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Reviewer list for 2023 2023 年审稿人名单
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2024-01-30 DOI: 10.1111/vec.13358
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引用次数: 0
Issue Information - Prelim 发行信息 - 初稿
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2024-01-30 DOI: 10.1111/vec.13303
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引用次数: 0
Prospective evaluation of platelet function and fibrinolysis in 20 dogs with trauma 20只外伤犬血小板功能及纤溶的前瞻性评价。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-12-06 DOI: 10.1111/vec.13356
Rachael Birkbeck DVM, MVetMed, DACVECC, DECVECC, Daniel L. Chan DACVECC, DECVECC, DACVIM, Duana McBride BVSc, DACVECC, DECVECC, MVMedSc, Stefano Cortellini DMV, MVetMed, DACVECC, DECVECC

Objectives

To determine platelet function and assess fibrinolysis in dogs following trauma using multiple electrical impedance aggregometry and a modified thromboelastographic (TEG) technique. To determine if the severity of trauma, as assessed by the Animal Trauma Triage (ATT) score and clinicopathological markers of shock, is associated with a greater degree of platelet dysfunction and fibrinolysis.

Setting

University teaching hospital.

Animals

Twenty client-owned dogs with trauma (occurring <24 h prior to admission and blood sampling) and ATT score of >4 were prospectively recruited. A control group of 10 healthy dogs was included.

Interventions

None.

Measurements and Main Results

Platelet function was measured using multiple electrode platelet aggregometry (MEPA) utilizing arachidonic acid, ADP, and collagen agonists. Fibrinolysis was assessed in citrated whole blood with the addition of tissue plasminogen activator (tPA; 50 U/mL) using kaolin-activated TEG. Conventional statistical analysis was performed to compare coagulation parameters between the groups and assess linear correlations. Median (interquartile range) ATT score was 5 (5–7), and 65% (n = 13) of dogs suffered polytrauma. Mean (± SD) time from trauma to blood sampling was 9 hours (± 6). Median (interquartile range) shock index and plasma lactate concentration were 1.1 (0.7–2.0, n = 16) and 2.9 mmol/L (0.9–16.0, n = 18), respectively. Four dogs did not survive to discharge (20%). There were no differences between the trauma and control group coagulation variables. A moderate negative correlation between ATT score and area under the curve for ADP was found (P = 0.043, r2 = −0.496).

Conclusions

Preliminary evaluation of platelet function measured by MEPA, and fibrinolysis measured by tPA-modified TEG, is not significantly different in this population of dogs with traumatic injury compared to healthy dogs.

目的:利用多重电阻抗聚集和改良的血栓弹性成像(TEG)技术测定创伤后狗的血小板功能和评估纤维蛋白溶解。通过动物创伤分诊(ATT)评分和休克的临床病理标记来确定创伤的严重程度是否与更大程度的血小板功能障碍和纤维蛋白溶解有关。单位:大学教学医院。动物:前瞻性地招募了20只客户拥有的创伤犬。对照组为10只健康犬。干预措施:没有。测量和主要结果:使用花生四烯酸、ADP和胶原激动剂,采用多电极血小板聚集法(MEPA)测量血小板功能。在柠檬酸全血中加入组织型纤溶酶原激活剂(tPA;50 U/mL),采用高岭土活化TEG。常规统计学分析比较各组间凝血参数并评估线性相关性。ATT评分中位数(四分位间距)为5 (5-7),65% (n = 13)的狗患有多重创伤。创伤至采血的平均(±SD)时间为9小时(±6),休克指数中位数(四分位数间距)为1.1 (0.7 ~ 2.0,n = 16),血浆乳酸浓度中位数(0.9 ~ 16.0,n = 18)。4只犬未存活出院(20%)。创伤组与对照组凝血指标无差异。ATT评分与ADP曲线下面积呈中度负相关(P = 0.043, r2 = -0.496)。结论:经MEPA测定的血小板功能的初步评价和经tpa修饰的TEG测定的纤维蛋白溶解,在这一创伤性损伤犬群中与健康犬相比没有显著差异。
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引用次数: 0
Evaluation of the use of intranasal atipamezole to reverse the sedative effects of xylazine in dogs 评价使用鼻内阿替帕唑逆转狗的镇静作用的噻嗪。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-12-06 DOI: 10.1111/vec.13357
Alex P. Focken DVM, Jordan M. Woodsworth DVM, Jennifer M. Loewen DVM, DACVECC

Objective

To assess the ability of intranasal atipamezole to reverse sedative effects of xylazine in dogs.

