Case report: Clinical and pathological findings in a canine patient with intervertebral disk extrusion resembling progressive myelomalacia.

A 4-year-old female spayed dog presented to the emergency department for non-ambulatory tetraparesis, which progressed to tetraplegia. Computed tomography (CT) confirmed cervical intervertebral disk extrusion at C5-6 extending to C6-7, and an emergency ventral slot was performed. After the procedure, the patient was placed on mechanical ventilation due to respiratory failure. Repeat assessment upon weaning her ventilatory support suggested the patient's neurological status had declined. Based on her deterioration and suspicion of progressive myelomalacia on magnetic resonance imaging (MRI), she was euthanized. Post-mortem histopathology of the spinal cord supported the presence of progressive myelomalacia. To the author's knowledge, this is the first case report describing a progressive myelomalacia in a canine patient with cervical intervertebral disk extrusion.

Inadvertent placement of an esophagostomy tube into the mediastinum of a cat.

An 8-year-old neutered male Siberian forest cat was presented for respiratory distress. Endoscopy, exploratory surgery of the neck, and sternotomy confirmed initial placement of the esophagostomy tube (e-tube) into the mediastinum. The patient recovered from surgery, developed laryngeal paralysis, and then arrested and died within 48 h after surgery. Key clinical message: To the authors' knowledge, there are no other case reports documenting inadvertent placement of an e-tube into the mediastinum of a cat. This case report highlights the complications that can be associated with incorrect placement of an e-tube.

Placement par inadvertance d'un tube d'oesophagostomie dans le médiastin d'un chat. Un chat des Forêts sibériennes mâle castré âgé de 8 ans a été présenté pour détresse respiratoire. L'endoscopie, la chirurgie exploratoire du cou et la sternotomie ont confirmé le placement initial du tube d'oesophagostomie (e-tube) dans le médiastin. Le patient s'est remis de la chirurgie, a développé une paralysie laryngée, puis a fait un arrêt cardiaque et est décédé dans les 48 heures suivant la chirurgie.Message clinique clé:À la connaissance des auteurs, il n'y a pas d'autres rapports de cas documentant le placement par inadvertance d'un e-tube dans le médiastin d'un chat. Ce rapport de cas met en évidence les complications qui peuvent être associées au placement incorrect d'un e-tube.(Traduit par Dr Serge Messier).

Septic pericardial disease and mediastinal abscessation in a cat with an intrathoracic needle foreign body.

OBJECTIVE: To describe the successful management of a cat with an intrathoracic sewing needle foreign body and septic pericardial effusion. CASE SUMMARY: A 10-year-old neutered female domestic longhair cat was referred for an intrathoracic metallic foreign body identified via thoracic radiography. Two weeks prior, the cat may have ingested a sewing needle. She was presented hemodynamically unstable; point-of-care thoracic ultrasound identified pericardial effusion with right atrial tamponade. Pericardiocentesis stabilized hemodynamic parameters. The effusion was grossly purulent, and bacterial culture grew an Actinomyces sp. The cat underwent a median sternotomy to remove the foreign body, debride associated mediastinal abscesses, and perform a partial pericardiectomy. Over the next 10 days, the cat was managed in hospital with a left unilateral thoracostomy tube and intermittent lavage of the pleural cavity. The cat was discharged, and follow-up at 7 days showed no evidence of pericardial or pleural effusion. NEW OR UNIQUE INFORMATION PROVIDED: Contrary to previous reports, this case shows that extra-gastrointestinal, specifically intrathoracic, sewing needle foreign bodies can cause significant morbidity in cats. To the authors' knowledge, this report is the first to describe septic pericardial disease resulting from documented foreign body ingestion in the cat. It is also the first case report of successful surgical management of mediastinal abscessation in the cat.

Intravenous lipid emulsion to treat suspected cocaine toxicosis in a dog.

A 6-month-old puppy was treated for suspected cocaine toxicosis. Supportive care was initiated but clinical signs worsened and treatment with intravenous lipid emulsion (ILE) was instituted. Clinical signs rapidly resolved in response to treatment with ILE.

Émulsion lipidique intraveineuse pour traiter une suspicion de toxicose à la cocaïne chez un chien. Un chiot âgé de 6 mois fut traité pour une suspicion de toxicose à la cocaïne. Un traitement de support fut initié mais les signes cliniques se sont aggravés et un traitement avec une émulsion lipidique intraveineuse (ILE) fut mis en place. Les signes cliniques se sont rapidement résolus en réponse au traitement avec ILE.(Traduit par Dr Serge Messier).

