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BACKGROUND: In the United States, 475,000 Americans die from a cardiac arrest annually. This demands providers to be competent in the management of cardiovascular emergencies. Despite the need, there is a lack of research regarding how to better provide training for medical students to address cardiopulmonary emergencies. We hypothesize that participating in the Medical Students as ACLS Instructors program will improve students' emergency management and clinical teaching competencies. METHODS: The University of South Dakota Sanford School of Medicine (USD SSOM) has developed and implemented an ACLS Instructor (ACLS-I) course for medical students. The ACLS-I course can accommodate up to 15 ACLS-certified MS3 students in good academic standing. The first 11 student-instructors from University of South Dakota Sanford School of Medicine (USD SSOM) class of 2023 were admitted to the program in 2021 with an additional 5 student- instructors from USD SSOM class of 2024 added in 2022. After obtaining instructor status, the student-instructors have been involved in teaching ACLS classes. Participants' knowledge, skills, and confidence will be assessed using an assurance index based ACLS assessment during the end of their 4th year of medical school. An added component in the quiz will assess the individual's comfortability in teaching their peers in clinical emergencies. In our assessment of the participants' knowledge, skills, and confidence, the control group will be USD SSOM students. Inclusion criteria for the control group include current student status at USD SSOM and ACLS provider certification. Exclusion criteria includes current or prior ACLS instructor certification. RESULTS: In July 2021, 11 students from the class of 2023 were admitted to the ACLS Instructor program and comprised a research group. Prior to admission, all 75 students of the class were tested on the ACLS knowledge and skills. The results have shown that at baseline, ACLS-I cohort test scores were not statistically significantly different from the control group. CONCLUSIONS: Current data demonstrates that ACLS-I students are a typical representation of the entire cohort prior to admission to the program. During sessions, there have been 10 different subjects covered by the ACLS-I students. 5 more students from the class of 2024 have been enrolled in the ACLS-I course. Through continued participation in sessions, the ACLS-I group is expected to demonstrate higher ACLS and teaching competencies as the curriculum progresses.
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Estudiantes de Medicina , Humanos , Estudios de Casos y Controles , Urgencias Médicas , Instituciones Académicas , CertificaciónRESUMEN
Sable antelope (Hippotragus niger), a large, dominant species, often require chemical immobilization for captive management. Despite several recorded protocols, limited objective or subjective data are available to guide chemical immobilization of this species. This study retrospectively compared immobilization drug combinations of carfentanil-xylazine (CX), thiafentanil-xylazine (TX), etorphine-xylazine (EX), carfentanil-acepromazine (CA), and butorphanol-azaperone-medetomidine (BAM) for healthy sable antelope at one institution. Clinically applicable physiologic measures, subjective ratings, and timing of anesthetic milestones of 161 events for 107 individuals revealed the following statistically significant findings (P < 0.05). Induction ratings were best for TX, highest degree of muscle relaxation occurred with BAM and TX, and anesthetic ratings were best for TX and EX. Time to recovery was longest and complications 2.56 times more likely with CX. Time to recumbency was shortest in TX. Heart rate was highest in CA and lowest in BAM. For immobilization procedures, this study suggests TX would be the preferred combination for H. niger. However, all drug combinations evaluated can be used successfully to immobilize H. niger, and certain combinations may be situationally preferred based on desired muscle relaxation, expected induction or recovery times, or anticipated procedure length.
