Veterinary Clinical Podcasts

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Welcome to the RVC veterinary clinical podcast. In these shows, Dominic Barfield, with the technical help of Brian Cox talks to a variety of different faculty/specialists/clinicians from the RVC about clinical relevant material to everyone in practice, if you are just about to start your veterinary career or you are a seasoned professional we aim to provide something for everyone. Whether you’re listening whilst you are cooking dinner, driving home, walking the dog or even at the gym, we want to give you some practical tips and advice that you won’t necessarily find in the text books or journal articles that we hope makes a difference to your patients. Find the show notes on https://goo.gl/ECRxGh you can follow me on twitter @dombarfield or email any suggestions/comments to dbarfield@rvc.ac.uk.

  • 42 Ophthalmological examination

    Fri, 16 Jun 2017

    Author: Dominic Barfield

    Duration: 00:50:50

    42 Ophthalmological examination

     

    In our 42nd podcast we might not uncover the mysteries of life the universe and everything, though we do have the opportunity to refresh our approach to ocular examination with Charlotte Dawson, lecturer in ophthalmology here at the RVC. It was Jeff Smith who taught me ophthalmology in Sydney, who said more is missed by not looking than not knowing. To be fair he might have borrowed that from Thomas McCrae, one of the forefathers in post graduate medical education, though it is still as pertinent now as it was then.

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Traumatic brain injury

    Tue, 30 May 2017

    Author: Dominic Barfield

    Duration: 00:38:42

    Today we talk to Elsa Beltran, one of our fabulous senior lecturers in neurology and neurosurgery here at the RVC about traumatic brain injury.  Initial assessment, tools that we can use to grade injury and see if there is an improvement or not, when to think about diagnostic imaging, and more. We’d loved talking to her and am sure you will get a lot out of it.

    Some papers of interest including Elsa’s paper on the use of MRI in Traumatic brain injury;

    https://www.ncbi.nlm.nih.gov/pubmed/22063205

    https://www.ncbi.nlm.nih.gov/pubmed/22063206

    http://onlinelibrary.wiley.com/doi/10.1111/jvim.12368/abstract

    http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2001.tb01594.x/abstract

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Coxofemoral luxation

    Thu, 18 May 2017

    Author: Dominic Barfield

    Duration: 00:26:27

    In this podcast, we talk to Elvin Kulendra, lecturer in orthopaedic surgery here at the RVC about coxofemoral luxation in dogs.  The most common luxation in dogs and the majority are related to trauma. Elvin talks about initial assessment, the major body systems, and gait and neurological function, which radiographs to take and steps on how to perform a closed reduction, which should be successful 50% of the time (higher in cats). Allegedly there are 20 ways to perform an open reduction, though we don’t talk about all of them. Cage rest regardless of reduction technique for at least 4 weeks, lead walking only (no jumping, stairs etc).

     

    A review on coxofemoral luxations: https://www.ncbi.nlm.nih.gov/pubmed/15943127  

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Acute vestibular disease

    Fri, 12 May 2017

    Author: Dominic Barfield

    Duration: 00:29:25

    In this podcast, we talk to Joe Fenn, lecturer in veterinary neurology and neurosurgery here at the RVC about presentation and management of acute vestibular disease. There might be a couple of references to wittertainment, though it’s mainly about vestibular disease. Enjoy.

     

    Here are a couple of links if you’d like to read more on vestibular disease:

    https://www.ncbi.nlm.nih.gov/pubmed/22847320

    https://www.ncbi.nlm.nih.gov/pubmed/22847321

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Blood pressure in dogs and cats

    Mon, 1 May 2017

    Author: Dominic Barfield

    Duration: 00:33:20

    In this podcast, we talk to Dr Rosanne Jepson, lecturer in internal medicine here at the RVC about blood pressure in dogs and cats.

     

    Hypotension, hypertension and everywhere in between. How, with what, where and why to measure. Are we underestimating, overestimating with different techniques? Cuff size and repeatability of readings. Do your patients have ‘white coat’ hypertension? Tips and tricks, if you are regular user, or it is something that you are wanting to bring in more to your practice. Enjoy the pod.

     

    Here are some links:

    Consensus statement from ACVIM published in 2007, https://goo.gl/bmtxuP though we believe will be updated soon

    IRIS http://www.iris-kidney.com International Renal Interest Society, a great resource.  

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Rule of Six

    Fri, 7 Apr 2017

    Author: Dominic Barfield

    Duration: 00:28:02

    In this podcast, we talk to Tom Cardy, staff clinician in neurology and neurosurgery here at the RVC about the ‘Rule of Six’, or the ‘Six Finger Rule’ (which has no bearing on Count Rugen or indeed Inigo Montoya). It is a clever process used to teach clinical reasoning in canine spinal disease, in six steps.

     

    Signalment

    Onset

    Deterioration

    Pain

    Asymmetry

    Neuroanatomical localisation

     

    Here is the link to the paper published in the Veterinary Record in 2015 http://veterinaryrecord.bmj.com/content/early/2015/07/21/vr.102988

     

    Tools and mnemonics that make our day to day life easier are always warmly welcomed!