PLASMA COLLOID OSMOTIC PRESSURE IN CHRONICALLY DEBILITATED LOGGERHEAD SEA TURTLES (CARETTA CARETTA).

Colloid osmotic pressure (COP) is an important component of the forces that manage capillary filtration and is determined by circulating plasma proteins. Patients affected by conditions resulting in hypoproteinemia often suffer severe hemodynamic derangements, including decreased COP. Because chronically debilitated sea turtles (CDT) present with severe hypoproteinemia, the objectives of this study were to 1) determine differences in plasma COP and blood analyte data (packed cell volume [PCV], sodium, chloride, plasma protein fractions) in CDT at admission compared with data from apparently healthy rehabilitated turtles at time of release (HRT) admitted from various stranding causes, and 2) to investigate correlations of COP with these selected blood analytes. COP, PCV, and most plasma protein fractions (excluding pre-albumin and γ-globulins) were significantly lower in CDT upon admission as compared with HRT. Sodium and chloride did not significantly differ between CDT and HRT. A significant increase was observed with PCV and all plasma protein fractions as COP increased. Of all protein fractions tested, albumin contributed the most toward COP (r2 = 0.88, P < 0.001). The results of this study suggest that COP is significantly lower in CDT as compared with HRT, providing insight into the complexity of this critical clinical condition and a small step in advancing the understanding of associated hemodynamic imbalances. Although COP analysis is not readily available as a diagnostic test, this preliminary baseline data suggests that additional research studies are warranted, given the potential for optimization of fluid therapy during rehabilitation of CDT.

Oncotic pressure and the effects of water deprivation in healthy captive Asian elephants.

We evaluated the oncotic pressure (plasma colloid osmotic pressure, πc) in a group of healthy, captive Asian elephants (Elephas maximus; n = 21) with a colloid osmometer with a membrane cutoff of >20,000 daltons. The median πc for these elephants was 26.3 mm Hg with an interquartile interval of 25.5-26.8 mm Hg. The mean πc value was 26.0 mm Hg ± SD 1.1. We found moderate correlation between albumin measured by electrophoresis and πc (r = 0.622; p = 0.003). After a 16-h water deprivation test in a subset of elephants (n = 16), a difference in πc was not detected, despite a significant increase in serum total proteins, urea, and osmolality. These results indicate that πc is not a sensitive indicator of hydration status in elephants after a short period of water deprivation. Use of oncotic pressure as a diagnostic tool in diseased Asian elephants warrants further investigation.

Treatment of acute kidney injury secondary to oak intoxication with hemodialysis in a miniature zebu.

OBJECTIVE: To describe the successful management of acute kidney injury (AKI) secondary to oak intoxication using hemodialysis in a miniature zebu. CASE SUMMARY: A 1-year-old male intact miniature zebu was presented for evaluation of a 2-day history of lethargy, anorexia, decreased urine production, and dry, firm stool. Initial diagnostics revealed severe azotemia and the bull was presumptively diagnosed with AKI secondary to oak intoxication due to free access to oak trees in the pasture. Despite conventional management with IV fluids and supportive therapy, the degree of azotemia progressively worsened, and the bull became oliguric and fluid overloaded. Two treatments with hemodialysis resulted in reduction of azotemia and ketonemia, and resolution of fluid overload and oliguria. The zebu was discharged from the hospital after 10 days of hospitalization. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first reported case using hemodialysis for AKI in a bovid. Treatment with hemodialysis was effective in this case resulting in rapid resolution of azotemia, fluid overload, and oliguria. Hemodialysis may hasten the recovery and decrease morbidity and mortality in bovids with AKI.

Use of charcoal hemoperfusion and hemodialysis in the treatment of methotrexate toxicosis in a dog.

