scott@vtx-cpd.com
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Replying to Nadia C. 23/07/2023 - 14:44
Hello Nadia.
I would completely agree with these comments, we were in the same position with this case. Due to the significant red blood cell shape changes, we were still suspicious that the spleen might be more significant. For that reason, we did decide to perform splenectomy in this case. Histopathology confirmed hemangiosarcoma!
This was confirmed as a case of microangiopathic haemolytic anaemia (MAHA). MAHA refers to mechanical haemolytic anaemia characterized by red blood cell fragmentation as they traverse small-calibre blood vessels, typically seen as schistocytes on peripheral blood smear.
We ended up not using steroids in this case, but had blood on hand at the time of surgery to be prepared for any decompensation with the anaemia. I also started some sAME (acetylcysteine). To see is I could help protect the red blood cells a bit.
This was a tricky case from a decision making point of view. Thank you again for all of your brilliant contribution.
Scott 🙂
Replying to Sarah M. 26/07/2023 - 12:59
Hello Sarah!
I hope you are well. Nice to see a fellow Ayrshire resident on here!
No surprised to hear about your own dog, it seems we are cursed in that way.
Please let us know if you have any questions. Thank you again for joining the course.
Scott 🙂
Replying to Amy M. 26/07/2023 - 20:41
Hello Amy!
I am so excited that you are starting at Edinburgh Vet School! That is where I did my residency and it is one of my favourite places! Which department are you working in? I also worked in the charity sector in Edinburgh… I feel we are following similar paths! 🙂
I really hope you enjoy the course!
Scott 🙂
Replying to Suzanne Reeve 25/07/2023 - 16:49
Hello Suzanne.
Thank you so much for joining us. I hope you have had a lovely week.
Keeping up to date is definitely a challenge. Every time I present a webinar I am frantically looking up the most recent papers! I have this irrational fear they will publish something the day I record and I will miss it! 🙂
I really hope the course helps.
Scott 🙂
Replying to Kiera A. 25/07/2023 - 15:46
Kiera!
Welcome to the course. Thank you so much for joining us, I really hope you enjoy the course.
Interested to hear you do some referral work… medicine referrals I hope! 🙂
Please let me know if you have any questions at any time.
Scott 🙂
Replying to Victoria Rubasinska 28/07/2023 - 19:37
Hello Vicki!
Great question! I hope you are having a great week and enjoying the course.
I will pop the question to Ariane. I will also be interested to see her answer!
Scott 🙂
Replying to Sarah M. 26/07/2023 - 15:21
Hello Sarah!
Great question! I hope you are enjoying the course and I hope you have had a great week!
I will pass the question on to Ariane and get back to you ASAP!
Scott 🙂
Replying to Nadia C. 26/07/2023 - 23:12
Hey Nadia!
This is a REALLY interesting question. I have definitely used TXA in GI bleeding cases, but often the more chronic cases that are bleeding due to NSAIDs or masses. I would also use in GI bleeding cases with thrombocytopenia. Most of the AHD cases self resolve and many of them present with high PCV’s. I must admit I do not routinely use TXA in these cases.
There is nothing as far as I am aware in the veterinary literature about this and I am not able to find anything in the human literature.
It is an interesting thought, but I am not sure I would be using in these acute HGE cases.
Love to hear your thought though!
Scott 🙂
Replying to Talia C. 25/07/2023 - 11:25
I know these are just small case series, but still important to keep these possible complications in mind!
It would never cross my mind that the colon might perforate in this way!
Scott 🙂
Replying to Talia C. 25/07/2023 - 11:20
Talia.
These are really good points. I agree, you want to give yourself the best chance of getting the best sample. I would say that for this reason it is probably best to go for a long bone (humerus) when you can. The sternum is good for a quick sample, which might be helpful for things like leishmaniasis and some neoplastic problems. I did a bone marrow yesterday and only managed to get an aspirate, I totally failed getting a core sample. I still sent the sample off and you can often still get good information from the core.
Hopefully you will get a case soon that you can take a sample from!
Scott 🙂
Replying to Nadia C. 26/07/2023 - 23:14
Will keep you posted!
