Anthony Todd's Activities

What can I use to cover this?

Neil Wheadon — Thu, 24 Jun 2021 10:19:15 GMT

This has just come in. Done 4 hours ago. There are 2 flaps of skin, the hanging one is dead and has a narrow base.

It's around the stifle. Practically degloved, there is a 2cm strip of skin holding the two ends together

The dog is anaesthetised and the nurses are cleaning it as I speak.

Based on the 'stitch it and it can only fail, I can get the other flap half the way across.

This will need a graft, so my question is 'what's the best thing to cover the muscle with now? '

I know it's a basic question. I'm tempted to stitch a dressing on as it's so high up that a bandage will never hold

Thoughts (preferably ASAP)

Neil

PS It's a grey hound

CAN ANYONE HELP Please?

Julian Earl — Wed, 10 Feb 2021 14:08:55 GMT

Hello, This is a difficult post for me to write.

As many will know, I am/was an experienced vet, having qualified in 1981 in fact after wanting to be a vet since I was aged 7 or 8 years old. Then on the 8th August 2012, about 7.30pm, I crashed in a local cycle race, my passion outside of work and sustained life-threatening injuries: A basal skull fracture, multiple brain haemorrhages, a subdural haematoma, five broken ribs and a punctured lung plus a broken collar bone. Indeed, my wonderful consultant neurosurgeon at Hull, Gerry O'Reilly told my wife that I was not expected to survive, but here I am.

I was placed in an induced coma for 11 days and spent the subsequent four months after intensive care on the neurosurgical ward being largely confined to bed! Gerry clearly had the brain surgeon's skills to repair the damage to my skull etc, but I have tried to acknowledge that it has been my family and friends who have kept my inner spirit alive. This includes very many professional colleagues such as your good selves here on vetsurgeon.org. My cycling clubmates have gone out of their way to help me as well and I discovered how many true friends I really have! Far more than I knew about! These included school friends whom I had not seen for 40 years!! I have tried to thank everybody via letters,in the Vet Record and also the Vet Times!

Sheep Veterinary Society, do deserve a special mention as I have been a member since 1984 I joined for CPD but acquired lifelong friends! :) I now also consider Gerry O'Reilly himself as a good friend because he has been so supportive since and so positive. I must count as one of his successes? My first memory after my crash, at a recorded 30-35mph by a farm entrance where my helmeted head struck the tall kerbstone, was when I awoke; Gerry was sat next to my bed. He asked me what I was like as a person and what did I want to do in the future? I said, "Well, I am quite stubborn and do not give up easily!" In the future? Sorry RCVS, but I said, "All I want to do is get back on my bike!" He said, stubbornness is good on this ward! If you want to get back on your bike, then I will get you there! A fantastic reply, not Don't be daft, you cannot even even stand up alone at the moment! And especially that he had recently told Annika my wife that I was very unlikely to survive! But here I am, thanks to Gerry in the first instance...!

I am pleased to say that I am indeed back on the bike albeit as a Para-cyclist and have achieved top ten placings in the National Championship in 2018, and 2019, when after 2016 and when first registered as such I had to pull out due to lack of full control of my left hand on the handlebars and veering wildly a lot! In 2017 near Chester I finished in 11th; in 2018 5th in Essex, and 2019, 6th in South Wales. Pleasing progress Then in June 2021 I achieved 5th again, . Thwarted by COVID in 2020 as no champs were possible. Edited in June 2021 to say that on 5/6/21 I matched that 2018 result with 5th again in the National para-cycling time trial held near Bath on a hilly circuit of 18.5 miles. An edit: In 2021 I won my first two National Para-cyling events, in my particular category and those two wins have given me the National Title for the Para-Cycling Time Trial Series of this year. I never expected to be aNational Champion in mybeloved sport, para-cyclist or otherwise so this has been immensely satisfying!

