Self-care practices and depression, anxiety, and stress scores in veterinary students during a semester.

Objective: To measure associations between self-care activities and depression, anxiety, and stress of preclinical veterinary students during a semester. Procedure: Preclinical veterinary students at the University of Calgary Faculty of Veterinary Medicine were recruited voluntarily. Depression, anxiety, and stress scores (DASS-21) were measured, and a self-care questionnaire was administered at the beginning and end of the semester. Results: Depression, anxiety, and stress scores did not change during the fall semester (P = 1.000). At the beginning of the semester, students who spent 15 to 30 min (P = 0.042) or 30 to 60 min (P = 0.013) outside daily had lower anxiety scores compared to those who spent < 15 min outside daily; students who spent > 2 h daily on social media had higher stress scores than students who spent < 60 min (P = 0.024); and students who slept for 6 to 8 h daily had lower stress scores than students who slept < 6 h (P = 0.015). At the end of the semester, students who "often" felt that self-care techniques managed their stress had lower depression (P = 0.003) and anxiety (P = 0.011) scores than those who "rarely" did; students who spent 30 to 60 min outside daily had lower depression scores than those who spent < 15 min (P = 0.031); students who spent 15 to 30 min (P = 0.002) or 30 to 60 min (P = 0.009) outside daily had lower stress scores than those who spent < 15 min; and students who exercised 30 to 60 min daily had lower stress scores than those who exercised < 15 min (P = 0.047). Conclusion: Self-care activities that were associated with lower depression, anxiety, or stress scores at the beginning or end of the semester included spending at least 15 min daily outside or exercising; spending < 30 min on social media daily; and sleeping 6 to 8 h daily. These practices warrant further investigation. Clinical relevance: Encouraging certain self-care practices among preclinical veterinary students has the potential to enhance their mental health and should be considered part of a veterinary school curriculum.

Pratiques d'autosoins et scores de dépression, d'anxiété et de stress chez les étudiants vétérinaires au cours d'un semestre. Objectif: Mesurer les associations entre les activités d'autosoins et la dépression, l'anxiété et le stress des étudiants vétérinaires au cours d'un semestre. Procédure: Les étudiants vétérinaires de la faculté de médecine vétérinaire de l'University of Calgary ont été recrutés sur une base volontaire. Des scores de dépression, d'anxiété et de stress (DASS-21) ont été mesurés et un questionnaire d'autosoins a été administré au début et à la fin du semestre. Résultats: Les scores de dépression, d'anxiété et de stress n'ont pas changé au cours du semestre d'automne (P = 1,000). Au début du semestre, les étudiants qui passaient 15 à 30 min (P = 0,042) ou 30 à 60 min (P = 0,013) à l'extérieur par jour présentaient des scores d'anxiété inférieurs à ceux qui passaient < 15 min à l'extérieur par jour; les étudiants qui passaient > 2 h par jour sur les réseaux sociaux avaient des scores de stress plus élevés que les étudiants qui passaient < 60 min (P = 0,024); et les étudiants qui dormaient de 6 à 8 h par jour avaient des scores de stress inférieurs à ceux qui dormaient < 6 h (P = 0,015). À la fin du semestre, les étudiants qui estimaient « souvent ¼ que les techniques d'autosoins géraient leur stress avaient des scores de dépression (P = 0,003) et d'anxiété (P = 0,011) inférieurs à ceux qui l'étaient « rarement ¼; les étudiants qui passaient 30 à 60 min à l'extérieur quotidiennement avaient des scores de dépression inférieurs à ceux qui passaient moins de 15 min (P = 0,031); les étudiants qui passaient 15 à 30 min (P = 0,002) ou 30 à 60 min (P = 0,009) à l'extérieur quotidiennement avaient des scores de stress inférieurs à ceux qui passaient < 15 min; et les étudiants qui faisaient de l'exercice de 30 à 60 min par jour avaient des scores de stress inférieurs à ceux qui faisaient de l'exercice < 15 min (P = 0,047). Conclusion: Les activités d'autosoins associées à des scores de dépression, d'anxiété ou de stress plus faibles au début ou à la fin du semestre comprenaient le fait de passer au moins 15 minutes par jour à l'extérieur ou de faire de l'exercice; passer < 30 minutes sur les réseaux sociaux quotidiennement; et dormir 6 à 8 h par jour. Ces pratiques méritent une enquête plus approfondie. Pertinence clinique: Encourager certaines pratiques d'autosoins chez les étudiants vétérinaires a le potentiel d'améliorer leur santé mentale et devrait être considéré comme faisant partie du programme d'études d'une école vétérinaire.(Traduit par Dr Serge Messier).

