The IndeVets Happy Hour

Drs. Marisa Brunetti and Andrew Heller host Dr. Anita Patel to continue the breed predisposition series about one of their favorites: The Cavalier King Charles Spaniel, NOT TO BE CONFUSED WITH the King Charles Spaniel. 

Dr. Andrew Heller interviews Dr. Miguel Ortiz, IndeVet and member of the Western Veterinary Conference board, about the access-to-care issue facing our industry. 

Access to Veterinary Care Coalition Report :

https://pphe.utk.edu/wp-content/uploads/2020/09/avcc-report.pdf

AVMA Report on Economic Picture of Access to care in US

https://avmajournals.avma.org/view/journals/javma/260/14/javma.21.11.0486.xml

Association of demographics and veterinary care:

https://pubmed.ncbi.nlm.nih.gov/33466270/

Overview of Social Determinants that limit access to care:

https://www.frontiersin.org/articles/10.3389/fvets.2021.787555/full

AVMA Article on trauma, burden transfer, and burnout:

https://avmajournals.avma.org/view/journals/javma/260/12/javma.22.05.0196.xml

Dr. Robert Silver, DVM of Real Mushrooms joins the pod to discuss how mushroom supplements can be used therapeutically in our canine species. 

Check out Turkey Tail, Reishi, Lion's Mane, and Cordyceps.

CE credits can be earned here: https://ce.dvm360.com/courses/the-medicinal-magic-of-functional-mushrooms-yijn

Drs. Andrew Heller and Marisa Brunetti embark on a new series about breed predispositions. First up: Golden Retrievers!

Drs. Andrew Heller and Marisa Brunetti finalize interview Dr. Tara Bidgood from Zoetis to discuss Project WAG.

https://cloud.mc.zoetis.com/project-wag-landing-page-and-webform?utm_source=qr-code&utm_medium=fash-card&utm_campaign=project-wag/

Drs. Andrew Heller and Marisa Brunetti finalize their ophthalmology series with Dr. Casey Robinson. Check out these pearls of wisdom about uveitis. 

Drs. Andrew Heller and Marisa Brunetti get together to discuss a few new therapies that have hit the market. 

1. Zenalpha (dechra) - alpha 2 sedative

2. Spryng osteocushion (PetVivo)- joint injection

3. Zorbium (elanco)- transdermal buprenorphine

In case you missed the first AVMA convention after the COVID hiatus, Dr. Heller and his guests -- Amy Lloyd, VMD, Chaundra Schofield, VMD, and Kelly Dunham, DVM -- cherry pick some of the interesting tidbits they gathered from the lectures they attended in Philly. 

Show notes: 

Toxicity: 

a. Don’t ever give cats hydrogen peroxide!!!! Hemorrhagic gastroenteritis/death. NO SAFE AT HOME REMEDY in cats.

b. Use dexdomitor 7mcg/kg IM to cause 81% of cats to puke. Hydromorphone SQ can also work 75% of the time. Xylazine less likely.

c. Cholestyramine is a great drug to use when trying to detox a patient who ingested a drug or poison that undergoes enterohepatic recirculation. It’s a bile acid sequestrant.

d. ILE – Intravenous Lipid Emulsion – helps draw out fat soluble toxicants. (most commonly made of soy bean oil) – great for marijuana toxicosis.

Hyperlipidemia: 

a. Fenofibrate (micronized form) 4-10mg/kg BID – should resolve 80-100% of cases by 1 month. Will require lifelong therapy. 

b. Low fat diet will treat only 25% of cases. 

Dermatology update: 

a. Chlorpactin – study showed powdered chlorine 0.4% solution kills MRSP topically in just 10 secs.

Chronic UTI: Nitrofurantoin – given nightly for 4 months can help with deep seeded chronic infections.

Feline arthritis: 

a. Dr. Kristen Shaw gave some great resources for both vets and owners to  help to identify cats affected by arthritis during her lecture:

i. zoetisus.com/oa-pain/feline-exam-videos.aspx (you can also link to dog OA resources from here)

ii. Catoachecklist.com

iii. Solensiavetteam.com

Carrie Jurney gave a lecture on CPR for the veterinary soul – she broke down veterinary personality types, individual tendencies as well as common work place stressors.

a. Two great resources she suggested for suicide prevention training were:

b. QPR training – www.qprinstitute.com

c. American foundation for suicide prevention – https://afsp.org/

d. www.betterhelp.com/nomv - Get matched with a licensed therapist and enjoy a FREE MONTH of professional online counseling

e. Psychology today’s therapist finder

Many filters including language, gender (including option or non-binary), insurance type, price, ethnicity served, sexuality, and faith

Injection site sarcomas

a. Can include extraskeletal osteosarcoma (I did not know this!)

b. 1-2-3 rule:

1. Increasing in size after 1 month

2. Larger than 2 cm

3. Still present 3 months after vaccine

c. 42% recurrence rate with COMPLETE EXCISION

d. 21.7% metastatic rate

Mary Telle – Keratoconjunctivitis Sicca

a. **Neurogenic can be caused by long-term otic preparations like Osurnia and Claro**

i. Other causes include trauma, neoplasia, otitis, hypothyroidism

ii. Usually unilateral and associated with a crusty ipsilateral nostril

iii. Pilocarpine 2% ophthalmic solution given orally at a dose of 1 drop per 10 kgs PO bid to start, but may need to increase based on response

iv. Since it is a parasympathomimetic drug, need to watch for toxicity including salivation, vomiting, diarrhea, bradycardia, and weakness

Drs. Andrew Heller and Marisa Brunetti continue their ophthalmology series with Dr. Casey Robinson. Check out these pearls of wisdom about corneal disease. 

Drs. Andrew Heller and Marisa Brunetti continue their ophthalmology series with Dr. Casey Robinson. Check out these pearls of wisdom about Feline ophthalmology.