Scott 🙂
Just as a bit of a fun fact!
The enrofloxacin issue is not thought to be as much of a problem in lions and tigers!
Scott 🙂
INVESTIGATION OF ENROFLOXACIN-ASSOCIATED RETINAL TOXICITY IN NONDOMESTIC FELIDS
Kim M Newkirk, L Kathryn Beard, Xiaocun Sun, Edward C Ramsay
Abstract
Enrofloxacin is known to cause retinal toxicity in domestic cats. The hallmark lesion of enrofloxacin-associated retinal toxicity in domestic cats is thinning of the outer nuclear layer of the retina. Enrofloxacin is commonly used to treat bacterial infections in nondomestic felids because of its action against a wide spectrum of bacteria and the ability for it to be given orally. No previous studies have investigated the potential retinal toxicity of enrofloxacin in nondomestic felids. This retrospective study evaluated 81 eyes from 14 lions ( Panthera leo ) and 33 tigers ( Panthera tigris ) that had been enucleated or collected postmortem. The thickness of the outer nuclear retina was assessed in two separate sites in each eye by counting the rows of nuclei and by using digital image analysis software to determine the area of the nuclei at each site. Medical records were reviewed to determine the enrofloxacin dose for each cat. Cats that had not received enrofloxacin (n = 11) were compared with treated animals (n = 36). The outer nuclear layer thickness or area in treated versus untreated cats was not significantly different. Additionally, no clinical blindness was reported in any of the cats. This study showed no evidence of enrofloxacin-associated thinning of the outer nuclear layer in the lions and tigers evaluated, suggesting that enrofloxacin can be used safely in these animals.Just as a bit of a fun fact!
The enrofloxacin issue is not thought to be as much of a problem in lions and tigers!
Scott 🙂
INVESTIGATION OF ENROFLOXACIN-ASSOCIATED RETINAL TOXICITY IN NONDOMESTIC FELIDS
Kim M Newkirk, L Kathryn Beard, Xiaocun Sun, Edward C Ramsay
Abstract
Enrofloxacin is known to cause retinal toxicity in domestic cats. The hallmark lesion of enrofloxacin-associated retinal toxicity in domestic cats is thinning of the outer nuclear layer of the retina. Enrofloxacin is commonly used to treat bacterial infections in nondomestic felids because of its action against a wide spectrum of bacteria and the ability for it to be given orally. No previous studies have investigated the potential retinal toxicity of enrofloxacin in nondomestic felids. This retrospective study evaluated 81 eyes from 14 lions ( Panthera leo ) and 33 tigers ( Panthera tigris ) that had been enucleated or collected postmortem. The thickness of the outer nuclear retina was assessed in two separate sites in each eye by counting the rows of nuclei and by using digital image analysis software to determine the area of the nuclei at each site. Medical records were reviewed to determine the enrofloxacin dose for each cat. Cats that had not received enrofloxacin (n = 11) were compared with treated animals (n = 36). The outer nuclear layer thickness or area in treated versus untreated cats was not significantly different. Additionally, no clinical blindness was reported in any of the cats. This study showed no evidence of enrofloxacin-associated thinning of the outer nuclear layer in the lions and tigers evaluated, suggesting that enrofloxacin can be used safely in these animals.Replying to Nadia C. 16/07/2023 - 21:17
It does sound great.
I really like that veterinary medicine is moving in this way. I think we need to be flexible in the way we create roles for vet. If they want to do consult only, we should be OK with that!
Sound like the perfect role for you.
Scott 🙂
Replying to Nadia C. 16/07/2023 - 21:13
Hello!
Great question. You are correct! A high RDW indicates that the red blood cells are more variable in volume than normal. This may be due to the presence of smaller or larger red blood cells or a combination of either scenario. For example, increased numbers of immature red blood cells during a regenerative response to an anaemia will increase the RDW, because immature anucleated red blood cells are typically larger than normal.
You could also use the MCV and MCHC for this purpose.
Really interesting that you use methylene blue stain, not many people do this. That is very cool!
Scott 🙂
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