Page 7 - Clinical Connections - Spring 2017.indd

clinic now sees more cats than ever in its history. This has shortened the waiting list to a mere couple of weeks for most cases.”
The diagnostic imaging expertise and advanced imaging facilities are of great value to all of the clinical teams at the RVC, not least the Internal Medicine Service. Commenting on the value of the Diagnostic Imaging Service for such cases, head of service Randi Drees said: “Diagnostic imaging is routinely used by all clinical services at the Queen Mother Hospital
for Animals. Computed tomography (CT) examinations are especially helpful in evaluating the whole body and are heavily utilised by the Internal Medicine Service.
“The detailed information about anatomy provided by CT examination is especially helpful in larger patients. Common diagnoses made include airway diseases, such as pneumonia, liver disease, urinary or gastrointestinal disease, and the search for possible neoplasia.”
CASE STUDY 2
n Tiger, a ve-year-old male neutered domestic short-hair cat, was presented to the internal medicine team for
acute onset inappetance, renal disease and visualisation of a big and small kidney on ultrasound at the local veterinary practice.
A specialist abdominal ultrasound, followed by a contrast-enhanced Computed Tomography, identified Tiger to be suffering from a ureteric obstruction caused by a stone.
After a thorough discussion between the RVC’s internal medicine team and the soft tissue surgery team, placement of a subcutaneous ureteric bypass (SUB) system was offered to the owners. Using this recent technology, urine flow was re-directed from the renal pelvis past the
obstructed ureter straight into the bladder. Tiger regained his appetite and a
medical plan was constructed to try and prevent further urinary stone formation. The SUB device is a unique system designed for use in dogs and cats, to bypass a ureteral obstruction when traditional surgery or interventional techniques are contraindicated.The RVC is one of the first places in the UK and the world to routinely place SUB systems, which forms part of a range of other unique nephro- urology services provided by the internal medicine team, which includes cystoscopy, minimally invasive cystoscopy-guided cystotomy (working together with the
Soft Tissue Surgery Service) and laser lithotripsy.
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Left: Cystoscopy being performed on a patient looking for ectopic ureters
Below: CT scan of dog with an adrenal neoplasia. It was scanned to identify the mass (indicated by the arrow) and search for vascular invasion to evaluate if this can be amended surgically. Kidneys are labelled RK and LK (right and left)
Issue: Spring
INTERNAL MEDICINE SERVICE REFERRALS
DOG TOP 10
1. Chronic diarrhoea 2. Vomiting
3. Anaemia
4. Diabetes
5. Other hormonal
disease
6. Respiratory problems 7. Pyrexia
8. Polyuria/ polydipsia 9. Renal disease 10.Urolithiasis
Spring 2017 07