OBJECTIVE: To describe the successful use of charcoal hemoperfusion (HP) and hemodialysis (HD) in a dog in the treatment of methotrexate (MTX) toxicosis. CASE SUMMARY: An American Pit Bull Terrier accidentally ingested 56.8 mg/m2 of MTX. The patient's initial serum MTX concentration was 0.11 µmol/L. At this dosage, myelosuppression and gastrointestinal epithelial necrosis have been reported. Charcoal HP and HD in series were used to enhance elimination of MTX. Serial serum samples were obtained during the session at 0, 30, 60, 90, 120, 150, and 180 minutes and 12 hours after the session. These were later analyzed for MTX concentrations. Clearance of MTX was 73% and extraction ratio was 63% within the first 30 minutes of HP/HD. A 3-hour session eliminated all detectable traces of MTX. The dog tolerated the session well and did not develop any clinical signs of MTX toxicosis. NEW OR UNIQUE INFORMATION PROVIDED: HP and HD together were highly effective in enhancing elimination of MTX from this patient. The prompt use of extracorporeal techniques decreased toxic concentrations of MTX to safer values, which prevented myelosuppression and gastrointestinal injury. HP and HD in conjunction or in place of traditional therapy may be a viable option for the treatment of acute toxic exposures to MTX.

Kidney injury in a dog following bee sting-associated anaphylaxis.

This report describes a case of honeybee envenomation in a dog that developed anaphylaxis after being stung by approximately 10 bees. The dog subsequently developed acute kidney injury. The dog had a previous mild increase in blood urea nitrogen with normal creatinine, possibly indicating an insidious chronic renal degenerative process that went into acute decompensation at the time of bee envenomation.

Lésion rénale chez un chien après l'anaphylaxie associée à une piqûre d'abeille. Ce rapport décrit un cas d'envenimement d'un chien qui a été piqué par environ 10 abeilles et a développé l'anaphylaxie puis une lésion rénale aiguë. Le chien avait eu une légère hausse antérieure de l'azote uréique du sang avec une créatinine normale, ce qui indique éventuellement un processus dégénératif rénal chronique insidieux qui s'est développé en une décompensation aiguë au moment de l'envenimement par les abeilles.(Traduit par Isabelle Vallières).

Clearance of plasma ivermectin with single pass lipid dialysis in 2 dogs.

OBJECTIVE: To describe the use of single pass lipid dialysis (SPLD) for treatment of ivermectin toxicosis in 2 Australian Shepherd dogs with the ABCB1-1Δ gene mutation. CASE SERIES SUMMARY: Two Australian Shepherd dogs were presented for treatment of ivermectin toxicosis. Dogs were initially treated with intravenous lipid emulsion and supportive care, without improvement of clinical signs. They both developed respiratory paralysis and required mechanical ventilation. In order to increase the clearance of circulating ivermectin, SPLD was performed using dialysate containing 5% lipid. Blood samples were obtained immediately before and after dialysis and analyzed for serum ivermectin concentration. Ivermectin reduction ratio was calculated at 29% and 39% for each dog, respectively. When compared to intrinsic total body ivermectin clearance, only the second dog had a relative improvement of plasma clearance following SPLD. Both dogs were confirmed to be homozygous for ABCB1-1Δ gene mutations. Both dogs remained ventilator dependent for several days and ultimately made a full recovery. NEW OR UNIQUE INFORMATION PROVIDED: SPLD may be an adjunctive detoxification strategy for highly lipophilic toxins such as ivermectin.

Assessment of hemostatic changes in a model of acute hemorrhage in dogs.

OBJECTIVE: To evaluate hemostatic changes following experimental acute hemorrhage in dogs using traditional coagulation tests (eg, platelet count, prothrombin time [PT], and activated partial thromboplastin time [aPTT]), kaolin-activated thromboelastography (TEG), and whole blood multiple electrode impedance platelet aggregometry. DESIGN: Prospective study. SETTING: Research laboratory. ANIMALS: Five Beagles. INTERVENTIONS: Dogs were anesthetized prior to obtaining blood samples for baseline PCV, total plasma protein (TPP), arterial blood-gas, platelet count, PT, aPTT, TEG, fibrinogen, and aggregometry. Blood was obtained at 4 additional time points, following 20% blood volume loss, 40% blood volume loss, 60 minutes of sustained hypotension, and after autologous blood transfusion. In addition, heart rate and direct arterial blood pressure were measured at each time point. MEASUREMENTS AND MAIN RESULTS: Significant decreases were noted for PCV (P = 0.048), TPP (P < 0.0001), and arterial blood pressures (P < 0.0001) over time. Platelet count did not change significantly (P = 0.879), but platelet function was decreased following hemorrhage when arachidonic acid (P = 0.004) and ADP (P = 0.008) were used as agonists. The TEG variables R (P = 0.030), MA (P = 0.043), and G (P = 0.037) were significantly, albeit mildly, changed following hemorrhage. Significant prolongations in PT (P < 0.0001) and aPTT (P = 0.041), and decreases in fibrinogen concentration (P = 0.002) were also seen. CONCLUSION: Platelet dysfunction occurred following hemorrhage in this model, despite a stable platelet count. Additionally, significant changes associated with hemorrhage were documented in aPTT, fibrinogen, and MA. Platelet function testing in dogs with naturally occurring hemorrhage warrants further investigation.

