Episodios

  • Episode 23 - Pododermatitis Paw-dcast

    Episode 23 - Pododermatitis Paw-dcast
    Jul 29 2024
    Pododermatitis Paw-dcast Show Notes (00:00) John introduces the podcast and Sue introduces Ursula Mayer – the guest on the show. Chapter 1 - Paw-sibilities – introduction to pododermatitis. (02:21) John invites Ursula to introduce herself. Ursula discusses her background and passion for pododermatitis, its prevalence, and its impact on dogs' quality of life. (03:33) When asked to define pododermatitis, Ursula explains that it's inflammation of the paw skin, with a particular emphasis on chronic cases, known as C-PIF. She discusses the various signs to look out for, such as excessive licking, lameness, and specific changes in paw appearance as the condition progresses. (05:31) Sue talks about the complexity of pododermatitis, and Ursula draws parallels with chronic otitis in terms of the multifaceted factors involved. She emphasises the importance of considering predisposing factors, primary causes including orthopaedic issues, secondary influences, and perpetuating factors in diagnosing and managing the condition effectively. Chapter 2 - Paw-sibilities - Orthopaedic Influences and Breed Predispositions (06:57) Sue asks Ursula to explain how orthopaedic diseases can contribute to pododermatitis in dogs. Ursula explains that pain from orthopaedic conditions alters weight bearing, causing dogs to adjust their stance and potentially rub their paws together, leading to inflammation and abnormal walking patterns. She goes on to discuss specific orthopaedic diseases, including elbow dysplasia, hip dysplasia, and arthritis affecting joints such as toes, carpus, tarsus, elbows, hips, and the back. These conditions can disrupt normal weight distribution and contribute to the development of pododermatitis. (08:35) Sue further illustrates with an example and Ursula emphasizes the importance of referring chronic cases to orthopaedic specialists for thorough examinations and imaging. She acknowledges the complexity of diagnosing older dogs with multiple affected areas, stressing the need for integrated care across disciplines to effectively manage pododermatitis. (09:56) John asks if this is just dogs and Ursula confirms that while cats can also suffer from pododermatitis, the chronic form discussed, known as C-PIF, predominantly affects dogs and not cats. John then asks about breed predispositions, particularly in relation to posture-related issues in Labradors. Ursula elaborates that certain breeds, notably larger and heavier ones like bulldogs, French bulldogs, and pugs, are commonly affected. Labradors and Golden Retrievers also constitute a significant portion of cases. The characteristics such as short, bristly coats and broad, flat paws, may contribute to their susceptibility to the condition. Ursula notes that even without orthopaedic diseases, these breeds' anatomical traits appear to play a role in the development of pododermatitis. (12:20) Sue reflects on a study involving bulldogs walking on pressure plates, noting that those without interdigital lesions tended to walk more upright. She emphasises that dogs with flatter feet and heavier builds are more prone to issues due to their posture, suggesting a correlation between anatomical features and pododermatitis. She further discusses how these factors influence investigation and treatment approaches. Ursula agrees, highlighting the significant role of allergies alongside orthopaedic diseases in pododermatitis cases. She notes the complexity in distinguishing between underlying orthopaedic conditions and inherent anatomical predispositions in certain breeds. Ursula shares a case involving a dog initially treated for allergies, later developing orthopaedic issues that exacerbated pododermatitis, illustrating the interplay between these factors. (14:47) Sue outlines the investigative process, starting with a comprehensive history and dermatological examination, incorporating orthopaedic evaluations based on findings. Ursula explains her approach, emphasising the importance of ruling out issues, particularly Demodex, through rigorous testing methods. She discusses predisposing factors such as weight and breed characteristics, and systematically examines for primary diseases like allergies, orthopaedic issues, and endocrine disorders. Ursula stresses the need to assess secondary infections and carefully inspect paw conditions, especially ventrally, to identify specific dermatological and orthopaedic indicators. Chapter 3 – Paws-itive outcomes - Diagnostic and Treatment Approaches (18:24) Sue asks about infection management in pododermatitis cases. Ursula explains that for superficial cases of pododermatitis, she primarily employs topical treatments. However, in chronic cases where deep pyoderma is present, systemic antibiotics are often necessary. She emphasises the importance of not relying solely on antibiotics without addressing underlying factors, as this can lead to recurring infections and antibiotic resistance. In deciding ...
