Siamese

RE: Siamese

Anthony Todd — Wed, 23 Sep 2015 14:31:12 GMT

[quote user="Martin Atkinson"]Cyancobalamin ie B12 in cases where there is a deficiency yes[/quote]

Never diagnosed a case of deficiency of B12 but have given it to many animals back in the day with GI signs and they just "got better" which these days is frowned upon, unless you have a diagnosis which must be obtained by some sort of external "test" or procedure.

Of course, together with "the injection" they got the essential diet advice which may have helped too.

And, thinking back, Martin, it was uncle Clive and the spaniel with the bruised shoulder that made me concentrate on making the animal better with, or, shock horror, without a specialised test or procedure or an accurate diagnosis.

[quote user="Martin Atkinson"]It still doesn't justify giving it on a wing and a prayer.[/quote]

Except that the animal got better which used to be the aim.

RE: Siamese

Danny cazabon — Wed, 23 Sep 2015 14:30:39 GMT

Lila (Siamese) returned to the clinic on Saturday.

Not much has changed. Her weight is the exact same as her previous visit over a month ago.

LN WNL. Temperature 37.8. HR 180bpm.

Owner agreed to do Diagnostic bloods and Fpli, however refused further work up.

Changes are as follows;

WBC 23.46 (5.5-19.5), Lym 13.3 (1.5-7),

AMY 1156 (300-1100), ALP 9 (10-90), K 3.5 (3.7 -5.8)

Fpli negative

Conservative treatment was initiated and Z/D elimination diet has begun.

Will post results.

RE: Siamese

Anthony Todd — Tue, 22 Sep 2015 21:32:12 GMT

[quote user="Martin Atkinson"]If he gave me such friendly advice I nodded politely and ignore him.[/quote]

I probably lost the practice a good client, not to mention that the dog probably felt worse for longer too. of course, being on your own you'd never know.

I learnt from that case though.

RE: Siamese

Martin Atkinson — Tue, 22 Sep 2015 18:51:57 GMT

[quote user="Anthony Todd"]Obviously you didn't learn a thing or two from Uncle Clive.[/quote]Blimey Anthony, not like you to miss the opportunity to give some 'roids!

I hardly worked with him I just ran the branch in West Drayton sole charge and had my own agenda which suited me fine. If he gave me such friendly advice I nodded politely and ignore him. We had an understanding.

RE: Siamese

Anthony Todd — Sun, 20 Sep 2015 22:37:33 GMT

[quote user="Martin Atkinson"]I applied for a job there when I first qualified, didn't like the ethos and they didn't like me because I told them so!![/quote]

So you took a job with Uncle Clive, the master of client satisfaction and one who could teach T&H loads.

I worked for him and was admonished, quietly, as was his way, for not "giving something" to a spaniel I had visited with what I thought [and was] a bruised shoulder area.

I gave it nothing, said the dog would be fine in a few days. Client complained. Uncle Clive suggested a bit of bets would have made the dog feel so much better and satisfy the client, and he was right of course.

Obviously you didn't learn a thing or two from Uncle Clive.

RE: Siamese

Anthony Todd — Sun, 20 Sep 2015 18:03:49 GMT

[quote user="Martin Atkinson"]Vit B Complex[/quote]

It is,and always was B12 that's twelve. IIf you ever think of using B complex by injection think hard. it's the most painful stuff I have ever injected, cripes, iit even hurts cattle and that is saying something.

RE: Siamese

Aine Seavers — Wed, 16 Sep 2015 12:17:10 GMT

I am also a mere practiioner, why you would take exception to my sharing my experience of a household over run with Siamese cats to help others says more about you than it does about me as it is beyond me that you could come ot that conclusion!. George Bernard Shaw said- If you have an apple and I have an apple and we swap our apples - we have an apple- but if you have an idea and I have an idea and we share those ideas... that is what drives me- to share knowledge to help others- if you see something else in my posts then you are in the minority because in the 20yrs I have been on forums no one else has take such an issue with my posts- which are quickly written in the short space seconds I have free in my day and all other vets have gotten that. i came on this list to share and to learn- nothing else.

