scott@vtx-cpd.com
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Thank you so much for sharing!!!
I presume these are a human product? Can you get them quite easily?
How have you found using these? Are they well tolerated? Do they sick to the animals skin? I would worry that these sorts of things would stick too much or too little?!
Scott 🙂
Thank you for sharing this Laura.
As you say, this is a great review for those who are wanting to learn more about these monitors and start using them in practice.
Laura and I were discussing preferred site of placement at the live Q&A and in seems that the thorax comes out on top generally. This is an interesting excerpt from the discussion:
“The application of the FreeStyle Libre sensor was easy and painless in most cats, and only a few cats showed a slight reaction. The sensors were all placed by the same person (MK) and were easier to place on the dorsolateral thoracic wall than the dorsal aspect of the neck. This subjective observation is underlined by the fact that in nearly half of the cats where the sensor was placed on the neck, extra glue was necessary to fix the sensor to the skin. Moreover, the correlation between BG and IG was higher if the sensors were placed on the thorax than on the neck. In a study by Hafner et al, a Guardian Real-Time sensor placed in the dorsal neck region had a higher proportion of successful first calibrations and appeared to be clinically more accurate and reliable than those that were placed in the lateral chest wall or knee fold. However, the Guardian Real-Time is a different type of sensor and the numbers in that study were small. In contrast, a study by Shoelson et al showed a higher complication rate (early detachment, mild or major dermatological changes or a dysfunctional sensor) in cats where the FGMS was applied on the dorsal neck (n = 2/3) than cats in which the FGMS was applied on the dorsolateral aspect of the thorax (n = 8/30).”
Would love to know if anyone has a preferred placement site in cats or any top tips about placement generally!
Scott 🙂
Replying to Rebecca H. 16/11/2023 - 05:50
Thanks Rebecca.
That is really interesting regarding reading the values at a distance. I have never tried that… but will now. Really useful. Thanks for sharing.
I hope you are enjoying the course and having a lovely week.
Scott 🙂
Replying to Lucy B. 26/10/2023 - 12:27
Thank you so much for your comments Lucy.
You raise some great points and make me think about the decision making around battery foreign bodies too! My understanding is that some batteries (alkaline) are very corrosive and can cause quite significant mucosal damage.
If the battery has been ingested, in addition to the above concerns, it may also pose a foreign-body-obstruction threat, or if the battery remains in the stomach long enough for the casing to break down, heavy metals such as zinc or lead may be released and lead to toxicosis.
What are people’s approaches to battery injections? Do you ever worry about leaving them? Does it depend on the type?
Looking forward to hearing your thoughts.
Scott 🙂
Replying to Claire G. 14/11/2023 - 18:01
Hello again!
Really sorry about the problems regarding the recording.
All sorted now. I have removed the manic Mickey Mouse commentary!!!
Let me know if any other problems.
Scott 🙂
Replying to Claire G. 14/11/2023 - 18:01
Hey Claire.
I will have a look at this now and let you know ASAP!
Thank you for flagging!
Scott 🙂
Replying to Laura Jones 24/10/2023 - 15:11
Hay Laura.
I think that is an excellent point. I think it is great that we can give owners the ability to help so much with monitoring, but too much power in the wrong hands can be challenging!
I feel you may have just provided a mic drop moment. Do you mean that the Freestyle Libre scanners can be used as ketone meters?!?!?!?!?!? I am picking myself off the floor as we speak… how have I missed this?!
Scott 🙂
Replying to Cristina M. 12/11/2023 - 12:59
Cristina!
It is so lovely to see you here! Thank you for joining and supporting vtx.
Let us know if you have any question. I hope you are having a lovely week.
Scott 🙂
Replying to Sarah Keir 12/11/2023 - 13:35
Hey Sarah.
To be honest, it is mostly cats with tricky cholangiohepatitis cases and some pyothorax cases. Possibly some bronchopneumonia cases too. 99% of the time I would only be using based on culture… I know that is easier said than done in some cases.
I suppose the other stand out cases would be those with TB, when we crack open the pradofloxacin!
Scott 🙂
Replying to Sarah Keir 12/11/2023 - 13:39
Hey Sarah.
It is good to know there is one without the rubber bit! I agree, I have not used pill poppers for some time.
I am intrigued by pill putty… what is that!? Sounds like something I would but for the kids! 🙂
Hope you are having a good week.
Scott 🙂
Replying to Jon H. 11/11/2023 - 14:25
Thanks Jon.
You make some brilliant points! Thank you for highlighting that there is often not a very right or very wrong answer when it comes to decision making around these drugs… particularly omeprazole!
I totally agree, omeprazole is not a benign drug! Proton pump inhibitors (PPI) have a number of side effects. Small intestinal bacterial overgrowth is an adverse consequence of chronic PPI administration in people. Proton pump inhibitors increased survival of swallowed bacteria in the upper GI tract by decreased intestinal peristalsis, decreased gastric emptying, changes in epithelial mucus composition, increased pH, and increased bacterial translocation. Increased growth of bacteria in the upper GI tract may increase the risk of bacterial aspiration pneumonia.
Bacterial overgrowth can have deleterious consequences when PPIs are administered with other drugs that can injure the small intestinal (SI) mucosa. It is common to prescribe PPIs in patients at risk for upper GI injury from nonsteroidal anti‐inflammatory drugs (NSAIDs), but PPIs can alter the SI microbiome, increasing the risk of injury to the intestinal epithelium caused by NSAIDs. This effect is acid‐independent and unrelated to gastric mucosa injury caused by NSAIDs. Inhibition of intestinal cyclooxygenase 1 and 2 (COX‐1, COX‐2) enzymes injures the SI mucosa. Enterohepatic recycling of NSAIDs likely plays a role whereby high concentrations of NSAIDs in bile are secreted into the duodenum in close proximity to the major duodenal papilla. Some of the most serious intestinal lesions in dogs caused by NSAIDs occur in this region. Small intestinal injury may be caused by increased numbers of gram‐negative facultative anaerobic bacteria that flourish in the SI of patients treated with PPIs. Lesions are characterized by loss of villi, erosions, and multifocal ulcers distributed throughout the small bowel. Anaemia also may occur. Whereas some bacteria play a protective role against intestinal mucosal injury by NSAIDs, the intestinal dysbiosis arising from PPI administration increases the risk of NSAID‐induced intestinal injury.
Lots to think about!
Scott 🙂
Replying to Laura Jones 24/10/2023 - 15:09
This is really interesting!
Can you pop on the link for them? Would love to check them out!
Thanks for sharing.
Scott 🙂
Replying to Lucy B. 26/10/2023 - 13:38
Great to see you here Lucy!
I really hope you enjoy the sessions. Remember we have popped lots of useful resources on the discussion forum too, so do check those out!
Please let me know if you have any questions. I hope you have a lovely weekend.
Scott 🙂
Replying to Loren S. 05/11/2023 - 16:16
Hey.
Yes, taking blood from the catheter is really useful in this sort of situation!
Scott 🙂
Replying to Felipe M. 07/11/2023 - 10:13
Such a brilliant summary Felipe!
Thank you for sharing these really helpful thoughts.
Scott 🙂
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