scott@vtx-cpd.com
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Replying to Inge B. 22/07/2024 - 13:29
Hey pal!
Thank you so much for your really interesting response and insights. From my own experience, I agree that many people have preconceived notions about what chemotherapy will mean for their pets. Most of the time, we need to educate them on what chemotherapy actually entails for dogs and cats. I also believe that, in general, pet owners do not commonly regret their chemotherapy choices.
For me, the most important part of all of this is listening. As veterinary professionals, we often fail to fully understand the owners’ actual concerns, which can be very different from our own worries. Personally, at the end of every consultation, I always ask owners, “What are you most worried about?” The answers always surprise me and are extremely important. Often, they express concerns like, “I’m just really worried that my pet is going to die.” It’s a genuine fear for them, and we need to acknowledge and listen to that.
Thank you again for everything.
Best regards,
Scott x
Hello pal!
Thank you so much for your brilliant session. I wondered if you have any experience of using the MILA Tunneler for the retrograde placement of MILA Length-Adjustable Esophagostomy Tubes?
I have never used these before, but they are using them at my new job and are really cool!
Scott š
Great questions!
I hope you are enjoying the course.
I look forward to hearing Jon’s thoughts.
Scott š
Replying to Rosie Marshall 25/07/2024 - 16:22
Hi Rosie,
Welcome! It’s great to have you here. I have similar opinions about my dentistry teaching for sure, and I found that when I started in practice, it was what I was doing most of the time. I’m very happy to admit that I have limited knowledge about dental work nowadays, but I’m really happy to be involved in conversations about gingivostomatitis, so please feel free to share any insights or questions.
Thanks again for joining the courseāwe really appreciate your support!
Best regards,
ScottReplying to Ingrid T. 26/07/2024 - 11:52
Hi Ingrid,
Welcome! We’re really lucky to be able to work with you. Thank you so much for joining us. I’m really excited about the course and love your passion for dentistry.
Best regards,
Scott š
Replying to Rosanna Vaughan 25/07/2024 - 13:02
Hello Rosanna!
Welcome back to practice! Itās great to hear that youāre excited to get back into the swing of things, especially with dentals. Dental radiographs are such a game-changer for performing high-quality dental work.
If you ever have any questions or need advice on dental procedures or radiography, feel free to reach out.
Best,
Scott
Hey Inge.
Thank you so much for sharing this. Really interesting!
Do you find that many of your pet carers often regret going down the route of chemotherapy?
Scott x
Replying to Jon H. 18/07/2024 - 20:54
Hiya,
Honestly, I don’t normally read so many surgery-related journals. It just so happened that when I went on to the most recent Journal of Small Animal Practice, the early view articles were almost all surgically based, and I felt like I had to get involved. So, itās not typical for me to be so up-to-date with the recent surgical literature.
Best,
ScottReplying to Jon H. 18/07/2024 - 20:46
Thanks for sharing this, Jon. I certainly am becoming more comfortable using it with oral and nasal bleeding, but I must admit I’ve never applied it topically anywhere else. I did speak to an emergency and critical care specialist who had once instilled it into a thoracic cavity due to ongoing bleeding from there. I believe there may be some human medicine precedents for using it in that way, but I haven’t been brave enough to try it topically in other settings.
Interestingly, since starting work in Canada, we’ve been using Yunnan Baiyao a lot more for bleeding. It seems to be a popular option here, though it is an oral, not a topical, treatment. This study provides some insightful data on its use:
A prospective evaluation of oral Yunnan Baiyao therapy on thromboelastographic parameters in apparently healthy dogs.
J Vet Emerg Crit Care (San Antonio). 2018 May;28(3):221-225. doi: 10.1111/vec.12712.Abstract:
Objective: To determine the effect of Yunnan Baiyao (YB) on hemostatic parameters measured by thromboelastography (TEG) in healthy dogs administered 1 capsule of YB orally twice daily for 1 week.Design: Prospective study of client-owned dogs at a small animal specialty hospital.
Setting: Private referral center.
Animals: Eighteen client-owned adult dogs weighing at least 15 kg.
Interventions: Dogs had a baseline TEG performed and then each dog was administered 1 capsule of YB twice daily by mouth for 1 week and the TEG was reevaluated. Any side effects attributed to YB were noted at this time.
Measurements and main results: All 18 enrolled dogs completed the study. Dogs that received 1 capsule (250 mg/capsule) of YB orally twice daily had significantly increased G as well as A30 and A60 values. There was also a significantly decreased LY30 and LY60 values after 1 week. The YB appeared well tolerated as only one dog developed mild diarrhea.
Conclusions: The results of this study suggest that YB at 1 capsule orally twice daily in healthy medium to large breed dogs increases the strength of the clot as measured by TEG and that YB was apparently well tolerated in the study population reported here. Larger prospective studies in different disease states are warranted to further evaluate these preliminary findings.
Replying to Jon H. 18/07/2024 - 20:43
This is the problem when you get a medic meddling in surgical things!
Scott:)
Replying to Jon H. 18/07/2024 - 20:40
Hi Mark and Jon,
Thank you so much for your brilliant and comprehensive reply, Jon. I just wondered what your thoughts were regarding the placement of drains pre-operatively in septic cases, especially when these cases present in the middle of the night and you want to stabilize them before surgery.
