AD144 – Advance25 – Complex Medicine for Advanced Practitioners 1

Learn in your own time with this fully flexible Advance25TM Course. There are no real time sessions – suitable for all time zones.

Enjoy unlimited access to your course materials for a full 12 months. Ask all the questions you like on the discussion forum – there are no stupid questions! Get the help you need to deal effectively with your complex small animal medicine patients.

Complete the course and get your CPD / CE Certificate for 25 Hours of learning.

Use your new knowledge and skills straight away in your practice.
Revisit your course materials at any time during your 12 months’ access to refresh your knowledge whenever you have a relevant patient.

Session 1: Haematology and immunology

Session A: ‘The Drugs Don’t Work’. Management of immune mediated diseases beyond glucocorticoids.

Steroids are the mainstay of management of most immune mediated diseases. However, there are many situations when steroids do not seem to be ‘enough’, they are causing significant side effects, or they are not appropriate. In these cases, other immunomodulatory drugs might need to be considered. This webinar will discuss what other drugs are available in the UK, and review the evidence on their use in various immune mediated diseases.

Session B: Anaemia and transfusion medicine

Anaemia is a very common presentation in small animal practice. We will not talk about anaemia in huge depth, but rather focus on transfusion medicine and when certain blood products are indicated. Blood types in dogs and cats will be reviewed, with reference to newly discovered blood groups and the relevance of these. This presentation will be case-based using real cases to illustrate important points.

Session C: Coagulopathies

Anna will deliver a session on various coagulopathies from thrombocytopenia to hyperfibrinolysis syndrome. We will touch on interpretation of diagnostic tests and management of such cases.

Discussion forum: this is over to you to raise any questions on haematology or immune mediated diseases. Suggested discussion topics include: anti-thrombotic therapy; approach to pyrexia of unknown origin or cases of immune mediated polyarthritis; when is CRP useful?

Session 2: Gastroenterology and hepatobiliary disease

Session A: Chronic diarrhoea, a case-based approach

Chronic diarrhoea is one of the most common reasons that animals are presented to both first opinion and referral practitioners. It is often a source of considerable frustration to all parties involved! A logical approach to investigation and management is of critical importance in these cases. Katherine will talk through some cases to highlight key parts of the diagnostic pathway and dispel some myths about both diagnostics and treatments.

Session B: ‘The ALT is high, what next?’ Investigation and management of acute and chronic hepatopathies

Increased liver enzymes can be identified in both apparently healthy patients undergoing routine blood tests for screening purposes, and very unwell animals. The point at which such abnormalities should be investigated is often debated, and the diagnostic pathway to follow can be challenging. This presentation will discuss the logical approach to investigation of acute and chronic hepatopathies. General treatment approach will also be discussed, with the main focus on management of chronic hepatopathies.

Discussion forum: over to you to raise any specific topics for discussion on gastrointestinal and liver disease. Suggested discussion topics include: faecal matter transplant, probiotics, copper hepatopathies, antimicrobial resistance. Feeding tubes – placement, management and complications.

Session 3: Endocrinopathies

Session A: Diabetic ketoacidosis

This session will cover the presenting features of diabetic ketoacidosis and a detailed, logical approach to management.

Session B: ‘The Great Pretender.’ Approach to diagnosis and management of complex Addisonian cases

Hypoadrenocorticism can present in a host of different ways; it is well known as “the Great Pretender”. This session will explore the different types and presentations of hypoadrenocortcism (acute vs chronic; primary vs secondary; typical vs atypical) and the routes to diagnosis and management of such cases.

Session C: Approach to PU/PD

Many cases of PU/PD can be frustrating to understand and reach a final diagnosis. We will talk through a logical approach to PU/PD including when a modified water deprivation test is and is not (!) indicated.

Discussion forum: over to you to voice some topics for discussion. Suggested topics include: hypernatremia, hypercalcaemia, hypocalcaemia, other electrolyte disturbances. Use of Freestyle Libre monitors – uses and pitfalls, management of chronic diabetes.

Week 4: Uronephrology

Session A: Investigation and management of proteinuria in dogs and cats

The importance of measuring a urinary protein : creatinine ratio is commonly underestimated in our patients. Eva will discuss the relevance of proteinuria, and the approach to investigation and management of such cases. The recent literature on the use of telmisartan and other relevant drugs will be reviewed.

