APR. 2021
The Webinar Gazette
INSIDE THIS ISSUE: News From Our Community CPDer Of The Month Speaker Of The Month David's Reviews From The Literature Jane's Blog
Introduction from Anthony Chadwick The Webinar Vet, CEO I'm writing this on a sunny March morning in my spacious dining room listening to John Denver. He is a very old favourite. I also decided to put some sunny attire on to keep my spirits up. It was sad to celebrate the lockdown anniversary yesterday with so many lost over the last 12 months. However, there is room for optimism. The sun is shining; days are getting longer and the vaccine rollout is moving quickly. I got my own vaccine about 10 days ago. I know.... you can't believe I'm that old! However, I'm 55 later this week- where did all that time go? Life moves fast doesn't it? We must love the life we live and live in the present moment. The pandemic has re-affirmed for me that you do not know how long you have on the earth!
Ben Sweeney left Simply Vets a couple of months ago and I am keen to put some focused energy into the company over the next 3 months. For this reason, Kathryn Bell, my COO, will move up to acting CEO for the next three months. I will still be hosting webinars but won’t be as involved in the day to day running of The Webinar Vet, WikiVet and Conference Virtually... Simply Vet has been offering a fabulous payroll option for those affected by IR35 which has proved very popular with locum vets and nurses. We are bringing our values of quality and service to how we will run the payroll service for the benefits of our members including the practice managers who would otherwise have to deal with the onerous payroll duties. I’ve recorded a short YouTube video for you to watch https://www.youtube.com/watch? v=_cCKsJ_Jgnk. Please contact Joe Quantick at joe@simplylocums.co.uk if you want to Our new financial year begins on 1st April (I’m
understand what we have to offer.
not joking!). Our theme for this year is: "Building a Regenerative Veterinary World." I've been a
Last year was a very tough year but I was so
committed environmentalist all my life and it's
proud of my team who have been able to support
great to see the veterinary world embrace solid
our great profession in these trying times. I was
eco principles with groups like VetSustain and
so pleased we could step in and help so many
VetOffset and Eco Offset. It's also good to see
conferences that would have incurred huge
the main corporate groups taking their
losses cancelling their physical conferences. We
environmental responsibilities seriously.
helped the World Veterinary Assoc Congress in
Obviously, The Webinar Vet has taken many
Auckland in April and The World Congress of
million travel miles off the roads and airways
Veterinary Dermatology in Sydney in October.
through the last 11 years. In fact, we were
WCVD9 was my highlight of the year. I’ve been
awarded Silver status from the Investors in the
attending the world congress since 1996 in
Environment last year which was a huge thrill
Edinburgh, so it was a huge thrill to bring the
and we’ve been hosting webinars for IiE and
content to many of my derm colleagues in a
VetSustain over the last year.
virtual format. This year will also have its challenges and I’ve
However, this year, we will also be planting 2
just heard we will help the European Society of
trees for every new full member of The Webinar
Vet Derm to take their congress virtual as well. I
Vet. It’s my belief that we must act decisively
was looking forward to visiting Porto in
over the next five years to stop the world
September, but it is not to be. My hope and
deteriorating into a very dangerous position.
prayer is that this year will be one where we can
The pandemic started in a meat market where
put the painful past behind us and see a new
animals and nature weren’t treated with respect.
normal which will be kinder to our planet and
We must begin to realise that we are not
we’ll be kinder to each other.
masters of our own fate but are interconnected in a world of vast orchestrations. I hope you will
HAPPY EASTER!
join us on our journey. All of our small actions can add up!
Anthony
News From Our Community Introducing our new Head of Memberships Having Joined The Webinar Vet in September 2020 I am delighted to have the opportunity to lead our fantastic members team as Head of Membership and thought it was high time I introduce myself to you all. I started my life (let’s face it it’s much more than a career) in the Veterinary industry 15 years ago as a SVN in a mixed practice in North Wales. Like many I had a passion for animals driving me, but over my 8 years in practice it was my interactions with the clients which gave me job satisfaction, though I probably did not understand this aspect of my own behaviour until I was studying for my animal behaviour degree and had actually left practice. It was natural for me then to pursue a customer focussed role and so I transitioned into Sales. I worked with Pet nutrition initially which had been a passion of mine as a nurse but before long I was caught up in the world of memberships when I became a business development consultant for Denplan Pet Health Plans.
