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Principles of Animal Nursing.

Principles of Animal Nursing.

Parrot requiring nail clipping and beak trimming:
Summary of condition:
Due to not having the correct enrichment and food for the parrot that they would have in the wild their nails and beak can overgrow quickly and need trimming by a professional. They would use several different tools such as files and clippers to trim and file the nails/beak down.
Initial assessment:
During the initial assessment the veterinary surgeon would want to get as much information from just looking at the bird as well as asking the owner various questions. The vet would observe the bird whilst it is still in the cage or carrier box so that it would be handled as little as possible. (Avianwelfare.org, 2019) This is because when the bird is being handled it can stress them out and can cause injuries and possible death. Before handling the vet should make sure that the have a towel (as an example of PPE) ready to secure the bird and restrict movement of its wings so it is unable to fly away, protecting the safety of both the bird and vet.
As the bird does not have a contagious disease it will not have to use barrier nursing. However due to it being quite a stressful procedure it would be suitable to not put the bird in a room with any other animals that are noisy and might stress the bird further for example a dog or cat.
Nursing requirements:
To trim the parrot’s beak and nails putting it in isolation would probably be beneficial to reduce stress and make the treatment easier to carry out. Putting the bird in a dark and quite room would help to calm it so that when it comes to doing the procedure. The noise from other animals such as dogs barking would heighten the possibly already high anxiety the parrot would be feeling because it has already been removed out of its enclosure and taken to a different place. As the parrot would bite if not held correctly it would be suitable for the vet or RVN to wear gloves as a form of PPE
Recovery plan:
Due to the procedure not being a surgery there is not much recovery. To help them recover the owner could put the parrot in its cage in a dark room to help them relax away from the noises and light. People should not disturb them and keep noise to a minimum. To prevent the beak and nails overgrowing quickly owners could buy a perch which is specially designed to wear down the nails and beak. If this works then the parrot would not need to have the stressful treatment.
Regulations:
The regulations that would be affected by this treatment are:
The Animal Welfare Act protects the 5 needs of animals which would need to be protected when they are being treated at a veterinary practice.
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations is important as the vet performing the procedure could get hurt by the bird biting or if the file slips and cuts the persons hand.
Complementary therapies:
The main complementary therapy would be aroma therapy. The smells and vapours would calm the bird and to remove the tension from how they would have felt during the procedure. Essential oils such as Cedar wood, Eucalyptus and Lavender would be most suitable. (The Miracle of Essential Oils, 2019)
References:
Avianwelfare.org. (2019). [online] Available at: http://www.avianwelfare.org/shelters/pdf/NBD_shelters_parrots.pdf [Accessed 2 Jan. 2019].
The Miracle of Essential Oils. (2019). How to Use Essential Oils for Parrots – The Miracle of Essential Oils. [Online] Available at: https://www.themiracleofessentialoils.com/essential-oils-for-parrots/ [Accessed 15 Jan. 2019].

