Logan Eicher DVM, Anda A. Young DVM, MS, DACVECC, Leanna Hoover DVM, Kendon W. Kuo DVM, MS, DACVECC, Jiwoong Her DVM, MS, DACVECC
Objective
To evaluate the respiratory rate–oxygenation index (ROX), modified ROX index (ROX-HR), and the ratio of pulse oximetry saturation (Spo2) to Fio2 (SF) to determine if these indices over time are predictive of outcome in dogs treated with high-flow nasal cannula oxygen therapy (HFNC).
Design
Retrospective study.
Setting
Two university teaching hospitals.
Animals
Eighty-one client-owned dogs treated with HFNC for hypoxemic respiratory failure.
Interventions
None.
Measurements and Main Results
The ROX was defined as the SF divided by the respiratory rate (RR), and the ROX-HR was defined as the ROX divided by the heart rate multiplied by 100. The overall success rate of HFNC was 44% (n = 36/81). Dogs weaned from HFNC had a significantly higher ROX (P < 0.0001) at 1–3, 5–10, 12, and 15 hours than dogs that failed HFNC. Both the ROX and SF showed excellent discriminatory power in predicting HFNC failure at 6 hours, with an area under receiver operating curve of 0.85 (95% confidence interval: 0.72–0.99; P < 0.002) and 0.86 (95% confidence interval: 0.73–0.99; P < 0.001), respectively. The optimal cutoff values for predicting HFNC failure at 6 hours were a ROX ≤3.68 (sensitivity 72%, specificity 92%) and an SF ≤143 (sensitivity 79%, specificity 93%).
Conclusions
These results suggest that similar to people, the ROX and SF are useful predictors of HFNC failure. These indices are easy to measure at the bedside and may have clinical use. Future prospective studies are warranted to confirm the findings and to optimize cutoff values in a larger population of dogs undergoing HFNC.
{"title":"Retrospective evaluation of the respiratory rate–oxygenation index to predict the outcome of high-flow nasal cannula oxygen therapy in dogs (2018–2021): 81 cases","authors":"Logan Eicher DVM, Anda A. Young DVM, MS, DACVECC, Leanna Hoover DVM, Kendon W. Kuo DVM, MS, DACVECC, Jiwoong Her DVM, MS, DACVECC","doi":"10.1111/vec.13373","DOIUrl":"10.1111/vec.13373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the respiratory rate–oxygenation index (ROX), modified ROX index (ROX-HR), and the ratio of pulse oximetry saturation (Sp<span>o</span><sub>2</sub>) to Fi<span>o</span><sub>2</sub> (SF) to determine if these indices over time are predictive of outcome in dogs treated with high-flow nasal cannula oxygen therapy (HFNC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Two university teaching hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Eighty-one client-owned dogs treated with HFNC for hypoxemic respiratory failure.</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>The ROX was defined as the SF divided by the respiratory rate (RR), and the ROX-HR was defined as the ROX divided by the heart rate multiplied by 100. The overall success rate of HFNC was 44% (<i>n</i> = 36/81). Dogs weaned from HFNC had a significantly higher ROX (<i>P</i> < 0.0001) at 1–3, 5–10, 12, and 15 hours than dogs that failed HFNC. Both the ROX and SF showed excellent discriminatory power in predicting HFNC failure at 6 hours, with an area under receiver operating curve of 0.85 (95% confidence interval: 0.72–0.99; <i>P</i> < 0.002) and 0.86 (95% confidence interval: 0.73–0.99; <i>P</i> < 0.001), respectively. The optimal cutoff values for predicting HFNC failure at 6 hours were a ROX ≤3.68 (sensitivity 72%, specificity 92%) and an SF ≤143 (sensitivity 79%, specificity 93%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results suggest that similar to people, the ROX and SF are useful predictors of HFNC failure. These indices are easy to measure at the bedside and may have clinical use. Future prospective studies are warranted to confirm the findings and to optimize cutoff values in a larger population of dogs undergoing HFNC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 3","pages":"252-261"},"PeriodicalIF":1.3,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873748","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}
Alyson H. Fitzgerald DVM, Rebecca K. Davies DVM, DACVECC, Yuntao Zhang PhD, Steve Ensley PhD, DVM, Scott Fritz DVM, DABVT
Objective
To describe a case of bifenthrin toxicosis in a dog with a successful outcome following the use of therapeutic plasma exchange (TPE) and intralipid therapy.