RE: Siamese

Martin Atkinson — Wed, 16 Sep 2015 10:10:04 GMT

[quote user="Aine Seavers"]The only one saying Vit B Complex is you- no one else said complex.[/quote]You just said Vit B you did not define which one - perhaps I'm being pedantic but to me that is multi-vit B.

And as for your long next post I don't dispute the rational I have just taken exception to your first post which gave the impression that you consider you are the leading authority on Siamese cats and that we as mere general practitioners aren't familiar with the perceived idiosyncracies of the breed, The fact is that they are still cats and suffer from and require the same treatment for the same problems as other cats albeit somewhat skewed by their temperament.

RE: Siamese

Aine Seavers — Wed, 16 Sep 2015 02:26:45 GMT

So- you gave a cat who for his sins lives with owners who cant afford for you to run a series of investigative often highly invasive diagnostic tests but is not in the best of health he can be.

Do you do nothing? Or do you utilise your veterinary skills in full physical examination, perform the tests you can perform within the limits of the case, come up with a d/d- then with the benefit of your veterinary degree and clinical experience- based upon countless weekly hours of ced and reading and in consultation with other colleagues- formulate a plan that will first do no harm to the cat and secondly may be enough to assist the cat to push the condition below the threashold of clinical expression and discomoort so that time and the unique ability of the body to harness its internal pharmacy and reparative ability to return that patient to a good quality of life.

Would it in fact be remiss not to first address the aspect of diet in these conditions (when FB.intuss/suspicious mass etc ruled out on a physical exam) ?before putting the owner and the cat to intense investigation- we are so what we eat and if the diet is obviously amenable to improvement then should one not address that first.

If Vit B1 or Vit B12 depending on the suspected deficiency could assist the patient in a given disease presentation- then an educated informed decision is not a wing and prayer.

If you have had an inflammed tissue due to prolonged assault t by dietary antigens then there will be a lag phase before animal returns to health and in that time they will suffer which is why many in the feline world suggest a short course of preds to settled that down ( and yes we all know about cardiac cat and g/c issues so we factor that in our decision making.

I have lost count of the number of times I get second opinions where every last daz blinkin lights test was run- to no avail- when a good clinical exam would have revealed the faeces crammed with hair and so the cat's diet and /or , hairballing and/or behaviour an/or d mite infestations should have been addressed.

Look at how glucocorticoids are now de rigeur for several otitis presentations- the derm world has gone full circle on that one.The number of tests you can think of and the bigger the bill does not automatically make you a better vet- a very thorough one perhaps but why use a sledgehammer all the time when a lot less is sometimes needed.

In the need to get 'evidence' we often put our own needs before the patient in front of us- there are times when a perfect work up cannot be done- and to not Anticipate, Assess Alleviate as per WHO pain guidelines, to not fix the fixable, treat the treatable to assist the patient in their battle against a condition- then we fail a significant cohort of our patients.

RE: Siamese

Aine Seavers — Wed, 16 Sep 2015 01:18:25 GMT

The only one saying Vit B Complex is you- no one else said complex.

RE: Siamese

Martin Atkinson — Tue, 15 Sep 2015 14:37:38 GMT

[quote user="Aine Seavers"]Crikey- I must tell some of the Giants of the feline medicine world that you think their excellent research is dinovets! Vit B is an important evidence based factor in intestinal disease in cats- [/quote]Cyancobalamin ie B12 in cases where there is a deficiency yes. Vit B complex no. Be specific. It still doesn't justify giving it on a wing and a prayer.

RE: Siamese

Anthony Todd — Tue, 15 Sep 2015 12:37:34 GMT

[quote user="Martin Atkinson"]There is a middle ground between doing work for the sake of it just to generate funds and the dinovet VitB/Steroid cocktail 'hope for the best' approach you know.[/quote]

Trouble is the "hope for the best " isn't that at all.

It's the treatment and vital, dietary advice [in the current thread] which, from years of similar cases, and after a thorough manual exam and forensic history, which will cure more than 90% of animals presenting with GI symptoms.

