Martin Atkinson's Activities

Canaural out of stock

Martin Atkinson — Tue, 02 Apr 2019 08:35:19 GMT

As Canaural is out of stock what alternative ear drops are people using?

Rat castration

Martin Atkinson — Fri, 22 Mar 2019 13:21:50 GMT

It is a long time since I've castrated a rat and just wondered what the current recommended approach is: inguinally or scrotal like I would now do in a rabbit making a small nick over the epidymis of each testis?

Mycoplasma conjunctivitis in a cat

Martin Atkinson — Tue, 15 Jan 2019 16:44:39 GMT

Any updates on treatment of mycoplasma conjunctivitis in a cat. We have one that the PCR has just come back +ve. I'd started it on chloramphenicol ointment pending results of the swab and the perceived wisdom seems to be that it should resolve spontaneously with that. However, in anticipation that it might not anyone and bright ideas. I cannot recall diagnosing this previously but was going to try doxycycline tablets next.

This week in Vet Record - reporting breed deformities

Martin Atkinson — Fri, 23 Nov 2018 11:42:10 GMT

There is an article in this week's Vet Record by Emma Goodman Milne regarding dogs and cats with extreme conformational abnormalities selected for breeding. She cites the Animal Welfare act which states: 'No dog may be kept for breeding if it can reasonably be expected, on the basis of its genotype, phenotype or state of health' that breeding from it could have a detrimental effect on its health or welfare or welfare of its offspring', and encourages us to alert the authorities as it us upon whom the onus is most likely to fall.

It begs many questions: does this mean that we should be reporting every litter of brachycephalic pups, Bassets, Dachshunds, Shar-peis, CKCSs etc etc? And who are these 'authorities'? I can't see the police being interested, the RSPCA are too busy, trading standards in most areas don't have a clue. How many vets, especially those with a number of breeders are going to dob their clients? And how about GDPR: at what point can we breach that with the exemptions of vital or public interest if the breeder complains because nothing come from the reporting?

I have the greatest respect for Emma and wholeheartedly endorse the sentiment behind this but really can't see that we will change the world overnight especially given the commercial interests in the vast sums of money involved in breeding for both breeders and some vets, or for those of us who do care, without compromising our own positions.

Clinical conundrum: dog with lymphoma and possible HAC

Martin Atkinson — Thu, 29 Nov 2018 11:17:52 GMT

We have a dog with lymphoma which is about to start on chemotherapy and on its pre surgical blood profile it has a sky high ALP. Liver function is normal but it has a high urine cortisol creatinine ratio. Clearly there is a dilemma here if this dog has HAC immunosuppressive doses of corticosteroids are not going to exactly help. It seems pointless doing a LDDS or ACTH stim test as the priority is treating the lymphoma and the raised ALP & UC:C test may be due to non-adrenal disease associated with the lymphoma.

If it is really HAC anyone have experience of treating such a case concurrently with giving steroids?

Tortoise with possible haematuria and radiolucent thingie

Martin Atkinson — Wed, 28 Nov 2018 13:06:13 GMT

Here is a radiograph from a 7 year old Horsefield's tortoise, from the flat plastrum short tail we think is female albeit the owners were told it male, which has been passing pink urine although the sample they provided was clear bar urate crystals. As we suspected there may be bladder stones we took an X-ray and found this triangular shaped object in the mid abdominal region. My knowledge of tortoise anatomy is rather limited but I would have thought that it's too cranial for the bladder, could it be a kidney stone or what else could it be?

Imidacloprid resistance - tangent of Telemedicine Trial

Martin Atkinson — Thu, 01 Nov 2018 17:13:19 GMT

[quote user="Bob Russell"]With parasite resistance becoming an ever increasing problem (who else has been seeing imidacloprid failures, we certainly have seen a number?)[/quote]I have had a few clients who feel it is not working but no more than those who think selamectin isn't. This compared with the reports of a high proportion of vets are seeing failures with fipronil, IMO suggests this is more of an individual compliance/application technique issue rather than resistance. But whatever lungworm is our priority, as I tell clients, its the only common worm likely to kill your dog!