Case Summary
An 8-month-old female neutered poodle mix dog ingested an unknown amount of powered bifenthrin, which resulted in acutely altered mentation, cranial nerve deficits, and intractable tremors that persisted in severity despite aggressive medical management to include intravenous fluids, intravenous lipid emulsion, anticonvulsant medications, and methocarbamol. TPE was initiated after lack of significant clinical improvement 12 hours after initial presentation. The dog underwent cardiopulmonary arrest (CPA) following approximately 1 plasma volume equivalent exchange. The dog was successfully resuscitated and showed marked improvement 12 hours postarrest and post-TPE treatment. Serum bifenthrin concentrations were analyzed prior to TPE (445.38 ng/mL) and ∼10 hours after TPE (51.18 ng/mL), which resulted in an 89% reduction in serum bifenthrin concentration.
New Information
TPE may be a promising adjunctive therapeutic modality for bifenthrin toxicosis in dogs.
{"title":"Successful treatment of bifenthrin toxicosis using therapeutic plasma exchange","authors":"Alyson H. Fitzgerald DVM, Rebecca K. Davies DVM, DACVECC, Yuntao Zhang PhD, Steve Ensley PhD, DVM, Scott Fritz DVM, DABVT","doi":"10.1111/vec.13377","DOIUrl":"10.1111/vec.13377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe a case of bifenthrin toxicosis in a dog with a successful outcome following the use of therapeutic plasma exchange (TPE) and intralipid therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>An 8-month-old female neutered poodle mix dog ingested an unknown amount of powered bifenthrin, which resulted in acutely altered mentation, cranial nerve deficits, and intractable tremors that persisted in severity despite aggressive medical management to include intravenous fluids, intravenous lipid emulsion, anticonvulsant medications, and methocarbamol. TPE was initiated after lack of significant clinical improvement 12 hours after initial presentation. The dog underwent cardiopulmonary arrest (CPA) following approximately 1 plasma volume equivalent exchange. The dog was successfully resuscitated and showed marked improvement 12 hours postarrest and post-TPE treatment. Serum bifenthrin concentrations were analyzed prior to TPE (445.38 ng/mL) and ∼10 hours after TPE (51.18 ng/mL), which resulted in an 89% reduction in serum bifenthrin concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New Information</h3>\u0000 \u0000 <p>TPE may be a promising adjunctive therapeutic modality for bifenthrin toxicosis in dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 3","pages":"291-295"},"PeriodicalIF":1.3,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871665","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}
Alicia Mastrocco DVM, DACVECC, Jennifer Prittie DVM, DACVIM, DACVECC, Ann Marie Zollo DVM, DACVECC
Objective
To describe the successful conservative management of chemical pneumonitis and presumed acute respiratory distress syndrome in a cat secondary to inadvertent pulmonary polyethylene glycol–electrolyte solution (PEG-ELS) instillation.
Case Summary
PEG-ELS is commonly used in small animals for bowel cleansing and to treat constipation. There have been several instances of aspiration or accidental instillation of this solution into the lungs of both people and dogs. PEG-ELS was inadvertently infused into the lungs of the cat in the current report. After 10 days in the ICU, during which time treatment with oxygen therapy, antibiosis, diuretics, and corticosteroids was provided, the cat was successfully discharged.
New or Unique Information Provided
To the authors’ knowledge, this is the first report of instillation of PEG-ELS in a cat resulting in chemical pneumonitis and lung injury. We describe the successful management of this condition with conservative management and without the need for invasive interventions such as bronchoscopy and lavage or mechanical ventilation.
