Veterinary ECC Small Talk

Veterinary ECC Small Talk

By Shailen Jasani MA VetMB MRCVS DipACVECCMedicineHealth & FitnessEducation
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Veterinary ECC Small Talk episodes

  • Journal Papers Episode: JVIM 2015

    HORMONAL SEIZURES, IV POTASSIUM SUPPLEMENTATION, ICU SOUND LEVELS, BRAIN TUMOURS AND IMHA!

    In this episode of the podcast I discuss some of the papers that were published in the Journal of Veterinary Internal Medicine during 2015. Remember that this journal is now freely available via open online access.

    The papers I mention are as follows:

    Van Meervenne SAE, Volk HA, Van Ham ML. Association between Estrus and Onset of Seizures in Dogs with Idiopathic Epilepsy. J Vet Int Med 2015. 29(1):251-253.

    Hoehne SN, Hopper K, Epstein SE. Accuracy of Potassium Supplementation of Fluids Administered Intravenously. J Vet Int Med 2015. 29(3):834-839.

    Fullagar B, Boysen SR, Toy M, et al. Sound Pressure Levels in 2 Veterinary Intensive Care Units. J Vet Int Med 2015. 29(4):1013-1021.

    Hu H, Barker A, Harcourt-Brown T, Jeffery N. Systematic Review of Brain Tumor Treatment in Dogs. J Vet Int Med 2015. 29(6):1456-1463.

    Goggs R, Dennis SG, Di Bella A, et al. Predicting Outcome in dogs with Primary Immune-Mediated Hemolytic Anemia: Results of a Multicenter Case Registry. J Vet Int Med 2015. 29(6):1603-1610.

     

    ...and don't forget my SMALL ANIMAL EMERGENCY MEDICINE APP FOR IPHONE AND IPAD - Android version in development!

    37 min
  • Managing Dog Bite Injuries

    **Apologies for the less than optimal sound quality of this episode and the non-stereo recording!**

    Dog bite injuries are a relatively common problem to be faced with in small animal practice. In this episode of the podcast I am joined by Nicola Kulendra, a European specialist in small animal surgery, to discuss their management. Some of the points we discuss include:

    • Adhering to standard ECC principles in terms of initial stabilisation and analgesia
    • The mechanics of dog bites and the ‘tip of the iceberg’ concept
    • Exploring bite injuries to uncover their true extent; the role of diagnostic imaging
    • The importance of wound drainage
    • Bacterial involvement and the use of antimicrobials
    • The ‘two hit theory’ in cats with moderate-to-severe dog bite injuries
    • The ‘big dog, little dog’ phenomenon

      • iPhone/iPad users see HERE for my Small Animal Emergency Medicine app for iOS; Android version is in development.

       

      [This podcast is closely aligned with the MedEdLIFE Research Collaborative’s Quality Checklist for Podcasts.]

      1 hr
    • Patient Handovers/Rounds

      In this episode I am joined by Liz Hughston and Charlotte Rosenthal, both specialist ECC nurses from the USA, to discuss patient handovers/rounds.

      We start with a brief introduction to both my guests and then go on to discuss questions such as:

      • What is the basic purpose of handover?
      • Separate rounds for nurses and vets, or combined?
      • Strategies for doing an efficient and effective handover
      • Keys bits of information to communicate

        • This is the first episode in this podcast series to feature guests - please let me know what you think!

        Twitter: @VetEmCC

        1 hr 1 min
      • Acute liver failure

        Dogs and cats with acute liver failure may present as emergencies and be critically ill. In this episode of the podcast I discuss this condition based on a recent review article from the Journal of Veterinary Emergency and Critical Care*.

        (*Weingarten MA, Sande AA. Acute liver failure in dogs and cats. J Vet Emerg Crit Care 2015. 25(4):455-473.)

        Topics covered include:

        • Injury versus failure
        • Causes
        • Clinical findings
        • Diagnosis
        • Treatment including managing complications
        • Prognosis

          • Click Here For Your FREE Copy of a Transcript of This Episode

          For SHOW NOTES visit the website HERE.

          34 min
        • Early Approach to Dyspnoeic Cats, First Do No Harm!

          In this episode of the podcast I discuss an approach to the early management of dyspnoeic cats that is predicated on ‘first do no harm’ and thinking risk-benefit at all times. The main take-home messages from the episode are:

          • Appreciate that dyspnoeic cats can be very vulnerable and easily tipped over the cliff edge.
          • Even more so than normal, pay acute attention to the risk-benefit assessment at all times.
          • Understand that each cat is clearly going to be an individual patient with their own set of circumstances and behaviour, but that a hands-off, slow, staged approach is likely to be the least risky and most beneficial in most cases.
          • Continue to improve your ability and confidence in examining these cases paying attention to trying to anatomically localise the cause of the dyspnoea; this will allow you to make the most sensible decisions in terms of how to help the patient.
          • Don’t be in a hurry to x-ray dyspnoeic cats until and unless you feel like you have done all you can to make them as stable as possible beforehand.
          • And, lastly engage more with POCUS, point-of-care ultrasound, if you are not already.

