Thomas H. Edwards DVM, MS, DACVECC, Michael A. Meledeo PhD, Grantham C. Peltier MS, Alice F. Henderson, Luis A. Pompa, James A. Bynum PhD
Objective
To determine the characteristics of canine freeze-dried plasma (cFDP) as it is serially diluted with sterile water.
Design
In vitro experimental study.
Setting
Government blood and coagulation research laboratory.
Animals
cFDP from a commercial manufacturer.
Interventions
Ten units of cFDP were reconstituted to 100%, 90%, 80%, 70%, 60%, 50%, and 40% of the recommended volume with sterile water. The resultant solutions were analyzed for coagulation factor activity (factors II, V, VII, VIII, IX, X, and XII as well as antithrombin), fibrinogen concentration, prothrombin time, activated partial thromboplastin time, viscosity, osmolality, and kaolin-activated thromboelastography.
Measurements and Main Results
Viscosity, osmolality, and turbidity properties of plasma were increased in a reconstitution volume-dependent manner, with the 40% suggested volume generating approximately 2-fold increases in each. Similarly, factor activity levels and fibrinogen concentration increased by approximately 2-fold over this range in a concentration-dependent manner. Prothrombin time declined from 11.4 seconds at 100% volume to 10.9 seconds at 70% before increasing to 11.9 seconds at 40%. Activated partial thromboplastin time increased exponentially from 21.8 seconds at 100% rehydration to 100.0 seconds at 40%. R-time on TEG increased from 3.1 to 13.9 minutes at 50% rehydration, while alpha angle declined from 61.3° to 24.7° over the same range, and the maximum amplitude initially increased from 13.2 mm at 100% water to 18.6 mm at 70% water before dropping back down to 14.6 mm at 50% water. No clotting was observed with 40% rehydration.
Conclusions
The creation of hyperosmotic plasma from cFDP appears feasible with preservation of concentrated coagulation factors, although there are some unexplained effects that happen to coagulation functions at the highest concentrations tested using only 40%–50% of recommended rehydration volume. Further studies are needed to evaluate the hyperosmotic product in vivo.
{"title":"In vitro evaluation of hyperosmotic canine plasma suitable for infusion","authors":"Thomas H. Edwards DVM, MS, DACVECC, Michael A. Meledeo PhD, Grantham C. Peltier MS, Alice F. Henderson, Luis A. Pompa, James A. Bynum PhD","doi":"10.1111/vec.13353","DOIUrl":"10.1111/vec.13353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the characteristics of canine freeze-dried plasma (cFDP) as it is serially diluted with sterile water.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In vitro experimental study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Government blood and coagulation research laboratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>cFDP from a commercial manufacturer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Ten units of cFDP were reconstituted to 100%, 90%, 80%, 70%, 60%, 50%, and 40% of the recommended volume with sterile water. The resultant solutions were analyzed for coagulation factor activity (factors II, V, VII, VIII, IX, X, and XII as well as antithrombin), fibrinogen concentration, prothrombin time, activated partial thromboplastin time, viscosity, osmolality, and kaolin-activated thromboelastography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Viscosity, osmolality, and turbidity properties of plasma were increased in a reconstitution volume-dependent manner, with the 40% suggested volume generating approximately 2-fold increases in each. Similarly, factor activity levels and fibrinogen concentration increased by approximately 2-fold over this range in a concentration-dependent manner. Prothrombin time declined from 11.4 seconds at 100% volume to 10.9 seconds at 70% before increasing to 11.9 seconds at 40%. Activated partial thromboplastin time increased exponentially from 21.8 seconds at 100% rehydration to 100.0 seconds at 40%. R-time on TEG increased from 3.1 to 13.9 minutes at 50% rehydration, while alpha angle declined from 61.3° to 24.7° over the same range, and the maximum amplitude initially increased from 13.2 mm at 100% water to 18.6 mm at 70% water before dropping back down to 14.6 mm at 50% water. No clotting was observed with 40% rehydration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The creation of hyperosmotic plasma from cFDP appears feasible with preservation of concentrated coagulation factors, although there are some unexplained effects that happen to coagulation functions at the highest concentrations tested using only 40%–50% of recommended rehydration volume. Further studies are needed to evaluate the hyperosmotic product in vivo.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 1","pages":"63-68"},"PeriodicalIF":1.3,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592959","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}
M. Ryan Smith DVM, DACVECC, Virginie A. Wurlod MS, Dr vet med, DACVECC, DECVECC, Chin-Chi Liu MS, MApStat, PhD
Objective
To describe hemostatic derangements associated with canine anaphylaxis and to assess for association with syndrome severity.
