Oscillometric and Doppler techniques can provide continuous noninvasive blood pressure readings in cats and dogs: an instructional video.

OBJECTIVE: To provide a video tutorial detailing how to perform continuous noninvasive blood pressure monitoring in dogs and cats. ANIMALS: Any size dog or cat. METHODS: To measure blood pressure noninvasively, a blood pressure cuff is selected on the basis of the circumference of the limb and placed at the level of the right atrium. For oscillometric blood pressure measurement, the cuff is connected to an oscillometric unit that will automatically inflate and deflate the cuff in order to measure the patient's blood pressure using an internal algorithm. For Doppler blood pressure measurement, a sphygmomanometer is used to manually inflate the pressure cuff 30 to 40 mm Hg above the point where the audible arterial sounds disappear. Then, the cuff is gradually deflated until the audible arterial sounds return; the pressure at the first sound is recorded as the blood pressure. To generate continuous readings, the oscillometric machine is set to measure blood pressure as often as every minute. Alternatively, the Doppler crystal is taped to the patient's leg to facilitate repeated cuff inflation/deflation and collection of blood pressure values as often as every minute. RESULTS: Continuous blood pressure readings can be obtained by both the oscillometric and Doppler techniques. CLINICAL RELEVANCE: Continuous blood pressure readings identify trends in a patient's cardiovascular status. The most reliable oscillometric blood pressure reading is the mean arterial pressure. Doppler blood pressure values are considered systolic in dogs. Doppler values in cats underestimate systolic and overestimate mean blood pressure.

Basic triage in dogs and cats: Part III.

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if the ultimate goal is to refer the animal to another facility. Objective and procedure: The third and final part of this 3-part review article series discusses arrhythmias typical in emergency cases and the approach to animals that are presented with an inability to stand up and walk normally. A stepwise method to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Recognizing and knowing how to treat tachy- and bradyarrhythmias is important in stabilizing a dog's or cat's condition. Understanding how to differentiate the various reasons that a dog or cat is unable to stand on its own allows a veterinarian to both treat and communicate outcome expectations for those animals. Conclusion and clinical relevance: Do not refer emergent cases before basic stabilization is completed. Many emergency cases can either be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Triage de base chez les chiens et les chats : Partie III. Mise en contexte: Les cas d'urgence peuvent être présentés à toute heure du jour ou de la nuit. Tous les praticiens des petits animaux doivent avoir les compétences nécessaires pour trier et stabiliser les cas d'urgence courants, même si le but ultime est de référer l'animal vers un autre établissement. Objectif et procédure: La troisième et dernière partie de cette série d'articles de synthèse en trois parties traite des arythmies typiques des cas d'urgence et de l'approche des animaux présentant une incapacité à se lever et à marcher normalement. Une méthode par étapes pour catégoriser et stabiliser ces cas est décrite, ainsi que des conseils utiles pour optimiser l'expérience de référence, si cela est indiqué. Résultats: Reconnaître et savoir comment traiter les tachy- et bradyarythmies est important pour stabiliser l'état d'un chien ou d'un chat. Comprendre comment différencier les différentes raisons pour lesquelles un chien ou un chat est incapable de se tenir seul permet au vétérinaire de traiter et de communiquer les attentes en matière de résultats pour ces animaux. Conclusion et pertinence clinique: Ne référez pas les cas urgents avant que la stabilisation de base ne soit terminée. De nombreux cas d'urgence peuvent être traités par le vétérinaire initial ou envoyés à une clinique de référence sur rendez-vous après que les mesures de stabilisation appropriées ont été prises.(Traduit par Dr Serge Messier).

Therapeutic interventions using the peritoneal and coelomic cavity in dogs, cats, and exotic pets.