Would you ever recommend placing a drain to remove some of the fluids as part of the pre-surgery medical management? I did have a look in the literature but wasn’t able to find a huge amount about this topic.
Best regards,
Scott
Replying to Rosie Marshall 18/07/2024 - 11:49
Hey!
I think often the combination of therapies also works well. For instance, some cats will respond to a combination of diet and chia seeds. Speaking to a number of feline specialists, they are definitely moving away from alendronate for longer-term use, and I am too.
I would definitely recommend trying some of these other strategies. One of the biggest things is that cats tolerate steroids so well compared to dogs, making it easier to justify their longer-term use.
Best regards,
Scott
Replying to Ariane N. 15/07/2024 - 09:54
Thanks so much.
Really helpful!
Have a great week.
Scott š
Replying to Esther H. 12/07/2024 - 10:44
I do!
I use Chia seeds a lot in cats. I have popped a whole new post on regarding the topic. I am actually moving away from alendronate completely due to possible side effects:
“Hello everyone,
I wanted to share some insights from a recent study on the management of feline idiopathic ionised hypercalcaemia and ionised hypercalcaemia associated with chronic kidney disease. This study evaluates the efficacy of alendronate combined with standard treatment compared to standard treatment alone.
Study Overview:
Objectives:
To characterise the signalment, clinicopathologic data, complications, and the association between treatment and outcome in cats with idiopathic or chronic kidney disease-associated ionised hypercalcaemia.
To compare the outcome between cats managed with alendronate and standard treatment versus standard treatment alone.
Materials and Methods:This retrospective cohort multicentre study reviewed medical records of cats diagnosed with idiopathic or chronic kidney disease-associated ionised hypercalcaemia.
Cats treated with alendronate and standard treatment were assigned to the alendronate group, while those treated with standard treatment alone were assigned to the control group.
Standard treatment included dietary modification, monitoring of ionised calcium concentrations, and managing complications secondary to hypercalcaemia.
The follow-up period was 6 months.Results:
A total of 29 cats were enrolled in the study: 9 in the control group and 20 in the alendronate group.
Both groups showed a significant reduction in serum ionised calcium between the baseline and the follow-up visit. However, the reduction did not differ significantly between the two groups (mean change in ionised calcium concentration: -0.18 for the alendronate group and -0.17 for the control group).
Suspected bisphosphate-related osteonecrosis of the jaw was reported in one cat receiving alendronate.Clinical Significance:
The study observed similar reductions in serum ionised calcium concentration in cats treated with diet alone and in those treated with diet and alendronate.
These results should be interpreted with caution as the study was underpowered for meaningful statistical comparison.
Cats receiving alendronate should be monitored for adverse reactions, including osteonecrosis of the jaw.
Additionally, it has been relatively well documented that using chia seeds can be a really effective non-pharmacological intervention for the management of hypercalcaemia, and this is certainly something that I would do very routinely. Generally speaking, I will now avoid alendronate in the management of idiopathic hypercalcaemia in cats. I am much more likely to turn to diet, chia seeds, or even prednisolone or steroids as management options rather than using alendronate.Case Reports: Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series
Abstract:
Background: This case series describes the use of chia seeds (Salvia hispanica L.) as a non-pharmacological solution in managing feline idiopathic hypercalcaemia when dietary change alone fails.
Case Summary: Over a 2-year period, three female spayed, middle-aged, Domestic Shorthair cats were diagnosed with idiopathic hypercalcaemia. Initial management with various high-moisture pet foods did not result in normocalcemia. Supplementing the diet with chia seeds (2 g/cat/day) for 4 weeks resulted in normalization of ionized calcium concentration in all cats.
Conclusion: Chia seeds supplementation could be a useful tool in managing feline idiopathic hypercalcaemia.
Additionally, another paper highlights the potential complications associated with long-term bisphosphonate treatment:
Medicationārelated osteonecrosis of the jaw after longāterm bisphosphonate treatment in a cat
Abstract:
Background: A 12āyearāold, neutered female, domestic medium hair cat was evaluated for a nonhealing oral mucosal ulceration. The cat had a history of idiopathic hypercalcemia that had been treated with a bisphosphonate for 41 months. Oral examination identified exposed maxillary bone adjacent to a previous extraction site. Histopathology of the exposed bone and associated mucosa was most consistent with medicationārelated osteonecrosis of the jaw. Treatment involved both medical and surgical interventions. Oral mucosal healing occurred after 6 months of treatment.
For more details, you can access the full studies here:
Assessment of alendronate and dietary treatment in the management of feline idiopathic ionised hypercalcaemia and ionised hypercalcaemia associated with chronic kidney disease: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13755
Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7387619/
Medicationārelated osteonecrosis of the jaw after longāterm bisphosphonate treatment in a cat: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6430911/
I would love to hear your thoughts and experiences in managing feline hypercalcaemia. Have you found alendronate or chia seeds to be effective in your practice, and have you encountered any notable side effects?
Best regards,
Scott”
Replying to Ariane N. 13/07/2024 - 13:40
Really helpful!
Thank you so much for sharing!
Scott x
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