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ASK VETbytes – November 2024

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ASK VETbytes

Induction Of Emesis In Cats

Maxwell, K.M., Odunayo, A., Wissel, C. (2024)
Use of orally administered dexmedetomidine to induce emesis in cats.
Journal of Feline Medicine and Surgery 26(5), 1098612X241248980.
Full text available

QU. What was the success rate of inducing emesis in cats using orally administered dexmedetomidine at a dose of 20 µg/kg, as described in the study?

A. 43%

B. 67%

C. 83%

D. 100%

Click here for the answer

ANSWER
C  83%

MORE INFO
The study explored the use of orally administered dexmedetomidine at a dose of 20 µg/kg to induce emesis in cats. Emesis was successfully induced in 83% of the cats (5 out of 6), making it a potentially effective method for gastrointestinal decontamination following toxin ingestion. This novel administration route could be especially useful in scenarios where intramuscular injections may be more stressful or difficult to perform.

Dexmedetomidine, an alpha-2 agonist, works by stimulating the chemoreceptor trigger zone in the brain, which leads to both emesis and sedation. Although sedation was a noted side effect, no other significant adverse effects were observed in this study, highlighting the potential for oral administration as a practical alternative in emergency settings.

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ASK VETbytes – October 2024

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ASK VETbytes

Point Of Care Ultrasound (POCUS)

Buckley, C., Seitz, M., Will, R.W., et al. (2023)
Assessment of a standing position during abdominal point-of-care ultrasound on abdominal fluid score in dogs
Journal of Veterinary Emergency and Critical Care 33(5), 559-566
Abstract

QU. Which of the following statements is correct regarding the abdominal point-of-care ultrasound (POCUS) techniques used to detect peritoneal effusion in dogs, as described in this study?

A. The standing approach is less reliable than the right lateral approach for detecting peritoneal effusion in dogs

B. The standing approach is more sensitive than the right lateral approach for detecting peritoneal effusion in dogs

C. The standing approach showed excellent agreement with the right lateral approach for detecting peritoneal effusion in dogs

D. The right lateral approach is significantly more accurate than the standing approach in identifying small volumes of peritoneal effusion

Click here for the answer

ANSWER
C  The standing approach showed excellent agreement with the right lateral approach for detecting peritoneal effusion in dogs

MORE INFO
The study highlighted that the standing position for abdominal POCUS in dogs yielded results comparable to those obtained in the right lateral recumbency position. Both approaches showed good to excellent agreement with the gold standard full abdominal ultrasound. This makes the standing approach a viable option in clinical scenarios where lateral recumbency might not be practical or safe, such as in patients with respiratory distress or large body size. This flexibility in positioning enhances the clinical utility of POCUS in emergency settings.

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ASK VETbytes – September 2024

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ASK VETbytes

ANAPHYLAXIS

Fosset, F.T.J., Lucas, B.E.G., Wolsic, C.L., et al. (2023)
Retrospective evaluation of hypersensitivity reactions and anaphylaxis in dogs (2003-2014): 86 cases.
Journal of Veterinary Emergency and Critical Care 33(5), 577-586
Abstract

QU. What was the most common trigger for anaphylaxis in the dogs included in this 2023 retrospective study on hypersensitivity reactions?

A. Insect envenomations

B. Food allergies

C. Vaccines

D. Drugs

Click here for the answer

ANSWER
C – Vaccines

MORE INFO
This 2023 retrospective study found that vaccines were the most common trigger for anaphylaxis in dogs, accounting for 57.9% of anaphylactic cases.

Interestingly, the study also noted that cutaneous signs, which are often relied upon for diagnosing allergic reactions, were not present in over half the cases of anaphylaxis. This underscores the need for vigilance in identifying other signs, such as respiratory distress, cyanosis or circulatory shock, which were strongly associated with non-survival in affected dogs​.

In this study, the prognosis for anaphylaxis in dogs was generally favourable. The data indicated that the use of glucocorticoids for treating mild type I hypersensitivity reactions and anaphylaxis did NOT result in improved clinical outcomes or increased survival rates.

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BSAVA invests in VETbytes

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In partnership with BSAVA

BSAVA invests in next generation clinical resource

BSAVA has announced they are investing in the start-up company which owns VETbytes. VETbytes is a revolutionary point-of-care clinical resource that gives small animal veterinary professionals critical access to the latest evidence-based information.

It offers a library of concise clinical summaries that are drawn from global guidelines and peer-reviewed journals and has an exciting product pipeline building on the foundation of the current ECC app, with a nursing and a primary care app coming soon.

BSAVA Chief Executive Officer, Amanda Stranack said: “We are very excited about this product and its potential. The VETbytes concept perfectly aligns with our values and our mission to promote clinical excellence and evidence-based education to the veterinary community.

