To determine if prazosin administration decreased the rate of recurrent urethral obstruction (rUO) before hospital discharge and within 14 days.
388 cats with urethral obstruction.
Veterinarians who either always or never prescribed prazosin (generally, 0.5 to 1 mg, PO, q 12 h for 14 days) were recruited to complete observational surveys. Patient data and characteristics of relieving the obstruction, including perception of a gritty feel within urethra or difficulty unobstructing the cat, were recorded. The rate of development of rUO before hospital discharge and by day 14 was compared between cats that received or did not receive prazosin with the Fisher exact test. Other variables were similarly compared between cats with and without rUO.
302 (78%) cats received prazosin, while 86 (22%) did not. There was no association between prazosin administration and risk of rUO prior to discharge, with 34 of 302 (11.3%) cats receiving prazosin and 5 or 86 (5.8%) not receiving prazosin developing rUO. Within 14 days, a significantly higher proportion of prazosin-treated cats (73/302 [24%]) developed an rUO, compared with the proportion of non–prazosin-treated cats (and 11/86 [13%]). The perception of a “gritty feeling urethra” or difficulty of performing the catheterization was associated with increased risk of rUO.
Prazosin administration increased the likelihood of rUO by 14 days; ongoing investigation of other therapies to decrease rUO in cats is warranted. Without specific indications, the use of prazosin for the prevention of rUO should be discouraged.
Case Description—A 4-year-old 29-kg (63.8-lb) spayed female Husky crossbred was referred for emergency treatment because of catastrophic hemorrhagic shock following attempts at cystocentesis for investigation of suspected urinary tract infection.
Clinical Findings—On arrival at the hospital, clinicopathologic assessments revealed rapidly decreasing PCV and worsening hypoproteinemia, compared with findings immediately prior to referral. The dog had severe hyperlactemia. Ultrasonography revealed the presence of free fluid in the abdomen; the fluid appeared to be blood (determined via abdominocentesis).
Treatment and Outcome—Urgent surgical exploration was undertaken. Two small lacerations in the ventral aspect of the abdominal aorta just dorsal to the bladder were identified and repaired. Multiple transfusions of packed RBCs (5 units) and fresh frozen plasma (3 units) were administered, and autotransfusion of blood (1.2 L) from the abdomen was performed. The dog recovered well from surgery and anesthesia, but developed signs of severe pain and swelling of both hind limbs, which were attributed to reperfusion injury following aortic occlusion during surgery. Treatment included administration of S-adenosylmethionine (23 mg/kg [10.5 mg/lb], PO, q 24 h) and analgesia; 5 days after surgery, the hind limb problems had resolved and treatments were discontinued.
Clinical Relevance—In the dog of this report, aortic laceration secondary to cystocentesis was successfully treated with a combination of surgery and massive transfusion; the development of reperfusion injury was an interesting and reversible complication of surgery. The possibility of damage to intra-abdominal structures should be investigated if a dog becomes acutely ill after cystocentesis.
OBJECTIVE To determine opinions of veterinary emergency health-care providers on the topic of owner-witnessed CPR in small animal emergency medicine and to identify reasons for opposition or support of owner-witnessed CPR.
DESIGN Cross-sectional survey.
SAMPLE 358 surveys completed by American College of Veterinary Emergency and Critical Care diplomates and residents as well as other emergency-care veterinarians and veterinary technicians between August 14, 2016, and September 14, 2016.
PROCEDURES An internet-based survey was used to collect data on respondent demographics, CPR experience, and opinions about owner-witnessed CPR. Responses were collected, and the Fisher exact test or χ2 test was used to compare distributions of various opinions toward owner-witnessed CPR among certain respondent groups.
RESULTS Owner presence during CPR was opposed by 277 of 356 (77.8%) respondents, with no substantial differences among demographic groups. Respondents with ≤ 10 years of experience were less willing to allow owner presence during CPR, compared with respondents with > 10 years of experience. Respondents who worked at practices that allowed owner presence during CPR were more likely to report emotional benefit for owners.
CONCLUSIONS AND CLINICAL RELEVANCE Veterinary professionals surveyed had similar concerns about owner-witnessed CPR, as has been reported by human health-care providers about family-witnessed resuscitation. However, emotional benefits from family-witnessed resuscitation in human health care have been reported, and emotional impacts of owner-witnessed CPR could be an area of research in veterinary medicine. In addition, investigation is needed to obtain more information about pet owner wishes in regard to witnessing CPR performed on their pets.
To investigate the reasons for evaluation on an emergency basis of and short-term outcomes for chickens from backyard flocks.
Retrospective case series.
For chickens evaluated on an emergency basis at a New England veterinary teaching hospital in January 2014 through March 2017, information including age, sex, flock size, primary medical problem, final diagnosis, and immediate outcome was obtained from electronic medical records. Primary medical problems were classified as abnormal droppings, crop or gastrointestinal tract disease, lameness, neurologic disease, nonspecific signs (ie, undefined illness), respiratory tract disease, reproductive tract disease, and trauma.
78 chickens were evaluated on an emergency basis, of which 71 were females from small flocks. The median age of the chickens was 1 year (range, 0.1 to 7 years). The most common problem was trauma (n = 25), followed by nonspecific signs (11) and reproductive tract disease (10); 18 birds had neurologic disease (6), lameness (6), or gastrointestinal tract disease (6). Five birds had respiratory tract disease, and 3 had abnormal droppings. Six birds were brought to the emergency service for euthanasia only. Trauma, reproductive tract disease, and signs of Marek disease were most frequently identified in birds that were fully evaluated. Thirty-five (45%) chickens were discharged from the hospital.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that backyard flock chickens were evaluated on an emergency basis most commonly because of trauma and reproductive tract disease. Although approximately half of the evaluated chickens were euthanized, the remainder were discharged from the hospital and required medical management. (J Am Vet Med Assoc 2019;254:1196–1203)
To evaluate the utility of abdominal ultrasonography (AUS) to detect grossly evident masses in dogs with nontraumatic hemoabdomen.
