ACVECC-Veterinary Committee on Trauma registry report 2017-2019.

OBJECTIVE: To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. DESIGN: Multi-institutional registry data report, April 1, 2017 to December 31, 2019. SETTING: VetCOT identified and verified Veterinary Trauma Centers (VTCs). ANIMALS: Dogs and cats with evidence of trauma. INTERVENTIONS: Data were input to a web-based data capture system (Research Electronic Data Capture) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type, preadmission care, trauma severity assessment at presentation (modified Glasgow Coma Scale and Animal Trauma Triage score), key laboratory parameters, interventions, and case outcome were collected. Summary descriptive data for each species are reported. MEASUREMENTS AND MAIN RESULTS: Thirty-one VTCs contributed data from 20,842 canine and 4003 feline trauma cases during the 33-month reporting period. Most cases presented directly to a VTC (82.1% dogs, 82.1% cats). Admission to hospital rates were slightly lower in dogs (27.8%) than cats (32.7%). Highest mortality rates by mechanism of injury in dogs were struck by vehicle (18.3%), ballistic injury (17.6%), injured inside vehicle (13.2%), nonpenetrating bite wound (10.2%), and choking/pulling injury (8.5%). Highest mortality rates by mechanism of injury in cats were struck by vehicle (43.3%), ejected from vehicle (33.3%), nonpenetrating bite wound (30.7%), ballistic injury (27.8%), and choking/pulling injury (25.0%). The proportion of animals surviving to discharge was 93.1% (dogs) and 82.5% (cats). CONCLUSIONS: The VetCOT registry is a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. Overall survival to discharge was high indicating low injury severity for most recorded cases. Further evaluation of data on subsets of injury types, patient assessment parameters, interventions, and associated outcome are warranted. Data from the registry can be leveraged to inform clinical trial design and justification for naturally occurring trauma as a translational model to improve veterinary and human trauma patient outcome.

Total Intravenous Anesthesia for the Small Animal Critical Patient.

The practice of creating and maintaining general anesthesia using intravenous anesthetic drugs is defined as total intravenous anesthesia. Total intravenous anesthesia produces general anesthesia by selective drug properties that fulfill the 3 elements of anesthesia. Total intravenous anesthesia has potential application in veterinary emergency and critical care medicine. This article reviews the theory and application of total intravenous anesthesia and identifies possible application in emergency and critical care medicine.

ACVECC-Veterinary Committee on Trauma Registry Report 2013-2017.

OBJECTIVE: To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. DESIGN: Multi-institutional veterinary trauma registry data report. SETTING: VetCOT identified veterinary trauma centers (VTCs). ANIMALS: Dogs and cats with evidence of trauma presented to VTCs with data entered in the VetCOT registry September 1, 2013-March 31, 2017. INTERVENTIONS: VetCOT created a standardized data collection methodology for dog and cat trauma. Data were input to a web-based data capture system (REDCap) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type (blunt vs penetrating), preadmission care, hospitalization and intensive care requirement, trauma severity assessment at presentation (eg, modified Glasgow coma scale and animal trauma triage score), key laboratory parameters, necessity for surgical intervention, and case outcome were collected. Summary descriptive data for each species are reported. MEASUREMENTS AND MAIN RESULTS: Twenty-nine VTCs in North America, Europe, and Australia contributed information from 17,335 dog and 3,425 cat trauma cases during the 42-month reporting period. A large majority of cases presented directly to the VTC after injury (80.4% dogs and 78.1% cats). Blunt trauma was the most common source for injury in cats (56.7%); penetrating trauma was the most common source for injury in dogs (52.3%). Note that 43.8% of dogs and 36.2% of cats were reported to have surgery performed. The proportion surviving to discharge was 92.0% (dogs) and 82.5% (cats). CONCLUSIONS: The VetCOT registry proved to be a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. While overall survival to discharge was quite high, further evaluation of data on subsets of injury types, patient assessment parameters, interventions, and associated outcome are warranted.

Behavioral response and cost comparison of manual versus pharmacologic restraint protocols in healthy dogs.

