Sunday, 28 July 2019

PODCAST Valoración del dolor en el gato. Entrevista a Javier Benito de la Víbora







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Javier Benito de la Vibora LV, PhD, MSc, DES, ECLAM Board Eligible, ACVAA Board Eligible
es clínico e investigador. Su enorme interés por la analgesia y la ética, entre otras muchas cosas, le ha llevado a trabajar en una gran variedad de proyectos interesantes a los que hace referencia en el podcast de hoy.  Como excusa para hablar de su vasta experiencia en la valoración del dolor crónico felino, hemos utilizado un artículo publicado por sus compañeros Beatriz Monteiro y Paulo Steagall en Journal of Feline Medicine and Surgery (Chronic pain in cats: Recent advances in clinical assessment 2019 pp. 601–614).

Friday, 19 July 2019

ISFM Congress 2019- Outside the lecture hall


There is much more to a congress than just the lectures. It is a journey to a place where you may not have been before. It means new people, new ideas and inspiration that does not only come from the lecture hall, but from the social network created around it.

International Cat Care chose again a beautiful place to celebrate our annual ISFM congress this year. Cavtat is a town on the Adriatic Coast of Croatia. Dubrovnik is just half an hour away by boat. I only spent a few hours there but was amazed by its beauty… And by the incredible number of different types of swifts and swallows entertaining us with their acrobatic displays and cheering background music




Niko picked me up at the airport. He is the brother of the owner of the hotel where I stayed. He was pleased to share a beer with me on the terrace and kindly replied when I asked him about the house and the history of their family. The hotel had been the family house where they stayed during the war. He mentioned that the Hotel Croatia (where the Congress took place) was also used for this purpose, as it offered a safer shelter than regular accommodations. 






Niko was not impressed with the fact that some people would visit Dubrovnik with the sole purpose of seeing the sites where Game of Thrones had been recorded. The town has so much intrinsic value!

                                                      Click here to listen to Niko...😁
 

Among other things, this congress gives me the chance of meeting my Spanish colleagues once a year. Lots of interesting and sometimes controversial topics arose during our conversations.
One of them was the need to regulate the postgraduate qualifications with the aim of avoiding misconceptions among clients. They sometimes get confused when certain general practitioners call themselves “specialists”, without necessarily acquiring the knowledge and skills that qualified specialists offer. It is true that there is plenty of information available everywhere and some people are able to train themselves and achieving things in life that others need training for. But it is still necessary to help customers to differentiate which ones truly offer a specialised service. 

We also had a chat about the importance of including cats in some university training and CPD activities that often rule them out as potential candidates.   Both their “small size” that makes it difficult to clearly appreciate the anatomical structures, compared with dogs, and their “unpredictable nature” seem to be some of the most commonly perceived handicaps. My personal point of view on this one is that we could make an effort to work in a low stress environments, correct handling and selection of appropriate cats according to their temperament to maximise their ability to cooperate. Regarding the size… It matters but only up to an extent! I think students should be provided with the opportunity to face these problems for the very first time in a training rather than a working environment.  Cats now represent half of the case load in many practices, and clinicians will undoubtedly encounter challenging feline cases at some stage, not only canine ones.

A much less controversial topic was child friendly practices. Have you ever thought of offering children the chip inserter (obviously those that allow you to detach the needle!) for kids to practice injection skills? Saving some time to communicate with them about their cat’s health issue sounds like a great idea. Pets play such an important role in our emotional development… Unfortunately we do not always have the time though. 

It was very exciting to have the opportunity to meet feline vets from everywhere around the world. I cannot even remember the number of nationalities among the delegates, but there was a truly international atmosphere. I was surprised to meet such a great number of vets who have changed country to progress in their career. I am not just talking about English speaking places, but others such as Belgium, Germany, Dubai or Hong Kong. More than one just moved before learning the language. What a challenge! Although things are not necessarily easy for English speakers in English speaking countries. Some cultural differences seem to influence their experience and bureaucracy is not always easy either. I met a vet who qualified at Ross University School of Veterinary Medicine located in St Kitts, an AVMA accredited school. Before being allowed to practice in the UK, she had to take the MRCVS statutory membership exam, despite having completed a clinical rotation at RCVS during her last year at the university. On a cheerful note I have to say there were also some  cool stories… like the one where Alina ends up looking after the royal family’s pampered pooches!