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    41 m
  • Episode 22 - Unleashed: The Dawn of the Leishmania

    Episode 22 - Unleashed: The Dawn of the Leishmania
    May 21 2024
    Unleashed: The Dawn of the Leishmania Intro Chapter 1: The Attack of the Sandfly 3.17 Sue introduces the topic of leishmaniasis, and Christian describes leishmaniasis as a multisystemic disease affecting humans and animals, primarily dogs. He notes its prevalence in regions like the Mediterranean and its expansion due to climate change and imported infected dogs. 5.19 Sue questions whether leishmaniasis occurs naturally in the UK or is solely imported. Christian mentions reported cases in the UK, suggesting transmission via infected phlebotomine flies brought back by travelers from endemic regions. The conversation shifts to the sandfly vector responsible for transmitting leishmaniasis. Christian describes the sandfly as small, silent, and potentially painless, emphasizing its absence in the UK but the possibility of migration due to global warming. Christian advises against using repellents on dogs in the UK due to environmental concerns but stresses the importance of monitoring the situation, given he acknowledges the likelihood of sandflies reaching the UK in the future. 7.27 John queries if leishmaniasis can be transmitted by other vectors like fleas. Christian affirms that sandflies are the primary vector for the disease, although other potential vectors are suspected but not proven. John then asks if humans can contract the disease from infected dogs. Christian explains that with the vector absent in the UK, human transmission from dogs is unlikely. However, he emphasizes the importance of isolating positive dogs to prevent transmission through blood transfusion. Chapter 2: The Haunting Symptoms and Diagnosis 9.11 The conversation then transitions to the clinical signs of leishmaniasis. Christian describes typical systemic symptoms such as anorexia, weight loss, lethargy, and mucous membrane pallor, along with some less common signs like polyuria and polydipsia. Christian also discusses characteristic skin lesions, including non-pruritic exfoliative dermatitis and erosive lesions. Sue adds her observations about the scaly appearance of affected dogs without itchiness, contrasting it with parasitic skin conditions. Christian concludes by stressing the importance of diagnostic assistance in accurately identifying the disease, especially considering its varied clinical presentations. 12.09 Sue brings up how leishmaniasis can affect nails, prompting Christian to elaborate on what clinicians might observe. He describes nails that grow unusually long and fast, resembling talons rather than being deformed. Christian notes that this sign is relatively rare in his experience, with scaly dermatitis or ulcerative dermatitis being more common presentations. 13.11 Sue then queries whether certain clinical presentations carry a better prognosis than others. Christian explains that prognosis depends on the severity of internal organ involvement, particularly kidney disease. The disease originates from the skin but can affect various body parts due to the immune system's reaction. 14.12 John asks how general clinicians diagnose it. Christian outlines that diagnosis relies on compatible clinical signs and specific clinical pathologies, notably anemia and changes in protein levels. While general practitioners can conduct serological tests, more specialized examinations may require referral to a laboratory. Christian emphasizes the importance of considering travel history and ruling out other conditions before treatment initiation. 16.40 Sue raises the issue of screening for leishmaniasis in dogs rescued from abroad, inquiring about the incubation period and when to start screening. Christian explains that the incubation period varies greatly, suggesting performing a quantitative serological test six months after returning from an endemic area. If positive, measures like using repellent and excluding the dog from blood transfusion banks are advised. Sue seeks more detail on the blood tests, and Christian elaborates on measuring the amount of Leishmania-specific antibodies using quantitative serological tests. These tests help detect high antibody levels, indicative of infection. Advert Ditty What products do we have now? Do we have a Zincoseb one, any shampoos? Chapter 3: Eternal Vigilance Against the Parasite 18.55 John then asks about therapy options for positive cases. Christian emphasizes the goal of controlling clinical signs and pathological abnormalities, as complete parasite elimination is rare. Therapy typically involves a combination of leishmanicidal drugs, which aim to kill the parasite, and leishmaniostatic drugs, which maintain a low parasitic level, together aiming to reduce the parasitic load and prevent relapses. He notes the need for topical treatments alongside systemic therapy to manage symptoms like scaly skin. 22.00 John asks about drug availability and Christian mentions challenges in drug availability and potential side effects, particularly with drugs like allopurinol, which can cause ...