A survey of medication and raw food use among canine blood donors.

BACKGROUND: Blood donors are screened for medication use to determine their health status and to ensure that the collection will be safe and efficacious for transfusion. Although stringent medication deferral guidelines exist for human blood donors, no consensus exists as to which medications should be permitted among canine donors. METHODS: A brief survey regarding canine donor screening methods was distributed to an online hematology and transfusion medicine group and included questions pertaining to commonly prescribed medications and consumption of a raw food diet. KEY FINDINGS: The survey results demonstrate that more than half of the respondents accept canine donors given thyroid supplements, whereas respondents were split as to whether they accept canine donors given antihistamines chronically. Most survey respondents exclude canine donors taking anti-inflammatory or anti-itch medications unless in acute circumstances and only after a washout period. More than half of the survey respondents exclude dogs fed a raw food diet. SIGNIFICANCE: The survey results demonstrate that there is no obvious agreement regarding which medications to permit in canine donors. Evidence-based guidelines are needed to inform best practices and the subsequent decisions made by donor programs.

Burnout symptoms and workplace satisfaction among veterinary emergency care providers.

OBJECTIVES: To measure symptoms of burnout among veterinary emergency care providers (VECPs), determine how burnout symptoms among VECPs compare to human emergency care providers, and identify what demographic and workplace variables are associated with these symptoms. DESIGN: Cross-sectional study using an online survey and convenience sampling. SUBJECTS: A total of 1204 VECPs including mostly veterinarians and technicians. INTERVENTIONS: An online questionnaire using the Maslach Burnout Inventory and Areas of Worklife Survey was distributed between May and July 2018 via an email list and social media. VECPs working less than part-time (<20 h/week) and incomplete survey responses were excluded. MEASUREMENTS AND MAIN RESULTS: VECPs had higher total emotional exhaustion and depersonalization scores and lower total personal accomplishment scores compared to emergency department human healthcare professionals (P < 0.001). Subsets of VECPs with the highest burnout symptom scores included females, residents, those working in private or corporate referral hospitals, and those with off-shift duties. Workplace variables positively associated with burnout symptom scores among these groups typically included perceptions of an unmanageable workload, lack of control over work, little reward (recognition) for work, or an unfair allocation of resources at work. Conversely, VECPs working >20 years and those married or with children at home had lower burnout symptom scores. Workplace variables negatively associated with burnout symptom scores among respondents included perceptions of having a manageable workload, control over work, reward for work, or a fair allocation of resources at work. Multivariable analysis revealed that the variable most positively associated with emotional exhaustion and depersonalization was workload, whereas reward was most positively associated with personal accomplishment (P < 0.001). CONCLUSIONS: Burnout symptom scores are higher among VECPs compared to human emergency department teams. Targeting workplace variables such as workload and reward is warranted in future studies to determine strategies for reducing burnout among VECPs.

Our quest for creating a space that is welcoming to all: A commentary from the American College of Veterinary Emergency and Critical Care Diversity, Equity, and Inclusion Committee.

Diversity, equity, and inclusion (DEI) are crucial elements of successful veterinary emergency and critical care practices across the world. Embracing the elements of DEI creates a work environment that is safe and welcoming for all the members of the team. The American College of Veterinary Emergency and Critical Care DEI committee was formed to enhance and support efforts to increase racial diversity in veterinary emergency and critical care, as well as provide resources that will generate DEI practices across the country. This article provides an overview of the vision of the committee and some of the steps that have been taken to create a welcoming space for all represented in veterinary emergency and critical care.

Treatment of three cats with hyperviscosity syndrome and congestive heart failure using plasmapheresis.

