those beings with
the way that the animal kingdom lives as they hemoglobin as their respiratory pigment
adapt to the dynamic domain that they call have red blood.1 Other animals possess the
home. respiratory pigment hemocyanin.1 Instead
of iron, hemocyanin contains a copper atom
Blood colour is determined by specific mo- which, unlike iron, absorbs red light and
lecular compounds called respiratory pig- emits blue light.1 As a result, individuals with
ments.1 There are a variety of pigments that hemocyanin have blue blood.1 Blue-blood-
exist within blood, and they all work to carry ed creatures are often arthropods or mol-
oxygen from one location within the body lusks.1 Green blood can be the result of a
to another.2 Each pigment, when bound to couple different respiratory pigments. Both
oxygen, emits a certain colour.1 Respiratory chlorocruorin and hemoglobin can produce
pigments contain atoms that have oxygen green-blooded animals.1 In chlorocruorin,
binding ability.1 These atoms are usually there is an iron atom which binds oxygen
15which binds oxygen and emits green light.1
While the iron in hemoglobin makes the
blood appear red, in chlorocruorin, it gives
blood the colour green instead. Another way
in which animals can have green blood is
with the respiratory pigment hemoglobin,
however, there is a key step that occurs within
the animal’s metabolism that makes the blood
green and not red.1 In humans, red blood
cells are recycled. Hemoglobin is converted
to biliverdin and biliverdin is then converted Figure 1. The structure of hemoglobin.4
to bilirubin.1 Bilirubin is a compound that
emits yellow light and is toxic to the body.
Therefore, the liver works to remove it from Perhaps the most unique blood colour, found
the systemic circulation. Biliverdin is a com- in very few species, is colourless blood. There
pound that emits green light and in some are some animals, specifically ice fish, that
species it is the dominating compound in contain no respiratory pigments.1 Without
their blood.1 Whereas humans quickly trans- a respiratory pigment to emit specific wave-
form biliverdin to bilirubin for easy elim- lengths, the blood appears colourless.1 How-
ination, some animals are unable to make ever, colourless blood is very rare because for
this conversion, resulting in an increase in an animal to have no respiratory pigment,
the amount of biliverdin present.1 The green certain conditions must be present. In the
from the biliverdin is able to overpower the case of the ice fish, the cold water in which it
red from the hemoglobin, therefore while one lives contains a high amount of oxygen so no
would assume the blood to be red, it actual- oxygen transporter is needed in the blood.1
ly appears green.1 Skinks are known to have The fish’s habitat allows for the absence of an
green blood due to a biliverdin and hemoglo- oxygen binding molecule. The ice fish also
bin imbalance.1 has an increased blood volume compared to
other fish, due to the lack of a respiratory pig-
Other animals that have chlorocruorin in ment.1 Living in a high oxygen environment,
their blood are often part of the annelida phy- the ice fish has evolved by eliminating respi-
lum.1 Another colour that is seen among an- ratory pigments and increasing blood vol-
imals is violet.1 Hemerythrin, the respiratory ume. A variety of blood colours exist among
pigment, contains an iron atom that, when species and the wide colour spectrum can
bound to oxygen, emits violet light.1 Brachio- be associated with the variety of respiratory
pods are the predominant animals possessing pigments that exist.
this respiratory pigment.1 While there are
various respiratory pigments present among There are many different respiratory pigments
animals, one rare species has adapted to and the question of where these pigments
thrive without any respiratory pigment at all. came from is not uncommon. Many of the
answers are yet to be found, however some
links have been made between hemocyanin
and tyrosinase.3
16It was discovered that these two proteins References
both originate from a polypeptide that had a 1. Lutz D. The many colours of blood. American Chemical Society [Internet].
2016 [cited 2019 Jan 4]; 95-7. Available from: https://www.acs.org/content/dam/
copper element in its sequence.3 A theory for acsorg/education/resources/highschool/chemmatters/issues/best-of-chemmat-
ters/sample-lesson-plan-the-many-colors-of-blood.pdf
the origin of hemocyanin is that it was once
a form of tyrosinase.3 A long time ago, before 2. Hine R, Martin E. Respiratory pigment. Oxford University Press [Internet].
2016 [cited 2019 Jan 4]; 7. Available from: http://www.oxfordreference.com.
oxygen was as abundant as it is today, species subzero.lib.uoguelph.ca/view/10.1093/acref/9780198714378.001.0001/acref-
9780198714378-e-3844
thrived off of the lack of oxygen.2 Therefore
3. Lieb, B. Structures of two molluscan hemocyanin genes: significance for gene
when the oxygen content on earth started evolution. P Natl Acad Sci USA [Internet]. 2001 [cited 2019 Jan 6]; 98(8):4546-
to rise, many species may have died.2 Those 4551. Available from: https://www-jstor-org.subzero.lib.uoguelph.ca/sta-
ble/3055466?seq=4#metadata_info_tab_contents
animals with tyrosinase and its copper com-
4. Austin Peay State University. The components of hemoglobin [Image on
ponent in their blood may have started using internet]. Benjamin-Cummings; 2001 [cited 2019 Jan 7]. Available from: https://
www.apsubiology.org/anatomy/2020/2020_Exam_Reviews/Exam_1/CH17_He-
tyrosinase as an oxygen binding protein to moglobin_and_Iron_Metabolism.htm
survive, eventually evolving into oxygen-us-
ing species.2 Hemocyanin is thought to have
evolved from the tyrosinase protein. Perhaps
other respiratory pigments originated in a
similar way, hemoglobin developing from
another protein that contains iron. Never-
theless, the way in which these pigments
originated has allowed them to help animals
function successfully in an oxygen abundant
environment.
