Vetnews | Junie 2024 8 « BACK TO CONTENTS is around 1:2000 patients but as the patients become sicker with more complex disease the mortality is 1:75 (ASA 3 – 5). For cats, the situation is worse with 1:1000 healthy cats (ASA 1 – 2) and sick cats at 1:71 (ASA 3 – 5). This gives an overall mortality of 1:601 for dogs and 1:419 for cats. Unfortunately, this mortality rate has remained unchanged for the last 20 years. In humans, the anaesthetic mortality currently is around 1:10 000 for elective procedures in healthy patients. We have a long way to go. The aim of this talk is to discuss strategies and ways to improve survival rates and outcomes for patients who undergo anaesthetic procedures in veterinary medicine. Nothing will improve if you don’t measure it. What is the current anaesthetic mortality in your practice? Start a quality improvement database and monitor your performance. Often doing this makes personnel sensitive to the issue and indirectly improves outcomes through awareness. This also enables us to set a target goal to work towards. Each morbidity and mortality should be analysed, the events leading up to incident, the clinical condition of the patient and possible strategies to prevent this in the future should be discussed. A plan should be formulated and instituted. This is the approach followed in the airline industry and has been shown to improve outcomes. As most errors come from human factors, a psychologically safe culture needs to be established in the practice so that everyone feels free to voice their thoughts and opinions. Most patients die in recovery (60% Cats, 47% Dogs) or maintenance of anaesthesia (46% Dogs, 30% Cats). This gives the first areas to target. Post-anaesthetic monitoring of patients is vital. The most valuable monitor is a person. That person needs to be appropriately trained to know what to look for and how to respond. Most deaths are related to the cardiovascular (36% Dogs, 24% Cats) or the respiratory (Cats 28%, Dogs 18%) systems. Appropriate and effective monitoring of these vital systems is crucial to improve outcomes. Early identification and intervention will improve outcomes. Diabetes mellitus: an update on pathophysiology, treatment, and monitoring in dogs and cats Muhammad Seedat Onderstepoort Veterinary Academic Hospital (OVAH), Onderstepoort, South Africa Diabetes mellitus (DM) is a common endocrinological diagnosis in small animal practice, with parallels usually drawn between canine and feline DM to type I and type II DM in humans, respectively. Multiple review articles encompassing a variety of topics surrounding DM in dogs and cats have recently been published, including updates in definitions, genetic risk factors, pathophysiology, new diagnostic tools, present treatment strategies, future treatment options, and monitoring guidelines. Precision medicine, i.e. providing the right therapy for the right patient at the right time, is currently at the forefront of DM management in humans and is now an emerging concept in small animal veterinary practice as well. Exogenous insulin therapy remains the mainstay of DM management in dogs and cats. Recent advances have led to the development of new treatments in an attempt to perturb the common complications of DM management and improve owner compliance, with the most notable of these being the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in cats. This presentation will review the latest literature regarding the pathophysiology, treatment, and monitoring of DM in small animals. Relevant comparisons to DM in human medicine will also be outlined as part of a One Health discussion. v Events I WVAC 2024
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