Page 3 - Clinical Connections - Summer 2022

LETTER FROM THE EDITOR

Welcome to the summer 2022 edition surgical removal. Locoregional hyperthermia
of Clinical Connections. In this issue we have combined with intratumoral chemotherapy
a wealth of articles spanning fascinating has been developed to specifically target
clinical cases, progress in veterinary these types of tumours and has been shown
techniques and technologies, the impact to be extremely effective.
of small animal epidemiological studies on Page 7 features an article about how our
veterinary practice and animal welfare, and corneal cross-linking (CXL) initiative for small
one on anatomic pathology. animal, equine and exotics patients has been
The lead article features the case of a one- progressing. The procedure has now been
year-old Rottweiler, Lorna, who was treated delivered by our Ophthalmology Service for
for an acquired obstruction to her caudal two years and the article includes valuable
vena cava, after an apparent run-in with a information about the procedure and its use
deer. This had resulted in her having marked in managing infectious keratitis and malacia.
regional venous hypertension and severe The CXL process increases the resistance
unmanageable ascites. The owners opted of corneal tissue to enzymatic digestion
for a highly sophisticated surgical procedure, through formation of new chemical bonds
which was led by Professor Dan Brockman, between stromal fibres. It also has the ability
Director of our Cardiothoracic Surgery Service, ably assisted to kill microorganisms regardless of their antimicrobial resistance
by other members of our surgical and anesthesia teams. The pattern. The article includes an interesting case of a Shetland
surgery was successful and Lorna has returned to a happy and pony called Growl Tiger who had an excellent outcome after
normal life – so much so that once her hair had grown back she being treated with CXL.
managed to almost achieve a bronze medal at Crufts!! In an article spanning Page 8 and 9 we talk about the progress
We are increasingly aware of the role intestinal dysbiosis of the RVC’s ambitious VetCompass initiative (Veterinary
may play in a range of disorders in body systems other than the Companion Animal Surveillance System) over the last 15 years.
gastrointestinal tract. Understandably, attention has tended to The original aspiration, of improving companion animal health
focus on bacterial dysbiosis of the gut but don’t miss a fascinating and welfare by harnessing the power of anonymised veterinary
article by Ross Bond and Aarti Kathrani highlighting the possible records to generate robust clinical evidence, has expanded over
role of intestinal fungal dysbiosis in the overall process. the years to include a range of species and a multitude of health
On Page 5 Joe Fenn, Senior Lecturer in Veterinary Neurology risks. As the initiative grew out of our desire to better understand
and Neurosurgery, outlines the progress of hypophysectomy what types of disorders and their management was happening in
surgery over a decade at the RVC. The first cat with acromegaly general practice, it has always been wholly dependent upon the
and diabetes mellitus to undergo hypophysectomy was in 2012 support of vets across the UK and beyond. In that sense this is
and this pioneering procedure has been followed over the an initiative that has been delivered by the whole of the veterinary
last decade by a further 120 cats and 25 dogs with functional profession and facilitated by the RVC. We thank all those who
pituitary tumours resulting in hypersomatotrophism or pituitary have made clinical records available to us so we can learn from
dependent Cushing’s syndrome. The results of this procedure the data and share salient insights with fellow members of the
have been incredibly rewarding, not just because of the high veterinary professions in the wider world.
proportion of animals that are effectively cured but also because Finally, whether pathology is your thing or not, I’d encourage
these cases require veterinary and veterinary nursing colleagues you to read our Page 10 article by one of our recent anatomic
from our Neurology and Neurosurgery, Critical Care, Internal pathology residents, Kevin O’Brien. Kevin came from the USA to
Medicine and Anaesthesia services all working closely together undertake his residency here and his reflections are fascinating
to minimise complications and post-operative hospitalisation and and sometimes amusing. Completing such a programme during
optimise outcomes generally. A perfect example of the value of a pandemic throws up particular challenges – as you will have all
the multidisciplinary veterinary team of which we are so proud at found in your practice – but Kevin and the team took full advantage
the Queen Mother Hospital for Animals. of advances in technology, which made things somewhat easier.
Our equine article on Page 6 concerns targeted treatment for
inoperable melanomas. The Equine Referral Hospital has been Professor David Church, Deputy Principal and Acting Vice
using locoregional hyperthermia combined with intratumoral Principal (Clinical Affairs)
chemotherapy to treat equine melanoma since January. Though a
number of treatments are available for equine melanoma, none of
them are 100% effective – and some lesions are not amenable to

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