For any of you who missed out on this fantastic, case based discussion on treatment of metacarpal and metatarsal fractures, click the link below!
Surgical Rounds with Dr Alen Lai
May 1st, 2020Dr Alen tells us all about the “ins and outs” of elbow luxation. By the end of this session you will be prepared to perform and closed reduction, and know the next steps if closed reduction doesn’t work!
Surgical Rounds 8pm Monday 27th April
April 26th, 2020Dr Alen Lai will be presenting all his hints and tricks for diagnosing and managing elbow dysplasia. Join us via zoom on the following link –
Join Zoom Meeting
https://zoom.us/j/92304501148
Meeting ID: 923 0450 1148
Clinical Practice
January 24th, 2019Getting 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.
Technology
January 15th, 2019SUB Systems
We are seeing a run of ureteral obstructions in cats! Blocked Ureters are becoming more and more common, likely due to a combination of better detection and increasing incidence of calcium oxalate stones due to diet trends. We have been placing artificial ureters (subcutaneous ureteral bypass, or SUBs) in several cats recently, all of them going very well. Typical presentation is vomiting +/- anorexia, and a palpably enlarged or painful kidney (right more common than left). Some cats do not become azotaemic as their other kidney is still functional, so may go undiagnosed. Ultrasonography by someone trained to observe renal pelvic dilation and ureteral distension is sufficient to diagnose this, and the recommendation is usually to place a bypass as medical management fails in 85% of patients.
In the News
January 11th, 2019Rethinking Age of Desexing
What age should we be desexing dogs? Well, that’s controversial. The AVA recommend desexing somewhere between 4 months and 1 year of age, at the vet’s discretion. Below is a great summary of the impact of desexing (Goh, Compendium August 2016 – the full article is free to access at the Compendium website) – Longevity is increased in desexed dogs, but we can see that it predisposes to a number of other conditions. My approach is very breed dependent – For example, Dachshunds desexed early (<12 months) have double the risk of intervertebral disc disease than late desexed dogs, so I would recommend between 12 – 18 months for them.
Cruciate ligament disease is more common in large breed dogs desexed at <6mo, so I would delay to 12 months. The trend towards desexing females at 6 months of age was due to the increasing risk of mammary tumours with each oestrus cycle (Schneider et al, 1969), which has been challenged in a recent publication which suggests desexing females at <2.5y rather than before oestrus onset) (Bronden et al, Vet Rec. 2010). There are several papers available referring to individual breeds, their predispositions and the recommendations for desexing.
#foodforthoughtfriday
Technology
January 8th, 2019Ultrasound vs. CT in Large Dogs
Have you ever tried to ultrasound a large breed dog, and just felt like you’re missing something up under the ribs? Us too… all the time, even with the best of the best probes. Abdominal CT in sedated dogs has recently been found as significantly better at detecting mass lesions than Ultrasound in dogs > 25kg. In addition, we get information on surrounding muscle and bone, and if there is a mass, a quick “met-check” CT of the thorax is easy, and cheaper than adding on radiographs. We may be suggesting this in large or deep chested dogs as an alternative to ultrasound, and option of doing under sedation rather than GA will bring the costs down too. #technologytuesday
Fields et al, Vet Radiology and Ultrasound, 2012.
