What’s New

Continuing Education – Time for you to save the date!

Make sure you save the date so you don’t miss out on the upcoming Full-day “CE in the Vines” Masterclass.

Date: Saturday 14th September 2019

Location: Hunter Valley NSW

Watch out for further details in the coming weeks…

Our Sydney Full-day Masterclass recently held on 19th May 2019 was such a success and we were extremely excited to see a lot of our referring vets attend!

The Masterclass focused on three main services; Dermatology, ECC and Anaesthesia. These interactive workshop-style presentations had a number of cases to discuss across the services. Dr Yvonne Van Der Veek, ECC Clinician, focussed on common…and uncommon…poisons and toxins, Dr Clara Rigotti, Specialist Anaesthetist, discussed the hazards and pitfalls of neonatal, paediatric and geriatric anaesthesia and Dr Linda Vogelnest and Dr Philippa Ravens covered diagnostic approaches to common dermatology presentations.

Did you miss out on this Masterclass? Click on the links below to view the presentations from the day.

SASH Masterclass – ECC & Anaesthesia Presentations by Dr Yvonne Van Der Veek & Dr Clara Rigotti

SASH Masterclass – Dermatology Presentation by Dr Phillipa Ravens

SASH Masterclass – Dermatology Presentation by Dr Linda Vogelnest

Comprehensive Ophthalmology service now available on the Central Coast!


SASH Central Coast is proud to now offer a comprehensive Ophthalmology service. Dr Kate Hindley is now consulting on a permanent basis on Monday, Tuesday and Wednesday. Dr Kate can offer a range of in-house treatment options, ranging from a vast array of medical options through to the most delicate of eye surgeries including cataract removal and corneal grafts to treat ulcers. Dr Mark Billson continues to support the service  on Mondays.

 

 

 

 

“What is your diagnosis?”

Some valuable advice from our wonderful Ophthalmologist, Dr Kate Hindley.

A 2-year old F Mastiff X presents to your clinic with a few-weeks history of intermittent blepharospasm and epiphora on the right.  She is otherwise well with no other abnormalities found on physical exam. On clinical examination there is marked ocular pain requiring local anaesthesia to permit further investigation. List the clinical findings you can see in the photograph then think through what steps you might do next to reach a diagnosis.

 

Things you might consider

  • Fluorescein staining and STT (try to do the STT prior to the application of any topical dyes or local anaesthesia). If you’re using fluorescein then I recommend using a cobalt light
  • Tonometry
  • Basic neuroanatomy / neuro-ophthalmology testing
    • Menace, dazzle and PLR
    • Blink or palpebral reflex
    • Corneal sensation
  • Examination under magnification
  • Examine behind the third eyelid
  • Compare findings between the left and right eye
  • Can you exam the fundus
  • Consider the patients signalment

When you look at the photo what did you see? Did you list the following; corneal oedema, corneal vascularization, a superficial corneal ulcer in the lateral half of the cornea. Did you also see the entropion of the lower eyelid with secondary trichiasis as well as the periocular alopecia? Yes –great work! No, then you’re not alone. Sometimes ophthalmology is more about seeing what’s not obvious than concentrating on what is! Remember to take time with your ophthalmology exam, start at the beginning and develop a good examination technique by doing each and every step for each and every patient.

But if it still doesn’t make sense then our Ophthalmology and ECC team always available to help you get to that diagnosis.

“Cancer Detection” video for clients

We have made a video for your clients – ’10 things to check your pet for cancer’ which has now been released. Owners will be checking their pets for lumps and bumps and bringing them to you for testing – so let us know if you see more cases like this!

Watch video here 

Expanding our hours for Medical Oncology Patients on the Central Coast

Our Medical Oncologists, Dr Penny Thomas and Dr Sandra Nguyen will be expanding their SASH Central Coast hours to 4 days a week as of August. You will now be able to refer your patients for consult on Monday, Tuesday, Thursday and Friday between 8am – 6pm.

Dermatology clinical research trials

The team are currently enrolling patients in two clinical research trials at SASH Sydney: one on canine otitis externa (comparing once daily to twice daily topical medications), and one on a new oral supplement for canine atopic dermatitis. Contact our Dermatology team via email dermatology@sashvets.com if you would like to hear more about these trials. 

“Ticking through the seasons!” An Emergency case for thought…

In the depths of the recent artic spell, Terry presented to SASH Emergency with hindlimb weakness and increased respiratory effort. The owners had removed three ticks from him, including one that was engorged! Terry was treated according to the Tick Paralysis Advisory Panel protocol-B and he made a complete recovery. Ticks aren’t an unfamiliar presentation, but we typically think of peak tick season as accompanying warmer weather in Spring. Thankfully, since 2016 there has been a dramatic decline in the number of tick cases seen at emergency hospitals, which is generally credited to the new range of preventative products on the market. Cases like Terry’s underscore the importance of year-round prevention not just seasonal prevention, even in Sydney which has been especially chilly of late. This was Terry’s second time at SASH Emergency for tick paralysis. If your clients believe that year-round cover against ticks is unnecessary, it might be worth mentioning Terry.

 

AUSTRALIAN TICK PARALYSIS OF DOGS AND CATS – A Guide to Diagnosis Management, Treatment & Prevention

Congratulations Dr Tristram Bennett!