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    31 m
  • Episode 21 - Sustainability? It's (eco)-logical!

    Episode 21 - Sustainability? It's (eco)-logical!
    Mar 20 2024
    Welcome to a new episode of the Skinflint Podcast, celebrating our impressive milestone of 10,000 downloads. This episode is a deep dive into the crucial role of sustainability in veterinary dermatology, presented to you by Nextmune UK and Elearning.Vetand featuring Monika Linek. Chapter 1: Setting the Sustainability Stage (03:10) Sue introduces Monika to the podcast, who shares her experience as a German dermatologist and diplomat of the ECVD. Monika discusses her work in a referral practice in Germany and her involvement in "Parents for Future," advocating for climate justice and sustainability. (05:20) Monika defines sustainability as meeting present needs without compromising future generations' ability to meet their own. It involves maintaining a balance to prevent depletion of natural resources and harm to ecosystems. Sue emphasizes the importance of sustainability in preserving the Earth for future generations. Sustainable practices ensure a lasting and enduring system for future generations. (06:40) Sue raises the issue of sustainability in veterinary dermatology practices and asks Monika about potential improvements. Monika highlights several areas for improvement, including reducing carbon footprint from energy use, transportation, and waste management. (07:39) Monika acknowledges the challenges of telemedicine in veterinary dermatology due to the necessity of physical examinations. However, she sees potential in remote consultations for follow-ups or initial assessments, particularly for referring practices. Finding a balance between technology and quality care is crucial. Monika also notes telemedicine's ability to reduce clients' carbon footprint by minimizing travel, a point Sue agrees with, emphasizing its role in complementing traditional consultations and promoting sustainability. Chapter 2: Navigating Sustainable Solutions (10:19) John asks about areas in veterinary dermatology that could reduce carbon footprint. Monika underscores the importance of considering the environmental impact of drugs, particularly antibiotics and anti-parasitics. She notes the shift towards antibiotic stewardship and the need to rethink the use of topical anti-parasitics like chlorhexidine. Monika emphasizes the necessity of rethinking and changing practices regarding drug usage to minimize environmental impact. (12:32) John appreciates Monika's insights and finds them encouraging, as these considerations align with responsible veterinary practices. He delves into the choice between systemic and topical treatments in dermatology, seeking Monika's opinion on their sustainability. Monika discusses the need for susceptibility testing before antibiotic use and emphasizes the benefits of combining topical treatments with antibiotics to reduce treatment duration. She advocates for avoiding systemic antibiotics when possible, relying on topical treatments alone for superficial pyoderma. Regarding alternatives to chlorhexidine, Monika suggests hypochlorous acid as a more environmentally friendly option. Sue agrees, highlighting the importance of effective yet eco-friendly alternatives that do not compromise animal health. (16:28) The conversation shifts to the development of technologies like photonic therapy as potential replacements for topical treatments. However, Sue acknowledges the challenge of balancing efficacy, cost, and environmental impact in private veterinary practice. Monika points out the need to address the pricing of eco-friendly products, highlighting the broader systemic issues surrounding their accessibility and affordability. Chapter 3: Practical Sustainability (18:36) John raises a practical question about the disposal of unused medications and antiseptics. Monika mentions new guidelines in the UK for returning unused or expired antibiotics and medicines to clinics for proper disposal. She highlights the importance of implementing better waste disposal systems for medicines in the future. Sue adds that the UK has an "antibiotic amnesty" campaign encouraging people to return unwanted antibiotics to designated drop-off points instead of disposing of them improperly. These drop-off points include pharmacies and veterinary clinics, which have appropriate methods for disposing of clinical waste. (21:36) John raises the idea of reusing items in veterinary practice, such as scalpels and biopsy devices, instead of relying solely on single-use plastics. Monika suggests that while it may be challenging to revert to using glass syringes, there are still opportunities to explore reusable alternatives for certain items, such as surgical gowns and towels. Sue emphasizes the importance of putting pressure on manufacturers to produce more recyclable and sustainable products, even if it means paying a bit more. When discussing sterilization methods, Sue acknowledges that there are various factors to consider, such as the environmental impact of disposing of sterilizing ...
