scott@vtx-cpd.com
Forum Replies Created
-
AuthorPosts
-
Hey Liz.
I feel so inadequate when I look at echocardiography images… I often see problems that are not there and miss really obvious problems that are!!!
Was this murmur picked up completely incidentally? Were there any other clinical signs?
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 🙂
Hello everyone.
I hope you are all safe and well. I am so thankful that you have chosen to learn with us. My name is Scott, I am one of the directors at vtx and I am a specialist in small animal internal medicine.
I will not be able to help you that much with the cardiology side of things, but I am happy to help with any medicine related questions if you have them! You are in very safe hands with Liz from a cardiology perspective!
Remember to click ‘subscribe to this topic’ (bottom left) to get email reminders when people post on a forum. You can post questions on the discussion forum at any time.
Look forward to hearing from you.
Scott 🙂
Replying to Helen S. 14/08/2023 - 17:39
Hey Helen.
Thank you for sharing these brilliant resources. I love the incivility cards. Really easy, practical tools to help in some tricky situations.
I am working at a practice this week that has some incivility sign posts on the notice boards etc. I am not a fan of a poster on the wall being a substitute for appropriate leadership, but I think these things can act as reminders.
What are your thoughts on posters on walls?!
Scott x
Hello Lauren.
I am sadly not able to help with the cardiology question, I just wanted to say that I love your profile photo!
Very cardiology abstract!
Really pleased to hear you are enjoying the course!
Scott 🙂
Replying to Felipe M. 24/08/2023 - 15:28
HAHAHAH!
This might confuse me further,. My main question would be:
If we were to prescribe these products for dogs and cats, is there a recommended formula. Is this something that we can actually sell in veterinary practice?
Scott 🙂
Replying to Natalie H. 22/08/2023 - 21:20
Natalie!
18 years… I feel like there should be an award for that service.
I hope the course provides some new insights. It is really great of you to join us.
I feel like we will have lots to learn from you too!
Scott 🙂
Replying to Natalie H. 22/08/2023 - 21:27
Hello Natalie!
I am glad you enjoyed the session. I will save this question for the live Q&A if that is OK… will make sure to ask Harry lots of other fluid related questions too!!!
Hope you are having a lovely week.
Scott 🙂
Replying to Raquel M. 19/08/2023 - 11:52
It is so difficult to fit it all in!
I am back on clinics at the moment and struggling to find enough hours in the day!
Scott 🙂
Replying to Raquel M. 19/08/2023 - 12:53
Good question.
I have never heard of this limitation in dose. I would normally give 0.5-1mg/kg q8-12 hours. Most of the studies dose in this way without any top in dose per day as far as I am aware:
https://pubmed.ncbi.nlm.nih.gov/35899472/
Could you find the original source of this? Would be interested to look in to it more.
Scott 🙂
Replying to Francesca Lamb 08/08/2023 - 08:16
Hey Fran.
We did touch on this a little at the live Q&A. It is a great question. The exact epidemiology of lung worm in Scotland is not exactly determined. It is definitely more of a problem than when I first graduated. Seems to be more prevalent in Glasgow than the east, but I would keep it on my list of DDX for sure up your way!
I am always a fan of 5-7 days of fenbendazole in my my respiratory cases just in case!
Hope that helps.
Scott 🙂
Replying to Nadia C. 09/08/2023 - 23:00
Hello!
I am glad you enjoyed the case. I would indeed use N-acetylcysteine (NAC) when there is suspicion of oxidative damage to red blood cells for its potential antioxidant effect.
NAC is usually given as a 10% solution diluted 1 to 2 with saline as an IV bolus over 20 minutes through a 0.25 micron non-pyrogenic in-line filter at a dosage of 140 mg/kg initially followed by dosages of 70 mg/kg q 8-12 h.
Hope that helps.
Scott 🙂
Replying to Francesca Lamb 11/08/2023 - 16:09
Thanks again Fran.
I agree! The patient received treatment for possible lungworms (Advocate; Bayer) and underwent bronchoscopy. The airways appeared macroscopically normal; bronchoalveolar lavage fluid (BALF) was sent for routine bacterial and fungal culture (which were negative), Mycoplasma felis PCR (this was negative) and cytology (which showed severe pyogranulomatous inflammation). In addition to routine haematoxylin and eosin staining, the BALF was stained with Grocott methenamine silver to evaluate the presence of fungi (negative) and Ziehl–Neelsen (ZN), which showed acid-fast bacilli morphologically consistent with mycobacterial infection. The interferon gamma release assay (IGRA) was performed, and the results were compatible with infection by the less pathogenic member of the Mycobacterium tuberculosis complex (MTBC); that is, Mycobacterium microti (‘the vole bacillus’). Combining clinical signs and results, the patient was diagnosed with pneumonia and hypercalcaemia caused by M microti; that is, the cat had a form of tuberculosis commonly seen in cats in certain UK regions, including Scotland.
The patient was treated with rifampicin (Rifadin [Sanofi]; 10 mg/kg PO q24h), azithromycin (Zithromax [Pfizer]; 15 mg/kg PO q24h) and marbofloxacin (Marbocyl P [Vetoquinol]; 3 mg/kg PO q24h) for 2 months initially. A month after starting treatment, the cat’s body weight and appetite had improved, and iCa was normal. After 2 months of triple antibiotic therapy, haematology, serum biochemistry and thoracic radiographs were unremarkable, and rifampicin was stopped. After an additional 4 months, iCa and thoracic radiographs were unremarkable, IGRA was negative and serum vitamin D concentration was now normal, and so azithromycin and marbofloxacin were stopped.
Thank you for all of your brilliant answers and interaction!
Scott x
Replying to Raquel M. 19/08/2023 - 03:21
Hey.
I would normally go for 0.5mg/kg BID in most patients.
Hope that helps!
Scott 🙂
Misoprostol is also interesting!
Results from 41 control dogs and 39 dogs treated with misoprostol and aspirin at dosages ranging from 25 to 35 mg/kg q8h have been published in refereed journals, (but only 1 was a randomized controlled trial). Misoprostol dosages ranged from 3 μg/kg PO q12h to 15 μg/kg PO q8h. Dosing misoprostol once daily appears inadequate compared to administration q8h to q12h. Misoprostol significantly decreased GUE or haemorrhage associated with aspirin, but it did not completely eliminate gastric lesions. Misoprostol can be considered as prophylaxis for NSAID treatment if there is clearly a need for prophylaxis and PPIs fail or cannot be used. Except for aspirin, effectiveness of misoprostol for GI injury from other NSAIDs has not been tested in dogs and cats. Misoprostol is less effective for treating or preventing duodenal ulcer compared to gastroduodenal ulceration and erosion in both dogs and cats.
Misoprostol is effective for decreasing gastric lesions in dogs treated with high-dose aspirin, but it is unknown if misoprostol is effective for preventing gastroduodenal ulceration and erosion associated with administration of other NSAIDs in dogs and cats. There is no evidence that misoprostol decreases GUE from glucocorticoids in dogs and cats.
Overall, in sever cases of NSAID toxicity, I would still consider misoprostol use.
I hope that helps!
Scott 🙂
-
AuthorPosts