scott@vtx-cpd.com

Replying to Jacquin M. 14/01/2023 - 14:36

Of course!

Thanks again for sharing!

Scott 🙂

Replying to Jacquin M. 13/01/2023 - 13:38

Hello.

I really think most of these bloods could be explained by age then.

From an infectious disease POV, I suppose you could argue that some infectious organisms are intermittently shed, so the faeces could be a false negative.

I would definately consider 5-7 days of fenbendazole regardless, and this would even be worth repeating after 2 weeks if a course has already beeen given.

Did you say folate and cobalamin had been run?

Keep us updated with progress.

Scott 🙂

Replying to Alison Lambert 13/01/2023 - 11:29

Hello!

I agree with Alison. I think many of the changes here could be explained by age, particularly the ALP, RBC changes and possibly albumin.

The low albumin could still be due to GI loss or renal loss. Difficult to say definitively. A UPC would help determine whether it was renal. The albumin could also be due to a negative acute phase response. Overall, for the age of the dog I am not sure the albumin reduction is that dramatic. I would keep an eye on it however!

If there is any question overgrowth I would definitely do a bile acid stim in this case. cPSS cases can present in such a variety of ways, with such variability with general biochemistry and haematology.

I think it is SUPER unlikely but I may do a basal cortisol in this case to rule out Addison’s.

I am sure Jenny will have other thoughts.

Hope that helps.

Scott 🙂

Hello everyone.

I hope you are safe and well. Your feedback REALLY is appreciated. We want to make vtx the best it can be. Please take the time to fill out the survey if you can.

Thanks in advance.

Scott 🙂

Hello Raquel.

I hope you are safe and well. Happy New Year!

I have popped some thoughts under your questions below:

Wanted to double check. The Idexx lab range for cobalamin states that normal is from 284-836ng/L. Is it still recommended to supplement in animals with clinical signs when it has been below 400ng/L as you had advised in your course.

“Short answer… YES! Cobalamin should be supplemented whenever serum cobalamin concentration is subnormal. There is a 12% probability that dogs with low-normal serum cobalamin concentration (ie, less than approximately 400 ng/L) might also benefit from supplementation. Supplementation of Vitamin B12 is recommended when the cobalamin is low or low normal (< 400 ng/L), in addition to treatment of the underlying cause." Second question-1) why is it that Idexx uses a different reference range as normal? "Good question... short answer is... we are still learning. Reference ranges are established as they are, I am sure they will change with time." 2) for animals who have their cobalamin levels rechecked after the parenteral supplementation protocol. If the cobalamin is still below 400 ng/L but within the “284-836 mg/L” normal range. Then do I take it as the cobalamin levels as subnormal or normal at that point? Just in terms of knowing how I should supplement it going forward. "If the levels are still below 400 after supplementation, I would take that as abnormal and continue supplementation" I hope that helps. Scott 🙂