Pablo Alejandro Donati, Pablo E. Otero, Lisa Tarragona, Marcela Tunesi, Manuel Martín Flores, Santiago D´alotto, Arnaldo Dubín
Objective
To assess the splenic flow resistance index (RI) and its response to a fluid bolus in dogs showing circulatory abnormalities upon hospital admission.
Design
Prospective clinical study.
Setting
Veterinary referral hospital.
Animals
Nine dogs with circulatory shock and nine dogs without circulatory abnormalities.
Interventions
Dogs with circulatory abnormalities received an IV bolus of 30 mL/kg of balanced isotonic crystalloid fluid.
Measurements and Main Results
The splenic flow RI and the baseline aortic velocity–time integral of both groups of dogs were evaluated upon hospital admission. Measurements were repeated after the fluid bolus in dogs with circulatory shock. The Mann–Whitney U-test or the Wilcoxon rank sign test was used as appropriate. The median RI in dogs with circulatory shock was higher than that in dogs without hemodynamic disorders (median [interquartile range]: 0.64 [0.62–0.77] vs. 0.54 [0.51–0.54], P < 0.001). The best cutoff value to discriminate between the two groups was 0.61, with an area under the receiver operating characteristic curve of 1.00 (95% confidence interval [CI]: 1.00–1.00), a sensitivity of 100% (95% CI: 66.4–100), a specificity of 100% (95% CI: 66.4–100), a positive predictive value of 100% (95% CI: 66.4–100), and a negative predictive value of 100% (95% CI: 66.4–100). After fluid expansion, a significant decrease in the median splenic flow RI was observed (0.57 [0.54–0.71], P = 0.007 vs. basal).
Conclusions
The splenic flow RI may be a dependable tool for identifying circulatory shock in dogs and assessing their response to fluid therapy. Additional studies are required to evaluate the use of this index for the monitoring of organ perfusion, changes in cardiac output, and fluid responsiveness in critically ill dogs.
{"title":"Splenic Doppler Resistance Index for Detection of Circulatory Shock in Dogs","authors":"Pablo Alejandro Donati, Pablo E. Otero, Lisa Tarragona, Marcela Tunesi, Manuel Martín Flores, Santiago D´alotto, Arnaldo Dubín","doi":"10.1111/vec.13455","DOIUrl":"10.1111/vec.13455","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the splenic flow resistance index (RI) and its response to a fluid bolus in dogs showing circulatory abnormalities upon hospital admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Veterinary referral hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Nine dogs with circulatory shock and nine dogs without circulatory abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Dogs with circulatory abnormalities received an IV bolus of 30 mL/kg of balanced isotonic crystalloid fluid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>The splenic flow RI and the baseline aortic velocity–time integral of both groups of dogs were evaluated upon hospital admission. Measurements were repeated after the fluid bolus in dogs with circulatory shock. The Mann–Whitney <i>U</i>-test or the Wilcoxon rank sign test was used as appropriate. The median RI in dogs with circulatory shock was higher than that in dogs without hemodynamic disorders (median [interquartile range]: 0.64 [0.62–0.77] vs. 0.54 [0.51–0.54], <i>P</i> < 0.001). The best cutoff value to discriminate between the two groups was 0.61, with an area under the receiver operating characteristic curve of 1.00 (95% confidence interval [CI]: 1.00–1.00), a sensitivity of 100% (95% CI: 66.4–100), a specificity of 100% (95% CI: 66.4–100), a positive predictive value of 100% (95% CI: 66.4–100), and a negative predictive value of 100% (95% CI: 66.4–100). After fluid expansion, a significant decrease in the median splenic flow RI was observed (0.57 [0.54–0.71], <i>P</i> = 0.007 vs. basal).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The splenic flow RI may be a dependable tool for identifying circulatory shock in dogs and assessing their response to fluid therapy. Additional studies are required to evaluate the use of this index for the monitoring of organ perfusion, changes in cardiac output, and fluid responsiveness in critically ill dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"112-119"},"PeriodicalIF":1.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736283","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":"Carbon dioxide emissions associated with travel to and from EVECCS 2024","authors":"Sophie Adamantos, Karen Humm","doi":"10.1111/vec.13450","DOIUrl":"10.1111/vec.13450","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"180"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701511","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":"Emergency and Critical Care for Exotic Pets: A Need That Needs to be Fulfilled","authors":"Md. F. Kulyar, Quan Mo, Jindong Gao","doi":"10.1111/vec.13451","DOIUrl":"10.1111/vec.13451","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"178"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702164","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}
Grace E. Flynn, Cody I. Riffe, Kathleen M. Aicher, Lance R. Wheeler
Objective
To describe a case of clinically significant norepinephrine extravasation in a dog with a successful outcome following the use of subcutaneous phentolamine infusion.