Design

Prospective proof-of-concept study.

Setting

University research laboratory.

Animal

Six healthy, staff-owned dogs.

Interventions

Dogs were sedated with 1.1 mg/kg of xylazine intravenously. The sedation score of each dog was recorded every 5 minutes until they achieved a sedation score of >13/21 for 3 readings. Once achieved, 0.3 mg/kg of atipamezole was administered intranasally using a mucosal atomization device. Sedation scores continued to be recorded every 5 minutes until successful reversal was achieved (<4/21).

Measurements and Main Results

Average times to standing and normal wakefulness after administration of intranasal atipamezole were 6 minutes, 30 seconds and 7 minutes, 20 seconds, respectively.

Conclusions

Intranasal atipamezole successfully reversed the sedation effects of xylazine. The findings of this study provide justification for future controlled prospective studies into the potential use of intranasal atipamezole in a variety of settings including exposure to xylazine in operational canines as well as bioavailability studies for optimal dosing.

目的:评价阿替帕唑鼻内对犬羟嗪镇静作用的逆转作用。设计:前瞻性概念验证研究。环境:大学研究实验室。动物:6只健康的员工养狗。干预措施:犬静脉注射1.1 mg/kg的噻嗪镇静。每5分钟记录每只狗的镇静评分,直到镇静评分>13/21,连续3次读数。一旦达到,使用粘膜雾化装置鼻内给予0.3 mg/kg的阿替帕唑。每5分钟记录一次镇静评分,直至成功逆转(测量和主要结果:给予阿替帕唑鼻内后至站立和正常清醒的平均时间分别为6分30秒和7分20秒)。结论:鼻用阿替帕唑可成功逆转噻嗪的镇静作用。这项研究的结果为未来的对照前瞻性研究提供了依据,这些研究涉及到鼻用阿替帕唑在各种情况下的潜在应用,包括在操作犬中暴露于噻嗪以及最佳剂量的生物利用度研究。
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引用次数: 0
Issue Information - Prelim 问题信息-初步
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-27 DOI: 10.1111/vec.13216
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引用次数: 0
Retrospective evaluation and review of approaches for nonspecific lameness in dogs presented to an emergency service (2013–2014): 134 cases 2013-2014年对急诊犬非特异性跛行治疗方法的回顾性评估和回顾:134例。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-21 DOI: 10.1111/vec.13344
Meghan T. Ramos VMD, Alexandra M. Hartzell VMD, Cynthia M. Otto DVM, PhD, DACVECC, DACVSMR

Objective

This retrospective study aimed to characterize and evaluate the emergency approach, diagnosis, management, treatment, and follow-up of nonspecific canine lameness cases.

Design

Retrospective case series from September 25, 2013 to September 25, 2014.

Setting

The study was conducted at an urban university teaching hospital.

Animals

A consecutive sample of dogs presenting to the emergency service with nonspecific lameness in the designated timeframe was used to identify 134 cases. Owners were contacted to participate in the follow-up survey; dogs that died prior to data collection were excluded from the survey. Medical records were reviewed for lameness localization, etiology of lameness, diagnostics obtained, medications prescribed, and owner recommendations.

Interventions

Based on review of the medical records, the lameness localization, presumptive source of lameness (joint, soft tissue, neurological, or bone), diagnostics obtained, medications prescribed, and owner recommendations were recorded. Survey data included duration of lameness, perceived response to treatment, and activity level.

Measurements and Main Results

Definitive diagnoses were not assigned in 88.8% of lameness cases. A presumptive diagnosis of soft tissue injury was assigned in 45.3% of cases. Single limb lameness was more prevalent than multiple limb lameness. Owners whose dogs were treated with medication were significantly more likely to report that the lameness resolved (P = 0.049). Dogs with injury localized to ≥1 of the joints were significantly less likely to have resolution of lameness (P = 0.037). Treatment recommendations were predominantly pain control and activity restriction.