Design
Prospective observational study.
Setting
University teaching hospital.
Animals
Twenty-seven client-owned dogs, recruited from November 2018 to January 2022, diagnosed with anaphylaxis of varying severity were included. Study inclusion required presentation <6 hours after initiation of clinical signs, no medications or history of illness within the prior 2 weeks, lack of comorbidities expected to affect hemostasis, and lack of a disease state that could alternatively explain the clinical presentation.
Interventions
Blood samples were collected within the first hour of presentation for CBC, serum biochemistry, prothrombin time (PT), activated partial thromboplastin time (aPTT), and viscoelastic coagulation testing for use with a cartridge-based point-of-care device.
Measurements and main results
Clotting time and clot formation time were prolonged, alpha angle and maximum clot firmness were decreased, PT and aPTT were prolonged, and platelet counts were lower in severe cases compared to mild and moderate cases. There were no differences for any parameter between mild and moderate cases. The presence or absence of abdominal effusion was not associated with hemostatic status.
Conclusions
Global hemostatic derangements consistent with hypocoagulability are a prominent feature of severe anaphylaxis in dogs and should be considered for routine evaluation.
{"title":"Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity","authors":"M. Ryan Smith DVM, DACVECC, Virginie A. Wurlod MS, Dr vet med, DACVECC, DECVECC, Chin-Chi Liu MS, MApStat, PhD","doi":"10.1111/vec.13345","DOIUrl":"10.1111/vec.13345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe hemostatic derangements associated with canine anaphylaxis and to assess for association with syndrome severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective observational study.</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>Twenty-seven client-owned dogs, recruited from November 2018 to January 2022, diagnosed with anaphylaxis of varying severity were included. Study inclusion required presentation <6 hours after initiation of clinical signs, no medications or history of illness within the prior 2 weeks, lack of comorbidities expected to affect hemostasis, and lack of a disease state that could alternatively explain the clinical presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Blood samples were collected within the first hour of presentation for CBC, serum biochemistry, prothrombin time (PT), activated partial thromboplastin time (aPTT), and viscoelastic coagulation testing for use with a cartridge-based point-of-care device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and main results</h3>\u0000 \u0000 <p>Clotting time and clot formation time were prolonged, alpha angle and maximum clot firmness were decreased, PT and aPTT were prolonged, and platelet counts were lower in severe cases compared to mild and moderate cases. There were no differences for any parameter between mild and moderate cases. The presence or absence of abdominal effusion was not associated with hemostatic status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Global hemostatic derangements consistent with hypocoagulability are a prominent feature of severe anaphylaxis in dogs and should be considered for routine evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"648-655"},"PeriodicalIF":1.3,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92158044","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}
Miranda Buseman DVM, April E. Blong DVM, DACVECC, Lingnan Yuan, Jonathan P. Mochel DVM, MSc, PhD, DECVPT, Rebecca A. L. Walton DVM, DACVECC
Objective
To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration.
Design
Retrospective study between 2009 and 2019.
Setting
University veterinary teaching hospital.
Animals
Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH).
Measurements and Main Results
Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44–3.40, P < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11–7.141, P = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04–1.12, P < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09–1.56, P = 0.003), and base excess (OR: 1.27, 95% CI: 1.1–1.49, P = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16–1.63, P < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scores (OR: 1.10, 95% CI: 1.04–1.17, P < 0.001) were associated with increased red blood cell transfusion administration.