We are very proud of Specialist Surgeon, Dr Tristram Bennett who has been offered the opportunity to undertake a Fellowship in Surgical Oncology which is run by the Flint Animal Cancer Centre and Clinical Oncology Service of Colorado State University in August this year.

The programme is a year-long appointment and is only offered to one to two ACVS trained surgeons annually and leads to a board-certified sub-specialist qualification. This highly competitive fellowship will provide Dr Tristram training in the area of surgical oncology and aims to solidify his knowledge of the application of surgery to comprehensive cancer treatment to patients.

Needle Athroscopy now available!

The Sports Medicine & Rehabilitation department is very excited to have acquired a needle arthroscopy suite.  Needle arthroscopy differs from traditional scopes in that intra-articular views are obtained with a scope the size of an 18g needle and the procedure is performed with local anaesthesia and good sedation, opening up this diagnostic procedure to patients that are keen to avoid surgery, have co-morbidities or are cost constrained.

Arthroscopy is considered the gold standard for assessing the articular surface.  CT, MRI and musculoskeletal ultrasound look at proxies for joint health: effusion, subchondral bone & soft tissue changes.  Despite providing excellent 3D images, cartilage in veterinary patients can be less than 1mm thick and it is impossible to assess it without looking inside via arthrotomy or arthroscopy.  Despite its small size, we are still able to perform synovial biopsy

The cases most likely to benefit from needle arthroscopy as a diagnostic include:

  • Persistent forelimb lameness, particularly where there is suspicion of medial shoulder instability or shoulder tendinopathy
  • Assessment of post-operative meniscal injury following cruciate surgery
  • Elbow and hip dysplasia
  • Osteochondrosis
  • Any lameness with clinical or radiographic changes in more than 1 joint
  • In cases requiring synovial biopsy such as immune-mediated or neoplastic disease

If you have any questions around needle arthroscopy, please contact our Sports Medicine & Rehabilitation team.

6-Minute Walk Test (6MWT) Study with Dr Naomi Boyd

Our Sports Medicine and Rehabilitation team is running a study looking at a functional measure, the 6-minute walk test, and its association with mortality.

Functional measures such as the 6-minute walk test are used extensively in human medicine and demonstrate strong associations with mortality in a range of chronic illnesses including cardiac, respiratory and neurodegenerative diseases.  The results of these tests have been shown to more accurately predict survival time than other traditional measures of disease severity such as radiographs, lung function tests or lesion size.

The 6-minute walk test (6MWT) is fairly self-explanatory; the subject (canine or human) walks along a track at their own pace and the distance walked in 6 minutes is measured.  It is a test of submaximal exercise tolerance that more accurately reflects the patient’s ability to participate in normal, daily activities and thus, their quality of life.

Functional measures are infrequently used in veterinary medicine and research validating them for our patients is limited.  If we prove our hypothesis, the 6MWT is a cheap, reliable, non-invasive test that can be easily used in veterinary practice to provide powerful information on prognosis in chronic disease.  Moreover, it opens the possibility for exercise tolerance as a novel target for therapy.

Our study will be recruiting new referrals to the SASH Medical Oncology service.  Participants will perform the 6MWT and have a full orthopaedic exam and then be tracked for the remainder of the study.  If you have any questions about the study or patients that might be appropriate, please contact Dr Naomi Boyd.

Tapeworm cyst (Taenia serialis) cases on the rise!

Our Avian and Exotics team have seen quite a few complex cases recently, including the diagnosis and surgical removal of tapeworm cysts from several rabbits. These cysts develop in various places (retrobulbar region, cheek muscle and abdomen) after ingesting the eggs of Taenia serialis, a tapeworm found in the intestinal tract of dogs and foxes. We highly recommend you remind your clients to ensure they are worming their dogs regularly against tapeworm and not allowing pet rabbits to graze on potentially infected grass.

PEOPLE UPDATE

SASH SYDNEY

Critical Care: In August, we will be welcoming two new Criticalists, Dr Iain Keir and Dr Amy Dickinson to the team, who will join Dr Adelina Chan to ensure we have specialist cover for more of the day.

Anaesthesia: Dr Asher Allison and Dr Emma Johnson who have recently joined Dr Clara Rigotti to further expand our incredible onsite Anaesthesia team.

Radiology: Dr Barbara Kaser will join Dr Richard Lam, Dr Katharina Flatz and Susan Proctor in September to continue to support all our services with diagnostic imaging requests.

Surgery: Dr Tom Keeshen will be joining the team in September.

Neurology & Neurosurgery: We will be welcoming back Dr Jeanie Lau in September to further expand the service alongside Dr Patrick Kenny and Dr Georgina Childs.

SASH CENTRAL COAST

Internal Medicine: Dr Tunbi Idowu will be joining our ever-growing Internal Medicine team in August.

Sports Medicine & Rehabilitation: Our wonderful Rehabilitation Therapist, Rebecca Harvey has joined our Central Coast team on Tuesday, Wednesday and Thursday. Rebecca can also offer your clients consults via Skype if needed!

Surgery: We have welcomed Dr John Culvenor to the Surgery team on Wednesday and Thursday.