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Pragmatic decision-making in the charity situation
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Pragmatic decision-making in the charity situation
- Authors: Sally Everitt, Rachel Dean and Tim Browning
- From: BSAVA Manual of Canine and Feline Shelter Medicine
- Item: Chapter 3, pp 21 - 40
- DOI: 10.22233/9781910443330.3
- Copyright: © 2018 British Small Animal Veterinary Association
- Publication Date: December 2018
This chapter introduces basic concepts of clinical decision-making and evidence-based veterinary medicine, and suggests how they can be applied in a pragmatic way in a shelter or charitable environment. Decisions made in shelters and charitable organizations can be very different to those made in private clinical practice.Quick reference guides: Dealing with the elderly thin cat; Dealing with the elderly dog; Dealing with heart murmurs in dogs and cats.
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Figures
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3.2
Use of System 1 and System 2 in clinical decision-making. © 2018 British Small Animal Veterinary Association
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3.2
Use of System 1 and System 2 in clinical decision-making.
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3.3
Different options arranged in a ‘decision’ tree to help the decision-making process. (The numbers in the example are fictional and are for explanatory purposes only.) © 2018 British Small Animal Veterinary Association
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3.3
Different options arranged in a ‘decision’ tree to help the decision-making process. (The numbers in the example are fictional and are for explanatory purposes only.)
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3.4
The decisions made for cats in a shelter environment may be very different compared to decisions made for a privately owned cat with a dedicated owner – the evidence will be the same. (© Rachel Dean) © 2018 British Small Animal Veterinary Association
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3.4
The decisions made for cats in a shelter environment may be very different compared to decisions made for a privately owned cat with a dedicated owner – the evidence will be the same. (© Rachel Dean)
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3.5
The cycle of the five steps of Evidence-based Veterinary Medicine. © 2018 British Small Animal Veterinary Association
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3.5
The cycle of the five steps of Evidence-based Veterinary Medicine.
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3.6
A pragmatic approach to the multiple treatments available for many conditions involves careful consideration of which drug will make the most difference. (© Rachel Dean) © 2018 British Small Animal Veterinary Association
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3.6
A pragmatic approach to the multiple treatments available for many conditions involves careful consideration of which drug will make the most difference. (© Rachel Dean)
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Palpation for a thyroid nodule (goitre) is an essential component of physical examination of the elderly cat. Approximately 80% of cats with hyperthyroidism have a palpable goitre. (© Sarah Caney)
Palpation for a thyroid nodule (goitre) is an essential component of physical examination of the elderly cat. Approximately 80% of cats with hyperthyroidism have a palpable goitre. (© Sarah Caney) © 2018 British Small Animal Veterinary Association
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Palpation for a thyroid nodule (goitre) is an essential component of physical examination of the elderly cat. Approximately 80% of cats with hyperthyroidism have a palpable goitre. (© Sarah Caney)
Palpation for a thyroid nodule (goitre) is an essential component of physical examination of the elderly cat. Approximately 80% of cats with hyperthyroidism have a palpable goitre. (© Sarah Caney)
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Assessing the bodyweight of a cat. (© Sarah Caney)
Assessing the bodyweight of a cat. (© Sarah Caney) © 2018 British Small Animal Veterinary Association
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Assessing the bodyweight of a cat. (© Sarah Caney)
Assessing the bodyweight of a cat. (© Sarah Caney)
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Flowchart to illustrate the assessment of an older dog’s health status when the animal’s history is unknown.
Flowchart to illustrate the assessment of an older dog’s health status when the animal’s history is unknown. © 2018 British Small Animal Veterinary Association
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Flowchart to illustrate the assessment of an older dog’s health status when the animal’s history is unknown.
Flowchart to illustrate the assessment of an older dog’s health status when the animal’s history is unknown.
