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Veterinary ECC Small Talk

Shailen Jasani MA VetMB MRCVS DipACVECC

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Small talk and jibber jabber about small animal (canine, feline) Veterinary Emergency and Critical Care (ECC). Hosted by ECC specialist Shailen Jasani, Diplomate of the American College of Veterinary Emergency and Critical care, episodes cover a variety of topics relating to ECC including literature references and evidence-based medicine considerations. So join us for some ECC small talk, why don't you?
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In this episode I am joined by my friends and colleagues, Stacey Davidson and Ru Clements of VetLed, to discuss the role of Quality Improvement (QI) in improving patient care. We discuss what QI is and why you should be engaged with it. We also talk about the role of human factors and workplace culture in QI. A description of many of the terms used…
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This episode is focused on sepsis. I also talk about the relevance of the glycocalyx. And emphasise how much extrapolation there is from human medicine to veterinary practice. Topics covered include: Long-standing sepsis definitions and recently suggested updates History of sepsis management in human medicine; including early-goal directed therapy …
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Although feline hypertension may be a rare reason for emergency presentation, it is a condition that most small animal practitioners will have encountered both in routine practice and in critical care patients. This episode is based on the 2017 ISFM* Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats which were recently pu…
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Hepatic encephalopathy is a relatively common condition in dogs and to a lesser extent in cats. It is a disorder that all clinical veterinary staff, and especially those working in Emergency and Critical Care, should be aware of. This episode is based on a review article and covers the pathogenesis, clinical presentation, diagnosis, and management …
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Activated charcoal is a widely used therapy, especially in dogs, to facilitate gastrointestinal decontamination following toxin ingestion. Points covered in this episode include: A reminder about what activated charcoal is and how it is meant to work Comments about the use of activated charcoal as a therapy contrasting human and veterinary medicine…
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On this episode of the podcast I am joined by Kim Sheader (MSCP HCPC ACPAT Cat A, Chair ACPAT, RAMP), Chartered Veterinary and Human Physiotherapist, to discuss physiotherapy for the critical inpatient. Kim is a highly qualified and experienced physiotherapist and currently works with The Ralph Mobile Physiotherapy & Rehabilitation service. I start…
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On this episode of the podcast I am joined by Rene Agredano and Jim Nelson of Tripawds, “the world's largest support community for animal amputees”, to discuss how we as veterinary staff can be better prepared to help clients with dogs and cats that are either facing or have had a limb amputation. After some background discussion of the Tripawds re…
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Anaemia in critically ill cats; severe anaemia in blocked tomcats; spinal shock in dogs; haemorrhagic GI disease in veterinary ICUs. In this episode of the podcast I discuss a few papers from the latest issue of the Journal of Veterinary Emergency and Critical Care (JVECC) that especially caught my eye, in particular as they relate to primary care …
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Antimicrobial resistance is said to be one of the greatest challenges currently facing small animal veterinary medicine. How can we become part of the solution rather than part of the problem? In this episode of the podcast I start by providing a brief refresher of bacteriology and antibacterials before going on to discuss antimicrobial stewardship…
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In this episode of the podcast I am joined by Enid Traisman M.S.W., CT, CFS to discuss issues around emotional well-being in veterinary practice. Enid is the Director of Pet Loss Support Services at Dove Lewis, a non-profit emergency animal hospital in Portland, Oregon in the USA. Topics that we discuss in this episode include the following; where …
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In this episode of the podcast I take a look at magnesium and its role in clinical practice, something which many people may not be very familiar with. The episode is based on the following article: Humphrey S, Kirby R, Rudloff E. Magnesium physiology and clinical therapy in veterinary critical care. J Vet Emerg Crit Care 2015. Areas covered includ…
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HORMONAL SEIZURES, IV POTASSIUM SUPPLEMENTATION, ICU SOUND LEVELS, BRAIN TUMOURS AND IMHA! In this episode of the podcast I discuss some of the papers that were published in the Journal of Veterinary Internal Medicine during 2015. Remember that this journal is now freely available via open online access. The papers I mention are as follows: Van Mee…
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**Apologies for the less than optimal sound quality of this episode and the non-stereo recording!** Dog bite injuries are a relatively common problem to be faced with in small animal practice. In this episode of the podcast I am joined by Nicola Kulendra, a European specialist in small animal surgery, to discuss their management. Some of the points…
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In this episode I am joined by Liz Hughston and Charlotte Rosenthal, both specialist ECC nurses from the USA, to discuss patient handovers/rounds. We start with a brief introduction to both my guests and then go on to discuss questions such as: What is the basic purpose of handover? Separate rounds for nurses and vets, or combined? Strategies for d…
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Dogs and cats with acute liver failure may present as emergencies and be critically ill. In this episode of the podcast I discuss this condition based on a recent review article from the Journal of Veterinary Emergency and Critical Care*. (*Weingarten MA, Sande AA. Acute liver failure in dogs and cats. J Vet Emerg Crit Care 2015. 25(4):455-473.) To…
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Traumatic brain injury (closed head trauma) is relatively common in dogs and especially cats, often following motor vehicle collision. A rational approach to management is essential to try and maximise the chances of a successful outcome. In this episode of the podcast I discuss traumatic brain injury focusing on key aspects of management and touch…
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In this episode of the podcast I discuss an approach to the early management of dyspnoeic cats that is predicated on ‘first do no harm’ and thinking risk-benefit at all times. The main take-home messages from the episode are: Appreciate that dyspnoeic cats can be very vulnerable and easily tipped over the cliff edge. Even more so than normal, pay a…