ow do I top this next year, being the major problem now?? So where am I going with this? When in hospital I suffered some abuse from some nurses: a male nurse punching my arm if he thought I was trying to get out of bed which I was not! And bearing in my mind I had 5 broken ribs and the collar bone at the time. And one female nurse slapping me to wake me up! "You shouldn't be asleep at this time of day [It was 4pm]. I was in the process of recovering from the anaesthetic following one of my operations so that is why I was sleeping! I did rather snap at that nurse on that occasion! As for the male nurse, I told the Ward manager about this when I returned for a check up and he said, Yes I know who you mean but he was fired a few months later for something unrelated. Oh I said, well I'll shed no tears for him! In the following months when I was at home, I slept very poorly and suffered a lot of nightmares related to still being in hospital. I try to use mindfulness to return my presence of mind to the here and now of being at home in my own bed. My GP diagnosed PTSD and even now, 8 years later I still suffer nightmares and almost hallucinations of where I am.

I receive regular counselling both locally and initially from Vet-Life, I am told this will Pass! But can I be sure? My wife has gone above and beyond the call of duty in helping me. She was retiring as a district nurse, her own leaving do, when I crashed! The first advice that I was given was to be open about this problem. The PTSD has evolved into depression and anxiety which are extremely common after a major injury to the head! "So do not be ashamed", it is not a sign of weakness when I was concerned how it might be seen? Hence I am posting on here to ask for suggestions from my professional colleagues, all of whom have been wonderfully supportive of my difficulties during the past 8 years. I am honest enough to admit that I am glad I am now retired and away from practice so that I no longer have ready access to the Euthatal and similar should my resolve completely crumble. My former boss, David Greenhalgh to be specific, from 30 years ago has been very caring and he has pointed out that suicide stops things from getting worse, but it also stops things getting better! I could not inflict that pain on my wife and son, and nor on my sister who lost her husband from thyroid cancer just a couple of months ago. In one word, the reason I would not take this option, LOVE!, for my wife Annika and my son Robert. Plus I do still have unfinished business on the bike. There are personal bests to be broken yet!

I lost a good friend, Harvey Pickup to this in 2009 and my initial reaction afterwards was was both sorrow and anger! Blimey Harvey! Did you not know that you had friends out here? I've spoken to his parents since and he never talked to them about his difficulties either! So again, that is a reason for posting on here about this. So, Please be kind!

Thank you in anticipation for your help and suggestions. Much appreciated thanks.

Julian Earl Cert AVP- status [ SHP.] and WEL.], now retired....

The beautiful valley of Oxcombe,

Lincolnshire...

Out-of-hours survey

Arlo Guthrie — Tue, 24 Aug 2021 13:27:30 GMT

Anecdotally, pet owners are increasingly contacting vets out of hours for things which are certainly not emergencies.

To quantify this, I've created a survey.

Importantly, we ask you to consider the last time you were contacted OOH (not the time before, or any other time), and it must have been in the last two weeks.

Here is the survey: https://survey.alchemer.com/s3/6495987/Out-Of-Hours

Would be grateful for any constructive criticism. This is beta. If everyone thinks the question is framed OK, then I will share beyond vetsurgeon.org later today.

Tangent of: RE: Crisis in the profession?

Starting Up a New Practice - Help!

Sarah Bolt — Tue, 24 Aug 2021 15:55:16 GMT

Hi,

I am setting up a new vet practice and would appreciate any input on pretty much anything anyone has advice on!! Suppliers, wholesalers, buying groups, H&S people to do all the boring stuff!! Who would you recommend, who would you avoid?

Also, if anyone is looking to move on any equipment in the next couple of months, I'm open to whatever you might have, although am already sorted with an x-ray and ultrasound machine.

My practice is going to be compact, so any space-saving ideas also welcome.

I appreciate this is an incredibly broad subject and may warrant tangents, but I'm swinging from feeling excited to feeling completely lost an overwhelmed about every 30-45 seconds (that's normal right?!?!) so all tips and advice are very much appreciated.

Thanks in advance,

Sarah

MUSIC TO CHEER YOU UP??

