Discussions - Recent Threads

IMTP - 2nd line tapering plan with multiple relapses

Catherine Gerrie — Thu, 21 May 2026 09:26:54 GMT

My colleague has a 5y4m FN ESS with a chronic history of repeated immune mediated relapses.

She was diagnosed with IMTP in February 2023 after presenting with petechiae and bruising. Investigation for secondary causes were unremarkable and she was started on an immunosuppressive dose of steroids. There was initial stabilisation, but we did note some variation on platelet count whilst remaining on the same dosage (one week 90 x 10^9/L, another week >300) though none reaching a critically low value. Tapering took a while and eventually reached 0.15mg/kg (1/2 5mg tab po sid) which was not then stopped (owner led).

In September 2024 they presented with pyrexia, shifting lameness on hindlimbs and bilateral hock effusions. Platelets were normal. Investigation diagnosed IMPA and treatment was started at an immunosuppressive dose again using examinations and CRP to track response to treatment. This tapered nicely to EOD dosing and again was not stopped as the owners were concerned about relapse.

IMTP recurred in October 2025. Initial hospitalisation stabilised the platelet count and allowed movement to per os and out patient care. Reduction in dosage resulted in relapse though (platelet count reduced from 155 to 0 on smear, whilst on a 1.25mg/kg dose). Ciclosporin was then started at 4.8mg/kg per os SID and the steroid dosage increased. The platelet count resolved within 48hrs and then the ciclosporin has allowed tapering on the pred every 3 weeks without issue. The current dose is 0.75mg/kg per os SID.

The main is concern is about another impending relapse when the pred is stopped, and when the ciclosporin is tapered. We are not going to know unless we try, but any advice on people's experience with these difficult to taper cases would be welcome.

Canine Biome analysis

Sara Ramsey — Tue, 19 May 2026 12:47:25 GMT

We have had a client have their dogs faeces analysed at a laboratory in Aberystwyth and they have received a report and some recommendations.

I would like to remain open minded and wondered if anyone else is using these services. Our understanding of dysbiosis is growing all the time - hence to microbiota modulation approaches to diarrhoea.

The report is interesting but I felt some of the statements were a little too definitive and wondered where the evidence came from..canine studies or AI and extrapolation from human studies?

The recommendations do include 12 week courses of plant and fibre based supplements supplied by the company.

Does any one know if insurance covers this..It is around £180 for the initial analysis.

Perhaps it might be a good topic for our autumn meeting?

Balloon dilators

Laura Marshall — Mon, 18 May 2026 20:15:15 GMT

Hi colleagues,

One of our surgeons is having issues sourcing balloon dilators for colonic strictures. The only cones he’s found so far won’t supply the veterinary market.
Anyone have any recommendations?

Many thanks,

Laura

Brucella Canis in Veterinary Professionals

Steve Leonard — Fri, 15 May 2026 16:18:42 GMT

Hi,

This is a sensitive subject and is troubling a lot of small animal practitioners currently with regards what is the risk to our teams, clients and patients.

I have a colleague who has kindly consented to having me sharing her situation with you as it highlights how little we know about this disease in people. She had minimal contact with a dog who subsequently tested positive late last year (who knows how many other unknown carriers she has done dentals, spays etc on).

Unfortunately, earlier this year she became quite unwell with a fever. She was pregnant and tragically miscarried. Her GP has a sister who is a vet and was happy to test for B.canis. She had high serology results and a positive PCR result.

Weeks later she still is positive on both tests and her infectious disease specialist has told her the only people he is seeing this in is pretty much always veterinary professionals.

Treatment is not without significant risk to her health. She would need to hospitalised for IV antibiotics that carries significant risk of AKI and then possibly up to 6 months of oral tx. Elimination is not certain.

She is not an isolated case and there are potentially lots of chronic / subclinical cases out there. Her consultant stated he has approached BVA and BSAVA for funding to do some more research into the situation because wider finding doesn't seem to be available (as it affects such a limited cohort - i.e. us). This funding doesn't seem to have been forthcoming but I am not sure when the approach was made.

