Veterinary Clinical Podcasts

Today we talk to Jo Hedley, Lecturer in Exotic species and small mammal medicine and surgery here at the RVC about an approach to common problems with backyard chickens. Covering routine healthcare (vaccinations and anti-parasite medications) and an approach to birds presenting that have been bitten by a fox, sour crop, breathing problems and issues with egg laying. A little vignette to get you started if it has been a while since you last saw a backyard chicken.   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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 Jill Maddison, Professor of General Practice and has an international reputation from pharmacology to clinical problem solving. Currently the chair of the World Small Animal Veterinary Association Continuing Education Committee. We could have talked about anything such is the breadth of her knowledge and understanding, though we chose to talk about clinical reasoning. Enjoy. Define the problem Refine the problem Define and refine the system Define the lesion   https://www.amazon.co.uk/d/cka/Clinical-Reasoning-Small-Animal-Practice-Jill-Maddison/1118741757 (other retailers are available)     If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

This is the second part of the podcast talking to Dr Patrick J Kenny. Pat was a senior lecturer here at the RVC lecturer in veterinary neurology and neurosurgery, though has recently returned home to Sydney. We talk to Pat about an approach to spinal trauma, the Do’s and Don’ts, what imaging to perform and how to immobilise a patient. We pick up shortly after we were side tracked talking about steroids.   Immobilisation Primary survey (ABC’s, or major body systems) Oxygen Check for deep pain Analgesia Secondary survey Focus on maintaining blood pressure and keep up with oxygenation Diagnostic imaging – survey radiographs and CT        If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Dr Patrick J Kenny. Pat was a senior lecturer here at the RVC lecturer in veterinary neurology and neurosurgery, though has recently returned home to Sydney. We talk to Pat about an approach to spinal trauma, the Do’s and Don’ts, what imaging to perform and how to immobilise a patient.   Immobilisation Primary survey (ABC’s, or major body systems) Oxygen Check for deep pain Analgesia Secondary survey Focus on maintaining blood pressure and keep up with oxygenation Diagnostic imaging – survey radiographs and CT       If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

We catch up again with Charlotte Dawson, lecturer in ophthalmology here at the RVC, to ask her about her tips and tricks from an array of ophthalmological presentations and conditions.       If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Kate English, lecturer in clinical pathology here at the RVC. From tips on blood collection and how to smear, to how you interpret the results. Listen and enjoy! We’re not suggesting that after you listen to this podcast that you will be able to look at a blood smear and guess the PCV, but you will listen to someone who does!  If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

42 Ophthalmological examination   In our 42nd podcast we might not uncover the mysteries of life the universe and everything, though we do have the opportunity to refresh our approach to ocular examination with Charlotte Dawson, lecturer in ophthalmology here at the RVC. It was Jeff Smith who taught me ophthalmology in Sydney, who said more is missed by not looking than not knowing. To be fair he might have borrowed that from Thomas McCrae, one of the forefathers in post graduate medical education, though it is still as pertinent now as it was then.   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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 Elsa Beltran, one of our fabulous senior lecturers in neurology and neurosurgery here at the RVC about traumatic brain injury.  Initial assessment, tools that we can use to grade injury and see if there is an improvement or not, when to think about diagnostic imaging, and more. We’d loved talking to her and am sure you will get a lot out of it.Some papers of interest including Elsa’s paper on the use of MRI in Traumatic brain injury;https://www.ncbi.nlm.nih.gov/pubmed/22063205https://www.ncbi.nlm.nih.gov/pubmed/22063206http://onlinelibrary.wiley.com/doi/10.1111/jvim.12368/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2001.tb01594.x/abstractIf you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Elvin Kulendra, lecturer in orthopaedic surgery here at the RVC about coxofemoral luxation in dogs.  The most common luxation in dogs and the majority are related to trauma. Elvin talks about initial assessment, the major body systems, and gait and neurological function, which radiographs to take and steps on how to perform a closed reduction, which should be successful 50% of the time (higher in cats). Allegedly there are 20 ways to perform an open reduction, though we don’t talk about all of them. Cage rest regardless of reduction technique for at least 4 weeks, lead walking only (no jumping, stairs etc).   A review on coxofemoral luxations: https://www.ncbi.nlm.nih.gov/pubmed/15943127     If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Joe Fenn, lecturer in veterinary neurology and neurosurgery here at the RVC about presentation and management of acute vestibular disease. There might be a couple of references to wittertainment, though it’s mainly about vestibular disease. Enjoy.   Here are a couple of links if you’d like to read more on vestibular disease: https://www.ncbi.nlm.nih.gov/pubmed/22847320 https://www.ncbi.nlm.nih.gov/pubmed/22847321   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Dr Rosanne Jepson, lecturer in internal medicine here at the RVC about blood pressure in dogs and cats.   Hypotension, hypertension and everywhere in between. How, with what, where and why to measure. Are we underestimating, overestimating with different techniques? Cuff size and repeatability of readings. Do your patients have ‘white coat’ hypertension? Tips and tricks, if you are regular user, or it is something that you are wanting to bring in more to your practice. Enjoy the pod.   Here are some links: Consensus statement from ACVIM published in 2007, https://goo.gl/bmtxuP though we believe will be updated soon IRIS http://www.iris-kidney.com International Renal Interest Society, a great resource.     If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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.

In this podcast, we talk to Tom Cardy, staff clinician in neurology and neurosurgery here at the RVC about the ‘Rule of Six’, or the ‘Six Finger Rule’ (which has no bearing on Count Rugen or indeed Inigo Montoya). It is a clever process used to teach clinical reasoning in canine spinal disease, in six steps.   Signalment Onset Deterioration Pain Asymmetry Neuroanatomical localisation   Here is the link to the paper published in the Veterinary Record in 2015 http://veterinaryrecord.bmj.com/content/early/2015/07/21/vr.102988   Tools and mnemonics that make our day to day life easier are always warmly welcomed!   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; 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 dbarfield@rvc.ac.uk; 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.·      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 dbarfield@rvc.ac.uk; 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 dbarfield@rvc.ac.uk; 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.