60 Hypoadrenocorticism treatment

Veterinary Clinical Podcasts

Dominic Barfield

814108, Higher Education, Education, Medicine, Rvc, Science & Medicine, Veterinary, Science, Higher, Royal

5 • 643 Ratings

🗓️ 10 November 2017

⏱️ 41 minutes

🔗️ Recording | iTunes | RSS

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Summary

For the 60^th Pod we have a treat, not one but two Professors join Brian and myself in the studio. This week we talk to Hattie Syme, Professor of internal medicine and David Church, Deputy Principal here at the RVC about treating patients with hypoadrenocorticism. The initial therapy and the transitional therapy. It is all about supplementing with mineralocorticoids and glucocorticoids. Now there might be differing views on which medications to use. This all came about from a conversation with them both on the clinic floor and thought that a slight contrast in views would be good for you to hear.

You could have a look at what is written about therapies prior to listening http://www.msdvetmanual.com/endocrine-system/the-adrenal-glands/hypoadrenocorticism#v3271580

To screen for HypoA https://www.ncbi.nlm.nih.gov/pubmed/22092627

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Transcript

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0:00.0	Goodaid, Dominic Valfiard here, and this is the RVC Clinical Podcast. Thank you for listening and thank you for subscribing on your smartphone or whatever generic fruit-based device.
0:07.8	So we're really grateful for you taking the time to download and listen to the RVC podcast.
0:11.9	We don't ask for anything in return, but we'd be incredibly grateful if you could pop to the Apple Podcasts or iTunes and leave us a review. Obviously, a five-star review would be great. I'm sure there's other reviews out there, but you can give that to other podcasts.
0:24.4	But it will really help our metrics and get this information out there to people who want to listen to it.
0:30.5	So today we've got a special treat because I'm joined not only by one person but by two people.
0:36.7	So today we have with Professor Hattie Sime.
0:39.3	Hello, Hattie. Hello. And Professor David Church. Hello, Dom. And I thought because
0:45.3	we had a discussion at one point in the clinic and I thought that maybe this could reach a wider
0:52.3	audience about the treatment for animals with acute hypoadrenocoricism
0:59.0	crisis and also their ongoing management. So I thought it would be fair to ask you both your
1:06.0	opinions on that and we'll probably break it up just the acute treatment and then the chronic treatment.
1:14.5	And in the interest of parity as well, probably I should say whoever starts first can start last for the next part, if that makes sense.
1:24.9	Sounds fantastic.
1:26.4	Yes. So who would like to start about the initial management of hypodrenicorism?
1:33.3	Well, I think we probably should have beauty before, beauty before whatever, ugliness.
1:41.3	So that should be Hattie should start, don't you think?
1:45.1	Absolutely. Absolutely.
1:52.5	Okay. So if we've got a dog in acute adrenal crisis, I'm assuming that we're referring here to a dog with electrolyte disturbances that's collapsed and that needs acute emergency management.
2:01.6	So consider it putting aside for the moment those dogs that we do diagnose with
2:08.6	hypoedronocorticism that don't have any electrolyte disturbances.
2:14.6	I think in terms of the acute management fluids are vital. So in terms of managing the hypercalaemia
2:24.4	and things, actually if you give them high rates of fluids, that's going to address that pretty effectively if you give the kidneys
	...

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