Laura Jones
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Replying to Katy Jones 24/10/2023 - 22:36
Hi Katy!
Great question – and to be honest there’s not one right answer, it will depend on individual clinican preference and the particular patient to some extent.
Personally, we tend to use Plasmalyte-148, or Hartmanns for our cases for the reasons you describe. I’ve also worked with people who will make custom fluids by adding saline and Hartmanns – but that’s really getting complicated!
@Scott – what do you do with these?Replying to scott@vtx-cpd.com 24/10/2023 - 04:52
Not at all!
Honestly, we’re using them SUPER often now. They’ve replaced curves in pretty much all cases, and we also use them on our DKAs once we’ve corrected fluid/lyte/acid base issues.
We tend to get our clients to download the app, but have a reader we loan out to people who can’t use the app. However, I try to keep the reader on hand as we also use it as our blood ketone meter (you can buy ketone strips that go into the bottom of the reader which is fab!). I find that clients get on well with them – we do have a couple who should not have access to that much information though, and have tried to adjust their pet’s own insulin doses before 🤦♀️
Replying to scott@vtx-cpd.com 24/10/2023 - 05:09
LOVE a nebuliser – my fave for cats is the BreathEzy one as it’s really quiet. I’ve had a couple of chronic rhinitis cases buy their own, but I’ve also worked in clinics where we loaned them out on a deposit system 🙂
Hi Jodie!
We use the same dose, crushed with water and administered via a urinary catheter. I can’t say I’ve appreciated a significant different in onset of effect if I’m honest.
There’s a paper published in the American Journal of Veterinary Research, I’ll link it below for you:“Objective: To determine the pharmacokinetics and efficacy of trazodone following rectal administration of a single dose to healthy dogs.
Animals: 6 healthy adult dogs.
Procedures: Each dog received a single dose of trazodone (approx 8 mg/kg) per rectum. Trazodone tablets were crushed into a powder, mixed with 5 mL of tap water, and injected into the rectum via a red rubber catheter. Sedation scores were assigned, and blood samples were collected for determination of plasma trazodone concentration at predetermined times before and after drug administration. Pharmacokinetic parameters were estimated by noncompartmental analysis.
Results: Plasma trazodone concentration remained below the detection limit for 1 dog even though it became moderately sedate. Median (interquartile [25th to 75th percentile] range [IQR]) maximum plasma trazodone concentration and volume of distribution and clearance corrected for bioavailability were 1.00 μg/mL (0.66 to 1.40 μg/mL), 10.3 L/kg (7.37 to 14.4 L/kg), and 639 mL/kg/h (594 to 719 mL/kg/h), respectively. Median time to maximum plasma trazodone concentration and elimination half-life were 15 minutes (range, 15 to 30 minutes) and 12 hours (IQR, 7.99 to 12.7 hours), respectively. All dogs became mildly or moderately sedate, and the extent of sedation was maximal at a median of 30 minutes (IQR, 30 to 60 minutes) after trazodone administration. No adverse effects were observed.
Conclusions and clinical relevance: Rectal administration of trazodone may be a viable option for sedation and treatment of anxiety in dogs for which administration of sedatives and anxiolytics by other routes is contraindicated. Further research is necessary to better elucidate the pharmacokinetics and efficacy of trazodone following rectal administration and determine optimal dosing.”
LOVE some pre-visit anxiolytics – we tend to do gabapentin for cats and trazodone for dogs. In really severe cases we’ll use them together. Also a fan of rectal trazodone in dogs that are really challenging to medicate – we’ll do this in patients recovering from GA/sedation where we expect a difficult recovery, for example. Anyone else doing this?
Scott – this is super interesting! I have never seen this done. I am going to get my geek on and read all about it though!
Replying to Lisa S. 29/09/2023 - 21:30
Hi Lisa,
Ahh yay a medicine convert! I may be biased but it really is the best (just ask Scott, he’ll agree). Looking forward to learning with you – let me know if you have any questions!
Laura xReplying to Nicola Scott 22/09/2023 - 18:55
Hi Nicola,
So great to be learning with you – I totally agree, there is so much more we can do to support these patients! Hopefully you’ll leave the course with some more tips and tricks you can use in your clinic to do that. Let me know if you have any questions!
Laura xReplying to Rebecca H. 22/09/2023 - 18:03
Hi Rebecca,
So pleased to have you here – there is such a great crossover between medicine and ECC so I am sure it will help your role! Let me know if you have any questions!
Laura xReplying to Jodie A. 18/09/2023 - 13:40
Hi Jodie,
So great to have you here – let me know if you have any questions!
Laura xReplying to Lynne Holcroft 18/09/2023 - 10:00
Hi Lynne,
So lovely to be learning with you – let me know if you have any questions!
Laura xHi everyone,
Welcome to this course! I’m so excited to be learning with you over the next few weeks.
I’m Laura, your tutor for this course – I’m an RVN based in the South of England. I’m currently the Senior Medicine RVN at The Ralph Referral Centre, and gained my VTS in Small Animal Medicine in 2019. I’m a huge medicine geek, and love all aspects – especially haematology, endocrinopathies and renal/urinary medicine.
Please let me know if you have any questions as we work through the lessons, or if you have any cases you’d like us to chat through.
Looking forward to chatting to you!
LauraHi everyone!
I’m Laura, and I’m one of the speakers on this course – you’ll see me on the ‘Tubes, Lines and Catheters’ lesson!
I’m an RVN based at The Ralph Referral Centre in Buckinghamshire. I’m currently the Senior Internal Medicine Nurse, and have previously led the ICU Nursing Team.
My background (and main passion) is medical nursing, and I became a Veterinary Technician Specialist (VTS) in Internal Medicine in 2019. My main passion is ANY aspect of medicine, plus all the advanced practical skills that come with managing medical and intensive cases. I’m a big geek about placing tubes and lines, endoscopy, calculations, endocrine disease and about pretty much anything medical, to be honest!
I’m looking forward to learning with you all on the course, and hopefully passing on my love of medicine to you all!
Laura xHello!
FAB topic. So we actually do get the vast majority of our samples from PIVCs at the time of initial placement, so long as we’re happy that the sample has been easy to obtain. I personally really like this technique especially in patients at risk of thrombocytopenia (a LOT of my patients in medicine) or for neuro cases where we might be worried about increased ICP.
When we take from the IVC at time of initial placement, we do use 1ml syringes and take them a tube at a time to minimise clotting, excessive negative pressure on the syringe, etc, and get good results with this.
However we do not take samples from them after initial placement – we would use a PICC line if ongoing samples would be indicated, and collect from them via the push-pull method.
Interested to see what other people do!
Laura -
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