1 00:00:01,470 --> 00:00:03,400 Welcome to the vet podcast, 2 00:00:03,854 --> 00:00:06,158 by the Vet guru, Brendan and Mark. 3 00:00:06,794 --> 00:00:08,781 Get ready for the latest veterinary news. 4 00:00:09,669 --> 00:00:12,448 Information and entertainment. Don't forget to visit us 5 00:00:12,448 --> 00:00:15,068 at the vet website. Vet dot com. 6 00:00:15,623 --> 00:00:16,576 Now. Sit back. 7 00:00:17,310 --> 00:00:19,170 Relax. It's over to the Vector, 8 00:00:19,789 --> 00:00:21,070 Brandon and Mark. 9 00:00:23,070 --> 00:00:23,570 Welcome 10 00:00:23,870 --> 00:00:26,363 to the Vector Brendan here with Mark. As 11 00:00:26,363 --> 00:00:27,661 always and 12 00:00:28,197 --> 00:00:30,112 mark you're on mute, I think this. So 13 00:00:30,191 --> 00:00:32,127 I need to unmute yourself 14 00:00:32,823 --> 00:00:36,449 after 300 plus episodes, we're still having technical 15 00:00:36,667 --> 00:00:38,899 issues. There you are. I can hear you. 16 00:00:40,414 --> 00:00:42,168 Yes. You're probably open in a can of 17 00:00:42,168 --> 00:00:44,241 beer or something I expect now in new 18 00:00:44,320 --> 00:00:47,278 Mark. Yeah is but we don't necessarily wanna 19 00:00:47,278 --> 00:00:48,255 expose our wonderful 20 00:00:49,742 --> 00:00:50,639 to hydrating 21 00:00:51,014 --> 00:00:51,093 yourself. 22 00:00:52,047 --> 00:00:53,558 No doubt. How are you Mark? 23 00:00:54,289 --> 00:00:56,526 I'm great, Brandon. I'm really... I was telling 24 00:00:56,526 --> 00:00:58,145 you before we came on air that 25 00:00:58,763 --> 00:00:59,483 I did a bit of, 26 00:01:01,320 --> 00:01:01,820 bush 27 00:01:02,531 --> 00:01:03,031 bush 28 00:01:03,485 --> 00:01:06,372 walking bush was the again. We we're were 29 00:01:06,508 --> 00:01:09,076 we were walking in un untrained bush just 30 00:01:09,213 --> 00:01:10,700 doing some cross country 31 00:01:11,056 --> 00:01:13,195 stuff to get to survey some of the 32 00:01:13,195 --> 00:01:15,834 animals up here during my, but it was 33 00:01:17,236 --> 00:01:17,736 exhausting 34 00:01:18,123 --> 00:01:19,811 I'd... I'd... Today, I feel 35 00:01:20,341 --> 00:01:22,639 as old as I really am, and that's 36 00:01:22,639 --> 00:01:24,857 a very very old It's very old. 37 00:01:26,381 --> 00:01:28,289 Don't usually feel like that, but I do 38 00:01:28,289 --> 00:01:31,388 today, saw these, sore ankles and the Quad 39 00:01:31,467 --> 00:01:33,636 Brendan, My my... Usually, my 40 00:01:34,343 --> 00:01:36,011 skinny little quad don't have to do too 41 00:01:36,011 --> 00:01:37,203 much work, but today. 42 00:01:38,474 --> 00:01:40,380 Leg for. A leg day. 43 00:01:41,016 --> 00:01:41,334 Yes. 44 00:01:41,890 --> 00:01:42,390 But 45 00:01:42,937 --> 00:01:45,000 It was worth it. I'm sure. It was 46 00:01:45,000 --> 00:01:45,738 worth it, 47 00:01:46,111 --> 00:01:46,825 for summer. 48 00:01:47,381 --> 00:01:48,174 It's for the 49 00:01:49,206 --> 00:01:49,706 amazing 50 00:01:50,254 --> 00:01:52,806 bush bash and the bush you get to 51 00:01:52,806 --> 00:01:54,959 see them out. Yes. Hold on. But now 52 00:01:55,039 --> 00:01:57,033 I I feel you're pain as we're talking 53 00:01:57,033 --> 00:01:58,708 about. I know what it's like. 54 00:01:59,425 --> 00:02:01,270 As as I say in the classic. It 55 00:02:01,270 --> 00:02:02,144 sucks getting old, 56 00:02:03,496 --> 00:02:05,483 and we are all getting older. 57 00:02:06,278 --> 00:02:07,391 Minute by minute mark. 58 00:02:08,284 --> 00:02:09,645 And I sit with that. We're gonna jump 59 00:02:09,645 --> 00:02:11,324 into our. We're our podcast and We're going 60 00:02:11,324 --> 00:02:13,965 to say, please send us an email edgar 61 00:02:13,965 --> 00:02:14,925 at g mail dot com. 62 00:02:15,645 --> 00:02:16,284 Say hello. 63 00:02:17,578 --> 00:02:18,766 Tell us how old you are, if you 64 00:02:18,766 --> 00:02:19,084 like. 65 00:02:19,876 --> 00:02:22,174 What you're up to, what country you are 66 00:02:22,174 --> 00:02:24,339 in what clinic you work at and 67 00:02:25,203 --> 00:02:28,633 what's your favorite species to treat this week 68 00:02:28,633 --> 00:02:30,627 or this year or of all time. 69 00:02:31,744 --> 00:02:34,456 We'd love getting emails and visit our website? 