scott@vtx-cpd.com

Replying to elaine elder 29/11/2021 - 19:38

Hey Elaine.

It is a really good question! We also used to use Oxyglobin during my residency. It went off the market and has not made any attempt to come back, so this is really not an option now.

Xenotransfusion is definitely a great option in the true emergency while you sort out getting actual cat blood by whatever means!

Scott 🙂

Replying to Zoe McGarry 19/11/2021 - 12:05

Hey Zoe.

Hope you are well.

I have started a whole new thread regarding the feline blood bank.

Would love to hear your thoughts.

Scott 🙂

Replying to Lesley M. 22/11/2021 - 22:09

Hey Lesley.

Hope you are well. I totally understand your concerns. We were having this exact debate last week at work. We are not currently able to have a feline blood bank in the UK due to RCVS concerns and regulations within this country, but it is OK for us to import this blood from another country.

The donation scheme in Portugal is very well set up. The donors are client-owned cats and cats. Most of the cast are brought in by owners just as we do in UK for dogs. The facility itself is excellent and the blood is all screened appropriately. I have even had colleagues that have even visited!

I would love to hear your thoughts!

Scott 🙂

Replying to Nichola C. 25/11/2021 - 21:23

Hello.

Hope you are OK. Blood pressure is definitely an important part of the monitoring in shock patients. It is best used as part of many other parameters that are important to keep an eye on too.

The treatment of shock can be distilled down to the idea of improving oxygen delivery as soon as possible; there is a narrow therapeutic window before cellular energetics become deranged and cannot be reversed. The goal is to normalize blood pressure, central venous pressure, and the physical parameters of heart rate, pulse quality, capillary refill time, mentation and urine output.

Systemic hypotension is defined as a systolic arterial blood pressure < 80 mm Hg and/or MAP < 60 mm Hg in either dogs or cats. Normal Arterial Blood Pressure Values in Adult Dogs & Cats BLOOD PRESSURE VALUES DOGS CATS Systolic arterial pressure 90 to 140 mm Hg 80 to 140 mm Hg Diastolic arterial pressure 50 to 80 mm Hg 55 to 75 mm Hg Mean arterial pressure 60 to 100 mm Hg 60 to 100 mm Hg I would ultimately be aiming for a mean pressure of 80mmHg when resuscitating with fluids. Hope that helps. Scott 🙂

Replying to emily a. 23/11/2021 - 23:11

Hello Emily.

I hope you are safe and well. Following on from Andy’s message, I am sorry about any confusion regarding these lessons.

I hope you are enjoying the course.

Let me know if you have any other questions.

Scott 🙂

Hello.

These are the most challenging cases, especially when family are involved!

I would say the priority is indeed to get the hyperthyroidism under stable control and keep a very close eye on what the kidneys are doing. Despite the increase in SDMA, I would be encouraged by the USG and the creatinine. This should be early in CKD progression, but obviously the hyperthyroidism can have an effect on how this looks from a blood and urine POV.

The main DDX for the haematuria have to be inflammation, infection, uroliths or something structural. Hopefully the imaging has helped rule many of these things out, but there are always subtleties that could be missed. I think the meloxicam idea is a good one and should not be too much of a risk:

https://pubmed.ncbi.nlm.nih.gov/21906984/

It is not that common to get lots of haematuria as a consequence of CKD alone. Other DDX I would consider would be a coagulopathy (assess platelets, PT and aPTT) and possibly idiopathic renal haematuria. Renal haematuria can be really challenging to diagnose in cats as it normally requires cystoscopy.

How has this urine been collected?

Scott 🙂