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    38 m
  • Episode 20 - We’ve Been Expecting You, Malassezia

    Episode 20 - We’ve Been Expecting You, Malassezia
    Jan 9 2024
    Chapter 1: "The Dermatological Agent: Ross's Malassezia Mission" 02.42 - John begins by welcoming Ross to the Skinflint podcast and acknowledges Ross's expertise in "Malassezia." He asks Ross to share his background and explain what Malassezia is. Ross introduces himself as a professor of veterinary dermatology, detailing his experience in farm practice and later transitioning to small animal practice. He pursued further studies and a Ph.D. specifically focusing on Malassezia, and so has been interested in them for more than 30 years. 03.44 - John asks Ross to elaborate on Malassezia, describing it for listeners who might not be familiar with the term. Ross explains that Malassezia is a group of yeast found naturally on the skin of various mammals and birds, thriving in lipid-rich environments. It typically exists as a commensal organism on the skin but can become an opportunistic pathogen, leading to dermatitis and otitis in dogs and occasionally in cats and horses. 05:27 - Sue asks if Malassezia is the same across different species or if there are variations. Ross explains that there are 18 known species of Malassezia, each potentially adapted to a specific host. He discusses examples like M. cunicui in rabbits, M. caprae in goats, and M. equina in horses. He notes M. pachydermatitis as the dominant species in dogs, which is unique as it can grow on routine culture media, unlike other species requiring lipid supplementation. In contrast, cats may have different species like M. nana and M. slooffiae, among others, leading to variations in yeast colonisation. There's a discrepancy between what's identified molecularly and what's observed in cultures, particularly in dogs, highlighting an unexplained scientific disparity. Chapter 2: "Species Confidential: Malassezia's Breed of Intrigue" 8.44 - John asks Ross about the location of Malassezia on animals. Ross mentions that, in dogs, Malassezia is predominantly found in web spaces (75-80%), lip fold regions (similar proportion), and ear canals (about one-third). Lower levels are detected on the trunk, axilla, groin, and dorsum due to their warm, moist nature. 10.00 - John inquires about identifying Malassezia in cytology with dermatology tests like tape strips or impression smears. 07:35.54 - Ross confirms that Malassezia has a characteristic peanut-shaped morphology, identifiable under microscopy, usually abundant in specimens obtained from areas like a friendly basset hound's ear wax or neck fold wax, which are good teaching examples. 08:17.63 - Sue asks Ross about determining the relevance of Malassezia presence in ears or skin. Ross explains breed-specific variations in normal yeast population, how certain breeds might have high yeast counts without causing issues, and that the anatomical site also influences yeast populations. He notes that there's no clear clinical cut-off for relevance; treatment response often helps assess its significance, as excessive yeast might not always correlate with clinical symptoms. 14.39 - John asks Ross about the clinical signs indicating an overgrowth of Malassezia. Ross explains that signs like inflamed or greasy skin, particularly in folded areas, ears, neck, or groin, are indicative of a potential Malassezia issue, especially in predisposed breeds (he names some). 16.48 - Sue asks Ross about Malassezia as a primary or secondary disease and its relation to underlying issues. Ross mentions that Malassezia is a commensal yeast and when it causes disease, it's often secondary to an underlying problem, involving immune system imbalances or hypersensitivity responses. Ross confirms that even in breeds prone to Malassezia, like Basset Hounds, there's usually an underlying cause for yeast proliferation. He mentions high Malassezia colonisation in mucosal populations of Basset Hounds, indicating more than just skin folds contributing to the issue. Chapter 3: "Fungal Intrigue and Secret Signs: Unravelling Malassezia's Plot" 20.33 - John discusses the common misconception regarding skin folds and Malassezia issues in certain dog breeds with Ross. They touch upon the possibility of Malassezia hypersensitivity, its occurrence in certain dogs, and its association with atopic dermatitis. Ross explains that while Malassezia hypersensitivity exists, its clinical presentation might not always correlate with immediate hypersensitivity reactions. He discusses intradermal testing in Bassett Hounds and the presence of IGE reactivity in some dogs, especially those with atopic tendencies. 25.19 - Sue asks Ross about primary care veterinary surgeons' preferred methods for diagnosing Malassezia dermatitis. Ross recommends simple techniques like ear swabs, tape strips, and microscopic examination for diagnosing Malassezia in primary care settings. 26.21 – John asks about whether this can be transferred between pets and humans. Ross discusses the potential for Malassezia ...