Session B: ‘From Rolling Stones to Dire Straits’. Urolithiasis; beyond struvite and calcium oxalate

Struvite and calcium oxalate urolithiasis are commonly encountered in our patients, and management strategies are fairly well known, though cases can still be very frustrating to manage. This presentation focuses on less common urolith composition and management strategies that could be considered. Medical treatment and minimally invasive management techniques will be discussed.

Discussion forum: you can raise any uro-nephrology topic to discuss. Examples could include: is SDMA useful? Pitfalls in management of struvite urolithiasis; dietary management of stone disease.

Week 5: Respiratory disease

Session A: It ‘Won’t Stop Running’. Approach to the never ending nasal discharge

This session will focus on chronic nasal discharge. This is a common and frustrating presentation and a logical approach is paramount to achieve a final diagnosis. The main differential diagnoses and management strategies will be discussed.

Session B: Lower airway and pulmonary parenchymal disease

This will be a case-based presentation, highlighting some common and less common lower airway and pulmonary parenchymal diseases in both dogs and cats. Clinical and radiographic presentations will be reviewed, together with treatment modalities and prognosis.

Discussion forum: we will be guided by you, but some suggested topics could include management of Aspergillus and other fungal diseases, such as cryptococcus.

Week 6: Infectious Disease

Session A: ‘Home and Away’; A focus on vector borne diseases

With pet travel becoming increasingly common, we are seeing more vector borne diseases in pets the UK. This session will focus on the diagnosis and treatment of Leishmania and Ehrlichia in dogs.

Session B: Current affairs. Coronavirus in cats and TB in the UK pet population

FIP in cats is a commonly encountered fatal disease, but we are now seeing hope for treatment of this disease. What are the new treatments and what is the evidence to support their use?
Mycobacterial infections have been present in the pet population for many years. Are case numbers increasing and why? Katherine will cover the different groups of mycobacterial diseases and some novel and non-invasive diagnostic techniques.

Session C: Leptospirosis in the UK

Prevention, clinical presentation, diagnostic tests and treatment of Leptospirosis.

Prevention, clinical presentation, diagnostic tests and treatment of Leptospirosis.
Discussion forum – any questions or discussion topics on infectious disease can be raised by you. Suggested discussion topics include: cases of SARSCoV2 in cats and other species, what does the human vaccine mean for cats? Should we always PTS cases of TB – if not, which cases? Babesia and IMHA – treatments for different Babesia species.

What do Vets Say About this Course?

‘The forum was brilliant, the speakers were all very engaged and put a lot of effort into answering our questions.’

Adele Fryers MRCVS

‘Feline diabetes, thyroid and hypothyroid diseases lectures were great!’

Alessandra Baroni MRCVS

‘Really helpful, thorough and up to date information – it’s had a direct positive impact on my clinical practice – thanks!’

Leanne Thompson MRCVS

‘Lectures were highly detailed and of right level for advanced practitioners. I have already applied information from this course to cases seen in practice.’

Menai Heyes MRCVS

‘Really easy to use and interesting talks. Really enjoyed the final talk on COVID and TB and the update on FIP’

Victoria King MRCVS

‘Great course, had the right balance of being appropriate material for first opinion practitioners to use in daily work for cases but extra bits of information to be even more knowledgeable about the cases’

Lucy Heap MRCVS

‘Very informative and well presented, really helpful. I feel more informed to treat many types of medical case. I mainly read others questions in the forum and found this really interesting and helpful’

Cynthia Hodge MRCVS

Tutors

Anna Threlfall BVSc MVetMed DipACVIM DipECVIM-Ca MRCVS RCVS. EBVS and American Specialist in Small Animal Internal Medicine

Katherine Clarke BVSc BSAVA PGCertSAM MRCVS DipECVIM CA. EBVS European Specialists in Small Animal Internal Medicine

Daniel Thompson MA VetMB PgCert VPS CertAVP MRCVS DipECVIM-CA. EBVS European Specialist in Small Animal Internal Medicine.

Eva Buresova DVM MRCVS DipECVIM CA. EBVS European Specialists in Small Animal Internal Medicine

Any Questions? Call us now on 0151 328 0444