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20TH ANNIVERSARY Compendium December 1999

On the Horizon…

VeterinaryControversies
D
uring 1999, Compendium celebrated 20 years of publication by ex-
amining how various fields of veterinary medicine have advanced
over the past two decades and considering where they are headed
in the future. Technologic advances, development of new drugs (or new
uses for existing agents), scientific discoveries, and shifting public opinion
will continue to affect veterinary medicine; as the field evolves, controversy
will continue to arise regarding the benefits and dangers associated with
new or changing practices. To wrap up our 20th anniversary celebration,
this month Compendium looks toward the future and topics that are likely
to be debated well into the next century. We polled various experts on cur-
rent controversies, and their opinions are the source for this column. We do
not propose to settle any disputes but rather to present both sides of some
potentially contentious subjects.a than the traditional focus on vaccina-
tions—has arisen.
Vegan Vets?
Many veterinary students who have entered the profession because Alternative Therapies
of their fervent concerns about animal welfare are strongly opposed As in human medicine, the
to food animal agriculture; such students and graduates are leaders main arguments against
in the fight against “factory farming” and promote vegetarianism. On the other alternative therapies in the
side are veterinarians who are leaders in the food animal industry, are responsible veterinary field are the lack of reliable
for much of the industry’s expansion and adaptation of technology, and have scientific studies on the effectiveness
lobbied for improvements in how the industry treats food-producing animals. of these therapies, the lack of stan-
The veterinary profession may be forced to address this issue, particularly in vet- dardized protocols for administering
erinary colleges where faculty need to present course material to all students, them, not knowing whether any in-
even those who find the subject offensive. herent side effects are associated with
such therapies, and the fear that using
Vaccination Protocols them may delay conventional thera-
For years, practitioners have relied on annual vaccinations as py. Conversely, alternative therapies
both a way to guarantee that animals receive routine health may complement conventional thera-
checks and a solid source of income. Recent recommendations that some vac- py, thereby minimizing the use of
cines do not need to be boostered as frequently as once thought have raised con- medications with known adverse ef-
cerns. Whereas some veterinarians believe that the overall health care of pets will fects. In addition, even if alternative
suffer if animals do not need to be vaccinated for some disease each year, others therapy alone does not completely
question whether data from a study investigating the duration of immunity con- treat or cure a disease, it may ease an
ferred by a specific vaccine can be extrapolated to other vaccines. Supporters of animal’s suffering. As owner interest
the revised recommendations argue that the emergence of vaccine-induced sar- in alternative therapies grows, veteri-
coma indicates that vaccinating less frequently is a prudent step; there is also a narians are being forced to offer this
belief that vaccinating too frequently hyperstimulates the immune system, po- option to their clients or lose them to
tentially leading to the development of allergies or other diseases. Amid the con- practitioners who do. The question
troversy, a new emphasis on educating owners about the need for yearly physical then arises: Who is qualified to pro-
examinations and the long-term value of routine preventive health care—rather vide these therapies? Should such al-
a
The editors of Compendium realize that many controversial topics are not presented here.
ternatives as acupuncture or chiro-
Readers interested in preparing a column that discusses the pros and cons of a particular practic manipulation be administered
topic in more detail should contact the appropriate species editor. by veterinarians only, or can trained
Compendium December 1999 20TH ANNIVERSARY

