scott@vtx-cpd.com
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Hey Helen!
Great to hear from you as always. I will make sure Tori sees this.
I hope you are having a great week.
Scott 🙂
Replying to Laura S. 07/10/2025 - 11:06
Hey Laura!
Interesting! Is this a trichomonas case? What have you decided on so far treatment wise? Did you confirm with PCR?
Scott:)
Replying to lucy Woeginger 07/10/2025 - 11:19
Hey Lucy.
I hope you are well!
Great question! I will make sure Liz sees this. I hope you are enjoying the course. Any feedback is much appreciated!
Scott 🙂
Replying to Mihai R. 05/10/2025 - 17:25
Hello!
Thank you for your question!
Thank you so much for joining the course. I will make sure to pass on your question, and we will get it answered ASAP!
Have a great week.
Scott
Replying to Helen Collins 03/10/2025 - 13:01
Oh wow!
That is exciting! MJ and I went to vet school together… a very long time ago!
Say hello from me!
Scott 🙂
Replying to Julia Biernat 01/10/2025 - 19:16
Thanks Julia.
I must admit that I do not find myself reaching for the blood culture bottles that often, but it is important to remember we have the option for certain cases.
Scott 🙂
Replying to Victoria R. 30/09/2025 - 20:44
This is so interesting!
Love when you can reference your own work! 🙂
I will look at my approach with this and consider alternative wipes.
Scott 🙂
I hear you!
I get lots of pictures of poo!
Scott 🙂
Replying to Shona McTaggart 29/09/2025 - 11:45
Hi Shona!
So lovely to see you on here, I’m absolutely thrilled you’ve joined the course. Sounds like you bring a wealth of experience, and I think you’ll find the sessions really helpful for those trickier feline views and interpretation. Great that you’ve already got the dental radiography in place.
Enjoy your holiday in Oz, and fantastic that you’re planning to get stuck into the first couple of weeks while you’re away. Looking forward to learning alongside you!
Scott 🙂
Helen!
This might be the first discussion forum post we have ever had that has mentioned the midge…
You must be practising in Scotland!
Scott 🙂
Replying to Victoria R. 30/09/2025 - 20:19
Really interesting case!
Thanks for sharing.
Scott 🙂
Replying to Raquel M. 28/09/2025 - 15:30
Really interesting!
You’re right, there is some support in the literature for lameness being linked with systemic inflammatory disease like pyometra.
In dogs, immune-mediated polyarthritis (IMPA) can occur as a “reactive” phenomenon, where an inflammatory focus elsewhere in the body (e.g. infection, neoplasia, or pyometra) triggers sterile synovitis via circulating immune complexes. This can present as shifting-leg lameness, stiffness, or reluctance to move, sometimes without obvious joint swelling (Clements et al. 2004; McCarthy et al. 1996). Exacerbation of pre-existing osteoarthritis by systemic cytokines is also a plausible mechanism.
There are even case reports where anterior uveitis and IMPA co-occurred, likely through the same immune-mediated pathways (e.g. Yoon et al. 2024, zonisamide-induced IMPA with uveitis). So while the pyometra-uveitis link is better established (Jitpean et al. 2014; Fortuny-Clanchet et al. 2025), I think your observation of lameness could well fit into this broader “reactive inflammation” picture.
Clinically, it makes me think: if a pyometra case presents with unexplained limb pain or stiffness, it might be worth a quick joint palpation and even synovial fluid sampling if there’s effusion, especially if lameness improves as the systemic disease resolves.
Thanks for raising it!
Scott 🙂
References:
Clements DN, et al. Diagnosis of canine immune-mediated polyarthritis: a review of 40 cases. J Small Anim Pract. 2004;45:336–342.
McCarthy G, et al. Immune-mediated polyarthritis in the dog: clinical and laboratory findings in 31 cases. J Small Anim Pract. 1996;37:103–110.
Yoon J, et al. Presumed zonisamide-induced, immune-mediated polyarthritis and anterior uveitis in a dog. Front Vet Sci. 2024;11:1352217.
Jitpean S, et al. Outcome of pyometra in female dogs and predictors of peritonitis and prolonged postoperative hospitalization in surgically treated cases. BMC Vet Res. 2014;10:6.
Fortuny-Clanchet M, et al. Prevalence of anterior uveitis in dogs diagnosed with pyometra. J Small Anim Pract. 2025.
Replying to Julia Biernat 30/09/2025 - 08:51
Hi Julia,
Informing owners about the uncertainty but also the low risk is exactly how I tend to frame it too. In many cases, especially when emesis isn’t an option, it feels reassuring to have something we can do in the moment, even if the evidence base is thin.
And you’re absolutely right, these kinds of discussions are valuable!
I hope you are having a lovely week.
Scott 🙂
Replying to Raquel M. 27/09/2025 - 17:29
Interesting!
I wonder what caused the lameness? I am trying to find some good images of uveitis to share too.
Scott 🙂
Replying to Julia Biernat 22/09/2025 - 09:31
Hi Julia,
That’s a really good question and not tedious at all! I hope you are enjoying the course! Any feedback is always appreciated!
Sorbitol is the cathartic most often included in veterinary activated charcoal products. Its role is to increase osmotic draw into the gut lumen, which in turn speeds up intestinal transit. That’s the intended effect, to help move the charcoal–toxin complex through the GI tract faster and reduce reabsorption.
Where it sometimes gets phrased differently is in the context of what happens if you give multiple doses: repeated cathartic administration can lead to significant fluid and electrolyte shifts, ileus, and dehydration. That clinical consequence can look like delayed gut motility, but pharmacologically the mechanism is increased transit time. So, to be clear for your slides, cathartics like sorbitol speed up gut transit.
On your second point, you’re right about the ongoing debate around activated charcoal in grape/tartaric acid toxicity. The data is still very limited:
The ASPCA/APCC (and more recently the ASPCA Pro guidelines) generally advise against charcoal in grape/raisin/tartaric acid cases, mainly due to lack of proven efficacy and the fact that the toxin responsible seems to act via renal tubular mechanisms rather than an enteric-absorbed pathway.
That said, many clinicians (myself included) would still consider charcoal in certain situations, especially if emesis isn’t safe, as in your geriatric pug with CHF. It’s unlikely to harm if given as a single dose, and could theoretically help if some fraction of toxin is still unabsorbed.
The cost issue with Carbodote is very real, especially in larger dogs. Owners should absolutely be part of that discussion, we need to balance uncertain benefit against a fairly high cost.
I’m really sorry if there was any inaccuracy in what I presented, and I’ll make sure the material is updated so it’s clear and accurate going forward.
And I agree, it’s sad not to have more concrete options, sometimes charcoal is all you’ve got in the moment, even if the evidence base is thin.
Scott 🙂
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