OBJECTIVE: To provide a video tutorial describing intraperitoneal (IP) and intracoelomic (IC) therapeutics (IP/IC fluid therapy, euthanasia, direct peritoneal resuscitation). ANIMALS: Dogs, cats, and exotic pets. METHODS: Peritoneal and coelomic centesis allows for delivery of fluids or to perform euthanasia. The peritoneal and coelomic membranes contain a vast network of capillaries and lymphatics that allow absorption of fluids and blood products. Needles are inserted aseptically IP or IC at species-specific locations to avoid iatrogenic damage. In mammals, the needle is inserted in a periumbilical location at a 1- to 2-cm radius from the umbilicus, while the needle is inserted into the ventral inguinal fossa in chelonians and lateroventrally in lizards and snakes. Direct peritoneal resuscitation is a human technique in which a dextrose/electrolyte solution infused IP reduces ischemia-reperfusion injury, edema, and tissue necrosis to improve mortality in patients with diseases like shock and sepsis or who require acute abdominal surgery. RESULTS: Isotonic crystalloids are given IP/IC at 10- to 20-mL/kg doses (smaller volumes in reptiles) and blood products at standard calculated doses. Sodium pentobarbital without phenytoin (3 mL/4.5 kg) is used for IP/IC euthanasia. CLINICAL RELEVANCE: Being aware of multiple routes for fluid and blood product administration allows treatment in animals for which intravenous or intraosseous catheterization is undesirable or impossible. While intravenous or intraosseous routes are always preferred, especially for resuscitation, familiarity with locations for IP/IC fluid and euthanasia is useful. Techniques like direct peritoneal resuscitation are not currently used in animals but might be translated to veterinary cases in the future.

Basic triage in dogs and cats: Part II.

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if cases are ultimately referred to another facility. Objective and procedure: The second part of this 3-part review article series discusses animals that collapse at home as well as dogs and cats with bleeding. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Having a robust and methodical approach to animals that collapse is important for many emergency cases, as the causes and treatment methods vary. Bleeding can lead to acute death if left untreated and knowing the steps to stop bleeding is important for patient stabilization. Conclusion and clinical relevance: Do not refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Triage de base chez les chiens et les chats : Partie II. Contexte: Les cas d'urgence peuvent être présentés à toute heure du jour ou de la nuit. Tous les praticiens des petits animaux doivent avoir les compétences nécessaires pour trier et stabiliser les cas d'urgence courants, même si les cas sont finalement transférés vers un autre établissement. Objectif et procédure: Le deuxième de cette série de trois articles traite des animaux qui s'effondrent à la maison ainsi que des chiens et des chats qui saignent. Une approche par étapes pour catégoriser et stabiliser ces cas est décrite, ainsi que des conseils utiles pour optimiser l'expérience de référence, si elle est indiquée. Résultats: Avoir une approche robuste et méthodique face aux animaux qui s'effondrent est important dans de nombreux cas d'urgence, car les causes et les méthodes de traitement varient. Les saignements peuvent entraîner une mort aiguë s'ils ne sont pas traités et connaître les étapes à suivre pour arrêter le saignement est important pour la stabilisation du patient. Conclusion et pertinence clinique: Ne référez pas les cas urgents avant d'avoir terminé la stabilisation de base. De nombreux cas d'urgence ne nécessitent pas de référence urgente et peuvent être traités par le vétérinaire initial ou envoyés à une clinique de référence sur rendez-vous après que les mesures de stabilisation appropriées ont été prises.(Traduit par Dr Serge Messier).

Basic triage in dogs and cats: Part I.

Background: Emergency cases can present at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases even if they ultimately aim to refer the patient to another facility. Objectives and procedures: The first part of this 3-part review article series covers respiratory distress and seizures. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Having a strong methodical approach to animals in respiratory distress optimizes treatment. Similarly, achieving cessation of seizures, along with having a good understanding of the causes of seizures, allows for patient stabilization. Conclusion and clinical relevance: Do NOT refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps are completed.

