Raquel M.
Forum Replies Created
-
AuthorPosts
-
I’ve recommended Aerokat to clients when I was in the UK. I can’t remember now if I had any issues with it or how many clients actually followed it. That was when I was working for 1 year in London. I haven’t seen that many cases here in Cayman Islands so far but I do have an acquaintance that was having difficulty with the inhaler and I sent him resources that I found online from other vet resources. I do like that there has been research done to support what may work. I think having it demonstrated in the clinic would make it easier for clients to buy into it. Not always easy for the vet to do when we’re buy with consults and short on time but would be a great idea for a nurse consult.
Hi Scott,
Is there a recording available for this?
I haven’t noticed increased clotting tendencies. I have anecdotally thought that some heartworm positive dogs may bleed a bit more during surgery.
In the country where I’m from, ehrlichiosis canis is extremely common. I worked at a charity/low cost clinic and screening wasn’t the standard prior to gonadectomy but I did have discussions about doing that. It wasn’t common during a surgery when a dog was bleeding more than usual that we would test during the surgery and detect E.canis and continue the surgery and start them on treatment-doxycycline. Again it was very low cost in a small country so I learnt to work with what was available and using spectrum of care approaches that wouldn’t work in every setting or to the comfort level of every vet! Often these dogs were asymptomatic or had vague clinical signs but healthy enough for elective surgery.
E.canis is very rare on island now but that’s one that I would most definitely prefer to screen for in endemic areas prior to surgery. Have you heard of any studies related to benefits of screening prior to elective procedures for tick borne disease?
This was super helpful. Thanks very much for posting! I’ll have a look at the full article as well. I’m working in an endemic area for heartworm in the Caribbean. I studied in UK and where I’m from originally, heartworm isn’t common but it’s very common in the Cayman Islands for sure!
I don’t routinely test beforehand for surgery in dogs that are on a regular preventative or with clinical signs -coughing etc. For dogs that aren’t up to date with or without clinical signs then I do prefer to test. Unless they are showing significant clinical signs or cardiac changes that I feel will increase anesthetic risk then a positive result prior to an elective gonadectomy in an asymptomatic dog wouldn’t deter me from doing the surgery if I have informed consent and the owner agrees.
For advanced disease then I avoid any elective anesthesia. I would also want to avoid elective surgery if the heartworm treatment protocol has started, whether or not there are clinical signs, and wait until after treatment finishes for safety. I remember seeing this recommendation on VIN I believe but not sure there are any studies to guide on that?
Replying to Laura S. 18/03/2025 - 14:52
Hi Laura,
Yes I do also. I think mainly it depends on the client and how receptive they are. It can be hard to track how well they are implementing changes also. It does require consult time to discuss and go through everything and I like handouts also. I’m not familiar with that quote or the resource it’s from but I do like it! I think it’s helpful if everyone in the clinic says the same thing to the client to reiterate but that’s not always the case. As associate vets we don’t often have control over that so I try to do the best I can but it’s frustrating for sure if some clients don’t want to listen. I give them the resources and I accept that it’s out of my control what they choose to follow or listen to in the short term or long term.
Replying to scott@vtx-cpd.com 25/02/2025 - 14:04
You know I’ve had some cats that wouldn’t take the hydracare but others that really love it. I will say due to the need to import it to maximize use I often tell clients to give one pouch SID, regardless of size. Which isn’t following the directions but at least it’s easier for them to stay on it consistently. I like that it can be purchased online over the counter and it does no harm. It’s easier than SQ fluids for most clients of course to do at home. I haven’t kept up with all of the research to show it’s benefits.
I’ve even known some vets to use it in dogs as well.
Replying to Felipe M. 25/02/2025 - 15:27
Thank you to both of you! That’s very helpful information and guidelines to follow. The clinic I worked at used to stock the paracetemol IV solution but this one currently doesn’t but in case I have it to hand in again then this is great information.
My current colleague mentioned that she felt dogs on chronic paracetamol use are predisposed to splenic tumors but I haven’t heard of this or seen evidence for this before. Do you either of you have any opinions on this?
Thanks for sharing this Scott! I love having evidence based guidelines to refer to when making recommendations for commonly seen cases. To answer your questions-
Have you observed prazosin reducing UO recurrence in your cases? I have used it and seen it used post-UO unblocking when discharging animals home to the owner. I can’t honestly say if it’s helped or not in some cases or other factors played a role.
Do you still include prazosin in your post-obstruction treatment protocols? Not routinely. I would use in cases where there a history of recurrent UOs if I really felt like all other interventions were working. Or in higher risk situations, say if the owner was at the point of rehoming or euthanasia if the UO recurred again.
Have you encountered issues with rebound spasm after stopping prazosin? I haven’t. It was more recently in my career that I learn from this platform that weaning cats off of the medication is recommended. I never used it very often however so that may have been why I never witnessed rebound spasm after stopping the prazosin.
What alternative medical or environmental approaches do you use to manage urethral spasm? I like to follow the OHIO Indoor Cat initiative guidelines. I’ve used Purina Hydracare supplements to help with hydration and decrease USG. I’ve used gabapentin as an anti-anxiety as well and buprenorphine, cerenia as visceral pain relief. I do find them challenging cases if the owner is not on board with making environmental changes and trying out different changes to see what might workThank you for posting this. The responses from Dr. Scott and Felipe have been super helpful.
The dose in the Plumb’s formulary used in USA for paracetemol is 10-15mg/kg every 8-12 hours and that’s most commonly used on island. We do have vets from the UK who does higher to the Pardale V dose which is 33mg/kg bid-tid.
For otherwise healthy animals, would the 10-15mg/kg as a starting dose be ineffective?
Kind regards,
RaquelReplying to scott@vtx-cpd.com 22/02/2025 - 00:32
Thanks very much for your thorough reply. I really appreciate it!
Replying to scott@vtx-cpd.com 16/10/2024 - 12:57
Hi everyone,
Oh those are great ideas Scott! I love email. I find it easier for me to explain things and clients have a record of it and I do as well. It gives clients a chance to take the information all and then get back to me with questions or concerns. I like email along with in person conversations. We use text as well at the clinic I’m at. Phone calls are fine as well but I think it helps keeping the phonelines free for concerns that can’t be dealt with in other ways.
I’m not sure if all clients like it. I give the option that they can call or arrange to see me in person if they would like to.
And yes I would really appreciate if you could draft a protocol and provide materials for the clinic for uncomplicated diarrhea : ) It would really help to encourage change. Thanks so so much!
Replying to scott@vtx-cpd.com 17/01/2025 - 14:37
I also read that Hills I/D Digestive food is labeled for growth as well? Unfortunately, my clinic only stocks the Hills I/D low fat but the other clinics on island seem to stock the Hills ID Digestive/Sensitive food more readily than the Purina HA. Would that be another good option also if it’s easier to source?
Replying to scott@vtx-cpd.com 17/01/2025 - 14:37
Thank you, that’s great advice as usual! I’ll relay that to the owner and thank you for offering advice on the discussion on reducing the use of metronidazole!
I’ll keep you informed
Replying to scott@vtx-cpd.com 14/01/2025 - 12:47
Good news, LLoyd’s owner said his stool was normal when I checked in earlier this week to discuss further recommendations with her. He is currently on his initial diet that the O had been using prior to the start of the diarrhea. It is a Grain Free diet by Taste of the Wild Brand.
When would be best to transition him to a more nutritionally balanced diet to aid him with gaining back a better BCS and weight and avoiding any negative effects of a grain free diet? How long of a transition would be best?
Thanks as always,
Raquel -
AuthorPosts