Anaesthesia:
The Veterinary Anesthesia Support Group
http://www.vasg.org/
The Veterinary Anesthesia Support Group is a website created and maintained by veterinary general practitioners with an interest in anesthesia, who have (in their own words) established above average anaesthetic protocols within their own practices. Their aim is to provide a readily available reference for anaesthesia, but emphasise that there is no "one size fits all" approach, and each animal should be assessed as an individual.
There are a number of sections, including analgesia, protocols, patient support and information by drug. The analgesia section describes an overview of the pain process and has discussions of the use of techniques and drugs such as constant rate infusions, NSAID administration and epidurals. The protocols section contains various drug protocols for pre-medication, induction and maintenance of anaesthesia. A section on various disease categories provides information on tricky anaesthetics such as diabetics and intracranial disease, and there is a useful formulary or anaesthetic drugs. Various support materials are available via e-mail (eg drug dose charts, iv fluid bag based CRI spreadsheets). The patient support section discusses the use of supplemental heat, fluids and monitoring.
This is an invaluable site, full of informative but easily digestible material, either to dip into for specific advice or to peruse in detail if you wish to re-assess your entire approach to anaesthesia.
The American College of Veterinary Anesthesiologists
http://www.acva.org/
The main point of interest in this site are a large number of abstracts from several meetings which can be browsed. There are none more recent than 2002, but those hosted are of use. ACVA position statements include an article outlining the ACVA recommendations for monitoring of anaesthesia in horses, as well as recommendations on pain relief, monitoring small animals and dealing with waste gases. Part of the site is restricted to ACVA diplomates, but it appears this is mainly to do with the administration of the organisation. Information about ACVA certification and residency standards is found on the front page, and there is even a positions vacant section for any anaesthetists who wish to move to the States.
Michigan State University Veterinary Teaching Hospital: Anaesthesia section
http://www.cvm.msu.edu/services/aneth/
This site is intended for use of students on their anaesthesia rotation in Michigan State University Veterinary Teaching Hospital. This does not mean that the information provided is all basic, however. The university's anaesthesia protocols are listed, for healthy dogs and for difficult anaesthesia situations, such as bronchoscopy, caesarian section, the sick or debilitated animal and the portosystemic shunt. Protocols for exotics, constant rate infusions and monitoring techniques are also listed. Another section of the site discusses maintenance of the anaesthetic machine - important information for anyone involved in anaesthesia. This site gives a comprehensive overview of veterinary anaesthesia, and provides an interesting insight into the protocols of a teaching hospital.
The Virtual Anesthesia Textbook
http://www.virtual-anesthesia-textbook.com/
The Virtual Anesthesia Textbook aims to draw information from the internet into one concise, textbook style website. It is largely dedicated to human medicine. There is a chapter on veterinary anesthesia, but it comprises mainly links to publishers, universities and equipment manufacturers. By contrast, the chapter on water, electrolyte, renal and acid-base, contains links to such gems as the "The fluid book", a comprehensive online text on fluid homeostasis, and a guide to renal physiology and function. Other chapters are similarly interesting, but some of the site is obviously less relevant to veterinary than human practitioners.
Cardiology:
VetGo Cardiology
www.vetgo.com/cardio/index.php
This excellent site provides a good overview of the subject of cardiology, with detailed information on a number of topics. The front page lists sections on cardiology concepts, quarterly cases, radiograph of the month, heart sound of the month, cardiology database (actually a radiography database) and a drug formulary. The concepts section goes into a surprisingly large amount of detail, covering subjects such as pathophysiology, therapeutics, congenital heart disease, echocardiography and electrocardiography. The information is easily accessibly in note form, and is as comprehensive as a small text book. Quarterly cases currently lists 5 cardiac cases which can be worked through step by step in full. Radiograph of the month has 2 years worth of images which you can use for self-assessment, with detailed analysis of changes provided for each. Heart sound of the month is similar, but allows you to listen different murmurs, with comments on what you are hearing. The drug formulary gives standard doses and side effects of the commonly used cardiac drugs. I would recommend this site to anyone with an interest in cardiology, or to any student revising for finals – it is a truly valuable resource.