            • Click Here For Your FREE Copy of a Transcript of This Episode

            For SHOW NOTES for this episode click HERE.

            41 min
          • Journal papers: PORV in dogs, Lactate in cats, and 'All in a tangle'

            In this episode of the podcast I discuss two papers from the Journal of the American Veterinary Medical Association in 2015. The first is on post-operative regurgitation and vomiting (PORV) in dogs and the second is on lactate in cats. To end the podcast I mention a letter-to-the-editor case report from Veterinary Anaesthesia and Analgesia, also in 2015, which describes a complication of oesophagostomy tube placement in a cat with a cuffed endotracheal tube.

            For abstracts and references, visit the website HERE.

            Click Here For Your FREE Copy of a Transcript of This Episode

            30 min
          • A Critical Patient Daily Checklist

            Critically ill patients almost by definition have a number of different problems and management considerations. They can be high maintenance requiring intensive care and it is easy to accidentally overlook different aspects of their care; this is especially the case when you are looking after more than one critically ill patient and/or working in an otherwise busy practice environment. 

            Using some form of checklist on a daily basis is a quick and easy way of being reminded of all the different aspects of the care of critically ill patients and hopefully minimises how often treatment considerations are overlooked and sub-optimal care provided.

            In this episode I discuss my version of a daily checklist for critically ill patients including aspects such as monitoring, analgesia, nursing care and non-clinical considerations.

            To download a COPY OF THE CHECKLIST for free and a TRANSCRIPT of the episode. visit the website HERE.

            You can also get a copy of the checklist by directly going to this link.

            Click Here For Your FREE Copy of a Transcript of This Episode

            32 min
          • The Shock Index in Veterinary Patients

            The shock index is equal to heart rate divided by systolic arterial blood pressure. It has received a fair amount of attention in the human medicine literature being evaluated for example in haemorrhagic hypovolaemic shock, especially post-traumatic, sepsis and obstetric patients, and for correlation for example to length of hospital stay and mortality. There is very little clinical veterinary information on the shock index.

            In this episode I discuss what the shock index is, the parameters that are included in the shock index, the potential value of the shock index, some of the human medicine studies, and the following two canine studies:

            Porter A, Rozanski E, Sharp C, et al. Evaluation of the shock index in dogs presenting as emergencies. J Vet Emerg Crit Care 2013. 23(5):538–544.

            Peterson KL, Hardy BT, Hall K. Assessment of shock index in healthy dogs and dogs in hemorrhagic shock. J Vet Emerg Crit Care 2013. 23(5):545-550.

             

            For show notes for this episode and a full list of all papers that informed or were mentioned in this episode, see HERE.

            Click Here For Your FREE Copy of a Transcript of This Episode

            49 min
          • Steroids and Shock!

            Whether or not steroids should be used in shock has been an on-going debate for many years. In this episode I discuss some of the literature, in particular relating to the use of steroids in septic shock, and the concept of ‘relative adrenal insufficiency’ – more recently referred to as ‘critical illness-related corticosteroid insufficiency’ (CIRCI).

            An episode summary is as follows:

            Use of steroids in shock in general is not recommended unless that patient happens to have a steroid-responsive disease as the cause of their shock; this is rare.

            • ‘Low dose’ or ‘physiological’ steroids can be used in patients with septic shock – or other critical illness – that is refractory to fluid resuscitation and exogenous catecholamine use; many veterinary practitioners may not have access to vasopressor/inotropic agents.
            • A positive response to low dose steroid use suggests the presence of CIRCI
            • Hydrocortisone is typically suggested; dexamethasone may be less preferable but can still be used

              • ***Much remains to be clarified about this in human and especially veterinary medicine in terms of which patients are the best candidates, when to start steroids, what protocol to use and so on.***

              This episode is in part derived from:

              Burkitt Creedon JM. Controversies surrounding critical illness-related corticosteroid insufficiency in animals. J Vet Emerg Crit Care 2015. 25(1):107-112.

              For SHOW NOTES of this episode including a full list of all papers that informed or were mentioned in this episode, see HERE.

              Click Here For Your FREE Copy of a Transcript of This Episode

              44 min
            • Canine Haemoabdomen - Part 2

              This is the second of a two-part mini-series on canine haemoabdomen loosely based around the following review article:

              Herold LV, Devey J, Kirby R, Rudloff E. Clinical evaluation and management of hemoperitoneum in dogs. J Vet Emerg Crit Care 2008. 18(1):40-53.

              If you have not yet listened to Part 1, please do before listening to this episode!

              Points discussed in this episode include:

              • Improving and maintaining oxygen-carrying capacity
              • Arresting haemorrhage
              • Autologous transfusion (cell salvage)
              • Abdominal counterpressure

                • For SHOW NOTES of this episode click HERE.

                Click Here For Your FREE Copy of a Transcript of This Episode

                36 min

              About Veterinary ECC Small Talk

              From the publisher's feed

              Small talk and jibber jabber about small animal (canine, feline) Veterinary Emergency and Critical Care (ECC). Hosted by ECC specialist Shailen Jasani, Diplomate of the American College of Veterinary…