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    47 m
  • Episode.19 - Mr. Bump’s Guide to Navigating Skin Tumours

    Episode.19 - Mr. Bump’s Guide to Navigating Skin Tumours
    Oct 19 2023
    John introduces the podcast and the co-hosts for this conversation; the guest on this episode is RCVS Specialist in Veterinary Oncology, David Killick. Chapter 1 – Little Miss Diagnosis David's Background: 2.14 - David began in general practice in 2003 and later specialized in medical oncology at the University of Liverpool, earning a PhD at the RVC in London. He is now the professor of veterinary oncology at the University of Liverpool. Malignant vs. Benign: 3.19 - Benign growths stay localized, mostly causing no problems during a pet's lifetime, while malignant growths can invade nearby tissues and spread. 4.49 - Approximately 40-50% of skin growths in dogs are malignant. Investigate All Lumps 5.30 - Investigate All Lumps: Investigating all skin lumps is essential, even if no immediate action is taken. Initial investigation involves history-taking and examination, looking for signs like attachment to underlying structures or enlarged lymph nodes. Biopsy Importance 8.05 - Diagnostic biopsy samples, including fine needle aspiration (FNA), are invaluable in veterinary medicine. FNA is minimally invasive, providing initial insights in 80-90% of cases. It may not offer a precise diagnosis but guides further steps. David suggests fine needle aspiration as a cost-effective initial diagnostic tool, emphasizing its utility in informed decision-making. Other options include incisional and excisional biopsies, each with its own considerations regarding risks and benefits. By prioritizing fine needle aspiration, veterinarians can efficiently navigate the path toward accurate diagnoses and appropriate treatment plans. Factors Influencing Animal Skin Tumours 11.05 - Sue inquires about factors influencing susceptibility to skin tumours in animals, such as age, breed, and sex. David discusses breed-related associations with specific diseases in veterinary oncology, citing mast cell tumours in bulldogs, boxers, and retrievers. He mentions melanomas more common in Scotties and Schnauzers and highlights characteristics like rapid growth and tissue attachment raising malignancy concerns. Identifying Common Benign Lumps Visually 13.18 - John seeks insights into visually identifying common benign lumps. David notes some, like skin tags, papillomas, and sebaceous adenomas, can be recognized by appearance. Skin tags are outgrowths, papillomas breed-specific, and sebaceous adenomas common in aging Cocker Spaniels. David advises monitoring, measuring, and fine needle aspiration for accurate identification. Understanding Pigmented Tumours in Dogs, Especially Melanomas 16.33 - Sue asks about pigmented tumours in dogs, melanomas specifically. David explains not all pigmented tumours are melanomas. Dark or black lesions suggest melanomas, including malignant melanoma and benign melanocytoma. Skin melanomas may require removal if melanocytes are detected, with digital and oral melanomas requiring active management. Identifying Melanocytes in Fine Needle Aspirations 18.00 - Sue questions melanocyte identification in fine needle aspirations. David notes pigmented tumours are usually melanomas, with characteristic black granules in cells. He mentions amelanotic melanomas' rare occurrence, especially in oral cases. Chapter 2 – Introducing Mr Mast Cell Insight into Mast Cell Tumours 18.52 - John seeks insight into mast cell tumours (MCTs). David explains their origin from mast cells, which release histamine and cause itchiness and redness. MCTs may periodically change size upon palpation. They are common in dogs, especially specific breeds, potentially requiring multiple management due to recurrence. Using Fine Needle Aspirations (FNAs) for Diagnosis and the Role of Veterinary Nurses 22.10 - John inquires about using fine needle aspirations (FNAs) for diagnosis and the role of veterinary nurses in interpreting samples. He wonders if preliminary assessments in practice are acceptable due to budget constraints and potential risks. David encourages practitioners, including vets and nurses, to develop cytology skills, which are enjoyable and relatively easy to learn. He suggests self-examining slides in their lab, writing reports, and seeking feedback for skill improvement. David notes that mast cell tumours are an excellent starting point for cytology learning as they often feature distinctive "fried egg-like" cells with blue to purplish granules. However, expert consultation is crucial for tumours with unusual characteristics or more aggressive features. The Necessity of Biopsies for Tumour Grading After FNAs 25.15 - Sue questions the necessity of biopsies after fine needle aspirates (FNAs) for tumour grading. David notes FNA's value in general practice and good correlation with histological grade. He emphasizes combining clinical tools and considering staging, especially for higher-grade tumours. For less aggressive cases, FNA of the draining lymph node may ...
