Tip of the Month - February

1 February 2019

Neurology

When to refer a dachshund with a suspected thoracolumbar slipped disc?

For dachshunds with sudden onset spinal pain or neurological deficits in the pelvic limbs, the most likely differential is a thoracolumbar intervertebral disc extrusion (slipped disc).

Tip of the Month - December

7 December 2018

Internal Medicine

The 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 will be appreciated. Unfortunately predicting the development of azotaemia in this situation is difficult.

Tip of the Month - November

2 November 2018

Internal Medicine

Interpreting 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.

Tip of the Month - October

5 October 2018

Soft Tissue Surgery

Haemoabdomen in Dogs

The most common cause in dogs is acute nontraumatichaemoabdomen secondary to malignantneoplasia causing splenic rupture. Other causesinclude trauma, iatrogenic following surgery(e.g. ovariectomy) or diagnostics (e.g. FNA),coagulopathies or torsion of the liver or spleen.

Tip of the Month - August

17 August 2018

Internal Medicine

Vaccination 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, we are keen to avoid preventable diseases, but do not want to cause harm by vaccinating animals if it is unsafe to do so. Ultimately the decision to vaccinate any animal on immunsuppressive medication or chemotherapy must be made on an individual basis, by considering their vaccinal history, their current health status and medications, and their current risk factors for exposure to these infectious diseases.

Tip of the Month - June

4 July 2018

Soft Tissue Surgery

Vacuum Assisted Closure

Vacuum assisted closure (VAC) or negative pressure wound therapy (NPWT) is a simple but effective method to promote rapid wound healing. It has been shown to be effective for management of large, complex, acute wounds as well as chronic wounds that have failed to heal by conventional methods. It is also commonly used to stabilise free skin grafts following placement.

Tip of the Month - May

18 May 2018

Internal Medicine

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 the portal system (eg reactive hepatopathies commonly seen secondary to gastrointestinal pathology).

Tip of the Month - April

20 April 2018

Soft Tissue Surgery

Enterotomy and enterectomy are commonly performed procedures in practice due to the frequent occurrence of gastrointestinal foreign bodies. Although these are common procedures, good surgical technique is essential as the consequences of dehiscence are devastating with the development of septic peritonitis.

Tip of the Month - March

2 March 2018

Internal Medicine

Diagnosing hyperadrenocorticism with confidence

Canine hyperadrenocorticism:

How to not stress about the diagnosis

1. Identify other diseases before endocrine testing 
2. ACTH (Synacthen^®) is not necessary to diagnose the condition in many dogs 
3. UCCR is rarely used to confirm the disease
4. Beware the 'unwell' dogs with hyperadrenocorticism

Tip of the Month - February

2 February 2018

Anaesthesia

'Local anaesthesia techniques for ovariohysterectomy'

Female ovariohysterectomy is one of the most common surgical procedures in veterinary practice. It can be extremely painful and although systemic pain medication is routinely included as part of the peri-anaesthetic protocol, some cases still respond to surgical stimulation and may display signs of pain during recovery period...

RSA Insurance Group – Important Update

9 November 2017

In order to stay committed to excellence and fully support our clients, North Downs Specialist Referrals will now be subsidising the £200 fee that may be charged to our clients by the Royal Sun Alliance (RSA) as part of their preferred provider’s scheme.

Tip of the Month - November

3 November 2017

Internal Medicine

Treatment 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...

Tip of the Month - October

6 October 2017

Anaesthesia

'Local anaesthesia for general practice: Castration'

Male Orchiectomy is a very common surgical procedure in veterinary practice. The procedure can be extremely painful and although systemic pain medication is routinely included as part of the peri-anaesthetic protocol, some cases still respond to surgical stimulation and may display signs of pain during recovery period.

Tip of the Month - September

1 September 2017

Cardiology

'The re-birth of the relevance of murmur intensity'

A heart murmur is an abnormal heart sound that indicates a degree of turbulence to the usually laminar blood flow in the heart. It can be physiological in athletic animals, due to congenital cardiac conditions in young patients or caused by non-cardiac condition affecting the way blood flows (anaemia, fever, high cardiac output states, etc) but in an adult dog it is often an indication of heart disease.

Tip of the Month - August

4 August 2017

Internal Medicine

Proteinuria

How do we measure it, and what are the pros and cons of the options? ...