Page 25 - Chiron Autumn 2018

Eradicating Rabies one very confused street dog at a time
with a wildly inconsistent frequency of Propofol top-ups– an unsettling prospect for many a participant more used to the luxuries of volatile agent. Particularly resistant patients requiring top-ops at frequencies exceeding every minute would require the addition of Ketamine and Diazepam as large cumulative volumes of Propofol often resulted in wildly disruptive tremoring (or ‘tap dancing’ as it was delightfully termed locally). The inherently more intensive anaesthetic monitoring required enhanced communication between surgeon and anaesthetist in order to prevent sudden awakenings – a
Right, I’m going to pull on this. Please don’t wake up!
horror frequently suffered by daydreamers upon pulling of the proper ligament.
Lengthy surgical days concluded with formal lectures where the training team discussed and justified their approach to anaesthesia & analgesia, complex wound closure, and antibiotic use – the latter drawing much attention to a historically very poor domestic safeguarding of new generation antimicrobials.
Community engagement extended far beyond taking advantage of ₹100 (£1) a bottle local brew, and the team joined Mission Rabies in their efforts to carry out mass Rabies vaccination on both stray and
Surgical preparation en masse
pet dogs. By implementing a programme of creeping immunisation, teams would aim to successfully capture, vaccinate and release 70% of the dogs in a given village; subsequently a given district; and eventually, in the entire state: 70% being the magic number at which Rabies can no longer sustain itself, with eradication in the entire subcontinent optimistically projected by 2030.
Overall, the two weeks were a challenging, productive yet enjoyable venture that I would recommend to vets of all experiences interested in a high-volume surgical opportunity.
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Ear cleaning: a three-stage approach
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Initial ear flushing (done by a veterinary surgeon only)
The initial ear flush must be done in a veterinary practice before the onset of treatment as it is important to establish that the ear drum is not damaged before any flushing is done. At this stage ears may be thick with wax and debris. A powerful wax softening ear cleaner, such as Otoprof, contains DSS and Propylene Gycol and, uniquely, Carbomide Peroxide. The peroxide base creates a foaming effect that very quickly helps remove and lift to the surface wax broken down by the softening action of the other actives. This significantly reduces the amount of time spent flushing with saline as well as reducing the likelihood of traumatizing the ear canal with catheter flushes.
Stage One / Stage Two - a stand-alone measure
Ear cleaning, to manage early stage ear problems where cleaning is needed, or where antibiotic drops are unnecessary, can be done as Stage 1 if the ear does not need an initial flush. (If an initial flush has been done, then follow-up ear cleaning would be Stage 2.) In these circumstances an ear cleaner needs to offer excellent anti-fungal and anti-bacterial activity. With a pH of 8, Otodine’s very gentle cleaning action is suitable for use in sensitive ears. Its patented formulation includes TrisEDTA, which has a potentiating effect on any antibiotics being used, and Chlorhexidine which is an excellent antibacterial.
Stage three - maintenance to help prevent relapse
Using an ear cleaner to maintain ear health and help prevent relapse requires a gentle cleaner that is easy to administer. Clorexyderm Oto is a water-based solution which travels well into the ear canal, causes minimal irritation and is well tolerated. Its formulation creates an acidifying cleanser with excellent anti- fungal, anti-bacterial and ceruminolytic qualities. It can be used once or twice a week for dogs prone to bacterial and fungal ear problems or the over production of wax, which can be a precursor to these problems.
For further advice, you can call Vetruus on 01494 629979 or visit www.vetruus.com
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