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scott@vtx-cpd.com

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  • scott@vtx-cpd.com
    Keymaster
    05:25 04/04/24

    This is a brilliant question and decision making that I ALWAYS find confusing!

    I look forward to hearing your thoughts.

    Generally, I have seen a trend toward norepinephrine in the last 5 years.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    05:23 04/04/24

    Replying to Felipe M. 02/04/2024 - 10:57

    This is an excellent review of what our options are.

    Thank you for sharing.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    05:21 04/04/24

    Hey.

    So it would seem like they are pretty equivalent. What do you tend to use in practice? Is one easier to dose than the other? Is one more available?

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    05:17 04/04/24

    Replying to Hayley O. 02/04/2024 - 21:39

    Hello Hayley!

    It is great to have you join us for another course. Thank you so much for your support.

    Endocrine cases are definitely some of the most challenging. Please let me know if there are any specific cases you would like to discuss.

    I really hope you enjoy the course.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    05:14 04/04/24

    Thank you so much to everyone for your understanding with this!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    04:45 04/04/24

    Replying to Kristin Herstad 30/03/2024 - 19:23

    Hey Kristen.

    I hope you are well. Thank you for your comments. I think I might be losing my mind. I am not able to find the part in the document where they mention this USG cut-off, can you remind me where it is. I am so sorry!

    Generally speaking, urine specific gravity values in apparently healthy small animals vary markedly, ranging from 1.006 to 1.050 in dogs and 1.005 to 1.090 in cats. In general, urine specific gravity is higher in healthy cats compared to dogs (mean 1.050 in cats versus 1.033 in dogs). In dogs, the specific gravity of morning samples is typically higher than evening samples. I often recommend that an owner collect multiple urine samples at home over several days to determine the ranges of urine specific gravity. In most cases, maintenance of a urine specific gravity greater than 1.030 in dogs and greater than 1.035 in cats is not supportive of polyuria unless due to marked glycosuria, or intermittent polyuria (primary polydipsia or disorders of the regulation of AVP secretion).

    I agree with your comments regarding the combination of PUPD and incontinence. I think that often the PUPD will tip the incontinence over the edge. I think it is valuable to investigate and treat both problems.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    04:23 04/04/24

    Replying to Felipe M. 02/04/2024 - 13:29

    Really interesting Felipe.

    I was really interested regarding your mention of robenacoxib. This is a drug I do not often consider, but should probably think of it more.

    Thank you again.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    04:20 04/04/24

    Replying to Natalie Niven 28/03/2024 - 22:09

    Hey Natalie.

    Some interesting comments. I have zero experience of using Librela. Osteoarthritis is often the least of my patients worries when they come to see me! 🙂

    It did get me thinking. Do they market the drug for anything else? Anything to your knowledge that would indicate it would be useful for pain in other clinical situations.

    Paracetamol is really a godsend. I like it as we can use it with steroids. Which covers most of my patients!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    00:33 04/04/24

    Replying to Natalie Niven 28/03/2024 - 21:58

    Natalie!

    Great to hear from you. Thank you for sharing your thoughts. Your plan sounds great. I have shared a bit more about the PE above that might help. I would agree with your problem list:

    Coughing
    Anisocoria
    Muffled heart sounds
    Pale pink mm
    Weight loss
    Partial anorexia
    Dehydration

    As with all DDX lists, they can end up being quite extensive and unnecessary! I think you have mentioned many of the most important differentials:

    Affected pupil smaller (miosis)

    a. Anterior uveitis
    b. Corneal ulceration/trauma
    c. Other intraocular disease
    d. Synechiae
    e. Horner syndrome

    Affected pupil larger (mydriasis)

    a. Glaucoma
    b. Pharmacologically induced
    c. Afferent lesion with anterior segment inflammation
    d. Retinal detachment/ degeneration
    e. Chorioretinitis
    f. Optic neuritis
    g. Optic nerve atrophy
    h. Retrobulbar lesion
    i. Optic tract lesion
    j. Retinal dysplasia (severe)
    k. Optic nerve hypoplasia
    l. Optic nerve coloboma
    m. Iris atrophy
    n. Oculomotor nerve (CN III) palsy
    o. Iris hypoplasia
    p. Iris coloboma
    q. Posterior synechiae

    I will share the results of some of the tests you have mentioned too!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    00:27 04/04/24

    Hello everyone.

    I wanted to give a bit more information about the physical examination 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).

    Hope that helps!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    00:06 04/04/24

    Replying to Rachel L. 28/03/2024 - 18:12

    Hey Rachel!

    This is a challenging case!!! I will make sure Felipe sees this and will ask Liz (our cardiologist) to comment too.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    23:59 03/04/24

    Replying to Talia C. 26/03/2024 - 15:12

    Hey Talia.

    I hope you are well and enjoying the course! It is an interesting concept. Getting owners more involved is a blessing and a curse. It is a fine balance!

    There are some vet practices (ER vets in the USA) that work a completely open concept where the owners can stay with their pets the whole time. They can stay over night and watch surgery! I am not sure how I feel about that!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    23:53 03/04/24

    Replying to Jackie L. 26/03/2024 - 11:03

    Hello.

    This is so interesting. I think we probably do not take advantage of the use of our skills across species. You are a perfect example of how this could work better!

    The forums are a funny beast… take people a bit of time to warm up!

    I hope you are enjoying the course.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    23:48 03/04/24

    Replying to Jo C. 25/03/2024 - 22:06

    Hey Jo.

    I hope you are well and enjoying the course!

    This is a great question. I will make sure Felipe sees this and we will get back to you ASAP!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    23:46 03/04/24

    Thank you for sharing Helen!

    Audio books have changed my life! Did we used to have to actually read books?!

    Scott 🙂

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