scott@vtx-cpd.com

Replying to Laura S. 11/03/2025 - 20:03

Hi Laura,

Great to hear your thoughts. I’m the same, I’ve never really looked for hypernatremia after AC either, and it’s not something that’s been flagged as a major concern when following VPIS advice. It’s interesting that your formulation contains glycerine rather than sorbitol, I wonder if that has any impact on sodium shifts.

I tend to stick to one or two doses unless enterohepatic recirculation is a factor, and then I’d usually go for every six to eight hours for three doses rather than continuing indefinitely. I guess it’s always a balance between risk and practicality.

This study is really interesting because it suggests that single-dose AC may be just as effective as multiple-dose AC in reducing overall plasma drug exposure in carprofen overdose. All AC protocols, including single-dose and multiple-dose AC, significantly reduced overall carprofen exposure compared to controls, and while multiple-dose AC shortened the half-life, it did not significantly outperform single-dose AC in lowering total drug exposure. From a practical standpoint, this could make AC administration more manageable, particularly in outpatient cases where multiple doses may not be feasible.

While looking into this, I also came across a case report of gastrointestinal obstruction secondary to activated charcoal granule impaction. A two-year-old Airedale Terrier received multiple doses of AC granules for carprofen toxicosis and ultimately required surgical removal of impacted charcoal material from the ileum. Not something we see every day, but definitely a reminder that more is not always better when it comes to AC.

And yes, it is always a light-coloured dog, isn’t it? Never the black Labs.

Scott

Full papers:

Carprofen overdose and AC effectiveness: https://onlinelibrary.wiley.com/doi/10.1111/vec.12305
Case report of AC impaction: https://onlinelibrary.wiley.com/doi/10.1111/vec.12980

Screenshot-2025-03-12-115556

Replying to Cristina M. 05/03/2025 - 17:48

Hi Cristina,

Great to hear your thoughts and experiences. I hope you are enjoying the course.

It’s really interesting to hear that you’ve been in situations where it was just you and a VCA performing CPR. That must have been incredibly challenging, but I completely agree that as a profession we’ve come a long way in improving how we handle these situations. Having regular team simulations makes such a difference in building confidence and efficiency.

I also found it surprising that 6 rescuers were considered the optimal number. Like you, I would have expected 4 to be enough in most cases, especially since many teams don’t have the luxury of more people actively involved. I completely agree that 8 can easily become too many, leading to confusion rather than efficiency.

Scott 🙂

Replying to Bethany Deadman 02/03/2025 - 17:31

Hi Bethany,

It’s great to hear from you, and I really like the approach your practice has taken with assigning crash roles in ASA 3 or above patients. That’s such a smart way to ensure everyone is prepared rather than scrambling in an emergency.

I completely agree that involving VCAs and receptionists can make a real difference when team numbers are limited. Giving them CPD opportunities for CPR training not only makes them more confident but also means they can step in effectively when needed. I also agree that minimising these situations is the best approach!

Scott 🙂