Conclusions
Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLEfast scores.
{"title":"Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009–2019)","authors":"Miranda Buseman DVM, April E. Blong DVM, DACVECC, Lingnan Yuan, Jonathan P. Mochel DVM, MSc, PhD, DECVPT, Rebecca A. L. Walton DVM, DACVECC","doi":"10.1111/vec.13343","DOIUrl":"10.1111/vec.13343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective study between 2009 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University veterinary teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44–3.40, <i>P</i> < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11–7.141, <i>P</i> = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04–1.12, <i>P</i> < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09–1.56, <i>P</i> = 0.003), and base excess (OR: 1.27, 95% CI: 1.1–1.49, <i>P</i> = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16–1.63, <i>P</i> < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)<sub>fast</sub> scores (OR: 1.10, 95% CI: 1.04–1.17, <i>P</i> < 0.001) were associated with increased red blood cell transfusion administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLE<sub>fast</sub> scores.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 1","pages":"76-80"},"PeriodicalIF":1.3,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92158045","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}
Jasper E. Burke VMD, DACVECC, Rebecka S. Hess DVM, MSCE, DACVIM, Elisa P. McEntee DVM, DACVIM, Maureen A. Griffin DVM, DACVS, Selimah M. Harmon DVM, Deborah C. Silverstein DVM, DACVECC
<div> <section> <h3> Objective</h3> <p>To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.</p> </section> <section> <h3> Design</h3> <p>Retrospective cohort study from 2010 to 2019.</p> </section> <section> <h3> Setting</h3> <p>Multicenter study.</p> </section> <section> <h3> Animals</h3> <p>Fifty-six client-owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology.</p> </section> <section> <h3> Measurements and Main Results</h3> <p>Dogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03–0.9, <i>P</i> = 0.04; OR: 0.07, 95% CI: 0.01–0.6, <i>P</i> = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01–0.87, <i>P</i> = 0.04).</p> </section> <section> <h3> Conclusions</h3> <p>Hepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and mult
{"title":"Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019)","authors":"Jasper E. Burke VMD, DACVECC, Rebecka S. Hess DVM, MSCE, DACVIM, Elisa P. McEntee DVM, DACVIM, Maureen A. Griffin DVM, DACVS, Selimah M. Harmon DVM, Deborah C. Silverstein DVM, DACVECC","doi":"10.1111/vec.13340","DOIUrl":"10.1111/vec.13340","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study from 2010 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Multicenter study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Fifty-six client-owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Dogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03–0.9, <i>P</i> = 0.04; OR: 0.07, 95% CI: 0.01–0.6, <i>P</i> = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01–0.87, <i>P</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and mult","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"665-675"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523725","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}
Ashley Genetti BVM&S, Efa A. Llewellyn BVetMed, DACVECC, DECVECC, FHEA
<div> <section> <h3> Objective</h3> <p>To assess compression rate accuracy among veterinarians and registered veterinary nurses (RVNs) without and with an audible aid.</p> </section> <section> <h3> Design</h3> <p>Prospective study with use of a canine CPR manikin.</p> </section> <section> <h3> Setting</h3> <p>Small animal teaching hospital.</p> </section> <section> <h3> Subjects</h3> <p>Thirty-six participants (20 veterinarians and 16 RVNs).