I absolutely love to build lasting relationships with practices and offering them exceptional customer service. The same level of service I expect from every company I deal with as an individual – and I am a demanding individual! The only flipside of this is that I take any losses personally as if losing a longstanding friend (a bit of meditation with Mike Scanlon can always help to bring me out of it though).After 4 years in Pet Health Plans I sadly left my practices behind for some personal development – having my son Dylan. The demands of a young family required me to stop being out on the road and look for a job a little closer to home, so I spent 2 years developing a further understanding of membership processes with an online pet food subscription company.
Me in the early days as an RVN in practice (with my dog Cooper)
In all this time though I have never strayed from my RVN title and my continuation on the RCVS register has only been possible due to me keeping up to date with my CPD with The Webinar Vet. You can imagine then I jumped when an opportunity to work for The Webinar Vet arose. I’m so excited to use all I have learnt through my career in my new role as Head of Membership. I look forward to building those lasting relationships with you all and ensuring you are cared for and receive a high level of customer care and support from myself and all of the wonderful membership team. As an RVN I also have the honour of chairing some of our webinars – the first one being ‘Flipping the script on vet imposter Syndrome: why you’re more than ‘enough’ with the wonderful Katie Ford BVsC CERTAVP(SAM) PGCERT MRCVS on the 2nd of March – go and watch it ondemand if you haven’t already!
Me competing in Woof Mudder with my now dog Nala in 2019
CPDer Of The Month This month's CPDer is Darcy Herrity
"The Webinar Vet is an amazing learning platform. As a recent graduate I have gained so much knowledge and confidence in my own clinical cases thanks to the excellent lectures I have listened to over the past 12 months. A particular favourite of mine this month was ‘Feline Lower Respiratory Tract Disease’ by Danielle Gunn-Moore. This was an amazing lecture, easy to follow, with great tips to apply in practical scenarios. The Webinar Vet is an engaging and easy way to keep on top of CPD hours, especially during these uncertain times. Thank you so much to the entire Webinar Vet team! I look forward to further lectures, especially the upcoming ophthalmology lectures by Ron Ofri. "
Thanks so much! Darcy Herrity
The WINNER of our £500 VC2021 Associations Day sign up giveaway is...
Gemma Prophet! "The Webinar Vet has always offered fantastic value CPD, easily accessible and with varied, up to date topics. Not only that but they offer many CPD webinars free which is great to get CPD hours under the belt. One tonight that I unfortunately didn’t get home in time for, but that I wanted to watch, is then easily watchable at a later date as it is stored online. So handy. Thank you so much Webinar Vet, you really have made my week."
Congratulations, Gemma!
Speaker of The Month 50 % OFF DISCOUNT CODE:
SOTMApril
Dr Mike Scanlan
Mike worked as a Senior Lecturer in mental health at Northampton University and was a member of the IAPT education and training steering group. He is a member of the
Dr Mike Scanlan is the Director of Kind Minds Health and
Institute for Learning and Teaching in Higher Education.
Wellbeing and was responsible for setting up and designing
Mike regularly presents at IAPT conferences and has
the clinical model for the successful and award winning
published widely on the topic of primary care mental health.
‘Changing Minds’ Improving Access to Psychological
He has recently led the clinical development of a Court
Therapy (IAPT) service. He has also led the development of
liaison Mental Health Service in Milton Keynes and worked
the Northamptonshire Long Term Conditions Psychological
in 2015 to design and write the service specification for an
Therapy Service. Mike is trained to use Cognitive
IAPT equivalent service in Qatar. Mike is the author of the
Behavioural Therapy, Eye Movement Desensitization and
widely used and well-respected CBT guided self-help series
Response prevention (EMDR), Mindfulness and
of books entitled 'Moving Forward'. These books blend
Compassionate Focussed Therapy approaches. He has led a
theories of bibliotherapy with CBT principles. The books are
project supported by the Department of Health to illustrate
used in a number of IAPT services across the UK.
how telehealth principles can be utilised to deliver IAPT group therapy via videoconferencing to people with mental health problems with co morbid long-term conditions.
“EXCELLENT WEBINAR TO MAKE ONE FEEL WORTHY AGAIN DESPITE DEPRESSIVE TENDENCIES”
David's Reviews WEBINAR: RECOGNISING NON-ACCIDENTAL INJURIES (NAI) IN VETERINARY PRACTICE PAULA BOYDEN AND DAVE MARTIN
These two veterinary colleagues
There are 16 examples of abuse listed
between them have a wealth of
and then a further 17 examples of fatal
experience in this subject. Paula via
abuse, with another subsection on
her work as veterinary director of the
types of abuse-physical, sexual,
Dog’s Trust, as a longstanding member
emotional and neglect. As if the Royal
of the Links group, and with many
Family hasn’t been through enough
years of educating the next generation
negative press recently, we are shown a
of vets on this subject.