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Anestésicos , Antílopes , Mustelidae , Humanos , Animales , Hipnóticos y Sedantes/farmacología , Xilazina/farmacología , Estudios Retrospectivos , Niger , Inmovilización/veterinaria , Inmovilización/métodos , Azaperona/farmacología , Medetomidina/farmacología , Butorfanol/farmacología , Etorfina , Combinación de MedicamentosRESUMEN
Trazodone is a dose-dependent serotonin antagonist and agonist used to treat anxiety-related conditions. Trauma has been identified as the leading cause of morbidity and mortality in several nondomestic ruminant species and can be exacerbated by stress. In a recent study in domestic goats (Capra aegagrus hircus), trazodone reduced activity levels without adverse effects. Trazodone could allow for safer capture and handling in nondomestic ruminant species. The objectives of this study were to identify a dose of trazodone that decreases activity levels in captive blue wildebeest (Connochaetes taurinus) and to evaluate its safety and its effects on serum cortisol levels following a routine veterinary procedure. A pilot study using ethograms identified a group fed 15 mg/kg oral dose of trazodone as effective to reduce activity levels. Over 6 h, this dose resulted in a 111% increase in time spent sleeping or resting (P = 0.0003), a 41% increase in time spent lying down (P = 0.0016), a 64% reduction in time spent moving (P= 0.005), and a 65% reduction in time spent being vigilant (P= 0.026). Systemic absorption of trazodone was identified when plasma concentrations were measured after 2 h (95 ± 48 µg/L). Serum cortisol levels during a routine venipuncture event were not significantly different following trazodone administration (P > 0.05). Mild hyporexia was the only adverse effect noted at 15 mg/kg and was absent at a 12 mg/kg dose. Trazodone appears safe and promising to decrease activity in blue wildebeest and might thus have a positive effect on nondomestic ruminant welfare and the safety of veterinary procedures.
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Antílopes , Trazodona , Animales , Trazodona/farmacología , Hidrocortisona , Proyectos Piloto , Conducta AnimalRESUMEN
The blue wildebeest (Connochaetes taurinus; Burchell, 1823) is an African ungulate that is notoriously difficult to hand-rear and reintegrate into managed herds. The following case report is of a female wildebeest neonate that was orphaned, bottle-reared, and successfully reintroduced into a herd at a zoological facility. Since blue wildebeests are a highly precocial and herd-oriented species that calve synchronously in the wild as a reproductive strategy to maximize survival, early release of assist-reared neonates into managed herds before weaning may be an effective strategy for increasing the chance of acceptance. Wildebeest calves can also be easily trained for bottle-feedings in the field to facilitate early release. Due to a lack of literature on the assisted rearing and reintegration of wildebeest calves into managed herds, this case report provides useful techniques for the feeding, training, and releasing of bottle-reared wildebeests that may also be applicable to other assist-reared herd species at zoological facilities.
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Antílopes/fisiología , Animales , Animales Recién Nacidos/crecimiento & desarrollo , Animales Recién Nacidos/parasitología , Animales de Zoológico , Antílopes/crecimiento & desarrollo , Bovinos , Femenino , DesteteRESUMEN
Gastrointestinal disease is a common clinical problem in captive cheetahs (Acinonyx jubatus). It is reported that gastritis affects the vast majority of the captive population of cheetahs. Pancreatitis and acute and chronic enteritis have also been reported. These issues pose significant long-term health and welfare implications for cheetahs. Cobalamin, folate, methylmalonic acid (MMA), gastrin, feline pancreatic-specific lipase immunoreactivity (fPLI), and feline trypsin-like immunoreactivity (fTLI) immunoassays are important biomarkers of gastrointestinal disease in domestic cats. The goal of this study was to determine if these immunoassays validated in domestic cats could be used clinically in cheetahs, by establishing reference intervals (RI) for these biomarkers in cheetahs. A cohort of 40 clinically healthy cheetahs was selected from three zoological institutions on the basis of being free of clinical gastrointestinal disease and extra-gastrointestinal disease that could affect biomarkers, as well as having banked frozen serum. Cheetah biomarker RI, with domestic cat RI for comparison in parentheses, are as follows: cobalamin 470-618 pg/ml (290-1500 pg/ml), folate 2.2-15.7 ng/ml (9.7-21.6 ng/ml), MMA 365-450 nM/L (139-897 nM/L), fPLI 0.5-1.2 µg/L (0-4 µg/L), and gastrin 30-50 pg/ml (<10-39.5 pg/ml). This study shows that RI for gastrointestinal biomarkers can be notably different, even between species that are as closely related as the domestic cat and the cheetah. Additionally, it was found that the fTLI assay does not cross-immunoreact with cheetahs. In conclusion, this study emphasizes the importance of developing species-specific RI for biomarker assays and using caution when extrapolating RI from other species.