70 00:02:35,266 --> 00:02:37,094 Vet guru dot com. 71 00:02:37,729 --> 00:02:39,500 Poke around there. Look it out 72 00:02:40,430 --> 00:02:43,344 our 3 main sponsors and their websites 73 00:02:44,740 --> 00:02:47,372 support them because I support us mark. 74 00:02:48,249 --> 00:02:50,881 So we don't have any news stories because 75 00:02:50,881 --> 00:02:52,178 this is going to be a 76 00:02:53,048 --> 00:02:54,958 a mini cast, a little quick 1 mark, 77 00:02:55,117 --> 00:02:57,743 a little punchy podcast here, and do you 78 00:02:57,743 --> 00:02:59,891 wanted to chat about, which is a great 79 00:02:59,891 --> 00:03:02,294 little topic this 1, I think, it it 80 00:03:02,614 --> 00:03:05,091 it's an excellent 1 for 10 or 15 81 00:03:05,091 --> 00:03:05,330 minutes. 82 00:03:06,529 --> 00:03:07,269 Contrast radio 83 00:03:07,648 --> 00:03:08,547 as a diagnostic 84 00:03:08,926 --> 00:03:10,305 technique in exotic 85 00:03:10,619 --> 00:03:11,997 practice practicality. So 86 00:03:12,774 --> 00:03:15,327 shoving contrast into the animals and taking pics. 87 00:03:15,487 --> 00:03:17,243 Is that what we're talking about, Mark? It 88 00:03:17,243 --> 00:03:18,574 is indeed. I I think 89 00:03:19,573 --> 00:03:21,671 look, a lot of the reading I do 90 00:03:22,370 --> 00:03:22,870 about 91 00:03:23,888 --> 00:03:26,340 diagnostic processes does talk about 92 00:03:26,938 --> 00:03:29,750 more advanced imaging, a lot of clinics these 93 00:03:29,888 --> 00:03:31,744 have Ct scans or, 94 00:03:32,919 --> 00:03:35,311 ultrasound. There are a number of imaging modalities, 95 00:03:35,471 --> 00:03:35,844 but 96 00:03:36,284 --> 00:03:38,998 I just wanted to remind everyone of some 97 00:03:38,998 --> 00:03:42,611 of the valuable things that you can do 98 00:03:42,990 --> 00:03:44,427 when you just have an x ring machine. 99 00:03:45,879 --> 00:03:46,360 And 100 00:03:46,760 --> 00:03:48,919 and and the key thing I think here 101 00:03:48,919 --> 00:03:49,659 for me 102 00:03:50,199 --> 00:03:50,840 is that 103 00:03:52,040 --> 00:03:54,691 for many of our exotic species for many 104 00:03:54,691 --> 00:03:57,243 of the birds for many of the re 105 00:03:57,243 --> 00:03:58,440 reptile in particular. 106 00:03:59,237 --> 00:04:01,014 I find the 107 00:04:01,790 --> 00:04:02,290 contrast 108 00:04:03,639 --> 00:04:06,127 the detail that's rendered by our 109 00:04:06,900 --> 00:04:07,718 imaging systems 110 00:04:08,730 --> 00:04:10,025 on plane radio, 111 00:04:10,814 --> 00:04:13,448 to be a little bit well, difficult to 112 00:04:13,448 --> 00:04:15,763 interpret. And, you know, I think often of 113 00:04:15,763 --> 00:04:17,120 the bearded dragon with its 114 00:04:17,998 --> 00:04:19,296 lungs and air sac 115 00:04:20,405 --> 00:04:20,905 oblique 116 00:04:21,358 --> 00:04:22,948 positioned over the vis. 117 00:04:23,902 --> 00:04:24,402 And 118 00:04:25,015 --> 00:04:27,161 cheese. And there's times when those ace sacks 119 00:04:27,161 --> 00:04:28,535 are inflated and 120 00:04:29,163 --> 00:04:31,814 and you probably increase your 121 00:04:32,190 --> 00:04:35,557 contrast. But the way that the Vis thins 122 00:04:35,614 --> 00:04:37,389 down under that sort of 123 00:04:39,367 --> 00:04:42,303 at the the the poor root tissue, the 124 00:04:42,303 --> 00:04:42,621 lungs. 125 00:04:44,049 --> 00:04:47,000 Jeez can sometimes make it very difficult to 126 00:04:47,000 --> 00:04:50,017 interpret and the the yes trust in detail. 127 00:04:50,176 --> 00:04:52,081 Just doesn't let you say oh, that's the 128 00:04:52,081 --> 00:04:54,558 liver that's the flame. That's the stomach. And 129 00:04:54,558 --> 00:04:57,348 1 of the ways to highlight it is 130 00:04:57,348 --> 00:04:59,819 to have a little bit of contrast medium 131 00:04:59,819 --> 00:05:01,174 in the organ. 