photo of a Royal threatening a gundog, some years ago, with a large stick-
Dave is an experienced veterinary
mainly in this presentation I think, to
surgeon from a mixed general practice
demonstrate the dog’s reaction.
background, with a specialty in legal matters involving animals, both as an
We move on to neglect cases, giving
expert witness for the prosecution
some obvious examples, and asking the
teams and defense teams.
question ‘What would a reasonable person do?’ Skip the next two slides if
This is not a veterinary webinar for
you are easily upset by willful neglect
the faint hearted. The very first case, a
and cruelty. It is a cat with an appalling
6-month-old Rottweiler, presented by
facial tumour - one that I remember
Paula, will completely shock you, as it
very well (the photos were taken by me
did me. But it will emphasise right
as were some others in this webinar).
from the beginning how important it is
Another one, a few slides later, shows
to take these cases seriously and the
an elastic band that has eaten into a
hour and a half that follows will give
dog’s neck. In between these a morbidly
you a very good grounding on how you
obese dog demonstrating that,
can do your bit to help prevent animal
although emaciation due to willful
(and human) suffering.
starvation is more common, it can also be the opposite due to ignorance on correct feeding.
Some diagnostic pointers used in human
This is followed by a discussion on the impact of
medicine to suggest the possibility of non-
Covid lockdown on humans and pets, before
accidental injury have been incorporated into
Paula ends the webinar with two relevant
virtually the same suggestions for pets as a result
statements. –
of work done by the Links group. Diagnostic pointers for NAI in pets are suggested:
1.When animals are abused people are at risk, and when people are abused animals are at risk
History inconsistent with injury
(attributed to Phil Arkow, 1996)
Discrepant history
2.To say nothing, to do nothing, stops nothing
Repetitive injury
(Roni McCall)
Behaviour of the owner/pet- remember the gundog’s reaction to the stick
There were plenty of questions in the live session, especially concerning breach of confidentiality
One of many tips in the webinar is to be very
and Dave always advises contacting the
suspicious of the word ‘fell’ in any statement. For
Professional Conduct staff of the RCVS, even if
example - ‘off the bed, down the stairs, off the
they don’t seem all that supportive. Pragmatically
sofa, balcony etc.’ More shocking photos follow,
he advises continue with the breach of
this time from Dave’s extensive collection,
confidentiality unless specifically advised not to.
beginning with a dog with cropped ears, and a
It seems that one problem with the RCVS staff
ridiculous story by the owner as to how this
that answer vet concerns is that the people
occurred-it warrants the comment- ‘Really?’
answering the calls are not necessarily vets.
We are now introduced to a complicated story of
Discussion leads on to a very useful last
four cats seen by various different veterinary
contribution from Dave explaining three sections
practices. All four cats suffered appallingly but
of the Animal Welfare Act. These are sections 4, 9
the story demonstrates how difficult it can be to
and 18, which are clearly explained but it is
diagnose physical abuse when confronted with
worthwhile watching the webinar, accessing the
devious owners. Getting this case to court
act and taking note of these specific sections if
involved a lot of detective work.
you come across a case of NAI.
It is recommended that practices have a protocol
This has been just a short review of this excellent
for dealing with suspect cases: -
extensive webinar that covers many aspects of NAI. The essential role of vets in supporting
Have an appointed practice Links adviser
animal charities in dealing with these cases,
Get to know your RSPCA/SPCA inspector
administering to and curing many of the animals
Keep good clinical notes
that fall victim, but also supporting the
Establish a support network, many examples
prosecution in court is clear throughout.
of which are given.
Hopefully it will encourage colleagues to look at forensic medicine as a specialty well worth
Further advice is given on reporting and
pursuing and encourage contacts with animal
breaching client confidentiality. There is clear
charity inspectors and colleagues in the Link
guidance on this from the RCVS (section 14
group. There is a fantastic amount of good to be
Client confidentiality from the RCVS Guide to
done in this, admittedly sometimes upsetting,
Professional Conduct.)
area of animal welfare.
There is a very good summary by Dave, who has a great deal of experience in this field, on giving evidence in court.
