scott@vtx-cpd.com

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scott@vtx-cpd.com
Keymaster

11:56 05/10/21

Replying to Michelle S 05/10/2021 - 11:38

No problem!

Glad you liked it.

It is also a good reminder to anyone who has not send me their address yet!

Thanks again.

Scott 🙂

scott@vtx-cpd.com
Keymaster

11:24 05/10/21

Replying to Liz Bode 04/10/2021 - 20:50

Hey.

We use it in cats too. They don’t love the taste of it and can salivate a bit. It works well in cats too, I I would definitely recommend. I still use a lot of mirtazapine in cats too.

Scott 🙂

scott@vtx-cpd.com
Keymaster

09:40 04/10/21

Replying to Jacquin M. 03/10/2021 - 17:25

Hey.

I think my main tip with the multiparameter monitor is to get it out the cupboard and dust it off. I used to work in a practice where we only used it in unstable cases.

I would get in to the habit of using it in all cases. It all then becomes second nature. You learn from the stable cases, and know when things go wrong with the unstable cases!

Scott 🙂

scott@vtx-cpd.com
Keymaster

09:31 04/10/21

Replying to Lesley M. 03/10/2021 - 12:00

Hey.

I honestly use gabapentin in this case. There is also then the option to give further doses. I think would also be better from a ‘safely’point of view.

I wish I had a similar protocol for when I take my children on a plane!

Scott 🙂

scott@vtx-cpd.com
Keymaster

09:05 04/10/21

Hello everyone!

Just wanted to say hello too. My name is Scott and I have the privilege of taking you through the first lesson.

Please let me know if you have any questions at any time. If you are not comfortable popping them on the discussion forum then drop me an email:

scott@vtx-cpd.com

I look forward to hearing a bit about you all.

Scott 🙂

scott@vtx-cpd.com
Keymaster

15:21 01/10/21

Replying to Elizabeth D. 28/09/2021 - 22:06

Hey Elizabeth.

Really interesting question. It is not currently recommended to giev omeprazole in cases that are being given high doses of steroids.

No evidence from clinical reports of dogs or from research studies shows that gastroprotectant drugs are beneficial for preventing or decreasing GI complications from high doses of corticosteroids. The gastroprotectants used in these reports were sucralfate, misoprostol, and H2RAs (ranitidine, famotidine). Some of these reports were from the 1980s, before the use of PPIs, although a more recent study showed no benefit in healing or preventing development of gastric mucosal lesions in dogs using either misoprostol or omeprazole.

I hope that helps.

Have a lovely weekend.

Scott 🙂

scott@vtx-cpd.com
Keymaster

11:00 01/10/21

Replying to Elaine P. 30/09/2021 - 19:42

Hello.

Hope you are well and enjoying the course!

Trazodone can be administered as needed, daily as often as every eight hours, or by using a combination of the two schedules. Because of the wide range in reaching peak plasma concentration and in its half-life, it is important to recognize that dosing should be adjusted to account for this individual variability. Trazodone is dosed at 1.7 to 9.5 mg/kg orally every eight to 24 hours. It is recommended to begin dosing at 2 to 3 mg/kg orally every 24 hours and then gradually taper up to effect.

I would recommend giving the trazadone and gabapentin around 2 hours before the visit to the vets.

Scott 🙂

scott@vtx-cpd.com
Keymaster

15:36 29/09/21

Replying to Ilse v. 28/09/2021 - 01:48

Hello Ilse,

Hope you are well. Thank you so much for your question. There definitely is a suggestion that using peripheral blood (ear tip) may be better for the detection of Babesia.

I would not use a peripheral sample for anything else. Taking from a small vessel may be detrimental when assessing other parameters (particularly platelets).

An atraumatic sample from a bigger vessel is best for everything else.

Hope that helps.

