WSAVA Pain Management Protocols

For this latest blog post I wanted to basically draw your attention to the WSAVA Global Pain Council Pain Management Protocols that have recently been made freely available online.

Letting the Demons Out! Some thoughts on exploratory laparotomy...

“We didn’t find anything particularly abnormal but we let the demons out!” Heard that before? Sure you have and we laugh out loud. But should we be? Are too many unnecessary negative exploratory laparotomy procedures performed? Are too many exploratory laparotomies performed prematurely?

Top Tips for Coping with Night Shifts

So this is a blog post I have wanted to write for some time and thankfully the moment has arrived! I hope you find it of some interest/use. The tips and strategies that follow with respect to coping with night work are a combination of my thoughts and tips gathered from members of the Veterinary ECC Small Talk community via email – THANKS so much to those who contributed. Right, let’s get on with it…

Ever seen dialysis disequilibrium syndrome in tomcat urethral obstruction?

Ostroski CJ, Cooper ES. Development of dialysis disequilibrium-like clinical signs during postobstructive management of feline urethral obstruction. J Vet Emerg Crit Care 2014. 24(4):444-449.

Dear Puppy, Please Don't Drink So Much Water Or You Might Seizure?

So this is some interesting stuff – well, I think so anyway! I want to thank my good friend Kate Russell for raising this with me as well. The basic question at hand here is can a puppy drink so much water in a single episode as to cause water intoxication and a hyponatraemic seizure?

Choppy Choppy! My Top 5 Surgery Tips (N. Kulendra DipECVS)

STOP THE PRESS! This blog edition is my first ever guest blogger post! Love it. Here Nicola Kulendra, European Specialist in Small Animal Surgery and a dear friend and colleague, shares some of her top surgery tips for you. Also be sure to look out for the free PDF giveaway at the end which contains some other points relating to Soft Tissue Surgery (that is my creation, not Nicola's).

Syringe feeding: Yes, No, or It depends?

A while back I recorded a podcast on nutrition in sick animals with Dan Chan DACVECC DACVN, Head of Emergency and Critical Care (ECC) at the Queen Mother Hospital for Animals, Royal Veterinary College, UK. The podcast is linked to at the end of this blog post. One of the things we discussed in that podcast was the use of syringe feeding.

Angiostrongylus vasorum (canine lungworm)

I have just published a podcast on Angiostrongylus vasorum which you can find HERE. Coincidentally a couple of papers have recently been published in The Veterinary Record on this and I thought I would provide a summary of their main findings in this blog post for those who cannot access these papers. I won’t be commenting on methodology, just transcribing from their manuscripts!

Fluoroquinolones and the Feline Retina

A short while back someone emailed me to ask what my recommendations are when it comes to using fluoroquinolones in cats with respect to the potential for retinal damage and blindness. She had been discussing the issue with colleagues in her practice and there was no consensus which was not helped by the fact that the formularies and other book resources they had available did not entirely agree with each other – quelle surprise?!

Emergency medicine: it's a different way of thinking/practicing

In this post I wanted to touch on some of the things that make emergency medicine a bit different from routine/elective/non-emergency (!) medicine.

Canine parvovirus infection - role for interferons?

We are all familiar with the potential for canine parvovirus (CPV) to cause severe morbidity and mortality. Treatment is symptomatic and supportive and antibiotics are used in many/all cases (there is more to say about this but that is for another blog some other time!). The ability to provide good intensive care can significantly impact on outcome but nevertheless some dogs will die. None of the medical therapies currently used are expected to have any effect on modulating or dampening down the actual pathology of the disease (although early enteral nutrition likely helps to ameliorate intestinal changes to some degree). A treatment that could reduce disease severity and even lower mortality is therefore something that is undoubtedly very desirable but does such an option exist?

Heartbroken: traumatic myocarditis/myocardial contusions

Traumatic cardiac injury is probably not something that many people give much consideration to. When we see dogs and cats that have suffered blunt thoracic trauma we think a lot about the thoracic injuries that can compromise respiration such as pneumothorax or pulmonary contusions. But how often do we wonder how the heart is?

Out-of-date adder antivenom: to use or not to use?

I am not going to go into any detail here suffice to say that when it comes to treating envenomation by the common adder (common European adder, Vipera berus), antivenom is the only therapy shown to have a beneficial impact on progression and outcome. It is true that mortality in dogs and cats from bites by this snake is (very) low but antivenom use can significantly reduce severity and duration of morbidity which attenuates suffering and saves pet carers money too! As I say, I am not going to get into any more about the treatment here – except to say NO STEROIDS and NO EMPIRICAL ANTIBIOTICS!

Inducing emesis in cats: what's to be done?

Cats do not tend to ingest poisons as often as dogs do, this we know, and therefore the scenario in which one may be considering inducing emesis in a cat is encountered less often. That said, the Veterinary Poisons Information Service (VPIS), based in the UK, gets more or less one telephone enquiry a day about a cat that has ingested a toxin (personal communication, 2014) so it is not totally unheard of! I am going to skip some of the other talking points about gastrointestinal decontamination, especially in cats, here and just consider the circumstance in which it has been decided to induce emesis in a cat. What are the options?

Neonatal puppy viability: modified APGAR score

I imagine most people will agree that perinatal and neonatal medicine in companion animal practice lacks a certain degree of sophistication and expertise when compared to human medicine. The reasons for this are of course numerous and not for elaboration here. I did recently come across someone referring to the modified APGAR score when describing a case of dystocia in a bitch and I must admit I had not heard of it being used before.

Feline arterial thromboembolism (FATE): 10 points and a paper

Theory refresher

I came across the paper below on feline arterial thromboembolism (FATE) and thought I would share some of its findings.

Journal bits 'n' pieces 001 Dog blood types and Methocarbamol CRI

These ‘journal bits ‘n’ pieces’ blogs are meant to be summaries of the background to and findings of interesting journal articles I come across without any intention to discuss the methodology or critique the papers.

What's involved in making a clinical decision?

Clinicians make decisions all the time, indeed it is inherent in being a ‘clinician’, but what are the factors that influence the decisions we make. Some came to mind (in no particular order)…

Immunosuppressive drugs in canine primary IMHA: what's the evidence?

Background

In the treatment of immune-mediated haemolytic anaemia (IMHA), both primary (idiopathic) and secondary, immunosuppressive therapy is essential.

Decompression in canine GDV: orogastric intubation? gastric trocarisation?

Background

Gastric decompression is an essential part of the initial pre-operative stabilisation of dogs with GDV once aggressive intravenous fluid therapy is under way. There are two methods of achieving this: orogastric intubation and needle puncture (gastric trocarisation).

'Clinically proven' - what should it mean?

I recently came across information about a cooling mat for dogs and cats. AniMat Cool Gel Mat™ (AnimAlarm®, http://theanimalarm.com/animat-cool-gel-mat/) which the company says “uses a unique patented gel that stays cool automatically with no activation”. Well of course this pricked my interest because I started to think about ways in which we could use this in the clinic.

PCV vs. HCT, TS vs. TP

Measuring manual packed cell volume (PCV) and refractometric plasma total solids (TS) has long been part of the emergency database; moreover these parameters are often reassessed during hospitalisation.