David's Reviews WEBINAR: SURVIVING YOUR FIRST WEEKEND ON CALL AS A FARM ANIMAL VET LUCY JERRAM B.SC. MVETMED DIP ECBHM MRCVS
I couldn’t resist this veterinary
18 items are listed with a head torch,
webinar. My first weekend on call in
spare lube (lots of), sterile surgery kits,
farm practice is etched in my memory,
scalpel blades and sedatives prominent
even decades later. And it was very
on the list.
stressful. This contribution from Lucy is thoughtful, often humorous and full
Non-essential items include keys in an
of common-sense advice to help
easily found place, snacks, chocolate,
reduce stress. She graduated from the
spare clothes and warm hats, a diary, a
RVC in 2014 having acquired an
positive mental attitude and finally
intercalated degree in genetics at
deep breaths! 18 essential farm
UCL. Since then, it has been farm
veterinary medications are also listed.
vetting all the way with a residency at
Nothing has been left to chance.
the RVC leading to diplomate status of the European College of Bovine
An interesting list, in the form of a poll,
Health Management. Her current role
asks ‘what worries you most about
at Endell Vet Group is as a general
being on call’. This came up with 10
farm vet, teaching RVC rotations, LED
possibilities. Curiously not many
liaison role within CVS and as a new
seemed to worry me on my first
graduate buddy. Once you have
weekend duty. Every time the phone
watched this webinar you will feel that
rang, I prayed that it wasn’t a prolapsed
any new graduate with Lucy as their
uterus or a difficult calving. At that
mentor and buddy will be very
stage my experience of both was zero. It
fortunate, and almost guaranteed, I
didn’t take long before my prayers were
would have thought, to flourish in
not answered, but for each of my main
practice.
worries I got excellent backup from senior colleagues.
The webinar begins with a list of key essentials for your vet vehicle, which needs to be organised.
Not surprisingly, from the list in the webinar ‘The
The ‘art of triage’ follows, although I suspect this
farmer thinking you don’t know what you are
is more relevant to a colleague with more
doing’ and ‘No one to call for help’ featured
experience and perhaps finding themselves on
prominently in the response from the live
duty alone. After a common sense list of the kind
audience.
of questions to ask you are given a mini-exam in the form of seven potential emergencies and
We get a very good indication of what an
asked to prioritise them.
excellent mentor and colleague Lucy is by the next slide. Before heading out on a call the new
The final part of the webinar in pictorial form
colleague is advised to call the farmer to get a
describes some common farm emergencies and
basic history, location check and estimated time
ends with a quote from Maya Angelou
of arrival. All fair enough but the next bit was inspiring. Phone your backup (who may or may
‘I’ve learned that people will forget what you
not be your mentor), arrange if/when they will
said, will forget what you did, but people will
join you (always when a caesarean is possible,)
never forget how you made them feel’
call on the way home/ and let them know when you get home!
I thoroughly enjoyed this webinar. It will be of value to all vets and final year students. For those
The next part was also very reassuring,
soon to enter the profession it will perhaps
consisting of nine top tips from farm vets and
change their thinking and encourage them to look
farmers. I liked the advice ‘It’s not an admission
at mixed or farm practice. For colleagues in farm
of failure to call for help. Farmers won’t think less
practice, it will put you in the shoes of new
of you if you do.’ Two highlighted bits of advice
graduates (in case you had forgotten) and give
emphasise this: -
some ideas on how you can support them even more. For senior partners having a Lucy in your
Even experienced vets call for backup. It’s not
team, or getting some inspiration from this
failing so don’t apologise to vet or farmer.
webinar, will go a long way to help retention and
As long as you are in a supportive practice
prevent burnout.
you will not be alone. It’s not surprising that Lucy’s non-clinical I also liked the advice on getting into a vein -
interests include mental health, wellbeing and
another one of my first few weeks worries. ‘If you
drop out within the profession, apart from
can’t find the vein on the first shot don’t panic.
providing mentorship to newer members of the
Breathe and re-direct, you’ll get it!’
profession. All this knowledge and enthusiasm-
Then there is a section on looking after yourself,
yet still only in her 7th post-graduation year-an
from feeding, to finding colleagues to talk things
inspiration to everyone!
through (let them cook you dinner!). One of the best meals I had ever had in my life up to that point was cooked by my fellow colleague’s wife-a cordon bleu cook. I can still remember that meal today! A nice reminder too was to put things in perspective. ‘Will it matter: Next week? Next month? Next year?