132 00:05:02,624 --> 00:05:04,240 And as you 133 00:05:04,937 --> 00:05:06,474 suggested or hinted or 134 00:05:06,931 --> 00:05:08,627 or said, the start markets 135 00:05:09,004 --> 00:05:11,658 relatively simple to do this, relatively, 136 00:05:12,766 --> 00:05:13,266 risk 137 00:05:14,276 --> 00:05:16,977 free or small risk to do and it's 138 00:05:16,977 --> 00:05:17,294 and it's... 139 00:05:18,168 --> 00:05:20,234 You could usually do it with most of 140 00:05:20,234 --> 00:05:22,635 our space especially a reptile mark. You can 141 00:05:22,635 --> 00:05:26,000 also chat talk about your use of this 142 00:05:26,057 --> 00:05:28,046 sort of technique in birds as well, Mark. 143 00:05:29,018 --> 00:05:31,013 With the reptile, you can do it without 144 00:05:31,013 --> 00:05:32,769 knocking them out. It's just p them on 145 00:05:32,769 --> 00:05:33,169 the plate, 146 00:05:34,366 --> 00:05:37,214 shove some bar down their gut and take 147 00:05:37,334 --> 00:05:39,010 the x rays. Is that what we're doing 148 00:05:39,010 --> 00:05:39,170 mark. 149 00:05:40,048 --> 00:05:41,963 Pretty much. I think the key thing here 150 00:05:41,963 --> 00:05:44,597 though, the the thing I want to emphasize 151 00:05:44,597 --> 00:05:47,406 is that there's there's 2... And in the 152 00:05:47,406 --> 00:05:50,039 literature, there's an increasing amount of information about 153 00:05:50,039 --> 00:05:52,513 the sort of 2 broad groups of contrast 154 00:05:52,513 --> 00:05:53,764 medium to use. So 155 00:05:54,201 --> 00:05:55,653 Traditionally, otherwise used 156 00:05:56,741 --> 00:05:57,138 Bar. 157 00:05:57,693 --> 00:05:57,852 Yep. 158 00:05:58,725 --> 00:06:00,336 But the I 159 00:06:01,999 --> 00:06:05,535 contrast media, sort of intravenous, things like Gas 160 00:06:06,074 --> 00:06:06,574 and. 161 00:06:08,311 --> 00:06:11,440 Those I don't base. Maybe I also have 162 00:06:11,440 --> 00:06:13,196 a a role to play. And there's been 163 00:06:13,196 --> 00:06:15,770 some recent publications that suggest 164 00:06:16,148 --> 00:06:17,127 the the 165 00:06:17,678 --> 00:06:19,847 that there may be benefits to choosing, 166 00:06:20,777 --> 00:06:21,277 those 167 00:06:21,730 --> 00:06:24,988 name based idle based contrast mediums over the 168 00:06:24,988 --> 00:06:27,731 bar based ones. But always otherwise is the 169 00:06:27,788 --> 00:06:30,041 the bar, I do find 170 00:06:31,215 --> 00:06:33,787 that if I pay attention to the 171 00:06:34,099 --> 00:06:34,418 dose. 172 00:06:34,977 --> 00:06:37,952 Because obviously, the problem, bar is highly irr 173 00:06:38,091 --> 00:06:41,364 to pulmonary tissue. And so the key thing 174 00:06:41,364 --> 00:06:42,960 you don't want to have happen. 175 00:06:43,693 --> 00:06:44,193 Is 176 00:06:45,124 --> 00:06:48,702 is aspiration, reg and aspiration, whether it's, you 177 00:06:48,702 --> 00:06:51,246 know, our typical, small animals, dogs and cats, 178 00:06:51,897 --> 00:06:53,724 whether it's a bird or whether it's a 179 00:06:53,724 --> 00:06:55,869 reptile, you want to make sure that whatever 180 00:06:55,869 --> 00:06:57,163 goes into 181 00:06:57,855 --> 00:06:58,252 the 182 00:06:58,728 --> 00:07:00,897 the gut stays there. So 183 00:07:01,603 --> 00:07:03,616 Ga is my sort of 184 00:07:05,106 --> 00:07:07,334 take home message there. I want to use 185 00:07:07,334 --> 00:07:09,244 a tube. I want to get it w 186 00:07:09,244 --> 00:07:10,779 down the Esophagus and 187 00:07:11,568 --> 00:07:13,958 and very close to the stomach. I wanna 188 00:07:13,958 --> 00:07:16,529 use volumes that are not gonna stretch 189 00:07:16,905 --> 00:07:19,295 the stomach so that there's a a chance 190 00:07:19,295 --> 00:07:20,331 the animal will good. 191 00:07:20,984 --> 00:07:23,219 Obviously in birds, I'm using a crop needle 192 00:07:23,219 --> 00:07:25,316 to place that in the crop 193 00:07:26,093 --> 00:07:27,072 and technically 194 00:07:27,610 --> 00:07:29,946 handling the bird in such a way. So 195 00:07:30,419 --> 00:07:33,365 that gravity helps keeping in the crop and 196 00:07:33,365 --> 00:07:35,993 that the bird is not distressed and moving 197 00:07:35,993 --> 00:07:38,541 against a handle hand, for example. 