lay people provide them? If the latter of these patients with cage rest and the efficacy of these products in any
is allowed, how closely should lay peo- “benign neglect” unless there is defi- species, and at least one (i.e., col-
ple be regulated and/or monitored, nite evidence of hemodynamic im- loidal silver) has been found to be
and how much training, licensing, re- pairment. Among the reasons for highly toxic. How do veterinarians de-
gistration, oversight, and other restric- this “hands-off” approach is the con- cide which products to recommend
tions should apply? cern that antiarrhythmic agents may or discourage, and how do they coun-
have proarrhythmic effects that ac- sel clients without alienating them?
Is There a Dentist in the House? tually aggravate or enhance existing
Should equine dentistry be arrhythmias. This phenomenon is a Use of Medication in
restricted to licensed veteri- concern in humans, but whether it Performance Horses
narians? Those who answer occurs in dogs is open for discussion. As horses age, injury and
“yes” argue that veterinary dentistry other insults can limit ex-
involves the practice of veterinary med- Food Animal Medicine pectations for athletic per-
icine and that many horses require Events and pressures affect- formance and enjoyment as well as
chemical restraint or diagnostic proce- ing the North American ag- quality of life. Performance-enabling
dures (e.g., radiography, nuclear riculture industry may shape medications can assist horses and
scintigraphy) that are available only the world of food animal medicine in their owners in the controlled pursuit
through veterinarians. Conversely, ways that are difficult to predict. Pro- of pleasure use and athletic potential.
many veterinarians would prefer to let duction agriculture will be caught be- However, medications that may mask
someone else do the work. tween the intense need for more food an injury or illness have the potential
production in the coming decades and to exacerbate the condition and put
Is Newer Better? increased concern about the environ- horses at risk of greater harm. With
When a new procedure becomes mental impact of farming methods. As medication comes the risk of compli-
available, should veterinarians aban- agricultural markets become global cations (e.g., phenylbutazone and ul-
don traditional techniques in favor of and concentration of the industry cers), and the question is raised wheth-
emerging technology? For example, continues, many practitioners face po- er manipulating horses with drugs is
carbon dioxide lasers are being used tentially rapid reductions in their serving goals that are not in the
to perform onychectomy in cats be- client base and changes in the types of horse’s best interest.
cause of the improved pain and hem- services demanded. The profession is
orrhage control seen immediately after being caught in cultural conflicts (e.g., Endocrine Disease in Ferrets
surgery compared with conventional animal welfare, production systems, Adrenal gland disease and insulinoma
techniques. Some veterinarians also farm ownership, use of genetically are “recent” conditions in ferrets. Is
cite the potential for less stress to cats modified organisms) about how food this because of inbreeding, improper
because the paws do not need to be production should be organized. In diet, or early spay/neuter (i.e., before 6
bandaged when lasers are used. How- addition, some have expressed con- weeks of age)? Or are these diseases be-
ever, beginning approximately 3 days cerns about the concentration of pow- ing seen more frequently because fer-
after surgery, tissue necrosis occurs at er in fewer marketing channels. These rets have become popular pets and are
the site of the laser cut. Infection, and other factors will place intense now exhibiting “old age” diseases never
hemorrhage, or dehiscence may occur pressures on practitioners to address encountered in laboratory ferrets?
in cats that are not properly confined issues and participate in debates on
and kept away from litter, and digital topics that previously were never seen Donors Wanted
pad necrosis that results in a smaller as the purview of veterinarians. Differ- Veterinary medicine is be-
weight-bearing surface can lead to ing value systems (in producers, con- coming more sophisticated
late protrusion of the second phalanx. sumers, and practitioners themselves) in its knowledge of trans-
will place a premium on the need for plantation techniques. The basic
Trauma-Induced open, science-based consideration of problem is the ethical and moral
Cardiac Arrhythmia the trade-offs that will have to be dilemma of how to procure organs.
Many dogs develop car- made to find a middle ground among Kidney transplantation in cats, for
diac arrhythmia from se- these competing interests. example, is now routine; unlike in
vere shock or trauma, human medicine, however, organs
and clinicians disagree on how—or Neither a Food nor a Drug cannot be obtained from a healthy
whether—to treat this condition. Pet owners are buying nutra- and willing relative or a terminal ac-
Some clinicians provide aggressive ceuticals, herbal remedies, cident victim. Instead, donor organs
antiarrhythmic therapy, often via and other “natural” medi- come from shelter cats or from other
constant-rate intravenous infusion, cines for both themselves and their cats owned by the recipient’s owners.
whereas others prefer to treat most pets. Few studies have investigated Some veterinarians question whether
20TH ANNIVERSARY Compendium December 1999

