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    Keymaster

    Really interesting topic.

    I look forward to hearing people’s thoughts.

    Scott 🙂

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    Keymaster

    I have often wondered!

    When I worked with you at Wear, we only really used dexmedetomidine.

    When I first graduated all we used was medetomidine! I have not seen medetomidine used for quite a while any of the practices I have worked at.

    Interested to hear your thoughts.

    Scott 🙂

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    Keymaster

    Hey.

    I think this is a really interesting topic.

    Some cases pose a real challenge. Situations I find tricky are:

    1. When a patient is not able to have a NSAID at home due to concurrent medications or medical conditions.
    2. Limitations in cats, particularly when paracetamol is not an option.

    Looking forward to hearing your thoughts.

    Scott 🙂

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    Replying to Felipe M. 16/03/2024 - 13:28

    Totally agree.

    Involving owners in what we do also adds a layer of complexity.

    As with most things, we have to consider every case individually.

    Scott 🙂

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    Replying to Junwei Föhr 21/03/2024 - 10:03

    Thank you for being such a brilliant course delegate!

    We really appreciate your questions and interaction.

    Scott 🙂

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    Replying to Kerry Doolin 21/03/2024 - 11:37

    Kerry!

    Like actual talcum powder?! How the heck did they get that in to the pleural space?!

    I presume this is not published?

    Question is… was it scented?!

    Scott 🙂

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    Replying to Kerry Doolin 21/03/2024 - 11:41

    Really interesting Kerry.

    I think we have so much more to learn about this drug!

    Scott 🙂

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    Replying to Raquel M. 22/03/2024 - 16:59

    That is very exciting!

    Congratulation on the new position. If you ever need someone to come out there and do any teaching in person… let me know! 🙂

    Scott 🙂

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    Replying to Josep B. 22/03/2024 - 20:15

    Welcome Josep!

    Thank you again for working with us. Hope you are having a good weekend.

    Scott 🙂

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    Keymaster

    Hello Raquel!

    Great to hear from you. Exciting regarding the change in job! Are you working at a vet school?

    I will make sure Steph sees this. I will share some thoughts too.

    Scott

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    Replying to Kerry Doolin 22/03/2024 - 13:17

    So helpful Kerry.

    Thank you for sharing your thoughts.

    Scott 🙂

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    Hello again.

    The following reply is from Zoetis:

    “As per the data sheet for use of Cerenia use in dogs ‘neurological disorders such as ataxia, convulsions/seizures or muscle tremor have been reported in very rare cases’, as Cerenia is not licensed for use in cats we have no studies on this and therefore no data regarding the possible adverse events from this. Sorry I don’t have any more information to give you on this.”

    Seems like it might be a rare side effect. I would contact they directly to report these adverse side effects, particularly if yoy have had a few of them.

    Scott 🙂

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    Keymaster

    Replying to Junwei Föhr 16/03/2024 - 10:29

    Hello again.

    It seems like CRP may also have a possible role to play on the diagnosis of lung disease. A number of studies have shown that CRP seems to be higher in cases with bacterial pneumonia when compared to other inflammatory lung disease:

    https://pubmed.ncbi.nlm.nih.gov/24351049/

    Scott 🙂

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    Replying to Junwei Föhr 16/03/2024 - 10:29

    Hello.

    I hope you are well. I do indeed use CRP as a way of monitoring aspiration pneumonia cases. It can be a helpful tool to help determine when to stop antibiotics as you mention. This paper looked at CRP use in dogs with aspiration pneumonia and whether it is a reliable indicator of when to stop antibiotics. They found that in dogs where CRP normalised and clinical signs resolved that antibiotics were discontinued in as little as 1 week! This is much shorter than the traditional length of time, or 2 weeks past resolution on radiographs/ thoracic ultrasound (remembering imaging improvement often lags behind clinical).

    CRP is gaining more and more attention as a marker for when to stop antimicrobial treatment, and although this cohort was small I think it shows some useful findings. Here is the abstract, and the paper is open access through JVIM.

    https://pubmed.ncbi.nlm.nih.gov/35348224/

    Abstract
    Background

    Evidence regarding optimal treatment duration in dogs with aspiration pneumonia (AP) and the role of thoracic radiographs (TXR) and lung ultrasonography (LUS) in the long-term follow-up of affected dogs is lacking. C-reactive protein (CRP) is a reliable acute phase protein to monitor bacterial pneumonia in dogs.

    Hypothesis

    Investigate the safety of antimicrobial discontinuation based on clinical improvement and serum CRP normalization, as well as the usefulness of TXR and LUS for follow-up.

    Animals

    Dogs diagnosed with AP and treated with antimicrobials.

    Methods

    Prospective observational study. Antimicrobials were discontinued based on clinical improvement and serum CRP normalization after 1, 3, or 5 weeks. At each consultation, a quality-of-life questionnaire, physical examination, serum CRP, TXR, and LUS were assessed. Short- (2 weeks) and long-term (>1 month) follow-ups after treatment discontinuation were performed to monitor for possible relapses.

    Results

    Seventeen dogs were included. Antimicrobials were discontinued after 1 week in 12 dogs (70.6%) and 3 weeks in the remaining 5 dogs (29.4%). Short-term relapse was not observed in any dog and long-term relapse was diagnosed in 3 dogs. Thoracic radiographs and LUS were useful for diagnosis, but did not add additional information during follow-up, because image normalization lagged behind clinical improvement and serum CRP normalization.

    Conclusion and Clinical Importance

    Dogs with AP can be safely and effectively treated using a short-term antimicrobial regimen discontinued after clinical improvement and serum CRP normalization. Imaging might still be useful for complicated cases with a less favorable response to treatment.

    Scott 🙂

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    Keymaster

    Replying to Marit Veeber 18/03/2024 - 09:15

    Hello Marit!

    Welcome. Great to see you here, thank you so much for joining the course.

    I am sorry to hear you are at home unwell. I also love that you are taking advantage of being ill and catching up on CPD!

    I hope you feel better soon. Let me know if you have any questions.

    Scott

Viewing 15 posts - 1 through 15 (of 1,533 total)