Vet Finals

The Award Winning #VetFinals - free interactive veterinary revision sessions for vet and VN students, helping them revise. Founders @mossposs, @mwhiting81

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Herd Health Case 2021 https://t.co/8OJyBpOBGa

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Calving Case 2021 https://t.co/XNO5EMiH2R

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Infectious Farm Disease 2021 https://t.co/8X2MJaT8pw

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Good night guys! Hope it was useful - my dog is very confused as to why I haven't fed him yet and just been staring at the computer so I better give him some food!

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Thanks for a great case this evening Tom! And thanks to everyone that's got involved with #vetfinals this year!

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Wow, I can't believe that is an hour already, anyone got any questions? #vetfinals

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Sensible choices - I'm a go big or go home kind of person, so I would opt for methadone. Also paracetamol as an adjunct is an excellent suggestion. Key here is to avoid an NSAID for now until we've assessed perfusion and BP over the longer term #vetfinals

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⏰ Moderator message: 5 minutes to go! ⏰

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Okay, so we also need to consider what kind of pain relief we are going to use with this patient, what would you like to go for? #vetfinals

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Pain! it's important to recognise this, because if the patient was in hypovolaemic shock from bleeding into it's lungs, it will have drowned by now. If you decide to give a fluid bolus to this patient you'll pop more clots and make it worse - a common mistake made. #vetfinals

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Excellent! The pedantry worked - so BP is our enemy here, high BP is going to pop those clots. Now many of you have already mentioned treating this but...
BP 5 minutes after presentation was - Sys 200, Diastolic 120. Why do you think that's the case? #vetfinals

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@AnnaSilina6 Now I'm going to be even more pedantic - why would it dislodge the clots?

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Flow by/mask in short term sounds sensible, and nasal cannulas long term would be excellent! Cages make it difficult to reassess this patient. Hattie spotted the trick question - contusions, difficult to treat specifically, how could we make them worse though? #vetfinals

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@Hattie230899 I'm being pedantic, but why would over hydration worsen them?

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@AnnaSilina6 I'm being pedantic - but why?? :P

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@Sawyer63325669 Keep going - why would fluid overload cause it to worsen? I'm being pedantic :P

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@AnnaSilina6 TXA is a good shout! Evidence for it's use in dogs isn't really there currently, but theoretically and based on human usage it seems sensible. Need to be aware of it's downsides though, maintains clots so we need to make sure there are no 'bad clots' anywhere!

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Cool, so blood identified - our animal has pulmonary contusions which we need to treat; so a lot of you have already alluded to oxygen therapy as well so - how do you want to treat contusions? How would you like to give oxygen in the short term and long term #vetfinals

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@abbystjohn Pick one Abby - it got hit by a car, owner said to your nurse no history of any other problems.

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Okay great, so we've identified that there is fluid inside the lungs, next question though is what type of fluid? What do you think it most likely is? #vetfinals

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@Sawyer63325669 Blood absolutely, don't forget though, thoracocentesis in this case will go into the lung parenchyma, realistically you'll only get negative pressure when you draw back so you won't get any of it out as opposed to if it was in the pleural space