Friday, January 21, 2011

Home again

and pleased to be here. I was exhausted yesterday when I arrived, due to the fact that I had to be up at 4:30am to catch my flight. We got back around 12:30 (after having breakfast together), and collectively crashed on the couch for a Lost marathon, as well as pizza and gyros for dinner. It was decadent. Today, I have a list of things to accomplish before heading back to work tomorrow.

In the meantime, a few pearls I picked up at NAVC:

-Unlike dogs, if a cat does not have a heart murmur, it is highly unlikely that they have heart disease. Dogs can have heart disease in the absence of a murmur.

-Pimobendan (Vetmedin) is being used in cats with heart failure now, although the dose is extrapolated from dogs, and there are no scientific studies to support its use.

-Long term use of albuterol inhaled in cats may worsen the inflammation associated with feline asthma. It should be used infrequently and only as a rescue therapy.

-Approximately 90% of proptosed eyes (eyes popped out of the head) will likely need to be removed at some point. They commonly develop problems after being fixed such as ulcers, blindness, and suture loosening.

I'll have to leave you with that for now.


Anonymous said...

That's funny because I've always heard exactly the opposite about murmurs! I've actually seen cats in full-out heart failure without an audible murmur and my own cat has a 2-3/6 murmur but a full cardio workup showed no signs of heart disease. Interesting...

The Homeless Parrot said...

Anon - it is very true that cats with a murmur may have no disease at all. This speaker estimated that 50% of cats she sees with murmurs have no evidence of heart disease.

On the flip side, the absence of a murmur is USUALLY associated with no heart disease. It is highly unlikely, but like many things, not impossible!

Leahanne L said...

Wow, I had no idea about the albuterol. The cats I've seen prescribed it usually end up on an every other day administration. Do they recommend puffing with any coughing fit then, or only the severe ones? And how do you help the owner tell the difference?

Also, with the proptosed eyes: did they recommend just removing them across the board then? Or is it more of a case where you have to set up the client's expecations and let them know the risks before they choose?

The Homeless Parrot said...

Leahanne: According to the speaker, chronic use of albuterol was shown (in their study) to exacerbate eosinophilic airway inflammation. She recommended using it only as a "rescue medication" - but she did not define what that meant. Her recommendation was not to use it more than 2x/weekly, at the most.

As to the proptosed eye, no, Dr Williams did not recommend removing them carte blanche. He started out the lecture jokingly say, "I can sum this up in 3 seconds. Take them all out." He then went on to say that he gone back and looked at all of his proptosed eyes in the last 10ish years (n=15 or so), and he said that all but 1 had to later be enucleated.

Now, he is an ophthalmologist, so his sample is skewed. On the flip side, I have treated many of these, and they all seem to have complications - usually giant, nasty ulcers - despite ointment application at the lateral canthotomy site, as well as oral systemic antibiotics (which he recommended until the eye is opened up at 3 weeks). So yes, I think he believes that enucleation is ultimately where these are all headed.

The Homeless Parrot said...

Leahanne: He also recommended that if an owner calls you, the proptosis has just happened, and the owner is not squeamish - to have them take a wet, lukewarm wash cloth and push the eye back in. He said that once hemorrhaging starts behind the eye, and the blood clots, reduction is much, much harder.

He said that the eyes that he saved (and has seen saved) were dealt with within 1 hour or less of the initial trauma.

You do have to consider the possibility of being sued by an owner that harms the dog, of course. He explained that England is not quite so litigious.

Holly said...

Welcome home! Glad you learned some stuff, glad you made it home safely and glad you are blogging again!

Leahanne L said...

Ha, I can only imagine the conversations with clients over the phone, if I told them to put their dog's eye back in!

Thanks for all the info, very interesting.