The third #vetfinals session was appropriately placed just prior to the #y4rev GI exam so we were hoping it might prove useful to all! Zoe was our guest expert again and fuelled on tea and hummus tweeted from @vetfinalsguest (I will break her eventually and she will become a tweep herself!)
Zoe kicked off with the case presentation – a staffie with v+and d+ which is gonna be pretty regular for those of you going into SA practice in a few months time!
Questions for the owner were pretty straight forward and there were lots of good ideas.
And Nay also noticed that the dog had pretty horrid skin too so probably worth asking about dietary trials too!
Bit of an outside spot from Jenn
and Zoe replied that this was a good question, but apparently there is no conclusive evidence that helicobacter causes D+
….and then Zoe added the clinical exam findings
The pyrexia was immediately spotted
Everyone was sure that this was not one that would leave the hospital for the time being, and rightly so because of the level of dehydration and the HGE
There were many suggestions for haematology and biochemistry, and Zoe agreed that trying to rule out other issues was important. She pushed you for the mechanism of action of parvovirus and Louise & Jen knew about this
We then moved onto other potentials….
…and Ali and Nay knew all about this
Jenn wanted to know about giving this dog antibiotics – she’d seen fluoroquinolones given in practice but wasn’t sure why
Louise stepped in
And eventually the conclusion was reached that potentiated amoxycillin was good for the G+ve spectrum, with metronidazole to be avoided because of the fact it kill anaerobes which we think are good gut commensals to have around. Moving on from the antibiotic question (it was stressing a few of you out!)
The topic of antacids merited further discussion
So although the licensed option, cimetidine is not useful in these cases….a prokinetic may be useful if severe ileus is present
We also decided against interferon owing to the lack of efficacy
Derrick was (nearly) top of the class for this
And most of you got the idea that a bland diet is what was needed
Apart from Anna with this off the wall fish curry themed suggestion – probably not the best way to go!
And Emma made a good additional point
Anna also pointed out the importance of potential in contacts
And that was where we ended it (barring the dinner tweets of course!) As Zoe pointed out:
Here is a link to a good summary paper for further reading:
Next sessions in mind are equine (hopefully next week) and I’m working on a cow one!