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Liz Bode

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  • Liz Bode
    Keymaster
    20:50 04/10/21

    Replying to scott@vtx-cpd.com 14/09/2021 - 10:18

    Hi Scott,
    I’m keen to try this as some of my patients won’t eat until their heart failure is better controlled. Can you use it in both cats and dogs?
    Liz

    Liz Bode
    Keymaster
    19:26 30/09/21

    Replying to Anna Deen 24/09/2021 - 07:28

    Hi both,

    Great answers, it is a tricky one as this could be an MMVD lesion on the posterior valve. The murmur had not been noticed before, CRP was >70 mg/l (very high). I thought that this was most likely an endocarditis lesion – it oscillates separately to the valve and flails into the LA, it is very echodense and organised (almost polypoid). The posterior leaflet is not usually as affected as the anterior leaflet in MMVD, which increased my suspicions more. There was MR associated with it, although the anterior leaflet is also thickened and does display some evidence of MMVD.

    The lameness localised to the carpus, this was tapped and appeared septic. Blood cultures and joint fluid cultures were submitted. CT was performed. Urine cultures also. Then the dog was started on IV antibiotics including potentiated amoxicillin and enrofloxacin. In the literature they say to hospitalise for at least 7 days, but with financial considerations this was not possible. Therefore, she was discharged following normothermia and when she was eating on oral equivalents.

    She is currently doing well and I will re-echo in 4-6 weeks and recheck CRP. If CRP normal then I will stop antibiotics.

    Liz

    Liz Bode
    Keymaster
    17:05 26/09/21

    Replying to Liz Bode 20/09/2021 - 12:11

    Hi all,

    As promised, I have recorded me talking through the interpretation of the radiographs. Please find the link below and let me know if there are any issues with it.

    Radiograph interpretation

    BW

    Liz

    Liz Bode
    Keymaster
    20:24 23/09/21

    Hi Emma,

    That is a cool case (sadly not for the dog, but this is pretty rare I think?). Excellent work 🙂

    Liz

    Liz Bode
    Keymaster
    20:05 23/09/21

    For info (as I didn’t include it before) the paper speed is 50mm/s and sensitivity 20mm/mV

    Liz Bode
    Keymaster
    20:05 23/09/21

    Replying to scott@vtx-cpd.com 23/09/2021 - 11:19

    Hi Scott,

    Yes, just on the right front leg.

    Liz

    Liz Bode
    Keymaster
    12:13 20/09/21

    Replying to scott@vtx-cpd.com 10/09/2021 - 13:31

    Hey,

    I agree with Scott, gaba in cats and trazodone in dogs. It can be really helpful if you want to echo them conscious too as they have no affect on systolic function etc.

    Liz

    Liz Bode
    Keymaster
    12:11 20/09/21

    Replying to scott@vtx-cpd.com 17/09/2021 - 10:58

    Hi all,

    Some really good comments so far. I will try and record a little video explaining the radiographs and place the link on here…This might take me a few days to do but I think this will be more helpful then me writing it here.

    Liz 🙂

    Liz Bode
    Keymaster
    17:32 05/09/21

    Hi everyone,

    Following on from Scott’s post I also wanted to say hello. Scott has worked really hard to curate this course and I think it looks amazing! We really hope you enjoy it and please do remember that you can ask questions/ post cases etc on the forum and we will do out best to help you out. All feedback is welcome on what you enjoyed about the course and other topics you would want us to cover in future.

    We look forward to meeting you at the live Q and A sessions too.

    Liz 🙂

    • This reply was modified 3 years, 3 months ago by Liz Bode.
    Liz Bode
    Keymaster
    08:20 01/09/21

    Replying to scott@vtx-cpd.com 31/08/2021 - 16:59

    I agree, thanks for your input Austeja. I am definitely going to be keeping an eye out for more cases. this dog wasn’t on any other medication, but microloss of blood certainly makes sense.

    Liz

    Liz Bode
    Keymaster
    12:29 30/08/21

    Replying to scott@vtx-cpd.com 28/08/2021 - 09:18

    Hi Scott,

    Yes, it appeared that most of them did. My initial thoughts on the whippet I saw was to repeat the haematology and smear in 4-6 weeks. Other blood work was unremarkable, PLI normal, CRP <10 (WNL) and nothing exciting on echo. Of course, doesn't mean there isn't or wasn't something going on, especially given the clinical signs noted by the owner.

    I will keep you posted if anything more comes of it.

    Liz

    Liz Bode
    Keymaster
    17:23 28/06/21

    Replying to Nathalie Cunha 22/06/2021 - 06:55

    Hi Nathalie,

    This was indeed what we thought in this case – a focal atrial tachycardia for the reasons you have stated above 🙂 We controlled it with diltiazem and the heart remodelled back to normal (apart from the mass!).

    Liz

    Liz Bode
    Keymaster
    17:21 28/06/21

    Replying to Camilla Edwards 24/06/2021 - 20:41

    Hi Camilla,

    Sorry, this did cause some problems as we switched part way through the course to the new website. The link was on lesson 10, but you had to force completion of lesson 9 (I didn’t realise this until after the session). I will post it soon.

    Everyone will have 6 months from the start of the course to access the videos so no rush with those.

    Liz

    Liz Bode
    Keymaster
    17:19 28/06/21

    Replying to Gabriela Gonzalez-Ormerod 25/06/2021 - 21:01

    Hi Gabriela,

    Great questions also. In terms of management of RCHF the best way to monitor successful treatment is via a FAST scan to see if I can still see fluid. I would expect almost complete resolution after a week and by 2 weeks post furosemide there should be no fluid there at all. It is more tricky to monitor than LCHF though. You could also weigh them serially (as you point out ideally you would have the pre-CHF weight) or measure abdominal girth, but ultrasound is going to be most accurate. Similar to LCHF you are looking to remove all of the fluid.

    Hope that helps 🙂

    Liz

    Liz Bode
    Keymaster
    20:58 21/06/21

    Hi Nathalie,

    That really depends on if the flow has fully reversed or is still bidirectional. If bidirectional I would expect that the velocities will start to drop in both systole and diastole. Then you will lose the diastolic component and then both components if the PA pressure increases enough. I would start sildenafil if I documented pulmonary hypertension on echo (or had a high suspicion following the consensus statement). Sometimes there are anomalous vessels called aberrant bronchoesophageal arteries that enter the PA in a similar location to a PDA but have much lower flow around 3 m/s. You can get a murmur but not always – Geoff Culshaw published a case series in JSAP in 2013. In this case the pulmonary artery pressure is normal so there is no evidence of hypertension.

    Have you seen a suspicious case?

    Liz

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