veterinary emergency and critical care

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The democratization of ultrasound imaging refers to the process of making ultrasound technology more accessible. Traditionally, ultrasound imaging has been predominately used in specialized medical facilities by trained professionals. Advancements in technology and changes in the health-care landscape have inspired efforts to broaden the availability of ultrasound imaging to various settings such as remote and resource-limited areas. In this review, we highlight several key factors that have contributed to the ongoing democratization of ultrasound imaging, including portable and handheld devices, recent advancements in technology, and training and education...

OBJECTIVE: To assess the ability of intranasal atipamezole to reverse sedative effects of xylazine in dogs. DESIGN: Prospective proof-of-concept study. SETTING: University research laboratory. ANIMAL: Six healthy, staff-owned dogs. INTERVENTIONS: Dogs were sedated with 1.1 mg/kg of xylazine intravenously. The sedation score of each dog was recorded every 5 minutes until they achieved a sedation score of >13/21 for 3 readings...

OBJECTIVES: To determine platelet function and assess fibrinolysis in dogs following trauma using multiple electrical impedance aggregometry and a modified thromboelastographic (TEG) technique. To determine if the severity of trauma, as assessed by the Animal Trauma Triage (ATT) score and clinicopathological markers of shock, is associated with a greater degree of platelet dysfunction and fibrinolysis. SETTING: University teaching hospital. ANIMALS: Twenty client-owned dogs with trauma (occurring <24 h prior to admission and blood sampling) and ATT score of >4 were prospectively recruited...

OBJECTIVE: Describe the use of fixed-rate intravenous insulin infusions (FRIs) in cats and dogs with diabetic ketoacidosis (DKA) and determine if this is associated with faster resolution of ketosis compared to variable-rate intravenous insulin infusions (VRIs). Secondary objectives were to evaluate complication rates, length of hospitalization (LOH), and survival to discharge (STD). DESIGN: Randomized clinical trial (January 2019 to July 2020). SETTING: University veterinary teaching hospital and private referral hospital...

OBJECTIVE: To review and summarize the pharmacology of the antiepileptic drug (AED), levetiracetam (LEV), and to discuss its clinical utility in dogs and cats. DATA SOURCES: Veterinary and human peer-reviewed medical literature and the authors' clinical experience. SUMMARY: LEV is an AED with mechanisms of action distinct from those of other AEDs. In people and small animals, LEV exhibits linear kinetics, excellent oral bioavailability, and minimal drug-drug interactions...

OBJECTIVE: To determine whether emergency staff and students can predict patient outcome within 24 hours of admission, comparing the accuracy of clinician prognostication with outcome prediction by Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scoring and identifying whether experience or mood would be associated with accuracy. DESIGN: Prospective observational study between April 2020 and March 2021. SETTING: University teaching hospital...

OBJECTIVE: To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN: Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING: Two veterinary university teaching hospitals. ANIMALS: A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion...

OBJECTIVE: This retrospective study aimed to characterize and evaluate the emergency approach, diagnosis, management, treatment, and follow-up of nonspecific canine lameness cases. DESIGN: Retrospective case series from September 25, 2013 to September 25, 2014. SETTING: The study was conducted at an urban university teaching hospital. ANIMALS: A consecutive sample of dogs presenting to the emergency service with nonspecific lameness in the designated timeframe was used to identify 134 cases...

From boon molecules to molecules contributing to rising concern has been the sojourn of antibiotics. The problem of antibiotic contamination has gotten worse due to antibiotics' pervasive use in every aspect of the environment. One such consequence of pollution is the increase in infections with antibiotic resistance. All known antimicrobials being used for human benefit lead to their repetitive and routine release into the environment. The misuse of antibiotics has aggravated the situation to a level that we are short of antibiotics to treat infections as organisms have developed resistance against them...

Veterinary personnel are an essential yet often underappreciated workforce, critical for zoonotic disease prevention and response efforts that impact human health. During the early COVID-19 pandemic, the veterinary workforce supported emergency responses by promoting zoonotic disease risk communication, sharing animal health expertise, and boosting laboratory surge capacity against SARS-CoV-2 in animals and people. However, small animal veterinary workers (SAVWs), similar to healthcare workers, faced organizational challenges in providing clinical care to family pets, including those susceptible to SARS-CoV-2...

OBJECTIVE: To determine the characteristics of canine freeze-dried plasma (cFDP) as it is serially diluted with sterile water. DESIGN: In vitro experimental study. SETTING: Government blood and coagulation research laboratory. ANIMALS: cFDP from a commercial manufacturer. INTERVENTIONS: Ten units of cFDP were reconstituted to 100%, 90%, 80%, 70%, 60%, 50%, and 40% of the recommended volume with sterile water...

OBJECTIVE: To describe hemostatic derangements associated with canine anaphylaxis and to assess for association with syndrome severity. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Twenty-seven client-owned dogs, recruited from November 2018 to January 2022, diagnosed with anaphylaxis of varying severity were included. Study inclusion required presentation <6 hours after initiation of clinical signs, no medications or history of illness within the prior 2 weeks, lack of comorbidities expected to affect hemostasis, and lack of a disease state that could alternatively explain the clinical presentation...

OBJECTIVE: To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration. DESIGN: Retrospective study between 2009 and 2019. SETTING: University veterinary teaching hospital. ANIMALS: Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH)...

OBJECTIVE: To describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog. CASE SUMMARY: A 3-year-old female neutered mixed-breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram...

OBJECTIVE: To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation. DESIGN: Retrospective cohort study from 2010 to 2019. SETTING: Multicenter study. ANIMALS: Fifty-six client-owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology. MEASUREMENTS AND MAIN RESULTS: Dogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56)...

OBJECTIVE: To discuss the clinical presentation and successful treatment of a suspected case of intermediate syndrome due to organophosphate (OP) poisoning in a dog. CASE SUMMARY: Two dogs presented with acute cholinergic signs after ingesting an OP insecticide containing 50% acephate. Clinical signs consistent with acute cholinergic crisis resolved in both dogs within 24 hours postingestion. One dog developed an onset of neurological signs consistent with intermediate syndrome approximately 24 hours postingestion...

OBJECTIVE: To assess compression rate accuracy among veterinarians and registered veterinary nurses (RVNs) without and with an audible aid. DESIGN: Prospective study with use of a canine CPR manikin. SETTING: Small animal teaching hospital. SUBJECTS: Thirty-six participants (20 veterinarians and 16 RVNs). INTERVENTIONS: Each participant completed the first 2-minute cycle of chest compressions without an auditory aid on a canine CPR manikin...

OBJECTIVE: To study the safety and effectiveness of consecutively administered ropinirole and apomorphine (both dopamine 2-like receptor agonists) for emesis induction in dogs. DESIGN: Prospective, crossover study design. SETTING: Institutional animal research facility. ANIMALS: Six healthy male purpose-bred Beagle dogs. INTERVENTIONS: Each dog received 4 treatments: (1) apomorphine infusion (21 μg/kg) over 30 minutes + ropinirole eye drops (3...

OBJECTIVE: To describe the overall clinical course of zinc toxicosis in dogs including source, time to source control, incidence of hemolytic anemia, acute liver injury (ALI), acute kidney injury (AKI), and pancreatitis. DESIGN: Retrospective case series from 2005 to 2021. SETTING: Six university veterinary teaching hospitals. ANIMALS: Fifty-five client-owned dogs with known zinc toxicosis due to metallic foreign body (MFB) ingestion...