Obviously, all our first thoughts were that in endemic countries they must see it all the time however according to her specialist is that surveillance is pretty much non-existence as low-priority in countries with plenty of other significant health issues to contend with.

In addition, like me, many of you may be blood donors and it struck me that is there a potential risk to recipients that hasn't been addressed here?

My colleague is well, thankfully and coping admirably with these difficult decisions regarding how to proceed. I think it has affected all of us who know her and I'm sure some of you also have friends and colleagues who may be facing a similar situation.

We don't want a knee-jerk panic response so I thought I would speak to you all here as you are an 'evidenced based' group that will give this proper thought. Also I know in many of your referral centres and universities there are people looking at the canine side, and possibly the human side already. If there is, it would help my colleagues to know that is the case. If not then maybe we can try and get some data and possibly approach BVA/BSAVA again with an idea of helping quantify the risk a little better.

Your thoughts gratefully received.

Steve

Zoom Spring Meeting....

Steve Leonard — Fri, 15 May 2026 08:21:43 GMT

Are there any else of you struggling to get onto the meeting - it's saying it's connected and host has started the meeting...

Subscription issues

Laura Marshall — Wed, 06 May 2026 13:19:51 GMT

Hi there,

I've had an email to say my subscription is overdue, but I've paid it. I've tried reaching out on email, but no response. Would someone get in touch please?

Thanks,

Laura

Veterinary Trustee at Cats Protection

Kit Sturgess — Mon, 27 Apr 2026 12:17:05 GMT

Hi All

My time as trustee at Cats Protection is coming to an end and we are looking for a veterinary trustee to join the board - this is a great role combining veterinary expertise strategy, volunteering and much more.

Link below.

If you want to chat to me about the role please drop me a line.

https://jobs.vettimes.com/job/152259/veterinary-trustee-voluntary-/

All the best

Kit

Ectopic pancreatic tissue in GIT - Autumn meeting 2026

Sarah Keir — Sun, 26 Apr 2026 16:43:45 GMT

Hi,

At the Autumn meeting last year, someone mentioned ectopic pancreatic tissue in GIT of dogs but I didn't write down who mentioned this. Perhaps it was in the panel discussion?

I have found a paper online but says it is very rare. Do we have more up to date data on how common ectopic pancreatic tissue is in dogs?

Many Thanks

Sarah

Congenital colonic vascular ectasia

Allison German — Fri, 24 Apr 2026 11:18:26 GMT

Hello! Please bear with the long post :)

I’m consulting a case I think may be congenital colonic vascular ectasia. It’s a 7yo MN small breed cross with chronic iron deficiency, microcytic anaemia, haematochezia and melaena present since pup, with spontaneous GI haemorrhage resulting in haemorrhagic/hypovolaemic shock requiring transfusion on occasion. Usually, stool consistency is optimal but dietary indiscretion or gastroenteritis trigger a more severe episode. Single source protein and hypoallergenic diets help but do not resolve the problem. Steroids may contribute to more severe haemorrhage.

Further, I wonder whether this dog may have hepatic portal vein hypoplasia as previous investigations have indicated microhepatica, multiple small cystoliths (type unknown), there is the microcytic anaemia present since pup which could be multifactorial, and a recent blood sample showed hypoglycaemia. It is bichon x toy poodle. A bile acid stimulation test is reported as “negative” though this is not definitive and ammonia has not been tested. This may be complicating the picture. Or a red herring!

The dog has had Addison’s ruled out by dynamic cortisol assay.

Coags reported WNL and not hypertensive though no recent checks.

