scott@vtx-cpd.com

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 🙂

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 🙂

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 🙂

Replying to Nikki McLeod 29/03/2024 - 10:22

Hello Nikki.

Thank you so much for joining the course. We really appreciate you being so supportive of vtx.

Have a great week.

Scott 🙂

Replying to Helen D. 24/03/2024 - 21:42

Helen!

Really lovely to hear from you. I hope you are well and enjoying the course.

Thank you for the brilliant question. I am not sure that anyone has specifically looked at the timing of maropitant administration in brachycephalic dogs. I would normally give on the morning of the procedure when I was giving other medication or at the time of premedication.

I do not specifically change my approach with PPI use in raw fed dogs. Do you mean due to the effect that the change in acidity will have on the food digestion and bacterial load?

I think I am just careful with the use of PPI’s generally and only use them when I gave a specific indication. I have also forwarded your question to our anaesthetist Felipe for his comment too.

Scott 🙂

Replying to Erin B. 24/03/2024 - 20:12

Hello Erin.

I hope you are well and enjoying the course. This is a brilliant question.

Dogs with protein-losing enteropathy have an increased risk of thromboembolic disease due to several factors related to the underlying condition. PLE leads to loss of proteins, including anticoagulant proteins like antithrombin, protein C, and protein S, which play crucial roles in regulating the coagulation cascade. This loss can result in a hypercoagulable state, making these dogs more prone to forming blood clots.

Additionally, the loss of proteins, particularly albumin, in PLE can lead to decreased oncotic pressure in the blood vessels. This can cause fluid to leak out of the vessels and into the tissues, leading to oedema and potentially altering blood flow dynamics, further increasing the risk of thrombosis.

Furthermore, the inflammation and tissue damage associated with PLE can activate the coagulation system and promote platelet activation, further contributing to a prothrombotic state.

Overall, the combination of protein loss, alterations in coagulation factors, and inflammation seen in PLE contributes to an increased risk of thromboembolic disease in affected dogs.

Which cases to use clopidogrel in is a whole other question. I would only tend to use it in cases that have more severe protein loss (under 15 g/L). Some people would use it in all cases that have a low albumin. I am not sure we know when exactly to use it, but in PLE cases with more significant reductions in albumin, I definitely would.

I hope that helps!

Scott 🙂