Welcome to the vet podcast,
by the Vet guru, Brendan and Mark.
Get ready for the latest veterinary news.
Information and entertainment. Don't forget to visit us
at the vet website. Vet dot com.
Now. Sit back.
Relax. It's over to the Vector,
Brandon and Mark.
Welcome
to the Vector Brendan here with Mark. As
always and
mark you're on mute, I think this. So
I need to unmute yourself
after 300 plus episodes, we're still having technical
issues. There you are. I can hear you.
Yes. You're probably open in a can of
beer or something I expect now in new
Mark. Yeah is but we don't necessarily wanna
expose our wonderful
to hydrating
yourself.
No doubt. How are you Mark?
I'm great, Brandon. I'm really... I was telling
you before we came on air that
I did a bit of,
bush
walking bush was the again. We we're were
we were walking in un untrained bush just
doing some cross country
stuff to get to survey some of the
animals up here during my, but it was
exhausting
I'd... I'd... Today, I feel
as old as I really am, and that's
a very very old It's very old.
Don't usually feel like that, but I do
today, saw these, sore ankles and the Quad
Brendan, My my... Usually, my
skinny little quad don't have to do too
much work, but today.
Leg for. A leg day.
Yes.
But
It was worth it. I'm sure. It was
worth it,
for summer.
It's for the
amazing
bush bash and the bush you get to
see them out. Yes. Hold on. But now
I I feel you're pain as we're talking
about. I know what it's like.
As as I say in the classic. It
sucks getting old,
and we are all getting older.
Minute by minute mark.
And I sit with that. We're gonna jump
into our. We're our podcast and We're going
to say, please send us an email edgar
at g mail dot com.
Say hello.
Tell us how old you are, if you
like.
What you're up to, what country you are
in what clinic you work at and
what's your favorite species to treat this week
or this year or of all time.
We'd love getting emails and visit our website?
Vet guru dot com.
Poke around there. Look it out
our 3 main sponsors and their websites
support them because I support us mark.
So we don't have any news stories because
this is going to be a
a mini cast, a little quick 1 mark,
a little punchy podcast here, and do you
wanted to chat about, which is a great
little topic this 1, I think, it it
it's an excellent 1 for 10 or 15
minutes.
Contrast radio
as a diagnostic
technique in exotic
practice practicality. So
shoving contrast into the animals and taking pics.
Is that what we're talking about, Mark? It
is indeed. I I think
look, a lot of the reading I do
about
diagnostic processes does talk about
more advanced imaging, a lot of clinics these
have Ct scans or,
ultrasound. There are a number of imaging modalities,
but
I just wanted to remind everyone of some
of the valuable things that you can do
when you just have an x ring machine.
And
and and the key thing I think here
for me
is that
for many of our exotic species for many
of the birds for many of the re
reptile in particular.
I find the
contrast
the detail that's rendered by our
imaging systems
on plane radio,
to be a little bit well, difficult to
interpret. And, you know, I think often of
the bearded dragon with its
lungs and air sac
oblique
positioned over the vis.
And
cheese. And there's times when those ace sacks
are inflated and
and you probably increase your
contrast. But the way that the Vis thins
down under that sort of
at the the the poor root tissue, the
lungs.
Jeez can sometimes make it very difficult to
interpret and the the yes trust in detail.
Just doesn't let you say oh, that's the
liver that's the flame. That's the stomach. And
1 of the ways to highlight it is
to have a little bit of contrast medium
in the organ.
And as you
suggested or hinted or
or said, the start markets
relatively simple to do this, relatively,
risk
free or small risk to do and it's
and it's...
You could usually do it with most of
our space especially a reptile mark. You can
also chat talk about your use of this
sort of technique in birds as well, Mark.
With the reptile, you can do it without
knocking them out. It's just p them on
the plate,
shove some bar down their gut and take
the x rays. Is that what we're doing
mark.
Pretty much. I think the key thing here
though, the the thing I want to emphasize
is that there's there's 2... And in the
literature, there's an increasing amount of information about
the sort of 2 broad groups of contrast
medium to use. So
Traditionally, otherwise used
Bar.
Yep.
But the I
contrast media, sort of intravenous, things like Gas
and.
Those I don't base. Maybe I also have
a a role to play. And there's been
some recent publications that suggest
the the
that there may be benefits to choosing,
those
name based idle based contrast mediums over the
bar based ones. But always otherwise is the
the bar, I do find
that if I pay attention to the
dose.