Has anyone had/diagnosed/treated a case? I’m concerned about the mechanical risk for haemorrhage during colonoscopy and the increased risk associated with biopsy. I’m planning to have a transfusion on standby. My temptation would be not to biopsy if abnormal colonic vasculature was present as it seems relatively pathognomonic? Diagnosis of underlying inflammation could be more safely made through histopathology at the time if the dog went for colectomy. The dog looks to have had a recent significant bleed halving the PCV. I was planning to wait until this improved prior to procedure. The dog has had capsule endoscopy but there was too much faecal material present in the colon to get adequate observation of the blood vessels for a diagnosis, just a suspicion. Moderate haemorrhage was present in the colon and in the stomach. Directional assessment is obviously more useful in this case alongside an assessment of the gastric mucosa with haemorrhage being present. The duodenum, jejunum and ileum had no visible lesions via the capsule. I could repeat capsule endoscopy after PEG-3350 cleansing, but may still have these questions to answer.

Has anyone used CT angiography to assess extent of lesions? CT angiography would also be useful in assessment of the liver… Costs are a factor in this case as obviously much is required so I need to choose wisely.

Has anyone used or does anyone perform argon plasma coagulation? Or does the success of this mainly depend on the extent of the lesions? With haemorrhage visible along most of the colon I guess this case is extensive and colectomy may be a wiser approach (dependent on endoscopic guidance).

I’d appreciate some wisdom to help my planning - thanks so much!

Allison

Unilateral facial nerve and vestibulocochlear nerve neuritis in a 2 year old DSH cat

Lisa Gardbaum — Wed, 15 Apr 2026 07:58:17 GMT

I saw a 2.5 year old MN DSH cat with a peracute onset of left sided facail nerve paralysis and vestibular signs. Haematology and biochemistry had all been unremarkable and otoscopic examination had been normal. I carried out an MRI (low field) which showed contrast enhancement of the left facial nerve and left vestibulocochlear nerve and no abnormalities of the middle ears or brain.

I have seen concurrent facial nerve paralysis and vestibular disease in dogs but never in cats.

I am wondering if I need to be checking for any particular infectious causes. In humans there is an association with herpes virus with facial nerve paralysis or it is thought to be a post viral symptom so have been wondering if there could be an infectious cause in cats.

Also there does not seem to be much evidence for the use of sterids or NSAIDs in these cases in humans or dogs, just symptomatic treatment so that is what I have elected to do.

Has anyone else seen this in cats or have any thoughts of other diagnostics I should consider?

mucocoeles and gluten-free diets in Border Terriers

Roger Wilkinson — Thu, 09 Apr 2026 08:30:05 GMT

Good morning all,

Just wondered what the feeling is on this. Do gluten-free diets reduce the incidence/progression of gb mucocoeles in Border Terriers?

Am I right in thinking there's nothing prospective published?

I presume people will have their own subjective impressions now as to whether gluten-free diets can be expected to be effective in this particular respect.

Kind regards

Roger

alpha-1 acid glycoprotein AGP measurement

Holly Lee — Wed, 25 Mar 2026 01:06:44 GMT

Hi,

Apologies if this is a foolish question..

Is AGP species specific, i.e. do I need a lab that can run a cat-specific AGP test or is a human lab running an AGP test OK?

I would like to use it to assess treatment duration in a cat with FIP that is responding well to anti-virals but currently in NZ and I don't think we have any of the veterinary labs offering this.

Thanks for the help

Holly

Length of chlorambucil treatment in PLE

Fiona Allsop — Mon, 16 Mar 2026 12:41:28 GMT

I have had a couple of PLE cases now that have required longer term (12 months) chlorambucil to keep steroid side effects just about acceptable and albumin/total protein levels around the bottom end of the reference range. Both patients had a good but not complete response to Purina HA. When I have tried to drop pred dose lower, albumin levels have crashed. Repeat haematology sampling has shown no sign of bone marrow suppression. Should I be more concerned about continuing chlorambucil in the even longer term and the chronic exposure to an alkylating agent? Would you switch out for ciclosporin or try to do more with dietary therapy? Any advice gratefully received

Dog potenitally bitten by a bat

Martin Whitehead — Thu, 12 Mar 2026 10:46:46 GMT

Hello all

All second-hand info, I'm afraid, and not one of our clients: One of our vet nurses asked me about her friend's dog who was seen last night to be "playing with" a bat, which then flew off. Bat species unknown, whether the dog might have been bitten unknown. (How the dog got hold of a bat that was able to fly, unknown!)