David's Reviews WEBINAR: THE SKIN BARRIER: A KEY PLAYER IN CANINE ATOPIC DERMATITIS LLUIS FERRER DVM PHD DIP ECVD UNIVERSITAT AUTÒNOMA DE BARCELONA Lluis Ferrer is from Mallorca (from the
Currently this involves genome studies
same village as Rafa Nadal) an
of Staphylococcus pseudintermedius
interesting insight that not many
attempting to answer the question
people know about! In veterinary
‘What makes a commensal organism a
dermatology of course he is
pathogen?’
recognised as a world expert. Graduating from the Zaragoza school
Today’s subject, however, was an
he immediately embarked on an
update on barrier function in atopic
academic career, first with an MSc in
skin. Rather than just give fact after
Animal Pathology and then a PhD at
fact, which perhaps with this potentially
the veterinary school in Hannover. In
academic subject could have turned out
1994 he obtained the diploma from
rather dry, he opts to take us into his
the ECVD and from 1995 he taught
clinic with a sharp student. This student
dermatology in Barcelona until a five-
is not afraid to ask some tricky
year stint in the Tufts, Boston school
questions!
as Professor of Dermatology (from
We are presented with an English setter,
2012-2017), before returning to
referred with a correct diagnosis of
Barcelona. At home in Catalan,
atopic dermatitis, but in spite of
Spanish, German and here in English
treatment has an increasing level of
he is guaranteed to give excellent
pruritus –now at 7/10. The treatment up
presentations and this veterinary
to referral had consisted of isoxazoline
webinar, generously sponsored by
orally, a limited antigen diet (2 weeks)
Protexin, is no exception.
DermalEase spot on drops, and a short course of prednisolone at a dose of 20
He began by a brief outline of his
mg/24 hours by mouth. Photos
current role, similar to most
demonstrate lichenification and
academics, which encompasses
erythema in the groin area. The initial
teaching, clinic time (two or three
step, as you would expect, was to
times weekly,) and for the remaining
perform skin cytology, which proved
time research.
negative for bacteria or yeasts.
The initial plan was to continue the
This early work supported the hypothesis that a
hypoallergenic diet, with weekly bathing, oral
central element in the pathogenesis of atopic
oclacitinib and continue DermalEase drops. At
dermatitis was an impaired epidermal barrier.
this point the student asked the first of many
This led to what Lluis described as a ‘paradigm
questions.
shift’ in atopic dermatitis. Instead of just regarding it as a hypersensitivity disease to
‘Why were DermalEase drops not withdrawn as
environmental allergens it is best considered as a
the dog was not improving?’
multifactorial disease with a central role skin
This gives Lluis the opportunity to explain that
barrier dysfunction. It wasn’t long before this
the drops had not had sufficient time to show
concept was introduced into the veterinary
benefit and also allows an explanation of how
literature. Two articles by Rosanna Marsella and
they work. DermalEase contain sphingolipids of
colleagues are cited from the journal Veterinary
animal origin that are precursors of epidermal
Dermatology.
ceramides. These promote endogenous ceramide production, providing support for healthy skin
A more detailed description of the normal skin
barrier formation and normal skin hydration
barrier function follows with the help of a
levels. The other ingredient is dermal hyaluronic
diagram of the epidermal components
acid, which supports proliferation and migration
demonstrating the cornified envelope. This
of dermal fibroblasts, also helping to maintain
contains filaggrin, involucrin, and loricin plus a
skin hydration.
lipid envelope that contains ceramides and
DermalEase drops repair the skin barrier,
sphingolipids. There are electron microscope
thereby reducing the penetration of allergens
illustrations of the envelopes before summarising
and microorganisms, while at the same time
the skin barrier defects seen in atopic dermatitis.
reducing trans-epidermal water loss. Two further two important points: -
Decreased expression of filaggrin Increased expression of filaggrin degrading
1. The drops have to be used as part of a
enzymes
multifactorial treatment plan for atopic
Increased expression of sphingomyelin
dermatitis
deacyclase
2. Must be used continuously for more than 4
Lower number of lipid bilayers.
weeks. This leads on to a slide emphasising that atopic The next question is:
dermatitis is a very complex disease.
‘But atopic dermatitis is a hypersensitivity. The dog will continue to be allergic’
Atopic dermatitis: epidermal barrier dysfunction,
The answer from Lluis is that ‘It’s a bit more
immune dysregulation and environmental
complicated-it’s not just an allergy. Let me
influences
explain’. The colour diagram accompanying the slide To do so he turns to early studies in humans
certainly looks complicated at first sight.
showing that more than 50% of atopic people
However, by focusing on its three main
have defects in filaggrin, and inflammation itself
components and following the line diagrams for
decreases filaggrin synthesis in the epidermis.
each it quickly makes sense. The three components are: -
1. Abnormal skin barrier
A final question is asked
2. Immune system dysregulation noting the acute Th2 and later Th1 responses in
‘Wouldn’t it make sense to administer
particular
sphingolipids orally?’
3. Environmental factors allowing for penetration across the skin barrier,
This question is answered by referring to a 2015
subsequent scratching and activation of
study by Olivry and others showing that essential
immune responses. Dysbiosis in the skin
fatty acids need to be given in high doses for
microbiota follows.
more than 8 weeks.