</p> </section> <section> <h3> Interventions</h3> <p>Each participant completed the first 2-minute cycle of chest compressions without an auditory aid on a canine CPR manikin. Each participant was then randomized to 1 of 3 auditory aid groups (Group B: Bee Gees “Stayin’ Alive”; Group Q: Queen “Another One Bites the Dust”; or Group M: traditional metronome) and then completed a second 2-minute cycle of chest compressions with the instruction to synchronize their compression rate with the beat of the auditory aid. An accurate chest compression rate was defined as obtaining a rate between 100 and 120 compressions per minute (cpm).</p> </section> <section> <h3> Measurements and Main Results</h3> <p>Median number of compressions administered by participants during Cycle 1 for the first minute was 111 (range 88–140) and for the second minute was 107 (range 80–151), with 25 of 36 (69%) participants obtaining an accurate chest compression rate. Median number of compressions administered during Cycle 2 for the first minute was 110 (range 76–125) and for the second minute was 110 (range 72–125), with 34 of 36 participants (94%) obtaining an accurate chest compression rate. Participants were more likely to obtain an accurate chest compression rate when an auditory aid was present compared to without (McNemar's test; <i>P</i> = 0.013). Subgroup analysis suggested the auditory aid was beneficial in Groups Q and M but not Group B (Kruskal–Wallis with Dunn's post hoc testing; <i>P</i> = 0.014, <i>P</i> = 0.0455, and <i>P</i> = 0.5637, respectively).</p> </section> <section> <h3> Conclusions</h3> <p>An auditory aid was associated with improved chest compression rate accuracy. However, as the auditory aid was not beneficial for Group B participants, our findings suggest that some auditory aids are more helpful than others.</p>
目的：评估无助听器和有助听器的兽医和注册兽医护士（RVN）压缩率的准确性。设计：使用犬心肺复苏模型进行前瞻性研究。设置：小动物教学医院。受试者：36名参与者（20名兽医和16名RVN）。干预措施：每个参与者在没有助听器的情况下，在犬心肺复苏假人上完成了第一个2分钟的胸外按压周期。然后，每个参与者被随机分为3个助听器组中的1个（B组：Bee Gees“Stayin‘Alive”；Q组：Queen“Another One Bites the Dust”；或M组：传统节拍器），然后完成第二个2分钟的胸外按压周期，并指示其压缩率与助听器的节拍同步。准确的胸部按压率被定义为获得每分钟100到120次按压（cpm）之间的速率。测量和主要结果：在第1周期中，参与者第一分钟的按压次数中位数为111次（范围88-140），第二分钟为107次（范围80-151），36名参与者中有25名（69%）获得了准确的胸部按压率。在第2周期中，第一分钟的按压次数中位数为110次（范围76-125），第二分钟的按压数量中位数为110（范围72-125），36名参与者中的34名（94%）获得了准确的胸部按压率。与没有助听器相比，有助听器的参与者更有可能获得准确的胸部压迫率（McNemar检验；P=0.013）。亚组分析表明，助听器在Q组和M组是有益的，但在B组不是有益的（Kruskal-Wallis与Dunn的事后检验；分别为P=0.014、P=0.0455和P=0.5637）。结论：助听器可提高胸部按压率的准确性。然而，由于助听器对B组参与者没有益处，我们的研究结果表明，一些助听器比其他助听器更有帮助。
{"title":"Usefulness of an auditory aid to improve chest compression rate accuracy during cardiopulmonary resuscitation","authors":"Ashley Genetti BVM&S, Efa A. Llewellyn BVetMed, DACVECC, DECVECC, FHEA","doi":"10.1111/vec.13351","DOIUrl":"10.1111/vec.13351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess compression rate accuracy among veterinarians and registered veterinary nurses (RVNs) without and with an audible aid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective study with use of a canine CPR manikin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Small animal teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects</h3>\u0000 \u0000 <p>Thirty-six participants (20 veterinarians and 16 RVNs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Each participant completed the first 2-minute cycle of chest compressions without an auditory aid on a canine CPR manikin. Each participant was then randomized to 1 of 3 auditory aid groups (Group B: Bee Gees “Stayin’ Alive”; Group Q: Queen “Another One Bites the Dust”; or Group M: traditional metronome) and then completed a second 2-minute cycle of chest compressions with the instruction to synchronize their compression rate with the beat of the auditory aid. An accurate chest compression rate was defined as obtaining a rate between 100 and 120 compressions per minute (cpm).