Because obviously, the problem, bar is highly irr
to pulmonary tissue. And so the key thing
you don't want to have happen.
Is
is aspiration, reg and aspiration, whether it's, you
know, our typical, small animals, dogs and cats,
whether it's a bird or whether it's a
reptile, you want to make sure that whatever
goes into
the
the gut stays there. So
Ga is my sort of
take home message there. I want to use
a tube. I want to get it w
down the Esophagus and
and very close to the stomach. I wanna
use volumes that are not gonna stretch
the stomach so that there's a a chance
the animal will good.
Obviously in birds, I'm using a crop needle
to place that in the crop
and technically
handling the bird in such a way. So
that gravity helps keeping in the crop and
that the bird is not distressed and moving
against a handle hand, for example.
All these things take
if you can manage all those things get
the correct volume,
not over fill
the the first part of the gastrointestinal
tract
and place it in the air, and it
stays there. The contrast as a consequence
highlights just the most important organs and makes
makes it much easier to interpret the the
ready grass that you take. Yes. Now with
the interpretation, mark, you've highlighted, you've sent me
a couple of
papers there, and I'll I'll try and link
to those in our show notes so at
guru dot com. 1 in particular,
the radio graphic anatomy and beer sulfate contrast
transit time of the gastrointestinal intestine attractive bearded
dragons mark. So Yeah. The beauty of these
sorts of,
practical type papers there. They they give you
a a good breakdown on how long it
will take in a normal animal for this
bar to travel through the guardians. Is that
correct? And and it's very it that is
precisely correct. And it's really interesting, brandon because
I often
thought
that the trans the transit time in
in reptile is definitely
slower, of course.
But but this study
traded that in healthy bearded dragons, the sort
of average transit time for the the Bar
contrast medium to get through the the gut
was only about
36 hours. And so
that information is very useful in terms of
giving us guidance about when particular Organs should
be empty and when the the Bar should
reach
the the large bow.
But, yeah, I was surprised how quickly
generally speaking,
such contrast medium goes through the gut. Yes.
Although those of us who are not used
to deal with exotic with gee, that's a
long time. So you need to bear in
mind that if you have that bitter dragon
in for a series of radio graphs
with
contrast, Mark. You need to keep it for
a couple of days I.
Initially,
initially, you'll probably take picks,
take some radio graphs every every hour or
so. And then,
you you
typically didn't think about taking it every what
4 to 6 or 12 hours. Yeah. Exactly.
The other thing that's interesting when talking about
transit times is that
if you are using 1 of the the,
I
contrast mediums,
they tend to go through
maybe 50 percent quicker.
So the medium, the contrast medium you use
may well change the rate of transit time.
So it's important to be aware of that.
And as you said, use papers that refer
to the specific tran
contrast medium
transit times that you're using.
Yes.
I'm in a good idea not that I've
done it, Mark, and I should
is
if you have some
of your own pets or your
clients who are willing to
donate them for a day or 2 and
to do do some of your in house
studies there mark, and then you can get
some benchmarks of particular list species that you
may be commonly seen.
And with the gear that you're using in
Your clinic as well. So, you know, I
think that's something that might be oswald worthwhile.
Worthwhile. What... But now you meant... You briefly
mentioned the risks mark. What what are the
main things were would look kin for,
dangers and and how to prevent them. If
you just wanna summarize that again. Well, the
key thing, the biggest risk
is
aspiration, aspiration ammonia bar in particular
is
is hugely irr
to respiratory
Mucosa.
So irr that it can cause,
monstrous
overwhelming
inflammation.
And destroy the function of the respiratory system.
There are definitely animals who have asp bar.
And
developed a fatal p as a consequence. So
you definitely wanna
limit the chance of that. If you have
an animal
that is, you know, that's nauseous, for example,
yeah And well, maybe you
suspect an obstruction.
Then lessen the volume once again, so the
sort of recommended volumes,
I always error on the side of,
being a little bit conservative. But if I
think there's a chance that we could have
some or vomiting.
And then I'll even use slightly smaller amounts.
And
and because the contrast medium is so
you know, it absolutely blocks out the
the x rays.
Often
particularly with small patients relatively small volumes will
still give you useful
information.
