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Objective: Primary objectives of this study were to determine presenting complaints, physical examination, clinicopathologic findings, and hospitalization time of dogs with spontaneous hypoadrenocorticism presenting with critical disease; and to compare those end points to dogs with a more stable presentation. Secondary objectives were to evaluate the shock index and to identify precipitating stressors. Animals: Eighty-four dogs at the Western College of Veterinary Medicine between 1998 and 2018 were included. Procedure: Data were retrieved from the medical records. Results: Collapse and depression were more common among critically ill dogs. Hyperlactatemia was rare despite a diagnosis of hypovolemic shock, and a shock index was ineffective in this patient subset. Isosthenuria, total hypocalcemia, and more severe acidosis were more common (P < 0.05) in critical dogs. Owner separation was the most common precipitating stressor. Conclusion and clinical relevance: We concluded that the critical Addisonian dog has unique characteristics that may aid in early disease identification.
Hypoadrénocorticisme canin : aper ç u de la crise Addisonienne. Objectif: Les principaux objectifs de cette étude étaient de déterminer les motifs de présentation, l'examen physique, les résultats clinico-pathologiques et la durée d'hospitalisation des chiens atteints d'hypoadrénocorticisme spontané présentant une maladie critique; et de comparer ces paramètres aux chiens avec une présentation plus stable. Les objectifs secondaires étaient d'évaluer l'indice de choc et d'identifier les facteurs de stress déclencheurs. Animaux: Quatre-vingt-quatre chiens du Western College of Veterinary Medicine entre 1998 et 2018 ont été inclus. Procédure: Les données ont été extraites des dossiers médicaux. Résultats: L'effondrement et la dépression étaient plus fréquents chez les chiens gravement malades. L'hyperlactatémie était rare malgré un diagnostic de choc hypovolémique, et un indice de choc était inefficace dans ce sous-groupe de patients. L'isosthénurie, l'hypocalcémie totale et l'acidose plus grave étaient plus fréquentes (P < 0,05) chez les chiens critiques. La séparation du propriétaire était le facteur de stress déclencheur le plus courant. Conclusion et pertinence clinique: Nous avons conclu que le chien addisonien critique a des caractéristiques uniques qui peuvent aider à l'identification précoce de la maladie.(Traduit par Dr Serge Messier).
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Acidose , Insuficiência Adrenal , Doenças do Cão , Cães , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia , Insuficiência Adrenal/diagnóstico , Insuficiência Adrenal/epidemiologia , Insuficiência Adrenal/veterinária , Acidose/veterináriaRESUMO
A 2-year-old spayed female Great Pyrenees cross dog was presented following the consumption of pure xylitol sweetener. Blood tests revealed hepatocellular leakage and cholestasis, hyperlactatemia, thrombocytopenia, and prolonged prothrombin and activated partial thromboplastin times. Thoracic radiographs on day 2 of hospitalization were consistent with pulmonary hemorrhage. Prior to death, the dog developed pulsus alternans suggestive of myocardial dysfunction secondary to severe systemic inflammation. This is the first report of pulsus alternans in a critically ill dog prior to clinical deterioration and death. This is also the first documentation of pulsus alternans with a high-definition oscillometric device. Key clinical message: Increased recognition of pulsus alternans and its potential implications in veterinary medicine may contribute to the identification of cardiovascular complications associated with systemic disease.
Pouls alternant chez un chien critiquement malade hospitalisé pour toxicité au xylitol. Une chienne Grand Pyrénées croisée stérilisée âgée de 2 ans a été présentée à la suite de la consommation de l'édulcorant xylitol pur. Des tests sanguins ont révélé une fuite hépatocellulaire et une cholestase, une hyperlactatémie, une thrombocytopénie et des temps de prothrombine et de thromboplastine partielle activée allongés. Des radiographies thoraciques au jour 2 de l'hospitalisation étaient conformes avec une hémorragie pulmonaire. Avant le décès, le chien développa un pouls alternant suggestif de dysfonction myocardique secondaire à une inflammation systémique sévère. Ceci constitue le premier rapport de pouls alternant chez un chien critiquement malade antérieur à une détérioration clinique et la mort. Il s'agit également de la première documentation d'un pouls alternant avec un instrument oscillométrique à haute définition.Message clinique clé :Une augmentation de la reconnaissance de pouls alternant et ses implications potentielles en médecine vétérinaire pourraient contribuer à l'identification de complications cardiovasculaires associées à des maladies systémiques.(Traduit par Dr Serge Messier).