Ophthalmic abnormalities secondary to periocular or ocular snakebite (pit vipers) in dogs--11 cases (2012-2014).

OBJECTIVE: To describe ophthalmic abnormalities secondary to periocular and ocular snakebite in dogs. ANIMAL STUDIED: Retrospective review of medical records from dogs presenting to the Small Animal Hospital at University of Florida following snakebites to the face (2012-2014). Two groups were identified: periocular bites (PB) and ocular bites (OB). RESULTS: Records from eleven dogs matched the search criteria and were included in the study (PB=9, 81.8%; OB=2, 18.2%). Both OB cases involved the cornea. Facial edema, blepharospasm, chemosis, and conjunctival hyperemia occurred in all cases (100%). Hemorrhage from the eyelids occurred in eight cases (72.7%; PB=7, OB=1). Subconjunctival hemorrhage occurred in seven cases (63.6%; PB=6, OB=1). Third eyelid laceration and nictitans gland prolapse occurred in 1 case each (9%; PB=1). Lagophthalmia was present in three cases (27.3%; PB=3), with secondary corneal ulcer in two cases (18.2%; PB=2). Corneal ulcer due to direct corneal bite occurred in two cases (18.2%-partial thickness with melting (1) and full thickness (1) ). Uveitis was present in 6 cases (54.5%; PB=4, OB=2), with flare and miosis in 4 cases (36.4%; PB=2, OB=2). Hyphema, fibrin in anterior chamber, and cataract occurred in one case (9%; OB=1). Vision loss occurred in two cases (18.2%; PB=2), secondary to retinal degeneration (PB=1) and amaurosis (PB=1). Mean follow-up time was 7 weeks (range: 3 days-11 months). Most clinical signs had resolved by last examination. CONCLUSIONS: Periocular symptoms were more commonly observed than ocular alterations, regardless of bite location. Appropriate supportive therapy should be instituted according to clinical signs.

Establishment of reference values for various coagulation tests in healthy Florida manatees (Trichechus manatus latirostris) and evaluation of coagulation in debilitated manatees during rehabilitation.

OBJECTIVE: To establish reference ranges for coagulation parameters in healthy Florida manatees (Trichechus manatus latirostris) and compare results with those for debilitated manatees undergoing treatment at a rehabilitation facility. DESIGN: Prospective study. ANIMALS: 29 healthy manatees and 45 debilitated manatees with various diseases. PROCEDURES: Manatees considered healthy on the basis of results of physical examination, CBC, and serum biochemical analysis underwent coagulation testing including measurement of prothrombin time, partial thromboplastin time, D-dimer concentration, platelet count, and fibrinogen concentration to establish reference ranges. For comparison, a group of manatees undergoing rehabilitation was also tested, and the results were compared. Thromboelastography was also performed on some animals. RESULTS: Values for D-dimer concentration were significantly higher in debilitated versus healthy animals. There was no significant difference for prothrombin time, partial thromboplastin time, platelet count, or fibrinogen concentration between groups. Thromboelastography was performed on 8 healthy animals. CONCLUSIONS AND CLINICAL RELEVANCE: Reference ranges were established for various tests of coagulation that may assist clinicians during the initial evaluation and rehabilitation of Florida manatees. Future research to evaluate the effect of specific disease processes on the coagulation cascade is recommended.

Severe Pit Viper Envenomation with Extended Clinical Signs and Treatment Complications in a Dog.

