Serveur d'exploration Stress et Covid

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<title xml:lang="en">There’s So Much More to Cats…</title>
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<name sortKey="Scherk, Margie" sort="Scherk, Margie" uniqKey="Scherk M" first="Margie" last="Scherk">Margie Scherk</name>
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<title level="j">The Veterinary Clinics of North America. Small Animal Practice</title>
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<journal-id journal-id-type="iso-abbrev">Vet. Clin. North Am. Small Anim. Pract</journal-id>
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<surname>Scherk</surname>
<given-names>Margie</given-names>
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<degrees>DVM</degrees>
<email>hypurr@aol.com</email>
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<aff id="aff1">4381 Gladstone Street, Vancouver, BC V5N 4Z4, Canada</aff>
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<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
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<p>Margie Scherk, DVM,
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Our current approach to medicine views the body as a composite of systems. This approach isn’t only used in teaching but also, for the most part, in medical specialization. Cats throw a wrench into this approach. They commonly exhibit comorbidities extending beyond 1 organ (eg, triaditis, chronic kidney disease with hyperthyroidism, diabetes with arthritis). In a way, this isn’t surprising as the body functions in an integrative manner. Inflammation on 1 body system may be reflected elsewhere as well. But might this “holistic” approach extend further? Cats are restrained and understated: it is easy to miss that they are uncomfortable or unhappy. Caregivers may not notice sickness until their cat is exhibiting clinical signs, such as vomiting, diarrhea, lethargy, rather than more subtle changes. And poor health may, in fact, be a physical manifestation of nonphysical problems, or disease.</p>
<p id="p0015">The Oxford dictionary defines the adjective holistic as: “Characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease.”
<xref rid="bib1" ref-type="bibr">
<sup>1</sup>
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Unfortunately, this term has polarizing connotations within our profession but remains useful with respect to looking at all factors affecting a patient. To a great degree, bodies are designed to heal when basic needs (hydration, nutrition, analgesia, and environmental and social) are met. As practitioners (and researchers), it is important to remember the basic tenet of medicine: “If you can do no good, at least do no harm.” It is imperative not to add the challenges of stress/fear, pain/discomfort, unpalatable, unappetizing food, or unnecessary medications to the mix. The idea for this 2-issue issue of
<italic>Veterinary Clinics of North America: Small Animal Practice</italic>
is to highlight not only exciting medical advances but also clinically relevant understanding of the effects of mental, emotional, and social factors on health, disease, and illness.</p>
<p id="p0020">The first section of this issue focuses on current understanding of how cats experience and manifest stress through behavior as well as illness and the role of the environment on feline welfare throughout all life stages. An extensive section follows addressing differences in pain and meeting analgesic needs, chronic pain, degenerative joint disease, and neuropathic pain. As cats commonly have comorbidities and overlapping clinical presentations, there is an article on complex disease management as well as one on dermatologic lookalikes of the face, nasal planum, and ears.</p>
<p id="p0025">Sometimes we request diagnostic tests out of a desire to be thorough even though the outcome of that test may not change the outcome for the patient. To this, there is an article on when to use new tests, when to stick with old tests, or whether to run tests at all, which addresses some of these concerns.</p>
<p id="p0030">Veterinarians (and veterinary nurses) go into animal care because of a love for animals and desire to help them. Part of our ability to be good caregivers is to maintain this passion throughout our careers. The fact that we work for our clients rather than for our patients can lead to medical compromises that cause disappointment, moral distress, or worse. The final article addresses the need to balance the art and the science of veterinary medicine in a moral and ethical way.</p>
<p id="p0035">I hope you will look forward to the second issue. It includes articles on feline nutrition, updates on infectious diseases, select digestive tract problems and endocrine disorders, use of genetics and stem cell therapies in practice, an update on feline oral health, as well as new neurologic entities in cats that have a stress/environmental component.</p>
<p id="p0040">I am extremely grateful to every author. Thank you for putting up with my nagging, cajoling, and attempts to fine-tune. Especially as much of this labor of love has been during the COVID-19 pandemic when every one of you has been stressed to the limit, trying to adapt to the rapidly changing requirements, be it in academia or in private practice. I hope that this pair of issues is greater than the sum of its individual parts. Thank you.</p>
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