Kathryn B.

Replying to [email protected] 04/07/2023 - 08:49

Depending upon when the day 23 BG was taken in relation to insulin the diabetic control doesn’t seem very good yet. No obvious causes of hormonal antagonism/infection/inflammation based on bloods and exam.
The collapsing episodes seem to predate the signs of DM developing, would maybe do Holter to confidently rule out an arrhythmia.
We don’t have the luxury of a blood gas machine so I am hopeless at interpreting those results, will leave that to someone more clever than me!

Problem list:
– weakness, especially at exercise
– PUPD
– cataracts
– maybe a bit bradycardic given that most Westies seem to get stressed at the vets!
– heart murmur

Is there any more recent blood work for this dog and any urinalysis, especially as it has become PUPD? If not I’d probably do those initially and also run an ECG. On the bloods I would be especially interested in glucose and in calcium levels, as derangements here could be related to the cataracts and also the weakness (although the two problems could be unrelated).

Then make plan for next steps based on these initial results…

Kathryn

Replying to Liz Bode 15/02/2023 - 19:52

Looks like a pericardial effusion. Ddx coagulopathy, cardiac neoplasia, idiopathic. I would maybe tap the abdominal effusion to rule out a coagulopathy causing a bicavitary effusion. I’m not sure I can see tamponade in the clip but if the patient is showing signs of right sided cardiac disease it seems likely. I would do a fuller echo to look for any cardiac neoplasia prior to therapeutic pericardiocentesis whilst monitoring ECG, with samples taken for cytology although they may not tell us a great deal beyond it probably being RBC.

Hi Scott,

Thanks for the fantastic GI webinar. I’ve not got to end yet so please ignore any questions that would be covered in the last half hour, just wanted to write down a few thoughts before I forget, sorry there’s a few:

– at the start of a d+ work up would it be worth just testing for parasites and Giardia, rather than bacteria given how difficult interpretation of bacteria can be? Then revisit bacterial testing later on if still no diagnosis? Or would you still test for everything at the get go?

– if you treat a positive faecal culture, be that parasitic/Giardia/bacteria, would you re-test a faecal sample at the end of the treatment course or just go by clinical cure?

– would you interpret faecal culture differently in a raw fed dog vs. commercially fed dog?

– do you have any good stats I can fire at owners about what % GI cases will improve on diet trial alone. It’s like they don’t want their pet to have a problem that will respond just to diet change – they want something more exciting! I find it so difficult to get people on board, they just seem to decide it’s a waste of time without even starting it

– if you give a probiotic at the same time as an antibiotic, would that supercharge any resistant bacteria?!

– what doses would you give for Sivomixx and VSL3 please, I’ve not used these before?

– is there any evidence for feeding dogs with GI dz the faeces of a heathy dog?

– I’ve worked with a lot of vets who give a one of jab of Betamox and dex to acute GI patients. Is there any evidence for/against the one off dex? (obviously wouldn’t give the Betamox!)

Case 1 – I think there is cardiomegaly as the heart fills >2/3 of the thorax on both views. On the lateral the trachea no longer runs at 45 degrees to the vertebrae and the caudal v/c looks like it’s running towards the shoulder rather than the elbow, suggested cardiomegaly. I calculate VHS to be about 12.5 so increased. The mainstem bronchi appeared split on the lat rather than overlying. I think there is an increase in sternal contact. There is a diffuse increase in opacity of the lung fields particularly caudodorsally. The pulmonary veins look larger than the arteries. On the DV view the L auricular appendage appears to be bulging. So I wonder if this patient has CHF 2ry to DCM

Case 2 – I think the cardiac structures look normal with a VHS of about 10. There are prominent air bronchograms present especially overlying the cardiac silhouette. The oesophagus seems quite prominent but I might be imaging that! If it is then I wonder if it could be aspiration pneumonia 2ry to megaoesophagus.

Replying to Liz Bode 26/10/2022 - 08:24

Thanks Liz 🙂

Hi, thanks for another great lesson. Couple of questions about raw feeding if that’s ok please!

– if a dog is raw fed, is it ok to swap straight onto a ‘normal’ commercial diet/cooked food e.g. if they decide to transition from raw to kibble, or if they have a GI upset and you suggest feeding cooked chicken and rice for a few days, or if they’re an in patient the practice and they need feeding? There seems to be an opinion from raw feeders that this will cause the dog to bloat/block/spontaneously combust, but I don’t know enough about raw feeding to know if there actually is any risk

– raw feeding clients often talk about the ratio their dog is fed (80:10:10, 75:15:10 etc), what does this mean and is it based on any kind of evidence?

Thanks 🙂

Hi Liz, thank you for a really useful webinar. Just a couple of questions please:

– what was the paper you mentioned regarding the usefulness (or not) of VHS please?

– any tips for differentiating ageing change/mineralisation vs. mets please?

Thank you 🙂