scott@vtx-cpd.com

Replying to Helen S. 14/05/2024 - 09:22

Hi,

Thanks for the recommendation! I’ll definitely check out Black Box Thinking by Matthew Syed to learn more about the theory of Marginal gains. Diary of a CEO by Steven Bartlett also sounds interesting and worth a read.

Have you found any specific insights from these books particularly helpful in your practice?

Scott x

Hello Raquel,

Great question! The method for measuring urine specific gravity (USG) with a refractometer can indeed vary.

Using a drop of urine prior to centrifugation is a quick and convenient method. However, it may not provide accurate results if there is debris or sediment present in the urine sample, as this can affect the refractive index. On the other hand, using the supernatant after centrifugation removes any sediment or debris, potentially providing more accurate USG measurements.

The decision to use one method over the other may depend on factors such as the condition of the urine sample and the specific requirements of the case. In some situations, such as when analyzing urine with visible sediment, using the post-centrifugation method may be preferred to obtain more accurate results.

Using both methods and comparing the two values can be a useful approach, especially if there are discrepancies between the measurements. This can help ensure the reliability of the USG measurement and provide additional information about the composition of the urine sample.

Ultimately, The vast majority of samples are analyzed pre-centrifuge. I would routinely do it before centrifuge.

Hope this helps!

Scott 🙂

Hello!

I hope you are well.

Yes, avoiding intramuscular injections in the caudal thigh area to prevent iatrogenic sciatic nerve damage is a prudent practice in both dogs and cats. The sciatic nerve is located in close proximity to this region, and inadvertent injection into or near the nerve can lead to significant complications. Instead, opting for alternate injection sites with less risk, such as the quadriceps or lumbar muscles, can help mitigate this potential risk.

I tend to avoid this injection site altogether. Instead, I opt for the lumbar muscles, which are generally better tolerated and present fewer risks.

Scott 🙂

Hi Liz,

Thanks for sharing these exciting updates on treating congenital diseases in dogs! The stenting for pulmonic valve issues, especially for those tricky R2A cases or where BVP didn’t quite do the job, sounds really promising. Great to hear the short-term data is looking good.

The AVP II devices for those tiny pups with PDAs are fascinating too. Being able to go through the femoral vein and avoid a thoracotomy is such a game-changer.

Looking forward to seeing how these advancements continue to develop!

Cheers,

Scott 🙂

Thoracocentesis Guide for Dogs and Cats

What is Thoracocentesis?
Thoracocentesis, also known as a chest tap or pleural tap, is a procedure to remove air or fluid from the thoracic cavity. It can be both diagnostic and therapeutic, especially in emergency situations.

When is Thoracocentesis Needed?

Respiratory distress (increased breathing rate and effort)
Dull lung sounds (a fluid line may be identified with effusion)
Confirmed by thoracic radiographs (pleural effusion, pneumothorax) and/or ultrasound (effusions)
Contraindications:

Severe coagulopathies
Diaphragmatic hernias
Avoid penetration of intestinal loops or liver (use ultrasound guidance)
Potential Complications:

Hemothorax (bleeding into the chest)
Iatrogenic pneumothorax (collapsed lung caused by the procedure)
Laceration of intrathoracic organs
Acute death from stress or over-restraint
Equipment Needed:

Butterfly catheter or plastic catheter with fenestrations
Extension set (for butterfly catheter, extension set is usually not needed)
Three-way stopcock
Syringe (10 to 60 mL depending on the size of the animal)
Graduated cylinder or bowl to collect and measure fluid
Sterile gloves and aseptic scrub solution
Procedure:

Positioning the Patient:

Sternal recumbency or standing for removing pleural effusion or pneumothorax
Lateral recumbency if needed for pneumothorax
Preparation:

Pre-oxygenate the patient if necessary
Clip and aseptically prepare the tapping region
Prepare a sterile environment for the equipment
Needle Selection:

Cats and small dogs: 1 to 1.5 inch (2 to 3.5 cm) butterfly needle or 22-23 gauge needle
Medium dogs and large cats: 1 inch (2.5 cm) needle or 20-22 gauge over-the-needle catheter
Large dogs: 1.5 inch (4 cm) needle or 14-20 gauge over-the-needle catheter
Insertion Site:

Typically at the 7th or 8th intercostal space (ICS) for fluid
8th or 9th ICS for air
Insert the needle just cranial to the rib to avoid intercostal vessels and nerves
Aspiration:

Attach the needle to the extension set, stopcock, and syringe
Apply gentle suction to generate negative pressure
Orient the needle ventrally for fluid and dorsally for air
Stop if blood is aspirated, if lungs rub against the needle, or if the patient moves excessively
Continue until fluid flow stops or until negative pressure is reached (do not remove all air immediately to avoid re-expansion injury)