This webinar deals with the skin barrier of course
Our very keen student is satisfied-this time –but
but my feeling is that Lluis could be invited back to follow up numbers 2 and 3 in a subsequent
‘if I have any more doubts, I will tell you!’
webinar. Lluis has the last word ‘You don’t need exams; Our student was not yet convinced that a couple
you can detect good students because they pose
of mls of lipids could repair the entire epidermal
intelligent questions’ -an interesting comment in
barrier of a dog. She asks:
these times.
Where is the scientific evidence?
This is an exceptionally good webinar and, as
Some very interesting research studies prove
mentioned above, I think we could benefit from
that it can. These are very convincing. There are
more on this subject from Lluis. Barrier function,
also some before and after clinical pictures of
in this presentation, is brought to life by taking us
atopic dogs. In addition, there is a new
into a teaching environment in the clinic. In the
DermalEase formulation in mousse form allowing
top right corner, you can see Lluis in real time
for a better spread on the surface.
making the whole lecture virtually identical to being at a congress. This was better though
Treatment of acute flares of canine atopic
because we had half an hour of questions
dermatitis is summarised under the headings
afterwards. You won’t usually get that in a congress!
·
Control infections
·
Control inflammation
·
Control pruritus
·
Decrease hypersensitivity reaction
·
Skin barrier repair
Suggested drugs are indicated for each heading and then in a similar fashion maintenance treatment is dealt with under: Prevention of infections Control/reduction of hypersensitivity Skin barrier repair
David's Reviews WEBINAR: SPLENECTOMY JOHN BERG DVM DACVS TUFTS UNIVERSITY CUMMINGS SCHOOL OF VETERINARY MEDICINE
I expect that a majority of colleagues
(from the spleen) and to the lungs when
in small animal practice will have
the primary site is the right atrium.
operated to remove a spleen sooner
There is an interesting statistic from a
rather than later in their careers. This
2011 article identifying the link between
should not deter from viewing this
RA site and splenic site.
excellent veterinary webinar because it contains numerous up to date
After listing the clinical signs and
statistics, a couple of very well
radiographic signs the superiority of
produced videos in real time, new
ultrasound as a diagnostic procedure is
equipment to aid in surgery, and
shown, although it is not reliable to
information on the latest research into
distinguish liver metastasis from
improving the outcome of the
nodular hyperplasia. Rule outs to HSA
procedure. You will also see the
are haematoma, fibrosarcoma,
largest example of a splenic tumour
leiomyosarcoma and lymphoma. Most
you are ever likely to encounter.
cases of splenic enlargement are HSA or splenic haematoma and there are stark
We begin with a reminder of the
differences between them. The typical
essential facts of canine splenic
features of splenic haematoma are
haemangiosarcoma, (HSA). It is a
listed. A key feature is that following
disease principally of large breed
removal of a splenic haematoma the
dogs-German shepherd, Golden
prognosis is excellent-in stark contrast
retriever and Labrador retriever.
to the prognosis of HSA. The distinction
Primary sites are the spleen, right
is therefore important, and some
atrium, liver and skin (usually benign).
helpful hints give some pointers to help
HSA can also occur rarely in cats and
differentiation, from for example case
small dogs.
statistics, whether haemabdomen is
HSA has a 100% metastatic rate-to
present and some differences
the liver, omentum, and mesentery
encountered in clinical pathology.
Before proceeding to the procedure of
Two controlled trials and 12 uncontrolled trials
splenectomy, essential preoperative care is listed
are itemised and a 2008 Tufts study of 208 dogs
and there is a revision of the vascular supply to
arrives at very similar conclusions. These are that
the spleen, which helps make the operation
with surgery alone the overall mean survival
easier and quicker. Also demonstrated in the
(MST), is only 1.6 months. A break down
video is the use of the LDS stapler and vessel
depending on the stage shows at best 5.5 months
sealing devices. The one demonstrated here is
for stage 1, 2 months for stage 2 and only .9
the Ligasure (Covidien). It is very high tech
months for cases where metastasis has occurred.
allowing rapid sealing of vessels via a
Adding chemotherapy increases this the overall
combination of pressure and heat. It even has a
MST to 3.4 months.
feedback system that bleeps when the sealing is complete.
