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scott@vtx-cpd.com

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Viewing 15 posts - 1,726 through 1,740 (of 2,102 total)
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  • 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)

    HC-duo
    HC-hepatic-LN
    HC-left-adrenal
    HC-liver-1
    HC-liver-2

    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 🙂

    scott@vtx-cpd.com
    Keymaster
    09:36 22/09/21

    Replying to Tone-Lise K. 21/09/2021 - 20:53

    Hey.

    Good question. The fresher the better, but the lab will often make them again after transit.

    I have tried to get in to the habit of making them straight away and popping them in a rack. You should be absolutely fine doing it the way you are, but the longer in EDTA the more likely there is for some artefact.

    Thanks.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    09:32 22/09/21

    Replying to Chloe H. 20/09/2021 - 16:31

    Hello!

    Hope you are safe and well. Great question. Cas just like to do things differently!!!

    The oxidative damage results in denaturation and precipitation of haemoglobin, with subsequent binding of the precipitated molecules to the internal surface of the erythrocyte membrane. Cats have a different red blood cell membrane composition. Feline red blood cells have relatively high concentrations of oxidizable sulfhydryl groups and so they are especially prone to Heinz body formation in association with oxidative damage. With a relative deficiency of glucuronide conjugation, they also are less able to defend against oxidative damage. Lastly, the feline non-sinusoidal spleen does not filter out Heinz body red blood cells efficiently.

    Hope that helps.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    20:10 21/09/21

    Replying to Lesley M. 21/09/2021 - 11:28

    Thank you for your kind words Jacquin, Mairi is amazing!

    Don’t worry Lesley… I will make sure to remind!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    20:02 21/09/21

    Replying to Anna D. 21/09/2021 - 13:35

    Welcome Anna!

    Remember the material is available for 6 months, so you should have lots of time to catch up.

    Lovely to have you on board!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    15:00 20/09/21

    Hello.

    Lesley, would you mind giving us an update on this case?

    The liver certainly appears very abnormal. This could indicate neoplasia, but could still just be non neoplastic reactivate change. In an ideal world, I would take FNA’s if possible. FNA’s of the liver are not perfect and will not be diagnostic in many cases, but might be diagnostic in some neoplastic cases. In some cases the only way to make a definitive diagnosis is going to be a biopsy.

    In cases where biopsy is not an option and I was to pick a regime of supportive care I would consider a combination of a product that contains sAME (Denamarin) and ursodeoxycholic acid (Destolit). Antibiotics are often not that useful in these cases. If all else fails then I do not disagree with good old steroids!

    Hope that helps.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    08:48 20/09/21

    Replying to deirdre coleman 19/09/2021 - 19:52

    Really interesting.

    Not something I have ever done!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    10:58 17/09/21

    Replying to Emma A. 15/09/2021 - 12:24

    Hello.

    If you email me the PDF I will try and share it in another way.

    scott@vtx-cpd.com

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    10:55 17/09/21

    Replying to austeja Zykute 15/09/2021 - 12:34

    Hello.

    I hope you are safe and well. We get it through a company called BOVA:

    https://www.bova.co.uk/

    Let me know how you get on.

    Scott 🙂

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Viewing 15 posts - 1,726 through 1,740 (of 2,102 total)
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