Triage de base chez les chiens et les chats : Partie I. Contexte: Les cas urgents peuvent se présenter à tout moment du jour ou de la nuit. Tous les médecins vétérinaires en pratique des petits animaux doivent avoir les compétences pour effectuer un triage et stabiliser les cas urgents fréquents même s'ils prévoient ultimement référer le patient à un autre établissement. Objectifs et procédures: La première partie de cet article de revue en 3 parties traite de la détresse respiratoire et des convulsions. Une approche progressive pour catégoriser et stabiliser ces cas est présentée, avec des conseils utiles pour optimiser l'expérience de référencement, si nécessaire. Résultats: Avoir une approche méthodique solide lors de cas de détresse respiratoire chez les animaux permet d'optimiser le traitement. De manière similaire, être capable de maîtriser les convulsions tout en ayant une bonne compréhension de leurs causes, permettent une meilleure stabilisation du patient. Conclusion et pertinence clinique: Ne PAS procéder au référencement de cas urgents avant d'avoir terminé une stabilisation de base. Plusieurs cas urgents ne nécessitent pas d'être référé en urgence et peuvent être pris en charge par le médecin vétérinaire primaire ou transféré à une clinique de référence après la prise d'un rendez-vous une fois qu'une stabilisation adéquate ait été complétée.(Traduit par Dr Serge Messier).

Clinical Assessment of Primary Hemostasis: A Review.

Primary hemostatic disorders such as thrombocytopenia and thrombocytopathia are commonly encountered in small animal practice. The key stages of primary hemostasis include platelet adhesion, activation, and aggregation. Understanding the interaction between tissues, platelets, and signaling molecules not only helps clinicians comprehend clot formation but also better recognize thrombocytopathias. Although congenital thrombocytopathia is rare, commercially available platelet function tests allow veterinarians to narrow differentials in many clinical settings. Thrombocytopenia can be easily diagnosed in any clinical setting. In this paper, we review the current understanding of primary hemostasis in veterinary medicine, including the clinical presentation and available diagnostics to identify platelet abnormalities.

Comparison of 4 point-of-care techniques to detect correct positioning of nasogastric tubes in dogs (2020-2021).

OBJECTIVE: To compare 4 point-of-care (POC) techniques to assess nasogastric (NG) tube placement versus radiographs as a reference standard. POC methods included air inflation with auscultation, fluid aspiration with pH measurement, ultrasonography, and capnography. DESIGN: Prospective observational study in hospitalized dogs between 2020 and 2021. SETTING: University teaching hospital. ANIMALS: Fifty-one dogs requiring NG tube placement as part of their normal care. INTERVENTIONS: After standard blind NG tube placement, each POC method was performed following standardized instructions. All POC methods were scored as to whether the investigator believed the tube to be in the gastrointestinal tract (as indicated by positive auscultation of borborygmus during insufflation, positive fluid aspiration with pH ≤5, presence of hyperechoic shadow in the esophagus, or absence of capnographic waveform). Subsequently, radiographs were taken to determine NG tube position as a gold standard. The sensitivity, specificity, and accuracy of each test as compared to 2-view thoracic radiographs were determined. MEASUREMENTS AND MAIN RESULTS: Sensitivity, specificity, and accuracy for each POC technique were as follows: air auscultation (84.4%, 50.5%, and 80.4%, respectively), neck ultrasound (95.6%, 83.3%, and 94.1%, respectively), capnography (91.1%, 33.3%, and 84.3%, respectively), and fluid aspiration with pH measurement (22.2%, 100%, and 31.4%, respectively). CONCLUSIONS: Among the 4 techniques evaluated, neck ultrasound had the best overall performance for assessing NG tube placement. Fluid aspiration with pH measurement might also have potential due to perfect specificity, but its clinical utility may be limited by low sensitivity and accuracy. Nonetheless, 2-view thoracic radiography should still be considered the standard method for confirmation of NG tube placement as none of the 4 POC techniques investigated showed both high sensitivity and perfect specificity.

Interstitial glucose monitoring has acceptable clinical accuracy in juvenile dogs.

