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scott@vtx-cpd.com

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  • scott@vtx-cpd.com
    Keymaster
    11:02 23/02/23

    Hey Lesley.

    I will share my thoughts. Would be interesting to hear Jenny’s thoughts too!

    You are right… Male dogs with urinary incontinence pose a more difficult challenge. Although a less common problem in males, less than 50% of male dogs respond to medical therapy, and the most successful treatment is phenylpropanolamine. One possible reason for this is a misdiagnosis of dogs with USMI when in fact they have overflow incontinence from urethral sphincter dyssynergia or functional urethral obstruction. Testosterone cypionate has had some anecdotal use in males with USMI and may provide some improvement. Urethral bulking agents may be placed antegrade through a cystotomy incision; however, there has not been a formal evaluation of this procedure and its overall success rate is unknown. Surgical placement of an artificial urethral sphincter appears to have some success in male dogs that fail medical therapy.

    I think it is important to work up these male incontinent dogs as much as possible. I would definantely consider urine analysis and possible culture. An abdominal ultrasound would be helpful. The problem in male dogs is a visualisation of the lower part of the urinary tract. If clinical signs are suggestive of any urethral disease I would consider a retrograde urethrogram or possibly CT.

    In short, the first line medication trial would be phenylpropanolamine.

    Hope that helps.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    20:26 22/02/23

    Hello Ornella.

    I hope you are well and enjoying the course.

    I would normally use NAC when patients are hospitalised and I would normally give more than one dose. I normally use the following:

    N-acetylcysteine (140 mg/kg loading IV, then 70 mg/kg q 6 h for 7 treatments)

    I will then transition them on to oral sAME when they are tolerating food.

    Will be interested to see what Kerry thinks!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    10:33 22/02/23

    Hello Helen.

    I would agree that we are seeing more and more evidence that antibiotics are often not needed in these cases:

    https://pubmed.ncbi.nlm.nih.gov/36191142/
    https://pubmed.ncbi.nlm.nih.gov/31742807/

    I think they summarise really well here too:

    https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.44

    Can you share a little more about the plasma? What is the trigger for giving this?

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    16:17 20/02/23

    Replying to Lesley M. 14/02/2023 - 23:02

    Hey Lesley.

    Thanks for your thoughts. I will give the others a wee bit longer and then I can share what happened next.

    The clinical discussions part of the forum section of the website is where we share cases and some other useful stuff!

    Clinical Discussions

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    14:19 17/02/23

    Replying to Emma Holt 16/02/2023 - 12:40

    Nailed the photo!

    Have a great weekedn.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    13:11 16/02/23

    Replying to Emma Holt 16/02/2023 - 12:40

    HAHAHAHAH! I knew you would!

    I have even done helpful pictures!

    Image-1
    Image-2
    Image-3

    Looking forward to seeing it!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    20:18 15/02/23

    Replying to Emma Holt 02/02/2023 - 13:48

    Evening Emma!

    In other news… you need to add a profile picture on here!

    Peer pressure!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    14:53 15/02/23

    Replying to Kim Choo L. 08/02/2023 - 19:10

    Hello Kim.

    I hope you are well. Could you share the blood results? If you email them to me I can post them anonymously.

    scott@vtx-cpd.com

    I think with such a low cobalamin I would be suspicious of significant small intestinal disease/chronic enteropathy.

    It would be worth running a basal cortisol to rule out Addison’s. Have you tried a diet trial on this dog? If not it would be worth considering a hydrolysed diet. I would also consider Vivomixx as Jenny mentioned in her lecture.

    The cobalamin will need longer if you are supplementing orally (12 weeks in some studies). The other option would be weekly injections. The cobalamin review is really helpful:

    https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15638

    The next steps, in this case, maybe endoscopy/biopsies. Steroids may be necessary. I would also consider the abdominal US.

    The intermittent nature is not uncommon with some enteropathies. Will depend a bit on how much work the colon is doing with water reabsorption!

    Hope that helps.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    14:32 15/02/23

    Replying to Alison S. 08/02/2023 - 17:12

    Hey.

    The notes are avaiable at the top left corner of the lesson. I have circled on the image.

    Scott 🙂

    notes Notes
    scott@vtx-cpd.com
    Keymaster
    14:29 15/02/23

    Replying to Alison S. 08/02/2023 - 13:12

    Hey Alison.

    Let me know if you have any troubles finding the notes!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    13:22 15/02/23

    Replying to Liz Bode 02/02/2023 - 18:44

    HAHAHAH!

    Sorry, I should have read that properly!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    10:54 14/02/23

    Replying to Jennifer Cartwright 08/02/2023 - 23:04

    Really interesting Jenny!

    I look forward to seeing those results!

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    10:52 14/02/23

    Hey Jenny.

    Thank you for letting everyone know. Thank you so much for the brilliant course so far.

    Sending lots of love.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    09:18 14/02/23

    Replying to Cristina M. 14/02/2023 - 00:00

    Thank you Cristina!

    You beat me to it!

    Hope you are having a great week.

    Scott 🙂

    scott@vtx-cpd.com
    Keymaster
    16:54 09/02/23

    Replying to Francesca W. 10/01/2023 - 15:44

    Hello Francesca.

    I hope you are safe and well. I have no idea how I missed this question! I am so sorry for the delay!

    I would normally use the 100mg dose as you mention. You could absolutely increase this dose if needed. The recommended dose is 5-10mg/kg PO q8-12 hours.

    Interestingly, I was speaking to a colleague in the USA yesterday who works in a high volume spay and neuter clinic. They will use routinely ahead of elective procedures.

    Hope that helps.

    Scott

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