“Integrating EBVM into daily practice has been shown to have a positive effect on client relationships and practice teams and has the potential to improve patient outcomes. As an established partner to VETbytes and an advocate of EBVM, we are pleased to be able to take our relationship to the next level and to support the expansion of this high-quality resource.”

Alison Speakman, BSAVA President continued: “Finding time in busy practice life to stay up to date with the latest research and advances can be challenging, therefore enabling members to benefit from this fantastic tool quickly at the point of care is a huge step forward. The VETbytes app works really well for practitioners alongside the BSAVA manuals and formularies and is a very exciting development.”

Zoë Coker, co-founder of VETbytes and a BSAVA member, added “Our vision was to create something different, a new generation of clinical resource that was not only evidence-based and evidence transparent, but also interactive and updated in real time. We drew on our own experiences as vets, looked closely at what could go wrong in practice and then developed tools and techniques to reduce these errors, creating real QI.

“We hope to be able to enhance the quality of veterinary care, maximise efficiency and facilitate clinical decision making by providing clinicians with easy access to current, reliable and clinically relevant information and we are absolutely delighted to have the support of BSAVA whose values and vision are closely aligned to ours.”

BSAVA members are offered an exclusive 33% discount on VETbytes, to find out more about how to

access this discount, visit: https://www.bsava.com/membership/mybsava/member-benefits/myassociation/vetbytes/.

For more information about VETbytes: https://vetbytes.co.uk.

VETbytes checklists

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VETbytes launches a series of interactive checklists 

Checklists are defined as lists of actions arranged systematically that allow the user to consistently perform each action, record the completion, and minimise errors.

They are used extensively in healthcare and in addition to the obvious clinical benefits they have also been credited with improving team communication and supporting a culture of patient safety.

Where you see this “check box” symbol alongside the title of a condition, there is now an associated checklist available.

 

 

The checklists have been created in 2 formats to cater to all levels of expertise.

Keep It Simple summary (KISS) 

For those experienced clinicians who just need a reminder of what is and isn’t recommended, the “KISS” checklist is ideal. Users have the option to expand individual recommendations to gain access to drug doses and to understand more about the specific indications and risks for each treatment.

Extended Checklist

For clinicians with less experience or those unfamiliar with a particular condition, a more detailed checklist is available by clicking on the “expand all” button at the top right-hand side of the page.

We will be sharing some resources about how to effectively implement checklists into practice with our subscribers to ensure you get the most out of this exciting feature.

We are really interested in hearing your feedback about our checklists so please let us know if you have any ideas for additions or suggestions for changes that you would like to share

Contact us

VETbytes Interactive checklists

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January 2023

VETbytes launches a series of interactive checklists 

Checklists are defined as lists of actions arranged systematically that allow the user to consistently perform each action, record the completion, and minimise errors.

They are used extensively in healthcare and in addition to the obvious clinical benefits they have also been credited with improving team communication and supporting a culture of patient safety.

Where you see this “check box” symbol alongside the title of a condition, there is now an associated checklist available.

 

 

The checklists have been created in 2 formats to cater to all levels of expertise.

Keep It Simple summary (KISS) 

For those experienced clinicians who just need a reminder of what is and isn’t recommended, the “KISS” checklist is ideal. Users have the option to expand individual recommendations to gain access to drug doses and to understand more about the specific indications and risks for each treatment.

Extended Checklist

For clinicians with less experience or those unfamiliar with a particular condition, a more detailed checklist is available by clicking on the “expand all” button at the top right-hand side of the page.

We will be sharing some resources about how to effectively implement checklists into practice with our subscribers to ensure you get the most out of this exciting feature.

We are really interested in hearing your feedback about our checklists so please let us know if you have any ideas for additions or suggestions for changes that you would like to share

Contact us

Ask VETbytes: What are the treatment aims of head trauma/traumatic brain injury?

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This week, we asked VETbytes: “what are the treatment aims when managing a case with head trauma or traumatic brain injury?”. After your initial assessment, our vets recommend the following treatment aims, but first, remember:

Cerebral perfusion pressure = MAP – ICP
If ICP > MAP there is no cerebral perfusion

Optimise MAP
  • i/v fluids
  • +/- blood products
  • +/- vasopressor support
Reduce ICP
  • Avoid hypoxaemia
  • Avoid hypercapnia or hypocapnia
  • Promote venous drainage by elevating the upper body by 15–30 degrees
  • Manage seizures
  • Control pain
  • Reduce cerebral oedema with hypertonic saline or mannitol

To access the full clinical guide for head trauma and traumatic brain injury subscribe to VETbytes for £9.99/month or £99/year or start your free 30-day trial today! BSAVA members receive 33% discount and BSAVA 1st year qualified members 6 months FREE access, click here to find out more.

If you have any questions about using VETbytes, get in touch with the team today.

