scott@vtx-cpd.com

Replying to Liz Bode 29/08/2023 - 21:43

Thanks.

I was hoping for pyrexia or something! I will let other comment on the echocardiography loops… beyond my abilities I am afraid!

Scott 🙂

Hello Liz.

This is so interesting. Are you offering the left atrial decompression procedure at the moment?

What would be your preference if all procedures were freely available and cost was no barrier?

Are you sending many dogs for bypass and surgery? I was doing a locum at DWR where they offer surgery recently and most of their clients seem to be traveling to the UK for the procedure from the USA.

Thanks again for sharing.

Scott 🙂

Hey Sarah.

Some brilliant points! I will share my thoughts, but I am sure Steph will have more to add.

The lack of response to treatment is very frustrating in some cases. As you say, this can be challenging to predict. I must admit that I will mention the possible lack of response to treatment early on now. In my own experience, a complete lack of response does not happen that often, but is SUPER frustrating when it does. I think faecal transplantation is an interesting discussion here and I think we are using this more and more often. I know that the team at Edinburgh university are using it earlier in the disease course in dogs, but experience in cats is more limited. I am also using more Vivomixx in cats. Again, the evidence for this is limited at best. I would love to hear Steph’s thoughts. Would love to hear your thoughts too Sarah.

The medication concern is a challenging one too. I am not aware of any alternative formulation of chlorambucil.

The biopsy question is a great one too! What is your experience with GI biopsies in cats Sarah? Is this something you offer? I must admit that many of the owners I see are looking for a more definitive diagnosis, but I take your point regarding the treatment options. In some of the feline cases I am considering taking biopsies of more than just the GI tract (liver and pancreas), so do end up taking surgical biopsies.

Can the client live with the cat and its disease? I agree! This is always a tricky one to navigate and at the end of the day we are dealing with a manageable but not completely curable condition.

Thank you for sharing the consensus statement. Really helpful.

Scott 🙂

Replying to Raquel M. 20/08/2023 - 12:42

Hello!

Sorry about the delay in getting back to you. Thank you for sending on the information by email.

I have a feeling that this recommendation come from the fact that people will have observed that dogs may not require higher than the 8mg total dose. I am not able to find any literature to support this. Most of the studies will use a mg/kg dose.

Let me send this question to a few other specialist pals and see if I can get any more information for you!

Thanks again for the question.

Scott 🙂

This is so interesting Liz!

Thanks for sharing, I suppose my question is, how gentle is gentle pressure?!

I my head you would have to push quite hard to generate a murmur! What is your practical experience of this? Should we be cautious when examining cats generally?

Scott 🙂