Veterinary Medicine - March 2009 - (Page 116)

Correction In Table 4 on page 32 of the article “Local and regional anesthesia techniques, Part 1: Overview and ﬁve simple techniques” (January 2009), the units of measurement for the dosages of medetomidine and dexmedetomidine in the section on the intravenous regional block (Bier block) were incorrect. The units of measurement should have appeared as follows: • 2.5–5 mg/kg (dogs), 2–3 mg/kg (cats) 2% lidocaine; or 1–2 mg/kg (dogs), 1 mg/kg (cats) 1% mepivacaine buprenorphine 0.01 mg/kg local anesthetic; alternatively, dexmedetomidine may be used at 0.25 µg/ml of local anesthetic* tourniquet or sphygmomanometer cuff Surgery of the distal limbs; digit amputation; mass removal or biopsy, wound repair • Bupivacaine should never be used. • +/- morphine 0.1 mg/kg or • Ischemic damage to tissue is possible if the tourniquet is left on > 90 minutes. Intravenous regional block (Bier block) • +/- medetomidine 0.5 µg/ml of • Rapid systemic uptake of local anesthetic is possible if the tourniquet fails, resulting in possible toxicosis. • Sterile 18- to 22-ga IV catheter and * The medetomidine and dexmedetomidine dosages are based on the authors’ clinical experience. The authors also note that the effective minimum dosages have not been determined, but doses less than 1 µg/kg (total) of medetomidine or dexmedetomidine should be safe in patients with cardiovascular stability. Letters Being both the Mayo Clinic and Wal-Mart is OK In the letter “Our profession’s identity crisis” in the January 2009 issue of Veterinary Medicine, Dr. Drew L. Allen writes, “As I look for direction for my practice, should I be looking to the Mayo Clinic or WalMart?” He goes on to say, “Do you want to be a member of the medical community…or are you content to be in after-hours retail sales?” Dr. Allen is not the ﬁrst, nor I suspect the last, veterinarian to criticize veterinarians who choose to offer services other than medical and surgical services. I would like to point out to Dr. Allen that many veterinarians have business interests other than veterinary medicine. Many dabble in real estate, own restaurants, or have consulting ﬁrms. Just because some veterinarians choose to offer ancillary services under the same roof as their medical and surgical services does not make them any less talented or credible. I have no problem with Dr. Allen’s offering only medical and surgical services from 8 a.m. to 6 p.m. Monday through Friday. Likewise, he should have no problem if a erinary facility to either the Mayo Clinic or Wal-Mart. I compare it to a vehicle service station. Do we just pump gas? Do we decrease our proﬁt per transaction by selling gas at a nickel a gallon less than the competition? This may increase our monthly proﬁt, or will it? Do we sell food items on the side? Do we have a towing service? Do we have service bays? Is there a mechanic on staff? What hours are we open each day of the week? People who own vehicle service stations look at their proﬁt centers and their loss leaders. veterinarian chooses to offer medical and surgical services 24 hours a day, seven days a week along with boarding, grooming, training, and daycare. Offer what you are comfortable with and what your client base wants. We all make different choices in life. My offering boarding and grooming at my hospital does not mean that I cannot manage a diabetic cat or ﬁx a dog’s anterior cruciate ligament. Dr. Rick Beldegreen Stoney Creek Animal Hospital Charlotte, N.C. Veterinarians are in the service business I would like to comment on Dr. Allen’s letter in the January 2009 issue. I am a 1974 graduate. Letters such as Dr. Allen’s have been written since I started reading veterinary publications as a student, and I suspect they were being written long before I became a student. The speaker that Dr. Allen referred to had one invalid presumption. We are not in the retail business—we are in the service business. I do not compare a vet- Individuals in veterinary medicine need to decide three things: First, what services do they want to provide; second, how many hours do they want to work; and third, how much money do they want to take home. Then they simply bring these three factors together, which requires compromise. Stated differently, if you want to make more money, then you simply do one of two things: Work longer hours, or invest in specialized services that will generate more income per hour. Dr. William D. Carpenter Fairmont, W. Va. 116 March 2009 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - March 2009

Veterinary Medicine - March 2009 Contents Letters Correction Author Guidelines Hot Literature Idea Exchange A Challenging Case Local and Regional Anesthesia Techniques The Latest Scoop on Litter Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - March 2009

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.