Bren and Kirk discuss CPR survival rates jumping from single digits to 70-80% with an AED, then explain the difference between harmless age-related lens clouding in pets and true cataracts caused by inflammation, trauma, or diabetes.
Chapters
Hello, hello. So tonight, really interesting that we're going to talk a little bit about cataracts and how these poor dogs must be feeling. But before we go into that, Conor, we've got some news.
Oh yeah, we do. We nearly lost him. We nearly lost him. We were about to be a duo.
Just two. A duo.
A two-o.
I can't believe you said that.
Yeah, so poor Thompson was over in— where was he? He was over in Estonia spreading, spreading the good word.
And it was indeed.
Yeah, yeah. And he had a very successful time of it. I'm sure he'd love to have reneged us with his tales. And then on the way home, on the plane— I think he's in— leaving Germany. So was it Estonia to Germany? Did he say he was flying out of Germany?
Yeah, he said— he did say he was over Germany.
So yeah, it was always over Germany, and the, the airplane had engine trouble. And I was thinking, oh no, did you hear it? He goes, yeah, the plane slowed down, dropped in height purposely. But it's like, you don't want either of those two things happening. And then they said we're going to have to turn around because we've got an engine problem. I was like, oh no, oh my God. He said he didn't care at all.
I mean, oh, I don't know. He did say no, he got over it and then just went back to his podcast. Just typical. So he's now stuck. Was he coming on the way back over?
Is that right? It has to be a direct flight from Estonia to England. I mean, surely there's a heap of direct flights. I mean, why would you get two flights there? Did you ever have a near miss in a plane? Did you ever have anything exciting happen in the plane?
No, just rough turbulence. That's probably the worst. And, you know, I'm not really that worried when it comes to my wife.
Absolutely. Yeah, Chris is.
She eats my hand. I usually end up with a white-knuckle ride purely and simply because there's no blood getting to my fingers anymore.
Yeah, yeah, yeah. Put gin in her, put duty-free in her, takes the edge off. I was there, I was on the honeymoon there with Elaine and we were taking off. We flew to, I think it was Philly, and from Philly going on to West Coast, Canada, or stop in Tico City. And we landed in Philly, we get on American Airlines, and as we're taking off, both of us have our earphones on, we're settling down, this is gonna be a nice little flight. And then there's like clearly a hullabaloo, and it's like, oh, and then it's like they interrupted whatever we were listening or watching or whatever, and we need to interrupt this, there's something something something. And I missed it, you know, you're just waiting for them to stop talking to get back to whatever you're listening to. I look across and Elaine's like ashen face looking at me going— and I was like, oh shit, what did they just say? So I take off my earphones and I'm listening, and then it comes on again, Red 42, Red 42, we have an emergency on the plane. And I was like I was like, my stomach dropped. I was thinking, oh no, an emergency, that's surely terrible. And then she goes, we— and then like she speaks again, she goes, we at Red 42, we have a medical emergency. The first one I heard was Red 42, Red 42, we have an emergency. I didn't hear medical emergency. And then I heard it was a medical emergency. And I hate to admit, I was like, whew, you know, but so many, so many paths.
Until you then heard it was the pilot.
Yeah, yeah. Well, yeah, it's all automatic these days.
Just there for show. Oh yeah, like an airplane. We can autopilot till we get to Heathrow and then somebody else will have to deal with it.
Yeah, I think so. Well, I mean, I was scared when I heard that, but some poor old girl stood up and passed out in the aisle, but she was okay too. But they thought it was a heart attack, I think, probably. But she was good. They said, is there a doctor on the plane? And I went to stand up like in Friends. Laneside holding me down. You're not a doctor, Kirk. You remember that in Friends? Is there a doctor? And what's his name goes to stand over these like pale, pale toddlers. Oh, brilliant, the eagle.
Have you got a fossil that I need to save?