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In this episode of the podcast I discuss two papers from the Journal of the American Veterinary Medical Association in 2015. The first is on post-operative regurgitation and vomiting (PORV) in dogs and the second is on lactate in cats. To end the podcast I mention a letter-to-the-editor case report from Veterinary Anaesthesia and Analgesia, also in…
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Critically ill patients almost by definition have a number of different problems and management considerations. They can be high maintenance requiring intensive care and it is easy to accidentally overlook different aspects of their care; this is especially the case when you are looking after more than one critically ill patient and/or working in a…
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The shock index is equal to heart rate divided by systolic arterial blood pressure. It has received a fair amount of attention in the human medicine literature being evaluated for example in haemorrhagic hypovolaemic shock, especially post-traumatic, sepsis and obstetric patients, and for correlation for example to length of hospital stay and morta…
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Whether or not steroids should be used in shock has been an on-going debate for many years. In this episode I discuss some of the literature, in particular relating to the use of steroids in septic shock, and the concept of ‘relative adrenal insufficiency’ – more recently referred to as ‘critical illness-related corticosteroid insufficiency’ (CIRCI…
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This is the second of a two-part mini-series on canine haemoabdomen loosely based around the following review article: Herold LV, Devey J, Kirby R, Rudloff E. Clinical evaluation and management of hemoperitoneum in dogs. J Vet Emerg Crit Care 2008. 18(1):40-53. If you have not yet listened to Part 1, please do before listening to this episode! Poin…
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In a recent Facebook survey 80% of 150 respondents mentioned haemoabdomen, especially due to splenic rupture, as a top cause of collapse in dogs. This is the first of a two-part mini-series on canine haemoabdomen loosely based around the following review article: Herold LV, Devey J, Kirby R, Rudloff E. Clinical evaluation and management of hemoperi…
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Ketamine is a drug with complex pharmacology and a number of potential clinical effects and uses including a dose-dependent central nervous system continuum from analgesia through to sedation, partial dissociation and complete dissociation. In this episode I discuss this drug based around the following points: How does ketamine work? What does it d…
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Dyspnoeic cat with wheezes and an expiratory ‘push’ – the classic asthmatic cat, right?! In this episode I discuss this syndrome according to the following points: What do we call this syndrome? Who gets feline asthma? Pathogenesis Clinical findings Diagnosis Thoracic radiography Treatment – Acute crisis Treatment – Sub-acute and Chronic Alternativ…
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Red Cell Transfusions: To Pump Or Not To Pump? Although not worldwide just yet, veterinary practices are increasingly able to give red cell transfusions. But how should you do this – with or without an infusion device? In this episode I address this listener’s question: “What are your thoughts about using IVF pumps to administer blood products? The…
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Thankfully (!) pain management continues to gain increasing recognition in clinical veterinary practice. In this episode I look at some of the key points made in the following recently published guidelines focusing on those most relevant to ECC and acute short-term pain management: Epstein M, Rodan I, Griffenhagen G, et al. AAHA/AAFP Pain Managemen…
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Dogs (and cats) having a crisis as a result of hypoadrenocorticism (Addisonian crisis) can be in a life-threatening state and this represents one of the true small animal emergencies. Stabilisation of these patients starts with appropriately aggressive intravenous fluid therapy as the first priority and treatment for clinically significant hyperkal…
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Crystalloids versus colloids for resuscitation is an age old debate! In this episode I present the following paper before going on to talk about the use of colloids in hypoproteinaemia. Click Here For Your FREE Copy of a Transcript of This Episode For online presentations and notes on Hypovolaemia and Shock and Parenteral Fluid Therapy visit my onl…
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Today's episode is split into two sections but has an evidence-based medicine theme throughout. In the first section, prompted by something I recently encountered in human medicine, I discuss clinical policies and guidelines. How can we have confidence in them? In the second section of this episode I discuss a couple of journal papers looking at th…
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There are some well know standard principles of fluid therapy with different approaches to the treatment of hypovolaemia and dehydration. Regardless of the indication, individual patients may have additional problems or considerations that should influence our fluid therapy approach. In this episode I respond to questions sent in by listeners with …
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Do you see dogs and cats exposed to poisons around the festive period? Sure you do! There are many potential poisons and other hazards to which dogs and cats are more likely to be exposed during the Christmas period. In this episode I discuss some of them in detail - chocolate, grapes/raisins/currants/sultanas, xylitol - and mention a variety of ot…
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This episode focuses on the nutritional management of acute pancreatitis in dogs and cats answering questions such as: When should we be providing nutrition to dogs and cats with acute pancreatitis? Should we be using enteral or parenteral nutrition? Should we be using post-pyloric jejunal feeding or is oral or gastric feeding okay? The episode is …
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Cats with urethral obstruction ("blocked cats") can present in a state of shock with moderate-to-severe hypoperfusion and should receive adequate fluid resuscitation with bolus therapy as needed using an isotonic crystalloid solution before worrying about relieving the obstruction. Blocked cats may have clinically significant hyperkalaemia and can …
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Intravenous lipid emulsion (ILE) (e.g. Intralipid 20%) has been used for some time and is being used more and more as an antidote for certain toxins in both human and veterinary medicine. How does it work? What is the evidence base for its use? What poisons should we consider using it for in dogs and cats? These are amongst some of the questions th…
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Canine acute haemorrhagic diarrhoea is a common presentation in small animal veterinary practice and often these patients present as emergencies. Aside from fluid therapy and other medical treatments, antibiotics are often prescribed. But is this appropriate in all cases? Should all dogs with acute haemorrhagic diarrhoea receive antibiotics? Listen…
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