198 00:07:39,669 --> 00:07:41,019 All these things take 199 00:07:41,575 --> 00:07:43,560 if you can manage all those things get 200 00:07:43,560 --> 00:07:44,830 the correct volume, 201 00:07:45,624 --> 00:07:46,839 not over fill 202 00:07:47,149 --> 00:07:49,565 the the first part of the gastrointestinal 203 00:07:50,023 --> 00:07:50,523 tract 204 00:07:51,220 --> 00:07:53,216 and place it in the air, and it 205 00:07:53,216 --> 00:07:56,031 stays there. The contrast as a consequence 206 00:07:56,664 --> 00:08:00,037 highlights just the most important organs and makes 207 00:08:00,813 --> 00:08:03,367 makes it much easier to interpret the the 208 00:08:03,367 --> 00:08:05,851 ready grass that you take. Yes. Now with 209 00:08:05,851 --> 00:08:08,396 the interpretation, mark, you've highlighted, you've sent me 210 00:08:08,396 --> 00:08:09,214 a couple of 211 00:08:09,589 --> 00:08:11,974 papers there, and I'll I'll try and link 212 00:08:11,974 --> 00:08:13,485 to those in our show notes so at 213 00:08:13,485 --> 00:08:15,566 guru dot com. 1 in particular, 214 00:08:16,440 --> 00:08:19,062 the radio graphic anatomy and beer sulfate contrast 215 00:08:19,062 --> 00:08:22,579 transit time of the gastrointestinal intestine attractive bearded 216 00:08:22,579 --> 00:08:24,979 dragons mark. So Yeah. The beauty of these 217 00:08:24,979 --> 00:08:25,459 sorts of, 218 00:08:26,099 --> 00:08:28,899 practical type papers there. They they give you 219 00:08:28,899 --> 00:08:32,105 a a good breakdown on how long it 220 00:08:32,105 --> 00:08:35,123 will take in a normal animal for this 221 00:08:35,123 --> 00:08:37,664 bar to travel through the guardians. Is that 222 00:08:37,664 --> 00:08:40,259 correct? And and it's very it that is 223 00:08:40,539 --> 00:08:43,252 precisely correct. And it's really interesting, brandon because 224 00:08:43,412 --> 00:08:44,072 I often 225 00:08:44,769 --> 00:08:45,269 thought 226 00:08:45,726 --> 00:08:48,461 that the trans the transit time in 227 00:08:48,854 --> 00:08:50,549 in reptile is definitely 228 00:08:51,005 --> 00:08:51,802 slower, of course. 229 00:08:53,156 --> 00:08:54,851 But but this study 230 00:08:56,119 --> 00:08:58,512 traded that in healthy bearded dragons, the sort 231 00:08:58,512 --> 00:09:02,282 of average transit time for the the Bar 232 00:09:02,420 --> 00:09:04,574 contrast medium to get through the the gut 233 00:09:04,574 --> 00:09:05,792 was only about 234 00:09:06,422 --> 00:09:08,273 36 hours. And so 235 00:09:09,601 --> 00:09:12,701 that information is very useful in terms of 236 00:09:12,701 --> 00:09:15,667 giving us guidance about when particular Organs should 237 00:09:15,667 --> 00:09:18,544 be empty and when the the Bar should 238 00:09:18,544 --> 00:09:19,044 reach 239 00:09:20,062 --> 00:09:21,420 the the large bow. 240 00:09:22,553 --> 00:09:25,287 But, yeah, I was surprised how quickly 241 00:09:25,745 --> 00:09:26,702 generally speaking, 242 00:09:27,261 --> 00:09:30,148 such contrast medium goes through the gut. Yes. 243 00:09:30,547 --> 00:09:32,063 Although those of us who are not used 244 00:09:32,063 --> 00:09:34,218 to deal with exotic with gee, that's a 245 00:09:34,218 --> 00:09:35,815 long time. So you need to bear in 246 00:09:35,815 --> 00:09:37,591 mind that if you have that bitter dragon 247 00:09:38,144 --> 00:09:40,635 in for a series of radio graphs 248 00:09:41,808 --> 00:09:42,308 with 249 00:09:42,684 --> 00:09:44,516 contrast, Mark. You need to keep it for 250 00:09:44,516 --> 00:09:45,812 a couple of days I. 251 00:09:47,558 --> 00:09:47,717 Initially, 252 00:09:49,071 --> 00:09:50,186 initially, you'll probably take picks, 253 00:09:51,222 --> 00:09:54,009 take some radio graphs every every hour or 254 00:09:54,009 --> 00:09:54,726 so. And then, 255 00:09:55,523 --> 00:09:56,294 you you 256 00:09:57,527 --> 00:09:59,833 typically didn't think about taking it every what 257 00:09:59,833 --> 00:10:02,219 4 to 6 or 12 hours. Yeah. Exactly. 