scott@vtx-cpd.com
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Replying to Daphna S. 11/10/2021 - 18:45
Hey Daphna and Rebecca.
Sorry confusion regarding the notes vs the lecture.
I got a bit over excited with the material and could have gone on for days with this topic!
I am planning to present the slides that were not at the lesson at the first live Q&A. I will present these at the ned of the session and it will be recorded.
Hope that makes sense.
Scott 🙂
Replying to Daphna S. 11/10/2021 - 18:48
Lovely to hear from everyone!
Even those late to the party! 🙂
Have a lovely week everyone!
Scott 🙂
Replying to Elaine P. 10/10/2021 - 21:43
Thank you so much for this feedback Elaine.
I thought it was a brilliant session too. The challenge sometimes is to make sure we don’t include too much in each session… we could go on forever about some of these topics.
Felipe is brilliant and so good at explaining things. I am very lucky to get to work with him!
Have a lovely week.
Scott 🙂
Replying to Rebecca C. 11/10/2021 - 01:00
Hey Rebecca.
Thanks for the question. It is a great one! The use of gabapentin should not effect the haematology in the way that these sedation and GA would. Do you use gabapentin in cats. It really is a wonder drug for some cats. I have popped some details about the use of gabapentin and trazadone in cats prior to a visit to the vets!
Giving 1 single 100mg capsule of gabapentin to cats before their visit to the vets to reduce the stress of the veterinary visit. I have popped a helpful study below. It seems that trazodone may also be useful for this purpose too. I would love to hear people’s experience of this!
Effects of a single preappointment dose of gabapentin on signs of stress in cats during transportation and veterinary examination
OBJECTIVE To determine the effects of oral gabapentin administration prior to veterinary examination on signs of stress in cats. DESIGN Randomized, blinded, crossover clinical trial. ANIMALS 20 healthy pet cats with a history of fractious behavior or signs of stress during veterinary examination.
PROCEDURES Cats were scheduled for 2 veterinary visits 1 week apart and randomly assigned to receive a capsule containing 100 mg of gabapentin (13.0 to 29.4 mg/kg [5.9 to 13.4 mg/lb]) or placebo (lactose powder) prior to the first visit and the opposite treatment prior to the second visit. Owners were instructed to administer the assigned capsule orally 90 minutes prior to placing the cat into a carrier and transporting it to the veterinary hospital. Standardized physical examinations and blood pressure readings were performed. Owners assigned a cat stress score during transportation and examination, and the veterinarian assigned a compliance score at the visit. Scores were compared between treatments, controlling for various factors.
RESULTS Owner-assessed cat stress scores during transportation and veterinary examination and veterinarian-assessed compliance scores were significantly lower when cats received gabapentin than when they received the placebo. Sedation was a common effect of gabapentin administration, and ataxia, hypersalivation, and vomiting were also reported. All effects resolved within 8 hours after gabapentin administration.
CONCLUSIONS AND CLINICAL RELEVANCE Owners’ perception of stress in their cats is a primary reason for failing to seek veterinary care. Results of this study suggested that gabapentin is a safe and effective treatment for cats to help reduce stress and aggression and increase compliance for transportation and veterinary examination.
Efficacy of a single dose of trazodone hydrochloride given to cats prior to veterinary visits to reduce signs of transport- and examination-related anxiety
OBJECTIVE To evaluate the efficacy of a single dose of trazodone for reducing anxiety in cats during transport to a veterinary hospital and facilitating handling during veterinary examination. DESIGN Double-blind, placebo-controlled, randomized crossover study. ANIMALS 10 healthy client-owned cats (2 to 12 years of age) with a history of anxiety during transport or veterinary examination.
PROCEDURES Each cat was randomly assigned to first receive trazodone hydrochloride (50 mg) or a placebo PO. The assigned treatment was administered, and each cat was placed in a carrier and transported by car to a veterinary clinic, where it received a structured veterinary examination. Owners scored their cat’s signs of anxiety before, during, and after transport and examination. The veterinarian also assessed signs of anxiety during examination. After a 1- to 3-week washout period, each cat received the opposite treatment and the protocol was repeated.
RESULTS Compared with placebo, trazodone resulted in a significant improvement in the cats’ signs of anxiety during transport. Veterinarian and owner scores for ease of handling during veterinary examination also improved with trazodone versus the placebo. No significant differences were identified between treatments in heart rate or other physiologic variables. The most common adverse event related to trazodone administration was signs of sleepiness.
CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of a single dose of trazodone to cats prior to a veterinary visit resulted in fewer signs of transport- and examination-related anxiety than did a placebo and was generally well tolerated by most cats. Use of trazodone in this manner may promote veterinary visits and, consequently, enhance cat welfare.
Scott 🙂
Replying to Louise Groot 09/10/2021 - 08:57
Hey Louise.
I will get these uploaded ASAP!
Hope you have had a lovely weekend.
Scott 🙂
Replying to Louise Groot 10/10/2021 - 12:41
Hey Louise!
Hope you are safe and well. I will keep a note of these questions and we can maybe discuss with Hilary at the live Q&A if that is OK?
I can help with the Purina HA question, it is an excellent one. The reason I love Purina HA is that it can be used in almost every patient. It is indeed suitable for growing dogs. It is great for that reason in younger dogs with portosystemic shunts too!
Hope that helps.
Scott 🙂
Replying to Hannah B. 10/10/2021 - 15:19
HAHA!
No problem! It is so busy out there at the moment! Great question. Basically, with liver disease generally, there can be real variation with bile acids. Normal bile acids does not completely exclude a vascular abnormality. This is the results table from the paper I referenced:
If you look at the mean results, the vascular abnormality have higher bile acids overall. Most shunts are over 50 and many are over 100. However, if they are more normal, it does not rule a result out.
Hope that makes sense!
Scott 🙂
Replying to Anna Deen 10/10/2021 - 16:43
Hello.
Yes. You would need to do the BSA calculation for the patient first and then insert that in to the calculation.
Does that make sense?
Scott 🙂
Replying to Carriona Wheaton 07/10/2021 - 10:42
Thanks again!
I love a tick box too! Since CCD (ross-reactive carbohydrate determinant) blocking has become available the results of intradermal testing and serum testing have become much more comparable:
Evaluation of cross-reactivity of allergens by use of …https://europepmc.org/article/MED/12061535Agreement of serum allergen test results with unblocked and blocked IgE against cross-reactive carbohydrate determinants (CCD) and intradermal test results in atopic dogs. Gedon NKY, Boehm TMSA, Klinger CJ, Udraite L, Mueller RS. Vet Dermatol, 30(3):195-e61, 24 Mar 2019
The approach will vary a bit between dermatologists. Some will do both!
I will add question to the list for the live Q&A and we can discuss a bit more in detail with Hilary.
Scott 🙂
Replying to Lesley M. 06/10/2021 - 16:43
Sorry to hear that.
Scott
Replying to Carriona Wheaton 06/10/2021 - 20:35
Hey Catriona.
Hope you are well and enjoying the course.
Regarding the allergy blood work. Which blood tests were you thinking about? Are you doing the intradermal testing in clinic?
Just want to make sure I have all the information!
Scott 🙂
Replying to Emma A. 06/10/2021 - 21:26
This is a really brilliant question Emma.
I would agree that there is sometimes a difficult judgement call with antibiotics in these cases. Speaking very generally there are two populations of liver disease we see in dogs:
1. There are lots of cases where liver enzymes are increased in dogs that are not that unwell. These increases are found incidentally or are secondary to other problems. In these cases there would definitely not be a strong indication for antibiotics, most of these cases will not have an infectious component.
2. There is definitely a population that will present with increases in liver enzymes that are ‘sicker’. In these cases there would be an indication for antibiotics. I agree that parameters like temperature and white blood cell count would possibly help make these decisions. A reasonable first line choice in these cases would be amoxicillin/clavulanate. Imaging is helpful in these cases as the appearance of the gallbladder and liver can help guide decisions.
Don’t ask me about horses!
Hope that helps.
Scott 🙂
Replying to Rachel D. 06/10/2021 - 15:01
Thank you!
Really pleased it is helping!
Scott 🙂
Replying to Rachel P. 06/10/2021 - 12:40
Hey Rachel.
Thank you so much! I really wanted to follow through with my promise to make it easier to understand!
Scott 🙂
Replying to Nicola F. 04/10/2021 - 14:52
Hello.
Some suggestions from Hilary!
”Thank you for your question; pruritus in cats can be challenging
Regarding flea treatment – have you treated all animals and the house?
If you can rule out parasites then a food trial would be indicated _ I recommend a hydrolysed diet for 6 weeks. Regarding the prednisolone treat 2mg/kg daily until the pruritus is controlled and then taper, if starting a diet trial then I wouldn’t taper until 4 weeks into the diet trial. If they don’t want to do this then consider ciclosporin but this needs 4 weeks to full effect therefore run the prednisolone along with it for 2-3 weeks”Hope that helps.
Scott 🙂
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