Episode 6: POCUS: Ultrasound for Diagnosing Left-Sided Heart Failure in Respiratory Distress

Episode 12: The Use of Artificial Intelligence in Small Animal General Practice

TITLE: The Use of Artificial Intelligence in Small Animal General Practice STUDENT: Katherine Fleury FACULTY MENTOR: Dr. Patrick Whelan The use of Artificial Intelligence (AI) is growing in veterinary medicine is increasing, outpacing scientific review. AI is a branch of computer science that uses model training to perform tasks that normally require human intelligence. Common uses in the small animal setting include digital radiograph assessment and digital pathology. Other upcoming uses include pain assessment, automated dictation with data organization, and generative AI. These tools are aimed at increasing clinician efficacy, reducing the time spent on analysis and increasing the time spent with clients. This paper provides an overview of the aforementioned technologies as well as a discussion on how to prepare for future practice with AI. As these tools become mainstream, veterinarians need to be aware of how models are trained, who owns the data that is presented, who monitors the implemented algorithms, and how liability is being discussed.

Episode 11: Guide to Diagnosing and Treating Reptile and Amphibian Skin Conditions

A Small Animal General Practitioner’s Guide to the Identification, Diagnosis, and Treatment of Dermatologic Conditions in Reptiles and Amphibians STUDENTS: Emma Buchanan, Kaitlyn Dornstauder, Gabriel Godziuk FACULTY MENTOR: Dr Doug Whiteside While the demand for reptiles and amphibians as pets increases, as does the need for competent small animal general practitioners willing to diagnose and treat them. This paper imparts a valuable guide for practitioners to provide basic handling and restraint, critical care, and diagnostic testing upon presentation of reptiles and amphibians. In particular, the most frequently exhibited dermatologic conditions are explored and categorized by their etiology, clinical signs, specific diagnostic testing, treatment, and prognosis. Dermatologic conditions are separated into infectious and non-infectious for both reptiles and amphibians, with overlap affecting both species. Reptiles can be infected by a range of bacterial, parasitic, viral, and fungal agents presenting as diseases such as shell rot in tortoises, inclusion body disease in snakes, or chiggers in lizards. Amphibians are also susceptible to various infectious diseases, including red leg syndrome, cutaneous chytridiomycosis, and tick infestations. Non-infectious presentations such as burns, nutritional disorders, and neoplasia overlap between both reptiles and amphibians, however, non-species-specific conditions such as dehydration will also be explored.  This review aims to provide recommendations for care, management, and husbandry to prevent future occurrences of the mentioned conditions and allow practitioners to gain confidence in the presence of herptiles with dermatologic conditions.

Episode 9: Exploring Controversies in the Management of Feline Urethral Obstruction

Exploring Controversies in the Management of Feline Urethral Obstruction STUDENT(S): Alex Ferguson, Kaitlyn Dvorack, and Alex Hibberd FACULTY MENTOR(S): Dr. Soren Boysen ABSTRACT Feline urethral obstruction (UO) is a life-threatening component of feline lower urinary tract disease (FLUTD) accounting for a high number of cases presenting to veterinary ER services. Treatment of feline UO generally includes stabilization through intravenous fluid administration, correction of hyperkalemia and urinary catheter placement. Despite well-established basics in treatment plans, there are many controversial debates surrounding the optimal approach for addressing feline UO and preventing recurrent obstructions. Three of the major controversies include decompressive cystocentesis prior to unblocking procedures, cystocentesis without pursuing unblocking, and the use of prazosin to decrease the incidence of recurrent urinary obstructions. This review explores these three controversies in detail based on the available literature. Decompressive cystocentesis may be indicated for patients presenting too unstable for immediate urinary catheter placement. Decompressive cystocentesis as sole therapy should not be offered as first line treatment to feline UO patients, however, it may be an alternative to euthanasia for clients with financial restrictions. Prazosin has long been recognized as a drug to prevent recurrent urethral obstructions; however, based on the available literature there is little evidence to support this claim. In all cases, client communication and consideration of clinical presentation are essential for making treatment decisions.

Episode 6: POCUS: Ultrasound for Diagnosing Left-Sided Heart Failure in Respiratory Distress

POCUS for Life: An Ultrasound-based Diagnostic Approach to Left-Sided Congestive Heart Failure in Unstable Patients Presenting with Respiratory Distress. STUDENT(S): Rebecca Vavrek, Spencer Smith, Sukhjit Sidhu FACULTY MENTOR(S): Dr’s. Soren Boysen and Julie Menard ABSTRACT Left-sided congestive heart failure (L-CHF) is a common emergency presentation in small animal practice, manifesting as respiratory distress secondary to cardiogenic pulmonary edema. Such emergencies require rapid intervention. Point-of-care ultrasound (POCUS) is a patient side diagnostic that is swiftly integrated into triage. A powerful application of POCUS is rapid diagnosis of pulmonary edema secondary to L-CHF in unstable patients, allowing non-specialists to make treatment decisions based on sonographic signs of L-CHF. This paper focuses on identification of L-CHF using POCUS, but also includes methods of patient stabilization using oxygen and anxiolytics. We highlight the use of POCUS to diagnose L-CHF by outlining POCUS landmarks and corresponding pleural and lung space ultrasonography (PLUS) and cardiac findings. Additionally, other possible differentials are provided. Ultimately, identification of L-CHF can be made on patients presenting with respiratory distress through POCUS to identify diffuse B-lines on PLUS and an enlarged left atrium to aorta ratio ≥ 2:1. Such findings indicate beginning L-CHF treatment. Finally, we conclude with a literature-based comparison of POCUS to conventional methods of diagnosis of L-CHF and a diagnosis algorithm. Ideally, this paper improves the confidence of clinicians to rapidly diagnose and begin treatment of L-CHF using POCUS.

Episode 5: Improving Canine Atopic Dermatitis: Integrating a Spectrum of Care Approach

“Making Derm Great Again”: Integrating a spectrum of care approach into the diagnosis of canine atopic dermatitis (CAD) Tara Mulloy Mentors: Dr Becky Valentine and Dr Nanci Bond Abstract With increasing pressure for general practitioners (GP’s) to make fast diagnoses and treatment plans, dermatological patients presenting with non-specific clinical signs (pruritis) are often misdiagnosed or prescribed treatment plans that are not feasible for owners. Referrals to veterinary dermatologists are predominantly used when the GP is out of ideas, or the client is frustrated. For this reason, dermatological cases are one of the main reasons client’s lose trust in their GP and “vet-hop”. This is frustrating for the client, the untreated animal, and the veterinarian involved. In paper, I will introduce how integrating a spectrum of care (SOC) approach can facilitate the diagnostic process of complex dermatological conditions such as canine atopic dermatitis (cAD) for a GP, while also catering to the needs, abilities, and expectations of owners. I will show how simplified research-based algorithms and outlines can be helpful in streamlining a dermatological work-up for a GP, without compromising the standard of medicine. I will discuss where referrals can be effectively integrated at various steps of the diagnostic process and potentially limit time and cost, while maintaining client satisfaction. My goal is to introduce how a SOC approach to simplify dermatologic diagnosis for a GP.