Understanding and managing pain in the arthritic synovial joint: an update

Osteoarthritis is a very common cause of chronic pain in dogs and cats. Great progress has been made in the last 2–3 decades in unravelling the molecular mediators of joint pain. Now we are starting to see the benefits of this research in terms of new targets to block joint pain and new medicines reaching our pharmacy shelves. This review summarises the progress that has been made in understanding why and how arthritic joints cause pain. This will help readers understand novel medicines and provide insight into the others that might follow in the future.

Diagnosis and surgical management of idiopathic bile duct cysts in a bearded dragon (Pogona vitticeps)

The case presented shows the clinical signs, diagnosis and surgical management of idiopathic bile duct cysts in a bearded dragon (Pogona vitticeps). A 12-year-old female bearded dragon presented with constipation resulting from the consumption of sand. A soft mass about 4 cm wide could be palpated in the mid-coelom after the substrate passed. The animal started eating, but soon started showing signs of kyphosis. Ultrasound, radiography and computed tomography examinations revealed that the mass was a cyst 4 cm in diameter. Diagnostic laparotomy was performed and the large cyst and affected liver tissue were removed with a partial hepatectomy. Cytology of the cyst was unremarkable, but histopathological examination showed the lesions to be bile duct cysts. No sign of malignancy or inflammation could be seen.

Laparoscopic cholecystectomy in the dog

Cholecystectomy is a procedure used to rectify severe gallbladder disease that is not amenable to medical management. It is most commonly performed in dogs with gallbladder mucocoele, a condition affecting mainly small breeds such as the Border Terrier, Cocker Spaniel and Shetland Sheepdog. Traditionally, this has been done by open laparotomy but, in the human field, where cholecystectomy is a common and routine procedure, laparoscopic cholecystectomy has almost completely superseded open laparotomy, as it has been shown to be safer and have lower rates of morbidity. This article describes a technique for laparoscopic cholecystectomy in the dog as a suitable alternative to open laparotomy.

Reducing medication errors in practice: part 2

In part 1 of this article, the authors looked at the enormous possibilities for medication errors to occur ( https://doi.org/10.12968/coan.2021.0033 ). In this second part, the authors consider what can be done to avoid medication errors happening in veterinary practice and how systems of work can be used to help. As identified in the Institute of Medicine's report To Err Is Human, most errors result from faulty systems and processes, not individuals. Before steps can be put in place to avoid medication errors, it must be acknowledged that we are all human and thus susceptible to cognitive biases and external influences that cause us to make mistakes. Hence, any interventions put in place should focus on adjusting systems of work to make it easier to do things right and more difficult to do things wrong.

Feline blood pressure measurement: when is it needed?

Systemic hypertension is a common disorder, primarily affecting older cats. Most cases are secondary to underlying medical conditions, such as chronic kidney disease. If left untreated, systemic hypertension has the potential to cause serious damage to certain target organs and can be fatal. Target organs include the nervous system, cardiovascular system, eyes and kidneys. Target organ damage to the eyes is often pathognomonic and is detected on ophthalmological examination in up to 80% of cats with systemic hypertension. Blood pressure measurement is essential in confirming a diagnosis and should be prioritised in cats showing evidence of target organ damage. Blood pressure screening of apparently healthy older cats is justified, since the risk of hypertension increases with age. Systemic hypertension is diagnosed in cats with persistent elevation in their systolic blood pressure of 160 mmHg or higher. Stress and anxiety can cause a transient increase in systolic blood pressure so measurements should be collected in a manner that is as calm and ‘cat friendly’ as possible. In the presence of confirmed target organ damage, a single high systolic blood pressure reading confirms systemic hypertension. Where no target organ damage is detectable, evidence of elevated systolic blood pressure on two or more occasions is needed to confirm the diagnosis.

CPD article: Puppy nutrition: weaning and beyond

In 2019 and 2020, and especially during the COVID-19 pandemic, the number of households owning dogs increased considerably, and many of these pets were new puppies acquired during the lockdowns in the UK. With such a rise in puppy ownership, it has never been more important to ensure that these puppies receive adequate nutrition throughout their weaning and growth periods, and beyond. In this article, the nutritional considerations of growing puppies will be discussed, along with current pet food trends and how to ensure puppies are receiving a complete and balanced diet.

CPD article: Guiding the owner: the use of supplements in canine osteoarthritis management

Owners often reach for over-the-counter supplements for the management of canine osteoarthritis, believing them to be natural, side effect-free options. Some may ask for your opinion as a veterinary professional, whereas others will come to you already using certain products. It is imperative to be aware of the evidence for the relevant products and to encourage the use of good quality products as the first option. The aim should be to help prevent owners of arthritic dogs wasting their money buying multiple products with little or no evidence to back up their use, to be wary of bold unsubstantiated claims for improvements or health benefits, and to ensure that supplements are not used as a sole intervention for the management of arthritic pain, as they are unlikely to have the evidence base to support this claim.

Small animal Review

Summary: This month's Small Animal Review summarises studies on the effect of surgical preparation solutions on body temperature in cats, the persistence of leptospires in canine urine following treatment outcomes of oesophageal stricture.

CPD article: Felid lungworms: from complete strangers to major parasites

The parasitic nematodes Aelurostrongylus abstrusus, Troglostrongylus brevior and Capillaria aerophila affect the respiratory system of cats and are a primary cause of respiratory disease in cats in many countries. While they have been underestimated for a long time, in recent years academics and veterinarians have become more aware of their importance, and now felid lungworms are recognised as primary agents of respiratory disease. Therefore, timely diagnosis and treatment, and efficacious prevention methods are a priority in feline clinical practice. Recent data have unveiled many features of diseases caused by these nematodes, and this article reviews and discusses practical and clinical knowledge, as well as recent updates on clinical management of aelurostrongylosis, troglostrongylosis and capillariosis in cats.