Three cats were evaluated at a veterinary teaching hospital for congestive heart failure (CHF) secondary to hyperviscosity syndrome from plasma cell neoplasia. All cats had severe hyperproteinemia due to hyperglobulinemia. Multiple myeloma or plasma cell neoplasia was diagnosed based on cytopathology and post mortem examination. The cats presented with signs of CHF including acute collapse, tachypnea, increased respiratory effort, and pulmonary crackles. All cats had heart murmurs and echocardiographic signs consistent with hypertrophic cardiomyopathy. An enlarged left atrium was found in all cats and two of three cats also had spontaneous echocardiographic contrast. Plasmapheresis (centrifugal plasma exchange) was performed on all three cats by the removal of whole blood and the infusion of a balanced electrolyte solution while the whole blood was centrifuged and separated. The RBCs were then washed before being readministered to the patient. Plasmapheresis alleviated the clinical signs of CHF (tachypnea) in all three cats. Plasmapheresis should be considered in cases of CHF secondary to hyperviscosity syndrome to rapidly alleviate clinical signs associated with heart failure while diagnosis of the underlying cause is made and appropriate therapy implemented.

Serum procalcitonin concentrations in dogs with induced endotoxemia.

BACKGROUND: Procalcitonin (PCT) is an important biomarker for sepsis in human medicine, but there is little information regarding PCT as a biomarker for sepsis in dogs. There are no controlled studies evaluating serial concentrations of PCT in dogs. HYPOTHESIS/OBJECTIVE: That PCT would be rapidly detectable in serum after injection of LPS and would remain increased for at least 24 hours. Objective was to evaluate serial serum PCT concentrations in dogs after a single IV injection of LPS compared to placebo. ANIMALS: Six healthy mixed breed dogs. METHODS: A nonrandomized, placebo-controlled, crossover study was performed. Dogs were initially injected with placebo (0.9% NaCl; 1 mL, IV) and then experimental endotoxemia was induced by injecting lipopolysaccharide (LPS; 2 µg/kg, IV, once) after a 5-day washout period. Serial blood samples were collected for measurement of serum PCT after each injection. Difference in median PCT concentration between serial time points was assessed using a mixed effects model. RESULTS: After LPS administration, blood pressure decreased and body temperature increased along with the development of lethargy, vomiting, and diarrhea. Procalcitonin was significantly increased compared to baseline by 2 hours after injection of LPS (median = 67.9 versus 172.8, range = 46.0-74.1 versus 99.5-295.9, P = .0002) and remained significantly increased for 12 hours (median = 205.9, range = 119.9-297.4) with return to baseline by 48 hours. Procalcitonin was significantly higher than placebo 2, 4, 6, 8, 10, 12, and 24 hours after injection. There were no significant differences in PCT between time 0 and any of the subsequent time points in the saline group. CONCLUSIONS AND CLINICAL IMPORTANCE: Procalcitonin expression is likely to be a clinically useful biomarker for sepsis in dogs and might have an additional role in prognostication and therapeutic decision-making.

Renal failure in a guinea pig (Cavia porcellus) following ingestion of oxalate containing plants.

A 1-year-old guinea pig presented with anorexia, lethargy, and weight loss, 1 week after ingesting a peace lily leaf. Laboratory findings were suggestive of renal failure and included elevated blood urea nitrogen and creatinine with concurrent isosthenuria. The guinea pig was euthanized 1 month later due to worsening clinical signs.

Transfusion practice in dogs and cats: an Internet-based survey.

OBJECTIVE: To characterize and compare current canine and feline transfusion practices at private referral hospitals (PRH) and veterinary teaching hospitals (VTH), including information regarding blood donor screening; blood product collection, storage, and administration; recipient screening; and monitoring during transfusions. DESIGN: Internet-based survey. SUBJECTS: Sixty-five board-certified specialist veterinarians, 3 veterinarians, and 5 veterinary technicians from 53 PRH and 20 VTH. METHODS: A survey was disseminated via email LIST-SERVs; 1 survey response per hospital was included. MAIN RESULTS: Survey results revealed that PRH more commonly obtained canine and feline blood products solely from blood banks (P < 0.05) and VTH more commonly used hospital-run donor programs (P < 0.05). Canine cryo-poor plasma was more likely to be stored by VTH compared to PRH (P = 0.018) and VTH were more likely to store canine fresh platelet products for >72 hours (P = 0.046). The use of client-owned canine donors (P = 0.043), administration of precollection 1-deamino-8-d-arginine vasopressin to canine donors (P = 0.041), and storage of blood products in a dedicated refrigerator (P = 0.003) and -20°C or -80°C freezer (P = 0.044) were more common in VTH than PRH. However, the use of a refrigerator freezer (P = 0.001), single bag canine collection systems (P = 0.021), and agglutination cards for feline blood typing (P = 0.032), as well as warming of blood products prior to administration (P = 0.021) were more commonly reported by PRH compared to VTH. CONCLUSIONS: Although some transfusion practices including the method and length of storage of blood products, use and screening of blood donors, and administration methods varied between VTH and PRH, most transfusion practices were similar. The information reported from this survey could aid the development of future veterinary transfusion consensus statements.