OBJECTIVE: To compare the performance of an interstitial glucose monitor (IGM) versus a portable blood glucose monitor (PBGM) in sick juvenile dogs in a veterinary ICU. ANIMALS: 16 client-owned dogs admitted to the university teaching hospital under 1 year of age with systemic illness. PROCEDURES: Paired interstitial and blood glucose samples were collected. A third glucose measurement with a reference method was obtained when IGM and PBGM values were clinically disparate. Analytical accuracy was measured by Pearson correlation and agreement statistics, including mean absolute relative difference (MARD), bias, and 95% limits of agreement. The Parkes consensus error grid analysis was performed to assess clinical accuracy. RESULTS: 159 paired glucose measurements were available for analysis. Comparison of IGM readings to PBGM measurements resulted in an MARD of 15.4% and bias of -2.6%, with the 95% limits of agreement ranging from -42.5% to 37.4%. Positive correlation between IGM and PBGM (Pearson r = 0.65) was found. On consensus error grid analysis, 100% of the pairs fell into clinically acceptable zones (74.2% in zone A, and 25.8% in zone B). When disparate IGM and PBGM readings were compared to a laboratory reference standard (n = 13), both methods resulted in high MARD and wide limits of agreement. CLINICAL RELEVANCE: The IGM provides clinically acceptable glucose measurements compared to PBGM to monitor glucose levels in juvenile dogs in a clinical setting. Further clinical studies with a larger sample size, particularly in the hypoglycemic range, are needed to assess IGM performance in the lower glucose range.

Comparison of a commercial immunochromatographic strip crossmatch kit and standard laboratory crossmatch methods for blood transfusion compatibility in dogs.

OBJECTIVE: To evaluate agreement between 2 standard laboratory (SL) methods and an immunochromatographic strip (ICS) method to crossmatch dogs receiving RBC transfusions. A second objective was to evaluate uninterpretable SL crossmatch results as compared to ICS in the presence of autoagglutination. DESIGN: Prospective observational study (September 2018 to October 2019). SETTING: University teaching hospital. ANIMALS: Forty anemic dogs receiving RBC transfusions. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: All dogs received DEA 1-negative packed RBCs. Three crossmatch methods were evaluated against the same unit transfused to each dog: SL method performed at institutional laboratory (SL-I), SL method sent to a commercial laboratory (SL-C), and a commercially available point-of-care ICS method. Major and minor crossmatches were incompatible for 2.5%/7.5% of ICS tests, 82.5%/52.5% of SL-I tests, and 52.5%/27.5% of SL-C tests. Agreement between ICS and SL-C major (κ = 0.05) and minor (κ = 0.02) crossmatches and between ICS and SL-I major (κ = 0.009) and minor (κ = 0.03) crossmatches was slight. Agreement between SL-C and SL-I major (κ = -0.06) and minor (κ = -0.12) crossmatches was poor. Results of major and minor crossmatches were uninterpretable due to autoagglutination in 38%/38% for SL-I and 29%/18% for SL-C crossmatches. ICS method was interpretable for 93% (major) and 98% (minor) crossmatches. After exclusion of uninterpretable SL pairings, agreement still remained poor to slight between all tests. Only 1 of 40 dogs (2.5%; 95% confidence interval: <1.0%-13.2%) had an immediate immunological transfusion reaction. CONCLUSIONS: Lack of agreement between all methodologies was noted. The high level of incompatibility predicted by SL methods despite lack of clinically relevant reactions suggests a high false incompatibility rate as compared to the ICS test. ICS testing was also able to give results more frequently in the face of autoagglutination. Further work is needed to investigate the ICS method's ability to predict clinically significant transfusion reactions.

Conventional versus high-flow oxygen therapy in dogs with lower airway injury.

Dogs with lower airway pathology that present in respiratory distress often receive oxygen therapy as the first line of treatment regardless of the underlying cause. Conventional "low-flow" systems deliver oxygen with a maximum flow rate of 15 L/minute. Traditionally, when an animal's respiratory status does not improve with conventional oxygen therapy and treatments for underlying disease, options might be limited to either intubation and mechanical ventilation or humane euthanasia. High-flow oxygen therapy (HFOT) has been gaining popularity in veterinary medicine as an alternative route of oxygen supplementation for animals that require support beyond conventional therapy. High-flow oxygen therapy can supply a mixture of air and oxygen via a heated and humidified circuit. It is user friendly and can be used in an environment in which mechanical ventilation is unavailable. This review article is written for emergency doctors and general practitioners who lack access to mechanical ventilation. This article briefly reviews pertinent respiratory physiology, traditional oxygen supplementation techniques, the physiology of HFOT, and the limited evidence available in veterinary medicine regarding the use of HFOT, its applications, and limitations. Guidelines for the use of HFOT are suggested and HFOT is compared to conventional therapy.

