The Vet Vault: Fall In Love With Veterinary Science

Today’s bonus IVECCS live session wasn’t your average ‘clinical 101’. I had the absolute privilege of getting two brilliant minds on the yellow couch, and … wow.  Apparently 1 + 1 = 🤯 !! Clinical pathogist [https://cvm.msu.edu/directory/lucidi]Dr Cynthia Lucidi [https://cvm.msu.edu/directory/lucidi] joined me to unpack her talk on Diagnosing Ineffective Hematopoiesis.  If you’re a bit lost with that title - don’t worry, so was I!  So I brought backup: ECC legend Dr Claire Sharp [https://researchportal.murdoch.edu.au/esploro/profile/claire_sharp/overview] joined me to ask the smart questions, and together, they cracked open a topic every GP and ECC vet needs to understand: PIMA – Precursor-Targeted Immune-Mediated Anaemia. (If you’ve ever managed an anaemia case that almost looked like IMHA but just didn’t quite fit, or just an anaemia that didn’t want to fit into ANY of the boxes, it was probably this!)  This one started out GP-friendly, but with two minds like these-it escalated fast. Expect specialist-level gold. You’ll want to give this one your full attention. But I promise - it’s worth it! What we cover: * Defining ineffective haematopoiesis and how it differs from hypoplasia * Diagnostic criteria and differentials for PIMA vs. IMHA * Importance of timing and interpretation in persistent non-regenerative anaemia * Why bone marrow aspiration is underused and how to perform it effectively * Pathologist tips on identifying spherocytes and phagocytosis artefacts * Challenges of diagnosing IMHA and PIMA in cats * Role of transfusions and crossmatching in long-term PIMA management * Timeframes for response and remission in PIMA treatment * When to consider splenectomy for refractory cases * Clinical significance of myelofibrosis in dogs with PIMA * Educating clients and general practitioners on prognosis and referral timing Click here⁠⁠ [https://vvn.supercast.com/?coupon=IVECCS25] to access all of our clinical content at IVECCS special rates.

If you caught my conversation with Prof. Steve Epstein [https://www.vetmed.ucdavis.edu/faculty/steven-e-epstein] from IVECCS 2024, you already know this: When it comes to septic patients, timing of antibiotics is everything. Ok, maybe not EVERYTHING, because in our follow-up discussion 1 year later at IVECCS 25 [https://veccs.org/calendar-of-events/], Prof Steve explored an idea that might just shift your ICU protocols: duration of administration matters.  That’s the idea behind the concept is prolonged infusion - giving time-dependent antibiotics over extended periods for more sustained bacterial kill time. (Spoiler alert: it works. BUT...with a few caveats.) Jump in to this one for a straight-forward data backed action you can take with your critical patients that will save more lives. Topics We Unpacked: * Time-dependent vs. concentration-dependent antibiotics * Prolonged infusion vs. continuous rate infusion (CRI) * Human evidence: findings from the BLING III trial * Applicability of human data to veterinary patients * Dosing challenges and pharmacokinetics in septic animals * Practical recommendations for veterinary ICU settings ⁠Click here⁠⁠⁠ [https://vvn.supercast.com/?coupon=IVECCS25] to access all of our clinical content at IVECCS special rates.

We’re live at IVECCS [https://iveccs.org]! For the next few days we’ll be sharing some highlights from our favourite recordings with the fabulous speakers, where we get to the best bits from their talks at IVECCS, the premier conference for emergency and critical care veterinarians, technicians, practice managers, and students.  If you’ve worked in vet practice for more than a minute, you’ve seen it:A cat comes in, blocked and in pain.You know the treatment.The owner hears the estimate.And just like that — a treatable case turns into a heartbreaking goodbye. But what if there’s a better way? In this eye-opening talk, Dr. Corey Fisher breaks down practical, evidence-based protocols for managing feline urethral obstruction (iUO) without breaking the bank. He draws on peer-reviewed research and ongoing clinical trials to bust some myths about fluids, catheters, and cost. Most importantly? He’ll show you how to tailor treatment to the client’s budget while still delivering acceptable clinical outcomes. What You'll Learn: * Recurrence rates and euthanasia risk in feline urethral obstruction * The surprising data behind 8-hour catheter protocols * To flush or not to flush * Hyperkalemia management: hold the insulin! * Should you perform decompressive cystocentesis? The evidence says... * The most cost-effective pain relief  * Fluid therapy without the fluff: shorter stays * The meds we use that we shouldn’t * The truth about urinalysis and prescription diets: essential or optional? This isn’t just theory — it’s a mindset shift.Whether you're in a high-end clinic or resource-limited practice, you’ll walk away with real tools you can use today to improve care and protect your patients from unnecessary euthanasia. Click here⁠ [https://vvn.supercast.com/?coupon=IVECCS25] to access all of our clinical content  at IVECCS special rates.