Evaluation of peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and the placement of closed-suction abdominal drains.

OBJECTIVE To evaluate peripheral blood and abdominal fluid variables as predictors of intestinal surgical site failure in dogs with septic peritonitis following celiotomy and closed-suction abdominal drain (CSAD) placement. DESIGN Prospective study. ANIMALS 26 dogs with septic peritonitis that underwent celiotomy and CSAD placement. PROCEDURES Abdominal fluid and blood samples were collected prior to surgery and daily thereafter until CSAD removal. Abdominal fluid was collected through the CSAD. Analysis of all samples included pH, PCO2, PO2, PCV, WBC count, and total solids, glucose, lactate, and electrolyte concentrations. Abdominal fluid samples also underwent cytologic evaluation and bacterial culture, and the volume of fluid removed through the drain was recorded daily. The blood-to-fluid glucose and lactate differences, fluid-to-blood lactate ratio and blood-to-fluid WBC and neutrophil ratios were determined daily. Dogs were categorized into 2 groups on the basis of whether they had an uneventful recovery (UR) or developed postoperative septic peritonitis (POSP). RESULTS 23 dogs had a UR and 3 developed POSP. On the third day after surgery, the abdominal fluid WBC count was significantly lower and the blood-to-fluid WBC and neutrophil ratios were significantly higher for dogs in the POSP group, compared with those for dogs in the UR group. None of the other blood and abdominal fluid variables assessed differed significantly between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE Results failed to identify any objective predictive indicators for POSP in dogs with CSADs. Use of blood-to-fluid WBC and neutrophil ratios as predictive indicators for POSP requires further investigation.

Retrospective evaluation of prognostic indicators in dogs with head trauma: 72 cases (January-March 2011).

OBJECTIVE: To investigate the prognostic value of clinical and laboratory variables and scoring systems in dogs with head trauma. DESIGN: Retrospective study (January-March, 2011). SETTING: University teaching hospital. ANIMALS: Seventy-two client-owned dogs with a history of head trauma occurring ≤5 days prior to hospital admission. Dogs were excluded if they had an unconfirmed history of trauma, preexisting neurologic disease, or insufficient data available in the medical record. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data from hospital admission were collected, including vital signs; blood pressure; pulse oximetry; venous blood gases and electrolyte concentrations; plasma lactate and blood glucose concentrations; PCV; total plasma protein concentration; activated clotting time; WBC count; and serum albumin, creatinine, total bilirubin, and BUN concentrations. Modified Glasgow Coma Scale (MGCS), mentation, and animal trauma triage (ATT) scores were also calculated. Treatment with mannitol, hypertonic saline (HS), corticosteroids, benzodiazepines, or phenobarbital, and requirement for endotracheal intubation were also recorded. Outcome was classified as survival or nonsurvival to hospital discharge. Decreased pulse oximetry, pH, bicarbonate concentration, or base excess, and increased potassium concentration, lactate concentration, BUN concentration, ATT score, or mentation score were risk factors for nonsurvival. Decreased MGCS score was the strongest predictor of nonsurvival; a score ≤ 11 was 84% sensitive and 73% specific for predicting nonsurvival. Dogs were more likely to die before discharge if they required HS or endotracheal intubation. CONCLUSIONS: Dogs that did not survive following head trauma were more likely to have poor perfusion, severe concurrent injuries reflected by increased ATT scores, severe traumatic brain injury as evidenced by decreased MGCS or increased mentation scores, or requirement for HS administration or endotracheal intubation.