Conclusions

Nonspecific lameness represents approximately 4% of canine urban emergency cases. Highlighting the points of clinical care considerations in understanding the etiology of lameness in dogs represents an opportunity for improved patient care and growth in emergency referral and follow-up.

目的:本回顾性研究旨在描述和评估非特异性犬跛行病例的急诊方法、诊断、管理、治疗和随访。设计:2013年9月25日至2014年9月25日的回顾性病例系列。环境:本研究在一所城市大学教学医院进行。动物:在指定的时间范围内,对出现在紧急服务部门的非特异性跛行犬进行连续取样,以确定134例。联络船东参与跟进调查;在收集数据之前死亡的狗被排除在调查之外。对跛行定位、跛行病因、获得的诊断、处方药物和业主建议的医疗记录进行了审查。干预措施:根据对医疗记录的回顾,记录跛行定位、跛行推定来源(关节、软组织、神经系统或骨骼)、获得的诊断、处方药物和业主建议。调查数据包括跛行持续时间、对治疗的感知反应和活动水平。测量和主要结果:88.8%的跛行病例没有明确的诊断。45.3%的病例推定为软组织损伤。单肢跛行发生率高于多肢跛行。接受药物治疗的狗的主人更有可能报告跛行得到解决(P = 0.049)。损伤部位≥1个关节的狗跛行消退的可能性明显降低(P = 0.037)。治疗建议主要是疼痛控制和活动限制。结论:非特异性跛行约占犬类城市急诊病例的4%。在了解狗跛行病因方面,强调临床护理要点代表了改善患者护理和急诊转诊和随访增长的机会。
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引用次数: 0
Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography 建立健康犬体内硫胺素浓度的参考区间,并利用高效液相色谱法评估伴有和不伴有败血症的危重犬体内绝对硫胺素缺乏症的患病率。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-21 DOI: 10.1111/vec.13341
Noa Berlin DVM, DACVECC, Alexandra Pfaff Med Vet, DACVECC, Elizabeth A. Rozanski DVM, DACVECC, DACVIM, Nolan V. Chalifoux DVM, DACVECC, Rebecka S. Hess DVM, MSCE, DACVIM, Michael W. Donnino MD, Deborah C. Silverstein DVM, DACVECC

Objective

To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis.

Design

Prospective, observational, multicenter study, conducted between 2019 and 2021.

Setting

Two veterinary university teaching hospitals.

Animals

A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion.

Interventions

For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography.

Measurements and Main Results

The RI for whole-blood TPP in healthy dogs was 70.9–135.3 μg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes.

Conclusions

TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.

目的:确定健康犬体内硫胺素浓度的正常参考区间(RI),探讨伴有和不伴有败血症的危重犬体内硫胺素缺乏症的流行情况。设计:前瞻性、观察性、多中心研究,于2019年至2021年进行。单位:两所兽医大学教学医院。动物:109只犬分为3组:健康犬40只,疑似或确诊脓毒症且存在组织灌注不足(多普勒血压≤90 mm Hg或血浆乳酸≥3 mmol/L)犬33只,其他危重疾病且存在组织灌注不足的犬36只。干预措施:记录每只狗的CBC、血清生化、血浆乳酸浓度、全血硫胺素浓度、血压、生命参数、急性患者生理和实验室评估(APPLE)快速评分和临床结果,以及患者基本参数和饮食史。采用高效液相色谱法测定全血焦磷酸硫胺素(TPP)浓度。测量结果及主要结果:健康犬全血TPP的RI为70.9 ~ 135.3 μg/L。与健康对照相比,脓毒犬中位TPP浓度显著降低(P = 0.036)。在脓毒症犬与非脓毒症危重犬、健康犬与非脓毒症危重犬之间,TPP中位浓度无显著差异。27.3%的脓毒症犬的TPP浓度低于正常RI,而19.4%的非脓毒症危重犬的TPP浓度低于正常RI (P = 0.57)。TPP浓度与乳酸浓度、年龄、身体状况评分、最后一餐后时间、红细胞计数、血清丙氨酸转氨酶、APPLEfast评分或患者预后之间没有相关性。结论:与健康对照相比,败血症犬的TPP浓度显著降低,27.3%的败血症犬存在绝对硫胺素缺乏症。已建立的跨太平洋伙伴关系研究所允许对危重犬的硫胺素缺乏症进行进一步调查。
{"title":"Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography","authors":"Noa Berlin DVM, DACVECC,&nbsp;Alexandra Pfaff Med Vet, DACVECC,&nbsp;Elizabeth A. Rozanski DVM, DACVECC, DACVIM,&nbsp;Nolan V. Chalifoux DVM, DACVECC,&nbsp;Rebecka S. Hess DVM, MSCE, DACVIM,&nbsp;Michael W. Donnino MD,&nbsp;Deborah C. Silverstein DVM, DACVECC","doi":"10.1111/vec.13341","DOIUrl":"10.1111/vec.13341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, observational, multicenter study, conducted between 2019 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Two veterinary university teaching hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)<sub>fast</sub> score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>The RI for whole-blood TPP in healthy dogs was 70.9–135.3 μg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (<i>P</i> = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (<i>P</i> = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLE<sub>fast</sub> scores, or patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A review of the pharmacology and clinical applications of levetiracetam in dogs and cats 左乙拉西坦在犬猫体内的药理及临床应用综述。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-21 DOI: 10.1111/vec.13355
Alicia Mastrocco DVM, DACVECC, Jennifer Prittie DVM, DACVIM, DACVECC, Chad West DVM, DACVIM, Melissa Clark DVM, PhD, DACVIM, DACVCP

