Page 3 - Clinical Connections - Spring 2023

LETTER FROM THE EDITOR

The Cycles That Bind Us
uch in the veterinary world is therapy. Oscar, featured on page five, came
seasonal, whether we work in a to us at the age of six months as a result of
M university or in the wider community, clinical signs compatible with leptospirosis
whether we work with livestock, in the equine infection – azotaemia, hepatopathy and
sector, in small animal practice or in zoos. thrombocytopaenia. His was a bumpy road
We are bound together in our desire to help but Oscar made a complete recovery.
animals and progress our field – and we are I’d encourage you to take a look at the
bound together in seasonal cycles. pathology article on page six, about stomach
From certain disease risks, such as cancer in dogs – a more common problem
poisonous plants (such as ragwort) to periods than we perhaps recognise and one that
where there are elevated risks of poisoning can present challenges to diagnose early.
(such as mince pies at Christmas and As quality of life and veterinary care has
chocolate at Easter), to the wonder and stress improved, the frequency of cancer diagnosis
of lambing or small animal vaccinations, has soared. The earlier diagnosis takes place,
everything has its season. Outside of clinical the greater the options available.
work we have seasonal patterns, such as in the congress cycle An article by Rosanne Jepson on page seven addresses the
and our profession’s initiation rituals of white coat ceremonies important subject of antimicrobial stewardship. We have an
and graduation. antimicrobial stewardship programme and a dedicated team
The cyclical nature of much of our work keeps us on our toes to ensure good implementation of the programme. The team
by providing an endless stream of ever-shifting challenges – but provides an advice service for the hospital when complex cases
it also provides variety. Ultimately tackling these cycles provides arise, with careful consideration for all clinical options available.
impetus to change and adapt our profession to continue to Page eight covers the complex case of a guinea pig treated
improve the health and welfare of animals everywhere. by our Exotics and Small Mammals Service. She was initially
The modern veterinary world and our understanding of referred with an eight-week history of vocalising when urinating,
infectious diseases has been shaped by our ultimately successful progressing to haematuria and dysuria. At that point, having
efforts to eradicate rinderpest. And it took a human pandemic ruled out an infectious aetiology, she was discharged back to
to disrupt the seasonal cycles of the veterinary world. Rather the care of her local vet with ongoing meloxicam. She had an
than gathering together at congresses, we were confined to acute neurological episode four months after the first referral and
communication through Zoom and Teams. But as a profession investigations ultimately identified a persistent urachal remnant.
we emerged from that two-dimensional world and are firmly back The article on page nine, by members of our Pain Clinic, is about
on our whizzing cycle of seasonal activity. a 20-year-old cat, Harry, with an oral squamous cell carcinoma.
Articles in this issue underline how the veterinary world has The tumour invaded Harry’s nasal cavity and periorbital tissues,
been pushing on, despite Covid. Rather than seasonal cycles, precluding the possibility of surgical excision. His family wanted to
an actual cycle was responsible for the cover story. A tough make Harry happy for as long as possible without prolonging any
miniature dachshund was severely injured when she was hit by discomfort. They did just that!
the bike. The owners referred her to, as they put it, “give her a Last spring we included an article about Merlin, the first cat of
fighting chance”, and she has bounced back brilliantly! many with feline infectious peritonitis treated with remdesivir at
In our equine article, Roger Smith talks about developments the RVC. In this issue we feature Millie, whose clinical picture
in osteoarthritis treatment. From the ground-breaking culturing was complicated by severe hypoglycaemia and anaemia. I’d
of mesenchymal stem cells from the bone marrow of a horse encourage you to read Jodie Green’s article about Millie and her
20 years ago, to widespread use of autologous stem cells, to management. The introduction of a highly successful treatment
the development of an allogenic stem cell product, it’s been a for what was previously an almost uniformly fatal disease is one
fascinating journey! of the great stories of feline medicine in this decade.
Over the years we’ve included a number of articles about
continuous renal replacement therapy, but this issue includes Professor David Church, Deputy Principal and Acting Vice
details of a case involving intermittent renal replacement Principal (Clinical Affairs)

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