by elearningvet
Whether you simply have a pet with skin issues, or are a vet / vet nurse looking to bolster your CPD record with free, easy to listen to, on the go discussion on and around pet skin disease - this is the podcast for you! Join European leading dermatologist Dr Sue Paterson, Dermatology Veterinary Nurse John Redbond and Elearning.Vet content provider Paul Heasman as they pick their way through the scabby surface of pet skin disease. Expect interviews with some of the smartest minds in animal dermatology to get beneath the surface of the latest thinking on all things fur and skin, keeping their gloved fingers on the pulse of current topics itching to be discussed. This podcast is brought to you by Nextmune UK (formerly Vetruus), specialist in veterinary dermatology and immunotherapy. Nextmune bring you products such as Otodine and CLX Wipes – market leading products in the management of skin and ear cases. In association with Elearning.Vet - providing the highest quality veterinary content free of charge.
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5/26/2021
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February 26, 2025
Show Notes To celebrate Pet Dental Health Month, the Skin Flints team looked a bit further afield this month, exploring gum health and Canine Chronic Ulcerative Stomatitis with Hannah van Velzen. Chapter 1 – Understanding the Oral Mucosa and Inflammation (02:53) John welcomes Hannah, who introduces herself and her journey into veterinary dentistry, from her studies in the Netherlands to her current role leading the dentistry referral service at Fitzpatrick Referrals. She highlights the small but growing number of veterinary dentistry specialists in the UK. (05:46) Sue asks for a basic overview of the oral mucosa, as it plays a key role in CCUS. Hannah explains that gingiva surrounds and seals the teeth, preventing bacteria from entering the body, while mucosa covers the rest of the mouth. The mucogingival junction marks the boundary between the two and helps differentiate between gingivitis and mucositis. She describes the different types of mucosa, including lingual (tongue), palatal (roof of the mouth), alveolar (bone covering), vestibular (cheek and lip folds), buccal (cheeks), and labial (lips). These structures vary in thickness and function, with keratinized areas like the tongue and hard palate providing protection, while thinner, non-keratinized areas aid in saliva flow and bacterial clearance. (13:24) John then asks Hannah to define common inflammatory conditions affecting the mouth, including: Gingivitis – Inflammation limited to the gingiva, without mucosal involvement. Mucositis (stomatitis) – Inflammation affecting the mucosa, which is central to CCUS. Periodontitis – Inflammation of the structures supporting the tooth, which can lead to tooth loss. Hannah emphasises the importance of accurately defining oral lesions to guide diagnosis and treatment. Chapter 2 – What is CCUS? How Can It Be Diagnosed? (18:43) John introduces Canine Chronic Ulcerative Stomatitis (CCUS), asking how it relates to previous terms like CUPS (Canine Ulcerative Paradental Stomatitis) or contact mucositis. Hannah explains that CCUS was formerly known as CUPS, but the name changed as research showed that 40% of lesions occurred in areas without teeth, making the term "paradental" inaccurate. The condition is chronic, meaning it develops gradually rather than suddenly. (23:22) Sue asks how a primary care vet should determine whether a dog with oral ulcerations has CCUS or another condition, such as pemphigus vulgaris, lupus, or uremic stomatitis. Hannah acknowledges that many inflammatory and autoimmune diseases look similar and that no single exam finding confirms CCUS. She advises vets to follow key diagnostic steps: Perform a thorough dental cleaning and radiographs to rule out periodontal disease. Differentiate gingivitis (gum inflammation) from mucositis (mucosal inflammation). Take a biopsy if mucosal inflammation is present, as periodontal disease should not cause mucositis. Look for "lymphoplasmacytic infiltrates" on biopsy, which strongly suggest CCUS. If the biopsy findings suggest CCUS, referral to a dentistry specialist is recommended. If results are inconclusive, a dermatologist may need to investigate potential autoimmune conditions. (27:33) Sue asks whether "kissing lesions" (ulcerative lesions where mucosa touches the teeth) strongly indicate CCUS. Hannah agrees that they are a key sign, but notes that plaque build-up can also cause similar inflammation. A dental clean should be performed first—if inflammation persists despite clean teeth, CCUS is more likely. (28:31) Sue then asks if certain breeds are predisposed to CCUS. Hannah confirms that small breeds and terriers are overrepresented, particularly: Cavaliers, Labradors, Maltese, and Greyhounds. Greyhounds are prone due to poor dental health and periodontal disease. Spaniels may also be affected, though this is not yet confirmed in literature. Some affected dogs have severe gingivitis and mucosal inflammation despite excellent dental hygiene, making C
