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Simon is joined by Professor Kelly Tart from the Universityof Minnesota to discuss “Lorazepam reduces recurrence of urethral obstruction in male cats: a prospective, randomized, double-blinded, placebo-controlled study.” https://avmajournals.avma.org/view/journals/javma/aop/javma.26.01.0045/javma.26.01.0045.xmlThe study prospectively enrolled 80 cats following their first urethral obstruction and randomised them to receive oral lorazepam or placebo for one month. Five cats receiving placebo re-obstructed, compared with none receiving lorazepam, alongside encouraging findings regardingowner-reported lower urinary tract signs.We discuss the rationale behind the study, trial design, recurrence and lower urinary tract signs, reported adverse effects, and how to interpret the results. Finally, we ask the important clinical question: is the evidence strong enough to change how we manage cats after urethral obstruction?

Why is the severe anaphylaxis patient actually unstable, and how do you treat it? This was a fascinating discussion with Dr Ryan Smith about his group’s study on dogs with severe anaphylaxis that did not receive early epinephrine as part of their management. We cover those 49 cases, basic physiology, hepatic rupture and the protocol that Dr Smith and his team use. That protocol is available as supporting information to the study itself here: Canine Anaphylaxis Patients Receiving Late Epinephrine or No Epinephrine: 49 Cases (2019–2023) https://onlinelibrary.wiley.com/doi/10.1111/vec.70102 Other articles also mentioned: Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity https://onlinelibrary.wiley.com/doi/10.1111/vec.13345 Acute hepatic rupture causing hemoperitoneum in a dog with anaphylaxis https://onlinelibrary.wiley.com/doi/10.1002/vms3.1391 Clinical characteristics of two-hundred thirty-two dogs (2006-2018) treated for suspected anaphylaxis in Perth, Western Australia https://onlinelibrary.wiley.com/doi/10.1111/avj.13114

Here we have two amazing educators in Bobbi Conner DACVECC and Alex Blutinger DACVECC to discuss CPR orders, client presence in CPR events and tactics to help navigate these situations. How do you decide when to stop, or if we should even have started?! The studies we covered: Evaluation of Client Communication Regarding Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders: A Survey Study https://onlinelibrary.wiley.com/doi/10.1111/vec.70064 Evaluation of a Cardiopulmonary Resuscitation Video Decision Aid for Pet Owners https://onlinelibrary.wiley.com/doi/10.1111/vec.70070 Outcome prediction in dogs admitted through the emergency room: Accuracy of staff prediction and comparison with an illness severity stratification system for hospitalized dogs https://onlinelibrary.wiley.com/doi/10.1111/vec.13350 You can (and should) listen to more from Bobbi on The Veterinary Journal Club and Discussions podcast: https://podcasts.apple.com/gb/podcast/veterinary-journal-club-discussions/id1478755748

Here we discuss the role of antimicrobials in dogs with pyometra – how, or even if we need to use them. Anna Ylhäinen a doctoral researcher and clinician from the University of Helsinki Veterinary Teaching Hospital who recently published the following study with her team: Placebo is non-inferior to postoperative antimicrobial treatment in uncomplicated canine pyometra – A double-blinded randomized controlled trial. The Veterinary Journal. Open access. https://www.sciencedirect.com/science/article/pii/S1090023325001534 We also discussed further work from Anna and her team: Bacteria associated with canine pyometra and concurrent bacteriuria: A prospective study https://www.sciencedirect.com/science/article/pii/S0378113524003845

When to use, or rather, when not to use any peri-operative antimicrobials at all. Here we discuss the ENOVAT guidelines on surgical antimicrobial prophylaxis. There is a huge capacity for impact here by following and disseminating these guidelines. If you’re on board already, listen and spread the word. If you’re not converted yet, listen in and see what you think. At the end Fergus asks for your help in submitting cases with E. coli in their bile for an observational study he is actively recruiting for. The guidelines: European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) 2025 guidelines for surgical antimicrobial prophylaxis in dogs and cats. https://onlinelibrary.wiley.com/doi/10.1111/jsap.70072 Resources we mentioned: IVEG International Veterinary Evidence Based Guidelines Centre (IVEG) – University of Copenhagen https://iveg.ku.dk/ European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines for antimicrobial use in canine acute diarrhoea. https://www.sciencedirect.com/science/article/pii/S1090023324001473 ENOVAT website: https://enovat.eu Canine Cruciate Registry https://ccr.rcvsknowledge.org/ Fergus Allerton e-mail address for contributing biliary tract infections to the study: [email protected] Retrospective evaluation of surgical site infection after open splenectomies with and without perioperative prophylactic antibiotic coverage https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2105-3593

