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Small Animal Therapy: Ophthalmology and Neurology, Lisbon / Portugal, 30 November - 4 December 2009 heldCourse Masters (Neurology): Dr. Thomas Flegel DECVN, DACVIM (DE); Dr. Diana Henke (CH)Course Masters (Ophthalmology): Prof. Dr. Peter Bedford DECVO, DRCVS (UK); Dr. Charlotte Keller DECVO (CA) OVERVIEW Excellence in Veterinary Therapy (EVT) courses are most suitable for the certificate program (see: Certificate of Small Animal Veterinary Practice - www.esavs-certificate.org). The program design is based on a systematic approach to all organ systems and major diseases according to their frequency and importance to veterinary practice. A complete program cycle covering all major topics consists of a series of courses. Each course targets 2 to 3 themes and is a unit by itself and can be taken independently from any other. TOPICS Ophthalmology: The cornea can be a real battleground for disease, with some of the disease processes seen being common to both dogs and cats whilst others are species specific. Inflammatory reaction is commonplace in response to many kinds of trauma and infection, whilst the specific cause for other inflammatory keratopathies remains unknown,or,at best, ill-defined.Degenerative disease can present more of a conundrum though and may be a reflection of a systemic problem. In this session I will present the differential diagnoses for corneal opacitation and describe the possible therapies. The cornea is another pictorial site for disease, with severe consequences for sight in the absence of accurate diagnosis and effective treatment. Not every ulcer is the same. Although many ulcers heal quickly without much support, others need intensive medical and/ or surgical treatment. The age of the patient, the duration of the ulcer, the depth of the ulcer and the health of the cornea are some of the factors that need to be evaluated prior to the initiation of treatment. The lens is often ignored when it is clear, however, it becomes very obvious when it is opaque. Cataract formation is the most common abnormality of the lens. Many cataracts are inherited but they can also be a result of diabetes, trauma or chronic inflammation amongst other causes. The second most common problem of the lens is its dislocation with potentially serious complications. Lens problems are generally addressed surgically. The most attractive tissue of the eye is the uvea with its colors. A change in the color usually indicates disease whether it is in the iris or the fundus. Most of the inflammatory diseases in the eye involve the uveal tissue and many neoplastic diseases originate from or spread to the uvea. Uveal inflammation can be a sign of a systemic disease and therefore it is important to look beyond the eye. Early recognition of uveitis and its intensive therapy can lead to a successful outcome, the treatment of the underlying disease is, however, just as important. Some of the most interesting lesions are seen with congenital anomalies and degenerative abnormalities of the uveal tissue. The natural arrangement of a transparent retina overlying a reflective choroidal layer of tissue known as the tapetum renders the veterinary ophthalmologist the ideal situation in which to detect pathological change. Normal variations in the appearance of the fundus have to be appreciated, but changes in reflectivity, pigmentation and blood vessel appearance can all herald pathological change which, whilst not specific in terms of cause, will progress the diagnosis. The eye is structured around its retinal function, but the transparency of the ocular media allows meaningful ophthalmoscopy to be completed with ease in most patients.The changes which are seen in disease are usually most pictorial and in these two sessions I will demonstrate just how pictorial disease can be using the case histories of dogs and cats with congenital, inherited and acquired problems. Without doubt glaucoma presents both patient and clinician alike with the most serious ocular problem ever designed by fate. Whether primary or secondary in origin, whether acute or insidious in onset, whether painful or pain free, the resultant loss of retinal ganglion cell activity is irreversible and blindness almost certainly guaranteed. In an acute onset glaucoma the clinician is often too late to do anything more than to ease pain and slow the process to blindness whereas in the insidious types of glaucoma, impaired vision or even actual blindness may be the first clinical sign. Accurate early diagnosis and effective ocular hypertensive therapy are the cornerstones of the limited success possible, but both require a comprehension of why IOP elevates --- come and find out. Neurology: Disc protrusions are the most frequent cause of neurological disease in dogs. A careful neurological examination is necessary to localize the lesion and to direct the ensuing imaging examinations. The examination is also crucial to formulate a prognosis and indications for conservative or surgical therapy. The differential diagnosis of spinal cord lesions includes a number of other compressive lesions such as spinal trauma, inflammations of the extraspinal tissues and malformations. The differential diagnosis is based on the VITAMIND system, which classifies neurological diseases in major groups according to pathogenetic criteria. We will learn how to apply the VITAMIND system systematically. Focused imaging studies, of which we will