German shepherd with hip dysplasia requiring corrective surgery:
Summary of condition:
Hip dysplasia is a condition which mainly effects the larger dog breeds including German Shepherds who are often known to having the unfortunate problem. The condition occurs because the hip joint is loose (hip joint laxity) meaning that the femoral head and acetabulum move abnormally therefore putting strain on the joint and causing the lameness in the back legs. (Ufaw.org.uk, 2019). It is usually quite obvious that a dog has hip dysplasia as their back slopes downwards causing them to have an abnormal gait, putting additional pressure on the back legs resulting in stiffness and difficulty walking and getting upstairs(Fitzpatrick Referrals, 2019). In the corrective surgery it is usually a total hip replacement where the damaged joint is removed and a metal and plastic recreation is fitted (Fitzpatrick Referrals, 2019.)
Initial assessment:
On arrival to the vets the German shepherd would have an initial assessment done by a Registered Veterinary Nurse (RVN). During this they would do a 10 point health check to outline any other issues that could cause a problem. They may also do any tests such as a blood test which the Veterinary Surgeon (Vet) would review later. The German Shepherds respiration rate should be checked and a normal rate is within 12-35 breaths per minute. Anything below 8 and over 36 would be a concern to the veterinary nurse (S, Powell, 2019). Along with this the pulse should be checked which should be around 60-120 beats per minute however it should be taken into consideration that the dogs pulse as well as respiration rate may be higher because they might be stressed and in pain. An x-ray should be done as a diagnostic test even if one has been done before as the hip could have possible further damage that could be causing the animal more pain. When handling or restraining the dog the nurse would have to take into account the dogs poor condition in its back legs and be careful not to hurt them. As it may be in pain, the chance of aggression is increased so it would be suitable to use a muzzle or in more extreme cases a grasper/catch pole.
Surgery:
The main surgery to treat hip dysplasia that is most effective is a total hip replacement also known as THR. In this surgery the vet would remove the diseased hip joint and in place of the ball a metal implant is fitted. The implant is attached to the bone usually by cement so that it is secure. (Fitzpatrick Referrals, 2019.) Immediately after surgery the veterinary surgeon may prescribe pain relief medication such as opioids for example Methadone as it is one of the strongest pain medications a veterinary surgeon can access. The veterinary surgeon would be performing the operation as veterinary nurses are unable to under the Veterinary Surgeons Act 1966.
Nursing requirements:
Aseptic nursing would be used in a total hip replacement to prevent pathogens entering the open wound and causing infections. Some examples of how good aseptic technique is shown includes: a scrubbing in procedure before surgery, new set of sterile equipment for every surgery, the temperature of the room should be in-between 15-20°c and also plan to do ‘clean’ surgeries before dirty ones (Class notes, 2018.) If aseptic nursing wasn’t used correctly and the dog developed an infection it could result in having its leg amputated. It could possibly be life threatening for example if sepsis occurred.
Recovery plan:
Rehabilitation is very important after a total hip replacement as the dog could easily pop the joint out and be in a lot of pain. In the first 24 hours the German Shepard should eat light and bland food as it may not have much of an appetite due to the remains of anaesthetic still in their system. After 24 hours their normal appetite should come back and you can start introducing their normal diet back.
Due to having a hip replacement they should have restricted exercise. For example, they should only be on lead exercise in the garden away from other dogs so that it does not get excited and damage the hip. A sling might be helpful as well to put under the dog’s stomach and held by the owner to take the pressure off the dog’s hips. However if a dog is hyperactive the vet may think that it would be better to put the dog on cage rest for a couple of days so that the joint can start to heal without no complications.
As the dog would be quite immobile for a while after the surgery they should have extra padding where they are lying so that it is more comfortable. The German Shepard should be brought back to the vets for regular check-ups to make sure that the operation has been successful and if not discuss the next steps to helping the dog. The vet may prescribe a pain killer such as Metacam to help relieve their pain in their hip and make them more comfortable as it is an anti-inflammatory. It is very important that the dog does not lick or scratch the sutures as the wound could open and become infected. Therefore they could wear a buster collar to prevent them doing it.
Regulations:
The main legislations/ regulations that would effect this situation would include:
The Health and Safety at Work Act would ensure that the safety of the employees is protected for example reporting broken equipment that could harm people or even animals.
The Anaesthetics Act ensures that the operation must be done with anaesthetic and that only the vet can administer it.
The Control of Substances Hazardous to Health means that staff have to be trained correctly and stored in a safe way.
The Veterinary Surgeons Act outlines who can perform surgeries and who can’t. For example a RVN would not be allowed as they can only do minor surgeries.
Complementary therapies:
An example of a complementary therapy that would be suitable for the German Shephard is hydrotherapy. This would be beneficial as it will increase muscle mass due to the lack of use as they have been restricted. It works well as the restricted from the water makes the legs work harder to be able to move whilst minimising discomfort. (petMD, 2019)
References:
Ufaw.org.uk. (2019). German Shepherd – Hip Dysplasia – UFAW. [online] Available at: https://www.ufaw.org.uk/dogs/german-shepherd—hip-dysplasia [Accessed 3 Jan. 2019].
Powell, S. 2019. Registered veterinary nurse. Conversation with Abbie Sadler. 3 January.
Fitzpatrick Referrals. (2019). Hip Dysplasia – Fitzpatrick Referrals. [online] Available at: https://www.fitzpatrickreferrals.co.uk/orthopaedic/hip-dysplasia/ [Accessed 3 Jan. 2019].
Fitzpatrick Referrals. (2019). Hip Dysplasia – Fitzpatrick Referrals. [online] Available at: https://www.fitzpatrickreferrals.co.uk/orthopaedic/hip-dysplasia/ [Accessed 3 Jan. 2019].
Fitzpatrick Referrals. (2019). Hip Dysplasia – Fitzpatrick Referrals. [online] Available at: https://www.fitzpatrickreferrals.co.uk/orthopaedic/hip-dysplasia/ [Accessed 8 Jan. 2019].
Principles of animal nursing class notes taught by Mandy Downing (personal communication)
petMD, L. (2019). Hydrotherapy, Water Therapy, and Swimming for Dogs: Benefits, Risks, and Things to Consider | petMD. [online] Petmd.com. Available at: https://www.petmd.com/dog/general-health/how-hydrotherapy-and-swimming-can-benefit-dogs [Accessed 13 Jan. 2019].
Cat with cat flu:

