Veterinary Clinical Podcasts

In our 42nd podcast we might not uncover the mysteries of life the universe and everything, though we do have the opportunity to refresh our approach to ocular examination with Charlotte Dawson, lecturer in ophthalmology here at the RVC. It was Jeff Smith who taught me ophthalmology in Sydney, who said more is missed by not looking than not knowing. To be fair he might have borrowed that from Thomas McCrae, one of the forefathers in post graduate medical education, though it is still as pertinent now as it was then. If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Today we talk to Elsa Beltran, one of our fabulous senior lecturers in neurology and neurosurgery here at the RVC about traumatic brain injury.  Initial assessment, tools that we can use to grade injury and see if there is an improvement or not, when to think about diagnostic imaging, and more. We’d loved talking to her and am sure you will get a lot out of it.Some papers of interest including Elsa’s paper on the use of MRI in Traumatic brain injury;https://www.ncbi.nlm.nih.gov/pubmed/22063205https://www.ncbi.nlm.nih.gov/pubmed/22063206http://onlinelibrary.wiley.com/doi/10.1111/jvim.12368/abstracthttp://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2001.tb01594.x/abstractIf you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

In this podcast, we talk to Elvin Kulendra, lecturer in orthopaedic surgery here at the RVC about coxofemoral luxation in dogs.  The most common luxation in dogs and the majority are related to trauma. Elvin talks about initial assessment, the major body systems, and gait and neurological function, which radiographs to take and steps on how to perform a closed reduction, which should be successful 50% of the time (higher in cats). Allegedly there are 20 ways to perform an open reduction, though we don’t talk about all of them. Cage rest regardless of reduction technique for at least 4 weeks, lead walking only (no jumping, stairs etc.). A review on coxofemoral luxations: https://www.ncbi.nlm.nih.gov/pubmed/15943127   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

In this podcast, we talk to Joe Fenn, lecturer in veterinary neurology and neurosurgery here at the RVC about presentation and management of acute vestibular disease. There might be a couple of references to wittertainment, though it’s mainly about vestibular disease. Enjoy. Here are a couple of links if you’d like to read more on vestibular disease: https://www.ncbi.nlm.nih.gov/pubmed/22847320 https://www.ncbi.nlm.nih.gov/pubmed/22847321 If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

In this podcast, we talk to Dr Rosanne Jepson, lecturer in internal medicine here at the RVC about blood pressure in dogs and cats. Hypotension, hypertension and everywhere in between. How, with what, where and why to measure. Are we underestimating, overestimating with different techniques? Cuff size and repeatability of readings. Do your patients have ‘white coat’ hypertension? Tips and tricks, if you are regular user, or it is something that you are wanting to bring in more to your practice. Enjoy the pod. Here are some links: Consensus statement from ACVIM published in 2007, https://goo.gl/bmtxuP though we believe will be updated soon IRIS http://www.iris-kidney.com International Renal Interest Society, a great resource.   If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and

In this podcast, we talk to Tom Cardy, staff clinician in neurology and neurosurgery here at the RVC about the ‘Rule of Six’, or the ‘Six Finger Rule’ (which has no bearing on Count Rugen or indeed Inigo Montoya). It is a clever process used to teach clinical reasoning in canine spinal disease, in six steps. Signalment Onset Deterioration Pain Asymmetry Neuroanatomical localisation Here is the link to the paper published in the Veterinary Record in 2015 http://veterinaryrecord.bmj.com/content/early/2015/07/21/vr.102988 Tools and mnemonics that make our day to day life easier are always warmly welcomed! If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Today we talk to Stefano Cortellini, lecturer in emergency and critical care here at the RVC about the process and indications for Continuous Renal Replacement Therapy (CRRT) and Therapeutic Plasma Exchange (TPE). Further information about this therapy can be found here http://www.rvc.ac.uk/small-animal-referrals/advanced-techniques-and-specialist-procedures/continuous-renal-replacement-therapy Information on acute kidney injury (AKI) and grading can be found on the website of the International Renal Interest Society (IRiS) here http://www.iris-kidney.com/guidelines/grading.html The indications for considering treating patients with AKI are; metabolic acidosis, electrolyte imbalance (especially refractory hyperkalaemia), and uraemia. The patients we see, have a potential reversible cause, are often anuric and we can successfully catheterise.  tend to be most affected are those that are anuric. Some toxins can be removed by dialysis when different filters are used. TPE has been used for immune m

