Vet Lit minis

In this episode we welcome Dr Lauren Minter and Professor Deborah Silverstein to discuss:

-Factors associated with tracheostomy decannulation failure in dogs with BOAS

-When to attempt decannulation of these dogs

-Tracheostomy tube dislodgement

-Complications of suctioning

-Recurrent obstructive fibrinous pseudomembranes. See this report here: https://onlinelibrary.wiley.com/doi/10.1111/jvim.14650

…all in relation to their original study entitled “Factors that may be associated with tracheal decannulation failure in dogs requiring temporary tracheostomy after upper airway surgery for brachycephalic obstructive airway syndrome” https://onlinelibrary.wiley.com/doi/10.1111/vec.13453

Also see a recent related study here:

Retrospective evaluation of the outcomes of advanced airway management in intubated patients with brachycephalic obstructive airway syndrome: 52 cases (2010-2020), https://onlinelibrary.wiley.com/doi/10.1111/jsap.13907 covering specifically those dogs with BOAS that require emergency intubation.

Happy listening and reading!

A chance to cut is a chance to cure?

In this episode we cover:

The principles of cardiopulmonary bypass

Anticoagulation

The mitral valve repair itself

The ideal surgical candidate for mitral valve repair

The outcomes of such a procedure

The original study is below and covers further specifics such as case selection and post-op care plus summaries and discussion of fatalities. An overarching aim was that this should be useful for other centers establishing such a program.

Improvements over time are summarised by improving survival rates: 22/33 in the first quartile, 27/33 in the second quartile, 28/33 in the third quartile, and 30/33 in the final, most recent group. Do have a read.

Improvement in short-term outcome over time, in a single center embarking on a canine mitral valve repair program using a structured multidisciplinary approach

https://onlinelibrary.wiley.com/doi/10.1111/vsu.14229

In this podcast we discuss the actual prevalence of AKI in cats exposed to lilies, how bad the AKI seems to get when it does occur, and the changing management practices over time in toxin exposures, let alone in the management of lily exposure itself.

Happy listening!

Prevalence of acute kidney injury and outcome in cats treated as inpatients versus outpatients following lily exposure

https://avmajournals.avma.org/view/journals/javma/263/1/javma.24.05.0355.xml

Alex Lynch and Rob Goggs discuss the uses of viscoelastic testing, hyperfibrinolysis, when to use antifibrinolytics in dogs, and when to stop them! This is part 2 of 2.

A selection of studies referred to:

CURATIVE guidelines https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801

Characterisation of changes in the haemostasis system in dogs with thrombosis https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037

CRASH 2 Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

CRASH 3 Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext

WOMAN trial Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300

FAT CAT https://www.sciencedirect.com/science/article/pii/S1760273415000958

SUPERCAT https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml

Alex Lynch and Rob Goggs answer questions on indications for thromboprophylaxis, knowledge gaps in the area, if or when we should be more pro-active and ATE in cats. This is part 1 of 2.

A selection of studies referred to:

CURATIVE guidelines

https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801

FAT CAT

https://www.sciencedirect.com/science/article/pii/S1760273415000958

SUPERCAT

https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml

Characterisation of changes in the haemostasis system in dogs with thrombosis

https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037

CRASH 2

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

CRASH 3

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext

WOMAN trial

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage

https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300

Do you use rivaroxaban? Do you want to know more about using rivaroxaban? Or even apixaban? In this podcast we discuss both anticoagulant drugs with study authors Alex Lynch and Rob Goggs. I learnt plenty and I hope you will too!

We also recorded a ‘burning questions on thromboprophylaxis’ podcast that will be out very soon, so keep an eye out for that too! You can also find the podcasts on the www.vetlit.org/podcast page itself.

In this episode we cover:

The background to the use of oral anticoagulants

A brief tour of pharmacokinetics and pharmacodynamics.

The biological effect of both drugs, when it happens and the concept of rebound hypercoagulability after drug withdrawal.

The original study is here:

Comparison of the pharmacokinetics and pharmacodynamics of apixaban and rivaroxaban in dogs

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17216

In this podcast we discuss the impact of a short video to teach owners about antimicrobial stewardship. Chris Scudder talks to authors Emma Wright and Fergus Allerton about their study entitled “Influencing attitudes towards antimicrobial use and resistance in companion animals—the impact on pet owners of a short animation in a randomized controlled trial.”

If you’d like to use the video in your practice waiting room, it’s available here and has been translated into 20 languages. (https://www.youtube.com/watch?v=4ApEAfN4dWU)

The study itself documented positive effects on owner awareness relating to antimicrobial stewardship, using a common scenario of acute onset diarrhoea as the case example. It re-affirms the importance of owner education and sets the scene for more resources with similar aims and measurable outcomes.

You can read the article here: https://academic.oup.com/jacamr/article/6/3/dlae065/7665563

and find out more about ENOVAT here: https://enovat.eu/

In this episode we discuss antibiotic course lengths in dogs with pneumonia, with reference to a study entitled: Clinical course and radiographic resolution of pneumonia in dogs treated with a shorter versus longer course of antimicrobials: a randomized, double-masked, placebo-controlled study. (https://avmajournals.avma.org/view/journals/javma/aop/javma.24.04.0259/javma.24.04.0259.xml)

We also touch on topics such as use of point of care ultrasound and use of CRP in such cases.

Some extra resources below that we make reference to:

Successful management of aspiration pneumopathy without antimicrobial agents: 14 dogs (2014-2021) https://onlinelibrary.wiley.com/doi/abs/10.1111/jsap.13409

ACVIM consensus statement on therapeutic antimicrobial use in animals and antimicrobial resistance https://onlinelibrary.wiley.com/doi/10.1111/jvim.12562

Antimicrobial use guidelines for treatment of respiratory tract disease in dogs and cats: antimicrobial guidelines working group of the International Society for Companion Animal Infectious Diseases (ISCAID).

https://onlinelibrary.wiley.com/doi/10.1111/jvim.14627

Happy listening!

In this podcast we discuss the most frequent transfusion reactions in dogs with George Hall, lead author of a recent study entitled: A prospective multicenter observational study assessing incidence and risk factors for acute blood transfusion reactions in dogs.

The original article is here: https://onlinelibrary.wiley.com/doi/10.1111/jvim.17175

For your (extra) interest: Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs: https://onlinelibrary.wiley.com/doi/10.1111/vec.13044

In this podcast we discuss IV catheters and their complications in light of a study entitled: Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice. https://onlinelibrary.wiley.com/doi/10.1111/jsap.13782

The data that support the findings of this study are openly available in Figshare.com at https://doi.org/10.6084/m9.figshare.25283356.v1