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Median number of compressions administered by participants during Cycle 1 for the first minute was 111 (range 88–140) and for the second minute was 107 (range 80–151), with 25 of 36 (69%) participants obtaining an accurate chest compression rate. Median number of compressions administered during Cycle 2 for the first minute was 110 (range 76–125) and for the second minute was 110 (range 72–125), with 34 of 36 participants (94%) obtaining an accurate chest compression rate. Participants were more likely to obtain an accurate chest compression rate when an auditory aid was present compared to without (McNemar's test; <i>P</i> = 0.013). Subgroup analysis suggested the auditory aid was beneficial in Groups Q and M but not Group B (Kruskal–Wallis with Dunn's post hoc testing; <i>P</i> = 0.014, <i>P</i> = 0.0455, and <i>P</i> = 0.5637, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An auditory aid was associated with improved chest compression rate accuracy. However, as the auditory aid was not beneficial for Group B participants, our findings suggest that some auditory aids are more helpful than others.</p>\u0000 ","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"639-647"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523755","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}
Lasse I. Saloranta DVM, Jouko M. Levijoki MSc, Arja M. Vuorela MSc
<div> <section> <h3> Objective</h3> <p>To study the safety and effectiveness of consecutively administered ropinirole and apomorphine (both dopamine 2-like receptor agonists) for emesis induction in dogs.</p> </section> <section> <h3> Design</h3> <p>Prospective, crossover study design.</p> </section> <section> <h3> Setting</h3> <p>Institutional animal research facility.</p> </section> <section> <h3> Animals</h3> <p>Six healthy male purpose-bred Beagle dogs.</p> </section> <section> <h3> Interventions</h3> <p>Each dog received 4 treatments: (1) apomorphine infusion (21 μg/kg) over 30 minutes + ropinirole eye drops (3.75 mg/m<sup>2</sup>); (2) ropinirole infusion (108 μg/m<sup>2</sup>) over 30 minutes + apomorphine SC (100 μg/kg); (3) apomorphine SC (100 μg/kg) + ropinirole eye drops (7.5 mg/m<sup>2</sup>) after 30 minutes; and (4) ropinirole eye drops (7.5 mg/m<sup>2</sup>) + apomorphine SC (100 μg/kg) after 30 minutes. Infusions were administered via a catheter instrumented in the cephalic vein. Eye drops and SC injections were administered as described in the product inserts. Blood samples were taken for ropinirole and apomorphine concentration analysis before dosing and periodically following administrations. The washout period between the treatments was 5–7 days.</p> </section> <section> <h3> Measurements and Main Results</h3> <p>Number of vomits and clinical signs were recorded. Alertness and heart rate were monitored in conjunction with blood sampling. The average number of vomits varied between 4.3 and 8.8 (range 1–16) following treatments. Signs of nausea, vomiting, and lethargy were seen in all individuals without significant differences between treatments. Moderate to marked, transient increase in heart rates was detected in all treatments. Infrequent noted side effects included ocular hyperemia, blepharospasms, and muscle tremors. Prior treatment with apomorphine significantly decreased the absorption of ropinirole eye drops.</p> </section> <section> <h3> Conclusions</h3> <p>The safety and efficacy profiles of this experimental study support that ropinirole and apomorphine could be administered consecutively in cases where the treatment using 1 substance has resulted in an incomplete evacuation of the stomach contents, and the attending v
{"title":"An experimental study of consecutive administration of ropinirole and apomorphine for emesis induction in dogs","authors":"Lasse I. Saloranta DVM, Jouko M. Levijoki MSc, Arja M. Vuorela MSc","doi":"10.1111/vec.13339","DOIUrl":"10.1111/vec.13339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To study the safety and effectiveness of consecutively administered ropinirole and apomorphine (both dopamine 2-like receptor agonists) for emesis induction in dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, crossover study design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Institutional animal research facility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Six healthy male purpose-bred Beagle dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Each dog received 4 treatments: (1) apomorphine infusion (21 