Mellora Sharman's Activities

Iris Staging References vs Lab Reference ranges

Steve Leonard — Thu, 10 Jul 2025 08:41:51 GMT

Now then,

I have tried to search the forums to see if this has been discussed before and can’t find anything.

Normal reference ranges for CREA from our external lab and in-house machine differ quite markedly (especially for felines) to the IRIS staging ranges.

I was always advised to use the lab ranges but then how do we stage them as we haven’t got the cutoffs for different stages from the lab, just the upper limit of normal.

thoughts appreciated Steve

Faecal Testing

Joshua Bleakley — Tue, 15 Jul 2025 14:20:51 GMT

Hi all,

I hope this is not too widespread/banal a question, but with various lectures and discussions, I am wondering what to do. I currently use a very well known laboratory that offers a general faecal screening for dogs that includes microscopy and giardia testing, but also salmonella and campylobacter culture and a PCR screen for cats that seems to cover a wide variety of things. With dogs generally having a course of panacur anyway for enteropathies and with both dogs and cats now being treated more by diet than other means, is there any use to faecal testing? (Potentially barring the raw food fed crowd).

Am I limited by the lab we use and should consider a different source of testing? Or is faecal testing generally on the decline?

I know this is a very large topic, so any input/discussion would be grateful. I just wish to know what other clinicians are currently doing.

Thanks a lot,

Josh

Hydrolysed vs. Novel Protein Diets?

Harry Swales — Thu, 17 Apr 2025 07:02:55 GMT

Hi SAMSoc,

I just wanted to get an idea with people's experiences with hyrolysed diets for GI disease in dogs. I've recently had a number of vets (Dips/APs) state that they feel like they are having poorer responses to hydrolysed diets for GI disease compared to what they used to, and a better response to novel protein/carbohydrate diets (whether this is truly due to the 'novel' aspect or just a change in diet - who knows?). I've also had a number of clients report the same, and same with some of the GI FB groups. Conversely, I've had other vets suggest that this is not their experience.

Personally, this isn't my experience (hydrolysed still seems to have the highest chance of working), but I do think I see a completely different GI population than I used to - much less diarrhoea and much more hyporexia/condition loss/aerodigestive - so who knows? Rather arbitrarily, and disease dependent, I tend to go hydrolysed (Purina HA)-->Low fat --> gastrobiome --> chappie...

Obviously this is all incredibly subjective, but would just like to get an idea of other people's experiences?

Harry

Cat bladder abnormality... neoplasia?

Holly Lee — Tue, 30 Jul 2024 02:07:54 GMT

Hi all, I wonder if anyone could give me an opinion on whether some bladder changes are likely to be neoplastic?

This is a 9yo FN DSH belonging to one of the lovely vet nurses that I work with. No clinical signs just persistent haematuria picked up on routine screening.

There is a hyperechoeic area in the bladder neck - initially I thought it might be a urolith in the urethra however after passing a urinary catheter it appears that it is adjacent to the urethra rather than in the lumen. I am concerned it may be mineralisation in a mass lesion in the bladder neck.

I am not sure what to do next to figure out what it is and whether it is the cause of the haematuria - options include referral to a better ultrasonographer, contrast studies, or trying to get an FNA/biopsy of some sort (but worried about seeding).

There is also some dilation of the right renal pelvis (I think)

On radiography there is a mineralised area visible towards the bladder neck but also in at least one kidney.

Any thoughts welcomed, I hate giving colleagues bad news...

Thanks, Holly

Pred or triple therapy for H.pylori...chronic V+ FN 4yo.Vizla

Sara Ramsey — Wed, 22 May 2024 22:31:49 GMT

I am struggling to decide?

This little one has had very full work up including full thickness GIT biopsies at ex-lap (plus: faeces, TLI,folate,coalmine, Cpli,acth atim and also lungworm testing and treatment as owner was very very concerned about this) She has waxing and waning abdominal discomfort, hyporexia, grass eating+, vomiting and some intermittent loose faeces, some with mucoid blood. Not much on clinical exam and always very bright at the vets (much to the owners distress as she thinks we don't believe her...we do!!).