Objective

To review and summarize the pharmacology of the antiepileptic drug (AED), levetiracetam (LEV), and to discuss its clinical utility in dogs and cats.

Data Sources

Veterinary and human peer-reviewed medical literature and the authors’ clinical experience.

Summary

LEV is an AED with mechanisms of action distinct from those of other AEDs. In people and small animals, LEV exhibits linear kinetics, excellent oral bioavailability, and minimal drug–drug interactions. Serious side effects are rarely reported in any species. LEV use is gaining favor for treating epilepsy in small animals and may have wider clinical applications in patients with portosystemic shunts, neuroglycopenia, and traumatic brain injury. In people, LEV may improve cognitive function in patients with dementia.

Conclusion

LEV is a well-tolerated AED with well-documented efficacy in human patients. Although its use is becoming more common in veterinary medicine, its role as a first-line monotherapy in small animal epileptics remains to be determined. This review of the human and animal literature regarding LEV describes its role in epileptic people and animals as well as in other disease states and provides recommendations for clinical usage.

目的:综述抗癫痫药物左乙拉西坦(LEV)的药理作用,并探讨其在犬、猫的临床应用。数据来源:兽医和人类同行评议的医学文献和作者的临床经验。摘要:LEV是一种作用机制不同于其他AED的AED。在人和小动物中,LEV表现出线性动力学,良好的口服生物利用度和最小的药物-药物相互作用。严重的副作用在任何物种中都很少有报道。LEV在治疗小动物癫痫方面越来越受青睐,并可能在门系统分流、神经性血糖降低和创伤性脑损伤患者中有更广泛的临床应用。在人类中,LEV可能改善痴呆症患者的认知功能。结论:LEV是一种耐受性良好的AED,在人类患者中具有良好的疗效。虽然它在兽医学中的应用越来越普遍,但它作为小动物癫痫的一线单一疗法的作用仍有待确定。这篇关于LEV的人类和动物文献综述描述了它在癫痫患者和动物以及其他疾病状态中的作用,并提供了临床使用建议。
{"title":"A review of the pharmacology and clinical applications of levetiracetam in dogs and cats","authors":"Alicia Mastrocco DVM, DACVECC,&nbsp;Jennifer Prittie DVM, DACVIM, DACVECC,&nbsp;Chad West DVM, DACVIM,&nbsp;Melissa Clark DVM, PhD, DACVIM, DACVCP","doi":"10.1111/vec.13355","DOIUrl":"10.1111/vec.13355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review and summarize the pharmacology of the antiepileptic drug (AED), levetiracetam (LEV), and to discuss its clinical utility in dogs and cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>Veterinary and human peer-reviewed medical literature and the authors’ clinical experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <p>LEV is an AED with mechanisms of action distinct from those of other AEDs. In people and small animals, LEV exhibits linear kinetics, excellent oral bioavailability, and minimal drug–drug interactions. Serious side effects are rarely reported in any species. LEV use is gaining favor for treating epilepsy in small animals and may have wider clinical applications in patients with portosystemic shunts, neuroglycopenia, and traumatic brain injury. In people, LEV may improve cognitive function in patients with dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LEV is a well-tolerated AED with well-documented efficacy in human patients. Although its use is becoming more common in veterinary medicine, its role as a first-line monotherapy in small animal epileptics remains to be determined. This review of the human and animal literature regarding LEV describes its role in epileptic people and animals as well as in other disease states and provides recommendations for clinical usage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of insulin infusion protocols for management of canine and feline diabetic ketoacidosis 胰岛素输注治疗犬和猫糖尿病酮症酸中毒的比较。
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-21 DOI: 10.1111/vec.13354
Poppy Gant BVSc, MVetMed, DACVECC, DECVECC, Dominic Barfield BSc, BVSc, MVetMed, DACVECC, DECVECC, Jessica Florey BVM&S, MVetMed, DACVIM, DECVIM