The effect of blood usage protocol on the age of packed red blood cell transfusions administered at 2 veterinary teaching hospitals.

BACKGROUND: Controversy exists regarding the optimal duration of storage of units of canine packed red blood cells (PRBC) prior to transfusion, resulting in different blood usage strategies between hospitals. Two hospitals were studied: At North Carolina State University (NCSU), usage protocol dictates that the oldest units of PRBC (stored the longest) are prioritized for transfusion; whereas, at Ontario Veterinary College (OVC), units of PRBC are sorted according to age (days after collection) and PRBC are selected for transfusion according to clinician or technician discretion, such that PRBC could be administered after any storage duration, with no preference given to older units. OBJECTIVE: To evaluate differences in the age of PRBC administered to dogs at 2 veterinary hospitals with different age-related PRBC usage protocols during a 1-year period (2010-2011). KEY FINDINGS: The average age of units of PRBC administered at NCSU was older than that at OVC (P < 0.001). Additionally, a higher number of PRBC units older than 14 days old were transfused at NCSU (P < 0.001), and the age of the oldest administered PRBC unit was also older at NCSU (P < 0.001). NCSU discarded approximately 15 expired PRBC units, whereas OVC discarded 96 expired PRBC units during the study period. SIGNIFICANCE: A standardized protocol for the priority administration of the oldest stored PRBC resulted in the administration of significantly older PRBC, but fewer expired units of PRBC were discarded.

Evaluation of thromboelastography in two factor XII-deficient cats.

CASE SUMMARY: The current report describes thromboelastography (TEG) findings in two cats with factor XII (FXII) deficiency. The first cat was diagnosed with bilateral perinephric pseudocysts; hemostatic testing was performed prior to performing renal aspirates. The second cat was healthy; hemostatic testing was performed prior to inclusion into a research project. Both cats had markedly prolonged partial thromboplastin times and hypocoagulable TEG tracings when samples were activated with kaolin. However, when tissue factor (TF) was used to activate the sample, both cats had normal-to-hypercoagulable TEG tracings. The cats each had a subnormal FXII level. RELEVANCE AND NOVEL INFORMATION: TEG is becoming widely used to investigate hemostasis in veterinary patients, and TEG results in cats with FXII deficiency have not been previously reported. FXII deficiency is the most common hereditary hemostatic defect in cats. While FXII deficiency does not lead to in vivo hemorrhagic tendencies, it can lead to marked prolongation in activated partial thromboplastin and activated clotting times, and cannot be differentiated from true hemorrhagic diatheses without measuring individual factor activity. With the increased use of TEG to evaluate hemostasis in veterinary patients, it is important to recognize the effects of FXII deficiency on this testing modality. The finding of a hypocoagulable kaolin-activated TEG tracing and a concurrent normal TF-activated TEG tracing in samples should prompt clinicians to consider ruling out FXII deficiency.

Risk factors for transfusion-associated complications and nonsurvival in dogs receiving packed red blood cell transfusions: 211 cases (2008-2011).

OBJECTIVE: To determine whether the number, volume, or age of transfused packed RBC units; volume of other blood products; or pretransfusion PCV was a risk factor for transfusion-associated complications or nonsurvival in dogs. DESIGN: Retrospective case series. ANIMALS: 211 client-owned dogs receiving stored packed RBC transfusions. PROCEDURES: Information collected or calculated from the medical record of each dog included the total number, volume, and dose of packed RBC units; mean age of packed RBC units; number of packed RBC units > 14 days old; age of oldest packed RBC unit; volume and dose of other blood products used; pretransfusion PCV; acute patient physiologic and laboratory evaluation score; transfusion-associated complications; and outcome. RESULTS: The dose (mL/kg) of other blood products transfused was a risk factor for transfusion-associated complications (OR, 1.03; 95% confidence interval [CI], 1.01 to 1.05). The pretransfusion PCV (OR, 1.13; 95% CI, 1.06 to 1.21) and dose of packed RBCs administered (OR, 1.04; 95% CI, 1.02 to 1.07) were risk factors for nonsurvival. Age of transfused packed RBC units was not identified as a risk factor for transfusion-associated complications or nonsurvival, but the study was statistically underpowered to detect this finding. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of larger doses of other non-packed RBC blood products was a risk factor for transfusion-associated complications, and a higher pretransfusion PCV and larger dose of packed RBCs administered were risk factors for nonsurvival. Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.