Today we talk to Zoë Halfacree, senior lecturer in soft tissue surgery here at the RVC, about bite wounds and some things to consider in how to approach them, after initial patient assessment and stabilisation. Analgesia; full mu opioid based upon pain score Antibiotics; broad spectrum, such as potentiated amoxicillin Culture where possible Diagnostic imaging When to explore; preferably within 4-6 hours of presentation Lavage techniques; isotonic crystalloid (e.g. compound sodium lactate) using a 25ml syringe and 19-gauge needle. If you attach the fluid bag to an extension set and that to a three-way tap, with the needle and syringe, if makes it a little easier to flush Wet to dry dressing vs placing a drain Zoë discussed these aspects of bite wound management. Although this is a relatively common problem that we encounter, there is little information in the literature to help guide us on ways to manage these challenging patients. Enjoy! If you have any comments about this podcast, please get in t

In this podcast we talk to one of the principle investigators of the EPIC study, Professor Adrian Boswood. We discuss the findings of the evaluation of pimobendan in dogs with cardiomegaly caused by preclinical mitral valve disease. Why not go to the Journal of Veterinary Internal Medicine’s website, download it and have a read now! http://onlinelibrary.wiley.com/doi/10.1111/jvim.14586/full It is not often that a single paper has the ability to radically change clinical practice. This epic study has overwhelming evidence that pimobendan administration before the onset of clinical signs in dogs with mitral valve disease (MVD) prolongs the preclinical period by 15 months. The dogs were identified by having a ≥3/6 grade systolic heart murmur, echocardiographic evidence of MVD, and radiographic or echocardiogram evidence of cardiomegaly. You can also see a video of Professor Boswood discussing this study on youtube https://www.youtube.com/watch?v=wtzr1E3V-gE and an infographic too https://www.youtub

To kick start the return of the RVC Clinical podcast we speak to Karen Humm, Lecturer in Emergency and Critical Care here at the RVC. Karen was last heard here when she spoke to Shailen about this disease in number 23 of the podcast, two years ago now. As with most of the diseases we treat, prevention is far better than cure. There has been a paper published earlier in the year by groups at Bristol and Swansea University (http://www.ncbi.nlm.nih.gov/pubmed/26830203) that shows the prevalence can change dramatically depending upon your location. What is it like in your area? If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

Access to plain radiography is very widespread now in veterinary medicine. As with any diagnostic test it is essential to make sure that we use this modality in the best ways possible for our patients, their carers and indeed our personal and professional performance. In this episode I am joined by Andrew Parry who is a European specialist in Veterinary Diagnostic Imaging and a member of the Diagnostic Imaging team at the QMHA. Most of this long episode is spent discussing Andy's top 10 tips for how to get the most value out of plain radiography and radiology but we also talk about advanced imaging modalities that are becoming increasingly available and consider some of the issues surrounding this development. To summarise, Andy's top 10 tips were as follows: The more specific the question that you want to answer is, the more likely the imaging modality will answer it. Imaging used as a screening tool is rarely very useful. Make sure the appropriate imaging has been done. When do we use a retrograde study fo

Lymphoma (previously often referred to as lymphosarcoma) is one of the most (if not the most?) common types of cancer to affect dogs and cats. In this episode we discuss lymphoma in general terms covering a variety of topics such as what it is, patient presentation, clinical approach to the patient, treatment options and prognosis. For this episode I am joined once again by Chiara Leo, Lecturer in Oncology at the Royal Veterinary College. As always, if you have any comments about this podcast, please get in touch (email sjasani@rvc.ac.uk ; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page). Please take 30 seconds (!) to rate the podcasts in iTunes +/- write a review! Thanks. And remember we are now also on Stitcher Radio. (Image: "Canine lymphoma 1" by Joel Mills - Own work (Wikipedia))

In and amongst all the science and medicine that are at the centre of veterinary practice, it is essential that we don't overlook the overarching principles and considerations relating to Ethics and Animal Welfare. After all, they have to be a guiding light for what we do in clinical practice. This is the second in a two-part mini-series of podcast episodes featuring Martin Whiting, Lecturer in Veterinary Ethics and Law here at the RVC. In these episodes we discuss a variety of topics and issues. We start with discussing what 'veterinary ethics' and 'animal welfare' mean and then spend the remainder of the time seeing how these concepts apply to a variety of small animal clinical scenarios. The podcasts end with some comments on professional ethics in the context of regulatory bodies. If you haven't listened to Part 1, we would recommend you do this before listening to this second episode. As always, if you have any comments about this podcast, please get in touch (email sjasani@rvc.ac.uk ; tweet @R

In and amongst all the science and medicine that are at the centre of veterinary practice, it is essential that we don't overlook the overarching principles and considerations relating to Ethics and Animal Welfare. After all, they have to be a guiding light for what we do in clinical practice. This is the first in a two-part mini-series of podcast episodes featuring Martin Whiting, Lecturer in Veterinary Ethics and Law here at the RVC. In these episodes we discuss a variety of topics and issues. We start with discussing what 'veterinary ethics' and 'animal welfare' mean and then spend the remainder of the time seeing how these concepts apply to a variety of small animal clinical scenarios. The podcasts end with some comments on professional ethics in the context of regulatory bodies.  As always, if you have any comments about this podcast, please get in touch (email sjasani@rvc.ac.uk; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page). Please take 30 seconds (!) to ra

