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Veterinary Clinics of North America. Small Animal Practice

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https://www.readbyqxmd.com/read/27916285/a-quick-reference-on-hypoxemia
#1
REVIEW
Jonathan Bach
This article describes the calculation of the alveolar-arterial gas gradient and its clinical application in determining the cause of hypoxemia. It also outlines the analysis of arterial blood gases and the clinical approach toward diagnosis and treatment of respiratory disease.
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#2
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914758/fluid-therapy-in-lung-disease
#3
REVIEW
Elizabeth Rozanski, Alex Lynch
Fluid therapy is the cornerstone of supportive care in veterinary medicine. In dogs and cats with preexisting confirmed or suspected pulmonary disease, concerns may exist that the fluid therapy may impair gas exchange, either through increases in hydrostatic pressures or extravasation. Colloidal therapy is more likely to magnify lung injury compared with isotonic crystalloids. Radiographic evidence of fluid overload is a late-stage finding, whereas point-of-care ultrasound may provide earlier information that can also be assessed periodically at the patient side...
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914757/a-quick-reference-on-metabolic-alkalosis
#4
REVIEW
Daniel S Foy, Helio Autran de Morais
Metabolic alkalemia is characterized by an increase in bicarbonate concentration and base excess, an increase in pH, and a compensatory increase in carbon dioxide pressure. This article outlines indications for analysis, reference ranges, causes, and clinical signs of metabolic alkalosis. Algorithms for evaluation of patients with acid-base disorders and metabolic alkalosis are included.
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914756/the-colloid-controversy-are-colloids-bad-and-what-are-the-options
#5
REVIEW
Christine Wong, Amie Koenig
Biologic and synthetic colloid solutions are frequently used to increase oncotic pressure and to treat shock. Research has shown that each product has both risks and benefits. Hydroxyethyl starches have gained a reputation for increasing risk of death, acute kidney injury, and coagulation abnormalities in people, but additional studies are needed to see whether these concerns hold true in veterinary patients. This article reviews the risks and benefits of currently available products.
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914755/preface
#6
EDITORIAL
Jonathan A Lidbury
No abstract text is available yet for this article.
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914760/update-clinical-use-of-plasma-lactate
#7
REVIEW
├Źde Gillespie, Patricia G Rosenstein, Dez Hughes
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself...
November 30, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27908485/managing-fluid-and-electrolyte-disorders-in-kidney-disease
#8
REVIEW
Cathy Langston
Because of the role of the kidneys in maintaining homeostasis in the body, kidney disease leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, and repeated and frequent reassessment of fluid and electrolyte balance. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in kidney disease and some may be life-threatening...
November 28, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27908484/maintenance-fluid-therapy-isotonic-versus-hypotonic-solutions
#9
REVIEW
Bernie Hansen, Alessio Vigani
The goal of maintenance fluid therapy in small animals is to replace normal ongoing losses of water and salts when oral intake is withheld. Hospitalized dogs and cats may have multiple stimuli for antidiuretic hormone release that disrupt normal osmoregulation and predispose to water retention. Severe illness promotes retention of both sodium and water as edema. Commercially available fluids have electrolyte concentrations that are very different from dietary maintenance requirements, and potential consequences include development of hypoosmolality, edema, or both when excesses of water or sodium are administered...
November 28, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27894794/fluid-therapy-options-and-rational-selection
#10
REVIEW
Christopher G Byers
Administration of appropriate types and volumes of parenteral fluids is of paramount importance when treating sick and debilitated patients, especially those fighting critical illness. Fluid selection and accurate calculations must be performed logically and accurately to maximize positive outcomes. Knowledge of fluid types, as well as the complex relationship of the body's fluid compartments, helps clinicians develop rational fluid therapy plans for their patients.
November 25, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27894793/a-quick-reference-on-anion-gap-and-strong-ion-gap
#11
REVIEW
Carlos Torrente Artero
Metabolic acid-base disorders are common in emergency and critically ill patients. Clinicians may have difficulty recognizing their presence when multiple acid-base derangements are present in a single patient simultaneously. The anion gap and the strong ion gap concepts are useful calculations to identify the components of complex metabolic acid-base associated to the presence of unmeasured anions. This article presents their definition, normal values, indications, limitations, and guidelines for interpretation of changes in the clinical setting...
November 25, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27890436/respiratory-acid-base-disorders-in-the-critical-care-unit
#12
REVIEW
Kate Hopper
The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco2 may have a significant impact on outcome. Monitoring Pco2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis...