Evaluation of a transcutaneous blood gas monitoring system in critically ill dogs.

OBJECTIVES: To describe the use of a transcutaneous blood gas monitoring system in critically ill dogs, determine if transcutaneous and arterial blood gas values have good agreement, and verify if clinical or laboratory variables are correlated with differences between transcutaneous and arterial blood gas measurements. DESIGN: Prospective observational study. SETTING: University teaching hospital ICU. ANIMALS: Twenty-three client-owned dogs. INTERVENTIONS: In critically ill dogs undergoing arterial blood gas monitoring, a transcutaneous blood gas monitor was used to measure transcutaneous partial pressure of carbon dioxide (PtcCO2 ) and transcutaneous partial pressure of oxygen (PtcO2 ) values 30 minutes after sensor placement, which were compared to PaCO2 and PaO2 values measured simultaneously. Clinical and laboratory variables were concurrently recorded to determine if they were correlated with the difference between transcutaneous and arterial blood gas measurements. MEASUREMENTS AND MAIN RESULTS: Bland-Altman analysis revealed a mean bias of 4.6 ± 26.3 mm Hg (limits of agreement [LOA]: -46.9/+56.1 mm Hg) between PtcO2 and PaO2 and a mean bias of 9.3 ± 8.5 mm Hg (LOA: -7.5/+26.0 mm Hg) between PtcCO2 and PaCO2 . The difference between PtcCO2 -PaCO2 was strongly negatively correlated with HCO3 (-) (r(2) = 0.52, P < 0.001) and PaCO2 (r(2) = 0.58, P < 0.001) and weakly positively correlated with diastolic blood pressure (r(2) = 0.21, P = 0.044), whereas the difference between PtcCO2 -PaCO2 was moderately negatively correlated with diastolic blood pressure (r(2) = 0.33, P = 0.008). CONCLUSIONS: Agreement between transcutaneous and arterial PO2 and PCO2 measurements in these critically ill dogs was inferior to that reported in similar adult and pediatric human studies. The transcutaneous monitor consistently over-estimated PaO2 and PaCO2 and should not be used to replace arterial blood gas measurements in critically ill dogs requiring blood gas interpretation.

Multicenter prospective evaluation of dogs with trauma.

OBJECTIVE: To determine hospital admission variables for dogs with trauma including values determined with scoring systems (animal trauma triage [ATT], modified Glasgow coma scale [MGCS], and acute patient physiologic and laboratory evaluation [APPLE] scores) and the usefulness of such variables for the prediction of outcome (death vs survival to hospital discharge). DESIGN: Prospective, multicenter, cohort study. ANIMALS: 315 client-owned dogs. PROCEDURES: By use of a Web-based data capture system, trained personnel prospectively recorded admission ATT, MGCS, and APPLE scores; clinical and laboratory data; and outcome (death vs survival to discharge) for dogs with trauma at 4 veterinary teaching hospitals during an 8-week period. RESULTS: Cause of injury was most commonly blunt trauma (173/315 [54.9%]) followed by penetrating trauma (107/315 [34.0%]), or was unknown (35/315 [11.1%]). Of the 315 dogs, 285 (90.5%) survived to hospital discharge. When 16 dogs euthanized because of cost were excluded, dogs with blunt trauma were more likely to survive, compared with dogs with penetrating trauma (OR, 8.5). The ATT (OR, 2.0) and MGCS (OR, 0.47) scores and blood lactate concentration (OR, 1.5) at the time of hospital admission were predictive of outcome. Surgical procedures were performed for 157 (49.8%) dogs; surgery was associated with survival to discharge (OR, 7.1). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated ATT and MGCS scores were useful for prediction of outcome for dogs evaluated because of trauma. Penetrating trauma, low blood lactate concentration, and performance of surgical procedures were predictive of survival to hospital discharge. The methods enabled collection of data for a large number of dogs in a short time.

Prospective multicenter evaluation of coagulation abnormalities in dogs following severe acute trauma.

