scott@vtx-cpd.com

Replying to Raquel M. 18/03/2025 - 15:13

That’s a great point, Raquel. Hydracare definitely seems to be hit or miss with individual cats, but for the ones that take it, it’s an easy way to increase hydration without needing to resort to SQ fluids. I agree that simplifying the dosing to one pouch SID regardless of size is a practical approach—getting owners to stick with it consistently is often more valuable than perfect adherence to the recommended amount.

I haven’t seen much recent research on its efficacy either, but anecdotally, I’ve seen it help in some cases. Interesting that some vets have used it in dogs as well—I imagine it could be useful for chronic kidney disease patients or those needing extra hydration support without IV or SQ fluids.

Clients are already prone to selective hearing, so if different team members say slightly different things, it makes it even harder for them to understand the importance of environmental changes. I think your approach of giving them the resources and accepting what’s out of your control is the best way to handle it—it’s all we can do sometimes!

Scott 🙂

Replying to Cristina M. 14/03/2025 - 15:45

Hi Cristina,

That’s really interesting to hear about the approach in Italy. It makes sense that prevention efforts are keeping cases relatively low, which probably reduces the need for routine testing before surgery. I can see how it’s a difficult balance between identifying at-risk patients and adding unnecessary screening.

I’ve definitely seen more issues with lungworm-related coagulopathies in the UK than heartworm, and I agree that testing before abdominal procedures seems like a good precaution in those cases. I wonder if there will ever be a clearer consensus on pre-surgical screening for both heartworm and lungworm, or if it will always come down to clinical judgment and local risk.

Scott

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

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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 🙂