The Vet Vault: Fall Back In Love With Veterinary Science Dr. Hubert Hiemstra

Ah, those liver enzymes... sometimes they are up when you don't expect them to be. Sometimes they're up a bit... but not that much, so you don't know if it's actually significant. Or sometimes they're way out of whack, but you're not sure what that means exactly, or what to do next.

In this episode, Small Animal Medicine Specialist, RCVS Course Director and clinical reasoning guru Prof Jill Maddison helps us take a fresh look at  liver enzymes. We review what each enzyme tells us in dogs and in cats, how to interpret changes in both the 'well' patient with the surprise finding on bloods, and in the sick patient, and Prof Jill clears up common misconceptions and pitfalls around ALP, ALT, GGT, and bile acids.

This clinical episode has been unlocked for you by Vetnostics Pathology, one of the largest veterinary pathology groups in Australia with the most veterinary pathologists and veterinary medicine consultants. Vetnostics is the new nationally aligned name of what used to the SVS Pathology Network ( (Vetnostics NSW/ACT, Vetpath Laboratory Services WA/NT, ASAP Laboratory Vic , QMLVetnostics Qld/NNSW and TML Vetnostics Tas), with a new consolidated website (www.vetnostics.com), but the same exceptional quality diagnostics, same extensive courier network and same veterinary pathologists and veterinary medicine consultants on other the end of the phone or email to talk you through any tricky results and cases. 

Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up-to-date, easy-to-consume clinical episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Get help with your tricky cases in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space.⁠⁠⁠⁠⁠⁠⁠⁠

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠for Hubert's favourite clinical and non-clinical learnings from the week.

Episode Topics and Timestamps



05:01 ALT and ALP: Detailed Analysis

05:40 Challenges in Diagnosing Liver Disease

06:40 Liver Enzymes in Cats vs. Dogs

20:44 Bile Acids and Liver Function

26:51 Pre-Anaesthetic Liver Checks

36:35 Understanding Cholangitis in Cats

36:53 The Complexity of Diagnosing Liver Disease

37:45 The Role of Blood Tests in Wellness Checks

38:11 Interpreting Reference Ranges

40:53 Case Studies: Real-World Examples

42:05 The Challenges of Wellness Screening

44:21 The Importance of Biopsies

55:14 Biases in Diagnosis

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Many of us dream of building a practice, and then one day selling it and walking off into the sunset, minus responsibilities, and with our money problems solved. But what actually happens after what’s supposed to be ‘the big goal’? Who are you when you’re no longer the boss, and what’s next? 

In this episode, ⁠Dr Wolfgang Dohne⁠ tells us how he re-invented and reinvigorated his career post the sale of his practice.  He also give shares what he’s learnt about being a professional locum vet: the pro tips, the pros, and the cons, and what working in telemedicine has taught him about telemedicine as a career option, and also its potential role in our everyday lives in clinical practice. 



Join us at Science Week for the most cutting edge conference topics out there.

Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up-to-date, easy-to-consume clinical episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Get help with your tricky cases in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space.⁠⁠⁠⁠⁠⁠⁠⁠

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠for Hubert's favourite clinical and non-clinical learnings from the week.



Topics and Time stamps

04:41 Balancing Work and Personal Life

13:47 The Decision to Sell and Its Impact

23:30 Embracing Locum Work and Telemedicine

28:16 Tips for Successful Locuming

35:22 Overcoming Locum Anxiety

35:45 Essential Tools for Locum Success

36:31 Navigating Different Practice Management Systems

40:51 Building Strong Relationships with Nursing Teams

44:25 Introduction to Telemedicine

48:50 Practical Applications of Telemedicine

53:01 Integrating Telemedicine into Practice





Veterinary Ramblings

Furthest North

This little bonus episode is for a very select audience of brave souls who have already completed the written part of their Australia New Zealand College Of Veterinary Scientists membership exams, and are due to sit oral exams in a few week’s time. It's made from snippets of conversation about how to get into the right head space for the oral exams, with tips on last minute preparation, and what to expect in the actual exam.

Our guests are specialist surgeons and former examiners Dr Chris Tan and Dr Mark Newman, and former membership candidates Dr Justin Ward and Dr Stephen Mansour, and they deliver on the nuggets of wisdom that might help get you over the line. (Or at least stop you from wetting your pants on exam day!)

If you clicked on this episode, then I’m guessing that you already know WHAT the Australian and New Zealand College of Veterinary Scientists membership exams are. Maybe you’re considering sitting them, or perhaps you’ve already put your hand up for 2025, but you still have so many questions. Like, how much time would I need to commit, how much study is required each week, HOW hard is it actually, WHAT do I need to study, and how do I set myself up for success? Should I do a course, how do I utilise me mentors, or my study group, and perhaps the most important question… WHY would I even put myself through it?!



