Recent papers on emergency treatments - Veterinary Practice
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Recent papers on emergency treatments

Autologous blood transfusion in dogs with thoracic or abdominal haemorrhage

Veronica Higgs and others, Lakeshore Vet Specialists, Glendale, Wisconsin

Thoracic or abdominal haemorrhage in veterinary patients may result from a range of conditions causing vascular injury, such as trauma, organ torsion, ruptured neoplasia or coagulopathy. In cases of haemorrhage into a closed cavity, the shed blood can be collected and returned intravenously as an autologous blood transfusion to quickly provide blood components and intravascular volume.

The authors describe the use and outcomes of ABT in 25 canine cases, including 14 cases of vascular trauma, eight ruptured tumours and three incidents of coagulopathy, resulting from poisoning with the rodenticide brodifacoum. Their findings show that ABT is a useful adjunct to volume replacement in dogs with thoracic or abdominal haemorrhage and may be used as a bridge to definitive haemorrhage control when other blood products are not available or are unaffordable. Complications that may occur include hypocalcaemia, prolonged coagulation times and haemolysis.

Veterinary Emergency and Critical Care 25 (6): 731-738.

Effect of intra-operative lidocaine infusions in dogs with septic peritonitis

Luca Bellini and Christopher Seymour, Royal Veterinary College, Hertfordshire

Septic peritonitis, due to contamination of the peritoneal cavity with gut bacteria, results in a high mortality rate in affected dogs. Intravenous administration of lidocaine has been shown to have positive effects on inflammatory cytokines in experimentally-induced endotoxaemia in other species.

The authors examined the effects of intra-operative lidocaine infusions in 75 dogs with septic peritonitis that underwent laparotomy. Their findings show that the 48-hour survival rate was significantly better in those dogs that also received lidocaine and an opioid, compared with those given only the latter drug.

Journal of the American Veterinary Medical Association 248 (4): 422-429.

Comparing the costs of medical and surgical treatment of canine pyothorax

Jonathan Bach and Anusha Balakrishnan, University of Wisconsin, Madison

Pyothorax is an accumulation of purulent material within the pleural space and is a relatively uncommon but life-threatening condition. The condition can be managed by medical or surgical methods. The authors compared the costs of treatment between seven dogs receiving medical therapy, five given early surgery and seven receiving surgery later in the management of the case. Total costs were significantly lower in the medically treated group than in those receiving later surgery. Both pre-operative and total costs were higher in dogs receiving late surgical treatment than when patients were given early surgical care.

Canadian Veterinary Journal 56 (11): 1,140-1,143.

Guidelines on the reporting of cardiopulmonary resuscitation procedures

Manuel Boller and others, University of Melbourne, Australia

Cardiopulmonary resuscitation in companion animals is an uncommon and unpredictable procedure associated with a poor survival rate. An international group set up in 2013 aims to improve success rates for resuscitation events. It has highlighted the need for uniform descriptions of the methods used and the clinical outcomes. The authors provide recommendations for reviewing and reporting CPR events and establish non-ambiguous definitions for the terminology to be used. They suggest that these guidelines will help researchers by encouraging high quality studies producing comparable findings.

Journal of Emergency and Critical Care 26 (1): 11-34.

Treatment of feline asthma complicated by diabetes and heart failure

Laura Nafe and Stacey Leach, Oklahoma State University

Feline asthma is a common disorder of the lower airways, resulting in eosinophilia and bronchoconstriction. Standard therapy with glucocorticoids and bronchodilators may be contraindicated in patients with certain concurrent diseases. The authors describe a case of asthma in a five-year-old domestic shorthair cat that had also been diagnosed with diabetes and hypertrophic cardiomyopathy.

The cat, which was receiving frusemide and enalapril therapy for its congestive heart failure, was given oral cyclosporin instead of glucocorticoids for its asthma, resulting in resolution of the airway inflammation.

Journal of Feline Medicine and Surgery 17 (2): 1,073-1,076.

