Page 3 - Clinical Connections - Spring 2023
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LETTER FROM THE EDITOR


                 The Cycles That Bind Us
                 uch  in  the  veterinary  world  is                        therapy. Oscar, featured on page five, came
                 seasonal,  whether  we  work  in  a                        to us at the age of six months as a result of
          M university or in the wider community,                           clinical signs compatible  with leptospirosis
          whether we work with livestock, in the equine                     infection – azotaemia, hepatopathy and
          sector, in small animal practice  or in  zoos.                    thrombocytopaenia. His was a bumpy road
          We are bound together in our desire to help                       but Oscar made a complete recovery.
          animals and progress our field – and we are                         I’d encourage you to take a look at the
          bound together in seasonal cycles.                                pathology article on page six, about stomach
            From certain disease risks, such as                             cancer in dogs – a more common problem
          poisonous plants (such as ragwort) to periods                     than we perhaps recognise and one that
          where there are elevated risks of poisoning                       can present  challenges to diagnose early.
          (such as mince pies at Christmas and                              As quality of life and veterinary care has
          chocolate at Easter), to the wonder and stress                    improved, the frequency of cancer diagnosis
          of lambing or small animal vaccinations,                          has soared. The earlier diagnosis takes place,
          everything has its season. Outside of clinical                    the greater the options available.
          work we have seasonal patterns, such as in the congress cycle   An article by Rosanne Jepson on page seven addresses the
          and our profession’s initiation rituals of white coat ceremonies   important  subject  of  antimicrobial  stewardship.  We  have  an
          and graduation.                                     antimicrobial  stewardship  programme  and  a  dedicated  team
            The cyclical nature of much of our work keeps us on our toes   to ensure good implementation of the programme.  The team
          by providing an endless stream of ever-shifting challenges – but   provides an advice service for the hospital when complex cases
          it also provides variety. Ultimately tackling these cycles provides   arise, with careful consideration for all clinical options available.
          impetus to change  and adapt our profession  to continue  to   Page eight covers the complex case of a guinea pig treated
          improve the health and welfare of animals everywhere.   by  our  Exotics  and  Small  Mammals  Service.  She  was  initially
            The modern veterinary world and our understanding of   referred with an eight-week history of vocalising when urinating,
          infectious diseases has been shaped by our ultimately successful   progressing  to  haematuria  and  dysuria.  At  that  point,  having
          efforts to eradicate rinderpest. And it took a human pandemic   ruled out an infectious aetiology, she was discharged back to
          to disrupt the seasonal cycles of the veterinary world. Rather   the care of her local vet with ongoing meloxicam. She had an
          than  gathering  together  at  congresses,  we  were  confined  to   acute neurological episode four months after the first referral and
          communication through Zoom and Teams. But as a profession   investigations ultimately identified a persistent urachal remnant.
          we emerged from that two-dimensional world and are firmly back   The article on page nine, by members of our Pain Clinic, is about
          on our whizzing cycle of seasonal activity.         a 20-year-old cat, Harry, with an oral squamous cell carcinoma.
            Articles in this issue underline how the veterinary world has   The tumour invaded Harry’s nasal cavity and periorbital tissues,
          been pushing on, despite Covid. Rather than seasonal cycles,   precluding the possibility of surgical excision. His family wanted to
          an  actual cycle was responsible for the cover story.  A tough   make Harry happy for as long as possible without prolonging any
          miniature dachshund was severely injured when she was hit by   discomfort. They did just that!
          the bike. The owners referred her to, as they put it, “give her a   Last spring we included an article about Merlin, the first cat of
          fighting chance”, and she has bounced back brilliantly!   many with feline infectious peritonitis treated with remdesivir at
            In our equine article, Roger Smith talks about developments   the RVC. In this issue we feature Millie, whose clinical picture
          in  osteoarthritis  treatment.  From  the  ground-breaking  culturing   was  complicated  by  severe  hypoglycaemia  and  anaemia.  I’d
          of mesenchymal stem cells from the bone marrow of a horse   encourage you to read Jodie Green’s article about Millie and her
          20 years ago, to widespread use of autologous stem cells, to   management. The introduction of a highly successful treatment
          the development of an allogenic stem cell product, it’s been a   for what was previously an almost uniformly fatal disease is one
          fascinating journey!                                of the great stories of feline medicine in this decade.
            Over the  years we’ve included a number of articles about
          continuous renal replacement therapy, but this issue includes   Professor David Church, Deputy Principal and Acting Vice
          details  of  a  case  involving  intermittent  renal  replacement   Principal (Clinical Affairs)




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