A look at the latest emergency and critical care literature - Veterinary Practice
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A look at the latest emergency and critical care literature

A summary of the latest academic publications, answering the question “what’s new?” in this month’s spotlight topic: emergency and critical care

A look through the latest literature: 37 of 37

Retrospective evaluation of 501 cases of acute salbutamol exposure in dogs

Joanna Crouchley and Nicola Bates, Veterinary Poisons Information Service (VPIS), London, England

Salbutamol is a beta-2-adrenergic receptor agonist used as a bronchodilator in human asthma patients. Dogs may be exposed to the drug by chewing an inhaler belonging to a family member. The authors describe the clinical findings in 501 cases recorded on the VPIS database. The most common clinical sign was tachycardia, with tachypnoea, depression and vomiting present in many cases. The prognosis was generally good: two dogs died, but 499 either recovered or showed no significant clinical signs. There were no reports of persistent cardiac injury or thermal damage due to the compressed gas used in some salbutamol products.

Journal of Veterinary Emergency and Critical Care, 32, 500-506

Clinical features and outcomes in 15 patients undergoing hypertensive emergencies

Dave Beeston and others, Royal Veterinary College, Hawkshead, England

There is little published information on the incidence and clinical consequences of hypertensive emergencies in veterinary patients. These events are considered an uncommon presentation in human patients, but they are known to have a high mortality rate of around 12.5 percent, usually resulting from neurovascular damage. The authors describe the findings from seven canine and eight feline cases treated at a university clinic. Patients presented with signs including seizures, blindness, altered mentation and lateral recumbency. Acute kidney injury was the most frequent underlying cause, seen in nine cases. Amlodipine was the first-line treatment in 10 patients, with five cats and three dogs surviving to discharge.

Journal of Small Animal Medicine

Comparison of rapid and prolonged stabilisation in gastric dilatation volvulus

Eloise Lhuillery and others, Centre Hospitalier Vétérinaire des Cordeliers, Meaux, France

Medical stabilisation, including gastric decompression and the placement of an indwelling nasogastric tube, is necessary before beginning surgery to treat gastric dilatation volvulus in dogs. However, there is some discussion among surgeons on how soon the procedure should begin after stabilisation. The authors compare the outcomes achieved in dogs undergoing immediate surgery within two hours of presentation or delayed surgery in which the procedure takes place up to 10 hours after the patient arrives at the clinic. Their results showed no significant clinical differences between the two groups.

Veterinary Surgery, 51, 843-852

Thoracolumbar intervertebral disc-associated epidural haemorrhage in dogs

Jenni Bridges and others, Ethos Veterinary Health, Woburn, Massachusetts

Spinal epidural haemorrhage is a fairly common sequela to intervertebral disc herniation in dogs. The authors compared the clinical presentation and magnetic resonance imaging findings in dogs undergoing hemilaminectomy with signs of epidural haemorrhage (63 cases) or without (97 cases). Dogs with haemorrhages were more likely to present within 48 hours of onset of clinical signs and were more likely to be non-ambulatory. French Bulldogs were significantly overrepresented in the group of dogs with epidural haemorrhage (23 out of 63 cases).

Journal of Veterinary Internal Medicine, 36, 1365-1372

Acute pulmonary oedema in a dog with severe pulmonary valve stenosis

Stefano Oricco and others, Centro Veterinario Imperiese, Imperia, Italy

Pulmonary stenosis is a congenital heart disease and a common finding in canine cardiac patients. The standard treatment is balloon valvuloplasty, which is considered a safe and reliable procedure; however, the authors describe the first reported incident of severe complications in a dog receiving this treatment. The patient was a five-month-old female English Cocker Spaniel that experienced a sharp drop in right ventricular pressure during its recovery from anaesthesia, along with hypoxaemia and dyspnoea due to pulmonary oedema. The dog recovered under intensive care with oxygen therapy, continuous positive airway pressure and furosemide therapy.

Journal of Veterinary Cardiology, 39, 1-7

Therapeutic obstacles in the management of canine refractory status epilepticus

Marios Charalambous and others, University of Veterinary Medicine, Hannover, Germany

Status epilepticus is a condition involving prolonged seizures, which, if left untreated, can develop into a refractory state in which the patient does not respond to standard medications. Such cases may result in irreversible brain damage and death. There is, however, a lack of clinical consensus on the appropriate treatment of refractory status epilepticus. The authors review our current understanding of the underlying pathophysiology of status epilepticus at its different temporal stages with the aim of identifying a more effective therapeutic approach.

The Veterinary Journal, 283-284, 105828

Evaluation of organ failure scores in dogs with severe sepsis and septic shock

Ann-Mari Osgood and others, Texas A&M University, College Station

Sepsis is a condition that causes high morbidity and mortality in canine patients, and its early detection is essential to ensure a positive outcome. The authors examine the value of a quick sequential organ failure scoring system in differentiating between patients with severe sepsis and septic shock and those with non-infectious systemic inflammatory response syndrome, a condition causing similar signs. They found that this method had poor sensitivity for detecting severe sepsis and septic shock and was also ineffective as a prognostic tool.

Journal of Small Animal Practice

Vital signs on admission in cats with brain herniation

Jiwoong Her and others, Auburn University, Alabama

Brain herniation is a result of the movement of the brain within the skull in response to raised intracranial pressure, which can lead to a life-threatening neurological emergency and permanent brain damage. The authors examined the clinical records from 32 cats with brain herniation and compared the findings with control cases with intracranial lesions but no evidence of herniation. Cats with herniation presented with lower consciousness scores on the modified Glasgow Coma Scale, but this was not attributable to or predictive of herniation. Older cats with intracranial neoplasia were at increased risk of herniation.

Journal of Feline Medicine and Surgery, 24, 770-778

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