258 00:10:02,775 --> 00:10:04,922 The other thing that's interesting when talking about 259 00:10:04,922 --> 00:10:06,250 transit times is that 260 00:10:06,846 --> 00:10:09,155 if you are using 1 of the the, 261 00:10:10,986 --> 00:10:11,486 I 262 00:10:12,817 --> 00:10:13,613 contrast mediums, 263 00:10:14,742 --> 00:10:16,970 they tend to go through 264 00:10:17,527 --> 00:10:18,959 maybe 50 percent quicker. 265 00:10:19,675 --> 00:10:22,960 So the medium, the contrast medium you use 266 00:10:23,017 --> 00:10:26,209 may well change the rate of transit time. 267 00:10:26,605 --> 00:10:28,828 So it's important to be aware of that. 268 00:10:28,987 --> 00:10:30,971 And as you said, use papers that refer 269 00:10:30,971 --> 00:10:32,344 to the specific tran 270 00:10:34,090 --> 00:10:34,829 contrast medium 271 00:10:35,366 --> 00:10:37,120 transit times that you're using. 272 00:10:37,759 --> 00:10:37,998 Yes. 273 00:10:38,795 --> 00:10:40,550 I'm in a good idea not that I've 274 00:10:40,550 --> 00:10:42,087 done it, Mark, and I should 275 00:10:43,039 --> 00:10:43,539 is 276 00:10:44,158 --> 00:10:45,457 if you have some 277 00:10:46,155 --> 00:10:47,774 of your own pets or your 278 00:10:48,873 --> 00:10:51,131 clients who are willing to 279 00:10:52,404 --> 00:10:54,404 donate them for a day or 2 and 280 00:10:54,404 --> 00:10:56,665 to do do some of your in house 281 00:10:57,845 --> 00:10:59,764 studies there mark, and then you can get 282 00:10:59,764 --> 00:11:02,658 some benchmarks of particular list species that you 283 00:11:02,658 --> 00:11:03,857 may be commonly seen. 284 00:11:04,656 --> 00:11:06,334 And with the gear that you're using in 285 00:11:06,414 --> 00:11:08,732 Your clinic as well. So, you know, I 286 00:11:08,732 --> 00:11:10,570 think that's something that might be oswald worthwhile. 287 00:11:11,381 --> 00:11:13,393 Worthwhile. What... But now you meant... You briefly 288 00:11:13,450 --> 00:11:15,438 mentioned the risks mark. What what are the 289 00:11:15,438 --> 00:11:18,559 main things were would look kin for, 290 00:11:19,198 --> 00:11:21,195 dangers and and how to prevent them. If 291 00:11:21,195 --> 00:11:23,272 you just wanna summarize that again. Well, the 292 00:11:23,272 --> 00:11:25,290 key thing, the biggest risk 293 00:11:25,603 --> 00:11:26,103 is 294 00:11:27,032 --> 00:11:29,756 aspiration, aspiration ammonia bar in particular 295 00:11:30,129 --> 00:11:30,606 is 296 00:11:31,320 --> 00:11:33,250 is hugely irr 297 00:11:33,558 --> 00:11:34,376 to respiratory 298 00:11:34,907 --> 00:11:35,304 Mucosa. 299 00:11:35,939 --> 00:11:38,716 So irr that it can cause, 300 00:11:39,271 --> 00:11:39,771 monstrous 301 00:11:40,382 --> 00:11:40,882 overwhelming 302 00:11:41,254 --> 00:11:41,413 inflammation. 303 00:11:42,544 --> 00:11:46,379 And destroy the function of the respiratory system. 304 00:11:46,539 --> 00:11:49,575 There are definitely animals who have asp bar. 305 00:11:50,308 --> 00:11:50,786 And 306 00:11:51,422 --> 00:11:54,866 developed a fatal p as a consequence. So 307 00:11:55,003 --> 00:11:56,139 you definitely wanna 308 00:11:56,992 --> 00:11:58,424 limit the chance of that. If you have 309 00:11:58,424 --> 00:11:59,083 an animal 310 00:11:59,951 --> 00:12:03,134 that is, you know, that's nauseous, for example, 311 00:12:03,851 --> 00:12:05,943 yeah And well, maybe you 312 00:12:06,477 --> 00:12:08,251 suspect an obstruction. 313 00:12:09,598 --> 00:12:13,350 Then lessen the volume once again, so the 314 00:12:13,350 --> 00:12:14,888 sort of recommended volumes, 315 00:12:15,905 --> 00:12:17,741 I always error on the side of, 316 00:12:19,034 --> 00:12:21,115 being a little bit conservative. But if I 317 00:12:21,115 --> 00:12:23,454 think there's a chance that we could have 318 00:12:24,475 --> 00:12:25,995 some or vomiting. 