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    46 m
  • Episode 18 - ’Ear All About It!

    Episode 18 - ’Ear All About It!
    Sep 13 2023
    Log this CPD with 1CPD here (00:00) John introduces the podcast and welcomes our guest for this episode - the founder of the Dermatology Referral Service in Glasgow, Peter Forsythe. Chapter 1 – The Ears (02:58) John welcomes Peter Forsythe, who talks about how he got involved in dermatology and how ear disease makes up half the caseload in the referral practice he works at. (04:41) John asks why it is important dogs have clean ears and Peter discusses the long tube made up of the auricular and annular cartilages which are lines with glandular skin which produces wax - which combines with skin cells to make up what we know as wax. He says a build-up can alter the environment on the ear canal, increasing humidity and increasing the number of microbes such as bacteria and yeast, which - whilst normally present - can develop into an overgrowth or even infection. He also talks about the concretions, or balls of ear wax which can form adjacent to the tympanic membrane or ear drum, and they are called ceruminoliths and can sit on the ear drum and damage and even perforate it. So it is important to manage this ear wax and keep the ear clean. (07:55) Sue asks about the ‘self cleaning’ mechanism the ear called epithelial migration and Peter describes this as similar to the shedding of cells we have on our continuously growing skin cells, but in the ear these have a sliding, upward motion to them as they do this, and this slowly carries cells and wax up and out the ear like a slow moving escalator – at the speed our nails grow at. (09:49) Sue asks if this changes with age and Peter says there isn’t information on age changes, but in cases of inflammation or disease this is affected, slowing it down and then leading to increased build up of wax. Peter says the human ear produces 2 kilos of wax in a lifetime! (11:32) Sue asks what Peter recommends to clients in terms of ear cleaning with puppies and he doesn’t recommend routine ear cleaning in puppies if they are healthy, as the mechanism is working well; however, he does think in those breeds where they are prone to ear disease, that it is good to get them used to you handling their ears at a young age. Chapter 2 – The Cleaning (13:34) Sue asks about hairy ear canals or plucking ears and Peter says in his view plucking hairy ear canals in poodles and bichons for example, where the hair can trap the wax, can irritate and inflame the ear and begin ear disease, so he wouldn’t pluck them. If the dog has got ear disease (otitis) then some plucking maybe necessary – but ear phobia – where a dog has had bad experiences and they won’t let people go near their ears, is more of an issue and plucking can lead to this. He would prefer then to begin cleaning if you can see wax building up. This is the same with a dog with a pendulous (flappy outer) ear (which can also contribute to ear disease) – but he does point out too much cleaning can overly wet the ear and cause more problems – so each case must be considered carefully. (17:15) Sue asks as a pet owner who can see so many different ear cleaners, what can help you decide and what to look for and Peter divides these into two. Firstly softening or dissolving ear wax products called cerumenolytics, containing things like propylene glycol, mineral oils, glycerine; through to secondly salicylic acid or even stronger sodium docusate (DOSS) or carbamide peroxide (which is only recommended in anaesthetised dogs) which dissolves. Sue clarifies then this depends on how waxy the ear is as to which you reach for and Peter says it is recommended to talk to the vet about it rather than purchasing straight from the internet. (21:10) John points out it is important then for any nurse or vet to have a good understanding of the ear cleaners on their shelves and Peter wholeheartedly agrees, saying for example a more water based ear cleaner being used to dissolve and remove wax doesn’t make sense and also cleaning isn’t comfortable for the dog; so it is important to demonstrate the use of a product to an owner, and give them tips such as warming the ear cleaner a little to make it more comfortable. Chapter 3 – The Cleaners (24:20) John asks about powders and Peter remembers when they were used more frequently, but he does not recommend them at all as they mix with the wax and make it stickier and dryer. John goes on to ask what changes in the ear once disease starts to set in; Peter says if a dog has had ear disease once, it is very likely to happen again and can happen repeatedly. Over time this changes detrimentally the ear canal; the lining becomes thicker and the tissues become swollen and oedematous, the glands become enlarged and even massive over time; all this narrows the ear canal and impairs the epithelial migration and so you have an increased build up or wax in a smaller canal and this favours the further build up of bacteria and/or yeast in the ear. He ...