A well-known Prof at Florida told me that a high percentage of GI cases referred to him were simply dietary sensitivities.

You'd be amazed at the number of cats with incurable diarrhoea that go out [to drink milk for the hedgehog next door, for instance]. Gotta keep them in!

Full bloods and biopsies won't find, or cure, that!

Even dinovets had the wit, ears and fingers to pick up the intussuception or things needing further tests or exams.

Anyone, even some vets, will tell you that, unless you "say something, do something and give something" any ancillary, but vital advice, goes out of the clients mind because you didn't give it an injection.

PS B12 and Bets is a really good appetite stimulant too [and therefore a valuable diagnostic aid in that, if the animal is still inappetent you'd better have another look!

PPS. in the days of tinned food D++ was really common, less so now with dried food, so we learnt to treat D+ early on.

RE: Siamese

Aine Seavers — Tue, 15 Sep 2015 12:08:09 GMT

Crikey- I must tell some of the Giants of the feline medicine world that you think their excellent research is dinovets! Vit B is an important evidence based factor in intestinal disease in cats- and vomiting cats are most often intestinal- according to current experts -so to be current not dino one should be using Vit B.

O'Brien, DP & Packer, RA (2010) Metabolic encephalopathy: organic acidurias. In August, JR (Ed): Consultations in feline internal medicine. Vol 6. Elsevier Saunders, Philadelphia. pp:595
Simpson, KW et al (2001) Subnormal concentrations of serum cobalamin (vitamin B12) in cats with gastrointestinal disease. J Vet Intern Med 15:26-32
Ruaux, CG, Steiner JM, Williams DA (2001) Metabolism of amino acids in cats with severe cobalamin deficiency. Am J Vet Res' 2062:1852-1858
Ermens, AA et al (1993) Increased uptake and accumulation of cobalamin by multiple myelom bone marrow cells as a possible cause of low serum cobalamin. Eur J haematol 50:57-59
Simpson, KW et al (2001) Subnormal concentrations of serum cobalamin (Vitamin B12) in cats with gastrointestinal disease. J Vet Intern Med 15:26-32
Ruaux, CG (2006) Cobalamin in the diagnosis and treatment of chronic gastrointestinal disease. In: Consultations in Feline Internal Medicine. Ed: August, JR. Elsevier Saunders, Missouri (USA)
Simpson, K et al (2012) Suspected acquired hypocobalaminaemic encephalopathy in a cat: resolution of encephalopathic signs and MRI lesions subsequent to cobalamin supplementation. JFMS 14:350-355
Salvadori, C et al (2003) Degenerative myelopathy associated with cobalamin deficiency in a cat. J Vet Med A Physiol Pathol Clin Med 50:292-296

Barron, PM et al (2009) Serum cobalamin concentrations in healthy cats and cats with non-alimentary tract illness in Australia. AVJ 87(7):280-283

RE: Siamese

Martin Atkinson — Tue, 15 Sep 2015 11:26:51 GMT

[quote user="Anthony Todd"]Tandy and Hughes: "Say something, do something, give something"[/quote]Ah, Tandy and Hughes possibly the first of the practices with a corporate attitude before anyone had even invented the word corporate let alone incorporated. I applied for a job there when I first qualified, didn't like the ethos and they didn't like me because I told them so!!

Anthony me old dino, There is a middle ground between doing work for the sake of it just to generate funds and the dinovet VitB/Steroid cocktail 'hope for the best' approach you know.

RE: Siamese

Anthony Todd — Tue, 15 Sep 2015 11:01:57 GMT

[quote user="Martin Atkinson"]Sounds like a dinovet cocktail to appease the owners![/quote]

Probably the best description, but the key thing which modvets seem always to ignore, after x weeks of faffing about with tests for what probably [playing percentages] was just a simple dietary sensitivity.

And very often. with the key and vital diet advice, now glossed over with a plethora of rare possibilities, it worked.

Patient and client happy

Tandy and Hughes: "Say something, do something, give something"

And this client left...... Fees? [must've been hundreds]

No improvement? More tests? No diagnostic direction based on probability?