Julian Earl — Sat, 14 Aug 2021 18:03:42 GMT

Thank you to George cooper for this idea but here goes...:

What music do you recommend to help someone who is severely depressed? This person being me, hence my thread asking if anyone can help?

My own answers to ths question include a double CD the classic Experience with a wide range of very uplifting tacks. Top has to be The William Tell Overture , never failing to make me smile! Rde of the Valkyries and many, many more. Handel and Arrival of the Queen of Sheba...

For rock music Ilike anything from Alice Cooper to the Who [ the greatest UK rock band surely? Heard Won't Get Fooled Again on Radio 2 this morning, and had forgotten its brilliance!

Prog rock is good stuff as well: Genesis Selling England for the wit/puns and general ironic humour. The Doors are a lifelong favourite, not necessarily uplifting as such just great music!

Ona different tack, I have a very good CD set of bird songs which is very, very relaxing to listen to unless you are a cat stuck indoor when t seems to be rather confusing!

I do have my Linguaphone set for Swedish that I have not gone through. literally for year, maybe for 12 years so should go through that again for when I see the In-laws again!

Thanks George for this idea. Over to all of you now...!

The 5 minute consult, any comments regarding why we should be doing these rather than 15 minutes in here please

Neil Wheadon — Sun, 03 Oct 2021 18:02:09 GMT

[quote user="Anthony Todd"]But why not? What takes 15 minutes? Do you think most clients really need/understand/want to pay for 15 minutes or is it that they are given the obligatory 15 minutes anyway for anything?[/quote]

Tangent of: RE: Crisis in the profession?

Like the bicycle thread, here's the 5 minute consult thread

Vets 'helping pet owners prolong animal agony'

Arlo Guthrie — Mon, 20 Sep 2021 08:36:32 GMT

Interesting article in the Sunday Times this weekend. Think this share link will work, but it may expire after a few people click it:

https://www.thetimes.co.uk/article/7198fbec-18b6-11ec-a4b1-45d6202ceafe?shareToken=0fa8a75dc7c83566cbcba234baa20c2d

It's a bit of a variation on a theme. I've argued for a while that the level of treatment given these days is increasingly out of proportion to the value of the thing being treated (however you measure value). The ST article argues that overtreatment causes unnecessary suffering.

I'm trying to find out more about the somewhat secretive group behind the story: https://www.ethicsfirst.co.uk/

Meantime, what does everyone else think?

Crisis in the profession?

Bob Russell — Thu, 29 Jul 2021 14:53:01 GMT

We are short staffed yet are being inundated with requests by non-clients to register. Apparently at least seven local to us are not allowing new registrations and as on 48 hours ago we have had to do the same to preserve the sanity of those we have working.

Self-isolation was our trigger but we genuinely cannot take clients from all over Southampton.

Bright ideas why and suggestions would be appreciated but we are tired, fed up and one member of staff is now off sick with stress. I do not normally allow stress to affect staff!!

Feline diarrhoea panels

Kara Gibson — Thu, 30 Sep 2021 10:14:13 GMT

Hi,

I've recently had a couple of these come back positive for Feline parvovirus in kittens around 3 months old and either not vaccinated or only had 1st vaccine. They both had ongoing mixed small/large bowel diarrhoea but were otherwise totally well in themselves. In-house SNAP tests are negative.

Is it possible they've had a 'mild' viraemia perhaps due to maternal protection and first vaccination? sI this a false positive? Will a previous vaccination have any impact on the PCR?

Vet shortage hits ITV News

Neil Wheadon — Wed, 18 Aug 2021 21:47:03 GMT

www.youtube.com/watch

SOME LA ADVICE...

Julian Earl — Thu, 23 Sep 2021 19:34:11 GMT

As a mixedpractitioner for 40 years I feel I can offer so me useful/valid avice especially to newer graduates? things that I was ot specifically taiught but learnt the harder/longer way!