January 24, 2025
This month, Skin Flints welcomes a European and Australian boarded veterinary dermatologist, Sonya Bettenay. Show Notes (00:00) John introduces this month’s podcast, his co-hosts, and the topic. Chapter 1 – First Cut: Introducing Skin Biopsies (02:21) John invites Sonya to introduce herself, and she discusses her current work in Munich - focusing on skin biopsies, clinical practice, and teaching. Sue highlights Sonya's credentials, noting her Australian and European board certifications. Sonya explains her dermatology training in Australia and California and her involvement with the ECVD as an examiner and tutor. (03:57) Sue and Sonya discuss the challenges pathologists face in interpreting biopsy samples and the importance of taking quality samples to aid diagnosis. Sonya reflects on improvements in biopsy submissions over the years but notes that obtaining multiple samples often provides a more comprehensive picture. (05:31) John asks Sonya to explain what a skin biopsy is. Sonya describes it as a microscopic examination of the skin, providing insights beyond surface-level observation. Sonya outlines cases where biopsies are useful, such as unusual presentations that deviate from common conditions, and emphasises the need to tailor biopsy timing based on the patient's condition. Chapter 2 – Going Deeper - Steps Before Biopsy (09:15) Sue asks Sonya whether biopsies should replace basic investigative tests. Sonya emphasises that fundamental diagnostic steps such as skin scrapes, hair plucks, and impression smears should be performed first in most cases. However, she highlights exceptions, particularly for vesicular or severe oral mucosal lesions, where early biopsy is crucial to diagnosing immune-mediated conditions. Sonya explains the importance of maintaining the integrity of vesicular lesions during biopsy to ensure accurate diagnosis. She stresses the need to take elliptical samples to include surrounding healthy tissue and avoid disrupting the lesion structure. (11:52) Sue and Sonya discuss the distinction between primary and secondary lesions. Sonya explains that primary lesions, such as pustules and vesicles, provide the most diagnostic value, whereas secondary lesions, like crusts and alopecia due to self-trauma, may offer limited insights. (15:15) John asks about choosing biopsy techniques. Sonya shares her preference for biopsy punches due to their precision and ease of use, while acknowledging the importance of elliptical excisions for fragile lesions like vesicles. She explains the technical aspects of both methods and how they can impact diagnostic outcomes. Chapter 3 – Preservation - Sustainability and Practical Considerations (19:30) Sue raises concerns about the sustainability of single-use biopsy punches. Sonya explains that while some attempts to sterilise and reuse them have been made, they often result in decreased sharpness and reliability. She advises using new punches for best results but acknowledges the need for sustainable alternatives. Sonya discusses her approach to biopsy sampling, recommending taking multiple samples to ensure comprehensive diagnosis. She suggests including normal tissue alongside affected areas for comparison. Sue and Sonya explore potential innovations for more sustainable biopsy tools, such as reusable handles with replaceable blades. (23:19) John asks if separate biopsy punches should be used for each sample. Sonya clarifies that one punch can typically be used for multiple samples unless dealing with particularly tough tissues that may dull the instrument. (23:52) John then asks who can take biopsies and Sonya notes that all vets and also veterinary nurses may be able to take samples depending on local regulations, particularly for alopecia cases. She highlights the importance of orienting samples correctly by marking the direction of hair growth to aid pathologists in accurate analysis. (27:25) Sue and Sonya discuss the need for deep biopsies in cases of hair lo
November 25, 2024
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