Scott 🙂

scott@vtx-cpd.com
Keymaster

15:21 29/09/21

Replying to Hayley B. 29/09/2021 - 13:16

It is still lovely to hear from everyone, even if you are late to the party! 🙂

I love to hear all of our stories. I love that we are in a profession full of such a wonderful mix of interesting people with such a variety of experience. We all have so much to bring to the table.

I also love that some many people have come through the lovely vet mums group! Such a kind and supportive space!

Scott 🙂

scott@vtx-cpd.com
Keymaster

10:53 27/09/21

Replying to scott@vtx-cpd.com 24/09/2021 - 09:57

Hello.

I am posting some more images and blood results for this case on behalf of Emma:

Yes the haematology and electrolytes were unremarkable and biochemistry as follows:
Glucose: 6.12 (4.11-7.95)
Crea 70 (44-159)
Urea 3.4 (2.5-9.6)
BUN 12
Phos 0.95 (0.81-2.2)
Ca 2.67 (1.98-3)
TP 59 (52-82)
Alb 28 (23-40)
Glob 31 (25-45)
ALT 194 (10-125) HIGH
ALP 624 (23-212) HIGH
GGT 20 (0-11) HIGH
Tbil 2 (0-15)
Chol 4.75 (2.84-8.26)

There’s no evidence of an insulinoma/glucagonoma based on these bloods, but it couldn’t be excluded.

I have uploaded some still ultrasound images to the following links (a couple of liver, the left adrenal gland, duodenum and the hepatic LN, I’m not sure how well they will be labelled after I’ve cropped them)

Sadly I think finances are limited, so PTS might be the next step.

Other options we could consider would be symptomatic treatment (analgesia, anti-emetics and skin treatment) alongside hepatoprotectants and amino acid infusions.

Because this case isn’t diabetic Prednisolone could also be considered to try and manage the skin disease.

scott@vtx-cpd.com
Keymaster

09:57 24/09/21

This is a really interesting case!!!!

Do you have any blood work that you could share?

Superficial necrolytic dermatitis is assumed to be secondary to an underlying metabolic disorder. The resulting hepatic and cutaneous changes are characteristic and much more severe and serious than those associated with the common secondary vacuolar hepatopathies reported with many endocrinopathies. In humans, most cases have a glucagon-secreting tumor and concurrent diabetes mellitus. A few dogs have been reported with glucagonomas, which are usually metastatic, and one case has been reported in a dog with an insulinoma. In most canine cases, there is no identifiable mass, serum glucagon concentration is normal, and the cause remains obscure. Superficial necrolytic dermatitis also has been reported in 11 dogs being treated with phenobarbital, although the contribution of the antiepileptic to the disease was unclear in this retrospective study and the response to stopping treatment was not known.

The adrenal changes is interesting. I suppose you would have to go down the road of demonstrating it is not functional. You could consider serial BP measurements, catecholamine assessment, ACTH stim or LDDST.

What is that plan with the dog?

Thanks so much for sharing!

Scott 🙂

scott@vtx-cpd.com
Keymaster

11:22 23/09/21

Replying to Roy Spigelman 06/09/2021 - 21:57

Of course!

In the post now!

Hope you are well.

Scott 🙂

scott@vtx-cpd.com
Keymaster

11:19 23/09/21

Really nice images Liz.

Was the dog just lame on one leg?

Interested to hear peoples thoughts.

Scott 🙂

scott@vtx-cpd.com
Keymaster

09:29 23/09/21

Replying to Anna Bassett 22/09/2021 - 21:38

Hey Anna.

Great question. Yes, in cases where you have a clinical suspicion, I would definitely check. Especially in PUPD cases where you are not finding anything else. This paper is great becuase it highlights the number of patients that had normal total calcium but actually abnormal ionised results.

Scott 🙂

scott@vtx-cpd.com
Keymaster

09:50 22/09/21

Replying to Tone-Lise K. 21/09/2021 - 20:49

Lovely to hear from everyone!

I especially love that we joined by people from all around the world.

Hope you are all enjoying the first lesson.

Scott 🙂
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scott@vtx-cpd.com

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