The colour of blood, while very symbolic,
also has other functions. It provides infor-
mation on respiratory pigments, connects
species with their habitats and way of living,
and gives indications of evolution that has
occurred in the animal kingdom. The sci-
entific world has gained a great amount of
knowledge on the past due to investigating
blood colour. Who knows, perhaps there is
still much to be learned about the future, if
humans are able to decode even more in the
field of hematology.
17PROBIOTIC PETS:
The interactions of microbial
communities between owner and
pet
Dennis Zhu
The definition of a human organ system is microbes, which often get transferred to their
a collection of anatomical structures that owner during handling.6 Interestingly, the
function cohesively to maintain homeostasis. length of time an individual spends with a
It is often said that humans have 11 major dog is directly proportional to the similarity
organ systems; the integumentary, skeletal, of the microbe communities. As the result of
muscular, nervous, endocrine, cardiovascu- this, dog owners tend to have a significant-
lar, lymphatic, respiratory, digestive, urinary, ly greater diversity of bacteria on their skin
and, reproductive systems. Each one of these and within their intestines when compared
systems are critical in executing an important to non-dog owners.6 Furthermore, dogs may
task for the body and cohesively work in uni- also facilitate the transfer of microbes be-
son to modulate homeostasis. For instance, tween the household. Couples that cohabited
the nervous system secretes peptide hor- with a dog contained similar community taxa
mones to trigger appetite while the digestive between each other while couples that did not
system catabolizes ingested food into simpler own a dog had significantly different commu-
molecules for metabolism. In the field of nities.7 The beneficial effects of certain bacte-
research, scientists have been slowly uncover- ria such as those in the genre Ruminococcus
ing the mysteries of a 12th organ system, one and Oscillospira are correlated with lower
that plays a major role in regulating metabo- rates of obesity and allergy-related illnesses.1,5
lism, behavior, and, disease immunity despite
being completely invisible to the naked eye.7
That is, the host microbiome; the aggregate of
microbial communities such as bacteria that
exist within and on the surfaces of the human
body.7
Alike the genetic make-up of individuals, mi-
crobiomes are unique to each person.7 Inter-
estingly, the communities of microbes found
on canines are often alike to those found on
their owner.6 As dogs wander around in the
outside environment, their paws and noses Figure 1. Similarity of microbe communities
often pick up a wide array of benign between same and different families.6
18Subsequently, children raised in an environ-
ment with dogs had greater amounts of gut
Ruminococcus and Oscillospira.8 Although
there are many beneficial organisms on dogs
that can be transferred onto humans, there
are also a wide array of parasites that can
cause zoonosis. Common canine parasites
such as Toxocara canis (canine roundworm)
can infect owners after handling fecal mat-
ter and cause severe asthma.4 Specifically for
feline enthusiasts, a different single celled
Figure 2. Mouse scent preference; cat vs
parasite resides in cats that can be easily
rabbit.2
transmitted to humans.
The term “crazy cat lady/man” is coined to The genes TgAaaH1, TgAaaH2 within the
allude to the individuals who seemingly have genome of T.gondii allow the translation of
no limit to the number of feline companions tyrosine hydroxylase, an enzyme catalyzing
they could keep. It was often thought that this the formation of dopamine, and is perhaps
unsatisfiable desire for cats was the outcome the mechanism to facilitate these behavior
of self-inherited psychological abnormali- changes.3 Although there has not been a
ties however, researchers have been linking causal relationship confirmed with toxoplas-
this issue to a sneaky protozoan; Toxoplasma mosis and feline-affinity, it is worth noting
gondii. This protozoon has two distinctive given that 30% of the world’s population is
life cycles; an asexual phase that requires an infected with this organism.3
intermediate host (e.g. humans, birds, rats)
and a sexual phase that requires a single The depth and complexity of how certain
definitive host; cats.3 T. gondii will often be microorganisms can affect our health and
transmitted to humans (toxoplasmosis) via behaviour is not yet fully understood howev-
contact with feline feces and quite often re- er, we can certainly say that there are many
mains asymptomatic. In a classical case study hidden interactions that have yet to be ful-
with rats, researcher have discovered that ly uncovered. When animals and humans
T.gondii can migrate to areas of the brain and co-inhabit, their microbiomes undoubtedly
alter the behavior of these animals.2 Rats that interact and mix.1,6 Thus, the popular idea
were infected with T.gondii seemingly lost the that pets are very similar personality-wise to
natural instinct of resisting predation and ac- their respective owners may be very true, just
quired imprudent attraction to feline scents.2 in reverse.
