This section of the website is dedicated to bringing you news, interesting cases, and random musings of interest to veterinary professionals. AG = Alex Gough, AHM = Alasdair Hotston Moore, and LG = Lisa Gardbaum.
16.3.10
Congratulations to Rosemary Lodge Veterinary Hospital, which was nominated in the prestigious PetPlan awards in the category of Veterinary Practice of the Year, and to Alex Gough who was nominated in the category of Vet of Year. The nominators are anonymous, so thank you whoever you were!
12.10.09
I have recently started using the new drug Masivet (ABScience) for mast cell tumours in cats and dogs and have been very excited about the potential of this new drug. We have had two cases of inoperable mast cell tumours, one of which recurred despite a course of vinblastine and prednisolone, which have responded dramatically to Masivet. It is the first drug registered for the treatment of cancer in veterinary medicine. The active ingredient is Mastinib a tyrosine kinase inhibitor. With mast cell tumours (MCTs) it inhibits the tyrosine kinase c-kit receptors on mast cells inhibiting migration, growth and differentaiation of mast cells. It has been shown to be very effective in treating grade 2 or 3 MCTs that are non-resectable, incompletely resected or that recur after surgery in preventing recurrence and slowing progression. It is licensed for use in dogs at 12.5mg/kg/daily although toxicity studies have shown it to be safe for use in cats at a dose of 10mg/kg/day. They come in 150mg and 50mg tablets sizes. Possible side effects include hypoalbuminaemia seconday to proteinuria, haemolytic and non-regenerative anaemia, AST/ALT elevations and neutropaenia and it is advised to monitor for these monthly. Occasional vomiting or inappetence as a result of histamine release can occur at the onset of treatment but the concurrent use of anti-histamines may prevent this. This drug may have a future role in the treatment of other tumours such as T-cell lymphoma !! LG
12.10.09
I have now been working at Bath Vets for 6 weeks and have been very pleased with how quickly I have settled in and the range of cases presented to me. My own interests in soft tissue surgery are wide and the case load reflects this, with both the "bread and butter" of soft tissue referrals (TECA, tie backs, oral masses etc.) and the more unusual (chylothorax, congenital and acquired portosystemic shunts and so on). I am particularly interested in the application of minimally invasive surgery (in appropriate cases) and since the kit arrived ten days ago we have performed three laparoscopies, one thoracoscopy and three urethrocystoscopies. The last of these was for urinary incontinence and revealed bilateral ectopic ureters. The images were fantastic and this technique continues to hold the wow factor for me in diagnosis: I'll post the video shortly and put the link to it from here for you to enjoy with me!. AHM
7.10.09
A visit from an old patient was a pleasant surprise today. Molly, a lovely 18 month old Springer Spaniel presented to me 6 years ago with severe acute anuric renal failure. She had been given a very poor prognosis from another referral centre, but the owners and referring vets wanted to give her a chance. Conservative treatment having failed to restore urine output, Molly underwent peritoneal dialysis. After 2 weeks of intensive treatment, Molly went home. There was still a question mark over whether there had been any permanent kidney damage, but she seemed happy at follow up 6 months later. Seeing her today, as a bright healthy 8 year old, who had had no further problems apart from a scary encounter with a tractor, was a very rewarding experience. AG
1.10.09
Well the summer has been hectic. The new hospital has opened, Alasdair our new surgeon has started, Alex passed his PGCert in neuroimaging, we have had an open day, Alex has finished the second edition of his breed book, and oh yes, we have been pretty busy clinically too. It's excellent having Alasdair on board full time now, able to operate straight away on medical cases that turn surgically, and he seems to be enjoying private practice too. Will try to update the blog a bit more often as life becomes hectic. Thank you though to all our clients and referring vets for keeping us so busy.