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Continuous Renal Replacement Therapy and Therapeutic Plasma Exchange 36

    Fri, 31 Mar 2017

    Author: Dominic Barfield

    Duration: 00:22:41

    Today we talk to Stefano Cortellini, lecturer in emergency and critical care here at the RVC about the process and indications for Continuous Renal Replacement Therapy (CRRT) and Therapeutic Plasma Exchange (TPE). Further information about this therapy can be found here http://www.rvc.ac.uk/small-animal-referrals/advanced-techniques-and-specialist-procedures/continuous-renal-replacement-therapy

     

    Information on acute kidney injury (AKI) and grading can be found on the website of the International Renal Interest Society (IRiS) here http://www.iris-kidney.com/guidelines/grading.html

     

    The indications for considering treating patients with AKI are; metabolic acidosis, electrolyte imbalance (especially refractory hyperkalaemia), and uraemia. The patients we see, have a potential reversible cause, are often anuric and we can successfully catheterise.  tend to be most affected are those that are anuric. Some toxins can be removed by dialysis when different filters are used. TPE has been used for immune mediated diseases (IMHA, polyradiculoneuritis), and cutaneous and renal glomerular vasculopathy.

     

    If you are in the UK and have a patient that you might think benefit from this therapy, then do not hesitate to contact the RVC http://www.rvc.ac.uk/small-animal-referrals/

     

    Suggested reading.

    Review of CRRT and blood purification http://onlinelibrary.wiley.com/doi/10.1111/vec.12028/abstract

    Single pass lipid dialysis for ivermectin toxicosis http://onlinelibrary.wiley.com/doi/10.1111/vec.12581/abstract

    Therapeutic plasmapheresis in IMHA http://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2009.00431.x/abstract  

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @dombarfield or @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • Bite wounds 35

    Wed, 4 Jan 2017

    Author: Dominic Barfield

    Duration: 00:29:11

    Today we talk to Zoë Halfacree, senior lecturer in soft tissue surgery here at the RVC, about bite wounds and some things to consider in how to approach them, after initial patient assessment and stabilisation.

    ·      Analgesia; full mu opioid based upon pain score

    ·      Antibiotics; broad spectrum, such as potentiated amoxicillin

    ·      Culture where possible

    ·      Diagnostic imaging

    ·      When to explore; preferably within 4-6 hours of presentation

    ·      Lavage techniques; isotonic crystalloid (e.g. compound sodium lactate) using a 25ml syringe and 19-gauge needle. If you attach the fluid bag to an extension set and that to a three-way tap, with the needle and syringe, if makes it a little easier to flush.

    ·      Wet to dry dressing vs placing a drain

     

    Zoë discussed these aspects of bite wound management. Although this is a relatively common problem that we encounter, there is little information in the literature to help guide us on ways to manage these challenging patients.

    Enjoy!

    If you have any comments about this podcast, please get in touch, email dbarfield@rvc.ac.uk; tweet @RoyalVetCollege using #rvcpod; or use the RVC Facebook page. We would greatly appreciate your time to rate us on iTunes and write a review.

  • 34 EPIC

    Thu, 3 Nov 2016

    Author: Dominic Barfield

    Duration: 00:43:40

    In this podcast we talk to one of the principle investigators of the EPIC study, Professor Adrian Boswood. We discuss the findings of the evaluation of pimobendan in dogs with cardiomegaly caused by preclinical mitral valve disease. Why not go to the Journal of Veterinary Internal Medicine’s website, download it and have a read now! http://onlinelibrary.wiley.com/doi/10.1111/jvim.14586/full

     

    It is not often that a single paper has the ability to radically change clinical practice. This epic study has overwhelming evidence that pimobendan administration before the onset of clinical signs in dogs with mitral valve disease (MVD) prolongs the preclinical period by 15 months. The dogs were identified by having a ≥3/6 grade systolic heart murmur, echocardiographic evidence of MVD, and radiographic or echocardiogram evidence of cardiomegaly.

     

    You can also see a video of Professor Boswood discussing this study on youtube https://www.youtube.com/watch?v=wtzr1E3V-gE and an infographic too https://www.youtube.com/watch?v=5qxHMGZ-9aU

     

    It is indeed EPIC.

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.

  • 33 Angiostrongylosis redux

    Mon, 10 Oct 2016

    Author: Dominic Barfield

    Duration: 00:26:04

    To kick start the return of the RVC Clinical podcast we speak to Karen Humm, Lecturer in Emergency and Critical Care here at the RVC.  Karen was last heard here when she spoke to Shailen about this disease in number 23 of the podcast, two years ago now.

     

    As with most of the diseases we treat, prevention if far better than cure. There has been a paper published earlier in the year by groups at Bristol and Swansea University (http://www.ncbi.nlm.nih.gov/pubmed/26830203) that shows the prevalence can change dramatically depending upon your location. What is it like in your area?

     

    If you have any comments about this podcast, please get in touch (email dbarfield@rvc.ac.uk; tweet @RoyalVetCollege using #rvcpod; or use the RVC facebook page). We would greatly appreciate your time to rate us on iTunes and write a review.