μg/kg) over 30 minutes + ropinirole eye drops (3.75 mg/m<sup>2</sup>); (2) ropinirole infusion (108 μg/m<sup>2</sup>) over 30 minutes + apomorphine SC (100 μg/kg); (3) apomorphine SC (100 μg/kg) + ropinirole eye drops (7.5 mg/m<sup>2</sup>) after 30 minutes; and (4) ropinirole eye drops (7.5 mg/m<sup>2</sup>) + apomorphine SC (100 μg/kg) after 30 minutes. Infusions were administered via a catheter instrumented in the cephalic vein. Eye drops and SC injections were administered as described in the product inserts. Blood samples were taken for ropinirole and apomorphine concentration analysis before dosing and periodically following administrations. The washout period between the treatments was 5–7 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Number of vomits and clinical signs were recorded. Alertness and heart rate were monitored in conjunction with blood sampling. The average number of vomits varied between 4.3 and 8.8 (range 1–16) following treatments. Signs of nausea, vomiting, and lethargy were seen in all individuals without significant differences between treatments. Moderate to marked, transient increase in heart rates was detected in all treatments. Infrequent noted side effects included ocular hyperemia, blepharospasms, and muscle tremors. Prior treatment with apomorphine significantly decreased the absorption of ropinirole eye drops.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The safety and efficacy profiles of this experimental study support that ropinirole and apomorphine could be administered consecutively in cases where the treatment using 1 substance has resulted in an incomplete evacuation of the stomach contents, and the attending v","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"34 1","pages":"31-39"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523723","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}
{"title":"Acute kidney injury in dogs following ingestion of cream of tartar and tamarinds and the connection to tartaric acid as the proposed toxic principle in grapes and raisins","authors":"Nicola Bates, Zoe Tizzard, Nick Edwards","doi":"10.1111/vec.13349","DOIUrl":"10.1111/vec.13349","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"722-723"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523722","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}
To describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog.
Case Summary
A 3-year-old female neutered mixed-breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram. Resolution of hypokalemia was documented 12 hours after initial presentation, at which time fluid therapy and potassium supplementation were discontinued. There were no further periods of sinus tachycardia, but instead the dog developed ventricular ectopy with rapid couplets (instantaneous rates of 300/min). An echocardiogram revealed normal cardiac size and function. Twenty-four hours after presentation, the patient developed severe hyperkalemia, despite discontinuation of fluids and potassium supplementation for 12 hours. Serial venous and urinary electrolytes were performed for determination of the fractional excretion of electrolytes. These data confirmed rebound hyperkalemia (7.0 mmol/L), consistent with a markedly increased fractional excretion of potassium, and secondary to the release of potassium from inside the cells. Fluid therapy with dextrose supplementation was provided until 36 hours postpresentation. The hyperkalemia resolved, and the dog was discharged after 44 hours of hospitalization.
New or Unique Information Provided
This case documents rebound hyperkalemia following treatment of albuterol toxicosis in a dog. This case highlights the importance of understanding the distribution of total body potassium when treating serum hypokalemia. Transcellular shifts of potassium, as in the case of albuterol toxicosis, can lead to rebound hyperkalemia even after discontinuation of potassium supplementation. This case further explores the utility of fractional excretion of electrolytes in elucidating the etiology and management of electrolyte disturbances.
