Brendan Corcoran talked about comparative idiopathic fibrosis which is seen in WHWT. Radiography is the least sensitive method of diagnosis but can exclude the possibility. If used in conjunction with bronchoscopy, though, it is comparable with CT. Sildenafil and pimobendan can be used in treatment but the only real life saving treatment is a lung transplant. This can often present as a dog in acute respiratory distress.
Eric Monnet discussed the brachycephalic syndrome and advised operating early to stop the secondary sequelae of everted saccules and laryngeal collapse. In the young dog it is the stenotic nares and elongated soft palate which starts the syndrome along with possibly a narrowed trachea. The patient often has respiratory effort and may open mouth breath. Cyanosis and hyperthermia may be seen. These dogs often have oesophageal reflux with oesophagitis and gastritis. If surgery is performed early these signs will often disappear. Dexamethasone may be needed if the animal presents acutely along with a temporary tracheostomy. Surgery is reasonably straightforward and can be carried out by a non specialist. Administering oxygen via a mask before surgery can be useful along with rapid intubation after which the dog will breath better. Vagal tone may be high so it is worth including atropine
Arthur House discussed surgical treatment of problem ears. His treatment of choice was the total ear canal ablation and bulla osteotomy with limited applications for the lateral wall resection. Complication rates have been quoted at between 21-59% and these include: deafness, haemorrhage, fistulae, dehiscence and, of course, facial nerve paralysis. When entering the bulla the epithelium should be curetted out but the dorso-medial area should be avoided. After the ear has been removed he recommended histopathology and culture and sensitivity of the affected tissue as antibiotics will be required.
Amy Fauber discussed vestibular disease. When otitis media and interna are present it is usually as an extension of bacterial infection in otitis externa. Eight weeks of antibiotics are required to treat osteomyelitis and clindamycin may be considered. Vestibular disease can also be caused by metronidazole toxicity. This is a central vestibular disease which improves by stopping the metronidazole and starting diazepam which competes with the metronidazole receptors. Diazepam is given at 0.5mg/kg iv once and then orally tid for three days. Dogs can make an excellent recovery if recognised quickly enough.
I also attended lectures of new concepts in vaccination, Addison’s disease, pneumothorax and urethral obstruction. A great conference and, hopefully, over the next few months we will get some of the speakers to give presentations for us.
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To your CPD success