In this we discuss the peculiarities of cats falling out of windows – what we can expect to find and how we might manage them. Think chest tubes, cardiac rupture, traumatic pancreatitis and a nostalgic dose of physics. Vicente was lecturing on this topic at IVECCS in San Diego, sees plenty of these cases in Valencia, Spain and has a particular interest in traumatic coagulopathies. There are some great articles listed below for your interest. If you find these useful, a quick star rating really helps these conversations reach more vets who might also enjoy them. Articles: High-rise syndrome in cats and dogs. JVECC 2022 https://onlinelibrary.wiley.com/doi/10.1111/vec.13206 High-rise syndrome in cats (part 1): epidemiology and risk factors. JFMS 2025 https://journals.sagepub.com/doi/10.1177/1098612X251334091 High-rise syndrome in cats (part 2): injury patterns and survival rate. JFMS 2025 https://journals.sagepub.com/doi/full/10.1177/1098612X251334096 Pancreatic rupture in four cats with high-rise syndrome. JFMS 2012 https://journals.sagepub.com/doi/10.1177/1098612X11431527 Retrospective evaluation of traumatic pneumomediastinum in dogs and cats (2005–2022): 52 cases. JVECC 2024 https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13384 Recommended recumbency to avoid insertional complications during small-bore wire-guided thoracostomy tube placement in cats-a cadaver study. BMC Veterinary Research 2024 https://link.springer.com/article/10.1186/s12917-024-04301-7

Here we discuss how best to use fluid therapy in our critical patients – specifically, the concepts of fluid stewardship, hidden fluids, replacement versus maintenance fluids, sodium load and when fluid overload can happen. Dr Alexandra Pfaff has been building a fluid stewardship team and recently authored a study entitled: Retrospective Evaluation of Risk Factors and Outcome in Dogs With and Without Fluid Overload During Hospitalization in the journal of veterinary internal medicine. https://onlinelibrary.wiley.com/doi/10.1111/jvim.70132 The International Fluid Academy https://www.fluidacademy.org/

This study documents a higher frequency of seronegative myasthenia gravis dogs than was previously thought to be the case and discusses a classification approach that is likely to be built on over time. An Vanhaesebrouck as lead author joins Abbe Crawford to discuss – so you’re in excellent hands to learn more about myasthenia gravis. Case Series of Canine Myasthenia Gravis: A Classification Approach With Consideration of Seronegative Dogs https://onlinelibrary.wiley.com/doi/10.1111/jvim.70113

“Anesthesia safety is less about picking the ‘correct’ drug combination, and more about how you take care of and stabilise the patient…” Join myself and Dr Lydia Love as we discuss the 2025 Small Animal Anesthesia and Sedation Monitoring Guidelines, specifically thinking how we can improve the care of our ICU and ER patients. We cover all sorts: hypothermia, sedation vs anesthesia, recovery, cases such as urethral obstruction and septic peritonitis, locoregional anaesthesia and plenty more! For reference The American College of Veterinary Anesthesia and Analgesia Small Animal Anesthesia and Sedation Monitoring Guidelines 2025 https://www.vaajournal.org/article/S1467-2987(25)00071-6/fulltext Coccygeal epidural with local anesthetic for catheterization and pain management in the treatment of feline urethral obstruction https://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2010.00609.x

In this episode we welcome Dr Lauren Minter and Professor Deborah Silverstein to discuss: -Factors associated with tracheostomy decannulation failure in dogs with BOAS -When to attempt decannulation of these dogs -Tracheostomy tube dislodgement -Complications of suctioning -Recurrent obstructive fibrinous pseudomembranes. See this report here: https://onlinelibrary.wiley.com/doi/10.1111/jvim.14650 …all in relation to their original study entitled “Factors that may be associated with tracheal decannulation failure in dogs requiring temporary tracheostomy after upper airway surgery for brachycephalic obstructive airway syndrome” https://onlinelibrary.wiley.com/doi/10.1111/vec.13453 Also see a recent related study here: Retrospective evaluation of the outcomes of advanced airway management in intubated patients with brachycephalic obstructive airway syndrome: 52 cases (2010-2020), https://onlinelibrary.wiley.com/doi/10.1111/jsap.13907 covering specifically those dogs with BOAS that require emergency intubation. Happy listening and reading!

