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Sarah Clements

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Viewing 15 posts - 1 through 15 (of 27 total)
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  • Sarah Clements
    Participant

    Hi Scott!

    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

    Sarah Clements
    Participant

    Replying to [email protected] 11/11/2022 - 17:41

    Did it actually specify? I mean my hairs get everywhere 😕😬😳🤣

    Sarah Clements
    Participant

    Replying to [email protected] 03/11/2021 - 09:39

    I am not going to make any suggestions but would love to see the path report!

    Sarah Clements
    Participant

    Excellent, thanks Scott 🙂

    Sarah Clements
    Participant

    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!

    Sarah Clements
    Participant

    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.

    Sarah Clements
    Participant

    And the pancreatic screen has come back positive….

    Sarah Clements
    Participant

    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!

    Sarah Clements
    Participant

    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.’

    Sarah Clements
    Participant

    Ah!!! Hi Fran!! ?
    Hahahha special guest appearance indeed, and a very welcome one!

    Sarah Clements
    Participant

    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 🙂

    Sarah

    Sarah Clements
    Participant

    I will post once I’m back at work next week! 🙂

    Sarah Clements
    Participant

    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!!

    Sarah Clements
    Participant

    What can I say! I am preparing for a Christmas DKA ?
    Yeah that makes sense. I think. I just get confused with the dextrose etc.
    So say you’ve been using your neutral insulin and the BG goes below 5.5 and so you stop the insulin and start dextrose – if everything else is stabilising nicely and the animal starts eating, would you wait for the BG to come up again before you start long-acting insulin?
    Thanks Scott!

    P.S. I know I need to get a life!

    Sarah Clements
    Participant

    Thanks Scott, you’re a star. I saw her on friday and her starved bile acids were 13 but post-prandial were 69.2 so I’ve sent her off to referral and will eagerly await the report!

Viewing 15 posts - 1 through 15 (of 27 total)