Negative pressure wound therapy with body wall reconstruction in a dog

Mirja Nolff and others, Ludwig-Maximillians University, Munich

A vacuum delivered to the wound bed has been shown to aid healing when managing traumatic soft tissue defects. The authors employed this technique in combination with an infusion of polyhexanide antiseptic and a polypropylene mesh to repair a large defect in the abdominal wall. The patient was a four-year-old spayed female dachshund with multiple haematomas and puncture wounds along its left abdominal wall after being attacked by another dog. Therapy was well-tolerated and the mesh was completely covered by granulation tissue after 10 days, when the wound was surgically closed.

Australian Veterinary Journal 93 (10): 367-372.

Measurements of platelet activation in critically ill dogs

Sean Majoy and others, Tufts University, Massachusetts

Platelet activation is a feature of a range of acute conditions, including immune-mediated haemolytic anaemia, parvoviral enteritis and sepsis. The authors measured platelet activation in 82 critically ill dogs to identify any correlation with the severity of the illness. Their findings show that critically ill dogs have hyperactive platelets, which may have contributed to a high incidence of hypercoagulability in this patient population. There were no differences between survivors and non-survivors in their ow cytometry and thrombo-elastography values.

American Journal of Veterinary Research 76 (4): 328-337.

Single-incision, laparoscopic-assisted jejunal resection and anastomosis

Jacob Rubin and others, University of Pennsylvania

A two-year-old castrated male Pomeranian was presented with a six-week history of chronic vomiting, intermittent anorexia and lethargy. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction.

The authors describe treatment with a laparoscopic-assisted, mid-jejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day following surgery and follow-up at two and eight weeks post-operatively confirmed that surgery had been successful.

Journal of the American Animal Hospital Association 51 (3): 155-160.

Aetiology and treatment of pyometra in intact female cats

Fiona Hollinshead and Natali Krekeler, Matamata Veterinary Services, Matamata, New Zealand

Pyometra is a common condition in intact queens but one that may often go undiagnosed, as the clinical signs may be mild and will not necessarily involve a mucopurulent discharge. The authors review current knowledge of the aetiology and treatment of this condition in cats. They suggest that the availability of new drugs and protocols for the medical treatment of pyometra may help in guiding clients with female cats intended for breeding on whether to opt for spaying as a treatment for a recurrent disease problem.

Journal of Feline Medicine and Surgery 18 (1): 21-33.

Removal of an airway foreign body in a dog using a flexible endoscope

Manuel Martin-Flores and others, Cornell University, New York

Airway foreign bodies can be life-threatening and so will often require urgent intervention. The authors describe a case in a 10-year-old spayed female Silky weighing 4.7kg, which had aspirated a fragment of an orotracheal tube. Due to the animal’s small size, flexible endoscopy could not be performed through the lumen of a tracheal tube. So following induction, the endoscope was introduced through a laryngeal mask airway. That arrangement allowed the instrument to be introduced into the trachea without interrupting the supply of oxygen or sevo urane.

Journal of the American Animal Hospital Association 51 (5): 325-328.

Addisonian crisis in a dog being treated with pentobarbitone

Veronika Simerdova and others, University of Brno, Czech Republic

Idiopathic epilepsy is the most common neurological disease in dogs and phenobarbitone is the drug of choice for its long-term treatment. This drug may accelerate metabolism of both exogenous and endogenous steroids. The authors describe an incident in a two-year-old intact female Irish setter which had been receiving phenobarbitone treatment for three weeks.

It presented with abnormal mentation and laboratory abnormalities including azotaemia, hyponatraemia and hyperkalaemia. An Addisonian crisis was suspected and, following further tests, successfully treated with glucocorticoids.

Australian Veterinary Journal 93 (4): 105-108.

Acute idiopathic polyneuritis with spontaneous remission in an Abyssinian kitten

Aurelien Jeandel and others, National Veterinary School, Maisons-Alfort, France

Polyneuropathies are an uncommon finding in cats, particularly in kittens. The authors describe a case in a six-month-old intact female Abyssinian cat with a pelvic limb weakness.

Neurological signs were consistent with a polyneuropathy and this was confirmed on electrophysiological and histological examinations. No infectious agents were identified. The kitten recovered spontaneously and at two years’ follow-up there had been no evidence of a relapse.

Canadian Veterinary Journal 56 (12): 1,279-1,282.

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