Up to the challenge of questioning established dogma…? | Centre for Veterinary Education

Up to the challenge of questioning established dogma…?

By Lis Churchward

Leading UK specialists—Sophie Adamantos (Criticalist) and Mickey Tivers (Surgeon) certainly are! And they are both excited about the chance to join their Australian colleagues to co-present at the upcoming Critical Care in Internal Medicine & Surgery Conference.

Scroll down to the end of the blog to watch Sophie’s short video. Her enthusiasm for this conference is inspiring! She gives a brief rundown on what you can expect each day, and at the masterclass. She and Mickey take a unique approach in how they impart their knowledge and experience and want you, the participant, to question and challenge them throughout: 'We can learn an enormous amount from each other.'

Sophie’s top tips & benefits

  • Fluid therapy should be individualised, constantly monitored and refined.  
    It is just as easy to overdo as underdo fluid therapy. Patient status changes and with that their fluid therapy requirements.
     

  • Bleeding patients need a protocolised approach to ensure an accurate diagnosis is achieved, in order to correctly treat and prognosticate.
     
  • Severe anaemia in cats is not always terrible!  
    Some cats live long and happy lives with effective treatment (with a normal PCV!)

 

We’ll be challenging dogma—particularly that which is entrenched in the literature without a sound evidence base.  We are not afraid to say what we think or to be challenged with your ideas.  We will give you the tools to question your teaching and beliefs.

We’ll present a multi-disciplinary approach to surgical emergencies which will demonstrate the conflict in idealisms and the differences in priorities. We will use the available evidence base to demonstrate how and why we make decisions as well as highlighting the gaps.  

 

Figure 1. Anaemic cat 

 

Mickey’s top tips & benefits

  • Use of checklists - can they make you a better clinician/surgeon?
    Surgical checklists are potentially a powerful tool for reducing error and improving patient safety. We will take you through how to design a checklist appropriately and implementation to maximise the benefit. 
     

  • Ureteral obstruction. Or subs versus stents, or can we sneak by with medical therapy?
    Ureteric obstruction is an increasingly recognised cause of renal insufficiency in cats. Early detection is vital to ensure the best potential outcome.  Subcutaneous ureteral bypass (SUB) device is the recommended way of surgically managing cats with ureteric obstruction. The procedure is technically demanding but has been associated with good outcomes in cats.



     

  • Management of urinary tract trauma  
    Traumatic urethral rupture in cats can be very challenging to treat, requiring reconstruction or urethrostomy. Cystostomy tubes are very useful to bypass the urethral trauma, allowing stabilisation of the animal, management of other injuries and reduction in inflammation prior to definitive management further down the line.

Figure 2. Subcutaneous ureteral bypass  

Figure 3. Retrograde urethrogram showing a
urethral rupture in a cat

 

  • Brachycephalic obstructive airway syndrome 
    With the dramatic and ongoing increase in the popularity of brachycephalic breeds, brachycephalic obstructive airway syndrome (BOAS) is becoming more and more common. While the respiratory signs are well recognized, these dogs frequently have concurrent gastrointestinal signs which can impact on quality of life. Brachycephalic dogs with BOAS should be assessed and managed for regurgitation and hiatal hernia and managed appropriately.
     

 

 

 

 

 

 

 

 


 

Figure 4. Soft palate bulldog

  • Congenital portosystemic shunts – intra and extrahepatic – what’s new, what’s changed?
    Surgical management is recommended for most animals with congenital portosystemic shunts. However, surgery is not without risk, and how do we decide when to intervene? We will look at the evidence base for different treatment and also explore possible risk factors for poor outcomes.

 

Don’t miss this dynamic duo in Melbourne Monday 17 - Friday 21 June

Author

Engagement Communications Specialist

Lis celebrated 25 years working for the CVE in July 2016. Building a strong CVE professional community has long been a key focus, to which end she completed a Masters of Marketing at the University of Sydney in 2016. Her capstone consulting project was based around surveying veterinarians in Australia and overseas to discover how they experienced the CVE both as a membership organisation and participants in continuing professional development. Lis was awarded the Australian Marketing Institute Prize for Best Consulting Project in 2016 for the most outstanding research project in her graduating class. The vast volume of data generated in this research project is being used to assist the CVE to adapt, improve and innovate to ensure that membership remains as relevant and as accessible today as when Tom Hungerford and colleagues first established the CVE in 1965.