Obviously, the risk to the dog - and so, possibly, secondarily to the owner down the line - is very low, but...

For now, I have advised that if the dog is not rabies vaccinated, to get that done ASAP.

Any other advice in this situation?

Thanks

Martin

How are you using IV ondansetron for in patients

Sara Ramsey — Tue, 10 Mar 2026 11:49:32 GMT

loading dose and then a 6 hour CRI as per BSAVA formulary?

IV SID/BID

We have mixed opinions and I would like to make sure we are using it effectively and all happy with the same plan.

Thank you

anyone doing transanal surgery for benign rectal stricture?

Roger Wilkinson — Thu, 26 Feb 2026 10:15:27 GMT

Hi guys,

I'm involved in the care of a 9 y.o. FN border collie belonging to a vet. She has a 2 year history of recurrent benign rectal stricture just cranial to the level of the pubis. Initially good but temporary response to repeated ballooning and intralesional dex. But she's needed this x 5 in the last year or so and the mass of scar tissue is pretty substantial now.

Just wondered if anyone out there has experience of cutting these endoscopically? ...or indeed any other ideas gratefully received. Anything to avoid full on excision and anastomosis.

Many thanks in anticipation

Roger

Does anyone have an AI use protocol yet?

Lucy Knight — Tue, 10 Feb 2026 19:15:15 GMT

Would be interested to hear how others are using the technology!

Thank you

Lucy

Atypical or glucocorticoid deficient hypoadrenocorticism, PLE and EPI

Shona Haydon — Fri, 06 Feb 2026 09:52:06 GMT

Hello!

First off apologies if my question has been addressed recently! I tried searching but all the posts on this topic seemed to be from 6-15 years ago!

The case is a 7 year old border collie with 4 kg weight loss in a year. Pica, bulky pale faeces and more picky appetite. Blood samples revealed hypoalbuminaemia (15g/l), hypocholesteroleamia, hypocobalaminaemia (<235) and lack of stress leucogram. TLI consistent with EPI. Abdominal ultrasound revealed slim, small adrenal glands bilaterally and small volume abdominal effusion in pockets. Pancreas subjectively small. LN unremarkable. GI layering and thickness unremarkable. An ACTH stimulation test has confirmed hypoadrenocorticism.

So it looks like a case of EPI and also hypoadrencorticism mimicking PLE. I believe that in the paper with case reports on hypoadrenocorticism causing PLE like syndrome, then all dogs were atypical and treated with glucocorticoids alone, but this paper is now a few years old...

So....

What is the most current thinking on how best to manage atypical/glucocorticoid-deficient hypoadrenocortcism?

Are people measuring pre and post ACTH aldosterone to determine if or are you simply monitoring electrolytes over time to determine whether desoxycortone private (Zycortal) is required?

What dose of prednisolone are you utilising (0.25-0.5mg/Kg initially tapering with aim of a more physiological dose of 0.05-0.1mg/kg daily?

Thank you!

Shona

Feline Diabetes Mellitus PhD Studentship at the RVC

Christopher Scudder — Wed, 04 Feb 2026 15:00:43 GMT

Dear SamSoc Members,

If you're interested in companion animal endocrinology and would like to learn more about feline diabetes, and hopefully help progress the knowledge in this field, then please take a look at https://www.rvc.ac.uk/study/postgraduate/phd/studentships/feline-diabetes. We're able to offer a 3 to 3.5 year PhD studying feline diabetes mellitus at the Hawkshead Campus at the RVC. The goal being trying to find biomarkers and treatments which can help us manage diabetes in cats in the best possible way. The PhD is fully funded, and with Ruth Gostelow and Lucy Davison and co-supervisors with me, we hope to offer good training and support to whovever joins our team.