Les chiens avec une pathologie des voies respiratoires inférieures qui présentent une détresse respiratoire reçoivent souvent une oxygénothérapie en première intention, quelle que soit la cause sous-jacente. Les systèmes conventionnels à « faible débit ¼ fournissent de l'oxygène avec un débit maximum de 15 L/minute. Traditionnellement, lorsque l'état respiratoire d'un animal ne s'améliore pas avec l'oxygénothérapie conventionnelle et les traitements de la maladie sous-jacente, les options peuvent se limiter à l'intubation et à la ventilation mécanique ou à l'euthanasie. L'oxygénothérapie à haut débit (HFOT) gagne en popularité en médecine vétérinaire en tant que voie alternative de supplémentation en oxygène pour les animaux qui nécessitent un soutien au-delà de la thérapie conventionnelle. L'oxygénothérapie à haut débit peut fournir un mélange d'air et d'oxygène via un circuit chauffé et humidifié. Il est convivial et peut être utilisé dans un environnement où la ventilation mécanique n'est pas disponible.Cet article de revue est écrit pour les médecins urgentistes et les médecins généralistes qui n'ont pas accès à la ventilation mécanique. L'article passe brièvement en revue la physiologie respiratoire pertinente, les techniques traditionnelles de supplémentation en oxygène, la physiologie de la HFOT et les preuves limitées disponibles en médecine vétérinaire concernant l'utilisation de la HFOT, ses applications et ses limites. Des lignes directrices pour l'utilisation de la HFOT sont suggérées et la HFOT est comparée au traitement conventionnel.(Traduit par Docteur Serge Messier).

Assessment of the physical compatibility of injectable enrofloxacin with commonly used intravenous fluids and drugs during simulated Y-port administration.

OBJECTIVE: To evaluate physical compatibility of small animal (SAE) and large animal (LAE) injectable formulations of enrofloxacin with select IV fluids and drugs. SAMPLE: 162 admixtures containing SAE or LAE with saline (0.9% NaCl) solution, lactated Ringer solution (LRS), Plasma-Lyte A (PLA), 6% hydroxyethylstarch 130/0.4 (HES), metoclopramide, or ampicillin-sulbactam. PROCEDURES: In the first of 2 simultaneously conducted experiments, admixtures containing enrofloxacin (10 mg/kg) and a volume of IV fluid that would be administered over a 20-minute period when dosed at the maintenance infusion rate (40 mL/kg/d for saline solution, LRS, and PLA and 20 mL/kg/d for HES) were created. In the second experiment, enrofloxacin (10 mg/kg) was admixed with saline solution (40 mL/kg/d) and metoclopramide (2 mg/kg/d) or ampicillin-sulbactam (30 mg/kg). In both experiments, admixture components were infused into a flask over 20 minutes assuming patient weights of 5, 10, and 20 kg. Admixtures were created by use of undiluted SAE and SAE diluted 1:1 with saline solution and undiluted LAE and LAE diluted 1:1 and 1:10 with saline solution. Admixtures were assessed for physical incompatibility at 0, 15, 30, and 60 minutes after completion of mixing. Physical incompatibility was defined as gross precipitation, cloudiness, Tyndall effect, or change in turbidity. RESULTS: Admixtures containing undiluted SAE or LAE were physically incompatible with saline solution, PLA, LRS, and HES. Because saline solution was used to dilute SAE and LAE, all admixtures containing diluted SAE or LAE were also physically incompatible. Physical compatibility of enrofloxacin with metoclopramide or ampicillin-sulbactam could not be assessed because those admixtures also contained saline solution. CONCLUSIONS AND CLINICAL RELEVANCE: Enrofloxacin was physically incompatible with all tested solutions.

Cryopreservation of feline red blood cells in liquid nitrogen using glycerol and hydroxyethyl starch.