Summary of condition:
Cat flu is a quite common condition that could be could either virally or from bacteria. The illness can be life threatening if not treated quick enough or not correctly. It is spread from direct contact from an infected cat or a carrier cat who has been infected but is not showing the signs of having the illness.
Initial assessment:
On arrival a RVN would conduct an initial assessment where they would do a 10 point health check as well as look for the symptoms of the condition. This includes: loss of appetite, sneezing, inflamed eyes and high temperature along with other things. A vet would then approve what the RVN should have picked up on then talk to the owners about the next steps for treatment. During an initial assessment the vet could do a diagnostic test which is to take swabs from the eyes, nose or mouth to send off to the laboratory where they can confirm it is cat flu. As it is very contagious, vets don’t always treat them at the practice because of the risk to other cats that do not have the problem, so the owner would take them home. (Cats.org.uk, 2019) When handling the cat the RVN or vet could wrap them in a towel to prevent it from kicking its legs and trying to get away. The towel would also keep them warm but they would want to be careful that the cat doesn’t overheat as then the condition could get worse.
Nursing requirements:
Barrier nursing would be used to treat cat flu. This is because cat flu is very contagious to other cats so it is very important that they do not get infected. To do this the cat would be put in isolation which is a physical separation to keep the infected cat safely away from the others. When entering the isolation room the RVN’s or vets would have to wear a sterile gown, gloves and mask which would be removed as soon as leaving the room to avoid the infectious pathogens from passing onto the healthy animals. (Class notes, 2018.)
Recovery plan:
When at home the cat should be isolated from other cats as they could still be carrying the infection and could pass it on to the other cats in the home. Antibiotics and anti-inflammatories are the main drugs used to treat the symptoms of the illness as there is no one drug to cure the whole thing. Therefore the owners would have to do the following things in order to aid the recovery: warm food to encourage them to eat, clean eyes and ears to remove the discharge and to keep them in a warm and quite room away from noises to make them as comfortable as possible. It could be weeks before the cat recovers fully, and behaviours go back to normal again. Another important thing to do is to make sure that the cat is always hydrated as they lose a lot of hydration whilst ill.
Regulations:
The regulations that would affect this situation are:
The Control of Substances Hazardous to Health means that products such as medications and cleaning equipment should be correctly controlled so that they do not get misused and potentially harm both humans and animals.
The Health and Safety at Work act ensures that the safety of the people and animals are protected when they are at the practice. Staff should attend training and always be responsible of the patients and other staff.
Complementary therapies:
The complementary therapy for a cat with cat flu would include aromatherapy. Using things such as hydrosols which are alcohol free and water soluble. (Healthy Living, 2019). Doing this would calm the cat as well as clearing their airways. By doing these the cats’ symptoms should improve and as a result the illness should start clearing up quicker. Both aromatherapy and steam inhalation will benefit the cat’s condition greatly and will help them recover more.
References:
petMD, L. (2019). Hydrotherapy, Water Therapy, and Swimming for Dogs: Benefits, Risks, and Things to Consider | petMD. [online] Petmd.com. Available at: https://www.petmd.com/dog/general-health/how-hydrotherapy-and-swimming-can-benefit-dogs [Accessed 13 Jan. 2019].
Principles of animal nursing class notes taught by Mandy Downing (personal communication)
Healthy Living. (2019). Aromatherapy for Cats | Care2 Healthy Living. [online] Available at: https://www.care2.com/greenliving/aromatherapy-for-cats.html [Accessed 15 Jan. 2019].

Bacterial Genomics and Metagenomics – Essential Approaches to Study Microorganisms