Poor reviews - what to do about them

Martin Atkinson — Thu, 11 Oct 2018 09:09:59 GMT

A client has just posted a damning review of our practice which is patently untrue. She lied to us about the two puppies she brought in being her own (she is a bulldog breeder) which were already being treated at another vets and said she'd rescued them. She is using at least two other vets in addition and the bitch that bore the pups had a caesarian at one even though she was registered elsewhere. I actually went out of my way to discuss the case of one with carpal vagus with an orthopaedic surgeon to find the best way of treating it.

Once I found she was lying I advised her that as she had not told me the truth (she also said she was a veterinary nurse but she is not registered) I could not work with her especially as she was already using at least three other vets and gave her the sack. She also made the same sort of complaints to the vet who saw the pups when they were 2 days old (although I'm not sure if she posted a review) so at last she's consistent. She has clearly become vindictive because of this - hell hath no fury like a dog breeder scorned!

Should we let sleeping dogs lie or respond? I can't use the evidence the vet who did the caesar gave against her as it was given in confidence.

Cat with erythrocytosis

Martin Atkinson — Wed, 26 Sep 2018 15:24:51 GMT

I saw a cat this afternoon presented because it is polydypsic. She was diagnosed with mild IRIS stage 2 CKD (Crea 219 umol/l, BUN 12.9 mmol/l) 4 months ago from a pre-surgical blood profile prior to a dental procedure. I took little notice of it then but her PCV was 47.1% (normal 24-45) and HGB 15.1g/dl (8-15). A repeat blood profile today showed a PCV of 49.7% HGB the same, MCHC 30.4 (30-36.9), PLT & WBC counts all normal, and improved renal function BUN 109, Crea 147 Phos 1.44. I was unable to take her blood pressure.

It is unlikely that this due to dehydration on two separate occasions and her serum protein levels were normal and she was not particularly stressed so splenic contraction is unlikely. I am going to try and get a urine sample and send away for EPO test.

Anyone have experience of polycytaemia in a cat and if so do you think these RBC levels are worth worrying about as it may just be normal for this cat - I would be happy as a cyclist with a natural PCV of 49.7%!!!

IM injection in cats

Martin Atkinson — Thu, 13 Sep 2018 14:45:02 GMT

[quote user="Julian Earl"]For intramuscular injections to cats, do not, repeat, NOT inject into the quadriceps unless you want a very upset cat! It is far easier to have the cat held firmly down via the shoulders on the table's surface and inject into the muscles behind the wing of the ilium. Te quadriceps has a tight sheath meaning that the increased pressure is rather painful. The iliac muscle does not have this and tolerate the injection well if done gently of course! I have found this effective for volumes up to 0.5ml and rarely use more than that in a cat IIRC! It seems that many people do not know this so I've often seen cats get very upset by a painful intra-quadriceps injection. I use this for alpha-adrenergics etc., etc.[/quote]

Tangent of: RE: Top Tips From Vets For Vets: Win £50

The issue I have with this is that there is a risk of iatrogenic damage to the sciatic nerve. I do not find that the needle going into the quads is more painful, it is what you inject and the volume which determines the degree of pain. If I was attempting IM injection by myself on a cat I would restrain it by the shoulders or scruff and inject into the lumbar muscles.

miR-122 test for liver disease

Martin Atkinson — Wed, 05 Sep 2018 13:39:36 GMT

I read in Vet Times Aug 20 issue (only just got round to fishing it off the pile of journals on the floor!) about this new test (miR-122) which has apparently been developed by the University of Edinburgh as a test for liver disease. The full paper has been published in JVIM but as I'm not a subscriber I've not been able to read it.

For those who are not aware, it is heralded as a test for early liver disease. Lead researcher Prof Richard Mellanby goes on to say, 'We struggle in some cases to diagnose liver pathology and what we've shown is that it is a very specific, sensitive marker'. Even Prof Mellanby then suggests only that he is 'cautious' the test would be better than present biochemistry tests.

Is it just me or does anyone else find it difficult to understand how one test can possibly give a diagnosis of the pathology of liver disease. given the multiple possible causes, and add more to the diagnosis than a panel of ALP, ALT, Tbil, Cholesterol, BA and GGT?

