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scott@vtx-cpd.com

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Viewing 15 posts - 616 through 630 (of 1,928 total)
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  • scott@vtx-cpd.com
    Keymaster

    Thanks for sharing Liz.

    I think rivaroxaban is a super interesting drug. Based on the ACVIM consensus for the treatment of immune mediated haemolytic anaemia (IMHA) in dogs and cats, the jury is still out regarding the best drugs to use regarding the risk of thromboembolic disease.

    Considering the underlying mechanisms of venous thromboembolism commonly seen in dogs with IMHA, it is proposed that a treatment strategy incorporating anticoagulants may be the favoured approach for thromboprophylaxis, especially within the initial two weeks following diagnosis. In cases where the use of anticoagulants, along with the necessary monitoring, is not accessible or practical, recommendations lean towards administering antiplatelet drugs as a preferable alternative to not utilizing any form of antithrombotic medication. Insufficient evidence is available to make strong recommendations on the choice of anticoagulant in IMHA. The strongest evidence supports the use of individually dose‐adjusted UFH. Other anticoagulants including enoxaparin and rivaroxaban appear to be safe and may be efficacious. It is important to emphasize that UFH should not be administered without individualized dose adjustment. In situations where this isn’t possible or practical, the use of injectable low-molecular-weight heparins or direct oral Xa inhibitors like rivaroxaban is suggested.

    In short, I have been using a combination of rivaroxaban and clopidogrel for my IMHA cases, particularly in the early stages of treatment.

    Thanks again for sharing.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Lesley m. 14/09/2023 - 22:18

    Welcome Lesley!

    It must be quite a change from the large to small animals. I am in awe of people who do large animal stuff!

    I really hope you enjoy the course.

    Any questions, let me know.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Idris Vandekinderen 17/09/2023 - 19:46

    Welcome Idris.

    Thank you so much for joining us and thank you for your kind words.

    I really hope the course is helpful.

    Let me know if you have any questions at anytime.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Hughes Mileng 18/09/2023 - 11:55

    HAHA!

    I am feeling those vibes too!

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Jodie A. 18/09/2023 - 13:40

    Hey Jodie!

    Many thanks to you for joining us and supporting vtx.

    Laura is the best in the medicine business, so you are in safe hands.

    I really hope you enjoy the course. Please let us know if you have any questions.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Liz Bode 17/09/2023 - 20:44

    Really interesting.

    Thank you for sharing.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Steph Sorrell 18/09/2023 - 11:28

    I agree!

    I would retrieve endoscopically when possible. There was another earlier study looking at this:

    https://pubmed.ncbi.nlm.nih.gov/25029309/

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Idris Vandekinderen 17/09/2023 - 21:20

    Hello Idris.

    I hope you are well. Thank you for your comments.

    I agree… I would not rest either! I must admit I would retrieve them by endoscopy if possible. There is another review article looking at this:

    https://pubmed.ncbi.nlm.nih.gov/25029309/

    Do you ever use endoscopy to retrieve foreign bodies?

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Lesley m. 15/09/2023 - 00:14

    Hey Lesley.

    You make some great points. I would worry and would remove when possible. There are a number of these sharp foreign bodies migrating in quite concerning ways:

    https://pubmed.ncbi.nlm.nih.gov/35083753/
    https://pubmed.ncbi.nlm.nih.gov/15266859/

    I LOVED that you brought up the asparagus! I tried to find an actual reference for this, but could not find one. Where did you see this mentioned?

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Replying to Laura Jones 18/09/2023 - 07:56

    Laura!!!!

    We are so excited that you are running this brilliant course!

    I am very excited to medicine geek out with you for the next few weeks!

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Hello Lynne.

    Lovely to have you here! The thought of lambing and calving fills me with dread! I really hope you enjoy the course.

    Let us know if you have any questions.

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Here is the radiographic report:

    R lateral abdomen, DV thorax, oblique thorax and R and L lateral thorax radiographs available to review as JPEG images

    Skeleton:
    There are no skeletal abnormalities

    Thorax:
    There is a an alveolar pattern with air bronchograms affecting predominently the right middle lung lobe. The other lung lobes are unremarkable.
    The cardiac silhouette is within normal limits. There are no abnormalities in the cranial mediastinum, the oesophagus is mildly dilated with air on the left lateral view. The diaphragmatic line is clear on the right lateral view but obscured on the left lateral view.

    Abdomen:
    There is moderate ingesta and a small structure of bone opacity in the stomach. There is mild gas in the colon as expected. The remaining abdominal organs are unremarkable

    DDx aspiration pneumonia, bronchopneumonia, haemorrhage, less likely oedema, torsion or neoplastic infiltrate

    scott@vtx-cpd.com
    Keymaster

    Replying to Claire G. 17/09/2023 - 17:26

    Claire!

    You are spot on! Great observations. Interestingly, when this case was referred to me there was a concern about a possible defect in the diaphragm. I think that confusion came due to the opacity in the ling field.

    Air bronchograms indeed! I will pop the full report below.

    Any thought on next steps?

    Scott πŸ™‚

    scott@vtx-cpd.com
    Keymaster

    Really interesting Liz!

    Is this drug currently available in the UK? As far as I am aware, we do not use it in any other clinical settings in small animal, is that correct?

    Scott x

    scott@vtx-cpd.com
    Keymaster

    Replying to Sybil Dryburgh 16/09/2023 - 20:13

    Interesting, they might just be painful?

    Did you go down the gabapentin road?

    Scott πŸ™‚

Viewing 15 posts - 616 through 630 (of 1,928 total)