Objective

Describe the use of fixed-rate intravenous insulin infusions (FRIs) in cats and dogs with diabetic ketoacidosis (DKA) and determine if this is associated with faster resolution of ketosis compared to variable-rate intravenous insulin infusions (VRIs). Secondary objectives were to evaluate complication rates, length of hospitalization (LOH), and survival to discharge (STD).

Design

Randomized clinical trial (January 2019 to July 2020).

Setting

University veterinary teaching hospital and private referral hospital.

Animals

Dogs and cats with DKA and venous pH <7.3, blood glucose concentration >11 mmol/L (198 mg/dL), and β-hydroxybutyrate (BHB) concentration >3 mmol/L were eligible for inclusion. Patients were randomly assigned to receive either FRI or VRI.

Interventions

Neutral (regular) insulin was administered IV as an FRI or VRI. For FRI, the rate was maintained at 0.01 IU/kg/h. For VRI, the dose was adjusted according to blood glucose concentration.

Measurements and Results

Sixteen cats and 20 dogs were enrolled. Population characteristics, mean insulin infusion rate, time to resolution of ketosis (BHB <0.6 mmol/L), complications, LOH, and STD were evaluated. In cats, overall resolution of ketosis was low (9/16 [56.3%]), limiting comparison of protocols. In dogs, resolution of ketosis was high (19/20 dogs [95.0%]) but the time to resolution in the FRI group was not different than that in the VRI group (P = 0.89), despite a 25% higher average insulin infusion rate in the FRI group (P = 0.04). The incidence of complications was low and did not differ between protocols. In cats, LOH and STD did not differ between protocols. All cats that died (5/16) did so within 78 hours and none had resolution of ketosis. Dogs receiving FRI had a shorter LOH (P = 0.01) but STD did not differ between protocols. Six dogs (30.0%) did not survive to hospital discharge but all had resolution of ketosis.