John summarises the survival statistics: -
The perioperative mortality, described as the
Randomised prospective trials are needed
short-term outcome at Tufts, and based on a
Adriamycin and metronomic chemotherapy
retrospective study of 539 dogs undergoing
are moderately effective
splenectomy is approximately 7.5%. Thromboses
Survival beyond one year is rare but: -
and coagulopathies accounted for the majority of
-Surgical morbidity is low
deaths, and reasons for this are explored. There
-Quality of life is excellent
is a warning about the danger of missing HSA on histopathological examination and misdiagnosing
The fact that the quality of life immediately
it as a splenic haematoma. This results from
following splenectomy is excellent leads many
sampling errors, and there needs to be caution in
owners to agree to surgery, in spite of such
the early stages post operatively if haematoma
disappointing survival rates. Careful discussion is
has been diagnosed. This is because splenic
more obviously needed for the stage 3 cases. The
haematoma, as previously mentioned, has an
problem in many instances is that owners are
excellent prognosis for cure, whereas as
reluctant to come to an immediate decision of
demonstrated in the following slides HSA has a
euthanasia and opt for a short period of
very poor prognosis.
remaining time with their dog.
A literature search from 1985-2007 reveals that
This is another superb webinar by John Berg with
there hasn’t been a great deal of progress over
a third due shortly. Not to be missed.
time in mean survival of dogs following splenectomy alone or with splenectomy plus chemotherapy. In this search the stages of the disease were classified as 1. Involvement of the spleen alone. 2. Rupture. 3. Metastasis.
From The Literature
Just a couple of articles this month. They are from the consistently excellent journal Feline Medicine and Surgery Open reports. Most of the articles are, as suggested by the journal title, one off reports. Many of these are written either by established academics or by interns/residents in referral institutions, but not exclusively. Best of all the entire journal is free to access with no need to pay or belong to an institution. An article in the latest edition of the journal caught my attention, describing a case of leishmaniasis in a cat. Generally thought to be rare in this species there has been an increase in endemic areas of Europe. This case describes a cat infected in Texas. The authors did a fantastic job in not only diagnosing and treating the cat but did so in the face of a complete absence, at times, of owner compliance. It is a lesson in persistence! The cat presented with a linear erosion of the right pinnal margin, an ulcerated exophytic nodule on the right hock and a swelling in the right nostril. The diagnosis was made on cytological and histopathological grounds. PCR confirmed the presence of Leishmania mexicana, a species endemic in Texas. Not content with this the authors managed to conduct an epidemiological investigation at the owner’s premises, which identified Lutzomyia, a sandfly species known to be a vector of leishmaniosis. There are some good clinical and cytological pictures.
Treatment was long and laborious, punctuated by missed appointments, failure of treatment compliance and lack of permission to undertake surgical procedures. An additional complication is that standard treatments for felines have not been validated. In this patient allopurinol showed initial promise but was discontinued following a suspect drug reaction. Topical imiquimod similarly improved lesions initially but was discontinued due to difficulties in administration. The final hurdle, you might consider insurmountable, was that other drugs typically used in canines, meglumine antimonate and miltefosine, were not available in the USA at the time. Improvisation resulted in the novel use of artemisinin, an extract from the plant Artemisia annul. This is traditionally used in Asia to treat people with visceral leishmaniosis and malaria. By finally persuading the owners to use an insecticidal collar (flumethrin/imidacloprid) and the cyclical use of artemisinin there was a very good clinical response with resolution of lesions over a six-month follow up. This is a great little article that reads like a detective story and worthwhile reading for its educational content, but also to admire the persistence and thoroughness of the authors-lucky cat! The other article I looked at was from Japan.
CT and MRI characteristics of presumptive hypervitaminosis in a cat Yoshihiko Yu and others Journal of Feline Medicine and Open Reports March 15, 2021 The article contains a useful summary of hypervitaminosis A in cats, and although this cat was a stray (hence the presumptive in the title) the images of the skeleton are very persuasive. In fact, the authors note that this, according to their knowledge, is the first case report documenting CT and MRI findings in hypervitaminosis A in the cat. The article may therefore be of particular interest to those colleagues that have access to CT and MRI, but also to colleagues in practice that are yet to see a case. It’s a very long time since I saw a cat with this problem. At the time feeding raw liver was not unusual and cats seemed to become addicted to it and absolutely refused any other food. I am not sure if cases are still being seen but if they are this article is as mentioned above is very good revision. In particular the images, along with the conventional radiographic findings, are quite superb. I was struck, not being an expert in this field, of how the three imaging modalities combined to give fantastic diagnostic clarity. It’s worth accessing the article just to look at these.