This manuscript describes the extended clinical abnormalities that can occur in severe snake envenomation and the clinical signs associated with antivenom hypersensitivity in a 3 yr old dog. Treatment consisted of IV fluid therapy, analgesics, a vasopressor, cardiac antiarrhythmia drugs, and polyvalent pit viper antivenom. Following initial response to treatment, relapse of clinical signs occurred. Most interesting was the recrudescence of clinical signs on day 7 that may have been caused by the release of deposited venom during surgical debridement of necrotic skin. The resulting extensive clinical signs required multiple vials of antivenom (22 vials over a 7 day period). Both F(ab')2 antivenom and antivenin (Crotalidae) polyvalent were used in this dog because of availability logistics. It is thought that this large amount of antivenom resulted in type I (anaphylaxis) and type III hypersensitivity (serum sickness) reactions. The dog made a complete clinical recovery. This description of extended, fluctuating clinical abnormalities that were associated with envenomation together with the development of hypersensitivity reactions that were presumably secondary to antivenom administration is information that can be useful for the management of patients afflicted with severe pit viper envenomation.

Comparison of cardiac output determined by an ultrasound velocity dilution cardiac output method and by the lithium dilution cardiac output method in juvenile horses with experimentally induced hypovolemia.

OBJECTIVE: To assess the accuracy of an ultrasound velocity dilution cardiac output (UDCO) method, compared with that of the lithium dilution cardiac output (LiDCO) method, for determination of cardiac output (CO) in juvenile horses with experimentally induced hypovolemia. ANIMALS: 12 anesthetized 2- to 6-month-old horses. PROCEDURES: For each anesthetized horse, CO was determined by the LiDCO and UDCO methods prior to any intervention (baseline state), after withdrawal of approximately 40% of the horse's blood volume (low CO state), after maintenance of hypovolemia and infusion of norepinephrine until mean arterial blood pressure was equal to baseline value (high CO state), and after further infusion of norepinephrine and back-transfusion of withdrawn blood (posttransfusion state). For each of the 4 hemodynamic situations, CO and calculated cardiac index (CI) values were obtained by each method in duplicate (8 pairs of measurements/horse); mean values for each horse and overall mean values across all horses were calculated. Agreement between CI determined by each method (96 paired values) was assessed by Bland-Altman analysis. RESULTS: For the UDCO method-derived CI measurements among the 12 horses, mean ± SD bias was -4 ± 11.3 mL/kg/min (95% limits of agreement, -26.1 to 18.2 mL/kg/min) and mean relative bias was -10.4 ± 21.5% (95% limits of agreement, -52.6% to 31.8%). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that, compared with the LiDCO method, the UDCO method has acceptable clinical usefulness for determination of CO in foals.

Thromboelastographic evaluation of hemostatic function in dogs treated for crotalid snake envenomation.

OBJECTIVE: To characterize the overall hemostatic changes in dogs envenomated by crotaline snakes via kaolin-activated thromboelastography (TEG), and to determine any prognostic/monitoring value from a TEG tracing on presentation, as well as during treatment with antivenom therapy. DESIGN: Prospective observational, cohort study. SETTING: University teaching hospital and primary emergency hospital. ANIMALS: Thirty-eight dogs envenomated by crotaline snakes. INTERVENTIONS: TEG tracings were evaluated on presentation to the hospital (pre) as well as immediately following (post) and 12 hours (12 h post) after antivenom treatment, if administered. MEASUREMENTS AND MAIN RESULTS: At presentation, data were available for 38 dogs envenomated by crotaline snakes. Twenty dogs were in Group 1 (Antivenin [Crotalidae] Polyvalent antivenom), 12 dogs were in Group 2 (Antivipmyn antivenom), and 6 dogs in Group 3 that were not treated with antivenom. The average number of vials administered to group 1 and 2 were equal at 2.2. On presentation, based on a G value < TEG reference range, 15/38 (39%) of the dogs had hypocoagulable TEG tracings. There was a significant increase in G and MA value from the pre and 12 hour post measurement (P = 0.0001 and 0.0003, respectively), as well as from the post to 12 hour post measurement (P = 0.003 and, 0.014, respectively). During the study, 5 of 38 dogs died (13%) and of the dogs that died, 4/5 (80%) had angle and MA equal to zero on presentation. A decreased G and MA were significantly associated with mortality (P = 0.02 and 0.04, respectively). CONCLUSIONS: A hypocoagulable TEG tracing, particularly a decreased G value and MA, is associated with an increased mortality in crotaline snake envenomation. G and MA also demonstrate a significant increase over treatment time.

