Vet Lit minis

Simon is joined by Professor Kelly Tart from the Universityof Minnesota to discuss “Lorazepam reduces recurrence of urethral obstruction in male cats: a prospective, randomized, double-blinded, placebo-controlled study.” https://avmajournals.avma.org/view/journals/javma/aop/javma.26.01.0045/javma.26.01.0045.xml
The study prospectively enrolled 80 cats following their first urethral obstruction and randomised them to receive oral lorazepam or placebo for one month. Five cats receiving placebo re-obstructed, compared with none receiving lorazepam, alongside encouraging findings regardingowner-reported lower urinary tract signs.
We discuss the rationale behind the study, trial design, recurrence and lower urinary tract signs, reported adverse effects, and how to interpret the results. Finally, we ask the important clinical question: is the evidence strong enough to change how we manage cats after urethral obstruction?

Why is the severe anaphylaxis patient actually unstable, and how do you treat it?

This was a fascinating discussion with Dr Ryan Smith about his group’s study on dogs with severe anaphylaxis that did not receive early epinephrine as part of their management.

We cover those 49 cases, basic physiology, hepatic rupture and the protocol that Dr Smith and his team use. That protocol is available as supporting information to the study itself here:

Canine Anaphylaxis Patients Receiving Late Epinephrine or No Epinephrine: 49 Cases (2019–2023)
https://onlinelibrary.wiley.com/doi/10.1111/vec.70102

Other articles also mentioned:

Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity
https://onlinelibrary.wiley.com/doi/10.1111/vec.13345

Acute hepatic rupture causing hemoperitoneum in a dog with anaphylaxis
https://onlinelibrary.wiley.com/doi/10.1002/vms3.1391

Clinical characteristics of two-hundred thirty-two dogs (2006-2018) treated for suspected anaphylaxis in Perth, Western Australia
https://onlinelibrary.wiley.com/doi/10.1111/avj.13114

Here we have two amazing educators in Bobbi Conner DACVECC and Alex Blutinger DACVECC to discuss CPR orders, client presence in CPR events and tactics to help navigate these situations.

How do you decide when to stop, or if we should even have started?!

The studies we covered:

Evaluation of Client Communication Regarding Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders: A Survey Study
https://onlinelibrary.wiley.com/doi/10.1111/vec.70064

Evaluation of a Cardiopulmonary Resuscitation Video Decision Aid for Pet Owners
https://onlinelibrary.wiley.com/doi/10.1111/vec.70070

Outcome prediction in dogs admitted through the emergency room: Accuracy of staff prediction and comparison with an illness severity stratification system for hospitalized dogs
https://onlinelibrary.wiley.com/doi/10.1111/vec.13350

You can (and should) listen to more from Bobbi on The Veterinary Journal Club and Discussions podcast: https://podcasts.apple.com/gb/podcast/veterinary-journal-club-discussions/id1478755748

Here we discuss the role of antimicrobials in dogs with pyometra - how, or even if we need to use them.

Anna Ylhäinen a doctoral researcher and clinician from the University of Helsinki Veterinary Teaching Hospital who recently published the following study with her team:

Placebo is non-inferior to postoperative antimicrobial treatment in uncomplicated canine pyometra – A double-blinded randomized controlled trial.
The Veterinary Journal. Open access.
https://www.sciencedirect.com/science/article/pii/S1090023325001534

We also discussed further work from Anna and her team:
Bacteria associated with canine pyometra and concurrent bacteriuria: A prospective study
https://www.sciencedirect.com/science/article/pii/S0378113524003845

When to use, or rather, when not to use any peri-operative antimicrobials at all.

Here we discuss the ENOVAT guidelines on surgical antimicrobial prophylaxis. There is a huge capacity for impact here by following and disseminating these guidelines.

If you’re on board already, listen and spread the word.

If you’re not converted yet, listen in and see what you think.

At the end Fergus asks for your help in submitting cases with E. coli in their bile for an observational study he is actively recruiting for.

The guidelines:

European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) 2025 guidelines for surgical antimicrobial prophylaxis in dogs and cats. https://onlinelibrary.wiley.com/doi/10.1111/jsap.70072

Resources we mentioned:

IVEG
International Veterinary Evidence Based Guidelines Centre (IVEG) - University of Copenhagen
https://iveg.ku.dk/

European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines for antimicrobial use in canine acute diarrhoea.
https://www.sciencedirect.com/science/article/pii/S1090023324001473

ENOVAT website:
https://enovat.eu

Canine Cruciate Registry
https://ccr.rcvsknowledge.org/

Fergus Allerton e-mail address for contributing biliary tract infections to the study: Fergus.Allerton@veterinarycentre.co.uk

Retrospective evaluation of surgical site infection after open splenectomies with and without perioperative prophylactic antibiotic coverage
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2105-3593