I actually rectal a lot of my patients (much to my colleagues amusement 🤣)- especially those with GI signs or non-specific ‘unwell’ signs.
I find it really helpful to see what the faeces look like and of course see what the anal glands are doing. I often think I can feel that the colon/rectum is oedematous/swollen in acute colitis cases but I’m not sure if there is any evidence that backs that up or if I’m just talking nonsense!
I once pulled a ball out per rectum from a beagle inpatient that had been in hospital for several days (which had a ‘negative’ ex-lap too) – Oops!!
Hi Scott
Great lectures so far! Few questions –
1. If you had a young dog with chronic diarrhoea (but otherwise well) that had giardia and isospora found on faecal analysis, would you focus on treating the giardia first {and keep in mind the possibility of an underlying CE)?
2. In raw fed dogs that present with acute diarrhoea do you still recommend a diet change onto a gastrointestinal diet for a few days? I usually do but I never know if this can upset the gut in itself?
3. Can you do FMT in cats?
I’m Sarah, qualified in 2010 from Glasgow. Currently on maternity leave. Found out I got my AP status on my last day of work back in July so need to keep up my CPD hours and try not to lose all my vet knowledge while I am off! 🤣🤣
Really looking forward to the course ☺️ xx
It’s not a real case but let’s say renal parameters are well within normal limits and iCa is moderately elevated (not sure what values would class as moderate elevation).
I am just concerned that I’ll end up in this situation at some point. PTH/PTHrp bloods are pricey!
I should probably know what I’m testing for shouldn’t I – looks like the pancreatic screening package ‘consists of an initial screening test and reported as positive, negative or equivocal. Any equivocal results will be sent to a referral lab for spec cPLi’. So I’m not really sure to be honest.
Does a positive result change anything that I am doing considering the dog isn’t showing any clinical signs of pancreatitis?
Also I spoke to Royal Canin – they said can try and stabilise while still feeding urinary diet but if struggling could use diabetic but only in the wet form as this has the s/o index.
The patient is a 10yr old FN min. schnauzer (of course).
She came in last Tuesday for an unrelated problem and brought a urine sample to check as she is on longterm urinary food due to previous CaOx urolithiasis. This urine sample showed no glucosuria.
She then came back to see a colleague on Friday as she had started with PU/PD, seemed to have lost weight and had urinary incontinence.
The urine at that stage was glu +++ and blood glucose was high 20’s. The same blood also showed a raised ALP in the 500s (was in the 800s around 1yr ago) and also T-Bil of 61.
She isn’t showing any pancreatitis signs but I was just slightly suspicious given the breed and the T-Bil etc.
HAC I am just keeping in the back of my mind given her longer term raised ALP.
Anyway I had her in yesterday to examine her myself. Apart from weight loss clinical exam was unremarkable. Abdo scan showed no obvious pancreatitis or biliary obstruction, just a sludgy gallbladder. I’ve sent some blood for a pancreatic screen anyway just to check.
Urine was still +++ glucose so I did get her started on caninsulin last night.
Plan on calling Royal Canin tomorrow to check whether would be better to move onto diabetic food or keep on the urinary? If you happen to know the answer feel free to tell me! ?
I just find it strange that it had such a rapid onset!
Hi all – this was the comment from the referral centre regarding the high bile acids in this patient –
‘In addition, an increase in the bile acids was identified on Lulu’s previous blood tests. The present clinical signs are unlikely to be related with the raised bile acids and therefore are considered an incidental finding. The most likely cause of this increase is a portal vein hypoplasia. This condition is a congenital condition that affects the microvasculature of the liver. The majority of the patients suffering from this condition do not present any clinical signs and the only changes are increases in bile acids. After discussing the different causes of increased bile acids with Lulu’s owner, no further investigations were undertaken at this stage and further investigations will only be recommended if further deterioration occurs.’
Hi all!
I am a small animal vet working in a fairly large first opinion practice in South Yorkshire. I have been fortunate enough to work in various roles within the same practice to keep things interesting! I have worked here since graduating (2010) except for a brief interlude back home in Scotland in 2018. I am partway through my certAVP in small animal medicine but I am taking it at a leisurely pace!! Look forward to meeting you all during the discussions 🙂
Hi, yeah I can update on this case. It went for referral but had no further episodes of strange behaviour in the period between presenting and going to referral so no further investigations were done.
Referral weren’t worried about the BAST results – can’t completely remember their comments!!
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