319 00:12:26,809 --> 00:12:29,678 And then I'll even use slightly smaller amounts. 320 00:12:30,953 --> 00:12:31,352 And 321 00:12:31,830 --> 00:12:34,322 and because the contrast medium is so 322 00:12:35,270 --> 00:12:38,157 you know, it absolutely blocks out the 323 00:12:39,009 --> 00:12:39,804 the x rays. 324 00:12:40,918 --> 00:12:41,418 Often 325 00:12:41,808 --> 00:12:45,172 particularly with small patients relatively small volumes will 326 00:12:45,388 --> 00:12:46,365 still give you useful 327 00:12:46,819 --> 00:12:46,978 information. 328 00:12:48,981 --> 00:12:50,727 And the other, it's a bit of a 329 00:12:50,727 --> 00:12:53,370 bit of a catch 2. The other potential 330 00:12:54,774 --> 00:12:55,274 danger 331 00:12:56,202 --> 00:12:56,941 that we 332 00:12:57,649 --> 00:13:00,126 probably my views in these to try and 333 00:13:00,126 --> 00:13:01,565 determine a problem with the gut, 334 00:13:02,684 --> 00:13:03,184 And 335 00:13:03,962 --> 00:13:05,721 if we have a perforation there, Mark, 336 00:13:06,760 --> 00:13:07,594 exactly So 337 00:13:08,453 --> 00:13:10,530 you know, it's a it's it's tricky isn't 338 00:13:10,530 --> 00:13:12,607 it because we're... We're we're using it to 339 00:13:12,607 --> 00:13:15,418 try and enhance the rad graph to to 340 00:13:15,418 --> 00:13:15,977 detect a, 341 00:13:16,615 --> 00:13:19,088 intestinal instruction or or but we may have 342 00:13:19,088 --> 00:13:19,748 a per 343 00:13:21,163 --> 00:13:22,853 part of the gut there that when we 344 00:13:22,853 --> 00:13:24,609 go in there and do the surgery that, 345 00:13:25,008 --> 00:13:27,003 hopefully, we're getting in there pretty damn quick 346 00:13:27,003 --> 00:13:28,998 after that, so we don't have much of 347 00:13:28,998 --> 00:13:31,348 that leakage of that that bar 348 00:13:32,283 --> 00:13:34,756 around that can be very irr outside the 349 00:13:34,756 --> 00:13:35,793 gut as well counted. 350 00:13:36,431 --> 00:13:38,186 And and that's 1 of the reasons that 351 00:13:38,186 --> 00:13:40,042 you might contemplate using 352 00:13:40,834 --> 00:13:42,192 the iodine based ones, 353 00:13:42,831 --> 00:13:45,228 they're certainly less likely to cause a problem. 354 00:13:45,388 --> 00:13:47,326 If you think you've got a perforation 355 00:13:48,439 --> 00:13:48,678 that, 356 00:13:49,877 --> 00:13:50,676 aspiration is 357 00:13:51,235 --> 00:13:53,972 you know, reg and aspiration is more likely. 358 00:13:55,641 --> 00:13:58,208 Then then using the iodine based ones 359 00:13:58,821 --> 00:14:01,523 is is far less likely to lead to 360 00:14:01,523 --> 00:14:02,023 those 361 00:14:02,398 --> 00:14:02,636 complications. 362 00:14:03,446 --> 00:14:05,196 And even to the point of... If you've 363 00:14:05,196 --> 00:14:06,150 got a foreign body, 364 00:14:07,423 --> 00:14:07,923 and 365 00:14:08,933 --> 00:14:12,210 you are planning surgery, you you obviously don't 366 00:14:12,210 --> 00:14:15,077 want the bar sort of floating around your, 367 00:14:16,351 --> 00:14:18,024 whatever it gives it will be the dragons, 368 00:14:18,262 --> 00:14:19,537 manage to stuff in their gold. 369 00:14:20,188 --> 00:14:21,059 And swallow. 370 00:14:21,693 --> 00:14:23,516 And so that's... Yeah. If it is a 371 00:14:23,516 --> 00:14:25,601 little. That's probably the only thing I would 372 00:14:25,656 --> 00:14:26,473 reflex the 373 00:14:27,654 --> 00:14:29,190 with a, a gastrointestinal 374 00:14:29,647 --> 00:14:29,886 patient, 375 00:14:30,524 --> 00:14:31,880 put a little bit of bearing in, but 376 00:14:31,880 --> 00:14:33,395 a little bit of thought in some of 377 00:14:33,395 --> 00:14:36,287 those cases about the risks and the likely 378 00:14:37,155 --> 00:14:37,655 consequences. 379 00:14:39,459 --> 00:14:39,618 Yeah. 380 00:14:40,413 --> 00:14:42,240 It would be too much to there. 381 00:14:43,353 --> 00:14:46,313 Mark. If happened. Now you wanted to chat 382 00:14:46,313 --> 00:14:49,816 about other types of contrast radio. 