lay people provide them? If the latteris allowed, how closely should lay peo-plebe regulated and/or monitored,and how much training, licensing, re-gistration, oversight, and other restric-tions should apply?
Is There a Dentist in the House?
Should equine dentistry berestricted to licensed veteri-narians? Those who answer
argue that veterinary dentistry involves the practice of veterinary med-icineand that many horses requirechemical restraint or diagnostic proce-dures (e.g., radiography, nuclearscintigraphy) that are available only through veterinarians. Conversely,many veterinarians would prefer to letsomeone else do the work.
Is Newer Better?
When a new procedure becomesavailable, should veterinarians aban-don traditional techniques in favor of emerging technology? For example,carbon dioxide lasers are being usedto perform onychectomy in cats be-cause of the improved pain and hem-orrhagecontrol seen immediately aftersurgery compared with conventionaltechniques. Some veterinarians alsocite the potential for less stress to catsbecause the paws do not need to bebandaged when lasers are used. How-ever, beginning approximately 3 daysafter surgery, tissue necrosis occurs atthe site of the laser cut. Infection,hemorrhage, or dehiscence may occurin cats that are not properly confinedand kept away from litter, and digitalpad necrosis that results in a smaller weight-bearing surface can lead tolate protrusion of the second phalanx.
Trauma-Induced Cardiac Arrhythmia
Many dogs develop car-diacarrhythmia from se-vereshock or trauma,and clinicians disagree on how
to treat this condition.Some clinicians provide aggressiveantiarrhythmic therapy, often viaconstant-rate intravenous infusion, whereas others prefer to treat mostof these patients with cage rest and
unless there is defi-nite evidence of hemodynamic im-pairment. Among the reasons forthis
approach is the con-cern that antiarrhythmic agents may have proarrhythmic effects that ac-tually aggravate or enhance existingarrhythmias. This phenomenon is aconcern in humans, but whether itoccurs in dogs is open for discussion.
Food Animal Medicine
Events and pressures affect-ing the North American ag-ricultureindustry may shapethe world of food animal medicine in ways that are difficult to predict. Pro-duction agriculture will be caught be-tween the intense need for more foodproduction in the coming decades andincreased concern about the environ-mental impact of farming methods. Asagricultural markets become globaland concentration of the industry continues, many practitioners face po-tentially rapid reductions in theirclient base and changes in the types of services demanded. The profession isbeing caught in cultural conflicts (e.g.,animal welfare, production systems,farm ownership, use of genetically modified organisms) about how foodproduction should be organized. Inaddition, some have expressed con-cerns about the concentration of pow-er in fewer marketing channels. Theseand other factors will place intensepressures on practitioners to addressissues and participate in debates ontopics that previously were never seenas the purview of veterinarians. Differ-ing value systems (in producers, con-sumers, and practitioners themselves) will place a premium on the need foropen, science-based consideration of the trade-offs that will have to bemade to find a middle ground amongthese competing interests.
Neither a Food nor a Drug
Pet owners are buying nutra-ceuticals,herbal remedies,and other
medi-cines for both themselves and theirpets. Few studies have investigated
December 199920TH ANNIVERSARY
the efficacy of these products in any species, and at least one (i.e., col-loidal silver) has been found to behighly toxic. How do veterinarians de-cidewhich products to recommendor discourage, and how do they coun-selclients without alienating them?
Use of Medication inPerformanceHorses
As horses age, injury andother insults can limit ex-pectations for athletic per-formance and enjoyment as well asquality of life. Performance-enablingmedications can assist horses andtheir owners in the controlled pursuitof pleasure use and athletic potential.However, medications that may mask an injury or illness have the potentialto exacerbate the condition and puthorses at risk of greater harm. Withmedication comes the risk of compli-cations (e.g., phenylbutazone and ul-cers),and the question is raised wheth-ermanipulating horses with drugs isserving goals that are not in thehorse
s best interest.
Endocrine Disease in Ferrets
Adrenal gland disease and insulinomaare
conditions in ferrets. Isthis because of inbreeding, improperdiet, or early spay/neuter (i.e., before 6 weeks of age)? Or are these diseases be-ing seen more frequently because fer-rets have become popular pets and arenow exhibiting
diseases neverencountered in laboratory ferrets?
Veterinary medicine is be-coming more sophisticatedin its knowledge of trans-plantation techniques. The basicproblem is the ethical and moraldilemma of how to procure organs.Kidney transplantation in cats, forexample, is now routine; unlike inhuman medicine, however, organscannot be obtained from a healthy and willing relative or a terminal ac-cident victim. Instead, donor organscome from shelter cats or from othercats owned by the recipient
s owners.Some veterinarians question whether