Veterinary ECC Small Talk

Latest Episodes:

What's Magnesium Got To Do With It? Feb 05, 2016

Show notes

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 include:
Background theory
Measuring magnesium
Magnesium disorders
Treatment

Click Here For Your FREE Copy of a Transcript of This Episode

For SHOW NOTES for this episode see Here.

And don't forget to check out my Small Animal Emergency Medicine App - currently for iPhone and iPad; Android version out soon!

Journal Papers Episode: JVIM 2015 Dec 24, 2015

Show notes

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 Meervenne SAE, Volk HA, Van Ham ML. Association between Estrus and Onset of Seizures in Dogs with Idiopathic Epilepsy. J Vet Int Med 2015. 29(1):251-253.

Hoehne SN, Hopper K, Epstein SE. Accuracy of Potassium Supplementation of Fluids Administered Intravenously. J Vet Int Med 2015. 29(3):834-839.

Fullagar B, Boysen SR, Toy M, et al. Sound Pressure Levels in 2 Veterinary Intensive Care Units. J Vet Int Med 2015. 29(4):1013-1021.

Hu H, Barker A, Harcourt-Brown T, Jeffery N. Systematic Review of Brain Tumor Treatment in Dogs. J Vet Int Med 2015. 29(6):1456-1463.

Goggs R, Dennis SG, Di Bella A, et al. Predicting Outcome in dogs with Primary Immune-Mediated Hemolytic Anemia: Results of a Multicenter Case Registry. J Vet Int Med 2015. 29(6):1603-1610.

...and don't forget my SMALL ANIMAL EMERGENCY MEDICINE APP FOR IPHONE AND IPAD - Android version in development!

Managing Dog Bite Injuries Dec 04, 2015

Show notes

**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 we discuss include:

Adhering to standard ECC principles in terms of initial stabilisation and analgesia
The mechanics of dog bites and the ‘tip of the iceberg’ concept
Exploring bite injuries to uncover their true extent; the role of diagnostic imaging
The importance of wound drainage
Bacterial involvement and the use of antimicrobials
The ‘two hit theory’ in cats with moderate-to-severe dog bite injuries
The ‘big dog, little dog’ phenomenon

iPhone/iPad users see HERE for my Small Animal Emergency Medicine app for iOS; Android version is in development.

[This podcast is closely aligned with the MedEdLIFE Research Collaborative’s Quality Checklist for Podcasts.]

Patient Handovers/Rounds Nov 06, 2015

Show notes

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 doing an efficient and effective handover
Keys bits of information to communicate

This is the first episode in this podcast series to feature guests - please let me know what you think!

Twitter: @VetEmCC

Acute liver failure Oct 02, 2015

Show notes

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.)

Topics covered include:

Injury versus failure
Causes
Clinical findings
Diagnosis
Treatment including managing complications
Prognosis

Click Here For Your FREE Copy of a Transcript of This Episode

For SHOW NOTES visit the website HERE.

Management of Traumatic Brain Injury (TBI) Aug 29, 2015

Show notes

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 touching on some potentially contentious issues. Areas covered include:

The need to prioritise potentially life-threatening problems that may be extra-cranial
Primary (already happened) versus secondary (aim to minimise) brain injury
Ensuring adequate oxygenation and ventilation
Ensuring adequate cerebral perfusion
Addressing raised intracranial pressure including hypertonic saline vs. mannitol; furosemide?
The importance of analgesia
Steroids?
Relevance of hyperglycaemia?
Prognostication

Click Here For Your FREE Copy of a Transcript of This Episode

For show notes for this episode go to the website HERE.

Get your FREE one page summary of TBI management

Early Approach to Dyspnoeic Cats, First Do No Harm! Jul 31, 2015

Show notes

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 acute attention to the risk-benefit assessment at all times.
Understand that each cat is clearly going to be an individual patient with their own set of circumstances and behaviour, but that a hands-off, slow, staged approach is likely to be the least risky and most beneficial in most cases.
Continue to improve your ability and confidence in examining these cases paying attention to trying to anatomically localise the cause of the dyspnoea; this will allow you to make the most sensible decisions in terms of how to help the patient.
Don’t be in a hurry to x-ray dyspnoeic cats until and unless you feel like you have done all you can to make them as stable as possible beforehand.
And, lastly engage more with POCUS, point-of-care ultrasound, if you are not already.

Click Here For Your FREE Copy of a Transcript of This Episode

For SHOW NOTES for this episode click HERE.

Journal papers: PORV in dogs, Lactate in cats, and 'All in a tangle' Jul 09, 2015

Show notes

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 2015, which describes a complication of oesophagostomy tube placement in a cat with a cuffed endotracheal tube.

For abstracts and references, visit the website HERE.

Click Here For Your FREE Copy of a Transcript of This Episode

A Critical Patient Daily Checklist Jun 26, 2015

Show notes

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 an otherwise busy practice environment.

Using some form of checklist on a daily basis is a quick and easy way of being reminded of all the different aspects of the care of critically ill patients and hopefully minimises how often treatment considerations are overlooked and sub-optimal care provided.

In this episode I discuss my version of a daily checklist for critically ill patients including aspects such as monitoring, analgesia, nursing care and non-clinical considerations.

To download a COPY OF THE CHECKLIST for free and a TRANSCRIPT of the episode. visit the website HERE.

You can also get a copy of the checklist by directly going to this link.

Click Here For Your FREE Copy of a Transcript of This Episode

The Shock Index in Veterinary Patients Jun 05, 2015

Show notes

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 mortality. There is very little clinical veterinary information on the shock index.

In this episode I discuss what the shock index is, the parameters that are included in the shock index, the potential value of the shock index, some of the human medicine studies, and the following two canine studies:

Porter A, Rozanski E, Sharp C, et al. Evaluation of the shock index in dogs presenting as emergencies. J Vet Emerg Crit Care 2013. 23(5):538–544.

Peterson KL, Hardy BT, Hall K. Assessment of shock index in healthy dogs and dogs in hemorrhagic shock. J Vet Emerg Crit Care 2013. 23(5):545-550.

For show notes for this episode and a full list of all papers that informed or were mentioned in this episode, see HERE.

Click Here For Your FREE Copy of a Transcript of This Episode

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