Bacterial Genomics and Metagenomics – essential approaches to study microorganisms
Introduction
Microorganisms make up two of the three domains of life and the microorganisms studied today have been produced through 3.8 billion years of evolution. The first stage in investigating bacterial processes is obtaining a pure culture of the bacteria, however currently only 0.1-1.0% of microorganisms can be purely cultivated using the standard techniques at our disposal (Riesenfeld, Schloss and Handelsman, 2004). The question is then raised as to how significant current microbiology is if 99% of the information is still not discovered. It is clearly vital that the research techniques used be able to overcome these issues around unculturability and the diversity of genomes that has restricted the forward movement in this area of microbiology. Some attempts have been able to produce breakthroughs in culturing the unculturable bacteria but overall a range of culture independent techniques would be needed in order to successfully culture the massive entity of unknown species in our environment. In this essay we will discuss some metagenomics and genomics approaches but mostly drawing focus on novel attempts to tap into the resource that is the uncultured microorganisms and the impact this can have on not only our knowledge of the world but also to improve industries such as biotechnology and potential drug discovery.
Culture independent studies based on 16s rRNA gene sequence analysis have made it clear that the majority of these ‘uncultured’ bacteria belong to new genotypes, divisions and classes in the domains of eubacteria (Sharma et al., 2005). Such studies have heavily indicated that environments we thought had been well covered actually may contain quite a lot of new bacteria and require necessary focus; these areas include simple garden soils and sea water. The early strategies to cultivate the ‘unculturable’ bacteria were based on the thought that such microorganisms are able to multiply in their own natural environments so cultivations in the laboratory were attempted using media with very low nutrient levels; this used the assumption that common laboratory media used media with a concentration of nutrients that wouldn’t typically be found in natural environments (Connon and Giovannoni, 2002). This method did in fact result in the isolation of new genera including ‘SAR11’ which is a member of the candidatus clade (Rappé et al., 2002). Success like this led to further uses of similar techniques in marine environments with the addition of altering physiological conditions such as pH, oxygen levels, temperature and osmotic conditions as well as presence/absence of growth factors.
Bioprospecting
Bioprospecting is the discovery and commercialisation of novel products (e.g. enzymes) based on biological resources and bioprospecting of microorganisms can be carried out using metagenomic approaches or culture dependent approaches (Vester, Glaring and Stougaard, 2014). Here we will focus on metagenomic approaches which can be of high value and although this method has the advantage of not requiring cultivation, they may be hindered by quality and quantity of DNA that can be attained from an environmental sample. The bioprospecting metagenomic approach can be sequence based or functional based (Figure 1). Sequence based metagenomics is a high throughput technique using bioinformatics analysis whereas functional based metagenomics involves expression of libraries to find genes or clusters of genes of interest (Vester, Glaring and Stougaard, 2014).

Figure 1. Comparisonof sequence based (red) metagenomics and functional based (green) genomics in bioprospecting (Vester, Glaring and Stougaard, 2014).
Biofilms
In a study by Venter et al in 2004 the Sargasso Sea was studied using metagenomic shotgun sequencing due to the simple community it would contain. The approach employed the steps seen in Figure 2 below. The Sargasso Sea is an intensively studied environment with limited nutrients and the study produced 1.6 billion base pairs of sequence information (Venter et al., 2004). However, the problem was that the community was not simple enough to allow assembly of most of the sequence reads into contigs (or scaffolds of the genomic sequence). An example of an even simpler community would be that found in biofilms. Tyson et al used biofilm found in extremely acidic waste water from an iron mine also known as ‘acid mine drainage’ which contained three bacterial lineages. The contigs were assembled into groups based on GC content and by the number of reads in each contig. These groups could then be assigned to a specific organism and with almost complete genome sequences from sequences of Ferroplasma type II and Leptospirillum group II affiliates it was possible to model metabolic processes that each of these genomes would contribute to the wider community in this environment (Tyson et al., 2004). This discovery coupled with sequencing and metabolic analysis was the starting point for ‘proteogenomic’ analysis. Protein extracted from biofilms in the acid mine drainage was used in shotgun mass spectrometry and the end result was that they were able to link peptides of the five dominant genomes but more notably this study identified a novel iron-oxidising cytochrome which is stable in acid (Ram et al., 2005). Further protein quantification led to a process being identified that could be key to the whole ecosystem hence proving the significance of biofilms and metagenomic studies in identifying novel functions or novel proteins. The above mentioned acid mine drainage sequencing project was able to effectively assign over 80% sequence reads to one of over 1100 scaffolds which could realistically assist with realistically determining the genome sequences of uncultured microorganisms living in diverse communities (Tyson et al., 2004).