Case Summary
An 8-year-old male neutered Labrador Retriever experienced norepinephrine extravasation from a cephalic, peripheral intravenous catheter while under anesthesia for an exploratory laparotomy. Upon recognition of norepinephrine extravasation, moderate subcutaneous edema and a painful dermal plaque were apparent at the extravasation site. Ten milligrams of phentolamine mesylate, a potent alpha-adrenergic receptor antagonist, were diluted in 10 mL of sterile saline and administered subcutaneously in small aliquots at multiple sites in the area of extravasation. The patient remained hemodynamically stable during and after the infusion. Most phentolamine injections produced instantaneous erythematous macules that resolved 24–36 h later, and the integument in the extravasation area rapidly changed from a “blanched” to a “pink” color. The subcutaneous edema gradually resolved within 7 days post-extravasation. At 12 h following extravasation, the dermal plaque progressed into a necrotic focus, which later developed into an ulcer (36 h), then a small crust (7 days), and finally healed epidermis (9 days). When the patient was euthanized 10 days after surgery due to continued decline secondary to systemic disease, there remained only a small superficial crust at the site of extravasation.
Unique Information
To the authors’ knowledge at the time of submission, this case report documented the first reported clinical use of subcutaneous phentolamine infusion for the management of norepinephrine extravasation in a veterinary species.
{"title":"Phentolamine Infusion for the Treatment of Norepinephrine Extravasation in a Dog","authors":"Grace E. Flynn, Cody I. Riffe, Kathleen M. Aicher, Lance R. Wheeler","doi":"10.1111/vec.13461","DOIUrl":"10.1111/vec.13461","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe a case of clinically significant norepinephrine extravasation in a dog with a successful outcome following the use of subcutaneous phentolamine infusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>An 8-year-old male neutered Labrador Retriever experienced norepinephrine extravasation from a cephalic, peripheral intravenous catheter while under anesthesia for an exploratory laparotomy. Upon recognition of norepinephrine extravasation, moderate subcutaneous edema and a painful dermal plaque were apparent at the extravasation site. Ten milligrams of phentolamine mesylate, a potent alpha-adrenergic receptor antagonist, were diluted in 10 mL of sterile saline and administered subcutaneously in small aliquots at multiple sites in the area of extravasation. The patient remained hemodynamically stable during and after the infusion. Most phentolamine injections produced instantaneous erythematous macules that resolved 24–36 h later, and the integument in the extravasation area rapidly changed from a “blanched” to a “pink” color. The subcutaneous edema gradually resolved within 7 days post-extravasation. At 12 h following extravasation, the dermal plaque progressed into a necrotic focus, which later developed into an ulcer (36 h), then a small crust (7 days), and finally healed epidermis (9 days). When the patient was euthanized 10 days after surgery due to continued decline secondary to systemic disease, there remained only a small superficial crust at the site of extravasation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Unique Information</h3>\u0000 \u0000 <p>To the authors’ knowledge at the time of submission, this case report documented the first reported clinical use of subcutaneous phentolamine infusion for the management of norepinephrine extravasation in a veterinary species.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"156-161"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702182","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}
Dory Meraz, Christina W. Bray, Andrew D. Eitzer, Steven W. Frederick
Objective
To describe hemothorax secondary to the spontaneous rupture of an aneurysmal dilation of a collateral vascular structure potentially resulting from chronic pulmonary thromboembolism in a dog.