Remember the old RMM cartoon [I quote again] "I just want the dog to get better Doc, so skip the blood tests"....

Trouble is modvets don't realise that the client is the one that has to feel "cured" and not conned.

I mean full bloods for, almost certainly, a simple gi problem? Come on!

RE: Siamese

Martin Atkinson — Tue, 15 Sep 2015 10:10:02 GMT

[quote user="Aine Seavers"])Vit B injections can help vomiters as can a short course of glucocorticoids if the vomiting is causes by irritated inflammed bowels.[/quote] Would you like to explain how Vit B works in this regard? And should you be giving glucocorticoids on the basis of an anecdotal assumption of 'irritated, inflammed bowels' without making an attempt to find the cause? Sounds like a dinovet cocktail to appease the owners!

RE: Siamese

Anthony Todd — Sat, 12 Sep 2015 12:19:52 GMT

And milk, particularly rich New Zealand milk, will almost certainly upset all of them!

RE: Siamese

Virginia Campbell — Sat, 12 Sep 2015 08:11:35 GMT

[quote user="Aine Seavers"]Siamese cats are like birds- behaviour and diet make up 90% of the triggers for illness.[/quote]

useful to know and easy to remember!

RE: Siamese

Aine Seavers — Sat, 12 Sep 2015 05:28:57 GMT

1)Siamese -they vomit more than any other breed- that's why the RC Siamese is shaped to slow them down and stop most of the vomiting.They are rarely unwell. Hills i/d also suits them.

2)vomiting in a cat accord to experts is an intestinal not gastric issue- often trichobezoars- dont forget the importance of anti -hairball potions for these cats- plus Zoom groom out the xs hair- esp if more than one cat as if a Siamese likes to groom it will groom ALL the cats not just themselves to the point the other cats with them give up self grooming and hand over their own coat maintenance to the main Siamese cleaner cat.

3)Vit B injections can help vomiters as can a short course of glucocorticoids if the vomiting is causes by irritated inflammed bowels.

Know the breed, its unique traits and work around that- Siamese cats are like birds- behaviour and diet make up 90% of the triggers for illness.

RE: Siamese

Danny cazabon — Mon, 24 Aug 2015 21:14:10 GMT

I have a gut feeling, (pardon the pun) that it may well be just a dietary intolerance issue. I'm hoping if her condition did deteriorate the client would have booked a sooner appointment.

I know there can be a genetic link between the breed and pyloric stenosis.

RE: Siamese

Anthony Todd — Mon, 24 Aug 2015 16:59:38 GMT

[quote user="Danielle Dillon"]That is definitely an idea to explore.[/quote]

I've never known an intusussception that wasn't inappetent and obviously very seriously unhappy, so pretty obvious on day one; by now it'd be moribund I'd guess.

Very easy to diagnose instantly with an old fashioned Mk 1 finger and thumb too.

RE: Siamese

Danny cazabon — Mon, 24 Aug 2015 12:31:08 GMT

Hello,

Thank you. That is definitely an idea to explore.

Unfortunately our client has missed their scheduled appointment and we have since been unable to contact her.

I only hope the issue has improved.

If I get the opportunity to do some diagnostic tests. I will be sure to post my findings.

Thank you all.

Danielle

RE: Siamese

Anthony Todd — Sat, 22 Aug 2015 09:46:13 GMT

[quote user="grumpyoldman"]siamese with intersucceptions [/quote]

These are very easy to palpate though, and I very much doubt if one would be missed. Mine stopped eating pretty early on.

RE: Siamese

grumpyoldman — Sat, 22 Aug 2015 00:53:49 GMT

not sure this may be of any help and I am sure its already been considered ,but I have seen several youngish siamese with intersucceptions , sometimes with waxing and waning symptoms involving vomiting, sometimes unravel with vomend sometimes needing surgery ,often complete with ascarids in situ. Maybe worth a suck on a milbemax tablet before going elsewhere particularly if its been in breeding establishments.

RE: Siamese

Anthony Todd — Fri, 21 Aug 2015 21:14:43 GMT

10 days on I'd love to know what's happening?