The social events definitely represent the most appropriate chance to meet people you never thought you were ever going to talk to. The first night I found myself seated next to Jane Armstrong, who revealed some details about what seems to be an impressive diet:


On the same table somebody was talking about different trends in different countries, such as Forti-Flora being used in the management of CKD in certain areas. I have not found scientific evidence about this. But it may be that the antioxidants in it are appealing in these cases? 

Anthony Chadwick, from the Webinar Vet  was very excited about some Spanish webinars they will be offering soon… And he took the chance to practice his Spanish with us! He also talked about a new app we may find interesting. I think we UK locum vets should keep our eyes open and look for “Locumer” whenever they release it. I believe it is about matching vets and practices via an “online dating-like” site. 

It is always nice to have a feline behaviour guru around. I love the way Sarah Heath jumps every time she spots a potentially unfair handling technique or anything that does not respect the feline behavioural needs.  






Samantha Taylor discussed some cases and controversial papers suggested by the audience. She did not only break the gap between delegates and the lecturers at that point, but also during the social events. I was very lucky to spend some time with her chatting about the challenges of vetting, motherhood and gender equality. And I learned from her that it is Boyles who described the small animal point of care ultrasound techniques 


Oh… and the Whova app! This relatively new thing about apps used in conferences is really useful to contact people and debate specific topics. There was a general concern about non neutered cats in the town and of course, being hundreds of us around, we could not stop thinking of neutering them all! Thankfully somebody reminded us of how annoying it can be for the local veterinary community to have outsiders interfering with what they are probably already dealing with. 

Another technological element I liked seeing around was the Sureflap. It would be interesting to find out how many cases of idiopathic cystitis it has solved! I have had two cats of my own who have benefited from its advantages, managing to keep the neighbour cats outside and preventing the associated stress of having unwanted insiders. Now it also enables us to play “Feline Big Brother” as it gives us plenty of information about our cats’ ins and outs via the app. I believe the information we will get from the feeders is going to help us lots with our patients’ health care. 

I am sure I have missed some important things here but hope you get a rough idea of how enjoyable it was from a professional and personal perspective. Obviously the lectures are the most important thing (and I got the impression that we all were more than happy with the standard this year!) but it would definitely not be that much fun if we lacked the social side of it. 

Before saying goodbye, have a look at these Croatian musicians! I listened to some of them live in Mlini the night before going back to Manchester. I am generally not very fond of rock music but these guys were good!! 

Friday, 12 July 2019

My favourite papers JUNE







Don’t you sometimes feel overwhelmed by the number of papers published every week? Once a month I choose three or four publications related to feline medicine that I find particularly controversial or interesting from a first opinion clinical point of view. I may also include a personal comment about EBVM or ethics!



BEHAVIOUR

Salonen et al. Breed differences of heritable behaviour traits in cats ScientificReports  (2019) 9:7949 

This study uses questionnaires to assess behavioural differences between 19 feline breed groups. A total number of 5726 are involved. They include environmental factors and even heritability! Which breed do you think seems to be the most extrovert? 



ENDOCRINOLOGY

Albuquerque et al.  Priorities on treatment and monitoring of diabetic cats from the owners’ points of view JFMS (June 2019)

We definitively have to make an effort to:

-          Help owners to recognise unstable diabetes

-          Talk about home blood glucose monitoring & the importance of diet on diabetic remission/stabilisation

-          Explain and supervise how to draw up insulin and inject the cat at the beginning of the treatment.

 

ECC

Gillespie et al. The Compliance of Current Small Animal CPR Practice With RECOVER Guidelines: An Internet-Based Survey Front. Vet. Sci. (June 2019)

Oops! It seems that we should read this a bit more often: RECOVER https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1476-4431.2012.00757.x



ANALGESIA

Adrian et al. Prescribing practices of veterinarians in the treatment of chronic musculoskeletal pain in cats Journal of Feline Medicine and Surgery 2019, Vol. 21(6) 495–506

Mmmm… Are you prescribing gabapentin when meloxicam would me more appropriate?  



Look at it with an EBVM eye: All these papers have something in common. They are all based on questionnaires. Would you like to know which are the biases that questionnaires may show? Go to A Catalog Of Biases In Questionnaires

Look at it with from an ETHICAL perspective: Once you read that paper about behavioural traits, how are you going to let it influence your clinical decisions? We have also observed behavioural differences in dog breeds, but it may not be as useful as we may think re problem-solving performance as the authors of these other paper find...