Discussions - Recent Threads

IMTP treatment when I can't use prednisolone. Refractory to MMF and ciclosporin - opinions please

Giulia Grenga — Fri, 24 Jul 2026 10:18:11 GMT

Opinions please.

13 year old FN Staffie. First diagnosed with IMTP in December 2025. Abdominal ultrasound showed heterogenous round splenic mass 2.6 cm x 2.92 cm (seen previously Oct 2024) and enlarged L adrenal 1.19 cm. Went into remission on prednisolone however had severe adverse effects so preds tapered and stopped in April 2026. Patient has relapsed in June 2026 (PLT 20 x 10’9, 140-700). Abdominal imaging static. Endocrine testing not supportive of hyperadrenocorticism. O refusing preds as concerned about how unwell dog was. IV vincristine given then mycophenolate started at 9.9 mg/kg BID beginning of June. No response thus far. Added in ciclosporin 5mg/kg BID start of July. Still no change in PLT count 14 x10^9/L (140 –700). Owner still declining steroids and wanting different drug. Limited to no literature about immunosuppressive drugs that don’t include pred for IMTP. I was debating stopping mycophenolate and adding leflunomide to ciclosporin. Opinions? Thanks!

RE: IMTP treatment when I can't use prednisolone. Refractory to MMF and ciclosporin - opinions please

Kit Sturgess — Fri, 24 Jul 2026 13:01:41 GMT

Hi Giulia

Tough case - the diagnostician in me would ask how comfortable you are that this is still an unassociated IMTP case - is there any possibility that this is secondary to another cause hence the poor response - in a 13yo SBT I would have to have paraneoplastic syndrome on the list.

I think it is really tough to treat some of these cases without prednisolone.

Ciclosporin absorption is very variable between patients so it may be that the dose is sub therapeutic - for some immune mediated disease doses as high as 10mg/kg q12hr have been used but monitoring is advised.

I personally have had limited observable benefits from leflunomide when I have used it other than in some low grade immune mediated disease cases such as polymyositis.

Despite its slow onset of action, given although low, this patients platelet count is stable I would consider azathioprine.

Personally I would try and discuss prednsiolone again - what were the side effects and were they dose dependent, could you use methylprednisolone?

Splenectomy would also be on my list depending on surgical facilities, access to fresh whole blood etc.

Hope that helps

All the best

Kit

Pyogranulomatous Lymphadenopathy in 18week old kitten

Stuart Black — Fri, 24 Jul 2026 12:26:49 GMT

Hello,

A little stumped with this one. Have a 18week old MN kitten in from a reacue situation. One of 5 from the litter. I have not seen any of the other litter

One was PTS due to increasing dyspnoea and multiple cutaneous nodules.

2 kittens have corneal oedema and vague neurological signs (mainly ataxia)

1 kitten apparently is bow legged and is very ill thrifty

This kitten is bright, eating and growing well but has this very large unilateral lymphadenitis (histo report below).

Felv/fiv negative, bloods otherwise normal (mildly high globulins). Abdominal and thoracic ultrasound is normal (no abdominal lymphadenopathy).

They have started GS-441524 presuming FIP but I think this would be less likely? None of the kittens have responded favourably after 1 week. We are potentially going to request PCR on the biopsy for mycobacteria. Poor response to amox/clav as well as nsaids.

I was struggling really with a robust differential list and worried about potential zoonotic infections. i have advised them to isolate the kittens from other animals for now pending advice.

Any advice would be very much appreciated!

INCISIONAL
Clinical History: Recurrent abscess type lesions on two kittens from the same litter, previous culture on

other kitten did not isolate any growth.
Pathology Report PRELIMINARY INTERPRETATION:

Tissue from ventral neck: Pyogranulomatous and plasmacytic inflammation with
prominent granulation tissue formation, oedema, haemorrhage and intralesional
bacteria
Pending special stains
COMMENTS:
The samples in Bumble's neck show pyogranulomatous and plasmacytic inflammation
with intralesional bacteria, which suggests underlying bacterial infection and agrees
with the culture results. Special stains have been requested to try to correlate these
findings with the microbiology results. An addendum will follow shortly. My colleague
Dr. Thomas Eley was consulted on this case for additional perspective and agrees with
this interpretation.
HISTOPATHOLOGIC DESCRIPTION:
Tissue from the ventral neck (per body map): This tissue is entirely comprised by
densely cellular aggregates of neutrophils, macrophages, plasma cells and fewer
lymphocytes in a background of collagenous matrix with numerous capillaries lined by
plump endothelium and hyperchromatic fibroblasts (granulation tissue). The
granulation tissue is extensively expanded by oedema and multifocal haemorrhage.
Occasionally, intralesional dense colonies of bacteria and foreign material are observed.
PATHOLOGIST:
Mafalda Casa Nova, DVM, DVSc, Dipl. ACVP

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

RE: Urinary incontinence in male dog

Holly Lee — Wed, 22 Jul 2026 03:55:45 GMT

Just an update: CT was consistent with ectopic ureter. At surgery both his ureters exited the same place within the bladder but close to sphincter and with a trough of tissue directing urine out of the bladder. Surgery corrected these but 3 weeks post surgery he has more typical USMI signs with more leaking when lying down/full bladder so currently trialling propalin and next step if that fails we'll try testosterone!

Just wanted to give a update to say thanks again for the input!

Holly

Young cat with ileal thickening & chronic D+

Holly Lee — Wed, 22 Jul 2026 03:53:04 GMT

Hi all,

Any opinions welcomed on this case that I am struggling with..

Ludo is a 1yo ragdoll x BSH MN cat who has at least 6m history of waxing and waning diarrhoea, some prior vomiting, weight loss and currently severe tenesmus and discomfort defaecating.

He had giardia diagnosed at one stage and treated with metronidazole (before I saw him) and has had various gastro diets and probiotics since then.

On ultrasound he had a severely thickened area of bowel wall in the distal ileum and enlargement of jejunal and sublumbar lymph nodes. 2 lots of cytology on lymph nodes have been reactive, PCR for coronavirus negative, FNA of bowel wall first one was non diagnostic, 2nd has shown neutrophilic inflammation (possible bacteria, possible contamination) - I'll copy report at bottom of post.

Prior to the last repeat ultrasound and FNAs we had trialled prednisolone for a suspicion of IBD after a risk-benefit discussion with O and electing not to biopsy at this stage; there was no response.

Given the neutrophilic inflammation I am wondering if there is some bowel wall infection and we need antibiotics but short of biopsy for histopathology and culture I feel like I am stabbing in the dark. I am reluctant to pursue full thickness biopsy at the moment given the risk of poor healing of an abnormal bowel wall, but we are not making progress and this kitty is having a bad time.

Any thoughts welcomed, even if it's that we can't progress without biopsy!

Thanks

Holly

Cytology report:

SITES: 1. Ileocecal colic lymph node: Four slides are received. 2. Ileum: Four slides are received. INTERPRETATION: 1. Ileocecal colic lymph node: Consistent with reactive lymph node 2. Ileum: Evidence of enterocentesis, septic neutrophilic inflammation COMMENTS: 1. Ileocecal colic lymph node: The mixed lymphoid population with scattered plasma cells and histiocytes is consistent with reactive/immune stimulated lymph node, most likely due to immune stimulation from the GI tract. There is no convincing evidence of primary lymphadenitis to suggest FIP, however lesions may be focal and the possibility of a non-representative sample cannot be excluded. 2. Ileum: There is apparent enterocentesis with collection of intestinal content explaining the large number Report Continued .... Page 1 of 2 Case Number: H26019438 CYTOLOGY Submitter: DR HOLLY LEE Owner: HARVEY-JOHANSEN of mixed bacteria, however there is also evidence of a significant neutrophilic inflammatory reaction associated with bacteria. This may reflect neutrophilic enteritis, or possibly an intestinal abscess. Correlation with clinical signs and ultrasonographic appearance of the area is recommended. CYTOPATHOLOGIC DESCRIPTION: 1. Ileocecal colic lymph node: These slides have areas of moderate to high cellularity with good to thick preparation and good cell preservation. There is moderate blood contamination and a pale pink to blue background containing numerous cytoplasmic droplets. The lymphoid population is composed of at least 75% small mature lymphocytes with a patchy increase in intermediate lymphocytes and low numbers of large lymphocytes. There are also scattered plasma cells and occasional histiocytes with no convincing evidence of lymphadenitis. Atypical cells are not observed. 2. Ileum: These preparations contain a thick background of abundant mixed bacteria (predominantly variably-sized bacilli) intermingled with mucoid debris and low numbers of RBCs. In most areas cellular preservation is poor, however there are some large clusters of markedly degenerate neutrophils with intracellular bacteria noted. Scattered fragments of variably sized and coloured material in the background appear consistent with intestinal content, with some recognisable fragments of hair shafts and plant material.