{"title":"Chemical pneumonitis secondary to accidental pulmonary polyethylene glycol–electrolyte solution infusion in a cat","authors":"Alicia Mastrocco DVM, DACVECC, Jennifer Prittie DVM, DACVIM, DACVECC, Ann Marie Zollo DVM, DACVECC","doi":"10.1111/vec.13380","DOIUrl":"10.1111/vec.13380","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the successful conservative management of chemical pneumonitis and presumed acute respiratory distress syndrome in a cat secondary to inadvertent pulmonary polyethylene glycol–electrolyte solution (PEG-ELS) instillation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>PEG-ELS is commonly used in small animals for bowel cleansing and to treat constipation. There have been several instances of aspiration or accidental instillation of this solution into the lungs of both people and dogs. PEG-ELS was inadvertently infused into the lungs of the cat in the current report. After 10 days in the ICU, during which time treatment with oxygen therapy, antibiosis, diuretics, and corticosteroids was provided, the cat was successfully discharged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>To the authors’ knowledge, this is the first report of instillation of PEG-ELS in a cat resulting in chemical pneumonitis and lung injury. We describe the successful management of this condition with conservative management and without the need for invasive interventions such as bronchoscopy and lavage or mechanical ventilation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 3","pages":"296-301"},"PeriodicalIF":1.3,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874323","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}
{"title":"Issue Information - Prelim","authors":"","doi":"10.1111/vec.13304","DOIUrl":"https://doi.org/10.1111/vec.13304","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"92-95"},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140333254","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}
Jessica Eisenbarth DVM, DACVECC, Charles O. Cummings DVM, Elizabeth A. Rozanski DVM, DACVIM, DACVECC, Emily Karlin DVM, DACVIM, John Rush DVM, DACVIM, DACVECC
Objective
To determine in adult chickens which of 3 CPR techniques, sternal compressions (SC), SC with interposed caudal coelomic compressions (ICCC), or lateral compressions (LC), results in the highest mean systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) as measured directly from the carotid artery.
Birds were sedated, anesthetized, and placed in dorsal recumbency. A carotid artery catheter was placed to directly measure arterial pressure. Ventricular fibrillation was induced with direct cardiac stimulation using a 9-Volt battery. Each bird then received 2 minutes of the 3 different cardiac compression techniques in a random order by 3 different compressors, with the compressor order also randomized. Birds were subsequently administered IV epinephrine, and transthoracic defibrillation was attempted. At the end of experimentation, each bird was euthanized, and simple gross necropsies were performed. Linear mixed models followed by pairwise paired t-tests were performed to evaluate differences in pressures generated by each technique.
Measurements and Main Results
The primary study outcomes were SAP, DAP, and MAP over 2 minutes of compressions for each compression technique. Pressures from ICCC (SAP: 27.6 ± 5.3 mm Hg, DAP: 18.7 ± 5.2 mm Hg, MAP: 21.7 ± 5.2 mm Hg) were significantly higher than those from LC (SAP: 18.9 ± 5.4 mm Hg, DAP: 11.6 ± 4.1 mm Hg, MAP: 14.1 ± 4.5 mm Hg). Pressures from SC (SAP: 24.5 ± 6.4 mm Hg, DAP: 15.2 ± 4.3 mm Hg, MAP: 18.3 ± 5.0 mm Hg) were not significantly different from ICCC or LC.
Conclusions
External compressions can generate detectable increases in arterial pressure in chickens with ventricular fibrillation. SC with ICCC generated significantly higher arterial pressures than LC. SC alone generated blood pressures that were not significantly different from those generated by SC with ICCC or LC.