1 in 383 00:14:49,816 --> 00:14:50,715 particular using 384 00:14:51,250 --> 00:14:52,046 using air. 385 00:14:52,936 --> 00:14:53,891 Well, I I do... 386 00:14:55,084 --> 00:14:55,743 I did 387 00:14:56,436 --> 00:14:58,186 a bit of a search once I've gotten 388 00:14:58,186 --> 00:14:59,243 a couple of papers 389 00:14:59,873 --> 00:15:01,468 about contrast. Medium. I... 390 00:15:02,505 --> 00:15:03,781 I did a bit of a search, and 391 00:15:03,781 --> 00:15:04,520 there is 392 00:15:05,057 --> 00:15:06,972 some... I haven't used it, but there is 393 00:15:06,972 --> 00:15:08,886 some publication to suggest that 394 00:15:11,686 --> 00:15:13,857 injecting air into the sealant 395 00:15:15,027 --> 00:15:16,163 can add 396 00:15:17,192 --> 00:15:17,909 a level of, 397 00:15:18,706 --> 00:15:19,206 changed 398 00:15:19,583 --> 00:15:21,279 contrast that might allow 399 00:15:21,815 --> 00:15:24,707 you to highlight particular mass lesions or 400 00:15:25,179 --> 00:15:27,433 I haven't used it and I would worry 401 00:15:28,927 --> 00:15:30,842 because the the rep tolls that we deal 402 00:15:30,842 --> 00:15:33,075 with. They're very forgiving, but they don't have 403 00:15:33,075 --> 00:15:34,373 a a 404 00:15:35,720 --> 00:15:38,528 diaphragm and if we're injecting air 405 00:15:39,699 --> 00:15:43,042 enough air to provide altered contrast to the 406 00:15:43,042 --> 00:15:43,997 abdominal Vis, 407 00:15:45,443 --> 00:15:47,829 I do worry that there might be some 408 00:15:47,829 --> 00:15:48,329 respiratory 409 00:15:48,703 --> 00:15:49,203 consequences. 410 00:15:50,452 --> 00:15:52,463 But that that is a published technique 411 00:15:53,156 --> 00:15:53,656 to 412 00:15:54,844 --> 00:15:56,063 to inject 413 00:15:56,762 --> 00:15:57,262 air 414 00:15:57,880 --> 00:16:00,458 into the sealant to provide 415 00:16:00,917 --> 00:16:03,015 an additional contrast. Yeah 416 00:16:03,330 --> 00:16:05,009 And it sort of mimics what happens in 417 00:16:05,009 --> 00:16:06,690 birds, birds with their air sacks. 418 00:16:07,649 --> 00:16:09,110 You can see some really 419 00:16:09,490 --> 00:16:11,819 exquisite detail a consequence of the s x. 420 00:16:12,058 --> 00:16:13,355 It's the part of the body 421 00:16:14,130 --> 00:16:15,108 where the 422 00:16:16,201 --> 00:16:18,549 abdominal Visceral a sort of all packed onto 423 00:16:18,688 --> 00:16:20,846 each other and very close to the reproductive 424 00:16:20,846 --> 00:16:23,583 tract. That's where some contrast, medium 425 00:16:24,202 --> 00:16:27,035 inside those organs inside the gastrointestinal 426 00:16:27,415 --> 00:16:30,475 tract will allow you to distinguish between Gi 427 00:16:30,774 --> 00:16:33,575 changes and maybe reproductive changes in birds? 428 00:16:34,134 --> 00:16:35,115 Yes. Now 429 00:16:36,068 --> 00:16:36,865 finally, mark, 430 00:16:38,701 --> 00:16:41,014 birds now I hinted at the fact that 431 00:16:41,014 --> 00:16:42,552 with a lot of our reptile 432 00:16:43,024 --> 00:16:45,975 we can take those ready without any form 433 00:16:45,975 --> 00:16:48,049 of s accommodation or anesthesia at all. So 434 00:16:48,049 --> 00:16:49,803 what's your process with the birds and do 435 00:16:49,803 --> 00:16:50,702 you have any 436 00:16:51,080 --> 00:16:52,537 concerns about that 437 00:16:53,805 --> 00:16:56,833 contrast agent that you've gathered that bird with, 438 00:16:58,905 --> 00:16:59,803 coming out, 439 00:17:00,259 --> 00:17:01,694 when you have it... If you have it 440 00:17:01,694 --> 00:17:02,353 an ace. 441 00:17:02,982 --> 00:17:05,682 Definitely Have a concern. And with many birds, 442 00:17:06,555 --> 00:17:07,928 I would probably 443 00:17:08,381 --> 00:17:11,501 make significant efforts to secure the airway 444 00:17:12,848 --> 00:17:15,565 so that if there was a reg good 445 00:17:15,565 --> 00:17:15,884 event, 446 00:17:16,843 --> 00:17:19,340 that the that I had the airways 447 00:17:19,654 --> 00:17:21,194 protected with an endo 448 00:17:21,654 --> 00:17:22,375 tube and 449 00:17:22,934 --> 00:17:25,174 and, you know, even if I've just placed 450 00:17:25,174 --> 00:17:26,234 that for the 451 00:17:26,948 --> 00:17:28,459 2 or 3 minutes that it takes to 452 00:17:28,459 --> 00:17:30,129 get a couple of radio graphs. 