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Acinonyx , Enfermedades de los Gatos , Gastritis , Animales , Animales de Zoológico , Biomarcadores , Enfermedades de los Gatos/diagnóstico , Gatos , Gastritis/veterinaria , Valores de Referencia , Especificidad de la EspecieRESUMEN
Moxidectin is a commonly used lipophilic anthelmintic with activity against a wide range of nematodes. It is labeled for use in cattle by oral, topical, and subcutaneous routes. In semi-free ranging conditions, many anthelmintics are remotely administered intramuscularly due to an inability to administer by other routes without restraint. During 2015-2016, three animals including a roan (Hippotragus equinus), sable (Hippotragus niger), and Arabian oryx (Oryx leucoryx) treated with moxidectin developed clinical signs consistent with toxicosis. The primary sign was severe neurologic depression within 12 to 24 hr. Based on recommendations in domestic cases, animals were treated with intravenous lipid therapy and supportive care while diagnostic testing was performed. All three initially improved prior to succumbing to secondary problems associated with prolonged recumbency. Moxidectin has been administered remotely on 97 occasions in eight different exotic ruminant species at Fossil Rim, with only the above three cases showing clinical signs of toxicosis. Two potential causes in these cases include poor body condition leading to a smaller volume of distribution, thus allowing higher concentrations to overwhelm the blood-brain barrier, or a genetic defect similar to some herding dog breeds. Given that cases were seen in three different species at an overall low incidence within a given species, a genetic defect is considered unlikely. The animals affected did have significantly lower body condition score than conspecifics, and it is considered likely that this predisposed these animals to toxicosis. Therefore, caution should be used when administering moxidectin intramuscularly in animals in poor body condition.
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Antílopes , Antiparasitarios/toxicidad , Macrólidos/toxicidad , Intoxicación/veterinaria , Animales , Animales de Zoológico , Resultado Fatal , Femenino , Masculino , Intoxicación/etiología , TexasRESUMEN
Using slit-lamp biomicroscopy, conjunctival biopsy, and morphological identification, a flock of four Greater rheas (Rhea americana) in Arizona were diagnosed with conjunctivitis secondary to Philophthalmus gralli (P. gralli) infection. Aquatic snails from the exhibit's water source were identified as Melanoides tuberculatus, a known vector for P. gralli. Comparison of partial sequences of DNA regions from P. gralli adults removed from the rheas and metacercariae from the aquatic snails demonstrated a 100% match, confirming the source of infection. The flock was divided into two treatment groups: the most severely affected rheas received both manual removal of trematodes and praziquantel 1% ointment OU q12 h and the least severely affected rheas were only given praziquantel 1% ointment OU q12 h. The rheas were permanently relocated away from the infected water source and aquatic snails. Initial resolution was seen at 17 weeks in the most severely affected rhea, which had 675 adult P. gralli removed and topical praziquantel. The two rheas that only received topical praziquantel showed resolution within 3 and 15 weeks. Current recommendations for treating P. gralli include: manual removal of trematodes, topical praziquantel 1% ointment, and relocation away from infected water sources and aquatic snails.