Case Summary
An 11-year-old male neutered Schnauzer mix weighing 12.6 kg was presented to the emergency service of a veterinary specialty referral hospital for an episode of collapse. The dog was diagnosed with spontaneous (atraumatic) hemothorax and stabilized. Contrast-enhanced computed tomography (CT) of the thorax identified a large, aneurysmal dilation of a suspected collateral vascular structure in the mediastinum with a large thrombus in the dilatation, consistent with a recent rupture. In addition, multiple mineralized pulmonary arterial thrombi were identified. These findings were suggestive of chronic, thromboembolic pulmonary hypertension with suspected secondary acquired collateral circulation and subsequent aneurysmal dilatation and rupture of one of these structures, resulting in the bilateral hemothorax. The underlying cause of the thrombi was not identified despite an extensive workup. Upon resolution of the hemothorax, the dog was discharged with clopidogrel and has had no recurrence in 4 years.
New or Unique Information Provided
This is the first description of canine hemothorax possibly caused by the rupture of an aneurysmal dilation of suspected pulmonary hypertension-related vascular collaterals in a dog. CT is indicated in dogs with atraumatic hemothorax and evidence of chronic pulmonary thromboembolism.
{"title":"Hemothorax Secondary to Rupture of an Aneurysmal Structure of Thromboembolism-Related Collateral Vasculature in a Dog","authors":"Dory Meraz, Christina W. Bray, Andrew D. Eitzer, Steven W. Frederick","doi":"10.1111/vec.13454","DOIUrl":"10.1111/vec.13454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe hemothorax secondary to the spontaneous rupture of an aneurysmal dilation of a collateral vascular structure potentially resulting from chronic pulmonary thromboembolism in a dog.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>An 11-year-old male neutered Schnauzer mix weighing 12.6 kg was presented to the emergency service of a veterinary specialty referral hospital for an episode of collapse. The dog was diagnosed with spontaneous (atraumatic) hemothorax and stabilized. Contrast-enhanced computed tomography (CT) of the thorax identified a large, aneurysmal dilation of a suspected collateral vascular structure in the mediastinum with a large thrombus in the dilatation, consistent with a recent rupture. In addition, multiple mineralized pulmonary arterial thrombi were identified. These findings were suggestive of chronic, thromboembolic pulmonary hypertension with suspected secondary acquired collateral circulation and subsequent aneurysmal dilatation and rupture of one of these structures, resulting in the bilateral hemothorax. The underlying cause of the thrombi was not identified despite an extensive workup. Upon resolution of the hemothorax, the dog was discharged with clopidogrel and has had no recurrence in 4 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>This is the first description of canine hemothorax possibly caused by the rupture of an aneurysmal dilation of suspected pulmonary hypertension-related vascular collaterals in a dog. CT is indicated in dogs with atraumatic hemothorax and evidence of chronic pulmonary thromboembolism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"171-175"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702177","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}
Stephanie Schiavone, April E. Blong, Miranda Buseman, Bianca Reyes, Valery Scharf, Lingnan Yuan, Jonathan P. Mochel, Rebecca A. L. Walton
Objective
To evaluate the frequencies of in-hospital complications and survival to discharge in dogs with surgically placed gastrostomy tubes (G-tubes) and to assess the association between G-tube complications and primary disease, serum albumin concentration, and plasma total protein concentration.
Design
A retrospective multicenter study was performed at two university teaching hospitals between January 2010 and December 2020, including 133 dogs with surgically placed G-tubes.
