scott@vtx-cpd.com
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Hey Emma.
How active was the sediment? How high was the UPC? On how many occasions has the UPC been increased?
My first comment would be that it is variable how sediment can actually effect the UPC, it often does not effect it that much:
https://pubmed.ncbi.nlm.nih.gov/15048621/
https://pubmed.ncbi.nlm.nih.gov/31951043/What was cultured from the urine?
If no signs of UTI then I would agree, we would not treat. However, some would argue that with CKD, there would be justification in treatment. So I might treat the UTI. Having said that if the UPC is significant, it probably needs treating too.
Does that help?
Scott 🙂
Replying to Kathryn B. 17/10/2022 - 16:23
Hey.
I must admit I have never used trazodone in cats. I think gabapentin works so well there is no need. I use trazodone in dogs much more commonly.
Scott 🙂
Replying to Liz Bode 17/10/2022 - 14:04
Hey Liz.
I have never used this! Really interesting. I did a quick literature search, but could not find anything specific in this area. I presume based on peoples experience?
Really interesting! Thank you for sharing!
Scott 🙂
Replying to adele smart 17/10/2022 - 21:51
Adele!!!!
What an absolute joy to have you here with us!
Thank you for joining and supporting the course!
Let me know if you have any questions.
Scott x
Replying to Jessica Wilson 18/10/2022 - 01:58
Welcome Jessica!
Where did you work overseas? Thank you so much for joining the course.
Please let me know if you have any questions.
Scott 🙂
Replying to Steph Sorrell 16/10/2022 - 11:36
Really interesting and really helpful!
Thanks.
Scott 🙂
Replying to Holly D. 16/10/2022 - 21:26
Hey.
I thought I would share my thoughts regarding the management of tracheal collapse. Long-term treatment mainly aims to decrease all potential promoting factors and the level of inflammation of the tracheal mucosa. Weight reduction in the obese animal is essential. Weight loss alone can be curative of clinical signs. Likewise, replacement of neck collars with harnesses can be effective. Removing the dog from respiratory irritants such as noxious gases, smoke, and dust is common sense and should be explained clearly to the owner. It is also important to detect and treat other diseases, including chronic airway disease, cardiac disease, and hyperadrenocorticism.
Long-term therapy consists of very low-dosage corticosteroids (prednisone 0.2 mg/kg PO q 24 h × 1-2 weeks, at 3-month intervals, for instance), or by inhalation (fluticasone, one 120 mcg puff q 12 h using a face mask and spacer), often in combination with a sedative-antihistamine. Oversedation must be avoided, since the animal must keep moving to avoid gaining weight and to promote clearance of tracheal secretions. Oral antitussive agents that are effective in controlling cough include hydrocodone (0.22 mg/kg PO q 12 h) and butorphanol (0.55 mg/kg PO q 12 h). I must admit that I most routinely use codeine as an antitussive. I would also consider antibiotics in some cases. I tent to think doxycycline is a good choice!
Hope that is helpful.
Scott 🙂
Replying to Samanta A. 16/10/2022 - 22:17
Hello.
I was on a live Q&A with feline specialist Steph Sorrell last week and she was discussing some of the possible side effects of alendronate treatment. This is not something I have seen clinically, but will definitely make owners more aware of:
https://pubmed.ncbi.nlm.nih.gov/30663796/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580850/Hope that helps too!
Scott 🙂
Replying to Dani B. 17/10/2022 - 09:18
Dani!
Never too late! So nice to see you here!
You sound very busy indeed! Please let me know if you have any questions.
Scott 🙂
Welcome everyone,
Thank you for joining our toxicities course, we really hope you enjoy the course and are so thrilled to be joined by the amazing Kerry! My name is Scott and I am one of the founders of vtx and a specialist in small animal internal medicine. Please introduce yourself in the thread below. We would love to know a bit more about you!
This course is a safe place to ask questions, discuss cases/situations, to start discussions with your fellow veterinary colleagues and mostly importantly to share your experiences (if you want to, that is).
I would also love to know what you hope to get out of the course?
Lessons will be released each Monday at 8am for the duration of the course. We will also post topics that you might find of interest too.
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Best wishes
Scott
Replying to Holly D. 15/10/2022 - 17:16
Hello!
I am not stepping in Liz’s toes with this one and am really interested to hear what she has to say. I do not have direct experience of using this drug. Can I ask what other therapy you have tried in this case?
Scott 🙂
Replying to Lynne F. 12/10/2022 - 12:39
Lynne!
How lovely to hear from you and how lovely to see you on here.
I hope all is well with you! We are all just about surviving I think!
Thank you so much for supporting the course, let me know if you have any questions at any time.
Scott 🙂
Thanks for sharing Liz.
All still very confusing to me. I wish I had paid more attention in cardiology!
Scott 🙂
Hey Lorna.
I hope you are well. Thank you for the great question. It is a not a drug I use. There is always a bit of a debate about a couple of human GI drugs that intermittently get used in small animal medicine, notably loperamide and buscopan.
Anticholinergics and opiates or opioids (loperamide, diphenoxylate) often are used for the nonspecific management of acute diarrhea, but anticholinergic agents can potentiate ileus and are not recommended. Opioid analgesics were thought to exert their effects by stimulating segmental motility, thereby slowing transit, but they actually act mainly by decreasing intestinal secretion and promoting absorption. They are indicated in short-term supportive management of acute diarrhea in dogs; they are contraindicated in cases involving obstruction or an infectious aetiology. Loperamide can have central nervous system side effects in collies and other dogs with the multidrug resistance (MDR-1) gene mutation. Antimuscarinic drugs such as hyoscine (buscopan) (butylscopolamine) generally are not recommended, as they can produce a paralysed, nonfunctional SI, can predispose to intussusception, and can cause intoxication. However, in mild cases of acute gastroenteritis, their antispasmodic effect could help relieve colic-type pain.
I did have a look for any dog specific literature, but could not find a lot:
https://pubmed.ncbi.nlm.nih.gov/31140850/
It did seem to be helpful and well tolerated in this context. Would love to hear other thoughts.
Scott 🙂
Replying to Ilse v. 15/10/2022 - 07:59
Hey.
Sounds like you did a great job with this! Well done on picking up the cardiomyopathy too!
Scott 🙂
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