Although sedatives are routinely administered to dogs for diagnostic and minimally invasive procedures, manual restraint is often used. The study compared intra-procedural behavioral response, scored on a 100-point, visual analog scale, and cost of restraint in healthy dogs given 1 of 5 treatments: manual restraint, dexmedetomidine at 125 µg/m(2) (Dex 125) or 375 µg/m(2) (Dex 375), Dex 125 plus butorphanol at 0.4 mg/kg (Dex 125 + Bu), or Dex 375 plus butorphanol at 0.4 mg/kg (Dex 375 + Bu). Mean behavioral response scores in dogs declined from baseline in the manual restraint group and improved in a linear fashion in the group order Dex 125, Dex 375, Dex 125 + Bu, and Dex 375 + Bu. Dexmedetomidine at 375 µg/m(2) or at 125 µg/m(2) or at 375 µg/m(2) in combination with butorphanol produced the best intra-procedural behavioral response. The cost of sedative drugs was offset by the opportunity cost of diverting personnel from revenue-generating activity to manual restraint.

Réaction comportementale et comparaison du coût des protocoles de contention manuelle par rapport aux protocoles de retenue pharmacologiques chez des chiens en santé. Même si des sédatifs sont régulièrement administrés aux chiens pour des procédures diagnostiques ou minimalement invasives, la contention manuelle est souvent utilisée. L'étude a comparé la réaction comportementale durant la procédure, évaluée sur une échelle analogue visuelle de 100 points, et le coût de la retenue chez des chiens en santé auxquels on a administré l'un de 5 traitements : la contetnion manuelle, la dexmédétomidine à 125 µg/m2 (Dex 125) ou à 375 µg/m2 (Dex 375), la Dex 125 et du butorphanol à 0,4 mg/kg (Dex 125 + Bu) ou la Dex 375 et du butorphanol à 0,4 mg/kg (Dex 375 + Bu). Les notes moyennes de réaction comportementale chez les chiens ont chuté de la valeur de base dans le groupe de contention manuelle et elles se sont améliorées de façon linéaire dans l'ordre des groupes Dex 125, Dex 375, Dex 125 + Bu et Dex 375 + Bu. La dexmédétomidine à 375 µg/m2 ou à 125 µg/m2 ou à 375 µg/m2 en combinaison avec du butorphanol a produit la meilleure réaction comportementale pendant la procédure. Le coût des sédatifs a été compensé par le coût découlant de l'affectation du personnel à des activités produisant des revenus au lieu de la contention manuelle.(Traduit par Isabelle Vallières).

Characteristics and outcomes in surgical management of severe acute pancreatitis: 37 dogs (2001-2007).

OBJECTIVE: Describe clinical characteristics and outcomes associated with canine patients undergoing surgical intervention for treatment of acute pancreatitis. DESIGN: Retrospective outcome study from 2001 to 2007. ANIMALS: Thirty-seven dogs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The following data were collected for dogs who underwent surgical intervention in the course of treatment for severe acute pancreatitis: preoperative clinicopathologic and physical data, ultrasonographic findings, surgical procedure detail, histopathologic findings, and transfusion requirements. The survival rate was 80.8% in dogs with extrahepatic biliary obstruction, 64.3% in dogs undergoing necrosectomy, and 40.6% with pancreatic abscess. Overall survival was 63.6%. Surgical complications included intraoperative and postoperative hemorrhage in 12 dogs, postoperative development of diabetes mellitus in 3 dogs, exocrine pancreatic insufficiency in 1 dog, and bacterial peritonitis in 2 dogs. CONCLUSION: Surgical intervention and aggressive postoperative care may be pursued in select dogs with severe acute pancreatitis. In dogs with extrahepatic biliary obstruction secondary to acute pancreatitis, surgical intervention may be associated with a good prognosis whereas dogs with pancreatic abscess formation may have a more guarded prognosis.

Safety and biocompatibility of the Myosplint system--a passive implantable device that alters ventricular geometry for the treatment of heart failure.

A passive implantable device developed for the treatment of heart failure, the Myosplint System, has demonstrated therapeutic efficacy in a canine model of pacing induced heart failure. The current study sought to demonstrate chronic device safety and biocompatibility, in vivo, in a normal porcine model. Two devices were implanted into each normal, beating heart of 6 juvenile and 15 adult pigs without cardiopulmonary bypass. Animals survived 90 (juvenile and adult) or 180 days (adult only). Serial hematologic and biochemical profiles were evaluated in each pig during the study period. A comprehensive necropsy study was performed in each pig to evaluate device stability, healing response, thromboembolism, hemorrhage, and intravascular hemolysis related to the Myosplint system. Six adult animals died from infectious disease (four) or perioperative (two) complications unrelated to device design or function and were excluded from the final analysis. No clinical, biochemical or pathologic evidence of significant, device related adverse events was observed in surviving animals. The chronic myocardial healing response appeared normal at term, and all devices maintained their structural integrity throughout the study. The Myosplint system was easily implanted in beating hearts and was rapidly incorporated into host tissues without clinically significant morbidity in this porcine model.