show examples lead than to a final diagnosis. When compressive lesions can be excluded in a spinal cord localization, we have to assume a primary disease of the cord such as infarct, myelitis and neurodegeneration. Using the VITAMIND approach and additional ancilliary aids such as CSF examination we can arrive at a specific diagnosis. This is a common disorder especially in large breeds. It is important to distinguish such lesions from spinal cord disease with a careful neurological examination. In most cases there are degenerative lesions of the lumbo-sacral spine, which can be seen on radiographs. However it is important to recognize clinically relevant pathology and not to overlook other causes of cauda equine dysfunction. Indications for conservative or surgical treatment will also be discussed. Monoparesis is most commonly found in the front limbs. Trauma is the most frequent cause. In such cases it is very important to distinguish between focal lesions of the radial nerve and avulsion of the brachial plexus, since the latter has a far more reserved prognosis. Sometimes we are dealing with diseases that affect multiple nerves simultaneously. In such cases, a systematic metabolic work-up is necessary to include/exclude disorders such as hypothyreosis and diabetes. Further causes such as para-neoplastic neuropathy and polyneuritis will also be discussed. This includes a wide spectrum of problems ranging from cardio-vascular disease to myasthenia gravis. We will show a systematic approach to the work-up of such cases and also demonstrate the possibilities of electrodiagnostics. Seizure disorders belong to the most frequent neurological problems in small animals. They can be caused by intracranial or extracranial diseases. They can result from organic brain lesions but they can also be idiopathic. We will show how a systematic clinical approach to seizures can lead to a diagnosis. Management of seizures is often difficult. We will discuss old and new therapies and how a therapeutic effect can be monitored. Lesions of the inner ear structures lead to loss of equilibrium and dramatic neurological signs. We will learn to recognize and understand these signs and how to find their specific cause. We will also discuss treatment of inflammatory diseases in this area. Vestibular signs can also result from lesions in the brainstem. Thus we will show how you can distinguish between a lesion in the inner ear and in the brain. This will than set the stage to discuss various lesions of the brain including encephalitis, tumors and degenerative diseases. Please note: Before the course participants will receive a DVD explaining the neurological examination and the principles of localization. They will also receive a handout explaining the principles of classification of neurological diseases. Participants are asked to study this material before the course. PROGRAM Monday, 30 November 2009 Ophthalmology 09:00-10:30 Cornea and non ulcerative disease 10:30-11:15 Coffee Break 11:15-12:00 Corneal disease case reports 12:00-13:15 Lunch 13:15-14:45 Corneal ulceration 14:45-15:30 Corneal ulceration case reports 15:30-16:00 Coffee Break 16.00-17.30 Retina and disease Tuesday, 01 December 2009 Ophthalmology 09:00-10:30 Uveal tract and disease 10:30-11:15 Coffee Break 11:15-12:00 Uveal tract case reports 12:00-13:15 Lunch 13:15-14:45 Retina and disease 14:45-15:30 Retina case reports 15:30-16:00 Coffee Break 16.00-17.30 Lens and disease Wednesday, 02 December 2009 Ophthalmology/Neurology 09:00-10:30 Glaucoma 10:30-11:15 Coffee Break 11:15-12:00 Lens and glaucoma case reports 12:00-13:15 Lunch 13:15-14:00 Compressive diseases of the spinal cord (Part I) 14:00-14:45 Peripheral vestibular disease 14:45-15:30 Central vestibular disease 15:30-16:00 Coffee Break 16.00-17:30 Practical excercises Thursday, 03 December 2009 Neurology 09:00-09:45 Compressive diseases of the spinal cord (Part II) 09:45-10:30 Cauda equina syndrome 10:30-11:15 Coffee Break 11:15-12:00 Monoparesis / Paralysis 12:00-13:15 Lunch 13:15-14:00 Primary diseases of the cord (Part I) 14:00-15:30 Practical excercises 15:30-16:00 Coffee Break 16.00-17:30 Practical excercises Friday, 04 December 2009 Neurology 09:00-09:45 Primary diseases of the cord (Part II) 09:45-10:30 Seizures (Part I) 10:30-11:15 Coffee Break 11:15-12:00 Seizures (Part II) 12:00-13:15 Lunch 13:15-14:00 Polyneuropathies / Myopathies 14:00-15:30 Practical excercises 15:30-16:00 Coffee Break 16.00-17:30 Practical excercises  Course Program: Ophthalmology & Neurology 2009
ATF credit hours (Akademie für Tierärtzliche Fortbildung, Germany): 30 (for Germany, Austria, Switzerland, Luxembourg) CPD points (Continuing Professional Developement): 40 Please also see ESAVS Certficate Program (ECSAVP) ONLINE MATERIAL Course Notes COURSE LOCATION Hotel and Travel Information
Hotels starting from 40,00 Euros per night: 
Hostels ranging from 7,50 - 60,00 Euros per night: (Please enter Lisbon, Portugal as location and select hostels in the northern city centre for easiest public transport to the course location) REGISTRATION Tuition fee: EURO 1.490,-- Early registration: EURO 1.390,-- (deadline for early registration: 30th April 2009) Participants attending two EVT courses in 2009: Internal Medicine & Emergency Care and Ophthalmology & Neurology may pay a special total discount price of 2.450,00 Euros |
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30.07.2010
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