This is the second part in the two-part mini-series on corneal ulceration in dogs and cats with Màrian Matas Riera who is a lecturer in Ophthalmology here at the RVC. If you haven't listened to Part 1 yet it is highly recommended that you listen to that episode first as we dive right back in here in the second part. In this two-part podcast mini-series we start with a refresher of the anatomy of the eye and more specifically the anatomy and function of the cornea. We then discuss causes of corneal pathology and the spectrum of severity in ulcerative keratitis. Examination of the patient and appropriate treatment according to severity are discussed and the podcast mini-series is rounded off with some chat about corneal transplant and a quick tangent on diabetic cataracts! As always, if you have any comments about this podcast, please get in touch (email sjasani@rvc.ac.uk; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page). Please take 30 seco

Finally some Ophthalmology! Corneal ulceration (ulcerative keratitis) is a problem that is encountered commonly in small animal practice and the approach to treatment depends on a good understanding of the severity of the problem in the individual patient. In this two-part podcast mini-series we start with a refresher of the anatomy of the eye and more specifically the anatomy and function of the cornea. We then discuss causes of corneal pathology and the spectrum of severity in ulcerative keratitis. Examination of the patient and appropriate treatment according to severity are discussed and the podcast mini-series is rounded off with some chat about corneal transplant and a quick tangent on diabetic cataracts! I am joined for this feast of Ophthalmology by Màrian Matas Riera who is a lecturer in Ophthalmology here at the RVC. Part 2 of this mini-series will be uploaded in approximately 3 weeks' time. As always, if you have any comments about this podcast, please get in touch (email

This is the second part of my discussion on blocked cats with Dr Rosanne Jepson, Lecturer in Small Animal Internal Medicine and Dominic Barfield, Lecturer in Emergency and Critical Care; and in absentia with Nicola Kulendra, Lecturer in Small Animal Surgery. And of course like in the first episode I can't help but chip in as well! As nentioned in the last post, there is a lot to talk about so we have not been able to plunge into the deepest depths in any one area but this is a very useful overview of the topic. As always, if you have any comments about this podcast, please get in touch (email sjasani@rvc.ac.uk; tweet @RoyalVetCollege using #saclinpod; or use the RVC's Facebook page). Please take 30 seconds (!) to rate the podcasts in iTunes +/- write a review! Thanks. And remember we are now also on Stitcher Radio.

Tomcats with urethral obstruction are sadly a common small animal emergency population; this problem is one of the 'classics' no doubt, and with the potential to be fatal. Survival rates in the short-term can be extremely high with the right approach to stabilisation and management, medium-to-long term the prognosis can be more guarded. In a slightly roundtable fashion I am joined to discuss this topic by Dr Rosanne Jepson, Lecturer in Small Animal Internal Medicine; by Dominic Barfield, Lecturer in Emergency and Critical Care; and in absentia by Nicola Kulendra, Lecturer in Small Animal Surgery. And of course I can't help but chip in as well! In this two-part podcast series we discuss a whole host of questions surrounding this disorder including what FLUTD is, approach to the blocked cat, and recommendations following successful intervention. There is a lot to talk about so we have not been able to plunge into the deepest depths in any one area but this is a very

All veterinary students have to undertake extramural studies (EMS) as part of their undergraduate training. How can they go about making the most of these experiences? Many veterinary practices and other organisations offer EMS placements to students. What steps can they take to ensure that not only do students get the most from their placement but also that the practice benefits from having students seeing practice with them? What steps can both parties take to maximise the potential of the EMS experience and ensure that it is as mutually beneficial as possible? These and other things, especially clinical teaching in practice, are what we discuss in this podcast episode for which I am joined by Ruth Serlin and Jane Tomlin. Both Ruth and Jane are very involved in student teaching and development at the RVC and they explain their respective roles further in the podcast. Anyone potentially interested in becoming an EMS provider, please see further details HERE. As always, if you have any comments about thi

Angiostrongylosis is a horrible disease affecting dogs not just in the UK but in many other countries besides. The two most commonly reported clinical presentations are associated with spontaneous bleeding or respiratory signs due to verminous pneumonia! In this podcast we discuss this parasitic infection in some depth and I am joined once again by Karen Humm who is a Lecturer in Emergency & Critical Care (ECC) at the QMHA and a co-Director of the Transfusion Medicine service. In the podcast Karen and I were not entirely clear about exactly what the two licensed veterinary preparations are licensed for...I am not sure I am any more clear so here are some links for you to check them out! Milbemax Advocate Alongside this podcast, I have also just published a short blog piece summarising a couple of papers on A. vasorum recently published in The Veterinary Record which you can find HERE. As always, if you have any comments about this podcast, please get in to