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24 HOURS PER DAY, 7 DAYS A WEEK in case of emergency

Tracheal Collapse

March 26th, 2020

Up to 71% of dogs with tracheobronchial collapse can be successfully managed with medications for more than 12 months* . Where medical management is no longer sufficient, tracheal stenting should be considered and is a viable option for relieving life threatening airway obstruction and can significantly improve quality of life. Tracheal stenting offers a high survival rate, even in those patients with severe clinical signs. The internal medicine service offers assessment of cases for tracheal stenting and this procedure can be performed on-site.

* White R, Williams JM. Tracheal collapse in the dog-is there really a role for surgery? A survey of 100 cases. J Small Anim Pract 1994;35(4):191–6.

Diabetic Cats

March 24th, 2020

The factors which increase the chances of achieving diabetic remission in cats include:

  • Low carbohydrate diet
  • Long acting insulin eg glargine
  • Older age
  • Early institution of tight glycemic control
  • Recent steroid administration
  • Absence of diabetic neuropathy
  • Lower serum cholesterol concentration

The protocol for achieving diabetic remission needs to be matched with the right owner. If you have a newly diagnosed diabetic cat case, consider referral to the internal medicine service of NVS for discussion as to whether the cat and owners are good candidates for a diabetic remission protocol.

Hypothyrodism – When Will Clinical Signs Likely Resolve?

March 17th, 2020

When treating hypothyroidism in dogs, it is important to set realistic time frames for resolution of clinical signs. As a rough guide, clinical signs should respond within the following timelines with appropriate treatment:

  • Mentation and activity = 2-7 days
  • Lipaemia and other clinical pathologic changes = 2-4 days
  • Dermatologic abnormalities = 2-4 months
  • Neurological abnormalities = 1-3 months
  • Cardiac abnormalities = 1-2 months
  • Reproductive abnormalities  = 3-10 months

Masticatory Myositis

March 12th, 2020

When presented with a possible case of masticatory myositis, it is important to remember there are two potential presentation types: acute and chronic forms.

Clinical signs associated with the acute form include:

  • Fever
  • Regional lymphadenopathy
  • Muscles of mastication swelling which are painful on palpation
  • Exophthalmos
  • Resists or unable to open the mouth

Clinical signs associated with the chronic form include:

  • Atrophy of the masticatory muscles
  • Muscle swelling/atrophy can be asymmetric
  • Enophthalmos
  • Inability to open mouth fully

Steroid Responsive Meningitis Arteritis

March 10th, 2020

We are learning more and more about steroid responsive meningitis arteritis (SRMA). This article published in JSAP (2019) by Spence et al. highlights that a significant number of dogs with SRMA also had cardiac abnormalities, including decreased fractional shortening, increased left ventricular dimensions, spontaneous echocontrast, pericardial effusions and increased cardiac troponins. Most of these abnormalities resolved with appropriate treatment for SRMA. However, in some cases where there was a clinical response noted for neck pain etc, the change in fractional shortening and left ventricular dimensions did not always resolve.

Platelet Rich Plasma (PRP) Therapy Now Available at NVS!

January 23rd, 2020

Platelet Rich Plasma (PRP) Injections have gained popularity in the human-world in the last few years – perhaps you’ve even had one yourself for a torn ACL, rotator cuff injury, tendinitis, or the like.

These injections have shown huge potential for our patients as well, particularly in the management of osteoarthritis, or tendon or ligament injuries. Northside Vet Specialists are excited to announce that we are now able to provide this therapy in hospital. The procedure is relatively quick, safe, and very effective.

If you have any questions, or have a patient that you feel would benefit from this procedure, please have a chat to a member of our surgical team on 9452 2933!

Video Capsule Endoscopy Now Available at NVS!

January 21st, 2020

Working up gastro-intestinal disease can be incredibly frustrating, but especially so in pets with co-existing problems that make anaesthetic procedures higher-risk.

Often we would recommend endoscopy to directly visualise the stomach and intestines, and potentially take biopsies at the same time. In higher-risk patients however, a less-invasive option would allow us to see the gastro-instestinal tract, and make an informed decision about whether a more invasive procedure is warranted. Enter video capsule endoscopy. This pill-sized capsule contains multiple cameras that take thousands of pictures as it makes its way through the body. No anaesthetic required- we just give the capsule by mouth, and wait for it to reappear…

:wink:

Capsule endoscopy is a great option for those cases where either the patient or the client would benefit from a low-risk, stepwise approach to diagnosis.

If you have any questions, or have a patient that you feel may be a candidate, have a chat with a member of our Medicine team! 9452 2933

Clinical Practice

January 30th, 2019

What Antibiotic Do I Use For…?

What antibiotic should I be using with suspected infectious cholangiohepatitis in dogs?

The most common bacterial infections of the liver ascend through the biliary system from the duodenum, and include Staphylococcal spp, E coli, and Clostridia. Good old Amoxycillin clavulanate at 20mg/kg BID would be an ideal choice to cover these most common organisms. If I am not seeing a response (resolution of pyrexia, reduction of liver enzymes), I get suspicious that this may not be a bacterial infection and consider liver biopsy / bile cytology and culture, and recommend further testing before escalating antimicrobial coverage.

Choices, choices..

Clinical Practice

January 24th, 2019

Getting to the Bottom of Anal Sacculitis

I have actually had buckleys success treating culture positive anal sacculitis with systemic antimicrobials – the more you give, the more resistant the bacteria are in there – but they are always in there…

The best medical success I have had is flushing weekly for 4-6 weeks and instilling a topical antibiotic + cortisone into the gland. I just thread a 22g catheter (without stylet!) into the duct, and attach a saline syringe and flush. My favourite ointment to instil is Panalog, but if you can’t get that either chloramphenicol + a cortisone-containing ophthalmalogic preparation seems to do the trick. I’ve also sucessfully used manuka honey a few times, but you have to use a big catheter because it’s so thick!

Regarding when to go to surgery: If the anal sac feels large and flaccid after a couple of flushes, I usually take them out. If they are full and feel like they have good tone, I tend to persist with medical managment.

Clinical Practice

January 10th, 2019

NSAID’s in CRF

The relationship between NSAIDs and chronic renal failure is a bit tricky. We know they can cause acute renal injury but the association with CRF is not as clear. Cats with CRF treated with meloxicam have a longer life expectancy than those not treated as they are euthanised for their OA!

In some patients with stable stage 2 CRF we recommend NSAIDs for OA management, but monitor renal parameters two weeks after starting, then three monthly ongoing. It is important to educate owners that dosing when dehydrated may trigger acute renal failure, so it is best they contact you for alternative pain management strategies if their kitty is unwell.