目的确定在成年鸡的 3 种心肺复苏技术中，胸骨按压 (SC)、胸骨按压加尾椎腔按压 (ICCC) 或侧向按压 (LC) 可使直接从颈动脉测量的平均收缩压 (SAP)、舒张压 (DAP) 和平均动脉压 (MAP) 达到最高值：设计：前瞻性、非盲法、实验性交叉研究：动物：10 只退役蛋鸡十只退役蛋鸡：干预措施：对鸡进行镇静、麻醉和背卧位。放置颈动脉导管以直接测量动脉压。使用 9 伏电池直接刺激心脏诱发室颤。然后，每只鸟按随机顺序接受 3 种不同的心脏按压技术治疗 2 分钟，3 种不同的按压器的顺序也是随机的。随后对鸟类进行肾上腺素静脉注射，并尝试经胸除颤。实验结束后，对每只鸟实施安乐死，并进行简单的大体尸体解剖。通过线性混合模型和配对 t 检验来评估每种技术产生的压力差异：主要研究结果为每种按压技术按压 2 分钟后的 SAP、DAP 和 MAP。ICCC 的压力（SAP：27.6 ± 5.3 mm Hg；DAP：18.7 ± 5.2 mm Hg；MAP：21.7 ± 5.2 mm Hg）明显高于 LC 的压力（SAP：18.9 ± 5.4 mm Hg；DAP：11.6 ± 4.1 mm Hg；MAP：14.1 ± 4.5 mm Hg）。SC的压力（SAP：24.5 ± 6.4 mm Hg；DAP：15.2 ± 4.3 mm Hg；MAP：18.3 ± 5.0 mm Hg）与ICCC或LC无显著差异：结论：体外按压可使心室颤动患儿的动脉压明显升高。SC与 ICCC 产生的动脉压明显高于 LC。单独体外按压产生的血压与体外按压加 ICCC 或 LC 产生的血压没有显著差异。
{"title":"A proof-of-concept study evaluating cardiac compression techniques for cardiopulmonary resuscitation in laying hens (Gallus gallus)","authors":"Jessica Eisenbarth DVM, DACVECC, Charles O. Cummings DVM, Elizabeth A. Rozanski DVM, DACVIM, DACVECC, Emily Karlin DVM, DACVIM, John Rush DVM, DACVIM, DACVECC","doi":"10.1111/vec.13369","DOIUrl":"10.1111/vec.13369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine in adult chickens which of 3 CPR techniques, sternal compressions (SC), SC with interposed caudal coelomic compressions (ICCC), or lateral compressions (LC), results in the highest mean systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) as measured directly from the carotid artery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, nonblinded, experimental crossover study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University teaching hospital laboratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Ten retired laying hens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Birds were sedated, anesthetized, and placed in dorsal recumbency. A carotid artery catheter was placed to directly measure arterial pressure. Ventricular fibrillation was induced with direct cardiac stimulation using a 9-Volt battery. Each bird then received 2 minutes of the 3 different cardiac compression techniques in a random order by 3 different compressors, with the compressor order also randomized. Birds were subsequently administered IV epinephrine, and transthoracic defibrillation was attempted. At the end of experimentation, each bird was euthanized, and simple gross necropsies were performed. Linear mixed models followed by pairwise paired <i>t</i>-tests were performed to evaluate differences in pressures generated by each technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>The primary study outcomes were SAP, DAP, and MAP over 2 minutes of compressions for each compression technique. Pressures from ICCC (SAP: 27.6 ± 5.3 mm Hg, DAP: 18.7 ± 5.2 mm Hg, MAP: 21.7 ± 5.2 mm Hg) were significantly higher than those from LC (SAP: 18.9 ± 5.4 mm Hg, DAP: 11.6 ± 4.1 mm Hg, MAP: 14.1 ± 4.5 mm Hg). Pressures from SC (SAP: 24.5 ± 6.4 mm Hg, DAP: 15.2 ± 4.3 mm Hg, MAP: 18.3 ± 5.0 mm Hg) were not significantly different from ICCC or LC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>External compressions can generate detectable increases in arterial pressure in chickens with ventricular fibrillation. SC with ICCC generated significantly higher arterial pressures than LC. SC alone generated blood pressures that were not significantly different from those generated by SC with ICCC or LC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"135-142"},"PeriodicalIF":1.3,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208458","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}
Rafael Françoso DVM, MsC, PhD, Raquel Y. Baccarin DVM, MsC, PhD, Renata F. de Siqueira DVM, MsC, PhD, Carla B. Belli DVM, MsC, PhD
<div> <section> <h3> Objectives</h3> <p>To evaluate the feasibility of using the FreeStyle Libre (a continuous glucose monitoring system [CGMS]) for instantaneous continuous monitoring of interstitial glucose in adult horses and examine the applicability and accuracy of this system in horses submitted to combined glucose–insulin test (CGIT).</p> </section> <section> <h3> Design</h3> <p>Laboratory measurements and continuous glucose monitoring system (CGMS) readings were analyzed using a 2 × 2 factorial statistical model with repeated measures over time. This analysis assessed the effects of the test (factor 1), group (factor 2), and their interactions (test × group, test × time, and group × time). Pearson's correlation analysis was applied to blood glucose values. Mean comparisons were conducted using the <i>t</i>-test, and agreement between techniques was assessed via the Bland–Altman method, with a 95% confidence interval.</p> </section> <section> <h3> Setting</h3> <p>Field study on private horse farms in association with a veterinary school.