November 24, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27890435/treating-hypoalbuminemia
#13
REVIEW
Bobbi J Conner
Hypoalbuminemia is common and associated with a variety of disease processes, including those leading to systemic inflammatory response syndrome, gastrointestinal disorders, hepatic disorders, and glomerular diseases. Some animals develop clinical signs directly caused by low serum albumin concentration. There is strong evidence that hypoalbuminemia is associated with worse outcomes; however, evidence justifying albumin supplementation is lacking. Severe adverse events are frequently reported with administration of human serum albumin and there is little evidence of benefit from other products...
November 24, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27876158/is-bicarbonate-therapy-useful
#14
REVIEW
Kate Hopper
Despite concerns about the negative effects of metabolic acidosis, there is minimal evidence that sodium bicarbonate administration is an effective treatment. In addition, sodium bicarbonate therapy is associated with many adverse effects, including paradoxic intracellular acidosis, hypokalemia, hypocalcemia, hypernatremia, and hyperosmolality. Definitive recommendations regarding bicarbonate therapy are challenging as there is little high-quality evidence available. In most clinical scenarios of metabolic acidosis, treatment efforts should focus on resolution of the underlying cause, and sodium bicarbonate therapy should be used with caution, if at all...
November 18, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27865359/getting-the-most-from-your-cytology-samples
#15
EDITORIAL
Amy L MacNeill
No abstract text is available yet for this article.
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27720280/preanalytical-considerations-for-joint-fluid-evaluation
#16
REVIEW
Caitlyn R Martinez, Kelly S Santangelo
Synovial fluid analysis is a key component of the minimum database needed to diagnose and manage primary and secondary articular joint disorders. Unfortunately, preanalytical variables can drastically alter samples submitted for evaluation to veterinary laboratories and it is considered the stage at which most laboratory error occurs. This article addresses common sources of preanalytical variability and error that are seen in veterinary medicine. With consistent quality control and reporting of specimens, downstream clinical decision making and management of patients can be accelerated and improved...
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27720279/bone-marrow-aspirate-evaluation
#17
REVIEW
Nicole I Stacy, John W Harvey
Important steps in bone marrow aspirate evaluation include determining if bone marrow evaluation is indicated; using appropriate aspirate collection, smear preparation, and staining techniques; and performing a systematic approach for the cytologic evaluation. The cytologic evaluation of bone marrow requires knowledge of the morphology of bone marrow cell types, the proportion of these cell types normally present, and the ability to evaluate overall cellularity of bone marrow. Accurate interpretation of bone marrow cytologic findings depends on evaluation of a current complete blood cell count...
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27567130/pigments-iron-and-friends
#18
REVIEW
Lauren B Radakovich, Christine S Olver
Iron, particularly hemosiderin, is a commonly observed pigment in cytology. Many pigments appear green to blue to black, making differentiation of pigment types difficult. While cytologic clues such as erythrophagia can help determine whether pigment is iron, Perl's Prussian Blue stain is used to highlight iron when these clues are not present. Other special stains can identify similar pigments such as copper. Identification of pigments is important as it directs cytologic interpretation, thus directly influencing patient diagnosis...
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27562934/urine-cytology-collection-film-preparation-and-evaluation
#19
REVIEW
Linda M Vap, Sarah B Shropshire
Cytologic examination of the urine sediment in animals suspected of having urinary tract disease or lower urinary tract masses is one of the best means of distinguishing inflammation, infection, and neoplasia and can help determine if a positive dipstick result for hemoglobin/blood is due to hemorrhage or blood contamination. The quality of the specimen collection and handling plays an important role in the quality of results, the validity of interpretations, and selection of appropriate course of action. The method of sample collection aids localization of pathology...
January 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27553300/common-infectious-organisms
#20
REVIEW
Craig A Thompson, Amy L MacNeill
Cytology offers a rapid, relatively noninvasive means to identify lesions of all varieties including immune-mediated, degenerate, inflammatory, and neoplastic. One area that is particularly amenable to cytologic diagnosis is infectious disease. Organisms that can be seen and identified include fungal, bacterial, protozoal, parasitic, viral, and algal. Rapid identification of pathogenic organisms allows the practitioner to initiate treatment quickly, giving the patient the best chance for recovery.
January 2017: Veterinary Clinics of North America. Small Animal Practice
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