Faecal Calprotectin Testing

Joshua Bleakley — Tue, 23 Jun 2026 13:01:34 GMT

Hi all,

I have just had a rep talking about faecal Calprotectin and wondered if anyone had any experience using the test or if anyone had big issues with it. It seems more of a use in monitoring cases than anything else but wondered what cases it differentiates between compared to clinical signs.

Thanks for any input,

Josh

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

RE: Brucella Canis in Veterinary Professionals

Katherine Clarke — Mon, 22 Jun 2026 13:46:18 GMT

HI Steve,

Your questions are, as always, good ones and we don't yet have the answers to them. There does seem to be more veterinary professionals testing positive in the UK than was initially expected and we don't yet understand why. I hope to start working with one of the consultants who treat people with B. canis (thanks to your colleague for putting me in touch) to try and get answers to this.

Chatting to vets that work in the US, people intermittently get infected with B. canis but because it is endemic out there (and because maybe their approach to antibiotic stewardship is, umm, different to ours), they will just treat it like any other infectious disease. Some dogs respond very well clinically and become seronegative (although can later become seropositive), while others just remain clinical and seropositive.

We are testing dogs that have not travelled that have signs that could be consistent with brucellosis such as discospondylitis, IMPA, reproductive failure etc. because it is impossible to be certain that they have not been exposed to brucella in the UK.

It is a rapidly changing and evolving situation and we just have to try and adjust what we are doing as we gain more information!

Katherine

RE: Aspergillus treatment

Jon Camilleri — Mon, 22 Jun 2026 13:36:11 GMT

Hi Pauline

Thank you for the reply. Apologies, I have been away.

I treated the one side this time (hadn't seen your reply). Plan to re-evaluate in a few weeks so option to treat both then

Regards

Jon

Aspergillus treatment

Jon Camilleri — Tue, 16 Jun 2026 09:04:56 GMT

Dear all

I cannot recall from the excellent aspergillus talk at SamSoc last year whether, in the setting of unilateral disease and a normal appearing contralateral side both on CT and rhinoscopy, it is recommended to treat both sides with antifungal solution and cream or if its OK to just treat the affected side. Must admit I have in the past just treated the affected side (both if bilateral obviously) and so far success rates have been good

Regards

Jon

Do you find diagnosis and treatment of liver disease in dogs and cats frustrating? Do you want to see more clinically relevant studies of liver disease in small animals to help us understand causes, treatment efficacy and prognosis better? If so, then the

Penny Watson — Sat, 20 Jun 2026 16:55:33 GMT

Hello everyone

Forgive me for the advert but I wanted to make everyone aware of the opportunity to come to our ECVIM pre congress - you don't have to be a specialist to come and we would really like input from motivated first opinion practitioners. Details below

Do you find diagnosis and treatment of liver disease in dogs and cats frustrating? Do you want to see more clinically relevant studies of liver disease in small animals to help us understand causes, treatment efficacy and prognosis better? If so, then the Society of Comparative Hepatology (SCH) would like your help!