A chance to cut is a chance to cure? In this episode we cover: The principles of cardiopulmonary bypass Anticoagulation The mitral valve repair itself The ideal surgical candidate for mitral valve repair The outcomes of such a procedure The original study is below and covers further specifics such as case selection and post-op care plus summaries and discussion of fatalities. An overarching aim was that this should be useful for other centers establishing such a program. Improvements over time are summarised by improving survival rates: 22/33 in the first quartile, 27/33 in the second quartile, 28/33 in the third quartile, and 30/33 in the final, most recent group. Do have a read. Improvement in short-term outcome over time, in a single center embarking on a canine mitral valve repair program using a structured multidisciplinary approach https://onlinelibrary.wiley.com/doi/10.1111/vsu.14229

In this podcast we discuss the actual prevalence of AKI in cats exposed to lilies, how bad the AKI seems to get when it does occur, and the changing management practices over time in toxin exposures, let alone in the management of lily exposure itself. Happy listening! Prevalence of acute kidney injury and outcome in cats treated as inpatients versus outpatients following lily exposure https://avmajournals.avma.org/view/journals/javma/263/1/javma.24.05.0355.xml

Alex Lynch and Rob Goggs discuss the uses of viscoelastic testing, hyperfibrinolysis, when to use antifibrinolytics in dogs, and when to stop them! This is part 2 of 2. A selection of studies referred to: CURATIVE guidelines https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801 Characterisation of changes in the haemostasis system in dogs with thrombosis https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037 CRASH 2 Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext CRASH 3 Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext WOMAN trial Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300 FAT CAT https://www.sciencedirect.com/science/article/pii/S1760273415000958 SUPERCAT https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml

Alex Lynch and Rob Goggs answer questions on indications for thromboprophylaxis, knowledge gaps in the area, if or when we should be more pro-active and ATE in cats. This is part 1 of 2. A selection of studies referred to: CURATIVE guidelines https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801 FAT CAT https://www.sciencedirect.com/science/article/pii/S1760273415000958 SUPERCAT https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml Characterisation of changes in the haemostasis system in dogs with thrombosis https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037 CRASH 2 Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext CRASH 3 Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext WOMAN trial Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300

Do you use rivaroxaban? Do you want to know more about using rivaroxaban? Or even apixaban? In this podcast we discuss both anticoagulant drugs with study authors Alex Lynch and Rob Goggs. I learnt plenty and I hope you will too! We also recorded a ‘burning questions on thromboprophylaxis’ podcast that will be out very soon, so keep an eye out for that too! You can also find the podcasts on the www.vetlit.org/podcast page itself. In this episode we cover: The background to the use of oral anticoagulants A brief tour of pharmacokinetics and pharmacodynamics. The biological effect of both drugs, when it happens and the concept of rebound hypercoagulability after drug withdrawal. The original study is here: Comparison of the pharmacokinetics and pharmacodynamics of apixaban and rivaroxaban in dogs https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17216

In this podcast we discuss the impact of a short video to teach owners about antimicrobial stewardship. Chris Scudder talks to authors Emma Wright and Fergus Allerton about their study entitled “Influencing attitudes towards antimicrobial use and resistance in companion animals—the impact on pet owners of a short animation in a randomized controlled trial.” If you’d like to use the video in your practice waiting room, it’s available here and has been translated into 20 languages. (https://www.youtube.com/watch?v=4ApEAfN4dWU) The study itself documented positive effects on owner awareness relating to antimicrobial stewardship, using a common scenario of acute onset diarrhoea as the case example. It re-affirms the importance of owner education and sets the scene for more resources with similar aims and measurable outcomes. You can read the article here: https://academic.oup.com/jacamr/article/6/3/dlae065/7665563 and find out more about ENOVAT here: https://enovat.eu/

In this episode we discuss antibiotic course lengths in dogs with pneumonia, with reference to a study entitled: Clinical course and radiographic resolution of pneumonia in dogs treated with a shorter versus longer course of antimicrobials: a randomized, double-masked, placebo-controlled study. (https://avmajournals.avma.org/view/journals/javma/aop/javma.24.04.0259/javma.24.04.0259.xml) We also touch on topics such as use of point of care ultrasound and use of CRP in such cases. Some extra resources below that we make reference to: Successful management of aspiration pneumopathy without antimicrobial agents: 14 dogs (2014-2021) https://onlinelibrary.wiley.com/doi/abs/10.1111/jsap.13409 ACVIM consensus statement on therapeutic antimicrobial use in animals and antimicrobial resistance https://onlinelibrary.wiley.com/doi/10.1111/jvim.12562 Antimicrobial use guidelines for treatment of respiratory tract disease in dogs and cats: antimicrobial guidelines working group of the International Society for Companion Animal Infectious Diseases (ISCAID). https://onlinelibrary.wiley.com/doi/10.1111/jvim.14627 Happy listening!

In this podcast we discuss IV catheters and their complications in light of a study entitled: Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice. https://onlinelibrary.wiley.com/doi/10.1111/jsap.13782 The data that support the findings of this study are openly available in Figshare.com at https://doi.org/10.6084/m9.figshare.25283356.v1