Cats are not small dogs – Vet Festival 2017

Noel Fitzpatrick at Vet Festival 2017

Sometimes I take for granted how much we now know, and this morning when someone said that when they were learning they were told that if you get cat bones in the same room then fractures will heal I was surprised. This was even more shocking as these words came from Prof Noel Fitzpatrick.

The dog has always been the top priority when it comes to vets, then cats became more popular as more has become known, and now the same thing is happening with the development of rabbit medicine. However this is about cats so back on track…

So Noel gave a tour through the cat skeleton looking at different problems and the solutions including some new ideas of own creation. Also here there was indication that a discussion is needed about the problems involved about getting new ideas out to share them with the world.

Either fortunately or unfortunately depending on the way you look at it there are well established rules within medicine and surgery. A lot of them help keep patients safe, and help prevent surgeons getting into trouble however sometimes they may be relied on too much without an understanding of why they exist – on in fact questioning their very existence. What resonated with me here was Noel saying that rules are there for a reason; however you need to understand when to break them.

This is in reference to a specific rule when it comes to using external fixation (rods and pins outside the body) to put fractures back together again. There is a rule that you can only use safe corridors which avoid muscles and other tissues when placing your pins. This rule means that ideally there are limited places where you can use external fixation as these safe corridors not exist in other places. Noel has tried to publish without success a series of 250+ successful cases where he has used external fixation on the cats pelvis without any complications which breaks the safe corridor rule but shows when done correctly it is successful.

A more light hearted moment was when Noel was told that he could not use the acronym SPIDER for a technique he developed for fixing toe fractures if he wanted to be published. Sometimes the best part of inventing something new is being able to give it a name and so the challenge has now been set for the first person to publish something with a SPIDER acronym…

The real osmosis education

Audience learning at vet festival

Many times I wish that I could just put a book under my pillow and it will be absorbed overnight as I sleep… I’ve tried (both under and on top) and unfortunately have never got this to work.

What I have found though is that there are some people that you can simply just be in the same room as and you will start absorbing knowledge and learning. These people just have something special – I have no clue whether it is the passion for teaching or something else however they just turn up and you start learning.

I’ve become better at recognising these people. They are the ones that I will look for when I go places to see practice or to conference. This weekend at the Vet Festival has been the same, sometimes I’ve not even bothered looking at the topic once I have seen the speakers name. It doesn’t matter what they are teaching, I will learn something useful because of the way they teach it.

This is something I think Noel has excelled at with the VET Festival as its not just about sitting in tents for a weekend, it is about how on Monday when you are back treating patients the care you can give has improved. Whether it is simply by using drugs in a different way, or just being confident enough to treat based on the clinical presentation instead of the diagnostic tests. It is understanding how to tell the difference between a problem in the eye and a problem in the brain. Or knowing where else to look when you get a tumour in a certain place.

The speakers at VET Festival all had this quality. When Clare overran and told people to leave if they had to not a single person moved. It is this that makes VET Festival truly special…

Vet Festival 2016 – Day 2 Roundup

Dr Laurent Findji on skin resconstruction

Sometimes you have that feeling where you know it’s the last day and you don’t want it to end. This is how I woke up this morning, excited for what I was to learn today, yet sad that in a little over 18 hours it was all going be over. I am hungry to learn, and every single thing I learn here will help me become a better vet.

Today started again with Prof Nick Bacon talking about thoracotomies which is where the chest is opened through the space between 2 ribs. This is normally used for surgery on the heart or lungs and sometimes just to remove tumours from within this space. The amount of information shared in this session was incredible – my take home point however was to consider all information and anatomy to determine the surgical approach. Sometimes it is easier, less painful and more sensible to make an approach through the abdomen under the rib cage.

Dr Philipp Mayhew talks thoracoscopy

Philipp Mayhew then again took the stage to look at how to work on the chest using a minimally invasive approach. Unfortunately with the size of the animal you are limited in what you can do with a key hole technique as things such as surgical staplers to remove a lobe of the lung are too bulky for smaller patients. However the ability to approach the chest with this technique does reduce the post-operative pain and improves recovery immensely as you are not pulling the ribs apart. In humans doing surgery thoracoscopically instead of open thoracotomy results in less pain, drainage, sepsis, pneumonia, and death.

Dr Clare Rusbridge talks chronic pain

After this I continued with Dr Clare Rusbridge – one of the best speakers I have ever come across who makes complicated things really simple. Today it was about chronic pain, syringomyelia and chiari-like malformation. I’d tried to learn about pain myself, however it is something really difficult to wrap your head around as there are different pathways and receptors. Here Clare spoke about the pain in context of the Cavalier King Charles Spaniel which due to bad breeding often suffers from these two painful conditions which affect the brain and spinal cord causing chronic pain. Chronic pain cannot be controlled with normal medicines as these do not act on the pathways activated with chronic pain.

Dr Laurent Findji on skin resconstruction

The next lecture was especially interesting for me as I had spent a few days in practice at the Fitzpatrick Referrals Oncology and Soft Tissue Hospital with Dr Laurent Findji. Laurent now was talking about skin flaps and reconstructive surgery. This is especially important in oncology surgery where you need to have the confidence in putting it back together again to cut loads of skin and tissue away to remove the entire tumour. In some human hospitals for oncology there are separate surgical teams for the removal of the tumour and reconstruction afterwards so that fear does not prevent removal of all cancerous tissue.

Prof Noel Fitzpatrick Limb Amputation vs Limb Salvage

Prof Noel Fitzpatrick took the stage again to discuss limb amputation vs limb salvage. This is something that is very possible now, however the question has now become just because we can, should we? This is usually required as the results from trauma or bone cancer, an important point to note here is that if a suspicion of bone cancer is there and limb salvage is an option then incisional biopsies should be avoided to prevent spread of tumour cells.

Sir Christopher Evans keynote Vet Festival 2016

The conference keynote was given by Sir Christopher Evans, a scientist that has been amazingly successful in turning science to profit. Nature is amazing, and yet it is something that is not really well understood, and Sir Christopher shared his story on how he used his knowledge combined with nature to create products that were in demand. Not once, but again and again. It was an inspirational story, and left one with much to think about.

ONE Live Concert 2016

The day ended with Prof Noel Fitzpatrick inviting everyone to join him at the ONE LIVE Festival to celebrate the difference that vets, vet nurses and everyone else in practice makes to the lives of animals every day. This is a reminder for every single person in practice out there that people care about the difference that you make every single day!