OBJECTIVES: The objective of this study was to evaluate the techniques and short-term effects of cryopreservation of feline red blood cells (RBCs) in liquid nitrogen using glycerol or hydroxyethyl starch (HES) as a cryoprotectant. METHODS: Feline RBCs were manually mixed with either 20% glycerol or 12.5% HES and frozen for 24 h in liquid nitrogen. The samples were thawed and glycerolized samples were manually washed. Success of the freeze/thaw process was determined by recovery rate of RBCs and evaluation of morphological changes using scanning electron microscopy (SEM). A unit of canine packed RBCs was also subjected to the same methodology to evaluate the cryopreservation handling technique. RESULTS: Feline RBCs preserved with 20% glycerol had a high recovery rate (94.23 ± 1.25%) immediately after thawing. However, the majority of the cells were lost during the washing process, with a final packed cell volume of <1%. A recovery rate was unable to be assessed for samples preserved with HES owing to the high viscosity of the mixture. SEM revealed significant morphological changes after glycerol was added to the feline RBCs. Although these morphological changes were partially reversed after thawing, the majority of the RBCs were lost during the washing process. Minimal morphological changes were noted in the HES sample. Similar results were noted with the canine RBCs. CONCLUSIONS AND RELEVANCE: The described manual technique for cryopreservation using glycerol was not able to successfully preserve feline or canine RBCs. In the present study, it was difficult to make conclusions about the efficacy of HES. Further studies evaluating HES as a cryoprotectant are warranted.

Transfusion Medicine: An Update on Antigens, Antibodies and Serologic Testing in Dogs and Cats.

Red blood cell transfusions have become an integral component in the treatment of anemic patients and the number of transfusions continues to increase from year to year in both veterinary and human medicine. Although crucial, red blood cell transfusions are not benign and can lead to serious adverse reactions. Therefore, determining the most appropriate donor unit to use for transfusion can be challenging. As transfusion medicine evolves, greater numbers of blood surface antigens are being documented and pretransfusion testing protocols are becoming more complex. In order to better understand this evolving field, this review presents the basic immunology of pretransfusion testing, including methodologies of blood typing and crossmatch testing, and their application in canine and feline medicine.

Ultrasound measurements of the caudal vena cava before and after blood donation in 9 greyhound dogs.

This prospective study evaluated variation in the diameter of the caudal vena cava (DCdVC) as a marker of change in intravascular volume before and after blood donation in greyhound dogs. A preliminary study determined that the DCdVC increased with body weight. Nine greyhound blood donors had ultrasonographic images acquired of the maximum and minimum DCdVCs in transverse and sagittal orientations and sagittal aortic diameter (AoD) before and after blood donation. The collapsibility index = [(maximal mean transverse DCdVC - minimal mean transverse DCdVC)/maximal mean transverse DCdVC] and transverse DCdVC:AoD ratio were calculated for each dog. In the greyhounds, the changes in mean minimal and maximal transverse DCdVC (0.69 and 0.84 mm, respectively) and sagittal mean maximal DCdVC (0.9 mm) and collapsibility index (0.018) were significantly different (P < 0.05) before and after blood donation. While statistically significant, the magnitude of DCdVC change found in this limited number of greyhound dogs with 8% intravascular volume loss during blood donation was small. This magnitude of change is likely indistinguishable in clinical patients.

Mesures par ultrason de la veine cave caudale avant et après le don de sang chez 9 chiens Greyhound. Cette étude prospective a évalué la variation du diamètre de la veine cave caudale (DCdVC) comme marqueur du changement du volume intravasculaire avant et après le don de sang chez les chiens Greyhound. Une étude préliminaire a déterminé que le DCdVC a augmenté le poids corporel. Neuf Greyhound donneurs de sang avaient des images échographiques acquises pour les DCdVC maximum et minimum dans les orientations transversales et sagittales et le diamètre aortique sagittal (AoD) avant et après le don de sang. L'indice de collapsibilité = [(DCdVC maximal transversal moyen ­ DCdVC minimal transversal moyen)/DCdVC maximal transversal moyen] et le ratio transversal DCdVC:AoD ont été calculés pour chaque chien. Chez les Greyhounds, les changements des DCdVC minimaux et maximaux transversaux moyens (0,69 et 0,84 mm, respectivement) et le DCdVC maximal sagittal moyen (0,9 mm) et l'indice de collapsibilité (0,018) étaient significativement différents (P < 0,05) avant et après le don de sang. Même si ce changement est significatif sur le plan statistique, l'ampleur du changement DCdVC constatée dans ce nombre limité de chiens Greyhound ayant 8 % de perte de volume intravasculaire durant le don de sang était faible. Cette ampleur de changement est probablement impossible à distinguer chez les patients cliniques.(Traduit par Isabelle Vallières).