We are dedicating our ECVIM pre congress meeting on 9th September 2026 in Berlin to identifying the most clinically important knowledge gaps in small animal hepatology and how we can address them with studies in both first opinion and referral practices. Your contribution would be greatly appreciated:

1) Have a look at the list of unanswered questions below and tell us if you have any additional questions about canine and feline liver disease that you have always wanted answered

2) Consider coming to our pre ECVIM pre congress in Berlin: this is open to all vets with an interest in liver disease - you don’t have to be a specialist - and you can attend either in person or on-line. Details are here and note that you can join the SCH for 3 years for €60 which is the difference between the non-member and member fees

SCH Precongress Day

ecvimcongress.org

We have an exciting programme ahead including lectures from Andrea Johnston Associate Professor of Small Animal Internal Medicine and Pathobiology from Michigan State who will consider the unanswered questions in veterinary hepatology; Dr Dan O’Neill, Professor of Veterinary Epidemiology and Senior Lead for VetCompass, Royal Veterinary College, UK, talking about what we don’t know about primary veterinary care of liver disease and why not – the VetCompass story and two leading human hepatologists who will give us the medical perspective which we hope will inspire us: Professor Jonathan Fallowfield (Chair of Translational Liver Research and Principal Investigator, Institute for Regeneration and Repair, University of Edinburgh who will talk about his recent and current experience in multi-centre studies and Dr Vishal Patel, Adjunct Reader in Hepatology, Consultant Hepatologist and Principal Investigator, The Roger Williams Institute of Liver Studies and King’s College London who will talk about studies in the oral-gut-liver axis in human chronic liver disease and its implications in portal hypertension

We hope to see you in Berlin or on-line!

The SCH Scientific committee

Dog liver disease – some unanswered questions

Decreasing the incidence of copper associated hepatopathy in the dog: with more appropriate diets, developing a serum or urinary marker, or better therapeutic options. Address the misconception that inflammation causes copper accumulation.
Effective treatment to reverse hepatic fibrosis which would require a way of noninvasively monitoring portal hypertension and liver stiffness
The effect of the microbiota/microbiome on liver/biliary tract disease and hepatic encephalopathy
Development of serum and tissue markers of immune hepatitis
What is the role of microthrombi in the progression of hepatic disorders in the dog, particularly gallbladder mucoceles, chronic hepatic and vacuolar disease? Value of anticoagulant versus procoagulant therapy and when is each appropriate.
Etiology , pathogenesis and therapy of degenerative vacuolar hepatopathy
Are we sure there isn’t a viral cause of canine chronic hepatitis? Whatever happened to acidophil cell hepatitis virus?
Better understanding of the progression of disease in acute liver failure in the dog so as to determine treatment strategies that increase survival

Cat liver disease – some unanswered questions

Understanding the causes of feline acute and chronic biliary tract disease – better stratification of disease types with antibody tests, imaging and pathology
Establishing patient registries of cats with chronic biliary tract disease to understand response to treatment, long term prognosis (recovery or waxing and waning) and chronic sequelae including neoplasia.
Better studies of the predictive ability of advanced imaging (CT and MRI) in cats with hepatobiliary disease and biliary obstruction
Role of “the common channel” anatomy and pancreaticobiliary malfunction in feline inflammatory hepatobiliary disease
What is the appropriate length of antibiotic therapy in cats with acute neutrophilic cholangitis/cholecystitis?
Prospective treatment trials with immunosuppressants in cats with lymphocytic cholangitis: maybe prednisone is not the answer
Standards of care (anaesthesia and surgical) in managing in cats undergoing biliary surgery
Microbiota/microbiome impact on liver/biliary disease

RE: Aspergillus treatment

Pauline Jamieson — Fri, 19 Jun 2026 11:13:40 GMT

Hi Jon,

My experience has been different. Where only one side appears to be affected and I that one side, this disease has a nasty habit of reappearing. So I treat both. However, it is unclear to me whether this is because the infection was not properly cleared and was in fact lurking on the other side, or whether this is reinfection in a susceptible patient. In which case this bilateral treatment was probably unnecessary. Most studies report very short follow-up times and the recurrences are often several to many months later, and the treatment is so expensive and often invasive that I suspect a lot of recurrences never make it back to the referral clinic if that is where they are treated. Rather the owners may give up. So we may be getting a false report of where these dogs are 2 years later.

Pauline

RE: Brucella Canis in Veterinary Professionals

Steve Leonard — Tue, 16 Jun 2026 08:04:24 GMT

Thanks Katherine,

In your chats with vets in other countries did you get an idea of how concerned they are with regards zoonotic risk? Looking at the world maps it seems that it's only Western Europe, Australia and NZ that are currently considered clear so tens of thousands of vets and millions of pet owners are potential exposed every year.