Conclusions

FRIs can be used in veterinary species but may not hasten reso

目的:描述固定速率静脉注射胰岛素(FRIs)在患有糖尿病酮症酸中毒(DKA)的猫和狗中的应用,并确定与可变速率静脉注射胰岛素(VRIs)相比,这是否与更快地解决酮症有关。次要目的是评估并发症发生率、住院时间(LOH)和出院生存率(STD)。设计:随机临床试验(2019年1月至2020年7月)。单位:大学兽医教学医院和私立转诊医院。动物:DKA和静脉pH为11 mmol/L (198 mg/dL), β-羟基丁酸(BHB)浓度为bbb30 mmol/L的狗和猫符合纳入条件。患者被随机分配接受FRI或VRI。干预措施:中性(常规)胰岛素作为FRI或VRI静脉注射。FRI的添加速率维持在0.01 IU/kg/h。对于VRI,剂量根据血糖浓度调整。测量和结果:16只猫和20只狗被纳入研究。结论:FRIs可用于兽类,但可能不能加速酮症的消退。
{"title":"Comparison of insulin infusion protocols for management of canine and feline diabetic ketoacidosis","authors":"Poppy Gant BVSc, MVetMed, DACVECC, DECVECC,&nbsp;Dominic Barfield BSc, BVSc, MVetMed, DACVECC, DECVECC,&nbsp;Jessica Florey BVM&S, MVetMed, DACVIM, DECVIM","doi":"10.1111/vec.13354","DOIUrl":"10.1111/vec.13354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Describe the use of fixed-rate intravenous insulin infusions (FRIs) in cats and dogs with diabetic ketoacidosis (DKA) and determine if this is associated with faster resolution of ketosis compared to variable-rate intravenous insulin infusions (VRIs). Secondary objectives were to evaluate complication rates, length of hospitalization (LOH), and survival to discharge (STD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomized clinical trial (January 2019 to July 2020).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University veterinary teaching hospital and private referral hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Dogs and cats with DKA and venous pH &lt;7.3, blood glucose concentration &gt;11 mmol/L (198 mg/dL), and β-hydroxybutyrate (BHB) concentration &gt;3 mmol/L were eligible for inclusion. Patients were randomly assigned to receive either FRI or VRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Neutral (regular) insulin was administered IV as an FRI or VRI. For FRI, the rate was maintained at 0.01 IU/kg/h. For VRI, the dose was adjusted according to blood glucose concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Results</h3>\u0000 \u0000 <p>Sixteen cats and 20 dogs were enrolled. Population characteristics, mean insulin infusion rate, time to resolution of ketosis (BHB &lt;0.6 mmol/L), complications, LOH, and STD were evaluated. In cats, overall resolution of ketosis was low (9/16 [56.3%]), limiting comparison of protocols. In dogs, resolution of ketosis was high (19/20 dogs [95.0%]) but the time to resolution in the FRI group was not different than that in the VRI group (<i>P</i> = 0.89), despite a 25% higher average insulin infusion rate in the FRI group (<i>P</i> = 0.04). The incidence of complications was low and did not differ between protocols. In cats, LOH and STD did not differ between protocols. All cats that died (5/16) did so within 78 hours and none had resolution of ketosis. Dogs receiving FRI had a shorter LOH (<i>P</i> = 0.01) but STD did not differ between protocols. Six dogs (30.0%) did not survive to hospital discharge but all had resolution of ketosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FRIs can be used in veterinary species but may not hasten reso","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcome prediction in dogs admitted through the emergency room: Accuracy of staff prediction and comparison with an illness severity stratification system for hospitalized dogs 通过急诊室入院犬的预后预测:工作人员预测的准确性以及与住院犬疾病严重程度分层系统的比较
IF 1.3 3区 农林科学 Q2 Veterinary Pub Date : 2023-11-21 DOI: 10.1111/vec.13350
Alice Le Gal DVM, MVetMed, DACVECC, DECVECC, Dominic Martin Barfield BSc, BVSc, MVetMed, DACVECC, DECVECC, Roseanne Helen Wignall RVN, Simon David Cook BSc, BVSc, MVetMed, DACVECC, DECVECC

Objective

To determine whether emergency staff and students can predict patient outcome within 24 hours of admission, comparing the accuracy of clinician prognostication with outcome prediction by Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scoring and identifying whether experience or mood would be associated with accuracy.

Design

Prospective observational study between April 2020 and March 2021.

Setting

University teaching hospital.

Animals

One hundred and sixty-one dogs admitted through an Emergency Service were assessed. Where data were available, an APPLEfast score was calculated per patient. An APPLEfast score of >25 was deemed a predictor for mortality.

Interventions

None.

Measurements and Main Results

Emergency staff and students were asked to complete surveys about dogs admitted to the emergency room. All clinicopathological data were available for review, and the animals were available for examination. Data collected included opinions on whether the patient would be discharged from hospital, a mood score, position, and experience in Emergency and Critical Care. One-hundred and twenty-five dogs (77.6%) were discharged; 36 dogs (22.4%) died or were euthanized. Two hundred and sixty-six responses were obtained; 202 responses (75.9%) predicted the correct outcome. Students, interns, residents, faculty, and nurses predicted the correct outcome in 81.4%, 58.3%, 83.3%, 82.1%, and 65.5% of cases, respectively. Of 64 incorrect predictions, 43 (67.2%) predicted death in hospital. APPLEfast scores were obtained in 121 cases, predicting the correct outcome in 83 cases (68.6%). Of 38 cases in which APPLEfast was incorrect, 27 (71.1%) were dogs surviving to discharge. Mean APPLEfast score was 22.9 (± 6.2). There was no difference in outcome prediction accuracy between staff and APPLEfast scores (P = 0.13). Neither experience nor mood score was associated with outcome prediction ability (P = 0.55 and P = 0.74, respectively).