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Enfermedades de las Aves/parasitología , Reiformes/parasitología , Infecciones por Trematodos/veterinaria , Animales , Antihelmínticos/uso terapéutico , Arizona/epidemiología , Secuencia de Bases , Enfermedades de las Aves/tratamiento farmacológico , Enfermedades de las Aves/epidemiología , Brotes de Enfermedades/veterinaria , Femenino , Masculino , Datos de Secuencia Molecular , Praziquantel/uso terapéutico , Caracoles/parasitología , Trematodos/genética , Infecciones por Trematodos/tratamiento farmacológico , Infecciones por Trematodos/parasitologíaRESUMEN
An 8-yr-old male buff-cheeked gibbon (Nomascus gabriellae) acutely developed abnormal behavior, decreased appetite, and dull mentation. Mild generalized muscle wasting and weight loss were the only other abnormalities noted on examination. Routine immunodiffusion serology for Coccidioides spp. were IgG and IgM positive. Magnetic resonance imaging of the brain was suggestive of an infectious meningoencephalitis with secondary obstructive hydrocephalus. A ventriculoperitoneal shunt was placed in standard fashion to reduce the imminent risk of mortality from increased intracranial pressure. Postoperative treatment included oral fluconazole, a tapered course of prednisolone, and physical therapy. Clinical signs improved steadily and the gibbon was fit to return to exhibit 8 wk post-shunt placement. This case of coccidioidomycosis demonstrates the complications that can occur with dissemination to the central nervous system and its management. It is the first published report describing the use of ventriculoperitoneal shunt placement in this species.
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Coccidioidomicosis/veterinaria , Hidrocefalia/veterinaria , Hylobatidae , Meningoencefalitis/veterinaria , Animales , Coccidioidomicosis/complicaciones , Coccidioidomicosis/patología , Hidrocefalia/patología , Hidrocefalia/terapia , Masculino , Meningoencefalitis/complicaciones , Meningoencefalitis/microbiología , Meningoencefalitis/patologíaRESUMEN
An adult female, wild-caught red coachwhip snake (Masticophis flagellum piceus) was euthanized at the Phoenix Zoo due to severe neurologic signs. Necropsy and histopathology revealed an invasive liposarcoma of the vertebral column, which likely caused the neurologic signs. Histology of the small intestine revealed a granuloma with intralesional yeasts morphologically compatible with the genus Coccidioides. The diagnosis of coccidioidomycosis was confirmed with immunohistochemistry staining. Coccidioides posadasii is endemic to Arizona and is an important cause of disseminated fungal infections in mammals in this region. This is the first known report of intestinal coccidioidomycosis in a veterinary species and the second report of coccidioidomycosis in a reptile.
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Coccidioides/aislamiento & purificación , Coccidioidomicosis/veterinaria , Serpientes , Animales , Animales de Zoológico , Coccidioidomicosis/patología , FemeninoRESUMEN
Over a 2-month period, individual birds belonging to species in multiple avian families, including Bucerotidae, Sturnidae, Columbidae, Corvidae, and Anatidae, were presented to the Animal Care Center at the Phoenix Zoo for emergency medical care. Common clinical findings were subdued behavior, weight loss, and an inability to fly. Biochemical abnormalities commonly included high calcium and uric acid concentrations and high to high-normal phosphorus concentrations. In cases in which necropsies were done, mineralization of organs often was present, frequently of the kidneys and cardiovascular system. Because of the high calcium and phosphorus concentrations, mineralization of tissues, cases representing multiple avian species, and the recent addition of rodent bait boxes containing cholecalciferol to the zoo's pest control program, a presumptive diagnosis of cholecalciferol toxicosis was made. Treatment most commonly consisted of daily fluid diuresis. These cases demonstrate that, although cholecalciferol is considered unlikely to cause relay toxicosis, primary toxicosis still should be considered in cases with sudden onset of nonspecific signs when exposure to cholecalciferol was possible.
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Animales de Zoológico , Enfermedades de las Aves/inducido químicamente , Colecalciferol/toxicidad , Rodenticidas/envenenamiento , Animales , Enfermedades de las Aves/patología , Aves , Femenino , Masculino , Rodenticidas/toxicidadRESUMEN
A 15-yr-old, female, maned wolf (Chrysocyon brachyurus) was euthanized after presenting semicomatose with severe, uncontrolled frank hemorrhage from her rectum 6 days following a routine physical examination and vaccination. Histopathology indicated severe hemorrhagic and necrotizing hepatitis with intranuclear basophilic inclusion bodies in the liver that were thought to be consistent with adenoviral infection. Further classification by polymerase chain reaction, immunohistochemical staining, virus isolation, and electron microscopy confirmed the etiologic agent to be canine adenovirus-2. A representative sample of the vaccine that had been used was submitted and sequenced along with the virus isolated from the maned wolf. The sequencing of the etiologic agent that had been isolated from the maned wolf was determined to be the same as the strain of virus used in the production of the modified live vaccine that had been administered 6 days prior to death. From this information, the diagnosis of vaccine-induced adenoviral hepatitis was made. This is the first confirmed case of vaccine-induced canine adenoviral hepatitis in a maned wolf.