My colleagues are thankfully very open minded still about whether the B.canis is responsible for their symptoms or it was found just because they looked for it after having symptoms that could have been caused by another agent.

With potentially lots of UK born dogs having already contracted B.canis as well in the many years we have been importing dogs from high risk areas are we really keeping our clinics clear of this bug by testing only foreign born dogs (as Joanna has noted)?

Still none the wiser but it does seem we could do with linking up with vets/institutions in endemic areas to see what can be learned. Anyone got any connections they can tap into?

RE: Brucella Canis in Veterinary Professionals

Katherine Clarke — Wed, 10 Jun 2026 07:06:36 GMT

Hi Steve,

I am so sorry to hear about your colleague.

I was the clinical lead for the development of the Brucella canis policy within Linnaeus and thus have done a lot of reading and chatting to foreign vets about Brucella to try and understand which countries should go on the 'red' list.

Spanish travelled dogs, I personally would say yes, you need to test every year if they go every year and waiting three months for seroconversion seems logical. We added Spain to the list around 18m ago when I became aware of three unrelated dogs imported from Spain who tested positive.

The situation in the US is variable with some states seeing more Brucella that others. But honestly, it is very hard to determine true prevalence anywhere due to lack of screening of asymptomatic dogs.

Happy to chat more if you need.

Katherine

RE: Brucella Canis in Veterinary Professionals

Penny Watson — Tue, 09 Jun 2026 13:26:29 GMT

Hi Steve

I am not an infectious disease expert but was wondering why you were particularly concerned about Spain - my brother lives there, with a dog, and I was not aware it was a particularly Brucella canis hot spot. So I did a quick literature review and found this.

https://www.sciencedirect.com/science/article/pii/S2352771425002617?via%3Dihub

I don't think travelling is the problem - otherwise we would be worried about dogs going to Switzerland or Holland or indeed Canada. I think what we need to know is how it is transmitted and what animals would be at high risk - is it still believed to be transmitted largely at mating and abortions and through milk or is there more widespread dog to dog transmission? If the former, I suspect the reason we are less worried about dogs from Holland, Switzerland and Canada is because of responsible breeding in those countries which I hope would contain the disease. Hence why illegally exported dogs from anywhere are a problem.

You could argue that this increased prevalence reported in those countries is due to increased testing- but I'll leave the infectious disease experts to comment more.

RE: Brucella Canis in Veterinary Professionals

Steve Leonard — Tue, 09 Jun 2026 11:39:22 GMT

Sorry Joanna, I thought I'd posted a thank you for this (but I obviously just thought it).

As we are now hitting the Summer holidays and I am lined up for lots more AHC's it's occurred to me that we have plenty of clients who do travel to Spain (an at risk country) for a couple of weeks. How are these pets going to fit into our regimes? Do we test them for Brucellosis 3 months after returning every year?

Does anyone have any contacts from the USA about B.canis over there? Is it on their radar as it is a 'High Risk' country according to the maps I've seen.

RE: Brucella Canis in Veterinary Professionals

Sara Ramsey — Thu, 28 May 2026 19:19:09 GMT

This is such an interesting thread and it is concerning given when you read the current guide lines...they tend to state that reproductive fluids are the highest risk, so I would say we are potentially complacent about other situations which aren't "reproductive".

Currently we have access to corporate guidance and we are supposed to flag if an animal is imported but this isn't done consistently, nor is recording which country they have come from.

We don't have many "imported rescues" so I wonder if that is why this is not on our radar?

Definitely time to tighten up.