目的:确定急诊人员和学生是否能够在入院24小时内预测患者的预后,比较临床医生预测的准确性与急性患者生理和实验室评估(APPLE)快速评分预测的结果,并确定经验或情绪是否与准确性相关。设计:2020年4月至2021年3月的前瞻性观察研究。单位:大学教学医院。动物:对通过紧急服务接收的161只狗进行了评估。在数据可用的情况下,对每位患者计算APPLEfast评分。APPLEfast评分为bbbb25被认为是死亡率的预测指标。干预措施:没有。测量和主要结果:要求急救人员和学生完成关于被送往急诊室的狗的调查。所有的临床病理资料都可以查阅,动物也可以进行检查。收集的数据包括对患者是否出院、情绪评分、体位以及急诊和重症监护经验的意见。出院125只,占77.6%;36只(22.4%)死亡或被安乐死。共获得266份答复;202个回答(75.9%)预测正确。学生、实习生、住院医师、教师和护士的预测正确率分别为81.4%、58.3%、83.3%、82.1%和65.5%。在64个错误预测中,43个(67.2%)预测了院内死亡。121例获得APPLEfast评分,正确预测83例(68.6%)。在APPLEfast错误的38例中,有27例(71.1%)是存活出院的狗。APPLEfast平均评分为22.9(±6.2)分。工作人员与APPLEfast评分结果预测准确率无差异(P = 0.13)。经验和情绪评分与预后预测能力均无相关性(P分别为0.55和0.74)。结论:工作人员预测结果的准确性与APPLEfast评分无显著差异,APPLEfast评分采用bbbb25作为预测死亡率的截止点。当预测不正确时,他们通常预测无法存活。
{"title":"Outcome prediction in dogs admitted through the emergency room: Accuracy of staff prediction and comparison with an illness severity stratification system for hospitalized dogs","authors":"Alice Le Gal DVM, MVetMed, DACVECC, DECVECC,&nbsp;Dominic Martin Barfield BSc, BVSc, MVetMed, DACVECC, DECVECC,&nbsp;Roseanne Helen Wignall RVN,&nbsp;Simon David Cook BSc, BVSc, MVetMed, DACVECC, DECVECC","doi":"10.1111/vec.13350","DOIUrl":"10.1111/vec.13350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether emergency staff and students can predict patient outcome within 24 hours of admission, comparing the accuracy of clinician prognostication with outcome prediction by Acute Patient Physiologic and Laboratory Evaluation (APPLE)<sub>fast</sub> scoring and identifying whether experience or mood would be associated with accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective observational study between April 2020 and March 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>One hundred and sixty-one dogs admitted through an Emergency Service were assessed. Where data were available, an APPLE<sub>fast</sub> score was calculated per patient. An APPLE<sub>fast</sub> score of &gt;25 was deemed a predictor for mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>None.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Emergency staff and students were asked to complete surveys about dogs admitted to the emergency room. All clinicopathological data were available for review, and the animals were available for examination. Data collected included opinions on whether the patient would be discharged from hospital, a mood score, position, and experience in Emergency and Critical Care. One-hundred and twenty-five dogs (77.6%) were discharged; 36 dogs (22.4%) died or were euthanized. Two hundred and sixty-six responses were obtained; 202 responses (75.9%) predicted the correct outcome. Students, interns, residents, faculty, and nurses predicted the correct outcome in 81.4%, 58.3%, 83.3%, 82.1%, and 65.5% of cases, respectively. Of 64 incorrect predictions, 43 (67.2%) predicted death in hospital. APPLE<sub>fast</sub> scores were obtained in 121 cases, predicting the correct outcome in 83 cases (68.6%). Of 38 cases in which APPLE<sub>fast</sub> was incorrect, 27 (71.1%) were dogs surviving to discharge. Mean APPLE<sub>fast</sub> score was 22.9 (± 6.2). There was no difference in outcome prediction accuracy between staff and APPLE<sub>fast</sub> scores (<i>P</i> = 0.13). Neither experience nor mood score was associated with outcome prediction ability (<i>P</i> = 0.55 and <i>P</i> = 0.74, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 ","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of veterinary emergency and critical care
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