scott@vtx-cpd.com
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Replying to Simon Patchett 01/08/2021 - 12:16
Yes!
Took me a minute to see it as the pathology is mainly over the heart. Once you see it, I think it is a really good example of an alveolar pattern.
It was a real shame with this dog, it did really well recovering from heat stroke and AKI, just as he was about to go home, he aspirated!!!!!!!
Sadly was PTS due to finance.
Scott
Replying to austeja Zykute 02/08/2021 - 13:19
Hey.
Really interesting. I am pleased there is a glimmer of hope here with this option. Here is the link again:
https://drive.google.com/file/d/13W_y0grU-WFICLGvq356u1Z2QAY-eGPg/view?usp=sharing
Scott 🙂
Replying to scott@vtx-cpd.com 24/07/2021 - 18:38
Hey.
Happy for you to post cases at any time.
Pop it in the forum as any other post and you can upload images here:
This will generate an image link that you can pop in the post!
Scott 🙂
Hello.
1. I have no experience of using higher doses of UDCA in this way. I have had a look and I am not able to find any references for this. Do you have any references from the lecture. I will have a chat to colleagues and have also dropped Mike an email. I will keep you posted.
2. The main issue with metronidazole and liver disease is the increased possibility of side effects. I would be careful not to use high doses, but it does not mean that metronidazole is totally off the cards. I would try and base antibiotic selection on culture as much as possible. Treatment with a broad‐spectrum antibiotic is indicated for bacterial hepatobiliary disease with coverage for Gram‐positive and Gram‐negative aerobes and anaerobes, as evidenced by the bacteriological culture results. These findings, along with the results of antimicrobial sensitivity testing, underscore the importance of this type of evaluation. While empirical coverage with either a fluoroquinolone and amoxicillin clavulanate or a fluoroquinolone, metronidazole, and a penicillin could be suggested based on the likely organisms involved, resistance remains a potential problem. Significant resistance to both amoxicillin clavulanate and fluoroquinolones among E. coli and Enterococcus spp. isolates, along with examples of changing resistance over time in isolates from individual cases, highlights that an empirical approach to antimicrobial treatment should be used with caution.
3. We will chat more regarding when to remove the gallbladder in that lesson, this decision making can be challenging. Poor resolution with medical management and continued thickening may indeed be an indication.
I hope that helps. Let me know if I can do anything else to help.
Scott 🙂
Replying to austeja Zykute 21/07/2021 - 10:40
Austeja and Lucy!
I have popped your questions in separate posts so they don’t get lost.
Hope that is OK.
Scott 🙂
Replying to Areti Tsioka 19/07/2021 - 20:18
Hey.
I honestly think I would be nervous too… but not sure there is a right or wrong answer here.
I suppose, depending on how badly controlled, you would need to give time for the potassium bromide to take effect.
Other drug considerations would be imepitoin or zonisamide. I would give the potassium bromide time in the first instance and maximise the dose of the levetiracetam in the short term to bridge the gap.
Interesting case. Let us know how things go!
Scott 🙂
Replying to Hannah B. 20/07/2021 - 20:40
Hi Hannah!
Hope you are well. Thank you for your question! It is a good one!
Let me have a chat with my surgical colleagues and I will get back to you ASAP!
Scott 🙂
Hello everyone.
This is an interesting case. Thanks for sharing the article Emma.
I totally agree that it sounds like removing the offending drug, in this case, is the most sensible first step. With almost all other haematological abnormalities I would say wait and see. My only thought here is the fact that it is platelets and there are none. I suppose the biggest issue is the high risk of really serious bleeding (brain and lungs). I honestly might be inclined to start immunosuppression (steroids) while we wait for a rebound after drug removal. Other options would be one-off vincristine or human intravenous immunoglobulin. I may be overreacting but I worry about the 0 platelets and the wait for them to normalise. This would be a case that you could then taper quickly.
Thoughts?
Scott 🙂
Replying to austeja Zykute 13/07/2021 - 06:19
Hello.
Lovely to hear from you. I hope you are enjoying the course. You are welcome to ask any questions at any time! I welcome that at any stage!
I have added some new links that should work.
Looking forward to hearing from you.
Scott 🙂
Hey.
Sorry the links did not work. Not sure why! Have posed again below. I will also email round to avoid any confusion:
https://drive.google.com/file/d/1luJw-Ts646S96zNz61q8Vg-fw8T81LJE/view?usp=sharing
https://drive.google.com/file/d/1eagajbyPpOpLIIImt_x9llnQ-DBxd4W3/view?usp=sharing
https://drive.google.com/file/d/17OIrqhk6MQkFvf_jn7SaZ9ARqA_F_kVZ/view?usp=sharingHope to see you there.
Scott 🙂
Replying to Lucy Morley 07/07/2021 - 12:50
Hey Lucy.
Lovely to hear from you. I am so glad you are enjoying the course. I know how mad things are out there at the moment, I hope you are managing to get out on the tennis course. I am certainly enjoying watching it!!!
I am really glad you are enjoying the course.
Let me know if you have any questions at any time.
Scott 🙂
Replying to austeja Zykute 05/07/2021 - 09:59
Hello Austeja.
Really lovely to hear from you. I am so excited you are joining us all the way from Lithuania.
I am really passionate about chronic liver disease, so really hope we can help you manage these cases better.
Remember to let me know if you have any questions at any time.
Scott 🙂
Sorry again for delay.
Liz is editing now, so should be up ASAP.
Scott
Replying to scott@vtx-cpd.com 22/06/2021 - 13:47
Hey.
See email below from RVC. Zoom this evening regarding an update with the cats. Free for veterinary professionals to join:
Dear All,
Please see below the link to join us on zoom, tomorrow night, Thursday June 24th at 9PM. We have set this meeting up via our college account and therefore, should not be limited in regards to participants. Please feel free to forward to colleagues that we may have missed on the list; but ensure that it is only distributed in the veterinary profession.
We can give a short update on the data we have collected so far; but as mentioned earlier main aim would be for all of us to share some of our experiences we have collected so far in regards to treating these patients, and we are very keen to hear from colleagues that have had some survivors.
Topic: RVC Discussion on recent cluster of severe feline pancytopenia
Time: Jun 24, 2021 09:00 PM LondonMeeting ID: 983 9890 8494
Passcode: 3wiL5+hTLooking forward seeing you all tomorrow.
Best wishes Barbara and KarenReplying to Rosie Webster 21/06/2021 - 20:10
I have another one today! It is a Sphinx cat so the bruising is really obvious.
The platelets are the thing that seems to be most effected first. The cat was not anaemic on presentation, but I am sure that will follow.
We are considering using the following drug which has not been used in cats before:
https://pubmed.ncbi.nlm.nih.gov/32096575/
We also might consider a granulocyte colony stimulating factor… all unknown territory though!
Scott
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