Ask VETbytes: Acute Haemorrhagic Diarrhoea Syndrome

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This week we were asked if antibiotics are indicated in cases of canine acute haemorrhagic diarrhoea syndrome (AHDS)? Our team of vets had the following advice:

  • Routine use of antibiotics is not recommended
  • Treatment of dogs with aseptic haemorrhagic gastroenteritis with co-amoxiclav does not reduce the time to resolution of clinical signs
  • Evidence suggests that the addition of metronidazole is not beneficial
  • Broad-spectrum i/v antibiotics are indicated in immunocompromised or neutropenic patients and in those with suspected sepsis
  • Stop antibiotics as soon as the patient is clinically well

[3][6][16][17][18][25][28]

Find more answers to common emergency and critical care questions, when you sign up to VETbytes.
Start your free trial today or subscribe for £9.99/month or £99/year.
BSAVA members receive 33% discount and BSAVA 1st year qualified members 6 months FREE access, click here to find out more.

[3] Unterer, S., Strohmeyer, K., Kruse, B.D. et al. (2011)
Treatment of Aseptic Dogs with Hemorrhagic Gastroenteritis with Amoxicillin /Clavulanic Acid: A Prospective Blinded Study
Journal of Veterinary Internal Medicine;25(5) 973-979
Full text available

[6] Unterer, S., Lechner, E., Mueller, R.S. et al  (2015)
Prospective study of bacteraemia in acute haemorrhagic diarrhoea syndrome in dogs 
Veterinary Record;176(12) 309
Abstract

[16] Dunowska, M. (2017)
What is causing acute haemorrhagic diarrhoea syndrome in dogs?
Veterinary Record;180(22) 539 – 541
No Abstract available

[17] Ortiz, V., Klein, L., Channell, S. et al. (2018)
Evaluating the effect of metronidazole plus amoxicillin‐clavulanate versus amoxicillin‐clavulanate alone in canine haemorrhagic diarrhoea: a randomised controlled trial in primary care practice
Journal of Small Animal Practice; 59(7) 398-403
Abstract

[18] Ziese, A.L., Suchodolski, J.S., Hartmann, K. et al. (2018)
Effect of probiotic treatment on the clinical course, intestinal microbiome, and toxigenic Clostridium perfringens in dogs with acute hemorrhagic diarrhea
PLOS One; 13(9) e0204691
Full text available

[25] Dean, R. and Perry, R. (2017)
Use of antibiotics in dogs with aseptic haemorrhagic gastroenteritis
In [clinically well dogs with haemorrhagic gastroenteritis] does [systemic antibiotics compared to no antibiotics] [decrease the time to resolution of clinical signs]?
BESTbets for Vets, University of Nottingham
Full text available

[28] Unterer, S. (2017)
Acute hemorrhagic diarrhea syndrome – an update
An urban experience, 42nd World Small Animal Veterinary Association Congress and FECAVA 23rd Eurocongress pp 242-243

Join us at BSAVA Congress – Book your live demo now

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VETbytes is delighted to be exhibiting at the upcoming virtual BSAVA Congress 2021, taking place 25-27 March, where we will be showcasing our Emergency and Critical Care (ECC) module.

Join us for live demonstrations of the ECC module during the event and sign up for a free trial of VETbytes during Congress for a chance to win one of three annual subscriptions (each worth £99) or an iPad 10 (32GB)*


*Terms and conditions:

  • One entry per person. One per prize per person. Prizes are non-transferable, non-refundable. Open to UK residents aged 18+
  • To enter the competition you must sign up for a free trial between 08:00 Thursday 25 March and 18:00 Saturday 27 March 2021
  • Closing date for entries is 18:00 Saturday 27 March 2021
  • Winner will be chosen at random from free trial subscribers between the above dates
  • Winners will be notified by email no later than Monday 29 March 2021
  • Winning entries will be published on the VETbytes social media pages, by entering the competition you consent to your name being published on their social media pages and website

 

Latest update: how do you diagnose a colonic torsion?

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One of the many VETbytes features is its ‘latest evidence’ feed, which provides a snapshot of the latest evidence in bitesize form, recently added to the emergency and critical care module.

Rapid identification of colonic torsion is imperative to prevent significant ischaemic injuries.

A new study by Czajkowski and Fryer,* describes a rapid, low morbidity test that can be used in cases of suspected colonic torsion in dogs which may help to differentiate this rare condition from generalised ileus or small intestinal volvulus.

To view the full evidence feed and find out how to recognise a colonic torsion in your patients, sign up for a free trial of the VETbytes emergency and critical care module or subscribe for an annual licence for only £99/year!

*Czajkowski, P.S., Fryer, K.J. (2020)
Colonic torsion in 4 Great Danes
Journal of Veterinary Emergency and Critical Care; 30 (5) 581-586
Abstract