Cobalamin Supplementation
Hypocobalaminemia is regularly seen in canine and feline small intestinal disease and exocrine pancreatic insufficiency (EPI). Despite other therapy, gastrointestinal symptoms may fail to resolve if low cobalamin levels are not corrected. Historically supplementation has been recommended by SC injections, as oral supplementation was suspected to be ineffective. However, oral supplementation has recently been shown to…
Read MoreProteinuria
How do we measure proteinuria, and what are the pros and cons of the options? Proteinuria is most commonly assessed using dipsticks, or submitting the sample for a urine protein: creatinine ratio (UPCR). Dipstick tests are cheap, and easy, but unfortunately are prone to inaccuracies. False negative results can occur in Bence-Jones proteinuria, or with…
Read MoreTreatment of Ionised Hypercalcaemia in Cats
When to measure blood calcium in cats and why do we worry? Clinical signs of hypercalcaemia include PUPD, weakness, depression, anorexia, vomiting, constipation, muscle twitching and cardiac arrhythmias. Often hypercalcaemia is detected on routine bloods as an incidental finding. The detection of ionised hypercalcaemia should always be investigated further and appropriate management instigated. Chronic, untreated…
Read MoreDiagnosing Hyperadrenocorticism with Confidence
Canine hyperadrenocorticism: How to not stress about the diagnosis Identify other diseases before endocrine testing ACTH (Synacthen®) is not necessary to diagnose the condition in many dogs UCCR is rarely used to confirm the disease Beware the ‘unwell’ dogs with hyperadrenocorticism Getting started Making a confident diagnosis of canine hyperadrenocorticism (HAC) can be a challenge.…
Read MoreInvestigating Liver Disease
Liver disease can be associated with specific clinical signs such as jaundice, non-specific clinical signs such as hyporexia, or can be asymptomatic and discovered incidentally when performing biochemistry tests for other reasons. It is important to be aware that liver disease may be primary (inflammatory hepatopathies, copper accumulation etc), or secondary to other pathologies within…
Read MoreVaccination on Patients on Immunosuppressive Medications and Chemotherapy
Deciding whether to vaccinate an animal on immunosuppressive medication or chemotherapy is challenging. Vaccination in such patients is not sanctioned by vaccine companies, as they have not thoroughly investigated their products in this setting. There is some experimental data to offer guidance in these situations, but this is limited. As both pet owners and vets,…
Read MoreInterpreting Pancreatic Lipase (PL) Results in Dogs with a Balanced Overview
Acute pancreatitis is a common cause of vomiting, inappetence, lethargy and abdominal pain in dogs, but confidently diagnosing pancreatitis can be a challenge. Biochemical changes seen in acute pancreatitis can include liver enzyme elevation, hyperbilirubinaemia, mild hypoalbuminaemia and markers of dehydration, but these findings can be seen in many other diagnoses of course. Amylase and…
Read MoreThe Thyroid and The Kidneys: a Love-Hate Relationship!
Hyperthyroidism and chronic kidney disease (CKD) are common conditions in older cats, so it is not terribly surprising that they can occur in the same patient. Hyperthyroidism “artificially” increases renal blood flow and glomerular filtration rate, potentially therefore masking renal insufficiency. Following therapy, when euthyroidism is restored, the true state of the cat’s renal function…
Read MoreManaging Subclinical Bacteriuria
In a time where there is increasing evidence that bacteria isolated from the urine of dogs and cats (and people!) is not always synonymous with a urinary tract infection, it can be increasingly confusing knowing when to reach for antibiotics. Hopefully the answers here will help clarify the current thinking on the management of bacteriuria.…
Read MoreAppropriate Antibiotic Usage in Practice
Antibiotic resistance is a serious concern facing both human and veterinary medicine, therefore it is vital that we use antibiotics appropriately. Here we present several conditions for which their use can be avoided, in the hope of increasing confidence when it comes to saying no to antibiotics. Pancreatitis In contrast to humans, dog with pancreatitis…
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