Page 3 - Clinical Connections - Summer 2022

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Page 3 - Clinical Connections - Summer 2022
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LETTER FROM THE EDITOR

               Welcome to the summer 2022 edition                           surgical removal. Locoregional hyperthermia
          of Clinical Connections. In this issue we have                    combined with intratumoral chemotherapy
          a wealth of articles spanning fascinating                         has  been  developed  to  specifically  target
          clinical cases, progress in veterinary                            these types of tumours and has been shown
          techniques and technologies, the impact                           to be extremely effective.
          of small animal epidemiological studies on                          Page  7  features  an  article  about  how  our
          veterinary practice and animal welfare, and                       corneal cross-linking (CXL) initiative for small
          one on anatomic pathology.                                        animal, equine and exotics patients has been
            The lead article features the case of a one-                    progressing.  The procedure has now been
          year-old Rottweiler, Lorna, who was treated                       delivered by our Ophthalmology Service for
          for  an  acquired  obstruction  to  her  caudal                   two years and the article includes valuable
          vena cava, after an apparent run-in with a                        information about the procedure and its use
          deer. This had resulted in her having marked                      in managing infectious keratitis and malacia.
          regional venous hypertension and severe                           The CXL process increases the resistance
          unmanageable  ascites.  The  owners  opted                        of  corneal  tissue  to  enzymatic  digestion
          for a highly sophisticated surgical procedure,                    through  formation  of  new  chemical  bonds
          which was led by Professor Dan Brockman,                          between stromal fibres. It also has the ability
          Director  of  our  Cardiothoracic  Surgery  Service,  ably  assisted   to kill microorganisms regardless of their antimicrobial resistance
          by other members of our surgical and anesthesia teams. The   pattern. The article includes an interesting case of a Shetland
          surgery was successful and Lorna has returned to a happy and   pony called Growl  Tiger who had an excellent outcome after
          normal life – so much so that once her hair had grown back she   being treated with CXL.
          managed to almost achieve a bronze medal at Crufts!!   In an article spanning Page 8 and 9 we talk about the progress
            We are increasingly aware of the role intestinal dysbiosis   of  the  RVC’s  ambitious  VetCompass  initiative  (Veterinary
          may play in a range of disorders in body systems other than the   Companion Animal Surveillance System) over the last 15 years.
          gastrointestinal tract. Understandably, attention has tended to   The  original  aspiration,  of  improving  companion  animal  health
          focus on bacterial dysbiosis of the gut but don’t miss a fascinating   and welfare by harnessing the power of anonymised veterinary
          article by Ross Bond and Aarti Kathrani highlighting the possible   records to generate robust clinical evidence, has expanded over
          role of intestinal fungal dysbiosis in the overall process.   the years to include a range of species and a multitude of health
            On Page 5 Joe Fenn, Senior Lecturer in Veterinary Neurology   risks. As the initiative grew out of our desire to better understand
          and Neurosurgery, outlines the progress of hypophysectomy   what types of disorders and their management was happening in
          surgery over a decade at the RVC. The first cat with acromegaly   general practice, it has always been wholly dependent upon the
          and diabetes mellitus to undergo hypophysectomy was in 2012   support of vets across the UK and beyond. In that sense this is
          and this pioneering procedure has been followed over the   an initiative that has been delivered by the whole of the veterinary
          last decade by a further 120 cats and 25 dogs with functional   profession and facilitated by the RVC. We thank all those who
          pituitary tumours resulting in hypersomatotrophism or pituitary   have made clinical records available to us so we can learn from
          dependent Cushing’s syndrome. The results of this procedure   the data and share salient insights with fellow members of the
          have been incredibly rewarding, not just because of the high   veterinary professions in the wider world.
          proportion of animals that are effectively cured but also because   Finally, whether pathology is your thing or not, I’d encourage
          these cases require veterinary and veterinary nursing colleagues   you to read our Page 10 article by one of our recent anatomic
          from our Neurology and Neurosurgery, Critical Care, Internal   pathology residents, Kevin O’Brien. Kevin came from the USA to
          Medicine and Anaesthesia services all working closely together   undertake his residency here and his reflections are fascinating
          to minimise complications and post-operative hospitalisation and   and sometimes amusing. Completing such a programme during
          optimise outcomes generally. A perfect example of the value of   a pandemic throws up particular challenges – as you will have all
          the multidisciplinary veterinary team of which we are so proud at   found in your practice – but Kevin and the team took full advantage
          the Queen Mother Hospital for Animals.              of advances in technology, which made things somewhat easier.
            Our equine article on Page 6 concerns targeted treatment for
          inoperable melanomas. The Equine Referral Hospital has been   Professor David Church, Deputy Principal and Acting Vice
          using  locoregional hyperthermia  combined with  intratumoral   Principal (Clinical Affairs)
          chemotherapy to treat equine melanoma since January. Though a
          number of treatments are available for equine melanoma, none of
          them are 100% effective – and some lesions are not amenable to


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