RE: Brucella Canis in Veterinary Professionals

Joanna Hansen — Thu, 28 May 2026 06:26:20 GMT

Our hospital’s SOP for the last couple of years (and we’ve had a previous staff member test positive):

-every dog on registering/appt booking is asked if they are UK born

-if non-UK then the owner has a choice to pay a small surcharge and we wear PPE and disinfect room after, or they can be tested

-if they have been tested prior to import we require a negative APHA test 3 months+ after import

-no dog will be admitted to our hosp or have any diagnostic testing done without a negative brucella test. In the event of an emergency we have in-house snaps tests and as long as that is negative we will hospitalise a patient but continue to use PPE until a negative APHA test

-no pregnant or immunocompromised individual is involved in taking bloods or caring for any non-tested dog

-if we have a positive case (and we’ve had quite a few) we do offer a repeat test to owners. If that comes back negative then we do discuss euthanasia. If the owner doesn’t want to euthanise then we advise complete isolation from all dogs/public places. In terms of the veterinary care we will continue to offer we are telephone consulting wherever possible and still providing routine care with ppe and environmental decontamination but the owners are aware that we will not hospitalise or do any form of procedure that puts our staff at risk -euthanasia would be offered instead.

-any dog in the same household as a positive dog is treated as though it is positive until a negative Brucella test 3 months after last contact with the positive dog

Sadly however, we recently we had 2 1-year-old UK born (and untravelled) dogs test positive (they were symptomatic, and the stud dog had recently tested positive). They had been in our hospital multiple times for various reasons and had completely “slipped through the net” despite what we’d previously considered to be a rigorous SOP.

I too would be interested to hear what others are doing….?

RE: Brucella Canis in Veterinary Professionals

Steve Leonard — Wed, 27 May 2026 21:12:52 GMT

Another colleague from the same practice has been tested for B.canis and has come back positive. She had been having odd aches and pains in her joints, chills and fatigue so asked her GP to get tested. Not sure what the follow up is likely to be at this point as waiting on referral to specialist.

Armed with this information we have increased our communication with regards testing dogs from outside the UK. We are trying to be level headed with the messaging and couching it in terms of gathering data to quantify the level of disease to help the profession and the government get a handle on the prevalence.

What we really haven't nailed down is what we are going to do if/when we get a positive case. Different vets have very different attitudes to risk and this presents a huge dilemma for deciding the level of care you can reasonably give as a practice.

I would be happy to do a home visit to perform a low risk procedure such as vaccination but what happens when this dog cuts itself badly in the owner's garden? Is it ok to bleed all over the car park, waiting room and throughout the practice? What if the vet is happy to see it but the nurse isn't or vice versa?

Has anyone got an SOP in place for positive cases already?

I did speak to Blood Donor Helpline. Not that helpful. They are aware of the disease, as expected, but only interested in symptomatic people. They asked the question "Have you been in contact with a dog with B.canis?" - well, how do I answer that currently? Not sure, I'll get back to you....

RE: Brucella Canis in Veterinary Professionals

Andrew Kent — Thu, 21 May 2026 10:12:55 GMT

I would love to hear how others are currently approaching travelled dogs given the above.

I find it an impossible balance - trying to juggle an appropriate degree of caution but without depriving large groups of dogs of appropriate care and causing panic amongst colleagues and clients. Plus (at least in our experience) the added risk of being basked on social media for expressing any degree of concern!

So we are trying to be pragmatic about it but not sure what that should really look like!

Great topic to discuss :-)

Andy

RE: Canine Biome analysis

Andrew Kent — Thu, 21 May 2026 10:09:02 GMT

Where I have seen reports from these and other companies my general impression is that the evidence base we have simply does not support the conclusions that are made.

It can be 'interesting' but I think we are a long way from the point where any real therapeutic decisions can be made based on the results.

Andy

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?

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.

RE: IMTP - 2nd line tapering plan with multiple relapses

Andrew Kent — Thu, 21 May 2026 10:06:49 GMT

Hi Catherine,

Tricky case!

I would broadly agree that this is trial and error but given the number of relapses I guess I would be tempted to maintain an immunosuppressant in this dog long-term (maybe even life-long) unless you run into issues.

I do think your ciclosporin dose might be a bit low - if you look at Andrew Mackin's work looking on pharmacodynamics (sadly testing is not currently available as far as I am aware) then most dogs need 10mg/kg/day (typically divided) to achieve immunosuppression and a small percentage even need more. So I would wonder if your chances of coming off steroid would be higher if you increased the dose....

I have had cases that I can then successfully maintain on clclosporin (or something else) and some that seem to be steroid dependent.

The other real challenge with these cases is accurate platelet counts - when you mention going from 90 to 300 it makes me think some of those might have been inaccurate.

Hope that helps,

Andy