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Raquel M.

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  • Raquel M.
    Participant
    13:02 12/04/22

    Replying to scott@vtx-cpd.com 12/04/2022 - 08:36

    Ok great thanks so much! I’m in the Cayman Islands 🙂. I’ll request an earlier finish work shift so I can attend the next in at the end of May.

    Raquel M.
    Participant
    19:55 11/04/22

    Will this be recorded? With the time difference, London time is 6 hours ahead of where I am. Realized that I missed it!

    • This reply was modified 2 years, 9 months ago by Raquel M..
    Raquel M.
    Participant
    16:32 24/03/22

    Hi again,
    I’m well thanks 🙂. Hope you are as well. No GI signs, normal appetite. They were discontinued because of the grass eating and omeprazole was started for 1 week or so then to restart the NSAIDs at a lower dose was what the other clinician advised.
    So my concern after your very informative lesson 3. Is that the prophylactic use of the omeprazole without confirmed GI ulceration could have done the opposite and increase the risk of GI ulceration after the NSAIDs were restarted?

    • This reply was modified 2 years, 9 months ago by Raquel M..
    Raquel M.
    Participant
    13:19 24/03/22

    Replying to scott@vtx-cpd.com 17/03/2022 - 14:36

    Hello,
    I’m terms of the indication for PPIs in cases of hematoemesis:-

    1) (a) what would you suggest for cases where an animal is reported to have a pinkish color in the vomitus or a few drops of blood as per O?

    (b) also if the owner reported the above was a one-off incident(or intermittent) and the other episodes of vomiting didn’t indicate any signs of blood then would you start with a PPi? Or only if the diagnostic workup confirmed GI ulceration?

    Was just wondering if there’s not a substantial amount of frank blood in the vomitus and the pinkish color or specks of blood reported by owner aren’t persistent. Then is it appropriate to use PPIs or not? Especially if the owner is unable to complete a full workup to rule out ulceration.

    Thanks as always,
    Raquel

    Raquel M.
    Participant
    12:15 24/03/22

    Replying to scott@vtx-cpd.com 20/03/2022 - 19:34

    Hi Scott,
    I had another question. A colleaguehad discontinued NSAIDs in a dog on long term nsaid use for arthritis throughout his elbows and hips. He had discontinued it because after questioning the owner had reported that the dog had been eating grass for the last few months. The dog had been doing really well on multimodal pain management along with the NSAIDs. I wasn’t aware that eating grass was a clinical sign of nausea or indication of GI ulceration from NSAID use. Are you able to shed some light on this? Is this something I should questioning owners about or is this something unproven?
    Thanks,
    Raquel

    Raquel M.
    Participant
    14:50 17/03/22

    Replying to scott@vtx-cpd.com 17/03/2022 - 14:36

    Thanks for quick reply! Really appreciate the advice. So grateful to have this platform where we can all discuss things that come up often in general practice

    Raquel M.
    Participant
    13:11 17/03/22

    MAROPITANT:-
    Is this a form of anti-emetic can be used to help stop vomiting whilst continuing with further investigations? If the initial exam, history taking doesn’t confirm an obstruction as a cause. And the initial rads don’t show gas dilation in the SI. Is it appropriate to use this type of anti-emetic in the period where we wait to repeat the rads and/or arrange for US? I know avoiding a prokinetic like metoclopromide is essential in obstruction or suspected cases. Wasn’t sure about using a Maropitant until a further work up can be completed.
    Thanks!

    Raquel M.
    Participant
    12:39 17/03/22

    Joined a bit late due to some technical issues with registering. Really looking forward to learning more!
    In terms of checking cobalamin and folate in vomiting cases. Is this something you would do routinely as part of the minimum database in both acute and chronic vomiting cases?
    Just curious as to when in the diagnostic process, would you recommend this? Is it after ruling out surgical disease? Is it when the vomiting is recurrent or chronic? Is it when there’s relapse of clinical signs of vomiting whilst on a treatment plan that worked before. Or relapse of clinical signs as soon as treatment ends?
    And what criteria do you use to define when a case moves from an acute onset vomiting to chronic?
    Hope that makes sense. Thanks!

    Raquel M.
    Participant
    12:36 17/03/22

    Could admin delete this post please. Meant to post it to the lesson 2 topic area

    • This reply was modified 2 years, 9 months ago by Raquel M..
    • This reply was modified 2 years, 9 months ago by Raquel M..
    • This reply was modified 2 years, 9 months ago by Raquel M..
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