Today we talk to Stefano Cortellini, lecturer in emergency and critical care here at the RVC about the process and indications for Continuous Renal Replacement Therapy (CRRT) and Therapeutic Plasma Exchange (TPE). Further information about this therapy can be found here http://www.rvc.ac.uk/small-animal-referrals/advanced-techniques-and-specialist-procedures/continuous-renal-replacement-therapy

Information on acute kidney injury (AKI) and grading can be found on the website of the International Renal Interest Society (IRiS) here http://www.iris-kidney.com/guidelines/grading.html

The indications for considering treating patients with AKI are; metabolic acidosis, electrolyte imbalance (especially refractory hyperkalaemia), and uraemia. The patients we see, have a potential reversible cause, are often anuric and we can successfully catheterise.  tend to be most affected are those that are anuric. Some toxins can be removed by dialysis when different filters are used. TPE has been used for immune mediated diseases (IMHA, polyradiculoneuritis), and cutaneous and renal glomerular vasculopathy.

If you are in the UK and have a patient that you might think benefit from this therapy, then do not hesitate to contact the RVC http://www.rvc.ac.uk/small-animal-referrals/

Suggested reading.

Review of CRRT and blood purification http://onlinelibrary.wiley.com/doi/10.1111/vec.12028/abstract

Single pass lipid dialysis for ivermectin toxicosis http://onlinelibrary.wiley.com/doi/10.1111/vec.12581/abstract

Therapeutic plasmapheresis in IMHA http://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2009.00431.x/abstract  

If you have any comments about this podcast, please get in touch (email [email protected]; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Today we talk to Stefano Cortellini, lecturer in emergency and critical care here at the RVC about the process and indications for Continuous Renal Replacement Therapy (CRRT) and Therapeutic Plasma Exchange (TPE). Further information about this therapy can be found here http://www.rvc.ac.uk/small-animal-referrals/advanced-techniques-and-specialist-procedures/continuous-renal-replacement-therapy

Information on acute kidney injury (AKI) and grading can be found on the website of the International Renal Interest Society (IRiS) here http://www.iris-kidney.com/guidelines/grading.html

The indications for considering treating patients with AKI are; metabolic acidosis, electrolyte imbalance (especially refractory hyperkalaemia), and uraemia. The patients we see, have a potential reversible cause, are often anuric and we can successfully catheterise.  tend to be most affected are those that are anuric. Some toxins can be removed by dialysis when different filters are used. TPE has been used for immune mediated diseases (IMHA, polyradiculoneuritis), and cutaneous and renal glomerular vasculopathy.

If you are in the UK and have a patient that you might think benefit from this therapy, then do not hesitate to contact the RVC http://www.rvc.ac.uk/small-animal-referrals/

Suggested reading.

Review of CRRT and blood purification http://onlinelibrary.wiley.com/doi/10.1111/vec.12028/abstract

Single pass lipid dialysis for ivermectin toxicosis http://onlinelibrary.wiley.com/doi/10.1111/vec.12581/abstract

Therapeutic plasmapheresis in IMHA http://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2009.00431.x/abstract  

If you have any comments about this podcast, please get in touch (email [email protected]; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Today we talk to Zoë Halfacree, senior lecturer in soft tissue surgery here at the RVC, about bite wounds and some things to consider in how to approach them, after initial patient assessment and stabilisation.

Zoë discussed these aspects of bite wound management. Although this is a relatively common problem that we encounter, there is little information in the literature to help guide us on ways to manage these challenging patients.

Enjoy!

If you have any comments about this podcast, please get in touch, email [email protected]; tweet @RoyalVetCollege using #rvcpod; or use the RVC Facebook page. We would greatly appreciate your time to rate us on iTunes and write a review.

Today we talk to Zoë Halfacree, senior lecturer in soft tissue surgery here at the RVC, about bite wounds and some things to consider in how to approach them, after initial patient assessment and stabilisation.

·      Analgesia; full mu opioid based upon pain score

·      Antibiotics; broad spectrum, such as potentiated amoxicillin

·      Culture where possible

·      Diagnostic imaging

·      When to explore; preferably within 4-6 hours of presentation

·      Lavage techniques; isotonic crystalloid (e.g. compound sodium lactate) using a 25ml syringe and 19-gauge needle. If you attach the fluid bag to an extension set and that to a three-way tap, with the needle and syringe, if makes it a little easier to flush.

·      Wet to dry dressing vs placing a drain

 

Zoë discussed these aspects of bite wound management. Although this is a relatively common problem that we encounter, there is little information in the literature to help guide us on ways to manage these challenging patients.

Enjoy!