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Adenovirus Caninos/clasificación , Hemorragia/veterinaria , Hepatitis Animal/inducido químicamente , Necrosis/veterinaria , Vacunas Virales/inmunología , Animales , Femenino , Hemorragia/inducido químicamente , Hepatitis Animal/patología , Necrosis/inducido químicamente , Vacunas Virales/efectos adversosRESUMEN
BACKGROUND: The original description of Pachysentis canicola Meyer, 1931 was based on an unknown number of specimens from an undetermined species of Canis in Brazil from the Berlin Museum. It has since been reported from other carnivores in South and North America. Our specimens from the maned wolf, Chrysocyon brachyurus (Illiger, 1815), in Texas, represent a new host record, and has shed more light on morphometric characteristics missing from the original description, and expanded the range of variations in characters that remained fixed since 1931 and that have been repeated in other taxonomic accounts. We have found additional specimens in striped skunk, Mephitis mephitis Schreber, also in Texas. METHODS: We have performed metal analysis on hooks using EDXA (energy dispersive X-ray analysis). Sequences for the 18S gene and ITS1-5.8-ITS2 region of rDNA were generated to molecularly characterize the species for the first time. RESULTS: Worms with a massive trunk and a globular proboscis with prominent dome-like apical organ and 12 irregular spiral rows of 4-5 hooks deeply embedded in cuticular folds each, totaling 48-60 hooks. We have included line drawings of the male and female reproductive systems, among other structures, also missing from the original and subsequent descriptions. We describe a new population of P. canicola from Texas and report on the metal analysis of its hooks using EDXA. We also assess the phylogenetic position of P. canicola supporting its independent status in the family Oligacanthorhynchidae, inferred from the two molecular markers. CONCLUSIONS: This is the foremost molecular characterization of any species of Pachysentis and will provide significant insights and reference for future molecular study of species of Pachysentis, especially from this newly described Texas population.
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Acantocéfalos , Canidae , Helmintiasis Animal , Animales , Femenino , Masculino , Filogenia , TexasRESUMEN
An 18-year-old, neutered, male Vietnamese pot-bellied pig (Sus scrofa) was treated for chronic, intermittent nasal discharge and sneezing. The animal was diagnosed with severe periodontal disease (grade IV), an oronasal fistula, and multiple tooth root abscesses via dental examination and computed tomography of the skull. Dentistry was performed, including multiple tooth extractions, and antibiotic therapy was initiated. Eighteen months later, the animal was evaluated for lethargy, anorexia, and a firm, 12 cm x 12 cm mass between the 2 rami of the mandible. Laboratory testing revealed moderate anemia, severe leukocytosis, and hyperglobulinemia. Skull radiographs indicated osteomyelitis of the mandible and soft-tissue swelling. A fine-needle aspirate and biopsy were taken, and results were consistent with squamous cell carcinoma. Treatment with piroxicam and antibiotics was initiated as needed to control signs of pain and secondary infection, respectively. Three months after diagnosis, the pig was euthanized due to cachexia and severe depression secondary to squamous cell carcinoma. On postmortem examination, the right mandibular area contained multiple, coalescing, irregular masses extending from the ramus rostrally to the mandibular canine teeth and ventrally within the intermandibular space, completely obliterating the normal anatomy. An open midshaft fracture was present on the right mandible. On histopathology, the masses were confirmed as locally invasive and destructive squamous cell carcinoma. No evidence of metastasis was noted in regional lymph nodes or in any of the distant sites evaluated.