Use of IV lipid emulsion for treatment of ivermectin toxicosis in a cat.

Ivermectin toxicosis in cats is infrequently reported. IV lipid emulsion (ILE) is a novel treatment in veterinary medicine that has been used for amelioration of adverse effects seen with multiple lipid soluble compounds. Previously, ILE has been investigated in experimental models with rats, rabbits, pigs, and dogs, mainly for resuscitation of cardiopulmonary arrest and treatment of hypotension due to local anesthetic drug overdose. There are few case reports in veterinary medicine of using ILE for drug toxicity. Only one feline case has been reported, with IV lipids used for treatment of lidocaine toxicity. This report describes a case of ivermectin toxicosis in a 1 yr old domestic shorthair that was safely and successfully treated using ILE.

Evaluation of tissue oxygen saturation with near-infrared spectroscopy during experimental acute hemorrhagic shock and resuscitation in dogs.

OBJECTIVE: To evaluate tissue oxygen saturation (Sto2) by use of near-infrared spectroscopy in experimental acute hemorrhagic shock and resuscitation in dogs. ANIMALS: 14 healthy adult purpose-bred Beagles. PROCEDURES: Dogs were anesthetized with isoflurane via facemask, anesthesia was maintained with propofol and rocuronium bromide, and dogs were mechanically ventilated to maintain normocapnia. Dogs were studied under normovolemia (baseline), hypovolemia with target mean arterial blood pressure < 40 mm Hg achieved and maintained steady for 10 minutes (hypovolemia T1), then 20 minutes later (hypovolemia T2), following resuscitation with shed blood (after transfusion), and after administration of 20 mL of hetastarch/kg (hypervolemia). Conditions were executed sequentially during a single anesthetic episode, allowing stabilization between states (10 minutes). Hemoglobin concentration, mean arterial blood pressure, arterial blood gas concentrations, cardiac index, oxygen delivery indexed to body surface area, and Sto2 were monitored. RESULTS: From baseline to hypovolemia T1, there was a significant reduction in mean ± SD oxygen delivery index (619 ± 257 mL/min/m(2) to 205 ± 76 mL/min/m(2)) and Sto2 (94 ± 4.4% to 78 ± 12.2%). Following resuscitation, Sto2 (80 ± 8.5% vs 92 ± 6.45%) and oxygen delivery index (211 ± 73 mL/min/m(2) vs 717 ± 221 mL/min/m(2)) significantly increased, returning to baseline values. Hypervolemia had no effect on Sto2 or oxygen delivery index. A strong correlation (r = 0.97) was detected between mean oxygen delivery index and Sto2 across all time points. CONCLUSIONS AND CLINICAL RELEVANCE: Under the conditions of this study, there was a strong correlation between Sto2 and oxygen delivery, suggesting that Sto2 may be used to estimate oxygen delivery.

The effect of using an impedance threshold device on hemodynamic parameters during cardiopulmonary resuscitation in dogs.

OBJECTIVE: To investigate the hemodynamic effects following the use of an impedance threshold device (ITD) in a canine model of cardiopulmonary arrest. DESIGN: Experimental, randomized crossover study. SETTING: Cardiovascular research laboratory at a university veterinary center. ANIMALS: Eight purpose bred beagle dogs. INTERVENTIONS: Dogs were anesthetized and instrumented for the measurement of right atrial pressure , systolic blood pressure, mean blood pressure, and diastolic arterial blood pressure, end-tidal CO(2) , and carotid blood flow (CBF). CBF was determined via ultrasonic flow probe placed around the carotid artery. Animals were taking part in an unassociated terminal study and following subsequent euthanasia with pentobarbital, standardized cardiopulmonary resuscitation (CPR) was performed with an impedance threshold device attached (ITD-CPR group) and without (S-CPR group). Order of treatment was randomized. MEASUREMENTS AND MAIN RESULTS: ITD group had increased CBF, coronary perfusion pressure, and a decrease in right atrial diastolic pressure. No differences in end-tidal CO(2) , diastolic arterial blood pressure, mean blood pressure, or systolic blood pressure were seen. Return of spontaneous circulation was not observed in any of the animals CONCLUSIONS: Use of the ITD resulted in favorable changes in hemodynamic parameters in dogs undergoing CPR. The ITD may be a useful adjunct during CPR in dogs and warrants clinical evaluation.