Kerida Shook
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Hi Scott,
very interesting xrays. There seems to be calcification in the lungs. I have not seen changes like that before. Also, the stomach ventrally has some abnormal contents? The kidneys- just a gross observation- look possibly enlarged to me. Could this be Vit d toxicity? Or pulmonary mycosis/mycobacteriosis? Were any blood tests done? A BAL may rule some infectious agent out, but I assume if you’re asking, then you are probably considering other diagnostics, correct? Curious to hear your assessment and plan!
Hope you are well, not worried about becoming the 51st state, and thanks for the interesting case!
Keri
Replying to scott@vtx-cpd.com 20/09/2024 - 12:44
Hi Scott, thanks so much for your help! We did four days of IV remdesevir, then 2 days of subcutaneous and Sunday the owners started with the oral GS44etc medication (wish they would find a better name π). Thoracocentesis sample returned as positive for FIP 2 days after we had started treatment. He was like a new cat even after the first injection. He did continue to lose weight the first 4 days which was concerning, but was eating well and playing. His weight stabilised on day 5 and 6, and we will get him back in for a weight recheck this coming week. His pyrexia resolved after the first IV injection. Here’s hoping he continues to do well!! This treatment is mind blowing. For those of us who’ve been around a while (I speak only of myself here π), and have had to euthanise countless cats due to suspicion of FIP, I just marvel at the chance to treat what previously would have been a sure death sentence…. I will update his progress π€ Thanks again for all your help and support! Keri
Replying to scott@vtx-cpd.com 19/09/2024 - 14:17
Thanks so much, Scott, this is really helpful. I will keep you updated π Sometimes, just a bit of reassurance is needed!
Hi Scott, very interesting! However, if I have a haemabdomen dog with a splenic mass, I generally recommend PTS. Who would have the time or the access to the equipment, to do a full body MRI or CT in an actively bleeding dog? Or can something like tranexemic acid (I can’t spell it…) slow bleeding? Or have I misunderstood the point here?
I’ll check the paper, but I find these cases very difficult, especially when the mean survival time in haemabdomen dogs post splenectomy is 3 months. This may have changed, but that is the last statistics I remember, so I do not think it is ethical to put any of these dogs through surgery. I would love to have a discussion on this, as my information may be out of date! But I really don’t want to hear about the anecdotal dog whose ruptured splenic mass was benign and they lived happily ever after π
I am looking forward to be proven wrong here!
KeriTrial a steroid inhaler if owners don’t want to pursue further imaging/diagnostics? Slowing her feeding down? Is there a seasonal pattern to her wheezing? Rule out FeLV/FIV?
Thanks for this information. I am a huge fan of Librella and Solensia and generally wholeheartedly recommend clients to try it for their OA animals. I have not seen any obvious side effects in dogs- just my observations- but seems to me when Librella doesn’t work then this occurs mostly in larger dogs. Also, my cat and our receptionist’s cat did get various degrees of pruritis from Solensia. My cat has it relatively mild, and I can control it with topicals but he is a different cat after he has had his Solensia, he can go up and down the stairs without bunny hopping. I only give it to him as and when he seems sore, or his bunny hopping on the stairs recurs, so he doesn’t get it every 4 weeks. And I worry (unecessarily) about his kidneys, so try to stay away from meloxicam.
Our receptionist’s cat, however, who was CKD stage 3, really suffered terribly with her itchy skin. She was self harming to the point of causing bleeding sores especially around her head, neck and ears. The Solensia was stopped, but her skin issues pursued for weeks and weeks, and we were limited as to what we could give her. It eventually did settle with topical steroid, antibiotics and piriton, but it took a very long time.
However, especially for elderly cats, I just think Solensia is a god send!Hi Scott, I have only ever used them as a new graduate in cat dentals, years ago, and never since. It does make the dentals a bit more challenging….. but better to not have a blind cat afterwards. I don’t recall a patient ever suffering from blindness post GA but it may not have been immediately obvious.
Hi all,
I am late to the party per usual, my name is Keri and I am hoping to really up my game in feline medicine. I have always maintained that cats are the women of veterinary medicine- it is seemingly all geared towards dogs. I have a rescue cat, Aksel, since 2019, who is my furry soul mate, and he went missing for 54 days at the beginning of this year (I can really recommend the cat tractive GPS collar- he doesn’t leave the house without it now). He was
a traumatised and skinny cat when he was finally found, but he is back to his regal self now. No dogs in my household since Aksel would find this highly unacceptable.
I will have a thousand questions for the course leaders, as I am a ‘vintage’ vet and really need to refresh my knowledge. Especially in cat anaesthetic protocols, since we have been having some issues with these at my present employment.
And thanks vtx for offering this course and thinking of the number 2 patients in vet med π
KeriHi Scott, thanks for being this interesting study to our attention. I wonder how much additional pain relief effect you would get with a one off injection? Or is a CRI necessaryβ¦β¦.I may just be attempting to avoid maths β¦
Thanks again!Thanks SO much Tessa and Scott. This dogs’ UCCR ratio was through the roof (not at work to check but seem to recall it was around about the 850?!), the subsequent LDDT confirmed Cushings, and the clinical signs fit. Although his urine SG was consistently about 1.001 so I was concerned about diabetes insipidous as well…He started his Vetoryl today so we’ll see how he gets on. With your videos, Scott, and having a ‘convenient’ case to work up on my own, I think I may (finally!!!) have at least the diagnostic flow chart/approach seared onto my brain…took long enough π
Hi Liz,
I would be very, very keen on an echo course with some practical days. That would be amazing. I have the equipment, just missing the expertise!
Hi Scott, I only ever very rarely experience the ‘vintage’ benefits π Most days I feel I would be better off going back to university or changing careers altogether. Such is the life in veterinary medicine, possibly? But thank you both for your fantastic courses, and educational/moral support. vtx is an amazing resource and it’s very much appreciated!
KeriHi everyone,
vintage vet here with very vintage knowledge. That’s why I am here, I have a lot to review, learn and update in my old brain, so please be patient. Cardiology is one of those (many) topics I feel I can intensely review, and three days later am again none the wiser. So, here I am again, just trying to justify my clients’ trust. I am looking forward to the course.
KeriHi Scott,
I placed the Freestyle Libre today on the dog from my previous post above. It went really well (so far), with the great help in the form of the video link you sent. We’ll see how measuring commences. It was quite straight forward to place, this may be a better option than in house glucose curves going forward, if owners are willing. I am curious to see the readings the owner (hopefully!) can now get. Thanks again for all your help and advice.
KeriHi Scott, how are you? After a miserably failed attempt to convince Abbot into sending me a (free) sample Freestyle Libre monitor for this case (it’s worth a try, right?), the owner does seem very keen to try one, so she is looking to source one herself. I am not even sure about how I would go about ordering/sourcing one…. I have offered to ‘install’ it for her. This owner can’t be referred due to cost concerns, she is aware I have not done it before (although it looks quite straight forward in the video, thanks for that) but she is keen to try, so I am very excited to see how it goes. I think its a brilliant idea to start implementing/offering to our diabetics for home monitoring. Also have been inspired by your lecture to create a DM protocol for us to use in the practice going forward.
Thanks again so much for your help and support, much appreciated. Hope you aren’t too inundated and pulled in too many directions at the moment, hope Easter can offer you some rest and relaxation (and chocolate of course)!
I will keep you updated.
Thanks! KeriThank you!!!
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