In mid-October 2019 VCF hosted the latest of its CPD days, this time near Chorley in Lancashire. The day was open to all, and brought a wide variety of delegates from both near and far.
The course looked at Feline Hyperthyroidism (FH) and Feline Cardiology and the evidence base that we can apply in first opinion practice.
Andrew Bodey has managed in excess of 1,750 cases of FH with radioactive iodine since 2008 and established the Hyperthyroid Cat Centre in 2013.
He began the day by describing the changing prevalence of FH since the first reported case in 1979 and suggestions for its causes. He highlighted its pathophysiology and suggested that describing FH as the commonest feline neoplasia rather than the commonest feline endocrinopathy, might encourage an early cure rather than palliative medication that leaves the underlying tumour to enlarge and potentially become more malignant.
The various diagnostic tests that are available were examined in turn and the pros and cons of each highlighted. Just as Pontius Pilate famously asked “What is truth?”, the challenge of defining true renal function using routinely available methods in the context of FH was discussed in detail.
The various options for treating FH were discussed including the evidence-base for each medical management, iodine depleted diet, thyroidectomy and radio-iodine treatment.
He evaluated the evidence for each, and with the first two, the need for continual testing to manage the condition and to fully evaluate any side effects over time. Having established the Hyperthyroid Cat Centre, you would expect him to suggest that radio-iodine treatment is the preferred method of treatment for FH, but the evidence presented was certainly very convincing. Given that after just 4 days a cat can be returned to its owner, and a lifelong cure is offered involving no additional medication, no side effects from medication and no continual testing etc., with an expected life span twice that of cats on medication, we were asked the question, why not make gold-standard the treatment of first choice, not last resort? One delegate described the evidence base as mind-blowing!
Dr Angela Bodey has provided a referral cardiology service at Abbey House Veterinary Hospital in Leeds since 2000 and has published on aspects of canine and feline hypertension since undertaking her PhD in the early 1990’s. She spent the afternoon addressing heart conditions in cats, and especially those relating to cats with FH.
She began with some great tips on how to do the initial examination, even in a grumpy cat, and to gain as much useful practical information as possible with some very simple approaches. She described in detail what to listen for and then how to assess the eyes to look for retinal changes which may give clues to help with the diagnosis. She then went on to look at ways to assess blood pressure, and again noting that in general practice it is not possible for us to measure the ‘real thing’ – we are limited to indirect methods of measurement.
Delegates had the chance to test their knowledge with a series of ECG traces from different cases. Angela then used these, together with some ultrasound videos, to clearly and skillfully explain the most common conditions that delegates would be likely to encounter. Woven into this was the best way to manage the various cases.
VCF has been blessed to have a number of folk who are involved with referral in specific areas of veterinary practice. This has been a great opportunity for the fellowship to offer excellent quality CPD to everyone within the veterinary profession as well as giving the chance for VCF members to come together and either meet for the first time, or strengthen already established friendships.
One of the course delegates writes:
“I recently attended a VCF CPD day for the first time.
My reasons for attending were several, I needed the CPD hours(!) the venue was local to me, the subject was relevant, and it was very reasonably priced!
The venue was very good, once I worked out which side of the M6 I needed to be on!! After a period of driving round in circles (the fault laying entirely with myself!!) I arrived to meet a friendly group and a welcome cup of coffee.
The morning session (hyperthyroidism in cats) was refreshingly intellectually challenging, discussing the aetiology, evidence base for our diagnostic procedures and treatments. The end result being (in my opinion!) that really radioactive iodine treatment is gold standard and the reasons for it not being a first line recommendation fell away considerably.
The afternoon was a whistle stop tour of feline cardiomyopathy, with a short ECG workshop, and ultrasonography thrown in – very useful.
Thank you to Andrew and Angela Bodey and VCF for an excellent day.”