1. Apecifically for caesareans in cattle and sheep.

2. Forget local infiltration of the flank for anaesthesia! It talkes too long, causes too much bruising and if not caful, sooner or later you will receive a hefty kick from a cow when you are inserting the eg 18gauge needle eg 18gauge, 5cm?> in through the flank to administer th local. Therefore, make a special effort to learn to do a paravertebral effivcietly. It takesa bit longer to do and stil beware kicks butwhen done correvtly it is highly effective and causes no bruising in the flank of course to interfere cwith your surgical wound. nor the healing thereof! combined with an rpidural in cows it is the only way o be recommended!E ews generally do not need an epidural as well though, only ratrely....But; IIn both specis you should hve ample time and more for the procedure this way!

However probably before opting forthe caesarean my main biy of sdvice that I learnt the hard and slower way is relatively simple! When calving a cow and lambing a ewe it ids not possible to useexcessive lubigel! When doing a calving and even alambing aswell despite the size-difference, the amount of Lubigel used should be measured in the number of bottles and not by the number of squirts or fractions of a bottle. If necessary, use 4,5, 6 in a cow to make everything very slippery! You know it makes sense!!

Alpaca and TB testing

Mike Dale — Sun, 08 Aug 2021 07:32:28 GMT

Long time since I wielded TT syringes. Can someone explain to me what is the fair scientific solution to this situation? People keep asking me because I'm a vet but I don't have current knowledge to give an opinion.

Suture material?

Julian Earl — Tue, 24 Aug 2021 10:28:38 GMT

From my purely theoretical position now, I would like to ask if there id still a role for suturing wounds such as ovariohysterectomy abdominal mid-line incisions or other laparotomy wounds in small animal surgery for catgut as a suture material? Or does everyone and indeed should everyone be using material such as Vicryl or my favourite, PDS? There are more expensive per cm but a reel of catgut is certainly not cheap. The last price that I can recall it was costing about £40 for a spool of sterile chromic catgut in around 2013 ?

What do you think of this nowadays please? Is there a role for catgut at all? I ask purely out of interest.Thank you for your replies...!

Feline Chronic Gingivitis Stomatitis Complex

Kara Gibson — Thu, 09 Sep 2021 01:56:41 GMT

I have a challenging case of severe FCGSC in a 15 month old MN DSH. He is FIV/FeLV negative, I have not bothered to check for Feline Calicivirus, just assumed he is probably positive.

I have read all the papers out there recently and I know how difficult these cases can be but just after a bit of advice on next step at this point.

His lesions are severe from the premolars backwards but particularly the caudal oral mucosa, lateral to the palatoglossal folds and even going down into the caudal oropharynx to include mild lesions on his epiglottis (I apologise for the lack of photos). He has no inflammation at all associated with the canines and incisors. I surgically extracted all premolars and molars one month ago and I know I have got all the roots. The extraction sites have healed very well, he only has a thin moderately inflamed line in this area but the gingiva lateral to the palatoglossal folds remains markedly inflamed and he is recently having blood tinged saliva.

He unfortunately vomits on oral meloxicam so currently he is on oral buprenorphine and pregabalin for pain relief. He has had 2 weeks of post-operative convenia as he was too sore to tablet. I hate giving steroids to these cats but in desperation I gave him a one-off depomedrone injection (as I can't give him NSAIDs) to try and settle the post op inflammation down 2 weeks ago, I also started him on oral interferon 1 week ago.

I know that he may require extraction of his remaining teeth but I am doubtful of good improvement given the lack of rostral lesions. He has quite proliferative tissue lateral to the palatoglossal folds, would there be any potential benefit in resecting it?

Does anyone have any experience using cyclosporin for these cases?

Anaesthetic monitors

Bob Russell — Wed, 01 Sep 2021 16:40:06 GMT

[quote user="Anthony Todd"]My last word on monitors, promise! Just make sure it has an audible apnoea alarm![/quote]

Tangent of: RE: Starting Up a New Practice - Help!

There are distinct disagreements as to the best monitors to use. It has not been discussed recently as far as I am aware.

There is more than a slight risk it will detract from the original post so if people want to discuss the pros and cons of the various monitors this thread may be interesting. If not it will die a death!

todaysveterinarypractice.com/.../