If you have any comments about this podcast, please get in touch, email [email protected]; tweet @RoyalVetCollege using #rvcpod; or use the RVC Facebook page. We would greatly appreciate your time to rate us on iTunes and write a review.

In this podcast we talk to one of the principle investigators of the EPIC study, Professor Adrian Boswood. We discuss the findings of the evaluation of pimobendan in dogs with cardiomegaly caused by preclinical mitral valve disease. Why not go to the Journal of Veterinary Internal Medicine’s website, download it and have a read now! http://onlinelibrary.wiley.com/doi/10.1111/jvim.14586/full

It is not often that a single paper has the ability to radically change clinical practice. This epic study has overwhelming evidence that pimobendan administration before the onset of clinical signs in dogs with mitral valve disease (MVD) prolongs the preclinical period by 15 months. The dogs were identified by having a ≥3/6 grade systolic heart murmur, echocardiographic evidence of MVD, and radiographic or echocardiogram evidence of cardiomegaly.

You can also see a video of Professor Boswood discussing this study on youtube https://www.youtube.com/watch?v=wtzr1E3V-gE and an infographic too https://www.youtube.com/watch?v=5qxHMGZ-9aU

It is indeed EPIC.

If you have any comments about this podcast, please get in touch (email [email protected]; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review

To kick start the return of the RVC Clinical podcast we speak to Karen Humm, Lecturer in Emergency and Critical Care here at the RVC. Karen was last heard here when she spoke to Shailen about this disease in number 23 of the podcast, two years ago now.

As with most of the diseases we treat, prevention is far better than cure. There has been a paper published earlier in the year by groups at Bristol and Swansea University (http://www.ncbi.nlm.nih.gov/pubmed/26830203) that shows the prevalence can change dramatically depending upon your location. What is it like in your area?

If you have any comments about this podcast, please get in touch (email [email protected]; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

To kick start the return of the RVC Clinical podcast we speak to Karen Humm, Lecturer in Emergency and Critical Care here at the RVC.  Karen was last heard here when she spoke to Shailen about this disease in number 23 of the podcast, two years ago now.

 

As with most of the diseases we treat, prevention if far better than cure. There has been a paper published earlier in the year by groups at Bristol and Swansea University (http://www.ncbi.nlm.nih.gov/pubmed/26830203) that shows the prevalence can change dramatically depending upon your location. What is it like in your area?

 

If you have any comments about this podcast, please get in touch (email [email protected]; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Access to plain radiography is very widespread now in veterinary medicine. As with any diagnostic test it is essential to make sure that we use this modality in the best ways possible for our patients, their carers and indeed our personal and professional performance. In this episode I am joined by Andrew Parry who is a European specialist in Veterinary Diagnostic Imaging and a member of the Diagnostic Imaging team at the QMHA. Most of this long episode is spent discussing Andy's top 10 tips for how to get the most value out of plain radiography and radiology but we also talk about advanced imaging modalities that are becoming increasingly available and consider some of the issues surrounding this development.

To summarise, Andy's top 10 tips were as follows:

As always, if you have any comments about this podcast, please get in touch (email [email protected] ; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page).

Please take 30 seconds (!) to rate the podcasts in iTunes +/- write a review! Thanks. And remember we are now also on Stitcher Radio.

Access to plain radiography is very widespread now in veterinary medicine. As with any diagnostic test it is essential to make sure that we use this modality in the best ways possible for our patients, their carers and indeed our personal and professional performance. In this episode I am joined by Andrew Parry who is a European specialist in Veterinary Diagnostic Imaging and a member of the Diagnostic Imaging team at the QMHA. Most of this long episode is spent discussing Andy's top 10 tips for how to get the most value out of plain radiography and radiology but we also talk about advanced imaging modalities that are becoming increasingly available and consider some of the issues surrounding this development.

To summarise, Andy's top 10 tips were as follows:

As always, if you have any comments about this podcast, please get in touch (email [email protected] ; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page).

Please take 30 seconds (!) to rate the podcasts in iTunes +/- write a review! Thanks. And remember we are now also on Stitcher Radio.

Lymphoma (previously often referred to as lymphosarcoma) is one of the most (if not the most?) common types of cancer to affect dogs and cats. In this episode we discuss lymphoma in general terms covering a variety of topics such as what it is, patient presentation, clinical approach to the patient, treatment options and prognosis. For this episode I am joined once again by Chiara Leo, Lecturer in Oncology at the Royal Veterinary College.

As always, if you have any comments about this podcast, please get in touch (email [email protected] ; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page).

Please take 30 seconds (!) to rate the podcasts in iTunes +/- write a review! Thanks. And remember we are now also on Stitcher Radio.

(Image: "Canine lymphoma 1" by Joel Mills - Own work (Wikipedia))