You'd have to fancy your chances, Bren, in any sort of medical emergency. I mean, surely pretty much all those skills that you have translate. I mean, not that you do too much CPR. Have you ever done CPR on a cat or a dog?
Yeah, I have. It's— oh yeah, but you've got to understand, so the interesting thing is that actually, uh, you know the defibs that you can now get? So we have one outside the front of the practice for, for people. So I did my first aid course for humans, uh, the other year, and actually it changes the survival rate dramatically if you can get one of those defibs on. So ridiculous. How many people do you think survive if you just do CPR when they've had arrest?
I thought lots. No.
Oh, give us an estimate, go on. I'm—
well, I'm going to stick with my original thoughts, thinking 75-80% if there's somebody there on point doing even bad CPR. I heard— what? I won't go lower than 50. 50-50. No way.
Drop it.
35%.
Drop it.
Oh, this is desperate. 25%.
Drop it.
20%.
Drop it.
No way, it can't be. You've got to have a better, better shot than 15%. 10%. 10%. 10%.
However, if you get the one of the shock things on them the defibs, it skyrockets. Whoa, it goes way back up to nearly 70 to 80%.
I just, I just, I'm absolutely staggered. I mean, bloody hell.
Yeah, so it is, it is a one of those that's, um, there's debates between 5 and 15%. I've given you the, the halfway part, um, depends on which figures you look at. But yeah, a number of times it is just a case of you know, doing manual CPR, and they've even taken, you know, the breathing bit out now. You just rely on the fact that the heart pumps are gonna, yeah, um, you know, give them the breaths. But yeah, defib makes a massive difference. Well, it tells you what to do. Yeah, so effectively you get it off the wall, so you'll ring the— in our case, the NHS, but you know, whichever emergency service— they tell you the code to take it out of the community defib and we've got one on the front of the practice, so it's all ready charged up and everything. So it's on a continual charge thing, and then you take it to the patient. Literally, as you lay it down and it starts telling you where to place the electrodes, you know, that are all in the pack, and you plug it in, it immediately says checking, and it will effectively read what, you know, has it truly stopped the heart, or is it, is it in fibrillation? Is it in asystole, all of that side of things. And then it will tell you what it's going to do and when to stand clear. And it even tells you how hard, making sure that you're putting the percussions onto the chest, etc.
Whoa.
But people assume, oh yeah, somebody's doing CPR, that patient's going to get up. Yeah, it's really hard to keep them going. Really, really hard.
Whoa. I'm shocked. That happened to my best friend right in front of me, 19 years old, in our house, in front of me. And it was a shocker what they said. Said he hadn't a hope. Any 19-year-old having a heart attack is— that's it. So yeah, shocker. And they said even if that happened in a hospital, they said it would be a pretty fatal kind of situation for a young lad. But yeah, shocker. But shocker, pardon the pun. Bloody hell. So is there such thing as a defib for pets, or is it just all manual stuff?
No, that's— no. So we have to do manual. Okay, you can Can defib them, but often what we're doing is, uh, you will probably— sorry if you guys are sensitive at this time on a Tuesday night— but you usually will crack the chest. So you'll open the chest and manually palpate the heart, okay, to get them— is there— which you're really going to go— yeah, yeah, um, well, you put a glove on, but yeah, yeah, um, and then in some of the hospitals they'll have a, um, paddles. But yeah, most people won't want you to do that to their pet, so they will only accept you going in with adrenaline and, you know, doing CPR on the table.
But what's the endpoint? I mean, once you've got your fist around the dog's heart, how are you going to kill it?
No, you can pretty much stitch them up. You know, you obviously are breathing for them because you've gone into the chest. If you can get the heart going again They don't do too badly. You put chest drains in and a few things like that. We used to do that in the late '80s, early '90s at the university hospitals. That's what they'd be doing, especially for their cardiac patients that were in for valve replacements or things like that. You know, somebody just spent in those days £15,000 on our dog's valve replacement, and then it goes into cardiac arrest. They just say, look, you know, you've got to try everything. We're not gonna waste that.
