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Annette

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  • Annette
    Participant
    11:26 14/05/21

    Hi Rose

    if im certain there is no obstruction and room with cervical palpation/dilation I normally start of low and increase doses based on bitch response. I often find that they respond before you reach 0.5iu, but i have gone to this level once in a labradoor who wanted to sleep rather than welp 🙂 I also give calcium in addition which I find help increase contractions.if my patients don’t respond to a lower level of oxytocin I always want to check that calcium is adequate too.
    =)

    Annette
    Participant
    11:21 14/05/21

    Hello

    The x ray is of good quality and the dog seems to have excess fat so a high BCS.
    there is small amount of osteophyte formation on some of the vertebrae which is to be expected with age.
    the dog is intubate and microchipped

    the heart is slightly enlarged as occupying more then 1/3 of the thorax on lateral and DV.it is also more than 2.5 rib spaces in size. the heart has increased sternal contact of the sternum.
    i think is looks like some increased bronchial signs and multifolcal patterns on the lung field. maybe mix with bronchial and interstitial pattern?

    my dxx would be
    pulmonary oedema with cardiomegaly
    tracheal collapse and negative pressure oedema
    neoplasia

    Annette
    Participant
    16:40 30/04/21

    thanks emma
    thats great =)

    Annette
    Participant
    19:27 15/12/20

    Thanks liz thats really helpful =). my first case is about a salbutamol MDI toxicity in a dog that developed hypokalemia and slight hyperglycemia. with everything eg treatment etc mentioned in the other structured fields. im not sure what to discuss.
    would you talk about things like eg in human literature overdose of salbutamol has caused DKA but that this patient only had mild hyperglycemia or that other reports oral burns 36 hours post ingestion. so after the initial signs were stabilised, but our patient didnt develop anything whilst hospitalised 48 hours?

    thanks

    Annette
    Participant
    21:12 02/06/20

    great, thanks guys

    Annette
    Participant
    14:55 02/06/20

    Thank you scott.
    So either Lipid sink theory where increasing lipid in the body prevent lipophilic substances to attach to the body tissue by providing binding to the intralipid
    or
    enhanced cardiac metabolism: where the myocardial contractility might be subdued by drugs and contractility might improve my giving fatty acids?

    Annette
    Participant
    21:36 09/04/20

    Thank you very much for your response Simon- that was very helpful 🙂

    Annette
    Participant
    22:52 08/04/20

    Urine would be useful to assess renal function and if the ins meet the outs. or if you need to alter your fluid treatment to match.

    the WBC initially increased and then decreased after 21 days, indicating that needed longer treatment to penetrate areas possible?

    Annette
    Participant
    13:50 01/04/20

    Initially i would run biochem/ haematology/ electrolytes/ smear
    ultrasound of joint +/- joint tap and assess fluid.

    Initial treatment:
    IV fluids
    IV paracetamol
    +/- opioids depending on comfort post paracetamol
    IV zinacef

    Annette
    Participant
    13:15 01/04/20

    Thanks scott

    Annette
    Participant
    17:44 30/03/20

    Hello Scott

    sorry the dose was 0.02mg/kg- they contacted the ACP rep who said that it would be out of the system at 10 hours. the dog was having nystagmus but much brighter around 11pm. 12 hours after but started to lift his head around 9 pm. and ACP was given 10.30am.

    there was no nystagmus or any circling or other neuro signs apart from hindlimb weakness and collapse prior to sedation.

    if you contacted one of your neurology guys you might know what happend to the case. He went to wear referrals for further imaging, so it be interesting to see what they found

    thanks for checking
    Annette x

    Annette
    Participant
    17:31 30/03/20

    Thats great, thanks for clearing that up scott 🙂

    Annette
    Participant
    13:46 30/03/20

    Hello Scott, how old was the animal, old/young? was it a shar pei?

    Problem list:
    anorexia,
    reluctant to exercise
    shifting lameness- discomfort on all limbs
    bcs 3/9
    tachycardia, possible pain related as dehydration 5%
    Pyrexia
    effusion both stifles, carpal and hocks
    dehydration 5%

    Dxx
    septic arthritis
    Immune mediated joint disease- chronic inflammatry/infectious, neoplasia,
    IMHA, IMTP
    Metabolic bone disorder- panosteitis
    trauma

    Annette
    Participant
    13:32 30/03/20

    Thank you for your answer scott.
    just to see that i got this right
    So the sodium is both lost through urine with diuresis and diluted by water being drawn into vasculature from intersitital fluid. Does that mean we shouldnt worry as the body as the sodium, just not in the extracellular space?

    Insulin will also cause hypokalemia- because it shifts potassium into the cells. which is why insulin is given with potassium supplementation? but is also potassium lost through increased diuresis? i get abit confused here as diabetics is said to be hyperkalemic due to lack of insulin, but then they have increased diuresis with the hyperglycemia as well.

    thanks
    Annette

    Annette
    Participant
    19:25 07/02/20

    another great pneumonic 🙂 thanks

    I agree that generally we cannot say high lactate is lactoic acidosis or poor tissue perfusion, but in the interpretation along side this patients blood gas Metabolic acidosis the high lactate could be one of the causes for its blood gas result.

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