We are currently on a hydrolysed diet with paracetamol. Her biopsies showed some eosinophilic and suppurative changes especially proximally and a more LC/PC picture in distal intestine. She also had lymphadenitis. Mild numbers of superficial H.pylori also seen.

I spoke to the IDEXX internal medic today as I thought the suppurative comment was odd, and by the end of the conversation we had convinced ourselves to trial metronidazole/amoxicillin/omeprazole for 2 to 3 weeks.

I'm not too sure though, I've always been a bit "on the fence" about H.pylori

Sorry for the potted history I'm not at work and it's keeping me awake!

I am eager to hear other thoughts:)

Happy to fill in any gaps as requested!

Any UK laboratories recommended for investigation of a possible muscular dystrophy?

Christopher Saul — Fri, 05 Apr 2024 16:12:28 GMT

Hello all,

I have an 11 month old miniature poodle cross in whom I'd developing an increasing index of suspicion for some kind of muscular dystrophy. I haven't seen a case in such a long time and I was wondering - are we best sending muscle biopsy samples to Dianne Shelton in San Diego or are there any UK based laboratories with a similar reputation?

Many thanks indeed.

Have a good weekend everyone!!

Fanconi-like syndrome

Mellora Sharman — Wed, 18 Oct 2023 09:20:50 GMT

Hello!

Just checking to see if anyone has seen any recent cases of Fanconi-like syndrome in dogs, and if yes - if you know and can share any dietary / treat history associated with those cases.

Just trying to figure out if there is a new set of cases incoming...

Thanks

Mellora

Recurrent Aspergillosis in Dobermann

Jon Camilleri — Mon, 22 Jan 2024 09:47:18 GMT

Dear all

I have been treating a lovely 5yr old FN Dobermann Pinscher for right sided nasal cavity aspergillosis. CT in July last year showed suspicion of right frontal sinus involvement as well as right nasal cavity disease:

'No lysis of the cribriform plate identified, but there is mild erosion on the ventral and middle aspect of the right
frontal sinus (blue circles) .Normal appearance of the intracranial structures, with no evidence of mass effect or
abnormal contrast enhancement. The ventricular system is normal' (Secondary right sided frontal sinusitis and hyperostosis)

Two treatments with clotrimazole infusion into the frontal sinus via trephination followed by infusion with clotrimazole cream in July last year. She responded well but signs recurred 2 months ago. I re-evaluated on Friday and a fairly sizeable plaque was evident in the caudal nasal cavity (a fairly large void now with turbinate destruction). I debrided/rake out as much as I could and would say at least 95-98% of gross plaque was dislodged. I repeated the trephination and clotrimazole infusion/cream instillation.

Unfortunately funds are limited to the extent that my client has said this is her dog's last chance with treatment.

Would adding in systemic treatment be reasonable or not at this stage (we could not repeat CT for cost reasons)? If so what regime do you use?

Thanking you in advance

Jon

How should I test for a diabetes insipidus?

Elizabeth — Wed, 03 Jan 2024 21:40:42 GMT

Extremely polydipsic dog with usg between 1.003 and 1.007. Bloods normal except SdMa 15 (url 14). Tacky gums but hCT 38% . I’m suspicious of DI - can I just test for a few days with desmopressin eye drops and monitor water intake and usg? Is the water deprivation test a real no-no - we wouldn’t be able to catheter but could do free catch samples.

Destructive rhinitis - probable sinonasal aspergillosis. Is this a euthanasia case or are there any treatment options?

Ian Hopkins — Thu, 14 Dec 2023 10:54:34 GMT

I have a 2 y.o. SBT with a 4 week hx mainly right sided mucosanguinous nasal discharge. CT highly indicative of nasal aspergillosis with the right frontal sinus severely affected with a fungal granuloma and calvarium destruction and potential localised meningitis. The dog has developed a facial tick in the last few days

The nasal rhinoscopy did not visualise any plaques and nasal turbinate biopsy has shown neutrophilic chronic rhinitis. Nasal discharge culture negative for fungal elements.

Enilconazole flush is contraindicated with potential neuro toxicity. Is this a euthanasia case or are there any treatment options?. The owner has a new born baby and is considering euthanasia on zoonotic and difficulty in treating reasons.