Figure 2. General steps involved in metagenomic shotgun sequencing (Schloss and Handelsman, 2005).
Metagenomic analysis of Bacteriophage
Microorganism communities are mostly made of bacteria and consequently are dominated by bacteriophages which will have a huge impact on the diversity and structure of these microbial communities (Wommack and Colwell, 2000). Just like bacteria themselves, bacteriophages are hugely diverse microorganisms so haven’t been as heavily studied in the laboratory as we would like, and many of the bacteriophage hosts haven’t been cultured for the same reasons. Without the equivalent 16s rRNA gene to study virus phylogeny, novel metagenomic analyses would be needed to study phage diversity in order to understand bacterial communities by investigating them through their respective bacteriophages. A study by Breitbart et al in 2003 investigated the diversity of bacteriophage in the human gut and marine environments. With the human gut being so complex and having over 400 microbial species in it, they began by analysing human faeces using metagenomics to study viral populations and constructed a viral library. A total of 532 clones were sequenced and almost 60% of them did not have similarity with earlier reported sequences in the literature (Breitbart et al., 2003). The sheer size of the viral community would outnumber the bacterial community in the human gut however the viral community likely affects the bacterial community structure through lysing and infection; they may also enhance genetic diversity by allowing exchange of genetic information between bacterial cells (Breitbart et al., 2003). The results of another similar study by Breitbart et al in marine environments revealed that bacteriophage populations were significantly different between two marine environments. This was thought to be influenced by the high proportion of gram positive and gram negative bacteria in the human gut and the seawater respectively, confirming that metagenomic study of bacteriophages would indeed be a potential avenue for the study of bacteria (Breitbart et al., 2002).
The Human Microbiome Project
The Human Microbiome Project investigated a section of the human microbiota in the colon of healthy adults. They thought that since there is 10 times more microbial cells than human cells present in the human body that understanding more about the microbial communities in the gut would be key to improving our ability to treat, diagnose and prevent diseases. When you consider that the gut microbial communities have already been invaluable in regulation of energy and controlling the immune system it can be seen that further knowledge of these microorganisms could be a huge leap forward (Turnbaugh et al., 2007).
References
Breitbart, M., Hewson, I., Felts, B., Mahaffy, J., Nulton, J., Salamon, P. and Rohwer, F. (2003). Metagenomic Analyses of an Uncultured Viral Community from Human Feces. Journal of Bacteriology, 185(20), pp.6220-6223.
Breitbart, M., Salamon, P., Andresen, B., Mahaffy, J., Segall, A., Mead, D., Azam, F. and Rohwer, F. (2002). Genomic analysis of uncultured marine viral communities. Proceedings of the National Academy of Sciences, 99(22), pp.14250-14255.
Connon, S. and Giovannoni, S. (2002). High-Throughput Methods for Culturing Microorganisms in Very-Low-Nutrient Media Yield Diverse New Marine Isolates. Applied and Environmental Microbiology, 68(8), pp.3878-3885.
Ram, R., Verberkmoes, N., Thelen, M., Tyson, G., Baker, B., Blake, R., Shah, M., Hettich, R. and Banfield, J. (2005). Community proteomics of a natural microbial biofilm. Science, 308(5730), pp.1915-1920.
Rappé, M., Connon, S., Vergin, K. and Giovannoni, S. (2002). Cultivation of the ubiquitous SAR11 marine bacterioplankton clade. Nature, 418(6898), pp.630-633.
Riesenfeld, C., Schloss, P. and Handelsman, J. (2004). Metagenomics: Genomic Analysis of Microbial Communities. Annual Review of Genetics, 38(1), pp.525-552.
Schloss, P. and Handelsman, J. (2005). Metagenomics for studying unculturable microorganisms: cutting the Gordian knot. Genome Biology, 6(8), pp.1-4.
Sharma, R., Ranjan, R., Kishor Kapardar, R. and Grover, A. (2005). ‘Unculturable’ bacterial diversity: An untapped resource. Current Science, 89(1), pp.72-77.
Turnbaugh, P., Ley, R., Hamady, M., Fraser-Liggett, C., Knight, R. and Gordon, J. (2007). The Human Microbiome Project. Nature, 449(7164), pp.804-810.
Tyson, G., Chapman, J., Hugenholtz, P., Allen, E., Ram, R., Richardson, P., Solovyev, V., Rubin, E., Rokhsar, D. and Banfield, J. (2004). Community structure and metabolism through reconstruction of microbial genomes from the environment. Nature, 428(6978), pp.37-43.
Venter, J., Remington, K., Heidelberg, J., Halpern, A., Rusch, D. and Eisen, J. (2004). Environmental Genome Shotgun Sequencing of the Sargasso Sea. Science, 304(5667), pp.66-74.
Vester, J., Glaring, M. and Stougaard, P. (2014). Improved cultivation and metagenomics as new tools for bioprospecting in cold environments. Extremophiles, 19(1), pp.17-29.
Wommack, K. and Colwell, R. (2000). Virioplankton: Viruses in Aquatic Ecosystems. Microbiology and Molecular Biology Reviews, 64(1), pp.69-114.

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