Yeah, yeah, yeah. Wow.
So, uh, yeah, but yeah, shocker.
Literally, literally, literally. Absolutely. We are Raw Pet Medics. Uh, we are two of the three of them anyway. Uh, you'll catch us on patreon.com.
The better two, it's the better two. Don't tell me.
Yeah, yeah, yeah. And we're patreon.com/rawpetmedics, and, uh, there you will find us. Um, I think I'm gonna without even telling you, Bren, I've got— I found this cool product and I want to try it out on dogs with cataracts, but we'll get through the show and then we'll see, we'll get to a few and we'll pick out— I'm thinking I'll just buy 3 or 4 of these, they're real cheap, and we'll give them to dogs with cataracts. And I was thinking, do you think this is a good idea, Bren? It seems like an absolute winner. So that is— stick around to the end of the show where I talk about that because I'm excited, but I want to get Bren's opinion on it first. So Bren, do you want to tell us what the difference is between cataracts and just old old eyes. I'm surprised at the title tonight. What's the difference?
Right, okay, so I think first things first, many of us worry about a dog's eyes changing, becoming cloudy, and there are many reasons for that. And people assume it's cataracts, and the same for cats. And actually, we've got to differentiate between what is the surface of the eye, the cornea, and that becoming opaque because of damage, you know, chronic inflammation, conjunctivitis, and we've done a previous live on that. So if you want to look about conjunctivitis, you know, red eye, there is a live from about 18 months ago that we did on that, especially in the summertime and allergies, etc. The next step is actually further back, is the lens of the eye. So what we're actually looking at here is the part of the eye which focuses the light on the retina. And that is held behind the colored part of the eye, which is the iris, which creates the pupil, which is the hole in the middle. And inside that, there is the lens. Now, that lens is made up of two layers of cells, okay, in a stroma, so in a gel-like pack. The back layer is— they're quite large, elongated cells. The front layer are much shorter, and they create this wonderful sack of clear material that the light can go through and refract around. Okay, so that is a wonderful structure that's in there, and what we need to be aware of is for that lens to work, it needs to be clear. But as it ages, those— that doesn't stay in that clear form, and it can start to refract light, and it will look blue in bright daylight. Okay. But if you shine a light on it, you will see straight through the lens and onto the retina, and the light will come straight back at you. So that is what we call nuclear sclerosis, which is an old age change to the eye. Whereas for and that means you can get light through. And so it's almost becoming more short-sighted. It's less able to focus the light, so it's not going to be able to read the Sunday Times and give you the crossword answers quite so readily. Yeah, but it is going to be able to at least see you, have quite a normal life, gesture, movement. Yeah, it's going to have relatively normal life. Yeah, the cataract is at any age, but certainly in older animals often is a change and either mineralization or scarring within the lens which actually stops the light passing through it and hitting the retina. So you start to actually get obstruction of vision because of those areas. So they can start in the middle and spread out. They can just be blotches on the lens itself. It can be through inflammatory damage. It can be through you know, the viral infections. It could be physical, yeah, it could be from physical damage, and then it could be from diabetes. And diabetes is a really interesting one because actually, um, that lens should stay nice and dehydrated to stay clear, okay? And actually, if glucose gets into the lens, then water gets sucked in, so the lens effectively swells and becomes opaque. So if you see any changes to your dog's eye, it is definitely worth getting the vet to look into the eye with an ophthalmoscope and see, can they see to the retina? Can they see what's going on with the retina or not? And if they can't and you think, yeah, it's maybe been drinking a little bit more, definitely get Am I live?
How come I'm on the main screen but it says live? How do I check if I'm live? Uh-oh, that guy wasn't picking my nose, everyone. Bren has mysteriously put me live. Let me just check Raw Pet Medics and see if my face is talking. Oh my God, I'm
