scott@vtx-cpd.com

Replying to Michel O. 22/02/2024 - 22:40

Very cool!

I really love the academic environment, it is a great mix of clinical work, teaching and some research.

Thank you again for joining us on the course.

Scott 🙂

Replying to Rachel L. 23/02/2024 - 13:50

Hey Rachel.

I agree, it is always something that has felt like a good idea, but it is nice to have something to support it!

Really interesting comments regarding the cat with polycythaemia! What was the reason for the polycythaemia? Cat can be tricky to regularly draw larger volumes from, so this is a great shout and something I will consider in future. We had a couple of cases that we managed with medical leeches when I was a resident, but not done this in a while. Pretty cool though! I have popped a case report below:

Leeching as initial treatment in a cat with polycythaemia Vera

C. S. Net, P. Arnoldq, T. M. Glaus

Abstract

Polycythaemia Vera was diagnosed in a three-year-old domestic shorthaired cat referred because of seizures and a high packed cell volume (PCV). Laboratory examination revealed severe erythrocytosis (PCV 79 per cent). Diagnosis was reached by excluding causes for relative and secondary absolute polycythaemia. As phlebotomy proved impossible for initial treatment due to hyperviscosity, four leeches were used to suck blood and the PCV was consequently reduced to 64 per cent. A further 24 hours later, when bleeding at the sites of sucking had stopped, the PCV was 56 per cent. Long-term management of the condition was achieved with hydroxyurea (100 mg/cat once daily) and intermittent phlebotomy. Initial treatment using leeches in cases of polycythaemia Vera is a simple, non-invasive, well tolerated and effective method where phlebotomy is not possible.

Replying to Junwei Föhr 20/02/2024 - 18:10

Hello Junwei,

I hope you are well. Thank you so much for sharing the video. Can you tell us a wee bit more about the dog? What is the signalment? Is the noise in the video the reason for presentation? Any other clinical signs.

I will look forward to seeing Jenny’s comments. I am happy to share some thoughts too.

Scott 🙂

Replying to Rachel L. 19/02/2024 - 19:22

Welcome Rachel!

Really lovely to have you here with us. Please make full use of the discussion forum and ask about any tricky cases that you are faced with in practice!

We are often very spoiled with anaesthesia in referral practice. I worded with Felipe for a number of years and did not really every have to think about the anaesthesia side of things. I am starting a new job next week and we do not have an anaesthesia specialist there… I am panicking already!

Hope you are having a lovely week!

Scott 🙂

Replying to Neus E. 16/02/2024 - 22:16

Welcome Neus!

Thank you again for your contribution. We are very lucky to be working with you!

Scott 🙂

Replying to Victoria Hughes 12/02/2024 - 06:29

Hey Victoria.

Thanks for the reply. I think it is an interesting discussion indeed.

I think the take home would be to avoid all other medications if possible!

I know that is easier said than done!

Scott 🙂

Replying to Scott M. 07/02/2024 - 11:55

Hello Scott!

I hope you are well. Great questions. Onion in any form has been reported to be problematic. I would worry about fresh onion and powdered products. It is also surprising how quickly it can have a negative effect. I have popped a nice review below:

“Onion (Allium cepa), garlic (Allium sativum), leek (Allium porrum), and chives (Allium schoenoprasum) are all members of the genus Allium (Amaryllidaceae family). These bulbous plants are strongly aromatic, producing a characteristic odor when crushed, and are commonly used (fresh, cooked, or dehydrated) as ingredients in many dishes. The components responsible for their toxicity are organosulfoxides. Chewing the plant converts organosulfoxides to a complex mixture of sulfur compounds. The primary toxicological mechanism of Allium-derived sulfur compounds is oxidative hemolysis characterized by the development of methemoglobinemia and Heinz body formation in the erythrocytes. Cooking, drying, and processing do not eliminate the toxic effect of Allium spp.. Dogs and cats are highly susceptible to Allium toxicosis and the ingestion of 5 g/kg of onions by cats and 15–30 g/kg by dogs is enough to cause clinically important hematologic changes. In the case of dogs, hereditary high erythrocyte-reduced glutathione and potassium concentrations observed in certain breeds (e.g., Akita, Shiba, and Jindo) lead to greater susceptibility to onion-induced oxidative damage. Clinical signs of Allium toxicosis may appear 1 day or several days after consumption depending on the amounts ingested. Common clinical signs initially include vomiting, diarrhea, abdominal pain, loss of appetite, and depression. Due to the developing anemia, pale mucous membranes, weakness, rapid respiratory and heart rates, jaundice, and dark urine (reddish or brown) indicating hemoglobinuria are subsequently observed. Several cases of dog and cat poisoning by Allium spp. have been reported in the literature. Poisoning has been reported to occur after the ingestion of Catalan spring onion commonly known as “calcot”, baked garlic, onion soufflè, butter-cooked onions, and Chinese steamed dumplings containing Chinese chives (Allium tuberosum) and garlic. A case in which a dog was intentionally fed a large quantity of raw onions by the owner has also been reported. From 1994 to 2008, 69 cases of canine poisoning and 4 cases of feline poisoning by Allium spp. ingestion were recorded by the Veterinary Poisons Information Service (VPIS). In the case of dogs, vomiting, diarrhea, abdominal pain and, less frequently, anemia, hematuria, and convulsions were reported. Two cases of death occurred and two dogs were euthanized. In the case of cats, gastrointestinal signs, lethargy, and polydipsia occurred in one case, while anemia and icterus were observed in the second case. One cat remained asymptomatic without treatment, and the other cat died from hemorrhage into the pleural and abdominal cavities. Recently, hypertension associated with garlic-induced hemolytic anemia has been reported in the case of a dog. No specific antidote is available for Allium toxicosis. Inducing vomiting should be considered in asymptomatic dogs and cats, provided there are no complicating factors and not more than 2 h have elapsed since ingestion. The administration of activated charcoal is indicated after vomiting has stopped. Once clinical signs have manifested themselves, treatment should consist of supportive care. Severely anemic animals may require a blood transfusion.”

Hope that helps.

Scott:)