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Providing some of the daily feed in suitable toys can help prevent boredom in older dogs with reduced exercise tolerance. (© Gemma Bourne)
Providing some of the daily feed in suitable toys can help prevent boredom in older dogs with reduced exercise tolerance. (© Gemma Bourne) © 2018 British Small Animal Veterinary Association
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Providing some of the daily feed in suitable toys can help prevent boredom in older dogs with reduced exercise tolerance. (© Gemma Bourne)
Providing some of the daily feed in suitable toys can help prevent boredom in older dogs with reduced exercise tolerance. (© Gemma Bourne)
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Older dogs may appreciate a more sedentary lifestyle. (© Zoe Belshaw)
Older dogs may appreciate a more sedentary lifestyle. (© Zoe Belshaw) © 2018 British Small Animal Veterinary Association
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Older dogs may appreciate a more sedentary lifestyle. (© Zoe Belshaw)
Older dogs may appreciate a more sedentary lifestyle. (© Zoe Belshaw)
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Rehoming an older dog can be very fulfilling for dog and owner alike. (© Zoe Belshaw)
Rehoming an older dog can be very fulfilling for dog and owner alike. (© Zoe Belshaw) © 2018 British Small Animal Veterinary Association
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Rehoming an older dog can be very fulfilling for dog and owner alike. (© Zoe Belshaw)
Rehoming an older dog can be very fulfilling for dog and owner alike. (© Zoe Belshaw)
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Approach to the asymptomatic dog with a heart murmur. Note that in all cases, the gold standard is echocardiography performed by a cardiologist. If not available, see suggestions above. CHF = congestive heart failure; DCM = dilated cardiomyopathy; LA = left atrium; MMVD = myxomatous mitral valve disease; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; PDA = patent ductus arteriosus; PH = pulmonary hypertension.
Approach to the asymptomatic dog with a heart murmur. Note that in all cases, the gold standard is echocardiography performed by a cardiologist. If not available, see suggestions above. CHF = congestive heart failure; DCM = dilated cardiomyopathy; LA = left atrium; MMVD = myxomatous mitral valve disease; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; PDA = patent ductus arteriosus; PH = pulmonary hypertension. © 2018 British Small Animal Veterinary Association
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Approach to the asymptomatic dog with a heart murmur. Note that in all cases, the gold standard is echocardiography performed by a cardiologist. If not available, see suggestions above. CHF = congestive heart failure; DCM = dilated cardiomyopathy; LA = left atrium; MMVD = myxomatous mitral valve disease; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; PDA = patent ductus arteriosus; PH = pulmonary hypertension.
Approach to the asymptomatic dog with a heart murmur. Note that in all cases, the gold standard is echocardiography performed by a cardiologist. If not available, see suggestions above. CHF = congestive heart failure; DCM = dilated cardiomyopathy; LA = left atrium; MMVD = myxomatous mitral valve disease; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; PDA = patent ductus arteriosus; PH = pulmonary hypertension.
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Approach to the asymptomatic cat with a heart murmur. BP = blood pressure; LA = left atrium; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; T4 = thyroxine.
Approach to the asymptomatic cat with a heart murmur. BP = blood pressure; LA = left atrium; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; T4 = thyroxine. © 2018 British Small Animal Veterinary Association
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Approach to the asymptomatic cat with a heart murmur. BP = blood pressure; LA = left atrium; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; T4 = thyroxine.
Approach to the asymptomatic cat with a heart murmur. BP = blood pressure; LA = left atrium; NT-proBNP = N-terminal pro B-type natriuretic peptide; PCV = packed cell volume; T4 = thyroxine.
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Right parasternal short-axis echocardiographic view showing the aortic valve (Ao) and left atrium (LA) in a cat with left atrial enlargement. A normal LA:Ao ratio is <1.5; values >1.8 are likely to indicate left atrial enlargement.
Right parasternal short-axis echocardiographic view showing the aortic valve (Ao) and left atrium (LA) in a cat with left atrial enlargement. A normal LA:Ao ratio is <1.5; values >1.8 are likely to indicate left atrial enlargement. © 2018 British Small Animal Veterinary Association
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Right parasternal short-axis echocardiographic view showing the aortic valve (Ao) and left atrium (LA) in a cat with left atrial enlargement. A normal LA:Ao ratio is <1.5; values >1.8 are likely to indicate left atrial enlargement.
Right parasternal short-axis echocardiographic view showing the aortic valve (Ao) and left atrium (LA) in a cat with left atrial enlargement. A normal LA:Ao ratio is <1.5; values >1.8 are likely to indicate left atrial enlargement.