</p> </section> <section> <h3> Animals</h3> <p>Ten healthy stallions were assigned to one of two groups based on their body condition scores (BCS). Group 1 (G1, <i>n</i> = 5) consisted of nonobese horses with a BCS of 5 or 6, while Group 2 (G2, <i>n</i> = 5) consisted of obese horses with a BCS of 7 or higher.</p> </section> <section> <h3> Interventions</h3> <p>A CGMS sensor was attached to the dorsolateral aspect of the proximal one third of each horse's neck. Laboratory blood glucose measurements and CGMS interstitial glucose readings were compared at different time points for up to 7 days after sensor fixation. Obese horses were also submitted to CGIT on Day 4.</p> </section> <section> <h3> Measurements and Main Results</h3> <p>A comparative analysis of glucose measurements obtained in G1 and G2 horses using the CGMS and enzymatic methods revealed significant group × time interactions (<i>P</i> < 0.001) and time effects (<i>P</i> < 0.001). No interactions were detected between group (<i>P</i> = 0.45), test (<i>P</i> = 0.62), group and test (<i>P</i> = 0.28), or time and test (<i>P</i> = 0.92). In G1 and G2, tests were significantly correlated (<i>r</i> = 0.84 and <i>P</i> = 0.00) at all time points (T0–T5). Agreement between the glucose values obtained using different methods was excellent despite a small time delay in CGMS detection of rapid changes in blood glucose.</p> </section> <section>
{"title":"Use of FreeStyle Libre for continuous glucose monitoring in adult horses","authors":"Rafael Françoso DVM, MsC, PhD, Raquel Y. Baccarin DVM, MsC, PhD, Renata F. de Siqueira DVM, MsC, PhD, Carla B. Belli DVM, MsC, PhD","doi":"10.1111/vec.13367","DOIUrl":"10.1111/vec.13367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility of using the FreeStyle Libre (a continuous glucose monitoring system [CGMS]) for instantaneous continuous monitoring of interstitial glucose in adult horses and examine the applicability and accuracy of this system in horses submitted to combined glucose–insulin test (CGIT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Laboratory measurements and continuous glucose monitoring system (CGMS) readings were analyzed using a 2 × 2 factorial statistical model with repeated measures over time. This analysis assessed the effects of the test (factor 1), group (factor 2), and their interactions (test × group, test × time, and group × time). Pearson's correlation analysis was applied to blood glucose values. Mean comparisons were conducted using the <i>t</i>-test, and agreement between techniques was assessed via the Bland–Altman method, with a 95% confidence interval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Field study on private horse farms in association with a veterinary school.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Ten healthy stallions were assigned to one of two groups based on their body condition scores (BCS). Group 1 (G1, <i>n</i> = 5) consisted of nonobese horses with a BCS of 5 or 6, while Group 2 (G2, <i>n</i> = 5) consisted of obese horses with a BCS of 7 or higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>A CGMS sensor was attached to the dorsolateral aspect of the proximal one third of each horse's neck. Laboratory blood glucose measurements and CGMS interstitial glucose readings were compared at different time points for up to 7 days after sensor fixation. Obese horses were also submitted to CGIT on Day 4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>A comparative analysis of glucose measurements obtained in G1 and G2 horses using the CGMS and enzymatic methods revealed significant group × time interactions (<i>P</i> < 0.001) and time effects (<i>P</i> < 0.001). No interactions were detected between group (<i>P</i> = 0.45), test (<i>P</i> = 0.62), group and test (<i>P</i> = 0.28), or time and test (<i>P</i> = 0.92). In G1 and G2, tests were significantly correlated (<i>r</i> = 0.84 and <i>P</i> = 0.00) at all time points (T0–T5). Agreement between the glucose values obtained using different methods was excellent despite a small time delay in CGMS detection of rapid changes in blood glucose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"123-130"},"PeriodicalIF":1.3,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140066305","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}
Noël K. Vezzi DVM, Selena L. Lane DVM, DACVECC, Britt A. Thevelein DVM, DACVECC, Benjamin M. Brainard VMD, DACVAA, DACVECC
Objective
To evaluate the sensitivity and specificity of a veterinary point-of-care (POC) luminometer-based kit for the diagnosis of septic peritoneal or pleural effusion in dogs and cats.