Results
Nine dogs (6.7%) experienced a complication associated with the surgically placed G-tube. The most common complication was stoma site infection/inflammation (8/133 dogs [6%]), which was managed with topical therapy alone. One dog had septic peritonitis secondary to gastrointestinal leakage (1/133 [0.75%]). There was no association between primary etiology, serum albumin concentration, or plasma total protein concentration and complications. No dog died or was euthanized as a result of G-tube complications.
Conclusions
A low in-hospital complication frequency was found to be associated with surgically placed G-tubes in dogs with a variety of primary disease processes. Stoma site infection or inflammation was the major complication noted. Surgically placed G-tubes may be useful in patients undergoing abdominal surgery that are likely to need ongoing nutritional support.
{"title":"Retrospective Evaluation of Complications Associated With Surgically Placed Gastrostomy Tubes in Dogs (2010–2020): 133 Cases","authors":"Stephanie Schiavone, April E. Blong, Miranda Buseman, Bianca Reyes, Valery Scharf, Lingnan Yuan, Jonathan P. Mochel, Rebecca A. L. Walton","doi":"10.1111/vec.13452","DOIUrl":"10.1111/vec.13452","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the frequencies of in-hospital complications and survival to discharge in dogs with surgically placed gastrostomy tubes (G-tubes) and to assess the association between G-tube complications and primary disease, serum albumin concentration, and plasma total protein concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A retrospective multicenter study was performed at two university teaching hospitals between January 2010 and December 2020, including 133 dogs with surgically placed G-tubes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine dogs (6.7%) experienced a complication associated with the surgically placed G-tube. The most common complication was stoma site infection/inflammation (8/133 dogs [6%]), which was managed with topical therapy alone. One dog had septic peritonitis secondary to gastrointestinal leakage (1/133 [0.75%]). There was no association between primary etiology, serum albumin concentration, or plasma total protein concentration and complications. No dog died or was euthanized as a result of G-tube complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A low in-hospital complication frequency was found to be associated with surgically placed G-tubes in dogs with a variety of primary disease processes. Stoma site infection or inflammation was the major complication noted. Surgically placed G-tubes may be useful in patients undergoing abdominal surgery that are likely to need ongoing nutritional support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"137-141"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702201","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":"Reply Regarding E/CC for Exotic Pets","authors":"Lily Parkinson","doi":"10.1111/vec.13460","DOIUrl":"10.1111/vec.13460","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"179"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702191","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}
Lauren E. Minter, Rebecka S. Hess, Deborah C. Silverstein
<div> <section> <h3> Objective</h3> <p>To evaluate the variables associated with unsuccessful tracheal decannulation in brachycephalic breeds after upper airway surgery.</p> </section> <section> <h3> Design</h3> <p>Retrospective study from 2010 to 2022.</p> </section> <section> <h3> Setting</h3> <p>University teaching hospital.</p> </section> <section> <h3> Animals</h3> <p>Fifty-one client-owned dogs requiring a temporary tracheostomy after upper airway surgery for brachycephalic obstructive airway syndrome (BOAS).</p> </section> <section> <h3> Procedures</h3> <p>Medical records of dogs receiving a temporary tracheostomy after upper airway surgery for BOAS were reviewed. Dogs that underwent a tracheostomy decannulation attempt were included. Data were extracted from the medical record, including signalment, patient size, type of airway surgery, presence of hypoplastic trachea, presence of laryngeal collapse, prophylactic versus emergency tracheostomy, frequency of cannula suctioning, and time from tracheostomy to decannulation attempt. The association of these factors with successful decannulation and the number of decannulation attempts were evaluated.</p> </section> <section> <h3> Results</h3> <p>Of 699 dogs with BOAS that had upper airway surgery, 54 (7.7%) had a temporary tracheostomy performed. Dogs with an increased frequency of tracheostomy tube suctioning in the 24-h period before the first decannulation attempt were less likely to have a successful decannulation (<i>P</i> = 0.03). Dogs with laryngeal collapse were less likely to have a successful decannulation at first attempt (<i>P</i> = 0.04). The overall probability of successful decannulation was 88.2% at a median of 50 postoperative hours. Forty-five percent of patients had a successful first decannulation.