Maybe like SDMA in chronic renal disease, it can be used as a screen in apparently healthy animals to give an earlier indication than these tests, especially as we're not usually going to be testing until there is clinical disease. Maybe one test may be easier/cheaper but it will still surely warrant further investigation and imaging/biopsy will still be necessary to make and absolute diagnosis.

One could argue the same about NT-proBNP in the diagnosis of cardiac disease and I've embraced that, but it is the only practical blood test presently available given Troponin is not a useful tool most of the time in our patients.

RSPCA payments for initial emergency treatment

Martin Atkinson — Mon, 03 Sep 2018 14:24:14 GMT

A MOP brought in a hedgehog found in the road and obtained an RSPCA code. We GA'd her, X-rayed her, found an old fracture of the hock and an abscess on the neck, gave her IP fluids, antibiotics and de-flead her and she's in our ICU awaiting transport to Tiggywinkles. Then called the RSPCA vetline to get authorisation for IET. They refused because it weight less than 1 kg. So why does it cost any less/use up any less resources if it weighed 999 gm that if it weighed 1 gm more?

I know the BVA agreement with the RSPCA is that wildlife casualties should be >1kg to qualify for IET but I though it only applied to birds or I wouldn't have bothered calling them, or I would have lied and said it weighed more than 1 kg! I would have treated this irrespectively but they hardly encourage us to treat such casualties when they have probably got far more money in the bank that I have.

Bitch with persistent oestrus

Martin Atkinson — Fri, 17 Aug 2018 11:18:51 GMT

Saw an 8 month terrier cross bitch this morning with vulval swelling and bloody discharge - classic pro-oestrus we all say. Problem is she started her first season on 5th June and followed a textbook pattern: vulval swelling then bleeding for 3 weeks then the bleeding stopped end of June. The owner isn't sure if the vulval swelling went down but is fairly sure it didn't completely but he's not the brightest spark in the fire and there is a bit of a language barrier. Bitch is well in herself, not anaemic, mild neutrophilia and rectal temp. 104F. Vaginal smear shows irregular shaped un-nucleated squamous cells but for some reason we can't identify any blood cells - they're all blurry possibly from damage taking the smear. Thought about doing a hormone assay but don't have enough blood. No ultrasound available but she is thin and I can't feel anything enlarged or uncomfortable (i.e. uterus) inside.

Plan now is to perform a clotting profile as I did see something like this years ago and it had a clotting defect (minus the vulval swelling mind you) and if that is normal, crack on and spay her as this looks like whatever is going on is going to persist or turn into a pyo.

Any advance on that idea?

Cat with chronic wheeze and arrhythmia

Martin Atkinson — Fri, 10 Aug 2018 11:51:29 GMT

This is an ECG from an 8 year old cat which was diagnosed with chronic inflammatory upper airway disease in April although the BAL was not conclusive for asthma and put on Flixotide inhaler with an improvement in its condition. She came in for her annual booster this week and on routine examination I detected an episodic ventricular arrhythmia. Her wheezing has recurred as the inhaler had run out. cardiac radiographs seem to show a moderately enlarged left atrium and VHS is 9.

My interpretation of the ECG is a wandering pacemaker or sino-atrial dissociation with accrochage. IMO probably secondary to HCM. We're performing NT-proBNP and will consider referral for echo if that is high.

Any better ideas on diagnosis. Sorry about the smudge in the middle of AVL & AVR the cat sat on the trace while still wet from the spirit form where we attached the leads.

You'll have to click on the link to get the ECG PDF file.

www.vetsurgeon.org/.../7536.Indie-Baines.pdf

Pug with multiple skin lesions

Martin Atkinson — Wed, 08 Aug 2018 11:17:40 GMT

Here's some pictures of an 8 year old Pug I saw today covered in these pigmented wart like lesions. They have been present for several years but getting more numerous and larger. This came in to have its nails clipped having moved vets. They suggested it had biopsies but seems this was declined. I've never seen anything like it but they all look benign and confined to ventral abdomen and limbs. Any thoughts anyone?