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    41 m
  • Episode 17 - Skin Flint vs The Derm Vet; a Podcast Collaboration Special

    Episode 17 - Skin Flint vs The Derm Vet; a Podcast Collaboration Special
    Aug 1 2023
    Log this CPD with 1CPD here (00:00) John introduces today’s guest - host of another veterinary dermatology podcast The Derm Vet, Ashely Bourgeois. Chapter 1: UK vs US Dermatology (02:50) Sue asks Ashley how she started out in podcasts and Ashley shares her story, wanting to stay involved in dermatology whilst also raising children and not wanting to lose that knowledge base, and helping others in that kind of position. (04:33) John asks Ashely and Sue what the difference between the UK and US in approach to dermatology. Sue says the approach is the same, but the system is slightly different and there isn’t so much of a referral process in the US as here in the UK. Ashley agrees, saying often people will come direct, but that they have good relationships with first opinion practices in order that clients are aware dermatologists exist. (06:45) Sue says the board certified dermatologists exist in both regions, but in the UK we have an intermediate tier of advanced practitioners which doesn’t exist in the states; therefore asking Ashley if there are any areas in the US which aren’t covered well geographically with specialists. Ashley says there are areas without specialists, and there is work to see if they can develop better coverage; including the possibility of telemedicine in for example a state that doesn’t have dermatologists. (08:58) Sue asks if the rules around dermatology prescribing through telemedicine differs state to state and Ashley confirms this, saying in her state for example, they must see a client at least once a year whereas in other states this is possible long term remotely. Chapter 2: UK vs US Antibiotic Use (11:30) Ashley then asks Sue if it differs in relation to staphylococcus infections in the UK and US and Sue says it really does, and also across Europe from the UK. She points out in Scandinavia they hardly use antibiotics at all and use antiseptics much more, and this seems to really correlate to having less resistance. Sue asks for example if Ashely would use vancomycin and Ashely says whilst she hasn’t for this one she has had to use rifampin and chloramphenicol. She reflects there is a shift in the mindset with the use of antibiotics because of the number of times they will only have one or two choices left due to resistance. (14:45) Sue asks if it is right you can buy neomycin, polymyxin, bacitracin over the counter and Ashely says you can for topicals, and said she even had a client who had fish antibiotics they were giving to their dog whenever they felt there was an infection. Sue reflects what would be available by comparison in the UK. Chapter 3: UK vs US In Practice (17:17) John asks whether a clients expectation would differ in terms of approach to a skin case in the states than in the UK and Ashley says there is much the same issue in terms of clients not understanding the long term nature of skin management, particularly in allergy and also the multimodal approach; where often more than one therapy is going to manage the patients skin. She is always quick to point out to owners these cases will change and even when well managed, this will change and they will flare up. (20:14) John reflects that in the US the Vet nurses or Vet Techs as they are called there are still as important to case management as here in the UK and Ashely passionately agrees, saying they are critical to the solidification of a case management – instilling confidence in the owners to the treatment plan long term. They also catch mistakes and understand the cases very well. (23:05) John asks Ashely about the education side in terms of the difference with logging CPD and education. Ashley says the regulations are quite strict in terms of whether she can talk off label at lectures and online and her and Paul reflect on some of these aspects. Chapter 3: UK vs US Dermatology Top Trumps (26:27) Sue asks Ashley for most common presentations and Ashley and Sue spend some time reflecting on the differing cases and presentations seen both in the US and UK. Where Ashely is in the US the climate is similar but Sue reflects it is interesting how the diseases are so different. (33:50) John wraps the podcast by asking Sue and Ashley what their favourite and least favourite disease it. Pemphigus comes out well whilst sterile nodular panniculitis and bald Pomeranians/alopecia X and lick granulomas really don’t! Visit Ashley’s Website HERE Search The Derm Vet Podcast on your podcast platform, or follow the link HERE
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    43 m
  • Episode 16: The Great Protein Debate - Beef or Beans?

