Steph Sorrell
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Hey Sarah,
Sorry I had replied to your original post yday but it doesnt seem to have uploaded- probably an error on my side!
Anyway these are brilliant points!
We know survival in general for IBD/FRE but for severe IBD there is no literature that I am aware of.
Tailoring treatment to the owner and the patient is critical and some of our feline patients are not the easiest to medicate. Quality of life always has to be considered and in some instances treatment may not be appropriate.
Thank you for sharing the consensus statement- it has some really good info on it!
Best wishes,
StephReplying to scott@vtx-cpd.com 30/08/2023 - 14:17
I use vivomixx too. There is a nice Vet Clinics of North America article from Silke Smitz who is a fan.
Edinburgh are certainly leading the way and I think they have a bank of healthy canine donors which they can use. I definitely consider FMT and at an earlier stage in poorly responsive cases as it can have some dramatic effects.Regarding biopsies, if there is evidence of triaditis then I think surgical biopsy is defintiely the way to go. If there is solely evidence of IBD/small cell lymphoma then I most often do not biopsy- endoscopically or surgically as it does not change the treatment.
Thanks for the fab discussions!
Best wishes,
StephHi Sarah,
Thanks for sharing this as I hadn’t heard of them either. I like dechra specific hydrolysed salmon. It seems to be pretty palatable too which also helps.
https://www.specific-diets.co.uk/cat/special-care-diets?CatAge=&SpecialNeeds=23
Best wishes,
StephHi everyone,
So pleased to have you joining us on this course. I am Steph and am an internal and feline medicine specialist. Cats are my passion and I am so exciting to be sharing this course with you.
I would love to hear more about you and any tricky/cool feline cases you may have 🙂
Best wishes,
Stephso sorry for the late reply!
So there is no data that I am aware of. However, as a business if they are not aware of mental health issues then they have no duty of care to make reasonable adjustments to assist an individual.
I have in the past declared my anxiety and have so far had helpful feedback from HR discussing if any adjustments are needed in the workplace, which for me they are not, but it opened a line of communication that otherwise would have been closed.Replying to Sarah Benzie 07/04/2023 - 19:27
I am so pleased to hear this Sarah!
Wellbeing plans are brilliant. They allow us to make informed decisions during the non stressful times and help colleagues know how best to help. I would love to see these being standard for all practices and am so pleased that you are keen to implement in your practice 🙂
Hello and welcome everyone!
We are so pleased you are joining us on this course. We have aimed to keep this as practical and relevant to you all whilst also empowering you to know your legal rights.
We encourage all interaction and there is no stupid question so please ask away!
We hope you find the course helpful and have tips to take forward in your work and personal life.
Best wishes,
StephHi,
Great question! Hypoadrenocorticism is so rare in cats. Had to do a quick literature search, but seems like there are less than 20 well documented cases and most have typical electrolyte imbalances. I therefore would not do an ACTH stimulation test in cases with only GI signs.
There are no studies looking at cut offs for basal cortisol- likely because its such a rare disease its hard to get numbers! Therefore an ACTH stimulation test is indicated for diagnosis.
Best wishes,
StephHi,
This sounds like a tough case! I think you will need sedation, but I would be on hand with ET tubes to convert into a GA if the cat decompensates.
I am not an anaesethesia specialist but in the past I have used butorphanol IM and if this is not enough after 20-30minutes then I would also give alfaxan. This should allow the patient to be amenable to IV placement which will be important in case of decompensation.
I hope this helps.
Best wishes,
StephYes you are correct, this is when the disease affects the small intestine.
Best wishes,
StephI would treat for any cases of GI disease as with cats often toileting outside, owners don’t always know if there is diarrhoea.
Best wishes,
StephReplying to Ilse v. 09/10/2022 - 23:14
Yes blind BAL would be really helpful. With asthma it affects the airways diffusely so you don’t need to have a guided sample.
Best wishes,
StephHi Ilse,
Wow, you have had some really interesting cases!
Imaging and bronchoscopy is probably going to be the most helpful diagnostics for dyspnoea cases. I tend not to do a tracheal wash, and instead do a bronchoalveolar lavage (BAL), most often guided by bronchoscopy and CT to target the lung lobe which is most affected. If this is not possible then you can also do a blind BAL.
I would not rely on pharyngeal swabs for culture as there are so many bugs in the oral cavity that it is heart to interpret. I would only use swabs for PCR for chlamydia/herpesvirus.
If the patient is dyspnoeic then I prefer to first try and stabilise with oxygen therapy and treatment as indicated e.g thoracocentesis if pleural effusion is present. My preference would be a short GA in these cases rather than sedation so that we have control over the airways and can give high concentrations of oxygen.Best wishes,
StephReplying to Sarah H. 29/09/2022 - 13:25
I tend to use famotidine in cases with poor appetite as anecdotally I feel it helps. I dont bother giving it hough if the cat is difficult to tablet.
That case stayed on chlorambucil longterm. We tend not to wean down so either give it or not and usually they require it long term.
Best wishes,
StephReplying to Pauline Brauckmann 18/09/2022 - 07:25
Hi Pauline,
Sorry for the late reply- I have been on annual leave and just back!
So I have seen in patients with vomiting/diarrhoea, that they may have irregular uptake of medical therapy so poorer control. For these patients I would focus on treating the IBD as well as the hyperthyroidism, so as well as considering hydrolysed diet, I would also consider B12 supplementation (if they have low serum levels) and consider scope/steroid trial if signs persist while on a diet. In these cases usually once IBD is stabilised then medical treatment is much easier to attain control. Alternatively you could consider more definitive therapy such as surgery or radioactive iodine for these patients.
Best wishes,
Steph -
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