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Ellensburg In Person CE Report

June 14, 2024

CE Report – by Olivia Burns

On Sunday June 2nd, 2024, Dr. Jeremy Gallman provided a 4 hour In-Person DVM Masterclass Intensive in Ellensburg, WA.  Ms. Olivia Burns, a 4th year student at WSU College of Veterinary Medicine attended this In-Person Class and provided the following summary of the topics covered as well as a brief article on Military Working Dogs (MWDs).

Veterinarians from across the state filled the room at Central Washington University. The opening pages of the notes teased at the intriguing topics to come: ‘June 2, 2024…DVM Masterclass Intensives – In Person…Major Jeremy Gallman…US Army Veterinary Medicine Officer…double-boarded…’ Dr. Gallman blended the meticulous excellence of military medicine with the applicable knowledge of civilian practice, as he covered:

Canine Hypoadrenocorticism: Dr. Gallman highlighted current literature, which demonstrated that primary typical Addison’s can have low aldosterone but initially normal electrolytes. Electrolyte changes can develop with time. This consideration does not alter the diagnostic protocol of resting cortisol as a screening test and ACTH stimulation as a confirmatory test. Once confirmed though, testing endogenous ACTH can differentiate primary atypical from secondary hypoadrenocorticism. The former requires continued electrolyte monitoring for conversion to primary typical due to the undetected low aldosterone. In such a case, treatment would be altered to include mineralocorticoids in addition to the glucocorticoids.

Diabetic Ketoacidosis (DKA): With the new gliflozins on the market for cats, Dr. Gallman judiciously addressed the possibility of euglycemic DKA while encouraging the use of the drugs with proper client compliance. He offered a balanced perspective about cases with co-morbidities—start insulin, monitor and supplement electrolytes, and concurrently treat the underlying etiology to return the patient to normal eating and return to maintenance insulin or gliflozin therapy at-home.  Applicable clinical tips were given on keeping IV insulin/KCl/KPhos separated by fluid bag, and on placing continuous glucose sensors on patients as a mainstay of glucose monitoring. The separate bags allow for changes in fluid rate and electrolyte needs; the in-clinic continuous glucose sensor reduces patient venipunctures and pricks.

Transferring Battlefield Canine Trauma Skills to Civilian Practice: Guidelines on triaging multiple patients are common in emergency practice, but what about triaging multiple injuries in a single patient? Dr. Gallman provided the M3ARCH2 PAWS acronym for such a case. The straightforward principles are particularly helpful in patients presenting with an unknown extent of trauma, and the acronym can be memorable even in situations of duress. It breaks down as follows: Muzzle, Massive hemorrhage, Medication, Airway, Breathing, Circulation, Hypothermia, Head trauma, Pain control, Antibiotics, Wounds, Splint(s). Detailed treatments for each section can be found in the Army Report 24 Jul 2023 081-68T-1608 as a .pdf form online. Another consideration is familiarization with ACVECC’s RECOVER CPR guidelines, which are scheduled for late June 2024 publication, with several new updates.

Evolution of the Modern MWD

Military working dogs (MWDs) have been—and continue to be—an integral part of US defense. Early accounts of dogs serving alongside US soldiers exist from the Civil War (Dungan, 1863). From the Civil War through World War I, the dogs’ tasks included guarding prisoners and carrying messages. Sergeant Stubby, a bull-terrier mutt of WWI, was the first dog ever given rank, his accolades including the capture of a German soldier and warning his regiment about mustard gas attacks (New York Times, 1926). Then, intelligence and loyalty of the individual dog were considered more than breed predisposition and capability (Baldridge, 1919).

World War II marked the shift from unofficial use of privately-owned dogs to organized canine procurement programs (Watson, 2019).  Manpower was vital to the war effort, and the military recognized dogs as force multipliers. Americans responded enthusiastically by volunteering an estimated 40,000 dogs. The need for organization and standardized training for the large population prompted the formation of the K-9 Corps and written guidelines by the Quartermaster Corps (US War Department, 1943). Certain breeds were identified as better-suited for assigned duties, and requirements were placed on the signalment of eligible dogs.

Breed, age, size, and behavior standards evolved as the roles of the dogs expanded and became more specific throughout the Korean, Cold, and Vietnam Wars (Watson, 2019). German Shepherds were chosen for sentry services, law enforcement, and attack dogs. Along with the Belgian Malinois breed, they also worked in mine detection and substance discovery. Labradors and occasionally Beagles were employed for scout and combat tracking. With more work and recognition, the dogs’ title changed from War Dogs to the modern Military Working Dogs.