</p> </section> <section> <h3> Conclusions</h3> <p>Results indicated that an increased frequency of tracheostomy tube suctioning or a diagnosis of laryngeal collapse was negatively associated with successful decannulation. The use of alternative methods to reduce respiratory secretions and the development of specific suctioning protocols may be warranted. Patients with laryngeal collapse requiring temporary tracheostomy may have a poorer prognosis. Multiple statistical comparisons were made without correction, so these data should be considered preliminary, and future studies are required to confirm these risk factors.</p>
{"title":"Factors That may be Associated With Tracheal Decannulation Failure in Dogs Requiring Temporary Tracheostomy After Upper Airway Surgery for Brachycephalic Obstructive Airway Syndrome","authors":"Lauren E. Minter, Rebecka S. Hess, Deborah C. Silverstein","doi":"10.1111/vec.13453","DOIUrl":"10.1111/vec.13453","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the variables associated with unsuccessful tracheal decannulation in brachycephalic breeds after upper airway surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective study from 2010 to 2022.</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>Fifty-one client-owned dogs requiring a temporary tracheostomy after upper airway surgery for brachycephalic obstructive airway syndrome (BOAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Procedures</h3>\u0000 \u0000 <p>Medical records of dogs receiving a temporary tracheostomy after upper airway surgery for BOAS were reviewed. Dogs that underwent a tracheostomy decannulation attempt were included. Data were extracted from the medical record, including signalment, patient size, type of airway surgery, presence of hypoplastic trachea, presence of laryngeal collapse, prophylactic versus emergency tracheostomy, frequency of cannula suctioning, and time from tracheostomy to decannulation attempt. The association of these factors with successful decannulation and the number of decannulation attempts were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 699 dogs with BOAS that had upper airway surgery, 54 (7.7%) had a temporary tracheostomy performed. Dogs with an increased frequency of tracheostomy tube suctioning in the 24-h period before the first decannulation attempt were less likely to have a successful decannulation (<i>P</i> = 0.03). Dogs with laryngeal collapse were less likely to have a successful decannulation at first attempt (<i>P</i> = 0.04). The overall probability of successful decannulation was 88.2% at a median of 50 postoperative hours. Forty-five percent of patients had a successful first decannulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicated that an increased frequency of tracheostomy tube suctioning or a diagnosis of laryngeal collapse was negatively associated with successful decannulation. The use of alternative methods to reduce respiratory secretions and the development of specific suctioning protocols may be warranted. Patients with laryngeal collapse requiring temporary tracheostomy may have a poorer prognosis. Multiple statistical comparisons were made without correction, so these data should be considered preliminary, and future studies are required to confirm these risk factors.</p>\u0000 ","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"131-136"},"PeriodicalIF":1.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702171","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.13395","DOIUrl":"https://doi.org/10.1111/vec.13395","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 1","pages":"1-4"},"PeriodicalIF":1.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424104","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}
Maria P. Vasquez DVM, Meredith Daly VMD, DACVECC, Corrin J. Boyd BSc, BVMS(Hons), GradDipEd MVetClinStud, MANZCVS, DACVECC, Dawn E. Crandell DVM, DVSc, DACVECC, Kelly E. Hall DVM, MS, DACVECC, Erin Long Mays DVM, DACVECC, Tandi Ngwenyama DVM, DACVECC, Jennifer Ortolani DVM, DACVECC, M. Ryan Smith DVM, DACVECC, Sabrina N. Hoehne Dr med vet, DACVECC, DECVECC, Linda Martin DVM, MS, DACVECC, Elizabeth B. Davidow DVM, DACVECC
Objective
To document clinical complications and intervention options associated with norepinephrine (NE) extravasation in dogs and cats.
Design
Cases were identified between 2015 and 2021. Because this is an uncommon complication, the findings are compiled as a descriptive retrospective study.