CT report below. TIA

Description: HEAD: The right nasal fossa is abnormal in appearance with extensive destruction of the nasal and ethmoturbinates extending from the level of the palatine fissure caudally to the rostrodorsal part of the ethmoturbinates. Due to the conchal loss there is a marked increase in air space in the right nasal fossae. There is thickening of the mucosa within the nasal fossae and in the area of conchal loss there are several clumps of deformed conchae. A moderate amount of discharge is present within the right nasal fossae. The right frontal sinus is abnormal with a large, irregular clump of material and areas of fluid dependently in the sinus. Adjacent to the abnormal sinus material there is focal, permeative lysis of the inner and outer tables of the frontal bone. There is mild focal increased contrast enhancement of the soft tissue medially in the right orbit adjacent to the abnormal bone There is no mass effect associated with the nasal disease. The left nasal fossa and frontal sinus are normal in appearance. The nasopharynx is normal. No intracranial abnormalities are visible. The rest of the head is normal.

Conclusion: • Destructive rhinitis - probable sinonasal aspergillosis

Additional comments: The nasal changes are quite severe, predominately right sided and most consistent with sinonasal fungal rhinitis but definitive diagnosis will require biopsy/visualisation of the fungal plaques. The abnormal material in the frontal sinus is typical of a fungal granuloma. There is erosion of the calvarium and localised meningitis/ intracranial extension of the presumed fungal disease is not excluded. Note extensive turbinate destruction and probable fungal granuloma in the right frontal sinus Note bony erosion of the right frontal bone and mild enhancement of the orbital soft tissue

Oral cat anti-diabetic Velagliflozin (Senvelgo)

Martin McDowell — Fri, 18 Aug 2023 15:13:22 GMT

Boehringer this week announced the launch of the oral once daily anti-diabetic for cats. Just wanted to let you know as it seems this has been missed from the news section or even Vet Times for that matter. I suspect we will hear all about it at the 2023 LVS in London.

Looks like the UK not likely to stay behind as the VMD is showing it as licensed with the 1st authorisation date of Aug 1st 2023

www.vmd.defra.gov.uk/.../A013166

https://www.vmd.defra.gov.uk/productinformationdatabase/files/SPC_Documents/SPC_2606066.PDF

https://www.boehringer-ingelheim.com/animal-health/companion-animals/pets/cat-feline-diabetes-medication-treatment-fda-approval

https://www.dvm360.com/view/fda-approves-first-oral-liquid-medication-to-treat-diabetes-in-cats

PS I'm not paid by Boehringer in any way.

What do you think of these guidelines for the correct use of antibiotics in urinary tract disease?

Neil Wheadon — Thu, 07 Dec 2023 13:44:58 GMT

Not a question, but something that this forum is useful for

I was unaware, but this article is interesting in regards correct use of antibiotics in urinary tract disease

https://www.iscaid.org/wp-content/uploads/2013/10/Urinary-guidelines.pdf

Neil

Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases

www.vetsurgeon.org/.../Urinary_2D00_guidelines.pdf

Proteinuria in well controlled Cushinoid dog

Laura Dell'Abate — Wed, 01 Nov 2023 13:14:05 GMT

Hello, I have a 13 year old whippet that is currently on 30 mg vetoryl SID. Pre vetoryl test done in August was 79.5 nmol//L.

Renal values are unremarkable. Cholesterol is slightly elevated .

The blood pressure was 170 mmhg at the end of September and protein creatinine ratio was 5.9

I have started benazepril SID . The blood pressure is now 150 mmhg and the protein creatinine ratio is 4.8.

Would you give the vetoryl BID rather than SID? Would you add telmisartan to the regime ? Is it normal for a well controlled Cushinoid dog to have such a high level of proteinuria ?
Thank you

Laura

Why do our colleagues treat acute diarrhoea (dogs) with antibiotics?

Alasdair Hotston Moore — Tue, 10 Oct 2023 08:01:31 GMT

In the light of this study

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0291057

that shows no benefit, and I suspect we all really know there is no benefit, why do so many vets nonetheless dispense antibiotics? And yet so many young vets equally worry about antibiotic stewardship. It’s genuine conundrum

Alasdair

What would you do in the case of high proteinuria in well controlled Cushinoid dog?

Laura Dell'Abate — Wed, 01 Nov 2023 13:11:13 GMT