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Doenças do Cão , Pulso Arterial , Animais , Estado Terminal , Doenças do Cão/induzido quimicamente , Cães , Feminino , XilitolRESUMO
The objectives of this study were to describe serial point-of-care test results in dogs infected with canine parvovirus (CPV), highlight clinicopathologic abnormalities at various timepoints, and investigate their association with the duration of hospitalization. Two-hundred and four dogs positive for CPV at the Western College of Veterinary Medicine between 2003 and 2015 were included. Data were recorded pertaining to emergency panel and venous blood gas tests at presentation, and every 12 hours thereafter (+/- 4 hours) for the first 72 hours of hospitalization. Common persistent abnormalities included hypoproteinemia, acidosis, hyponatremia, hypochloremia, hyperkalemia, and hyperbicarbonatemia. Ionized hypocalcemia was associated with a longer duration of hospitalization and mild hyperkalemia was associated with a shorter duration of hospitalization (P < 0.05). This study suggests that the use of point-of-care tests for in-hospital monitoring may provide insight into CPV case complexity and predict total hospitalization times.
Association entre les résultats des tests au point de service et la durée de l'hospitalisation pour l'infection par le parvovirus canin (20032015). Les objectifs de cette étude consistaient à décrire les résultats des tests au point de service chez les chiens infectés par le parvovirus canin (CPV), à souligner les anomalies clinico-pathologiques à divers moments et à étudier leur association avec la durée d'hospitalisation. Deux cent quatre chiens positifs pour le CPV au Western College of Veterinary Medicine entre 2003 et 2015 ont été inclus. Des données ont été consignées en lien avec le panel d'urgence et les tests de gaz du sang veineux à la présentation et toutes les 12 heures par la suite (+/− 4 heures) pour les 72 premières heures d'hospitalisation. Les anomalies persistantes communes incluaient l'hypoprotéinémie, l'acidose, l'hyponatrémie, l'hypochlorémie, l'hyperkaliémie et l'hyperbicarbonatémie. L'hypocalcémie inonisée était associée à une plus longue durée d'hospitalisation et une légère hyperkaliémie était associée à une plus courte durée d'hospitalisation (P < 0,05). Cette étude suggère que l'usage des tests au point de service pour la surveillance à l'hôpital peut fournir de l'information à propos de la complexité des cas de CPV et prédire la durée totale d'hospitalisation.(Traduit par Isabelle Vallières).
Assuntos
Doenças do Cão , Infecções por Parvoviridae/veterinária , Parvovirus Canino , Animais , Cães , Hospitalização , Humanos , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
Solar fuel generation requires the efficient capture and conversion of visible light. In both natural and artificial systems, molecular sensitizers can be tuned to capture, convert, and transfer visible light energy. We demonstrate that a series of metal-free porphyrins can drive photoelectrochemical water splitting under broadband and red light (λ > 590 nm) illumination in a dye-sensitized TiO2 solar cell. We report the synthesis, spectral, and electrochemical properties of the sensitizers. Despite slow recombination of photoinjected electrons with oxidized porphyrins, photocurrents are low because of low injection yields and slow electron self-exchange between oxidized porphyrins. The free-base porphyrins are stable under conditions of water photoelectrolysis and in some cases photovoltages in excess of 1 V are observed.
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OBJECTIVES: In preterm infants, the metabolic responses of gastrointestinal (GI) bacteria to different diets are poorly understood despite the possible effects on GI health. Therefore, we tested the hypothesis that diet influences bacterial metabolism by measuring short-chain fatty acids (SCFAs) in stool samples from very-low-birth-weight (VLBW) preterm infants without GI disorder as surrogate biomarkers of bacterial metabolism. METHODS: Ion chromatography was used to measure fecal SCFAs (acetate, formate, propionate, butyrate, and isobutyrate), lactate, and chloride in fresh stool samples collected from 32 preterm infants (without major congenital anomalies, GI disorders, or a recent history of antibiotic administration and on full feed of either expressed maternal breast milk [EBM; n = 13] or a formula for preterm infants [Similac Special Care Formula; preterm formula, PTF; n = 19]). RESULTS: The mean birth weight was 972 g, the mean gestational age was 27 weeks, and the mean postnatal age at first stool sample was 36 days. When adjusted for gestational age, the stools of EBM infants had higher concentrations (micromoles per gram of stool) of total SCFA (128 vs 68; P = 0.002), acetate (41 vs 13; P = 0.005), propionate (15.1 vs 4.4; P = 0.003), and chloride (21,814 vs 10,652; P = 0.02). Interactions between postnatal age and diet were detected for lactate (P = 0.05), propionate (P = 0.03), and butyrate (P = 0.03). CONCLUSIONS: Diets fed to VLBW preterm infants influence fecal SCFA profiles, and hence the metabolism of the GI bacteria, and potentially the health of preterm infants. The responses of bacterial metabolism to diet are influenced with postnatal age and gestational age at birth.