Case Studies in Cardiovascular medicine
www.vmth.ucdavis.edu/cardio/cases/
This site is written and maintained by Mark Kittleson, an ACVIM diplomate (cardiology) and author of the book Small Animal Cardiovascular Medicine. Currently 36 real cases are listed, all seen at UC-Davis, and referenced by presenting sign eg cough, syncope, bradycardia. The cases are presented in "rounds" format and each case is comprehensively described, with historical and physical findings, followed by (where appropriate) ECGs, radiographs, 2D and Doppler echo, diagnosis and follow up. In some of the cases, video and audio playback are available. There is also a small ECG library and a couple of photographs of interesting post mortem findings. The site is easily accessible and provides high quality CPD in bite-sized chunks.
CSU Auscultation library
www.cvmbs.colostate.edu/clinsci/callan/index.html
Auscultation is not a skill easily taught without being able to hear the various sounds, and this site helps to rectify this. Heart sounds in dogs, cats, cows and horses can be heard, as well as abnormal breath sounds. Unfortunately the dog and cat sections currently only contain normal heart sounds, but this site would be of use for students getting to grips with auscultation for the first time.
Veterinary Heart Institute
www.vetheart.com
This is the web site of a US veterinary cardiology referral centre. As well as details of their services, there is a section on "instruction materials for veterinarians." There is not an enormous amount of information, but the site is useful for its reviews of recently cardiology abstracts.
European Society of Veterinary Cardiology
www.esvc.net
The ESVC, publishers of the Journal of Veterinary Cardiology, present more cases, in variable amounts of detail. Some of these are quite unusual, such as a cardiac foreign body or a cardiac septal sarcoma. Also on the site are detailed guidelines on the diagnosis of subaortic stenosis, pulmonic stenosis and dilated cardiomyopathy.
Equine cardiology
www.provet.co.uk/equinecardiology
Blackwell Science have made available some of the text of Dr Mark Patteson’s book, Equine cardiology, online at this site. Dr Patteson is an expert equine cardiologist, and his book is one of the few resources on this subject. Topics covered include cardiac anatomy and physiology, clinical examination, diagnostic aids, congenital and acquired heart disease and arrhythmias. The final section gives useful advice on such problems as poor athletic performance, collapse, sudden death, and the ever tricky pre-purchase exam.
Miscellaneous:
BSAVA
http://www.bsava.com
The newly updated BSAVA website is a much more impressive beast than the old one.
In the non-members section there are sections on advice (eg MRSA, pet passports, medicines), publications and CPD announcements. The members section gives access to MP3s from BSAVA congress, plus online versions of JSAP, Companion, and the BSAVA formulary. There is also an online CPD log which members can use to keep track of the ongoing CPD. A forum section is promised but not available yet. Altogether a much more useful site, although FAB style disease information downloads would be a useful addition for the future.
RCVS online
www.rcvs.org.uk The RCVS website makes no pretensions to be a place for veterinary surgeons to come and learn, but instead concerns itself with the same functions that the RCVS itself performs: further education administration, professional conduct and issues affecting the profession as a whole. For vets pursuing RCVS qualifications, allowing students to see practice, interested in larger issues such as the competition commission, or looking for advice on matter of professional conduct, the RCVS website is essential to stay up to date.
For veterinary nurses, and practices involved in VN training, there is information on training practices, external verifiers and examinations, together with a large number of downloadable forms and documents necessary to wade through the red tape involved in training a VN.
For the general public, there is information on the role of the RCVS, careers information, how to make a complaint (and a helpfully public online Guide to Professional Conduct so the general public can see exactly where their vets may be deficient!) as well as a "Find a Vet" service.
The whole website has just been re-vamped, with a new look. The changes are largely cosmetic, but it is a little easier to navigate than the old site. It also conforms to legal requirements for accessibility in the new Disability Act, which many people will be unaware applies to websites.
The RCVS website doesn’t make fascinating reading, but neither does Yellow Pages, and they both fulfil a useful role.
Vet humour
(http://www.e-vet.com/humour2_new.htm)
If the above web sites have depressed you somewhat, visit the veterinary humour section of the e-vet site (which will be reviewed at a later date, along with the e-vet e-mail list). There are some excellent animal quotations, such as "If dogs don’t go to heaven, when I die I want to go where they went," medical terms: "Benign: What you be after you be eight", answers to "why did the chicken cross the road?" plus some oldie but goodie shaggy dog stories. Also useful for pepping up your after dinner speeches.
