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- Author or Editor: Kristin M. Zersen x
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Abstract
OBJECTIVE
To determine whether the use of a force-activated separation device (FASD) lowers the incidence risk of peripheral intravenous catheter (PIVC) complications in hospitalized dogs.
ANIMALS
367 dogs that were hospitalized and received IV fluids between January 11 and March 25, 2021.
PROCEDURES
A prospective, randomized controlled clinical trial was performed. Dogs hospitalized and receiving IV fluids for at least 24 hours were randomized to the FASD group or control group. PIVCs were placed following a standardized protocol. Dogs in the FASD group had the FASD device attached to their PIVC according to manufacturer instructions. For both groups, all PIVC complications were documented, and each complication was classified as extravasation, phlebitis, dislodgement, occlusion, or line breakage.
RESULTS
Results from 367 dogs (FASD group = 180, control group = 187) underwent analysis. The proportion of PIVC complications was significantly (P = .004) lower for the FASD group (8.9% [16/180]) versus the control group (24.6% [46/187]). Following adjustment for differences in hospitalization time, the odds of a dog in the FASD group having a PIVC complication was approximately one-third the odds of those in the control group (OR, 0.33; 95% CI, 0.17 to 0.63; P = .001).
CLINICAL RELEVANCE
Results indicated that the use of a FASD in hospitalized dogs receiving IV fluids is warranted to lower the incidence of PIVC complications and may also limit patient discomfort, owner expense, and staff time devoted to managing PIVC complications. Further research investigating its use in cats and other species should be considered.
Abstract
OBJECTIVE
To assess the diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in dogs with nontraumatic hemoabdomen.
ANIMALS
106 dogs with a nontraumatic hemoabdomen that underwent abdominal ultrasonography and splenectomy with histologic examination of splenic lesions between 2005 and 2018.
PROCEDURES
Medical records were reviewed for abdominal ultrasonographic and histologic findings. Diagnostic performance of ultrasonographic description of a splenic mass or nodule as cavitated as evidence of hemangiosarcoma or any malignancy was evaluated.
RESULTS
Ultrasonographic description of splenic lesions as cavitated had poor diagnostic utility in predicting presence of hemangiosarcoma or malignancy. Sensitivity and specificity of this test were 41.9% (95% CI, 30.5% to 54.3%) and 51.2% (95% CI, 36.8% to 65.4%), respectively, for detecting hemangiosarcoma, with positive and negative predictive values of 55.3% (95% CI, 41.2% to 68.6%) and 37.9% (95% CI, 26.6% to 50.8%), respectively. Results were similar for detecting malignancy. Cavitated lesions outside of the spleen were too rare for statistical analysis to be of value.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that relying on ultrasonographic description of cavitation to diagnose splenic lesions as malignant in dogs with nontraumatic hemoabdomen is unfounded. Other preoperative diagnostic tests may be more valuable in determining short- and long-term prognoses.
Abstract
OBJECTIVE
To determine whether premature death occurred among dogs with nonmalignant splenic histopathologic findings after splenectomy for nontraumatic hemoabdomen.
ANIMALS
197 dogs with nontraumatic hemoabdomen that underwent splenectomy and histopathologic evaluation between 2005 and 2018.
PROCEDURES
Information was obtained from electronic medical records, dog owners, and referring veterinarians to determine patient characteristics, histopathologic findings, survival information, and cause of death. Dogs were grouped based on histopathological diagnosis and outcome, and median survival times (MSTs) and risk factors for death were determined.
RESULTS
Histopathologic findings indicated malignancy in 144 of the 197 (73.1%) dogs with nontraumatic hemoabdomen. Hemangiosarcoma was diagnosed in 126 dogs (87.5% of those with malignancies and 64.0% of all dogs). Nine of 53 (17%) dogs with nonmalignant histopathologic findings had an adverse outcome and premature death, with an MST of 49 days. Risk factors for this outcome included low plasma total solids concentration, an elevated hemangiosarcoma likelihood prediction score, and a medium or high hemangiosarcoma likelihood prediction score category.
CONCLUSIONS AND CLINICAL RELEVANCE
This study showed that there is a group of dogs with nontraumatic hemoabdomen due to splenic disease that have nonmalignant histopathologic findings after splenectomy, but nonetheless suffer an adverse outcome and die prematurely of a suspected malignancy. Further evaluation of potential at-risk populations may yield detection of otherwise overlooked malignancies.
Abstract
OBJECTIVE
To determine whether shock index (SI) positively correlates with percentage blood loss and negatively correlates with cardiac output (CO) in a canine hemorrhagic shock model and whether SI and metabolic markers may be used as end point targets for resuscitation.
ANIMALS
8 healthy Beagles.
PROCEDURES
Between September and December 2021, dogs underwent general anesthesia for experimental induction of hypotensive shock, with the total volume of blood removed, CO, heart rate, systolic blood pressure, base excess, blood pH, and concentrations of hemoglobin, lactate, ionized calcium recorded, and SI calculated at 4 time points (TPs): after anesthetic induction when the dog had been stable for 10 minutes (TP1), 10 minutes after the mean arterial pressure stabilized to a target of 40 mm Hg following jugular removal of up to 60% blood volume to induce hemorrhagic shock (TP2), 10 minutes after autotransfusion of 50% of the removed blood (TP3), and 10 minutes after autotransfusion of the remaining 50% of the removed blood (TP4).
RESULTS
Mean SI increased between TP1 (1.08 ± 0.35) and TP2 (1.90 ± 0.73) and did not return to the prehemorrhage values for TP3 or TP4. SI correlated positively with percentage blood loss (r = 0.583) and negatively with CO (r = –0.543).
CLINICAL RELEVANCE
An increase in SI may support diagnosis of hemorrhagic shock; however, SI cannot be used as the sole end point of resuscitation. Significant differences in blood pH, base excess, and lactate concentration suggested they may be useful markers of hemorrhagic shock and need for blood transfusion.