OBJECTIVES: To describe coagulation abnormalities in dogs following severe acute trauma and to evaluate the relationship between coagulation, clinical, and laboratory variables, and disease and injury severity, as well as the ability of coagulation variables to predict the presence of body cavity hemorrhage (BCH), necessity of blood product administration, and outcome. DESIGN: Prospective, multicenter, observational study. SETTING: Two university teaching hospitals. ANIMALS: Forty client-owned dogs sustaining severe blunt or penetrating trauma. INTERVENTIONS: Blood samples were collected within 12 hours of the traumatic incident for measurement of blood gases, lactate concentration, platelet count, activated clotting time, prothrombin time, activated partial thromboplastin time (aPTT), fibrinogen concentration, antithrombin activity, D-dimer concentration, protein C activity, plasmin inhibition, plasminogen activity, and kaolin-activated thomboelastography. RESULTS: Decreased platelet count was a risk factor for the presence of BCH (P = 0.006) and decreased platelet count (P < 0.001), protein C activity (P = 0.001), angle (α) (P = 0.001), maximum amplitude (MA) (P < 0.001), and clot strength (G) (P = 0.002) were risk factors for blood product administration. Nonsurviving dogs were hypocoagulable with prolonged aPTT (P = 0.008), decreased plasmin inhibition (P = 0.033), decreased α (P = 0.021), and decreased MA (P = 0.038) compared to surviving dogs. Multivariate analysis accounting for disease severity showed that prolonged aPTT (P = 0.004, OR = 1.74) was the strongest predictor of nonsurvival. Prolonged aPTT was positively correlated with APPLE-fast score (P < 0.001, r(2) = 0.35), lactate concentration (P < 0.001, r(2) = 0.35), and negative base excess (P = 0.001, r(2) = 0.27). Acute traumatic coagulopathy, as defined by 2 or more abnormal coagulation tests, was diagnosed in 15% of dogs at hospital admission and was more common in dogs with increased disease severity (P = 0.002), decreased systolic blood pressure (P = 0.002), and increased lactate concentration (P = 0.011). CONCLUSIONS: In dogs with severe traumatic injuries and hypoperfusion, measurement of thromboelastography and aPTT should be considered to support clinical assessments in predicting the need for blood product administration and nonsurvival.

Effect of synthetic colloid administration on hemodynamic and laboratory variables in healthy dogs and dogs with systemic inflammation.

OBJECTIVE: To compare the effects of administering equal volumes of isotonic crystalloids and synthetic colloids on hemodynamic and laboratory variables in healthy dogs and dogs with systemic inflammation. DESIGN: Randomized, placebo-controlled, blinded study. SETTING: Comparative clinical research facility. ANIMALS: Sixteen adult purpose-bred Beagles. INTERVENTIONS: Dogs were first randomized to receive either lipopolysaccharide (LPS; 5 µg/kg, IV) or an equal volume of placebo (0.9% NaCl, IV). Dogs were then randomized into 1 of 2 groups receiving fluid resuscitation with either 40 mL/kg IV isotonic crystalloid (0.9% NaCl) or synthetic colloid (tetrastarch). After a 14-day washout, the study was repeated such that dogs received the opposite treatment (LPS or placebo) and the same resuscitation fluid regimen. Vital signs (heart rate (HR), oscillometric blood pressure) were measured and blood samples were collected for PCV, total plasma protein (TPP), serum lactate concentration, and colloid osmotic pressure (COP) measurements. MEASUREMENTS AND MAIN RESULTS: Healthy (placebo) dogs had similar decreases in PCV and TPP after administration of either fluid. Tetrastarch administration was associated with a larger increase in HR, systolic blood pressure, and mean blood pressure. Dogs with systemic inflammation had similar increases in systolic blood pressure and decreases in PCV, TPP, and lactate after administration of either fluid. Tetrastarch administration caused greater immediate increase in HR and mean blood pressure compared to 0.9% NaCl. In all dogs, 0.9% NaCl administration decreased COP and tetrastarch administration increased COP. CONCLUSIONS: Resuscitation with equal volumes of 0.9% NaCl and tetrastarch caused similar changes in hemodynamic and laboratory variables in dogs with LPS-induced systemic inflammation; however, larger increases in HR and blood pressure were seen within the first 2 hours following tetrastarch administration compared to 0.9% NaCl. Tetrastarch administration increased COP in all dogs, despite a decrease in TPP.