Emesis induction is successful for recovery of gastric foreign objects in cats.

OBJECTIVE: To prospectively assess the efficacy of emesis induction for the recovery of gastric foreign objects in cats and to determine if any factors influenced recovery. ANIMALS: 22 client-owned cats. PROCEDURES: Cats for which emesis induction was deemed appropriate were administered an emetic agent by the attending clinician between October 2018 and April 2021. Data collected included whether emesis was successful in recovery in some or all of the foreign object, time from administration to emesis, number of emetic events, and type, length, width, and surface area of the material ingested. RESULTS: Of the 22 cats that had emesis attempted, 11 (50%) vomited some or all of the foreign object. The time from ingestion to presentation, time from the last meal, presence of food in the vomitus, type of the object, and length, width, and surface area of the object did not influence the likelihood of successful recovery with emesis induction. The most common object cats ingested were rubber bands. CLINICAL RELEVANCE: Recovery of gastric foreign objects in cats with emesis induction alone may be successful 50% of the time. The type and size of the object is unlikely to influence whether or not emesis will be successful. This information can help prepare cat-owners for expectations and outcomes following attempts at emesis induction.

Inclusion of airway pressure release ventilation in the management of respiratory failure and refractory hypercapnia in a dog.

OBJECTIVE: To describe the use of airway pressure release ventilation (APRV) to relieve hypercapnia in a dog undergoing mechanical ventilation. CASE SUMMARY: A 3-month-old male Shar-Pei mix presented to the emergency department with suspected noncardiogenic pulmonary edema. Due to severe hypercapnia, mechanical ventilation was initiated. The hypercapnia failed to improve with conventional pressure control mechanical ventilation, bronchodilator administration, suctioning, or endotracheal tube replacement. The dog was transitioned to APRV and maintained in this mode for 36 hours. A modified APRV protocol in which inverse inspiratory to expiratory ratios ranged from 4.3:1 to 6.0:1 was utilized, resulting in a drastic improvement in the patient's hypercapnia. The patient eventually was transitioned off the ventilator, and no respiratory abnormalities have been noted at subsequent recheck examinations. NEW OR UNIQUE INFORMATION PROVIDED: This case documents the first use of APRV to relieve refractory hypercapnia in a dog undergoing mechanical ventilation and is one of the only recorded cases of using APRV for this purpose in the medical literature at large. APRV may be considered in cases of hypercapnia when traditional therapies fail, although caution is warranted as this mode of ventilation can also worsen hypercapnia.

Evaluation of subcutaneous versus intravenous administration of apomorphine for induction of emesis in dogs.

OBJECTIVE: To prospectively compare the effectiveness and any adverse effects of apomorphine administered SC or IV for induction of emesis in dogs. ANIMALS: 42 client-owned dogs. PROCEDURES: Dogs for which emesis induction was deemed appropriate by the attending clinician were prospectively randomized to receive apomorphine (0.03 mg/kg [0.01 mg/lb]) either SC (n = 20) or IV (22). Data collected included whether emesis was successfully induced, time from drug administration to emesis, number of emetic events, and adverse events (eg, sedation, protracted vomiting, or other). RESULTS: Of the 20 dogs given apomorphine SC, 16 (80%) vomited. Of the 22 dogs given apomorphine IV, 18 (82%) vomited. With regard to route of administration, the number of dogs in which emesis was induced did not differ significantly. Median time to the first emetic event was 13.5 minutes (range, 3 to 32 minutes) in the SC treatment group and 2 minutes (range, 1 to 5 minutes) in the IV treatment group; the difference was significant. There was no significant difference in the number of emetic events or frequency of adverse events between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Apomorphine administered SC or IV reliably induced emesis in dogs. Compared with SC administration of apomorphine, the time from drug administration to emesis associated with IV administration was significantly shorter, a finding that has clinical importance.