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Interview with Internal medicine consultant, Dr. Sue Ramoo MANZCVS

Dr Sue Ramoo

BVSc (hons) MANZCVS (internal medicine)

Email: info@vimsvet.com

Website: www.vimsvet.com 

Facebook: veterinaryinternalmedicineservices

Instagram: vimsvet

 

We asked Dr. Sue Ramoo a series of questions.

 

How do you currently work with referring veterinarians?

I provide a mobile in house referral service, in medical procedures however mainly in ultrasounds.


What are the 5 top presenting cases for referral for ultrasonography?

1) Abnormalities on routine bloodwork
2) Heart murmurs and staging cardiac disease in dogs
3) Palpable abdominal masses
4) Chronic vomiting or diarrhoea
5) Weight loss and ill thrift


Can you share some tips with our members who are interested in polishing up their skills in ultrasonography?

1) Undertake a long course in theory, ideally with a physiology base (eg post grad or certificate rather than a 'weekend' course)
2) Set aside time outside work to practice, on a regular basis


What are the 5 top presenting cases for referral for endoscopy?

1) Chronic vomiting
2) Chronic coughing
3) Anorexia
4) Hematuria/ dysuria
5) Colitis/tenesmus


What types of cases should vets recommend endoscopy as part of their diagnostic workup?

1) Chronic coughing, when pets are stable enough to undergo GA and tests.
2) Chronic vomiting, provided all other testing/imaging has been performed and treatment trials have failed.


What would be your tips when using endoscopy?

 1)Undertake proper training - the equipment is expensive and easy to damage.
2)Undertake training on cleaning protocols.


What are the 5 top presenting cases for referral for chemotherapy?

1) Lymphoma
2) Appendicular osteosarcoma
3) Urinary tract epithelial cell tumors
4) Mast cell tumors
5) Multiple myeloma


What types of chemotherapy regimes do you use and what is required by the client?

The regimes are too varied and dependent on tumor type, stage and patient. All clients require an initial consultation with us, to thoroughly manage expectations and understand the process of home care for the pet.


When managing client expectations, what are your key client education messages when managing oncology cases?

Depending on the chemotherapy protocols used, we focus on home care for the client, as well as expected remission times and quality of life whilst on these treatments.


Are there any advances in oncology treatments that you can share with our members?

The drugs are very similar to what we have been using over the past decade in Australia. Radiation is a large emerging field and is available interstate at this stage. The use of metronomic ('at home' chemo) is also being looked at in many tumors. Certain injectable cytotoxic is being used for subsets of mast cell tumors.


What advice would you give to any veterinarian interested in pursuing an internal medicine specialty?

Go for it! It is a lot of hard work and personal sacrifice, but I think a really driven individual with a drive for self-improvement and someone wanting to practice evidence-based medicine at all times, will do well.

 
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