Jervis Bay 18/19/20 May 2013

Grampians 11-12 May 2013

From a sign en route to Silverband Falls:

We climbed a winding track through a wonderland of woodland and forest. Away from the stream we find ourselves in an open forest of Brown stringybark. Here, wattle and tea-tree combine to make a distinct lower layer, where native birds such as fantails, robins and honeyeaters nest and feed. Scattered wildflowers complete the scene with Common Heath, showing its endless variety of colour from red to purest white.Overhead gang Gang Gang

Cockatoos call like the sound of a creaking door, while the laugh of the forever cheerful Kookaburra

intermingles with the ringing call of the Currawong. 1925.

Prosthetic Eyes For Children :: Champion Page | BackaBuddy

Prosthetic Eyes For Children :: Champion Page | BackaBuddy

Please open this link and read this touching story. Beverley and my youngest daughter, Elodie were best friends in high school and spent a lot of time at my house. Beverley, in typical fashion, has turned personal adversity into an opportunity to change the world for others less fortunate. Please support her cause!

Useful internet info for vets

Useful websites for new veterinary graduates

Natasha Wilks BVSc DipCoaching

Your Guide to Veterinary Career Success

Helping Veterinarians design their career strategy, improve client communication & increase their turnover so they can enjoy clinical practice & earn a great income.

www.HighPerformanceVets.com

Connect with Natasha via:

Facebook  I  LinkedIn  I  Twitter  I  You Tube  I  Google +

http://bestentrepreneur.murdoch.edu.au/Guide_to_Veterinary_Practice_Planing.pdf

http://veterinarybusiness.dvm360.com/vetec/Practice+Finances/Starting-from-scratch/ArticleStandard/Article/detail/323694

http://www.bls.gov/ooh/Healthcare/Veterinarians.htm
http://www.kookaburravets.com
www.vetlink.com.au

www.carltonprofessional.co.uk

Paintings

Karoo in Spring - near Touwsriver 2011

My dog, Diesel

Werribee River March 2013

Surf Coast between Anglesea and Aireys Inlet May 2013

Useful websites and Facebook pages for vets looking for employment in Australia

WEBSITES
www.seek.com.au
www.jobrapido.com
www.kookaburravets.com
www.vetlink.com.au
www.ava.com.au
http://daff.nga.net.au/fnt_jobs_list.cfm?

FACEBOOK
Veterinary employment and locum network

OTHER SUGGESTIONS

Universities (their websites)
LHPA
DPI
AQIS

Please leave a comment if you are aware of other websites, links or means of looking for veterinary work.

Immune-mediated thrombocytopaenia

Immune-mediated thrombocytopaenia.

Acquired bleeding in dogs is commonly caused by thrombocytopaenia. Binding of antibodies to the platelet surface leads to early clearance of these platelets from the circulation by the mono-nuclear phagocytic system. This condition is called primary immune-mediated thrombocytopaenia (IMT)  if other identifiable diseases are absent, and is considered to be an autoimmune disorder.

 Secondary IMT is associated with conditions such as neoplasia, infections (viral or bacterial) systemic lupus erythromatosus as well as rheumatoid arthritis. It may also be drug-associated.

Primary IMT is commonly seen in dogs. Certain breeds are predisposed e.g., cocker spaniels, old English sheepdogs, German shepherd dogs and poodles.  Middle aged females seem to be the most susceptible. Suspected triggers for primary IMT are genetics, gender, infectious agents, pollutants and stress, causing the humoral immune system to target host platelet antigens.

In secondary IMT, platelet associated antibodies may bind specifically to foreign antigens which have been absorbed onto the platelet surface. They may also bind non-specifically to form an immune complex.

Macrophages in the liver and spleen sequester these stimulated platelets at a vastly increased rate, reducing their normal half-life of about 5 days to mere hours or minutes. The spleen is an important source of anti platelet antibodies. Thrombopoiesis will often be increased in an effort to replace the sequestered platelets.

Diagnosis 

To make a diagnosis of primary IMT, other causes of thrombocytopaenia should be excluded. Consider splenomegaly, DIC, neoplasia, drug-associated and other immune-mediated thrombocytopaenia. 

Primary IMT is suspected when there is a sudden onset of symptoms of thrombocytopaenia and resulting anaemia, such as lethargy, anorexia, pallor, weakness, bruising, epistaxis, mucosal or surface bleeding, especially if preceded by a period of stress such as surgery, kenneling, oestrus or parturition. A severe platelet deficiency will be noted with a platelet count below 30 x 10⁹. This will also be obvious on a blood smear. Coagulation screening tests are often normal, though the activated clotting time may be slightly prolonged in severe cases. The buccal mucosal bleeding time is always increased. Giant platelets or megathrombocytes may be present and are indicative of enhanced thrombopoiesis. In some cases there may be suppression of bone marrow production. A stress leukogram may be seen. Concurrent haemolytic anaemia may be seen in about 20% of dogs with IMT.

Treatment

Response to corticosteroid therapy will confirm the diagnosis of IMT. Platelet count should return to normal within 7 to 10 days of starting treatment. Corticosteroids reduce the rate of macrophage induced sequestration of platelets, whether the IMT is primary or secondary. (There are no practical, readily available tests to differentiate between primary and secondary IMT.)

Glucocorticoids will also reduce antibody production, increase capillary resistance to haemorrhage and stimulate platelet production in some.  

Drugs recommended are oral prednisone or prednisolone: 2 mg/kg every 12 hours, or dexamethasone : 0.1 to 0.6 mg/kg every 24 hours.

Monitor platelet counts once a week and continue treatment until it is back to normal. Then taper the drug over the same period of time as that of the treatment. Some dogs may respond as soon as 1 week after starting treatment, but others may take several weeks. Some dogs may need to remain on treatment to prevent recurrence.

Unresponsive cases and dogs with recurrent disease may be treated with drugs such as vincristine (stimulates thrombopoiesis and reduces platelet phagocytosis by macrophages), cyclophosphamide, or by surgical removal of the spleen.

Reference:

Johnstone I. Bleeding Disorders in Dogs 2. Acquired disorders. 2002. In Practice 24:2 p67-68.