Design
Prospective study performed between January 2020 and July 2021.
Setting
University teaching hospital.
Animals
Forty-eight animals with naturally occurring peritoneal or pleural effusion collected by aseptic abdominocentesis or thoracocentesis.
Procedures
Effusion samples were split into filtered (using a 10-micron filter) and unfiltered aliquots and analyzed by the POC instrument according to the manufacturer's instructions and following variable incubation periods. Samples were also plated aerobically on standard and blood agar plates. Proprietary reagents were added to samples, causing bacterial ATP to generate bioluminescence that is detected by the luminometer. Bioluminescence values (relative light units [RLUs]) were recorded and compared with the presence of bacterial growth on the culture plates. Nucleated cell counts in native and filtered effusion samples were recorded.
Results
Twenty-one samples were septic based on positive culture. RLUs were higher in septic effusions for filtered and native effusions compared with sterile effusions. The use of a filter reduced cell counts. In filtered samples incubated for 30 minutes before testing, the sensitivity and specificity of the luminometer for diagnosis of infection in cavitary effusions were 81% and 82%, respectively, using a cutoff of 12,202 RLUs.
Conclusions
The luminometer kit evaluated in this study represents a viable screening tool for diagnosis of septic cavitary effusions and could be used in conjunction with other POC diagnostics to support the rapid diagnosis of infection.
{"title":"Performance evaluation of a Test&Treat rapid detection kit for the diagnosis of septic effusions in dogs and cats","authors":"Noël K. Vezzi DVM, Selena L. Lane DVM, DACVECC, Britt A. Thevelein DVM, DACVECC, Benjamin M. Brainard VMD, DACVAA, DACVECC","doi":"10.1111/vec.13372","DOIUrl":"10.1111/vec.13372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the sensitivity and specificity of a veterinary point-of-care (POC) luminometer-based kit for the diagnosis of septic peritoneal or pleural effusion in dogs and cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective study performed between January 2020 and July 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>Forty-eight animals with naturally occurring peritoneal or pleural effusion collected by aseptic abdominocentesis or thoracocentesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Procedures</h3>\u0000 \u0000 <p>Effusion samples were split into filtered (using a 10-micron filter) and unfiltered aliquots and analyzed by the POC instrument according to the manufacturer's instructions and following variable incubation periods. Samples were also plated aerobically on standard and blood agar plates. Proprietary reagents were added to samples, causing bacterial ATP to generate bioluminescence that is detected by the luminometer. Bioluminescence values (relative light units [RLUs]) were recorded and compared with the presence of bacterial growth on the culture plates. Nucleated cell counts in native and filtered effusion samples were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one samples were septic based on positive culture. RLUs were higher in septic effusions for filtered and native effusions compared with sterile effusions. The use of a filter reduced cell counts. In filtered samples incubated for 30 minutes before testing, the sensitivity and specificity of the luminometer for diagnosis of infection in cavitary effusions were 81% and 82%, respectively, using a cutoff of 12,202 RLUs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The luminometer kit evaluated in this study represents a viable screening tool for diagnosis of septic cavitary effusions and could be used in conjunction with other POC diagnostics to support the rapid diagnosis of infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"110-115"},"PeriodicalIF":1.3,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013782","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}
Michelle K. Beehler DVM, Meagan R. Painter DVM, DACVD, Courtney M. Peck DVM, DACVECC
Objective
To describe the clinical presentation and response to management of a dog with presumed oral mite anaphylaxis.
Case Summary
A 2-year-old male intact Golden Retriever was evaluated for a history of recurrent anaphylactic episodes. Over a period of 19 months, the dog had a total of 8 anaphylactic episodes that occurred in 2 different residences within the same state. The episodes most commonly resulted in vomiting and labored breathing, but the dog developed ascites, hypotension, and gall bladder wall edema during the most severe episodes. Serological testing demonstrated high immunoglobulin E levels to storage mites (SMs), specifically Tyrophagus SM. The dog's kibble was transitioned to being stored in small quantities in airtight containers in the freezer. At the time of publication, the dog has not had an anaphylactic reaction since making this change 1 year ago.
New or Unique Information Provided
Based on a literature search and to the best of the authors’ knowledge, this is the first time that SMs have been associated with severe recurrent anaphylaxis in a dog.