    Episode 16: The Great Protein Debate - Beef or Beans?
    Mar 22 2023
    Ep.16 Show Notes In this Skin Flints episode, Sue, John and Paul welcomed Dr Arielle Griffiths to the platform to discuss a very topical subject - sustainable pet food. (00:00) Introduction Chapter 1: “Understanding the Urgency: Why Sustainable Food is Necessary for Our Pets” (03:44) John welcomes Arielle to the pod, who talks about her work in the industry and in setting up the Sustainable Pet Food Association. As a GP vet she became involved in nutrition and did extensive research before also becoming environmentally and sustainably focused as a result of seeing a change in the world. (07:31) Sue asks Arielle to clarify what is meant by obesity-based diets and Arielle says this is where owners are (through love) overfeeding their pets and potentially causing arthritis, heart disease and a number of conditions relating to the excess weight. This tipped her to realise the use of plants as a base in food can really help, which was a big factor in her becoming vegan herself. (09:08) Sue clarifies we are talking about people feeding too much or an imbalanced diet and the carbon footprint of that diet – and that we are discussing dogs here and not cats. Arielle says that the need for palatability in foods has resulted in an excess of protein in the diet and more meat being used than needed, affecting the sustainability. She shared that wet, meat-based diets have the largest carbon footprint, including raw lean diets – with one study in Brazil demonstrating a dog on this diet matched that of a human in that country. Chapter 2: "Exploring the Landscape: What Constitutes Sustainable Food?" (11:49) John asks why vegetarian or vegan food is a more sustainable option and Arielle says it is proven that animal agriculture for the use in pet food accounts for 2.5 - 3% of the entire carbon footprint of the world. This comes from deforestation to provide this food and the by-products of the food as a result of the market. (13:40) Sue clarifies this as methane production from the animals used increasing the carbon emissions along with the deforestations. Livestock accounts for over 70% of global farming land use but only produces 18% of the world’s calories and 37% of total protein - with dog and cat food being equivalent to an entire country’s worth of production. But Arielle says the health benefits are what turned her more to vegetable based foods. (15:29) Sue comments on the information on the human side for the health benefits, with more GPs suggesting it – she asks if there is evidence to support this on the pet side. Arielle says there is and comments on how in the 27,000 years of domestic evolution dogs have developed to require 52% of their diet to be carbohydrate due to the change in their genes over that time compared to the wolf they descended from, which only needs 1.2% carbohydrate. She also says dogs 3,000 years ago were primarily plant based. (17:09) John asks if the theory of raw feeding being more natural for dogs is therefore unmerited and Arielle agrees, explaining that dogs obviously love eating food like this which is the success of the industry – but in terms of the environment there is significant evidence that resistant bacteria has been shown to be happening as a result of raw feeding, as well as it not being healthy for the dog. And she reiterates - a dog is not a wolf! (19:18) John goes on to clarify Arielle is advocating a formulated dog food which is vegetable based and asks if it could be insect based. Arielle says it could and there are a number of companies for this, but she focuses on vegetable based and insects are just using another way of recycling protein and therefore whilst they are more substantiable – they are not as much so as the vegetable equivalents. She mentions how she was one of three vets speaking on the subject at London Vet Show along with Professor Andrew Knight and Dr Mike Davies - talking about animal nutrition and the evidence for vegetable based diets, which previously had looked to have a vegan diet, but a new independent study from Australia and Mexico reviewing all the papers indicated the evidence is sound. She argues now we know they are healthier for our pets and our planet there is an urgency. Chapter 3: "Making Informed Choices: Considerations for a Sustainable Diet" (24:40) Sue asks what we do about different life stages and different conditions and Arielle says there is a puppy plant based food and a senior plant based food – and in fact any plant based food is good for senior dog. (26:12) Sue asks about particular conditions as well (e.g.) skin conditions and Arielle says she’s getting 2 or 3 people a day asking her to transition their dogs from meat diets because of an intolerance to it, and much has been shown to evidence the gut microbiome health being linked to that of the sin and therefore the skin health. (28:19) Sue asks if you can transition to a plant based diet ...
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