453 00:17:31,401 --> 00:17:33,650 I am much more confident 454 00:17:35,074 --> 00:17:37,007 than if I just left the bird 455 00:17:38,736 --> 00:17:41,443 without airway protection. There are some times and 456 00:17:41,443 --> 00:17:42,501 some birds where 457 00:17:43,929 --> 00:17:44,429 placing 458 00:17:44,730 --> 00:17:46,649 an e tube is gonna make the whole 459 00:17:46,649 --> 00:17:47,950 process more complicated. 460 00:17:48,649 --> 00:17:51,545 And I definitely depend on gravity and in 461 00:17:51,545 --> 00:17:52,365 those circumstances. 462 00:17:52,745 --> 00:17:54,445 So I would place the 463 00:17:54,985 --> 00:17:57,545 on some form of incline board. 464 00:17:58,025 --> 00:17:59,144 Yeah. So that, 465 00:17:59,879 --> 00:18:03,011 so that the it wasn't easy for the 466 00:18:03,309 --> 00:18:05,781 the contrast medium to run up hill as 467 00:18:05,781 --> 00:18:07,456 it were and and get to a point 468 00:18:07,456 --> 00:18:09,312 where it could be, asp 469 00:18:10,264 --> 00:18:12,022 And the other thing, of course, I mentioned 470 00:18:12,022 --> 00:18:12,841 it before 471 00:18:13,460 --> 00:18:13,960 handling. 472 00:18:14,978 --> 00:18:17,955 The the crop birds just sits as a 473 00:18:18,189 --> 00:18:20,416 a flux sac at the base of the 474 00:18:20,416 --> 00:18:20,735 neck. 475 00:18:21,530 --> 00:18:24,554 I know vigorous pal patient of that region 476 00:18:24,873 --> 00:18:26,664 in a sedated or an 477 00:18:27,045 --> 00:18:28,105 patient could definitely 478 00:18:28,964 --> 00:18:30,325 squeeze like toothpaste, 479 00:18:31,204 --> 00:18:34,244 Bar up any contents of the crop up 480 00:18:34,244 --> 00:18:35,617 towards the the 481 00:18:36,255 --> 00:18:38,807 the, ph and put it in the vicinity 482 00:18:38,807 --> 00:18:41,119 of the lot and make aspiration real danger. 483 00:18:41,278 --> 00:18:41,778 So, 484 00:18:42,713 --> 00:18:44,797 avoiding pal painting that area if the the... 485 00:18:45,035 --> 00:18:47,654 This paste mess method now. It always lets 486 00:18:47,654 --> 00:18:49,241 us stay brendan. And you know it. 487 00:18:50,829 --> 00:18:50,987 Well, 488 00:18:52,198 --> 00:18:54,276 I think with that, Mark, that's a great 489 00:18:54,276 --> 00:18:56,432 little summary there, and it... It's I think 490 00:18:56,432 --> 00:18:58,450 it's something that we often 491 00:18:58,844 --> 00:19:01,960 do not consider that's a simple technique that's 492 00:19:01,960 --> 00:19:05,176 very rewarding and helping us with that 493 00:19:06,126 --> 00:19:09,486 diagnostics there Mark, using contrast radio, 494 00:19:09,940 --> 00:19:12,084 and we'll link to those 2 papers. The 495 00:19:12,084 --> 00:19:13,196 other the other paper was 496 00:19:14,324 --> 00:19:16,233 with red sliders, 497 00:19:17,107 --> 00:19:19,835 the the comparison with bar 498 00:19:20,210 --> 00:19:21,187 and gas, 499 00:19:23,169 --> 00:19:25,164 and transit times as well. So 500 00:19:25,643 --> 00:19:27,738 I think with that, Mark, we'll it we'll 501 00:19:27,957 --> 00:19:28,994 get out of here. I'm gonna talk to 502 00:19:28,994 --> 00:19:30,590 you next week. Thanks for listening. 503 00:19:38,765 --> 00:19:41,098 Thanks link to the vet podcast by the 504 00:19:41,258 --> 00:19:41,897 Vet guru. 505 00:19:42,376 --> 00:19:43,895 Don't forget to visit us at the website, 506 00:19:44,134 --> 00:19:46,852 vet guru dot com where you can subscribe, 507 00:19:47,171 --> 00:19:49,978 view show notes, listen the previous episodes and 508 00:19:49,978 --> 00:19:52,440 more. You can contact us via email and 509 00:19:52,440 --> 00:19:54,903 vet guru at gmail dot com to ask 510 00:19:54,903 --> 00:19:57,228 a question or just say hi. Thanks again, 511 00:19:57,548 --> 00:19:58,587 and see you next time.