DOG SOCIALISING IN LOCKDOWN
Quite an achievement in 6 months for a dog that had never seen a nongreyhound before. But on the other
JANE DAVIDSON
hand, I’m worried that lockdown
Although not a puppy, my new dog
So how do I know his socialisation
walks, and limited doggy friends
Joey still needs socialisation, which
hasn’t gone as well as it could have?
means he thinks a stone horse is a
for C19 reasons has been more
Well one of his favourite things is
pretty good companion. Or maybe I
challenging. As an ex-racing
to sniff a gravestone in our local
need to look closer to home. As
greyhound Joey is used to kennel
graveyard. He likes the graveyard.
lockdown means I’m his main form
life. Everything has been new for
Its close by, its quiet and full of
of entertainment perhaps I’m not
him, stairs, buses, and the fact that
squirrels. His squirrel excitement
the amazing dog owner I thought I
dogs come in non-hound shapes
may be one reason he likes the
was. Upstaged by a stone horse…
and sizes. He settled well with my
space, but he also has another
Covid or no Covid maybe I need to
cat and he quickly got used to stairs
friend there.
up my game!
and even ventured on a bus. As it was raining, the bus was warm and
Recently he has become interested
headed home he seemed to think it
in one particular gravestone. It’s
was pretty good.
quite big and has a stone horse on top of it. Quite a classic headstone
So far, so good. He’s met his 2
of a weary horse, with head down
doggie friends for play dates. Ben
and a blanket over its hind
and Ellie have enjoyed his toys and
quarters. This is Joeys 3rd friend.
watched in amusement as he tries
He likes to stand on his hind legs
to slow down his running to run
and sniff all round the horse and
with them. He’s also recently
whine with excitement. I’m torn by
started to ask other dogs to play
this behaviour. I’m pleased as he’s
with him. In his very understated
worked out that the horse
Joey way, but it’s a big
sculpture looks like another animal
breakthrough.
that might play with him.
Register Free To Watch
Thursday 29th April 3pm - 5pm CET
WVA VIRTUAL SEMINAR FOOD SECURITY REGISTER NOW Raising awareness and promoting the veterinary role in achieving global food security.
The WVA’s recent release of a position statement on food security and nutrition, combined with the impact of SARS-CoV-2 on food supply chains throughout the world, make this a relevant, timely topic for veterinary continuing education. This seminar will raise awareness and promote the veterinary role in achieving global food security through the establishment of relevant partnerships with other professionals, integrating veterinary expertise into current and future global food security programs and identifying possible workforce opportunities for veterinarians outside of clinical practice. Go to our website schedule to register or visit here: https://vc2021.thewebinarvet.com/wva-virtual-seminar-foodsecurity/
APRIL PROGRAMME 2021 We've teamed up with some experts within the Veterinary industry to bring you diverse and informative CPD in 2021. See the timetable below:
1st
6th
Developing emotional intelligence in puppies
Digitally Extending Your Veterinary Clinic
Sarah Heath
Thom Jenkins
7th Raising Healthy Calves Geof Smith
8th Canine Mast Cell Tumours - Update on new treatments Owen Davies
13th 11th
Approaching the small mammal…what can we
Meditation with Mike Scanlan
actually do? John Chitty
14th Equine endocrine disease: an update Ruth Morgan
20th The Blocked Cat Chloe Fay
29th American Foulbrood : Foul in every sense John Hill
15th The brain is simply an extension of the retina! Blindness due to optic nerve and brain disease Ron Ofri
22nd Ultrasound of the canine and feline pancreas: technique, normal appearance, abnormalities. Panagiotis Mantis
29th WVA Virtual Seminar - Food Security
What are you watching? 1ST THE SKIN BARRIER: A KEY ELEMENT IN CANINE ATOPIC DERMATITIS
2ND LUNCHTIME BASIC BITESIZE PATHOLOGY: SMALL ANIMAL MAMMARY PATHOLOGY.
3RD CLINICAL USES OF HEMP EXTRACTS IN THE TREATMENT OF OSTEOARTHRITIS IN DOGS AND EMERGING EVIDENCE IN THEIR USE IN THE TREATMENT OF NEUROPATHIC AND ACUTE PAIN STATES
4TH ACUTE ABDOMEN
5TH HYPERCALCAEMIA IN DOGS AND CATS: AN OVERVIEW
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Karen is a Veterinary Surgeon from Kent has been a member of the Webinar Vet since 2014. She was picked at random from over 640 entries. VC2021 was The Webinar Vets 9th annual congress with over 144 hours of CPD, over 7 days. 7628 people from 86 different countries, registered for the event which is still available to view on demand until February 2022. Tickets are still available via: Tickets - The World's Largest Vet Congress VC2021 - Virtual Congress 2021 (thewebinarvet.com)