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Abstract
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.
Abstract
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.
Abstract
OBJECTIVE
To evaluate the utility of abdominal ultrasonography (AUS) to detect grossly evident masses in dogs with nontraumatic hemoabdomen.
ANIMALS
94 client-owned dogs.
PROCEDURES
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.
RESULTS
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.
Abstract
OBJECTIVE
To determine if prazosin administration decreased the rate of recurrent urethral obstruction (rUO) before hospital discharge and within 14 days.
ANIMALS
388 cats with urethral obstruction.
PROCEDURES
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.
RESULTS
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.
CLINICAL RELEVANCE
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.
Abstract
OBJECTIVE
To describe the clinical outcome of dogs that developed pneumothorax after an encounter with a porcupine.
ANIMALS
25 client-owned dogs from 2 practices in New England.
PROCEDURES
The medical records were searched for those of dogs that underwent care for porcupine quilling–associated pneumothorax (PQAP) between August 1, 2001, and October 15, 2023. Dogs were all large-breed dogs or large mixed-breed dogs and most frequently had clinical signs associated with pneumothorax, including labored breathing and tachypnea.
RESULTS
No cases occurred in winter months. Diagnostic imaging was useful for identifying pneumothorax, but not for localizing quills. Twenty-one of the 25 dogs underwent median sternotomy for quill removal, with quills found in lung tissue of 19 dogs. Two dogs had no intrathoracic quills identified at thoracotomy, but residual quills were identified in the intercostal muscles. Four dogs were discharged without surgery after apparent resolution of the pneumothorax. All dogs survived to hospital discharge; however, 5 dogs required subsequent quill removal from ongoing quill migration.
CLINICAL RELEVANCE
Porcupine quillings may result in traumatic pneumothorax associated with quill migration. Following quill removal, monitoring for the development of a pneumothorax is advised. Surgical removal of quills from the lungs has a good prognosis.
Abstract
CASE DESCRIPTION 2 dogs with chylothorax were identified to have cardiac mass lesions obstructing the return of venous blood from the cranial vena cava. Chylous effusion was presumed to have been a result of an increase in cranial vena cava pressure affecting flow of chyle through the thoracic duct.
CLINICAL FINDINGS Both dogs had tachypnea and pleural effusion requiring therapeutic thoracocentesis. Fluid analysis confirmed chylothorax. A heart-base mass was identified via echocardiography in each dog, and CT-angiographic findings confirmed obstruction to venous return in the cranial vena cava in both dogs and compression of the pulmonary artery in 1 dog.
TREATMENT AND OUTCOME Each dog was anesthetized, and self-expanding endovascular stents were placed with fluoroscopic guidance. In both dogs, the site of stent placement was the cranial vena cava, and in 1 dog, an additional stent was positioned in the pulmonary artery. Chylous effusion resolved successfully in both dogs after surgery, with postoperative survival times exceeding 6 months. Complications included periprocedural arrhythmias in both dogs and eventual obstruction of the stent with tumor extension and fluid reaccumulation in 1 dog.
CLINICAL RELEVANCE Endovascular stent placement may provide a useful palliative treatment for chylothorax secondary to vascular compression by a heart-base mass in dogs.
Abstract
Objective—To determine clinical characteristics of dogs that received massive transfusion and identify the underlying diseases, complications, and outcomes.
Design—Retrospective study.
Animals—15 dogs.
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)
Abstract
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.