While non-infected rats would avoid areas
scented with cats, infected rats would hap-
pily prance into a urine-laden environment
to their demise.2 It has been thought that the
evolutionary function of this behaviour mod-
ulation is to increase the probability of the in-
termediate hosts to become predated so that
the parasite could complete its sexual stage.2 19References
1 .Almqvist, C, a-C Egmar, G Hedlin, et al. Direct and Indirect Exposure to Pets
– Risk of Sensitization and Asthma at 4 Years in a Birth Cohort. Clinical and Ex-
perimental Allergy. 2003. Journal of the British Society for Allergy and Clinical
Immunology 33(9): 1190–7. DOI: 10.1046/j.1365-2222.2003.01764.x.
2. Berdoy, M., Webster, J. P., Macdonald, D. W., (2000) Fatal attraction in rats
infected with toxoplasma gondii. Proc. R. Soc. Land. https://doi.org/10.1098/
rspb.2000.1182
3. Gaskell EA, Smith JE, Pinney JW, Westhead DR, McConkey GA (2009) A
Unique Dual Activity Amino Acid Hydroxylase in Toxoplasma gondii. PLoS
ONE 4(3): e4801. https://doi.org/10.1371/journal.pone.0004801
4. Glickman, L. T., Magnaval, J. F., (1993). Zoonotic roundworm infections.
Infectious Disease Clinics of North America, 7(3), 717-732
5. Johnson, C. L., & Versalovic, J. (2012). The human microbiome and its poten-
tial importance to pediatrics. Pediatrics, 129(5), 950-60.
6. Song, S. J., Lauber, C., Costello, E. K., Lozupone, C. A., Humphrey, G.,
Berg-Lyons, D., Caporaso, J. G., Knights, D., Clemente, J. C., Nakielny, S.,
Gordon, J. I., Fierer, N., … Knight, R. (2013). Cohabiting family members share
microbiota with one another and with their dogs. eLife, 2, e00458. doi:10.7554/
eLife.00458
7. Structure, function and diversity of the healthy human microbiome. Na-
ture.2012;486(7402):207-214; PMID: 22699609.
8. Tun HM, Konya T, Takaro TK, et al. Exposure to household furry pets
influences the gut microbiota of infant at 3-4 months following various birth
scenarios. Microbiome.2017;5(1):40; PMID: 28381231.
203D PRINTING:
A RELATIVELY RECENT INNOVATION IN
VETERINARY MEDICINE
Arshia Nazem
Veterinary medicine has always been con- For instance, the College of Veterinary Med-
cerned with improving animal welfare and icine at the University of Tennessee mostly
quality of life. However, certain methods and uses these guides for the treatment of angu-
procedures are known to have specific limita- lar limb distortions and spinal operations.4
tions, which make veterinarians wonder how 3D printing is greatly used in the treatment
to find better methods that could surpass of limb and skull deformities, oral fractures,
these limitations. Regardless of the method and mandibular reconstructive surgeries.2
chosen, procedures should highlight the im- Additionally, the Auburn University Veteri-
portance of ethics by considering whether the nary Teaching Hospital uses this technology
animal would be able to have a high quality of to deal with complex situations such as a case
life if kept alive.1 As a new method, 3D print- involving a horse with facial bone fracture as
ing, also known as rapid prototyping or addi- a result of being kicked in the face.4 In this
tive manufacturing, has opened new doors in scenario, 3D printing assisted critical deci-
veterinary medicine.2,3 This technology has sion-making with regard to the operation and
existed for many years; however, its applica- determining what implants to use on the skull
tion in veterinary medicine is quite recent. of the horse.4 Evelyn Galban, a clinical assis-
tant professor of neurology and neurosurgery
3D printing has helped the development of at the University of Pennsylvania (Penn Vet),
veterinary medicine in many aspects such as uses additive manufacturing for treating spi-
3D-printed surgical models, face masks, pros- nal problems in dogs.4 Dr. Galban states: “A
thetics and orthotics, surgical planning and lot of our patients have a spinal malformation
education.3,4 3D printing allows veterinarians in which the vertebrae did not form normal-
to access and examine custom-made phys- ly, resulting in instability”.4 She believes that
ical models of skulls, bones and body parts there are many different operations to correct
through computerized tomography scans (CT spinal instability; however, she believes that
Scans).3 This enables them to create cutting 3D printing is quite advantageous relative to
and drilling guides and create a plan prior to other approaches.4 This method creates an ar-
surgical procedures, which reduces the time tificial duplicate of the patient’s spinal curva-
under anaesthesia, while improving the out- ture, which can then result in a custom-made
come of the procedure.2,4 stabilizing device that would match the spinal
malformed curve like a puzzle. 4
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