it is morally acceptable to put a healthy cat through a sur- derly, families with children under 5 years of age, and im-
gical procedure to save the life of a sick cat. Many surgeons munocompromised individuals. Some even believe that
insist that owners adopt the donor cat, and one could ownership of reptiles as pets should be made illegal, and a
therefore make the argument that by removing a kidney few communities (e.g., New York City) have enacted laws
from a shelter cat, the animal’s life has been saved—it has to do so. Others question whether reptiles represent a
a home and thus will not be euthanized. This may be true greater risk of human salmonella infection than do other
with kidney transplants, but what about other organs? Al- sources (particularly food) and suggest that client educa-
though corneas are easily obtained from cadavers, what tion regarding the potential for infection and how to pre-
about hearts, lungs, and livers? Should one animal be sacri- vent it is key.
ficed in order that another may live? These are the tough
questions that the profession will have to face as veterinari- What About All the Other Animals?
ans become more technically adept, new antirejection Large animal veterinarians cite the need for more
drugs emerge, and owners’ demand for such procedures in- research of drug doses and side effects for minor
creases. species (e.g., sheep, goats, llamas). AMDUCA
regulations have greatly assisted veterinarians in making treat-
Psittacines as Pets ment decisions regarding drug use in these species; these
Pet birds commonly have behavioral problems guidelines allow a wide range of drugs to be used but place
that most veterinarians would categorize as se- responsibility for avoiding violative residues with the veteri-
vere: They pluck feathers until they are bald and narians administering the drug. However, limited market size
self-mutilate to the point of needing medical attention. Not and perceived lack of need may have slowed or stopped de-
even people who are considered the “best” bird owners are velopment of drugs labeled for minor species use. Thus drug
immune from having these pickers as pets. Perhaps more re- dosages and withdrawal times are extrapolated from data de-
search on the wild behavior of birds is needed so that own- rived from other species. The lack of scientific data and label-
ers and practitioners can better supplement the social lives of ing can expose veterinarians to liability suits. The FDA’s mi-
pet psittacines, or perhaps selective breeding to develop nor species drug use program may need to be expanded to
birds that are better adjusted to our society is the answer. develop guidelines for various minor species.
Others would argue that these birds are not meant to be
pets and society’s attitude that “if we can breed these ani- Acknowledgments
mals, they can be pets” should not be allowed to prevail.
The editors of Compendium thank everyone who contributed
to this column:
Aminoglycoside Antibiotics in Cattle
■ David E. Anderson, DVM, MS, The Ohio State Universi-
The Animal Medicinal Drug Use Classifica-
ty, Columbus, Ohio
tion Act (AMDUCA) allows the extralabel use ■ Colin F. Burrows, BVetMed, PhD, MRCVS, University
of aminoglycosides (e.g., gentamicin, which is not ap- of Florida, Gainesville, Florida
proved for use in cattle). Generic gentamicin is very inex- ■ John Fetrow, VMD, MBA, University of Minnesota, St.
pensive and can be effective in cases of pneumonia. How- Paul, Minnesota
■ Patricia Thomblison Franks, DVM, MS, Veterinary Learn-
ever, reliable research demonstrates that gentamicin
ing Systems, Overland Park, Kansas
residues can be detected in cattle kidneys for up to 24 ■ Robert Friendship, DVM, MSc, University of Guelph,
months. Although the American Association of Bovine Guelph, Ontario
Practitioners, Academy of Veterinary Consultants, and ■ Earl Gaughan, DVM, Kansas State University, Manhat-
American Veterinary Medical Association have all passed tan, Kansas
■ Elizabeth M. Hardie, DVM, PhD, North Carolina State
resolutions stating that veterinarians should refrain from
University, Raleigh, North Carolina
using aminoglycoside antibiotics in cattle, such use contin- ■ Althea Jones, DVM, Veterinary Learning Systems, Tren-
ues today. Gentamicin residues could probably be detected ton, New Jersey
in a large percentage of kidneys in some populations of ■ Douglass K. MacIntire, DVM, MS, Auburn University,
slaughtered cattle, effectively giving animal agriculture an- Alabama
■ Nora Mathews, DVM, Texas A&M University, College
other “black eye” in the press. This once again raises the
Station, Texas
question: Just because something can be done, should it? ■ William E. Monroe, DVM, MS, Virginia Tech, Blacks-
burg, Virginia
Reptiles: Harbingers of Disease? ■ James N. Moore, DVM, PhD, University of Georgia,
As concern over salmonella infection increases Athens, Georgia
■ M. Gatz Riddell, DVM, MS, Auburn University, Alabama
in human medicine, how should the veterinary
■ Karen Rosenthal, DVM, MS, University of Pennsylvania,
community address the situation? Many people Philadelphia, Pennsylvania
believe that reptiles are a source for human salmonella in- ■ William S. Swecker, Jr. DVM, PhD, Blacksburg, Virginia
fection and thus are inappropriate pets, at least for the el-

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