目的：描述一只患有假定性口腔螨过敏性休克的犬的临床表现和治疗反应：病例摘要：对一只两岁大的雄性完整金毛寻回犬进行了评估，该犬有反复过敏性发作的病史。在 19 个月的时间里，该犬在同一州的两个不同住所共发生了 8 次过敏反应。发作时最常见的症状是呕吐和呼吸困难，但在最严重的一次发作中，该犬出现了腹水、低血压和胆囊壁水肿。血清学检测显示，该犬对贮存螨（SM），特别是酪螨SM的免疫球蛋白E水平很高。该犬的狗粮转为少量存放在冷冻室的密闭容器中。截至本报告发表时，自 1 年前做出这一改变以来，该犬未出现过敏反应：根据文献检索，就作者所知，这是 SM 首次与狗的严重复发性过敏性休克有关。
{"title":"Recurrent episodes of oral mite anaphylaxis in a dog","authors":"Michelle K. Beehler DVM, Meagan R. Painter DVM, DACVD, Courtney M. Peck DVM, DACVECC","doi":"10.1111/vec.13371","DOIUrl":"10.1111/vec.13371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the clinical presentation and response to management of a dog with presumed oral mite anaphylaxis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 2-year-old male intact Golden Retriever was evaluated for a history of recurrent anaphylactic episodes. Over a period of 19 months, the dog had a total of 8 anaphylactic episodes that occurred in 2 different residences within the same state. The episodes most commonly resulted in vomiting and labored breathing, but the dog developed ascites, hypotension, and gall bladder wall edema during the most severe episodes. Serological testing demonstrated high immunoglobulin E levels to storage mites (SMs), specifically <i>Tyrophagus</i> SM. The dog's kibble was transitioned to being stored in small quantities in airtight containers in the freezer. At the time of publication, the dog has not had an anaphylactic reaction since making this change 1 year ago.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>Based on a literature search and to the best of the authors’ knowledge, this is the first time that SMs have been associated with severe recurrent anaphylaxis in a dog.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"199-202"},"PeriodicalIF":1.3,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974866","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}
Adrienne D. Rhodes DVM, Pamela A. Wilkins DVM, MS, PhD, DACVIM, DACVECC, Annette M. McCoy DVM, MS, PhD, DACVS
Objective
To compare plasma l-lactate (LAC) values between samples collected from jugular and cephalic venipuncture in healthy horses and systemically ill horses.
Design
Prospective, experimental study.
Setting
Large animal university teaching hospital.
Animals
Thirty healthy adult university-owned horses and 43 client-owned horses presenting to the large animal hospital for elective surgical procedures or for emergent medical evaluation of systemic illness.
Interventions
Blood samples were collected from the jugular vein (JV) and cephalic vein (CV) and placed in EDTA blood tubes prior to any medical therapy. LAC values were obtained with a handheld lactate meter at the time of blood collection.
Measurements and Main Results
LAC was higher in CV samples than JV samples in healthy horses (P < 0.001); however, all values were within the normal reference range. Similarly, LAC was higher in CV samples than JV samples in systemically ill horses (P < 0.001), but the median JV value was within normal reference range (1.9 mmol/L [17.1 mg/dL]), while the median CV value was outside the normal reference range (2.9 mmol/L [26.1 mg/dL]).
Conclusions
The CV is an alternative venipuncture site for assessing plasma LAC if the JV is not accessible or to preserve the JV for subsequent catheterization. However, in ill horses, the CV value may be outside the reference range when the corresponding JV value would have been within the reference range.
