scott@vtx-cpd.com

Replying to Helen D. 14/04/2024 - 09:35

Hey.

Great question! I hope you are enjoying the course.

I would not use it routinely, but reserve for cases that had more severe bleeding. I would be more inclined to consider it if there was a bleeding mass in the GI tract and do use it in cases of GI blooding secondary to thrombocytopenia. As ever, there is not really a huge amount of evidence in veterinary medicine. The jury seems to be out a little in human medicine too. They seem to be more likely to use it for upper vs. lower GI bleeding:

https://pubmed.ncbi.nlm.nih.gov/34709209/
https://pubmed.ncbi.nlm.nih.gov/33041136/

Have you used this drug before?

Scott 🙂

Replying to Becky W. 09/04/2024 - 18:34

Thank you so much for joining us Becky!

Feel free to ask as many questions as you like!

Scott:)

Replying to Mónica P. 12/04/2024 - 11:52

IT is!

I have to give credit to the amazing Nikki McLeod for that tip!

Scott 🙂

Replying to Becky Cartwright 11/04/2024 - 19:44

Becky!

It is so wonderful to see you here! Thank you for joining the course.

Please let us know if you have any questions.

Scott 🙂

Replying to Lesley T. 04/04/2024 - 13:42

Hello Lesley.

It is really lovely to hear from you. I am really glad to hear you are enjoying the course!

Really interesting to consider the age of these patients. This recent study is helpful to have a look at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096654/

The following is a snippet from the results section of the paper:

“Signalment, laboratory findings, ultrasonographic findings, and endoscopic scores were compared between the FR‐PLE and IR/NR‐PLE groups (Table ​(Table1).1). The FR‐PLE group was significantly younger (mean age, 7.5 versus 10.4 years old; P < .001) and had lower CIBDAI scores (median score, 3 versus 10; P < .001) and CCECAI scores (median score, 5 versus 11; P < .001) than those found in the IR/NR‐PLE group." In short, the food responsive dogs do seem to be a bit younger. Regardless of age, I would still consider a diet trial if it were suitable for the case. Remember, if they have not responded to a diet in a couple of weeks, it is probably not going to be effective. If possible (particularly in younger dogs), I would always try another diet trial, and even a third! It is also important to remember that hydrolyzed is not the only option. I would consider novel protein and carbohydrate as well as low fat in some cases. May of the diet responsive dogs will also respond to steroids; I suppose the diet avoids all the steroid side effects if it is effective. I hope that answers that question, I feel I rambled a bit. I think it is fine to reach for steroids sooner in some cases, I certainly do! Owner compliance with diet is often an issue. I would still try all of the 'easy' low risk strategies if possible. I would try diet, worming and probiotics where possible. There is also an argument with intervening with a faecal transplant earlier. I would persist with diet, if possible, even if older animals, when they are clinically well. We chatted through a lot of this at the round table discussion too. I will make sure that recording is available. I hope that was helpful. Scott 🙂