This episode is made up of multiple conversations about surgery membership, and it will answer all of those questions and more. We talk to specialist surgeons Dr Chris Tan and Dr Mark Newman, as well as membership candidate (at the time of recording) Dr Stephen Mansour and recent successful membership candidate Dr Justin Ward. While the conversation focuses on surgery memberships, most of the information will be applicable to any of the specialties. 



If you need an on-the-go study aid for your surgery membership prep, or if you just want to take your surgery theoretical knowledge to the next level, check out our advanced surgery podcast at cutabove.supercast.com



Oh, and if you were just curious about what membership exams are: the ANZCS (Australian and New Zealand College of Veterinary Scientists) membership exams are rigorous assessments designed to evaluate the clinical knowledge and expertise of veterinarians who want to level up in their field of interest. Anyone with a degree that is eligible for registration in Australia or New Zealand and with more than 3.5 years in practice can register to sit memberships. The exams serve as a benchmark for professional excellence, enabling successful candidates to attain membership in the College, thereby recognising their advanced competency in a specific area of veterinary science. 

Still interested? Then keep listening!



Topics and time stamps

04:29 Exam Structure and Requirements

08:28 The Importance of Pathophysiology

12:52 Personal Experiences and Motivations

16:54 Balancing Study and Life

17:36 The Value of Membership Certification

26:59 Marketability and Practical Skills

29:36 Preparing for Membership Exams

31:21 Time Management and Study Schedules

35:56 Mentorship and Study Groups

48:17 Essential Study Resources

55:44 Balancing Study and Personal Life

Have you ever considered doing something other than clinical veterinary practice, only to get stuck at 'but what else could I do? The only skill I have is fixing sick animals!' Dr Steph Morley will show how how wrong you are.

You'll learn how the skills and attributes that make you a good vet are highly valued outside of the vet clinic, and how to re-write your CV to make it applicable to any industry.

And if you're not considering leaving practice - great! This conversation will help you better value your skills and knowledge and change the negative self talk that devalues your skills and makes you feel like an imposter.

Dr Stephanie Morley's career has included a degree in hospitality and business and working in clinical practice and practice management, and in lab animal medicine. This led her first major pivot into a role as the Associate Director of Business Development at the University of Michigan, and then to the entrepreneurial life as the Co-Founder and President of Zomedica. Dr Steph is currently the President of Vetlen Advanced Veterinary Devices, the team behind an innovative new antibiotic delivery device for veterinarians.



Join our community of Vet Vault Nerds to lift your clinical game and get your groove back with our up-to-date, easy-to-consume clinical episodes at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠vvn.supercast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.

Get help with your tricky cases in our ⁠⁠⁠⁠⁠⁠⁠⁠Specialist Support Space.⁠⁠⁠⁠⁠⁠⁠⁠

V⁠⁠isit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠for show notes and resources related to this episode.

⁠Subscribe to our weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ ⁠for Hubert's favourite clinical and non-clinical learnings from the week.





04:57 Your Unique Veterinary Superpowers

15:55 Overcoming Self-Doubt and Limiting Beliefs

25:00 Translating Veterinary Skills to Other Careers

36:42 Networking Tips for Introverts

38:27 Transitioning from Clinical Practice

47:19 Innovative Antibiotic Delivery Device

01:07:28 Advice for New Veterinary Graduates

You know that conversation that you have with your client when you first diagnose congestive heart failure in their mitral valve disease dog? The one where you say: 'This will be the thing that kills your pet.' Well, that conversation is changing. Veterinary cardiologists  Dr Brad Gavaghan and Dr Fiona Meyers  introduce us to TEER (Transcatheter Edge-to-Edge Repair), a minimally invasive procedure that can completely change the outcome for your mitral valve patients. In this episode they explain how it works, what the procedure involves, and what the risks are. They also guide us through selecting the right patients for this procedure so you don't miss the window of opportunity, and outline a new approach for screening and monitoring your newly diagnosed heart murmur patients now that the paradigm of care has shifted. We get into the practicalities of referring your patients, including setting expectations and cost of the procedure. 



This episode is from our RACE approve clinical podcast series. Join our Vet Vault Nerds at vvn.supercast.com for more updates, refreshers, pro tips, and show note with over 450 episodes in Small Animal Medicine, Surgery and Emergency and Critical Care.

Serious surgeons, interns, residents and membership candidates should check out our new Advanced Surgery Podcast for a deep level of foundational surgery content.



Subscribe to our ⁠weekly newsletter⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠ for Hubert's favourite clinical and non-clinical learnings from the week.