94 client-owned dogs.
Electronic medical records from 2014 to 2017 were searched to identify dogs with nontraumatic hemoabdomen that had an AUS performed by a radiologist and subsequently underwent gross evaluation by surgery or necropsy. Ultrasonography, surgery, and histology reports were reviewed, and descriptive statistics were performed. Sensitivity of ultrasonography to detect grossly identifiable masses was calculated.
Differences were identified between AUS and surgical or necropsy findings for 51 of 94 (54%) dogs. Splenic masses were most commonly identified as the cause of hemoabdomen. Sensitivity of AUS was 87.4%, 37.3%, and 31.3% for masses in the spleen, liver, and mesentery, respectively. Five dogs had more lesions identified with AUS than were found on gross evaluation; 0 of 6 dogs with peritoneal diffuse nodular metastasis had lesions detected by AUS.
CONCLUSIONS AND CLINICAL RELEVANCE
In this sample of dogs, the utility of AUS to detect grossly identifiable lesions in dogs with nontraumatic hemoabdomen was limited, with the highest and lowest sensitivity found for splenic masses and diffuse nodular metastasis, respectively.
A 6-year-old 5.25-kg (11.6-lb) castrated male domestic shorthair cat was referred to the Tufts Cummings School of Veterinary Medicine Emergency Service for management of thromboembolism in the distal portion of the aorta. The cat had no history of important medical problems.
On initial evaluation, the cat was bright, alert, and responsive. Body temperature (measured by use of an aural thermometer) was 39.7°C (103.5°F). The heart rate was 180 beats/min with an intermittent cardiac gallop. A grade 2/6 left parasternal systolic murmur was ausculted. The cat was eupneic (respiratory rate, 36 breaths/min), and auscultation of the lungs revealed no abnormalities. Paraplegia
OBJECTIVE To determine the prevalence of dogs hospitalized in an intensive care unit (ICU) with serum antibody titers against canine distemper virus (CDV) and canine parvovirus (CPV).
DESIGN Prospective observational study.
ANIMALS 80 dogs.
PROCEDURES Dogs hospitalized in an ICU for > 12 hours between February 1 and June 1, 2015, that had at least 0.25 mL of serum left over from diagnostic testing were eligible for study inclusion. Dogs with serum antibody titers > 1:32 (as determined by serum neutralization) and > 1:80 (as determined by hemagglutination inhibition) were considered seropositive for CDV and CPV, respectively. The date of last vaccination was obtained from the medical record of each dog.
RESULTS Of the 80 dogs, 40 (50%) and 65 (81%) dogs were seropositive for CDV and CPV, respectively. Of the 40 dogs that were seronegative for CDV, 27 had been vaccinated against CDV within 3 years prior to testing. Of the 15 dogs that were seronegative for CPV, 3 had been vaccinated against CPV within 3 years prior to testing. Ten dogs were seronegative for both CDV and CPV.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the prevalence of dogs hospitalized in an ICU that were seropositive for CDV and CPV was lower than expected given the high vaccination rate reported for dogs. Although the antibody titer necessary to prevent disease caused by CDV or CPV in critically ill dogs is unknown, adherence to infectious disease control guidelines is warranted when CDV- or CPV-infected dogs are treated in an ICU.
Objective—To determine clinical characteristics of
dogs that received massive transfusion and identify
the underlying diseases, complications, and outcomes.
Procedure—Medical records of dogs receiving a
massive blood transfusion were evaluated for transfusion
volume, underlying disease process or injury,
benefits and complications of transfusion, and outcome.
A massive transfusion was defined as transfusion
of a volume of blood products in excess of the
patient's estimated blood volume (90 ml/kg [40 ml/lb])
in a 24-hour period or transfusion of a volume of blood
products in excess of half the patient's estimated
blood volume in a 3-hour period.
Results—Six dogs had intra-abdominal neoplasia
resulting in hemoabdomen, 3 had suffered a traumatic
incident resulting in hemoabdomen, and 6 had nontraumatic,
non-neoplastic blood loss. Mean volumes
of packed RBC and fresh-frozen plasma administered
were 66.5 ml/kg (30 ml/lb) and 22.2 ml/kg (10 ml/lb),
respectively. All dogs evaluated developed low ionized
calcium concentrations and thrombocytopenia.
Transfusion reactions were recognized in 6 dogs.
Four dogs survived to hospital discharge.
Conclusions and Clinical Relevance—Results suggest
that massive transfusion is possible and potentially
successful in dogs. Predictable changes in electrolyte
concentrations and platelet count develop. (J
Am Vet Med Assoc 2002;220:1664–1669)
A 6-month-old 9.5-kg (20.9-lb) sexually intact male Vietnamese potbellied pig was presented for castration. Findings on preoperative physical examination were unremarkable, and food was withheld from the pig for 8 hours in preparation for the procedure scheduled for the following day.
The morning of surgery, the pig received maropitant (0.84 mg/kg [0.38 mg/lb], PO) and gabapentin (10.5 mg/kg [4.7 mg/lb], PO). Approximately 4 hours later, dexmedetomidine (2.6 μg/kg [1.2 μg/lb]), ketamine (2.6 mg/kg), midazolam (0.30 mg/kg [0.14 mg/lb]), and butorphanol (0.30 mg/kg) were administered IM. A marked level of sedation with no resistance to restraint was achieved. An intravenous