1.6.09
After about a year's hiatus, issue 2 of the Veterinary Clinical Digests is now available. This is a review of interesting papers (at least I think they are interesting) that I have dug out of recent Wiley-Blackwell journals, and the site offers free access to the full version of the papers I have reviewed. Check it out at http://www.veterinaryclinicaldigest.com/ AG
19.5.09
The vetsurgeon.org website turns out to be a major time drain - some very interesting debates, um, raging probably wouldnt be too strong a term. A colleague asked me to participate in a debate on raw food diets to discuss some claims that were being made regarding renal disease. I was drawn into the full debate on the pros and cons of a raw food diet, and while trying to remain open-minded about the debate, there appeared to be a distinct lack of, or reluctance to provide, evidence for the safety and improved survival time of a raw food diet. It is an interesting debate though, and one that might be worth reading for yourselves. You can make up your own mind whether the current level of evidence is enough to suggest that a potential increased nutrient level in raw food, eg in taurine levels, outweighs the possible risk of a bones and raw food diet such as ingestion of pathogens, many of whcih are zoonotic, and oesophageal and intestinal obstructions. AG
12.5.09
Back from a short tropical holiday (where it rained a lot) to find that my colleagues had coped perfectly well with out me! Busy again now. We seem to be seeing a FIP epidemic amongst our first opinion caseload for some reason, are other people seeing that or is it just a statistical blip?
The BSAVA have asked me to re-review their website after my slightly negative review of their older site. The new site is much improved I am happy to report. My new review can be found on this website in the Website Review section. AG
23.3.09
Two cases last week that were neurological and masquerading as other conditions. One was an elderly cat that frequently licked its lips and chomped its jaws. Oral or dental disease was a possibility, but there was also an episode of collapse, and corneal and palpebral reflexes were absent. MRI sadly a brain mass, suggesting the chomping was a partial epilepsy, but there was no response to phenobarbitone and dexamethasone, and sadly this case was euthanased.
The second case was a young Cavalier King Charles that was totally normal except for compulsively scratching its lower mandbile. Stimulation of the mandilbe produced a pronounced itch-scratch response. There was no evidence of dermatological disease. This isn't typical of my experience of syringomyelia, which normally involves neck scratching,but given the breed and age, MRI scan of the neck was performed and sure enough syringomyelia was present. Treatment has been commenced with gabapentin. AG
11.3.09
The website is now live. Enjoy browsing, and if you have any queries or think of anything you would like to see here, let us know.
We have been musing on some interesting cases recently. One case is a young cat with a chronic hypercalcaemia due to hypervitaminosis D, despite lack of toxins (rat bait and psoriasis cream can contain vitamin D) or granulomatous disease (which can also increase vitamin D levels within the blood stream due to increased production from the macrophages). We are speculating that there is some inborn/genetic error of vitamin D metabolism that has been reponsible for this condtion.
Another interesting pair of cases that we have seen over the last few months include two dogs with two different co-existing autoimmune diseases. The first was a young Viszla with neck pain and pyrexia. MRI of the brain and neck were unremarkable, but the masticatory muscles showed hyperintensities suggestive of inflammation. Muscle biopsies showed masticatory myositis, whicle CSF analysis showed meningitis. Infectious causes were ruled out, and a good response was seen to immunosuppressive doses of steroids. The second case was a young Springer which presented with a dropped jaw and masticatory muscle atrophy. Trigeminal neuritis would be a common cause of this presentation, but muscle biopsies again showed masticatory myositis, and CSF again showed meningitis. Again infectious causes were ruled out, and the dog is starting to respond to immunosuppressive doses of steroids. A brief literature review has not identified other reports of these conditions co-existing. Fortunately the treatment for both conditions is the same!
9.3.09
Putting the finishing touches to the BVR website. Hopefully it will go live soon. Our aim with this website is to not only provide easy to access information regarding our referral service, but also provide information for veterinary professionals and interested members of the public regarding the management of certain diseases, discussing the latest research literature, and sharing some interesting cases. We hope you find the site interesting. Any comments, please feel free to email us at contact@bathvetreferrals.co.uk. AG