Neurology:
Canine Epilepsy Network
http://www.canine-epilepsy.net/
This site is intended to be a resource for everyone interested in canine epilepsy, from owners and breeders, through vets, to research scientists. This is rather a broad target market, and in fact the most useful information on here will probably be to owners – the epilepsy basics guide is a good, in depth guide for owners of newly diagnosed epileptics. For vets, there are some details of the site authors ongoing research.
Virginia-Maryland Regional College of Veterinary Medicine – Veterinary Neurology
http://education.vetmed.vt.edu/Curriculum/VM8654/
This site hosts this college’s undergraduate neurology course. Lectures are presented as long and detailed pdf files, illustrated with diagrams where appropriate. Self assessments with detailed answers are provided for several of the sections. Among some of the more useful sections are an algorithm for treatment of the seizuring animal, and a guide to lesion localisation. This is a useful overview of the subject of neurology, with some considerable depth in parts.
Veterinary Neurology and Neurosurgery
http://www.neurovet.org/
This site is an on-line, peer-reviewed, international journal, dedicated to clinical practice and research in neurological disorders of animals. The on-line nature allows it to be distributed free of charge, and also allows the use of electronic format material that would not be possible in a print journal. Examples of this latter advantage include several video presentations of neurological disorders, including dogs suffering from cataplexy/narcoplexy while feeding or exercising, myoclonus and gait abnormalities.
Contents in the latest (February 2005) issue include a review of neuromuscular disorders affecting young dogs and cats, a review of clinical EEGs in dogs, and several case reports and case series. There are also a number of "what is your diagnosis" style case studies, often accompanied by videos. This journal has an interesting mix of material appropriate both at specialist and general practitioner level. It is encouraging to see this use being made of the internet’s capabilities, and one can only hope other journals follow suit.
Braund’s Clinical Neurology in Small Animals
http://www.ivis.org/advances/Vite/toc.asp
This is the full online text of a recent and comprehensive neurology book. It is divided into sections on neuroanatomical localisation and syndromes, aetiological categories of neurological diseases, neurodiagnostic techniques and special therapeutic techniques. Chapters within these sections are illustrated and fully referenced. The neurological imaging chapter has a large number of excellent images of radiographs, CT and MR images. This is an excellent neurology resource, and is hosted for free by the International Veterinary Information Service (IVIS). IVIS (www.ivis.org) is a huge veterinary resource in itself which is well worth browsing. Accessing the site requires registration, which is free.
Deafness in Dogs and Cats
http://www.lsu.edu/deafness/deaf.htm
All you wanted to know about deafness but were afraid to ask. This Louisiana State University hosted site has information about dog and cat breeds predisposed to deafness, prevalence figures, causes of sudden onset deafness and a guide to the brainstem auditory evoked response test. As well as a few links to other sites of interest, there are a number of full text peer-reviewed articles written by the site’s author
Oncology:
British Veterinary Oncology Study Group
http://www.vetoncology.org.uk/index.htm
This group aims to bring people interested in veterinary oncology together, in order to disseminate information on latest advances and best practice in the field. They also aim to produce collaborative clinical studies and in diagnosis and surgical and medical treatment of cancer. Proceedings of the first 4 annual meetings are available online, but unfortunately give very limited detail on the content of the lectures.
Veterinary Cancer Society
http://www.vetcancersociety.org
The Veterinary Cancer Society is a USA based organisation which, as with the British organisation, aims to promote communication amongst professionals involved in veterinary oncology, to collect data, and to design, implement and evaluate studies into cancer. Links to ongoing clinical research trials at US organisations are provided, but many of these links were broken. Ongoing studies by the Veterinary Cooperative Oncology Group are listed, which currently include investigations into mast cell tumours, the use of carboplatin in melanomas, and mandiulectomy in cats. However, clinical information relevant to practitioners is quite limited on this site.