If you'd like any more information about it then please email me: cscudder@rvc.ac.uk.

Thanks for reading :-)

Chris

in house cortisol test - inaccuracy

Sara Ramsey — Mon, 26 Jan 2026 15:30:53 GMT

We have capacity to measure in house cortisol. It is the Mipet version (not IDEXX).

I remember from various SAM Soc posts/CPD that we don't believe these are that accurate but would appreciate any more specifics on this please.

People are very used to using this assay in the practice I work in, where as I am sending mine out to be run externally. I would like to give the team a little more detail as to why I do this - rather than just being awkward

what situation would we be happy to use an in house analyser - ruling out Addisons perhaps?

Oral ondansetron anyone?

Christopher Saul — Fri, 23 Jan 2026 16:04:03 GMT

Hello everyone, I was just wondering if anyone has any experience in using oral ondansetron to manage chemotherapy-related nausea in an out-patient setting. It is generally accepted that oral bioavailability is poor, though one paper (Burke et al, JAVMA, 2022) seemed to suggest that orally administered ondansetron reduced the incidence and severity of nausea in dogs administered hydromorphone, ACP and glycopyrrolate.

Does anyone have any real world experience of the drug given orally?

Many thanks indeed

Chris :-)

Return to work support

Kit Sturgess — Thu, 15 Jan 2026 06:05:28 GMT

Hi All

This arrived in my in box from RCVS - if it might be of interest to you or a colleague in practice please forward and encourage them to participate. IT would be really great if we can encourage great vets and nurses to return to the professions after a career break. Hopefully a more structured and supportive way forward will make this easier.

All the best

kit

Trazadone/gabapentin and LDDST

Holly Lee — Wed, 14 Jan 2026 22:25:01 GMT

Hi,

I have been trying to find out if it's reliable to do a LDDST on a dog after a "chill protocol" with trazodone and gabapentin.

One paper I have found said there was no effect of trazodone on basal cortisol, another has indicated that it does impair response to ACTH, but elsewhere I saw a vet indicate that their pathologist advised it was fine for ACTH stimulation but not LDDST. I cannot find any papers on effect on suppression of cortisol.

Does anyone have any information or opinions that might help. I don't know that I will get blood from this dog with no medication on board and would also be concerned about stress affecting her results with no meds on board.

Thanks for your thoughts,

Holly

Urinary incontinence in male dog

Holly Lee — Wed, 14 Jan 2026 21:20:36 GMT

Hi, I'd be grateful for any thoughts on treatments for urinary incontinence in male dogs... this is my own dog so my logical thought process gets impaired.

5yo MN (neutered at 13m old) black lab. BCS 4-5/9, fit and healthy.

Urinary incontinence noticed, low level but likely been going on some time. Normal urination at other times, no change in stream noted, urinates frequently on walks to scent mark but this is normal for him. Not noted to be PUPD.

Bloods (general biochem, electrolytes, CBC) all completely WNL. Urine WNL but his morning USG was only 1.012 (only one off sample, will repeat when I get to it..).

I had in my head that deslorelin might be worth trying but now can't really find any evidence so not sure if I mistook that. I know you can try propalin but never had much success with it in the past.

So my questions are:

- should I be investigating further? It seem odd that he's having an issue at such a young age

- is there a recommended treatment that I'm missing?

Thanks for any suggestions, I can never really think straight when it's my own pet.

Holly

Starting vetoryl dose in dog with diabetes

Ann Hopkirk — Sat, 10 Jan 2026 10:37:16 GMT

I have a dog recently started on bid caninsulin for diabetes. She was initially ketotic though well, and clinically is now doing much better though still PU/PD. Her ACTH stim has confirmed the ongoing suspicion of HAC. I know that bid vetoryl is preferable but wondering what dose to start her on-half the daily sid dose recommended by Dechra or slightly higher? Thanks