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Carcinoma de Células Escamosas/veterinaria , Neoplasias de la Boca/veterinaria , Enfermedades de los Porcinos/patología , Animales , Antibacterianos/uso terapéutico , Biopsia , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Eutanasia , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/patología , Invasividad Neoplásica , Orquiectomía , Enfermedades Periodontales/patología , Enfermedades Periodontales/veterinaria , Piroxicam/uso terapéutico , Porcinos , Enfermedades de los Porcinos/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Extracción Dental/veterinariaRESUMEN
A 10-yr-old male intact Asian small clawed otter (Aonyx cinerus) was presumptively diagnosed by histopathology and immunohistochemistry with lymphangiosarcoma after bony destruction of the ischium and spinal column from local tumor invasion had caused progressive signs of hind limb lameness and paresis/paralysis, which led to humane euthanasia. At necropsy, the primary tumor was identified as a flocculent mass present under the caudal lumbar vertebrae. Multiple nerves were seen to run from the spinal cord into the wall of the mass. This mass had locally invaded the surrounding muscle, vertebral column, and spinal cord, which led to the clinical signs noted at presentation. Bony destruction was severe with almost complete obliteration of the right ischium and osteolysis of L6, exposing the spinal cord beneath. The tumor had metastasized to at least two different sites within the spleen. The abdominal tumor was confirmed to be of endothelial origin by the use of immunohistochemical staining for factor VIII-related antigen and was confirmed as lymphatic origin versus vascular origin because of the lack of red blood cells within the vessels. The length of time from initial presentation with hind limb lameness to euthanasia because of hind limb paralysis was 4 mo. This is the first report of lymphangiosarcoma, an uncommon malignant neoplasm of lymphatic origin, in a mustelid and the first report of neoplastic disease in an Asian small clawed otter. In addition, the presentation of hind limb paresis associated with bony lysis because of local tumor invasion has not been previously reported with lymphangiosarcoma in humans, domestic animals, or nondomestic animals.
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Vértebras Lumbares , Linfangiosarcoma/veterinaria , Osteólisis/veterinaria , Nutrias , Paresia/veterinaria , Animales , Diagnóstico Diferencial , Resultado Fatal , Vértebras Lumbares/patología , Linfangiosarcoma/complicaciones , Linfangiosarcoma/diagnóstico , Masculino , Osteólisis/etiología , Paresia/etiologíaRESUMEN
MRL/MpJ-Fas(lpr) (MRL/lpr) mice are an accepted animal model to study human systemic lupus erythematosus. We tested if a commonly used analgesic (buprenorphine hydrochloride) would reduce pain and distress in these mice without impacting the progression of autoimmune disease. Female MRL/lpr mice were randomly separated into four groups. Experimental groups received cyclophosphamide (25 mg/kg i.p. weekly), buprenorphine (0.09 mg/kg/mouse/day via drinking water), or cyclophosphamide+buprenorphine from 11 to 21 weeks of age. Controls received no treatments. Mice were monitored daily by a licensed veterinarian (blinded observer) and assigned a score weekly on parameters associated with pain and distress as well as progression of disease. Proteinuria was measured weekly, and serum anti-dsDNA antibody levels were determined at 11, 15, and 18 weeks of age. At 21 weeks of age, the animals were euthanized and the kidneys and spleens were removed for evaluation. Regardless of the parameter observed, buprenorphine did not significantly decrease distress when compared to the controls. Buprenorphine did not alter the progression of autoimmune disease, based on characteristics of splenic architecture and splenocyte cell profiles, development of lymphadenopathy, or kidney histology as compared to controls. This study indicates that buprenorphine at this dose and route of administration was ineffective in reducing distress associated with disease progression in the MRL/lpr strain. More studies are needed to determine if, at a different dose or route, buprenorphine would be useful as adjunctive therapy in reducing distress in MRL/lpr mice.