Setting
Cases were provided from 4 universities and 2 private practice groups in the United States, Canada, and Australia.
Small animal patients were included where extravasation of a NE constant rate infusion (CRI) was documented. Records were reviewed for information, including suspected underlying condition, description of the interventions pursued after identification of extravasation, clinical signs after extravasation, and survival to discharge or reason for patient death or euthanasia. When available, information was collected pertaining to the NE dose, dilution, total duration of CRI, and duration of CRI before extravasation was recognized.
Measurements and Main Results
The most commonly reported clinical signs after extravasation of NE were skin necrosis (n = 9 [64.3%]) and swelling (n = 6 [42.9%]). In 10 of 16 events (62.5%), discontinuation of the NE CRI and/or application of a warm compress to the extravasation site were performed; these were the most common nonpharmacological rescue measures. Two patients received subcutaneous phentolamine, and 1 patient underwent hyperbaric oxygen therapy. While surgical intervention was recommended for 4 dogs, 2 improved without surgical debridement. The overall survival rate from underlying disease processes was 57% (n = 8), with only 1 patient (7%) euthanized due to an injury from the extravasation.
Conclusions
Severe lesions can result from NE extravasation in dogs and cats, leading to euthanasia. Although phentolamine remains the treatment of choice, lesions may heal with alternative supportive measures.
{"title":"Multicenter retrospective evaluation of norepinephrine extravasation in dogs and cats (2015–2021): 14 cases","authors":"Maria P. Vasquez DVM, Meredith Daly VMD, DACVECC, Corrin J. Boyd BSc, BVMS(Hons), GradDipEd MVetClinStud, MANZCVS, DACVECC, Dawn E. Crandell DVM, DVSc, DACVECC, Kelly E. Hall DVM, MS, DACVECC, Erin Long Mays DVM, DACVECC, Tandi Ngwenyama DVM, DACVECC, Jennifer Ortolani DVM, DACVECC, M. Ryan Smith DVM, DACVECC, Sabrina N. Hoehne Dr med vet, DACVECC, DECVECC, Linda Martin DVM, MS, DACVECC, Elizabeth B. Davidow DVM, DACVECC","doi":"10.1111/vec.13442","DOIUrl":"https://doi.org/10.1111/vec.13442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To document clinical complications and intervention options associated with norepinephrine (NE) extravasation in dogs and cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cases were identified between 2015 and 2021. Because this is an uncommon complication, the findings are compiled as a descriptive retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Cases were provided from 4 universities and 2 private practice groups in the United States, Canada, and Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Fourteen patients (13 dogs, 1 cat) that experienced extravasation events (16 total).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Small animal patients were included where extravasation of a NE constant rate infusion (CRI) was documented. Records were reviewed for information, including suspected underlying condition, description of the interventions pursued after identification of extravasation, clinical signs after extravasation, and survival to discharge or reason for patient death or euthanasia. When available, information was collected pertaining to the NE dose, dilution, total duration of CRI, and duration of CRI before extravasation was recognized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>The most commonly reported clinical signs after extravasation of NE were skin necrosis (<i>n </i>= 9 [64.3%]) and swelling (<i>n</i> = 6 [42.9%]). In 10 of 16 events (62.5%), discontinuation of the NE CRI and/or application of a warm compress to the extravasation site were performed; these were the most common nonpharmacological rescue measures. Two patients received subcutaneous phentolamine, and 1 patient underwent hyperbaric oxygen therapy. While surgical intervention was recommended for 4 dogs, 2 improved without surgical debridement. The overall survival rate from underlying disease processes was 57% (<i>n</i> = 8), with only 1 patient (7%) euthanized due to an injury from the extravasation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Severe lesions can result from NE extravasation in dogs and cats, leading to euthanasia. Although phentolamine remains the treatment of choice, lesions may heal with alternative supportive measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 1","pages":"73-80"},"PeriodicalIF":1.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424017","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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