We’re live at IVECCS! For the next few days we’ll be sharing some highlights from our favourite recordings with the fabulous IVECCS speakers, where we get to the best bits from their talks at IVECCS, the premier conference for emergency and critical care veterinarians, technicians, practice managers, and students.  How much do you love intubating dogs with upper airway issues? You know that Frenchie or Pug needs an open airway - NOW - but you also know that intubating it is going to be hard. (And you REALLY would prefer not to do a tracheostomy!) We have good news… In today’s highlight we hear from Dr Cassie Lux, Associate Professor of Surgery at University of Tennessee, to dig into her talk on upper airway emergencies. The conversation covers how to identify the likely location of airway obstructions, prepare for safe intubation, and apply temporary surgical techniques that stabilise patients without committing to high-risk interventions. From temporary palatopexies to laryngeal stents and novel uses for human piercing gear, Dr. Lux outlines tools and procedures that general practitioners and ECC clinicians can implement right away. Topics Covered: * Why definitive airway surgery during crisis leads to poorer outcomes * Sound-based and visual cues to localise airway obstruction * Equipment essentials for challenging intubations  * Palatopexy as a temporary airway intervention * Use of laryngeal stents in laryngeal paralysis and collapse * Alternative temporary tracheostomy sites and techniques  * Novel use of silicone “flesh tunnels” for airway access * Managing airway swelling  * When to delay tracheostomy and opt for prolonged intubation * Tips for extubation and airway support during recovery Click here⁠ [https://vvn.supercast.com/?coupon=IVECCS25] to access all of our clinical content  at IVECCS special rates.

Ever had a case where you just knew what was wrong before you even touched the patient - but if someone asked you HOW you know, you couldn’t explain it?  That almost mystical “sixth sense” we develop in practice - that’s exactly what this episode is about. Our guest is Dr Annie Wayne [https://www.ethosvet.com/team-member/annie-wayne/] - a criticalist, educator, and learning strategist—who’s been exploring naturalistic decision making: the cognitive model that explains how experts think in real-time, and how to pass that intuition on. We talk about what separates expert intuition from novice reasoning, how to break down unconscious diagnostic processes, and how the right kind of mentorship can accelerate the path to expertise. Annie also shares her research on parenting and vet careers, challenging the stigma around pregnancy and parenthood during training. Here’s what you’ll learn: * What “naturalistic decision making” really means (and why it feels like a sixth sense) * How experienced vets spot subtle signs that others miss * How to externalise your gut feeling so younger vets can learn from it * Real-world strategies for mentorship and better clinical teaching * How to avoid the traps of lazy “shortcut” thinking * How this framework builds confidence and reduces stress in new grads * Annie’s personal take on parenting through training—and how to smash the stigma around pregnancy in vet careers This isn’t just about clinical decision-making - it’s about how we teach, how we lead, and how we support each other in a demanding profession. Lift your clinical game with our RACE approved clinical podcasts at ⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠ [https://vvn.supercast.com/]  for more clinical confidence and better patient outcomes, or check out our Advanced Surgery Podcast at ⁠⁠⁠⁠⁠cutabove.supercast.com⁠⁠⁠⁠⁠ [http://cutabove.supercast.com/].  Get case support from our team of specialists in our ⁠⁠⁠⁠⁠Specialist Support Space⁠⁠⁠⁠⁠ [https://the-vet-vault.mn.co/share/pWYTrfLxiUnCVDHu?utm_source=manual%E2%81%A0]. ⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠ [https://thevetvault.substack.com/?r=2v2kg5&utm_campaign=pub-share-checklist]for Hubert's favourite clinical and non-clinical learnings from the week. Join us in person for our epic adventure CE events at ⁠⁠⁠Vets On Tour⁠⁠⁠ [https://vetsontour.com/]. (Next up: Japan snow conference!)  Topics and Time Stamps 04:53 What is Naturalistic Decision-Making? 08:36 Expert vs Novice Thinking: Why Mentorship Matters 15:55 Risks of Shortcut Thinking and Balancing with Algorithms 19:11 Speeding Up Expertise: Can We Teach "Sixth Sense" Thinking? 22:47 Mentorship Models: Building Skills and Confidence 34:45 Can AI Help Naturalistic Thinking? 37:20 Parenthood and Veterinary Careers: Breaking Stigma and Building Support