{"title":"Comparison of plasma l-lactate between jugular and cephalic veins in healthy and systemically ill horses using a point-of-care device","authors":"Adrienne D. Rhodes DVM, Pamela A. Wilkins DVM, MS, PhD, DACVIM, DACVECC, Annette M. McCoy DVM, MS, PhD, DACVS","doi":"10.1111/vec.13364","DOIUrl":"10.1111/vec.13364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare plasma <span>l</span>-lactate (LAC) values between samples collected from jugular and cephalic venipuncture in healthy horses and systemically ill horses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, experimental study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Large animal university teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Thirty healthy adult university-owned horses and 43 client-owned horses presenting to the large animal hospital for elective surgical procedures or for emergent medical evaluation of systemic illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Blood samples were collected from the jugular vein (JV) and cephalic vein (CV) and placed in EDTA blood tubes prior to any medical therapy. LAC values were obtained with a handheld lactate meter at the time of blood collection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>LAC was higher in CV samples than JV samples in healthy horses (<i>P</i> < 0.001); however, all values were within the normal reference range. Similarly, LAC was higher in CV samples than JV samples in systemically ill horses (<i>P</i> < 0.001), but the median JV value was within normal reference range (1.9 mmol/L [17.1 mg/dL]), while the median CV value was outside the normal reference range (2.9 mmol/L [26.1 mg/dL]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CV is an alternative venipuncture site for assessing plasma LAC if the JV is not accessible or to preserve the JV for subsequent catheterization. However, in ill horses, the CV value may be outside the reference range when the corresponding JV value would have been within the reference range.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"131-134"},"PeriodicalIF":1.3,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984764","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}
Danielle M. Martindale DVM, Jenica L. Haraschak MS, DVM, DACVECC, Andrew J. Thiel DVM, Jonathan P. Samuelson MS, DVM, DACVP, John P. Buchweitz PhD, DABT
Objective
To describe the presentation, management, and postmortem examination findings in a dog with confirmed lisdexamfetamine dimesylate (LDX) toxicosis.
Case Summary
A 3-year-old female neutered mixed breed dog initially presented with neurological signs suspected to be secondary to LDX toxicosis. The dog was treated as typical for amphetamine toxicoses but developed severe respiratory and cardiovascular signs throughout their hospitalization. The progression of the cardiopulmonary signs led to cardiopulmonary arrest, for which CPR was unsuccessful. Postmortem examination exhibited severe hemorrhage throughout multiple organ systems. Toxicology testing confirmed the presence of unaltered LDX and its metabolite, amphetamine.
New or Unique Information Provided
This is the first case report documenting a severe progression of clinical signs and postmortem examination findings in a case of confirmed LDX toxicosis in a dog. Although the patient did not survive treatment, postmortem examination and microscopic evaluation of tissues allowed visualization of the extent of systemic pathophysiology. With prompt treatment, the prognosis of amphetamine toxicosis in dogs is generally considered good; however, this case report demonstrates a severe case in which even prompt and appropriate treatment did not prevent mortality. This suggests a need to establish negative prognostic indicators for which to monitor in cases of amphetamine toxicosis. Finally, this report is also unique in the fact that the LDX toxicosis was confirmed using a toxicological analysis technique not previously described clinically in dogs.
{"title":"Lisdexamfetamine dimesylate (Vyvanse) toxicosis in a dog","authors":"Danielle M. Martindale DVM, Jenica L. Haraschak MS, DVM, DACVECC, Andrew J. Thiel DVM, Jonathan P. Samuelson MS, DVM, DACVP, John P. Buchweitz PhD, DABT","doi":"10.1111/vec.13370","DOIUrl":"10.1111/vec.13370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the presentation, management, and postmortem examination findings in a dog with confirmed lisdexamfetamine dimesylate (LDX) toxicosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 3-year-old female neutered mixed breed dog initially presented with neurological signs suspected to be secondary to LDX toxicosis. The dog was treated as typical for amphetamine toxicoses but developed severe respiratory and cardiovascular signs throughout their hospitalization. The progression of the cardiopulmonary signs led to cardiopulmonary arrest, for which CPR was unsuccessful. Postmortem examination exhibited severe hemorrhage throughout multiple organ systems. Toxicology testing confirmed the presence of unaltered LDX and its metabolite, amphetamine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>This is the first case report documenting a severe progression of clinical signs and postmortem examination findings in a case of confirmed LDX toxicosis in a dog. Although the patient did not survive treatment, postmortem examination and microscopic evaluation of tissues allowed visualization of the extent of systemic pathophysiology. With prompt treatment, the prognosis of amphetamine toxicosis in dogs is generally considered good; however, this case report demonstrates a severe case in which even prompt and appropriate treatment did not prevent mortality. This suggests a need to establish negative prognostic indicators for which to monitor in cases of amphetamine toxicosis. Finally, this report is also unique in the fact that the LDX toxicosis was confirmed using a toxicological analysis technique not previously described clinically in dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 2","pages":"193-198"},"PeriodicalIF":1.3,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974863","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}
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