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Emma Holt

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Viewing 15 posts - 1 through 15 (of 74 total)
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  • Emma Holt
    Participant
    09:28 24/03/23

    Replying to Felipe M. 23/03/2023 - 14:16

    Hi Felipe,

    Thank you so much for this answer, it’s very helpful and gives some reassurance of the dose ranges for Nsaids with the references.

    Thanks again

    Emma

    Emma Holt
    Participant
    13:35 23/03/23

    Replying to Andy Bell 23/03/2023 - 13:30

    Thanks Andy 😊

    Emma Holt
    Participant
    13:07 23/03/23

    Replying to [email protected] 22/03/2023 - 12:39

    Hi

    I actually have a couple of questions if that’s OK :), I think one ECC and one analgesia (which maybe comes under anaesthesia?)

    ECC: I was having a discussion with a friend this week about measuring foetal heart rates with ultrasound. They measured it by getting a nice view of the foetal heart and counting the number of beats. Someone questioned if this was an accurate method, due to the need for a high frame rate on your ultrasound machine. I couldn’t find any specific information on measuring with this method and the only article I found was this one, using the M-mode. How do you measure foetal heart rate via ultrasound? https://www.bcfultrasound.com/canine-pregnancy-part-2-assessing-foetal-viability/

    Analgesia question: In a cat with CKD Iris stage 3, what analgesia would you choose for: 1) long term OA 2) Dental disease pain pre-GA? I think my best options are Nsaids or Gabapentin, but neither are ideal in cats with renal disease so wondered what your thoughts/preferences are?

    Thank you very much

    Emma

    Emma Holt
    Participant
    20:08 05/03/23

    Replying to Liz Bode 05/03/2023 - 19:39

    Thanks Liz.

    I will see how grumpy the cat is and avoid if possible, just to be safe 🙂

    Emma Holt
    Participant
    18:38 05/03/23

    Replying to Liz Bode 21/01/2021 - 21:04

    Hi Liz,

    I’m just re-visiting this post about Gabapentin pre-echo in cats. I generally use it for most echo’s, but I have a case booked in for a few weeks time which is CKD Iris stage 3. I know you said we need to be cautious about it’s use with renal disease. In practical terms how do you interpret this? Do you avoid it completely (and just use Torb +/- Alfaxan if needed), or would you go for the lower dose, so 50mg/cat rather than 100mg?

    Thanks

    Emma

    Emma Holt
    Participant
    18:35 05/03/23

    Replying to Liz Bode 26/02/2023 - 20:53

    Thanks Liz, that was a really interesting case.

    What breeds would you normally expect to see a PE in? And what sedation do you normally choose when draining pericardial effusions?

    Thanks again

    Emma

    Emma Holt
    Participant
    12:40 16/02/23

    Replying to [email protected] 15/02/2023 - 20:18

    Remind me how I do this again?! You know I’ll always cave in to peer pressure!

    Emma Holt
    Participant
    13:48 02/02/23

    Hi Liz,

    I would put the Problem list as:
    -progressive lethargy and weakness
    -Hyporexia
    -Fluid abdomen, which on examination has a fluid thrill
    -Hypodynamic pulses

    Possible ddx could include:
    -Progressive lethargy/weakness and hyporexia are quite non-specific clinical signs and could be attributed to a number of body systems (including CV, respiratory, metabolic, MSK).
    -Full abdominal appearance could be due to an abdominal mass, peritoneal effusion, overweight/HAC
    -Fluid thrill: We would need to get more info to know if it was a transudate, modified transudate, exudate includind haemorrhage etc.
    -Hypodynamic pulses could be due to a partial thrombi/obstruction, reduced cardiac output or hypovolaemia

    As a next step for further investigations I would like the following to start with:
    -blood pressure
    -Haematology, biochemistry and electrolytes
    -Abdominal and thoracic POCUS and if effusions are confirmed sampling these and sending for analysis would be helpful.
    -Depending on the POCUS findings full abdominal or echo scans may be indicated.

    🙂

    Emma Holt
    Participant
    19:51 12/01/23

    Wow, this would stress me out if I saw it as a complication! At least you were using omnipaque which is safe for IV administration! Congratulations on getting it published!

    Emma Holt
    Participant
    09:50 14/11/22

    Hi Helen,

    I’m really enjoying the course thank you, I can’t get the video link to work that you added to this post,but have downloaded Brene’s podcast episode for my next car journey.

    Within some teams I work in, I find there are occasionally some ‘negative’ people, who seem to respond to most things with barriers and negative comments, how would you approach trying to get these people on side?

    Thanks

    Emma

    Emma Holt
    Participant
    19:24 11/11/22

    Wow that’s an interesting title for a Friday evening ☺️

    Would definitely not have crossed my mind for my ddx list!

    Emma Holt
    Participant
    09:12 17/10/22

    Replying to Dan T. 13/10/2022 - 13:23

    Thanks Dan and Helen. The article is really interesting, and I think reflects what I have seen in some workplaces with the transition from in-person to remote management/leadership.

    My question arose from me trying to work out what type of leadership style my current line manager had and I was struggling to fit them into any of the categories.

    I definitely think communication is fundamental, alongside ensuring you get to know your team well, as this is much harder to do in remote settings. The article raises some interesting points about remote leaders being doers, which I completely agree with, as ultimately a remote leader has less to do with the small parts of your job and ultimately their actions/getting tasks done, rather than what they say has an impact.

    Thanks again, see you tomorrow night.

    Emma

    Emma Holt
    Participant
    16:26 10/10/22

    Replying to Liz Bode 06/10/2022 - 20:33

    Thanks Liz that’s great and really useful for future cases, using 1 as a cut off.

    Emma Holt
    Participant
    15:49 06/10/22

    Replying to Emma Holt 27/09/2022 - 17:05

    Hi Liz,

    Could I ask another question about myocarditis and Troponin please? I think that in HCM we would expect a high Troponin, but in myocarditis the troponin would be significantly higher, I haven’t really tested this much before, so I wondered what you would quantify as high vs very high. I had a cat that I have diagnosed with HCM, which had a horrible left ventricle, heterogenous and irregular in shape and the Troponin has come back as 0.2 (where normal is < 0.04). Is this high or very high?

    Thanks

    Emma

    Emma Holt
    Participant
    09:47 06/10/22

    Replying to [email protected] 05/10/2022 - 19:21

    Hi

    I’m Emma, I’m a peripatetic medic/ultrasonographer in the North East England/Edinburgh area. I’m not in a specific management/leadership role, but I think leadership skills are super important in every day vet life as we all work together as a team and hopefully I can learn lots over the next few weeks. I’d particularly be interested improve my communication in challenging situations.

    Thanks

    Emma

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