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Summer 2016
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Dear Veterinary Colleague,
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 Welcome to our Summer 2016 edition of The Veterinary Reporter! In our latest issue we present an article about insulinoma in dogs and cats, including diagnosis, management, and prognosis. We also provide an overview of the RECOVER guidelines for CPR in companion animals and include an article about Trazodone, a multifunctional pharmaceutical with uses beyond treatment of behavioral issues. In addition, two case studies are spotlighted: a challenging case of B-cell lymphoma in a 5-year-old Vizsla, and a case of Cushing's disease in a 10-year-old Cocker Spaniel. A DVM360 video interview discussing rising Cushing's diagnoses in our practices is also featured. Finally, we're very pleased to announce that this month we welcome two veterinary specialists to our family -- Eileen Kenney, DVM, DACVECC, and Desiree Rosselli, DVM, DACVS.
Please contact us if you have questions or would like further information about any of our newsletter topics. And let us know whenever we can be of assistance to you, your clients and patients -- we're here to help! Thanks for your continuing support and trust.
David Bruyette, DVM, DACVIM
Medical Director
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Behavior
TRAZODONE
Trazodone can reliably and safely induce sedation and anxiolysis in dogs and cats, making it a useful pharmacologic agent beyond the treatment of behavior problems. Some uses include situational anxiety related to separation, noise phobia, veterinary visits, hospitalization, travel, postoperative confinement, and nighttime restlessness associated with cognitive dysfunction, among others.
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Emergency/Critical Care
UPDATE ON CPR IN SMALL ANIMAL MEDICINE
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Cardiopulmonary resuscitation (CPR) in veterinary medicine has largely been modeled on human CPR practices. Until recently, no evidence based guidelines for the performance of CPR have existed in veterinary medicine. The Reassessment Campaign on Veterinary Resuscitation (RECOVER) had the goal of creating evidence based guidelines for CPR in cats and dogs. In 2012 the RECOVER guidelines were published in the Journal of Veterinary Emergency and Critical Care. In this article, we provide an overview of the RECOVER CPR guidelines for small animals as well as a link to the full guidelines published in the special issue of the Journal of Veterinary Emergency and Critical Care.
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| Internal Medicine
INSULINOMA IN DOGS AND CATS
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 Insulinomas (also known as beta cell insulin secreting tumor, beta cell adenocarcinoma/adenoma) are insulin-secreting tumors of the pancreatic beta cells. They are the most common endocrine pancreatic tumor in companion animals and are usually malignant. Insulinomas are uncommon in dogs and rare in cats, though these tumors are the most common cause of hypoglycemia in older dogs. In dogs, middle aged to older, medium to large breeds are predisposed. Large breed dogs are over represented. Breed dispositions have not been noted in cats. This article discusses clinical signs, diagnostics, tumor staging, medical and surgical management, adjunct therapy, and prognosis.
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| Internal Medicine Case Study
CUSHING'S DISEASE IN A 10-YEAR-OLD
COCKER SPANIEL
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"Hudson," a 10-year-old MC Cocker Spaniel was referred for evaluation of severe polyuria and polydipsia (PU/PD) of 3 months in duration. Physical examination revealed no significant abnormalities and previous laboratory analysis, including CBC, serum biochemical profile, ACTH stimulation test, serum ALP, was unremarkable except for a UTI that was treated with enrofloxacin. Hyperadrenocorticism (HAC) was still considered to be the most likely differential cause for the PU/PD, despite the previously normal ACTH stimulation test, given the signalment, history, and clinical signs. Further testing with a low-dose dexamethasone suppression (LDDS) test was diagnostic of pituitary-dependent hyperadrenocorticism (PDH), also known as Cushing's disease.
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Oncology Case Study
RESISTANT B-CELL LYMPHOMA IN A
5-YEAR-OLD VIZSLA
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"Tucker," a 5-year-old MC Vizsla, received a CHOP based chemotherapy for lymphoma by the referring veterinarian and initially was in complete remission; however, he relapsed soon afterward. Failing to respond to oral lomustine chemotherapy, Tucker was referred to VCA West Los Angeles Animal Hospital for rescue chemotherapy and evaluation for hemotopoietic stem cell transplantation (HSCT). MOPP rescue chemotherapy was administered. Testing revealed that Tucker had a resistant B-cell lymphoma with an associated grave long term prognosis. Allogeneic HSCT was recommended and with owner agreement, we proceeded with preparations for the procedure. Dog Leukocyte Antigen (DLA) testing confirmed that Tucker's littermate "Rusty" was a donor match. This case study details Tucker's journey through HSCT, both pre- and post-transplantation issues and the delicate balance of harnessing the powerful benefit of the donor's immune system to eliminate residual host tumor and establish recipient immunization against the malignancy while avoiding risks such as graft versus host disease (GVHD).
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Internal Medicine Interview
CUSHING'S DIAGNOSES ON THE RISE?
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A brief video interview with Dr. Sarah Wooten for DVM360 and Dr. David Bruyette, who discusses why you may be seeing more cases of Cushing's disease in your practice, and better insight into causes and best treatment practices.
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BEHAVIOR
EMERGENCY /
CRITICAL CARE
Update on CPR in Small Animal Medicine
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INTERNAL MEDICINE
Insulinoma in
Dogs and Cats
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INTERNAL MEDICINE CASE STUDY
Cushing's Disease
in a 10-year-old
Cocker Spaniel
Resistant B-Cell Lymphoma in a
5-year-old Vizsla
INTERVIEW
Cushing's Diagnoses
on the Rise?
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NEWS
WLA Welcomes
Eileen Kenney,
DVM, DACVECC
to Our ER/CC Team!
Welcome Surgeon
Desiree Rosselli,
DVM, DACVS
to Our Surgery Department!
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JOIN US FOR OUR UPCOMING
CE PROGRAMS!
October 5, 2016
November 2, 2016
December 7, 2016
January 4, 2017
Click on names for details and registration information
OUR LOCATION
VCA West Los Angeles
Animal Hospital
1900 S. Sepulveda Blvd.
Los Angeles, CA 90025
Ph 310-473-2951
Fx 310-979-5400
Click on Map for Directions
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CLINICAL STUDIES Call for Cases
Click on photo
for details about current clinical studies
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MEET OUR
VETERINARY SPECIALISTS!
Click on Photo
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