And the other, it's a bit of a
bit of a catch 2. The other potential
danger
that we
probably my views in these to try and
determine a problem with the gut,
And
if we have a perforation there, Mark,
exactly So
you know, it's a it's it's tricky isn't
it because we're... We're we're using it to
try and enhance the rad graph to to
detect a,
intestinal instruction or or but we may have
a per
part of the gut there that when we
go in there and do the surgery that,
hopefully, we're getting in there pretty damn quick
after that, so we don't have much of
that leakage of that that bar
around that can be very irr outside the
gut as well counted.
And and that's 1 of the reasons that
you might contemplate using
the iodine based ones,
they're certainly less likely to cause a problem.
If you think you've got a perforation
that,
aspiration is
you know, reg and aspiration is more likely.
Then then using the iodine based ones
is is far less likely to lead to
those
complications.
And even to the point of... If you've
got a foreign body,
and
you are planning surgery, you you obviously don't
want the bar sort of floating around your,
whatever it gives it will be the dragons,
manage to stuff in their gold.
And swallow.
And so that's... Yeah. If it is a
little. That's probably the only thing I would
reflex the
with a, a gastrointestinal
patient,
put a little bit of bearing in, but
a little bit of thought in some of
those cases about the risks and the likely
consequences.
Yeah.
It would be too much to there.
Mark. If happened. Now you wanted to chat
about other types of contrast radio. 1 in
particular using
using air.
Well, I I do...
I did
a bit of a search once I've gotten
a couple of papers
about contrast. Medium. I...
I did a bit of a search, and
there is
some... I haven't used it, but there is
some publication to suggest that
injecting air into the sealant
can add
a level of,
changed
contrast that might allow
you to highlight particular mass lesions or
I haven't used it and I would worry
because the the rep tolls that we deal
with. They're very forgiving, but they don't have
a a
diaphragm and if we're injecting air
enough air to provide altered contrast to the
abdominal Vis,
I do worry that there might be some
respiratory
consequences.
But that that is a published technique
to
to inject
air
into the sealant to provide
an additional contrast. Yeah
And it sort of mimics what happens in
birds, birds with their air sacks.
You can see some really
exquisite detail a consequence of the s x.
It's the part of the body
where the
abdominal Visceral a sort of all packed onto
each other and very close to the reproductive
tract. That's where some contrast, medium
inside those organs inside the gastrointestinal
tract will allow you to distinguish between Gi
changes and maybe reproductive changes in birds?
Yes. Now
finally, mark,
birds now I hinted at the fact that
with a lot of our reptile
we can take those ready without any form
of s accommodation or anesthesia at all. So
what's your process with the birds and do
you have any
concerns about that
contrast agent that you've gathered that bird with,
coming out,
when you have it... If you have it
an ace.
Definitely Have a concern. And with many birds,
I would probably
make significant efforts to secure the airway
so that if there was a reg good
event,
that the that I had the airways
protected with an endo
tube and
and, you know, even if I've just placed
that for the
2 or 3 minutes that it takes to
get a couple of radio graphs.
I am much more confident
than if I just left the bird
without airway protection. There are some times and
some birds where
placing
an e tube is gonna make the whole
process more complicated.
And I definitely depend on gravity and in
those circumstances.
So I would place the
on some form of incline board.
Yeah. So that,
so that the it wasn't easy for the
the contrast medium to run up hill as
it were and and get to a point
where it could be, asp
And the other thing, of course, I mentioned
it before
handling.
The the crop birds just sits as a
a flux sac at the base of the
neck.
I know vigorous pal patient of that region
in a sedated or an
patient could definitely
squeeze like toothpaste,
Bar up any contents of the crop up
towards the the
the, ph and put it in the vicinity
of the lot and make aspiration real danger.
So,
avoiding pal painting that area if the the...
This paste mess method now. It always lets
us stay brendan. And you know it.
Well,
I think with that, Mark, that's a great
little summary there, and it... It's I think
it's something that we often
do not consider that's a simple technique that's
very rewarding and helping us with that
diagnostics there Mark, using contrast radio,
and we'll link to those 2 papers. The
other the other paper was
with red sliders,
the the comparison with bar
and gas,
and transit times as well. So
I think with that, Mark, we'll it we'll
get out of here. I'm gonna talk to
you next week. Thanks for listening.
Thanks link to the vet podcast by the
Vet guru.
Don't forget to visit us at the website,
vet guru dot com where you can subscribe,
view show notes, listen the previous episodes and
more. You can contact us via email and
vet guru at gmail dot com to ask
a question or just say hi. Thanks again,
and see you next time.