staging.vettimes.com

Author: Kele Harris

  • Aggression as an unusual presenting sign of hypothyroidism

    Aggressive dog
    Image ©iStock.com/YuriyGreen

    I’ve not long come across a case of a middle-aged dog that had suddenly become unaccustomedly grumpy and started snapping at its poor owners.

    This was uncharacteristic, as it had no previous history of behavioural problems. There were no other obvious clinical signs – perhaps it had become lazy of late, but there was nothing to put your finger on.

    I recalled having attended a CPD event a while before when the speaker mentioned hypothyroidism leading to aggression. I thought this was worth a punt, and low and behold it had a very high thyroid-stimulating hormone level and very low thyroxine result. Our friend is now on thyroid supplementation and is much happier, although at the time of writing some two to three months into therapy, it was not completely better.

    So, it may be worthwhile considering a blood profile when presented with signs of aggression in middle-aged dogs.

  • Using PDS to “wire” mandibular symphyseal fractures in cats

    We have now started to use Polydioxanone (PDS) to stabilise symphyseal fractures in cats. We use 4 metric PDS passed under the mandible and around the canines in a figure of 8.

    In uncomplicated fractures, we have found this to be really effective and the fracture will heal within four to six weeks. If, like me, you have ever had trouble removing the wire at this time (see video below for example of a traditional wiring method), this technique may well be for you – not to mention the cat will not need further anaesthesia.

    Video: Avulsion fracture of the lower lip and the mandibular symphysis in a cat. Source, YouTube.

  • Check tear production in cases of facial paralysis

    Schirmer tear test
    Schirmer tear test

    We recently saw a 10-year-old, West Highland white that had developed a middle ear infection and facial paralysis.

    Following treatment and further investigation, it turned out the poor little chap had concurrent hypothyroidism. Several weeks later, I noticed the eye the same side as the ear infection had developed a mucopurulent discharge and mild keratitis.

    On checking its Schirmer tear tests, this was markedly reduced for that eye, and borderline for the other. A bit of research indicated facial paralysis can affect both tear and saliva production.

    The good news is the little chap is doing well with false tear preparations.

  • Inducing vomiting in dogs

    BarfIn our practice, the preferred way to induce vomiting after ingestion of poisons (most commonly raisins, chocolate and rat poison) is subcutaneous apomorphine.

    If a strong acid or alkali has been ingested, this is contraindicated. This also seems to occur most commonly out of hours for some strange reason.

    We give 30μg/kg SC and wait for the desired effect, which works very well and usually results in a peaceful night’s sleep for all concerned.

  • Anaesthetising rabbits

    Vet holding rabbit
    Image ©iStock.com/4774344sean

    It is generally accepted rabbit anaesthesia can be challenging, but we do a lot of rabbit neutering as part of our work for an animal charity and use a protocol that has proved very safe and effective.

    We also use yellow gauge catheters placed into an ear vein for IV administration.

    Vetergesic (buprenorphine) 0.07ml/kg
    Hypnovel (midazolam) 0.2ml/kg

    • Combine these drugs in one syringe and inject subcutaneously 20 minutes before procedure.
    • Rabbit will become quiet and relaxed.
    • Ketamine 0.2ml/kg diluted with 1:10 saline (that is, 0.2ml ketamine in 2ml saline).
    • Give this slow IV to effect.
    • Most rabbits use half a syringe, but occasionally I have had to use the whole syringe. If it is not having an effect, flush the catheter, and mask with isoflurane if required.
    • Rabbit will react if it goes extravascular;
      • once induced, spray Intubeaze and intubate – listen to breath sounds; there is usually no cough.
    • Rabbit can usually be maintained on 2% isoflurane.
    • Slower to wake up, but eating.
    • Hypnovel must be discarded within 24 hours, so better to try to book in all rabbits on the same day.
    • Premed can be used for x-rays; incisor trimming.

  • Top tips from the reception desk

    Communication is key. Image ©iStock.com/DenGuy
    Communication is key.
    Image ©iStock.com/DenGuy

    As I’ve done quite a few clinical tips now, I thought it would be interesting to ask our receptionists what their top tips from the front line would be.

    Sara, one of our excellent branch manager team, says communication is essential. Passing on as much information as possible to the clinical team can sometimes be challenging if presented with a very worried or upset client on the phone.

    Sara also says remaining calm is key, and she always does her best to reassure clients and ensure the patient turns up at the right surgery at right time.

  • Intuition works

    keep-calm-and-trust-your-intuitionI recently had a male cat presented that was “just a bit quiet” – it wasn’t moving much and, uncharacteristically, had not eaten breakfast that morning.

    The owner had barely removed our feline friend from the carrier when I thought: “This guy’s got a blocked bladder.”

    Abdominal palpation confirmed my intuitive diagnosis.

    I’ve been thinking about this a lot recently – what does it mean? Am I just getting old and have a subconscious feel for what’s coming in through the door?

    Then I heard a programme on Radio 4 (that confirms my age!) that said “gut feelings” were actually learned behaviour, and were your subconscious popping ideas into your conscious brain.

    So my tip would be to go with those hunches – you might just be right!

  • What’s causing the recurrent pyoderma and pruritus?

    Itchy Charlie
    Itchy Charlie by Dan Boldy [CC-BY-SA-3.0], via deviantART.
    Given my interest in dermatology a lot of itchy canine and feline individuals are passed in my direction.

    They often have a history of recurrent microbial skin infections either in the form of Staphylococcal pyoderma or Malassezia dermatitis, which is treated as and when it occurs.

    I’m often surprised to find these individuals are not receiving routine parasite control, even when many of them have been prescribed it (sadly it is not effective while still in the packet), particularly as we do have both lungworm (Angiostrongylus vasorum) and Sarcoptes about in our practice locality.

    My tip would be start to look for the underlying cause when these patients keep coming back – starting with Sarcoptes (and I personally prefer the blood test because I rarely find mites on scrapings).

  • When is a lipoma not a lipoma?

    Fine-needle aspiration (FNA).
    Fine-needle aspiration (FNA) of a mass. Image source: BSAVA ’09 Congress Times.

    We recently had a case where a freely mobile, soft mass on the ventral abdomen, which had been present for a number of years, had started to get larger.

    We carried out a fine-needle aspiration (FNA) biopsy, and I fully expected this to confirm the presence of a lipoma (a benign fatty tumour common in dogs).

    However, I was really surprised when the cytology revealed the presence of a mast cell tumour, with a surgical procedure to follow.

    My tip would be that it is definitely worthwhile checking out those seemingly innocuous “lipomas” with FNAs.

  • Use of Convenia for treatment of cat bite abscesses

    Many clients have difficulty tableting their cat.
    Many clients have difficulty persuading their cat to take tablets. Image source unknown.

    OK, a potentially controversial one this…

    There is a lot of evidence highlighting resistance to antibiotic therapy both in the human and veterinary fields. My understanding is that this is, in part, due to poor compliance.

    I’ve certainly come across clients who have difficulty giving tablets to their cat, and have also seen cases that “appear” to respond poorly to amoxicillin/calvulanic acid but then respond rapidly to Convenia.

    So, my argument is that injecting a long-acting preparation licensed for the treatment of soft tissue infections in cats (having bactericidal activity to the “usual suspect” oral bacterial flora of the cat) is preferable to giving oral meds that owners find difficult, and in some cases impossible, to administer.

    I might even suggest this may result in less resistance.

    I look forward to hearing your views…