scott@vtx-cpd.com

Replying to Talia C. 16/04/2024 - 15:02

Talia!

Thank you for bringing up asparagus! This has been mentioned quite a few times, but I have never been able to find a references or official recommendation for this.

Do you have any further information! I am fascinated to know where this came from. I can imaging a vet sitting in an ER somewhere just deciding that asparagus would be a good idea! Where do these ideas come from!

Hope you are well.

Scott 🙂

Replying to Nadine Daniell 16/04/2024 - 12:37

Hello Nadine,

Thank you for your response. You are absolutely correct! I’ll share a bit about what we did next.

The abnormalities found during the cat’s physical examination and the results of his LDDST support a diagnosis of Cushing’s syndrome due to a pituitary cause. The presence of a 12mm diameter bilateral adrenalectomy, as documented on abdominal ultrasound, strongly suggests pituitary-dependent hyperadrenocorticism. Although the absence of a visible pituitary mass does not rule out a pituitary adenoma, documentation of an appropriately elevated endogenous ACTH would be preferable before considering surgical management. After discussing all available treatment options (including medical management with trilostane, radiation therapy, hypophysectomy surgery, and bilateral adrenalectomy), the owner is currently considering proceeding with hypophysectomy surgery. We have advised starting insulin treatment for Norman’s diabetes mellitus (suspected to be secondary to insulin resistance resulting from his hyperadrenocorticism). Additionally, we have recommended initiating oral trilostane treatment for the cat to try to stabilize his hyperadrenocorticism and diabetes mellitus as much as possible before hypophysectomy surgery.

This is only the second cat I have ever seen with Cushing’s. Cool case!

Scott 🙂

Replying to Lesley T. 17/04/2024 - 17:55

Hello Lesley.

I am glad the extra information is useful.

You should have access to the forum for as long as you have access to the course, so plenty of time to access everything.

Scott 🙂

Replying to Katherine Howie 15/04/2024 - 19:26

Thank you so much for working with us Kath!

I am so excited about your brilliant sessions.

Thanks again!

Scott 🙂

Replying to Elle P. 15/04/2024 - 16:08

Elle!

What a joy to see you here! Thank you so much for joining us.

Really looking forward to learning together.

Scott 🙂

Replying to Mónica P. 14/04/2024 - 08:27

Hello Monica!

Lots of brilliant questions. I will work through these and get back to you ASAP.

Please feel free to share the details of the case you mentioned.

Scott 🙂

Replying to Kristin Herstad 29/03/2024 - 23:13

Hey Kristen.

Thank you again for your brilliant thoughts. I have shared the haematology and biochemistry below and the FeLV and FIV were both negative:

I wanted to remind you of the further examination details too:

Orthopaedic evaluation – No obvious orthopaedic abnormalities, however there was discomfort reported when the quadriceps muscles were palpated.
Femoral and peripheral pulses were palpable.

Ocular Examination: Anisocoria was observed with the right pupil larger than the left. No direct PLR was present in the right eye; however a consensual response was present when light was shone in the left eye. Large wedges of grey/black discoloured areas of fundus extending out from the optic disc. Consistent with chorioretinitis.

Neurological examination: No gross neurological deficits observed. No spinal cord or neck pain.

Blood pressure: 145 mmHg systolic (Doppler).

Any thoughts on next steps?

Scott 🙂

Replying to Mónica P. 04/04/2024 - 14:36

Hello Monica!

What an absolute honour that you would join us all the way from Mozambique. Thank you!

I really hope you are enjoying the course. Please feel free to ask as may questions as you like through the discussion forum. Please let us know if you have any sampling questions!

Thank you again for your support.

Scott 🙂