Vaccine-Associated Feline Sarcoma Task Force (VAFSTF)
http://www.avma.org/vafstf/default.asp
Despite the military sounding title, this organisation was founded in 1996 in response to the increased incidence of soft tissue sarcomas found at vaccination sites. The VAFSTF’s goals are to help investigate the epidemiology, aetiology, treatment and prevention of this condition. Information and guidelines on vaccinations, (both the need for and the problems with) are provided for the general public, and for the veterinary practitioner there are guidelines on the diagnosis and treatment of suspected vaccine-associated sarcomas, and vaccination site guidelines. A report on a round-table discussion by experts in the field in 2005 is available to provide the latest understanding of the disease.
Pet Cancer Vet
http://petcancervet.co.uk
This is the homepage of a private practice in Yorkshire which takes referrals in oncology. There is information for owners on the basics of cancer and some useful information for vets, including a weight:body surface area conversion chart. However, of particular interest is the section on electrochemotherapy. While the site acknowledges that this is a new and relatively unproven technology, it has reportedly shown some promise in tumours which are either inoperable, or where surgery would provide unacceptable morbidity to the animal. Cases for which the site claims treatment success with this technique include a fibrosarcoma in a cat’s paw, a synovial cell sarcoma in a dog’s leg and a squamous cell carcinoma in a dog’s mandible.
Radiology:
University of Minnesota, Department of Radiology
http://www.academic-server.cvm.umn.edu/radiology/
This site currently has 38 diagnostic imaging cases, 22 of which are radiographs. CT, MRI and ultrasound images are also included. The cases are not basic, including examples such as blastomycosis, a phaeochromocytoma and a strange radiograph of the chest of a calf with an ectopic heart, but are interesting and informative. Elsewhere on the site is a section on radiographic procedures, but this is currently incomplete and only has techniques for IVU and myelography.
Exotics radiology
http://cal.vet.upenn.edu/specrad/radiology/entrance.html
Radiography can be an important tool in the work up of the diseases of exotic animals, but given the variety of anatomies, and the infrequency with which the procedure is performed in exotics in general practice can make diagnosis difficult. This cheerful site provides normal radiographs of birds, rabbits, ferrets, iguanas and turtles, with anotations to show the locations of the major organs. 6 cases are presented in a walkthrough format. However, if the Microsoft Office paperclip annoys you, the style of this site may also.
Kansas State University College of Veterinary Medicine - radiology cases
University of Pennsylvania School of Veterinary Medicine - radiology cases
http://www.vet.ksu.edu/depts/VMTH/radiology/cow/index.htm
http://cal.vet.upenn.edu/radiology/index.html
These two university hosted sites both offer a series of radiology cases, with details of the clinical findings and discussion of the radiographs and the final diagnosis. The Kansas State site boasts 34 cases to a paltry 5 from Pennsylvania, but the Pennsylvanian cases are more detailed and have a more interactive approach to the diagnosis. The Kansas State site includes equine cases, and elsewhere on the site can be found annotated radiographs of normal horses.
Uroradiology
http://education.vetmed.vt.edu/Curriculum/vm8644/urorad/urorad.html
This site concentrates on the urogenital system, and a large number of images are hosted, categorised into 3 groups as abdominal masses and the peritoneal cavity, the upper urinary tract, and the lower urinary tract. These images are presented purely as the radiograph with a title describing the subject eg polycystic renal disease, ectopic ureter, with no signalment or history and no opportunity for self assessment. However, working through all the images on this site will be a good refresher in abdominal and urogenital radiology.
General veterinary radiology tutorials
http://www.animalinsides.com/genrad/genrad_main.htm
This section of a larger site concentrates more on radiography than radiology - how to get a good image safely. There is a lot of information here, which will be of use both to nurses studying for their final exams and vets wishing to improve their radiographic technique. Sections include how to use sandbags instead of manual restraint, common sedative protocols, radiation safety and 5 different contrast techniques. There is also a downloadable flow chart to post in your x-ray room, which can help you to make corrections when a poor image is obtained, and a 6 step procedure for making a detailed exposure chart is elucidated. Elsewhere on this site can be found a guide to radiation physics, a discussion of the pros and cons of digital radiography and a slide format presentation on geriatric radiology.