{"title":"Rebound hyperkalemia in a dog with albuterol toxicosis after cessation of potassium supplementation","authors":"Samantha J. Guida DVM, Lisa Bazzle DVM, DACVECC","doi":"10.1111/vec.13352","DOIUrl":"10.1111/vec.13352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 3-year-old female neutered mixed-breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram. Resolution of hypokalemia was documented 12 hours after initial presentation, at which time fluid therapy and potassium supplementation were discontinued. There were no further periods of sinus tachycardia, but instead the dog developed ventricular ectopy with rapid couplets (instantaneous rates of 300/min). An echocardiogram revealed normal cardiac size and function. Twenty-four hours after presentation, the patient developed severe hyperkalemia, despite discontinuation of fluids and potassium supplementation for 12 hours. Serial venous and urinary electrolytes were performed for determination of the fractional excretion of electrolytes. These data confirmed rebound hyperkalemia (7.0 mmol/L), consistent with a markedly increased fractional excretion of potassium, and secondary to the release of potassium from inside the cells. Fluid therapy with dextrose supplementation was provided until 36 hours postpresentation. The hyperkalemia resolved, and the dog was discharged after 44 hours of hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>This case documents rebound hyperkalemia following treatment of albuterol toxicosis in a dog. This case highlights the importance of understanding the distribution of total body potassium when treating serum hypokalemia. Transcellular shifts of potassium, as in the case of albuterol toxicosis, can lead to rebound hyperkalemia even after discontinuation of potassium supplementation. This case further explores the utility of fractional excretion of electrolytes in elucidating the etiology and management of electrolyte disturbances.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"715-721"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523726","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}
Renee D. Schmid DVM, DABT, DABVT, Deanna Lombardo DVM, Lynn R. Hovda RPH, DVM, MS, DACVIM
Objective
To discuss the clinical presentation and successful treatment of a suspected case of intermediate syndrome due to organophosphate (OP) poisoning in a dog.
Case summary
Two dogs presented with acute cholinergic signs after ingesting an OP insecticide containing 50% acephate. Clinical signs consistent with acute cholinergic crisis resolved in both dogs within 24 hours postingestion. One dog developed an onset of neurological signs consistent with intermediate syndrome approximately 24 hours postingestion. This patient's clinical signs resolved with the use of pralidoxime chloride.
New or Unique Information Provided
OP poisoning most commonly presents as an acute cholinergic crisis, with rare instances of animals developing intermediate syndrome. Few reports of successful treatment and recovery from intermediate syndrome exist in the veterinary literature, particularly with instances in which 2 dogs within the same exposure setting were treated for acute cholinergic signs and only 1 progressed to an intermediate syndrome. This report also highlights the importance of early intervention with pralidoxime chloride prior to the onset of aging.
{"title":"Suspected intermediate syndrome in a dog after organophosphate poisoning","authors":"Renee D. Schmid DVM, DABT, DABVT, Deanna Lombardo DVM, Lynn R. Hovda RPH, DVM, MS, DACVIM","doi":"10.1111/vec.13342","DOIUrl":"10.1111/vec.13342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To discuss the clinical presentation and successful treatment of a suspected case of intermediate syndrome due to organophosphate (OP) poisoning in a dog.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case summary</h3>\u0000 \u0000 <p>Two dogs presented with acute cholinergic signs after ingesting an OP insecticide containing 50% acephate. Clinical signs consistent with acute cholinergic crisis resolved in both dogs within 24 hours postingestion. One dog developed an onset of neurological signs consistent with intermediate syndrome approximately 24 hours postingestion. This patient's clinical signs resolved with the use of pralidoxime chloride.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>OP poisoning most commonly presents as an acute cholinergic crisis, with rare instances of animals developing intermediate syndrome. Few reports of successful treatment and recovery from intermediate syndrome exist in the veterinary literature, particularly with instances in which 2 dogs within the same exposure setting were treated for acute cholinergic signs and only 1 progressed to an intermediate syndrome. This report also highlights the importance of early intervention with pralidoxime chloride prior to the onset of aging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"705-709"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523754","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}
Jamie M. Burkitt-Creedon DVM, DACVECC, Daniel J. Fletcher PhD, DVM, DACVECC, Manuel Boller Dr med vet, MTR, DACVECC
{"title":"Further comments regarding CPR techniques in dogs","authors":"Jamie M. Burkitt-Creedon DVM, DACVECC, Daniel J. Fletcher PhD, DVM, DACVECC, Manuel Boller Dr med vet, MTR, DACVECC","doi":"10.1111/vec.13348","DOIUrl":"10.1111/vec.13348","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"33 6","pages":"728-729"},"PeriodicalIF":1.3,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523724","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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