scott@vtx-cpd.com
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Replying to Josep B. 06/09/2022 - 10:01
Hello Josep.
So excited that you are part of our course. Neurology is such a challenging area for most of us and I am sure you will make the management of the neurological patient that little bit easier!
Scott 🙂
Replying to Kerrie R. 07/09/2022 - 06:16
Hey Kerrie.
Thank you for flagging this up. We will have a look at this ASAP.
Hope you are having a good week.
Scott 🙂
Replying to Lori D. 06/09/2022 - 13:15
Lori!
Really excited that you are joining us. I hope the course can help get you back in to the swing of the cats and dogs! Sounds like you have had a really interesting career. I am sure you could teach us a few things!
Let me know if you have any questions at any time.
Scott 🙂
Replying to Ursula Lanigan 04/09/2022 - 22:45
In PFK deficiency, haemolytic crises are precipitated due to alkaemia-induced of red blood cells following excessive barking, panting, strenuous exercise and high temperatures. Therefore, the patient was kept calm, cool and rested. On subsequent testing the anaemia resolved but a reticulocytosis remained, indicating that there was ongoing increased red
blood cell turnover but that the management regime allowed the dog to compensate.So basically support care is required. I would not use immunosuppression in these cases.
Scott 🙂
Replying to Nicholas K. 05/09/2022 - 14:59
Hey Nick.
Hope you are well. Thank you so much for your great questions. Regarding Molly/CKD cases. I think it does vary with these cases as far as how often you need to run bloods. The are two main scenarios:
1. Not that often! There is a lot about these patients that will not change. Once they have been diagnosed with CKD, the renal parameters are not suddenly going to dramatically reduce with diet etc. I think I would be generally monitoring these patients every 3-6 months depending on clinical signs. Monitoring with bloods/urine is important as there are changes that can be acted on. If the patient becomes proteinuric, that can be treated. If the patient becomes hyperphosphataemic, that can be treated. If the patient becomes anaemia, that can be treated. Does that make sense?
2. Much more often! If the patient presents more acutely with renal disease, I would monitor bloods more. It is important to remember that patients with acute or acute on chronic renal problems might get better with initial fluid therapy, but they might also never go back to ‘normal’.
Regarding treatment with the PUPD patient while you are investigating. I would warn the owner from the start that the PUPD may be a persistent issue until you get right to the bottom of the problem. I would reassure them many of the DDX are not life threatening. There is no rush to diagnose Cushing’s disease! Most of the more serious issues would become evident more quickly. I would offer symptomatic treatment if needed (maropitant for vomiting/nausea).
Does that answer your question? I hope it helps.
Scott 🙂
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This reply was modified 3 years, 1 month ago by
scott@vtx-cpd.com.
Replying to Kelly M. 05/09/2022 - 22:19
Kelly!
Thank you for joining us! I will not ask what the year of graduation was!? 🙂 I feel like I need to go back to vet school almost every day, I think we all feel like we don’t know enough. I really hope you enjoy the course.
Scott 🙂
Replying to Amy E. 05/09/2022 - 21:32
Hello Amy.
Thank you for joining the course. Teaching the students sounds fun, that was always one of my favourite parts of working in universities. If there are any cases you would like to discuss, make sure to pop them on the forum.
Scott 🙂
Replying to Hannah McAuley 05/09/2022 - 16:48
Hello Hannah.
Thank you so much for joining us. I hope the course is helpful! Just so you know children are very welcome at the live Q&A’s! The veterinary world is definitely different post babies and COVID (I speak from experience), so I really hope we can help support.
Scott 🙂
Replying to Nicholas K. 05/09/2022 - 15:03
Hello Nick!
Hopefully the course will help you navigate your first few months in practice. I know it can be stressful, but it is also a really exciting time in your career, try and have as much fun as possible too.
Please let me know if you have any questions or any cases that you would like to discuss.
Scott 🙂
Replying to Kathryn B. 05/09/2022 - 14:43
Hello Kathryn.
Thank you so much for joining the course. I had my first job in the North East. PDSA in Gateshead… it is still the favourite job of my career!
I hope the course helps with your confidence. Please let me know if you have any questions at any time.
Scott 🙂
Replying to Mariska H. 05/09/2022 - 10:26
Hello Mariska!
Thank you so much for joining the course all the way from Tasmania! Please let me know if you have any questions at any time!
Scott 🙂
Replying to Georgina F. 05/09/2022 - 14:07
Georgie!
Thank you so much for being part of the vtx crew for this course! Such an honour to have you work for us!
Scott 🙂
Replying to Ursula Lanigan 27/08/2022 - 10:54
Hey.
Great questions. I am not sue we know exactly which antibiotic is best. I would try and use an antibiotic with as narrow as spectrum as possible. To be honest amox/clav or metronidazole would be fine. I would try and give these antibiotics orally if possible in these cases. I would only use IV if they had significantly altered conciousness.
There are some other options. The goal of oral antibiotic treatments is to reduce the mass of ammonia-producing bacteria in the colon. Neomycin, an aminoglycoside antibiotic, alters the composition of the bacterial flora in the colon, thus decreasing the number of ammonia-producing bacteria. Neomycin (20 mg/kg PO q12h) should be considered in patients intolerant of lactulose. Neomycin can also be administered via a retention enema (15 mg/kg diluted in water q6h after cleansing enema). Neomycin, although poorly absorbed from the intestines when given orally, is highly nephrotoxic and should never be given parenterally.
Studies on the use of oral metronidazole in treatment of HE are limited in human medicine and lacking in veterinary medicine. Metronidazole undergoes extensive hepatic metabolism; therefore, the dose must be reduced in patients with HE (7.5 mg/kg PO q8-12h) to avoid toxic effects. Advantages of using metronidazole over lactulose or neomycin include decreased risk of diarrhea and nephrotoxicity. Maintenance therapy at high doses has been associated with a central vestibular syndrome characterized by ataxia and nystagmus.
I hope that helps.
Scott 🙂
Replying to Ursula Lanigan 27/08/2022 - 08:47
Hello!
It was indeed PFK!!! This is the report from the genetic testing in the dog:
PFKD/ PFKD (Genetically Affected)
Interpretation:
The examined animal is homozygous for the causative mutation for PFKD in the PFKM-gene.
Trait of inheritance: autosomal-recessive
Scientific studies found correlation between the mutation and symptoms of the disease in the following breeds: American Cocker Spaniel, English Springer Spaniel, WhippetCool right!
Scott 🙂
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