Surgery:
The sites reviewed below show basic surgical and medical procedures in video format. Some are course material for vet students at various universities, so will probably be of most use to that audience. However, new graduates, people returning to work after an absence requiring a refresher, or changing their field of practice (eg large to small animal) should find them useful. More experienced vets may wish to view them to see if they can gain any tips which might improve their technique. However, they will probably be more interested in the sites below that show much more advanced procedures. Some videos require Windows Media Player, some require the Quicktime program which can be downloaded from http://www.apple.com/quicktime/download/
Veterinary techniques videos
http://www.vet.ohio-state.edu/1238.htm
This site, hosted by Ohio State University College of Veterinary Medicine, has a number of resources for students. The page listed above has 59 videos of various basic and more advanced veterinary techniques, from small and large animal medicine and surgery. Examples include CSF collection, bone marrow biopsy, rabbit castration and ovariohysterectomy and lateral ear resection.
Principles of Surgery
http://cal.vet.upenn.edu/surgery/
This site is divided into sections on surgical instruments, preparing the equipment for surgery, preparing the patient for surgery, preparing the surgeon for surgery and sutures. There are videos of a number of suture patterns, from basic simple interrupted, to less commonly used patterns such as Lembert, Connell and Cushing patterns, as well as how to use a skin stapler. The sections on surgical preparation would be useful to trainee veterinary nurses.
Equine castration.
http://www.vet.uga.edu/LAM/teaching/mueller/castration/default.html
This is a step by step guide to the procedure of equine castration. The procedure starts with interviewing the horse owner, which is amusing when questions include "Is the phase of the moon correct for gelding your horse at this time?" Apparently some horse owners believe that if the phase of the moon is right at the time of castration, the horse will perform better. Choices of anaesthetic are discussed, and videos of surgical prep and two techniques for castration are shown. A video of the important stage of recovery is also included.
Small Animal Cardiac Surgery
http://cal.vet.upenn.edu/cardiosf/index.htm
This rather advanced site describes by means of slides and video presentations the surgical techniques involved in treating patent ductus arteriosus (PDA), pulmonic stenosis (PS) and persistent right aortic arch. Obviously these are cases not to be taken on lightly, but they may be of interest to experienced surgeons or those taking further qualifications in surgery. It should be noted that treatment of PDA and PS are increasingly being performed in minimally invasive ways (balloon dilation, coil occlusion) and it is worth getting the opinion of a cardiologist in managing these cases.
http://cal.vet.upenn.edu/saortho/contents/contents.htm
No videos here, but a complete, free orthopaedics textbook, complete with pictures. Unfortunately it is somewhat dated, but many of the basic principles are unlikely to have changed.
Small Animal Clinical Sciences
http://www.vetmed.ufl.edu/sacs/notes.htm
There are a number of resources here for vet students, nurses and recent graduates, but of particular relevance to this article's topic are three quite lengthy videos on hand ties (8 minutes), canine orchiectomy (18 minutes) and canine ovariohysterectomy (30 minutes).
Zoonoses:
National Center for Infectious Diseases
http://www.cdc.gov/healthypets/browse_by_diseases.htm
This website, part of the Centers for Disease Control and Prevention site, lists 32 of the more important zoonoses, including Lyme disease, campylobacteriosis and toxoplasmosis. The site is USA-based, so includes some diseases not seen in the UK, such as rabies and plague, but these will be useful for travellers. The details of each disease are different, but typically give information on transmission, prevention and further sources of information. Although primarily aimed at the general public, this is a useful overview of zoonoses for vets.
Texas Department of State Health Services:zoonotic diseases
http://www.dshs.state.tx.us/idcu/health/zoonosis/default.asp
Although aimed geographically at Texas, USA, there is a large amount of information on zoonoses that are also found in the UK, such as leptospirosis and salmonellosis. There is information on the number of reported human cases of various zoonotic diseases, year by year for the last 10 years. There are also maps of reported diseases, which require special software to view in some cases. But this is a useful model for how other countries and regions could make information on local zoonoses available to the public and to health professionals.
Ectoparasites and Endoparasites
http://www.soton.ac.uk/~ceb/EctoEndodirectory/zoonoses.htm
Part of a larger and interesting site on parasitology.