scott@vtx-cpd.com
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Hello Rachel.
Thank you so much for your brilliant question. I hope you are enjoying the course.
Any feedback would be greatly appreciated!
I will make sure Georgia sees this question and we will get back to you as soon as possivle.
Scott 🙂
Replying to Victoria R. 14/09/2025 - 10:06
Hi Tori,
I really just wanted to pay tribute to the word ceruminous — it’s an absolute delight to say and deserves more airtime. There are a few words that have always stood out as favourites for me purely on how satisfying they are to say… notably ursodeoxycholic acid and levetiracetam.
But I think ceruminous has just earned a place on that list. It’s wonderfully ceremonious, really.
Scott 🙂
Hi Tori,
I’ve been using ChatGPT alongside dictation pretty much daily for about a year now, and honestly I don’t think I could practise without it anymore. I record almost every client interaction (consults, phone calls, follow-ups, always with consent), then feed the transcripts into ChatGPT to turn them into structured, professional notes.
I keep a separate ongoing chat thread for each patient, which I use to draft emails, referral letters, and clinical record entries. It’s streamlined so much of my admin and makes it easy to maintain continuity. Our hospital has also recently moved over to Co-vet, which I think looks excellent, the only reason I’m not using it fully is because my current workflow with dictation and AI is already so integrated and efficient.
Even this reply is dictated directly into ChatGPT, it’s become second nature now. It’s been a complete game changer for me.
So, I am not a fan of chat GPT to come up with the answers, but with the use of dictation it makes my words better!
Scott 🙂
Thanks for sharing this Tori.
Why do they think he was ataxic?
What do you think was the underlying reason for the severity of the skin disease?
I often see dogs with skin disease, especially around the vulva, with recurrent UTI’s. IS this something you see?
Scott 🙂
Replying to Victoria R. 06/09/2025 - 21:20
Hi Tori,
Totally agree with you, I think we do miss a fair few cases and only see the tip of the iceberg. I tend to see them more often through medicine referrals, usually when there’s Horner’s or a facial nerve component, and that does push me toward imaging and referral relatively early.
Scott 🙂
Replying to Pauline Brauckmann 23/08/2025 - 18:55
Hi Pauline,
Great question. Denamarin is not a core therapy for snakebite, but it can be a reasonable adjunct after the acute phase in dogs that develop hepatic enzyme elevations or suspected oxidative hepatocellular injury. I have to be honest though, I have not seen many snake bites in the parts of the world I have practiced in! Where do you practice… If you say Australia, you will know significantly more than me! 🙂
In most canine envenomations the primary problems are neurotoxicity, hemotoxicity or myotoxicity depending on the species, together with shock, coagulopathy, local tissue damage, and secondary renal risk. The only treatment that changes outcomes consistently is timely antivenom, plus aggressive supportive care, analgesia, fluid therapy, control and monitoring of coagulopathy, and management of local tissue injury. Denamarin, which combines SAMe and silybin, is a hepatoprotective and antioxidant supplement; it does not neutralise venom and will not influence the immediate course of envenomation.
Where it can help is later, once the dog is stable and eating, if you see ALT or AST increases, hyperbilirubinaemia, or a pattern suggesting hepatocellular stress from hypoperfusion, haemolysis, drug exposure, or systemic inflammation. In that context a two to four week course is reasonable and safe in most dogs. Dose SAMe at about 18 to 20 mg per kg once daily on an empty stomach and aim to include a silybin component around 4 to 5 mg per kg daily, which Denamarin provides. Recheck liver enzymes in two to three weeks and stop if values normalise and the dog is clinically well.
If the dog is nauseous or not tolerating oral meds, skip it in hospital. Intravenous NAC is a better inpatient antioxidant for very sick dogs who cannot take tablets, but it is not an antidote for snake venom either; use it only when there is a separate indication for parenteral hepatic support.
If there is significant local necrosis, coagulopathy, rising CK or myoglobinuria, prioritise antivenom, fluids, pain control, wound care, and monitoring of PT aPTT platelets PCV TS creatinine CK and urine output. Add Denamarin later if liver values are abnormal once the dog is eating.
There is no strong evidence that prophylactic Denamarin in all snakebite cases improves outcomes. Reserve it for documented or strongly suspected liver involvement.
I hope that helps! Please let me know how you got on with the course and if you have any feedback!
Scott 🙂
Replying to Sarah Keir 02/09/2025 - 07:31
I think I saw that image on your social media… it was impressive!
Scott 🙂
Replying to Sarah Keir 02/09/2025 - 07:28
I think that is maybe part of the problem… everyone considers it to be a rubbish part of the job!?
I used to love being hidden away in the dental room in my PDSA days!
Teaching was certainly very limited when I was at vet school.
Scott
Replying to Sarah Keir 02/09/2025 - 07:24
HAHAHAHAHA!
I wonder how long that ALT recovery is!?
Hope you had fun.
Scott 🙂
Thank you for sharing another brilliant video!
Scott 🙂
Thank you Liz for creating such a brilliant course!
Scott 🙂
Hey pal.
Thank you for sharing another brilliant video!
Scott 🙂
Replying to Sarah Keir 25/08/2025 - 15:37
Hey.
So I have seen a few things (skewers) migrate through the stomach wall and in to the spleen and out of the body wall.
I had one case where we found metal in the liver ‘incidentally’ when investigating a bladder mass… obviously harder to justify going in and removing something like that when it is a surprise finding.
I suppose you must spend your life finding ;incidental’ surprises on ultrasound!
Scott 🙂
Replying to Sarah Keir 25/08/2025 - 15:35
This is great!
I love that! I will start doing that!
That is a whole social media campaign right there!
Scott 🙂
Replying to Sarah Keir 25/08/2025 - 15:31
Hahaha!
Soap box appreciated! One thing I have noticed working in Canada is that there is a massive rise/popularity with people (non veterinary) offering GA free dental cleaning. There is a mobile van here that travels around Vancouver Island offering this.
I wonder why we are not so got at promoting the dental thing!
Scott 🙂
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