Comparison of ultrasound-guided and landmark-based techniques for central venous catheterization via the external jugular vein in healthy anesthetized dogs.

OBJECTIVE To compare time to achieve vascular access (TTVA) between an ultrasound-guided technique (UST) and landmark-based technique (LMT) for central venous catheter (CVC) placement in healthy anesthetized dogs. ANIMALS 39 purpose-bred hounds. PROCEDURES Anesthetized dogs that were hemodynamically stable following completion of a terminal surgical exercise were enrolled in the study during 2 phases, with a 45-day intermission between phases. For each dog, a UST and LMT were used for CVC placement via each external jugular vein by 2 operators (criticalist and resident). The TTVA and number of venipuncture attempts and catheter redirections were recorded for each catheterization. Placement of the CVC was confirmed by contrast fluoroscopy. After euthanasia, a gross dissection was performed during which a hematoma score was assigned to the catheter insertion site. For each phase, nonlinear least squares estimation was used for learning curve analysis of the UST. RESULTS Median TTVA, number of venipuncture attempts and catheter redirections, and hematoma score did not differ significantly between the 2 operators for either technique. Median TTVA for the UST (45 seconds) was significantly longer than that for the LMT (7 seconds). Learning curve analysis indicated that 8 and 7 UST catheterizations were required to achieve performance stability in phases 1 and 2, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the UST was comparable to the LMT for CVC placement in healthy dogs. The extra time required to perform the UST was not clinically relevant. Additional studies evaluating the UST for CVC placement in clinically ill dogs are warranted.

Fluid and Electrolyte Therapy in Diabetic Ketoacidosis.

Diabetic ketoacidosis is a dynamic disease that requires regular reassessment of an affected patient. Typical treatment regimens include crystalloid fluid therapy, insulin, and supplementation of dextrose, phosphorus, and potassium. This article presents an approach to and considerations for treatment of a diabetic ketoacidotic dog or cat.

Crystalloids: A Quick Reference for Challenges in Daily Practice.

There are numerous types, routes, and strategies of intravenous crystalloid therapy in veterinary medicine. Understanding basics of physiology and underlying disease pathologies can play an essential role in determining fluid therapy choices. This article provides an overview of fluid compartment physiology, a review of crystalloid types, and indications and interactions associated with intravenous crystalloid use.

Natural and Synthetic Colloids in Veterinary Medicine.

This review article covers basic physiology underlying the clinical use of natural and artificial colloids as well as provide practice recommendations. It also touches on the recent scrutiny of these products in human medicine and how this may have an effect on their use in veterinary medicine.

A Review of Available Techniques for Cardiac Output Monitoring.

The main objective of fluid therapy is to increase cardiac output (CO). Large, rapidly administered volumes of fluids are the cornerstone of treating patients in shock to restore circulating volume and improve tissue perfusion. However, determining exactly how much fluid a given patient requires can be challenging. If enough fluid is not given, poor tissue perfusion can lead to ischemia, anaerobic metabolism, and ultimately cell and patient death. Conversely, increased morbidity and mortality associated with excessive intravenous fluid administration has been reported in the human literature in a wide variety of conditions. This review focuses on types of available CO monitoring, their application in veterinary medicine as well as current research trends in noninvasive evaluation of CO.

Fluid Overload in Small Animal Patients.

Fluid therapy is used daily by veterinary practitioners and is an essential part of treatment of many veterinary patients. However, as with all interventions, there is the potential for negative side effects resulting from fluid therapy. Fluid overload is a key side effect that has been increasingly recognized in human medicine as leading to significant negative sequelae. Evidence related to fluid overload in veterinary medicine is sparse but it is likely that the same types of negative sequelae are seen in our veterinary patients. The goal of this review is to present a definition for fluid overload in small animal veterinary patients and ways to both recognize and treat fluid overload. Additionally, ways to avoid the development of fluid overload are described.