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Trato Gastrointestinal/microbiologia , Fórmulas Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/fisiologia , Recém-Nascido de muito Baixo Peso/fisiologia , Leite Humano , Bactérias/metabolismo , Peso ao Nascer , Dieta , Ácidos Graxos Voláteis/análise , Fezes/química , Trato Gastrointestinal/crescimento & desenvolvimento , Idade Gestacional , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Estudos ProspectivosRESUMO
A semiconducting porphyrin polymer that is solution processable and soluble in organic solvents has been synthesized, and its spectroscopic and electrochemical properties have been investigated. The polymer consists of diarylporphyrin units that are linked at meso-positions by aminophenyl groups, thus making the porphyrin rings an integral part of the polymer backbone. Hexyl chains on two of the aryl groups impart solubility. The porphyrin units interact only weakly in the ground electronic state. Excitation produces a local excited state that rapidly evolves into a state with charge-transfer character (CT) involving the amino nitrogen and the porphyrin macrocycle. Singlet excitation energy is transferred between porphyrin units in the chain with a time constant of ca. 210 ps. The final CT state has a lifetime of several nanoseconds, and the first oxidation of the polymer occurs at ca. 0.58 V vs. SCE. These properties make the polymer a suitable potential excited state electron donor to a variety of fullerenes or other acceptor species, suggesting that the polymer may find use in organic photovoltaics, sensors, and similar applications.
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Polímeros/síntese química , Porfirinas/síntese química , Semicondutores , Condutividade Elétrica , Teste de MateriaisRESUMO
OBJECTIVE: To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN: Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING: Two veterinary university teaching hospitals. ANIMALS: A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion. INTERVENTIONS: For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS: The RI for whole-blood TPP in healthy dogs was 70.9-135.3 µg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes. CONCLUSIONS: TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.
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Doenças do Cão , Sepse , Deficiência de Tiamina , Humanos , Cães , Animais , Tiamina , Estudos Prospectivos , Estado Terminal , Cromatografia Líquida de Alta Pressão/veterinária , Prevalência , Deficiência de Tiamina/epidemiologia , Deficiência de Tiamina/veterinária , Sepse/epidemiologia , Sepse/veterinária , Tiamina Pirofosfato , Lactatos , Doenças do Cão/epidemiologiaRESUMO
BACKGROUND: Viscoelastic coagulation monitor (VCM-Vet) is a point-of-care device that has been used to characterize hemostatic abnormalities in sick pets but has not been validated in veterinary patients. OBJECTIVES: We aimed to compare VCM-Vet and thromboelastography (TEG) in sick dogs with suspected disorders of hemostasis. METHODS: Duplicate VCM-Vet tests using untreated native blood performed concurrently on two VCM-Vet machines, and simultaneous TEG tests were performed (one citrated native (CN), and one activated with tissue factor (TF) at a 1:3600 dilution). Each VCM-Vet result was compared with both TF-activated and CN TEG. RESULTS: Fifty-three dogs were enrolled. Eleven cases displayed apparent hyperfibrinolysis. Spearman correlation coefficients for individual VCM-Vet devices and CN and TF TEG were obtained between R and CT values and ranged from 0.21 to 0.27, CFT and K (r = 0.60-0.67), angles (r = 0.51-0.62), and MCF and MA (r = 0.85-0.87). Comparison of the two VCM-Vet devices displayed positive correlations for all clot formation parameters with Lin's concordance correlation coefficients of 0.75-0.95. Variable lysis parameter agreement existed between the VCM-Vet devices and VCM-Vet and TEG. When samples were classified as hypercoagulable or coagulopathic, VCM-Vet had a low positive predictive value (17-33%) for the detection of hypercoagulable states and a moderate negative predictive value (64-74%) for the detection of coagulopathy as defined by TEG. CONCLUSIONS: VCM-Vet and TEG had variable correlations in clot formation values and a strong correlation for final clot strength. More information is needed to make conclusions about the lysis parameters. Artifact in the fibrinolysis portion of the test can confound the interpretation of VCM-Vet results.
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Transtornos da Coagulação Sanguínea , Doenças do Cão , Hemostáticos , Cães , Animais , Tromboelastografia/veterinária , Tromboelastografia/métodos , Sistemas Automatizados de Assistência Junto ao Leito , Hemostasia , Coagulação Sanguínea , Testes de Coagulação Sanguínea/veterinária , Transtornos da Coagulação Sanguínea/diagnóstico , Transtornos da Coagulação Sanguínea/veterinária , Tromboplastina , Citratos , Ácido Cítrico , Doenças do Cão/diagnósticoRESUMO
OBJECTIVE: To investigate the incidence and patterns of gunshot wound trauma in patients that were presented to an urban level 1 veterinary trauma center before and after the start of the coronavirus disease of 2019 (COVID-19) pandemic. ANIMALS: 24 dogs and 1 cat. METHODS: Medical records were retrospectively reviewed for patients presenting with gunshot wound injuries between March 2018 and February 2020 (prepandemic) and March 2020 and February 2022 (pandemic). The total number of patients presented to the hospital during those same time periods was also obtained. Patient data were collected including species, breed, age, sex, location of injury, trauma score (if available), surgical procedures performed, length of hospitalization, and case outcome. RESULTS: In the prepandemic period, 9 patients were presented for gunshot wound injuries, whereas there were 16 patients evaluated for gunshot wound injuries during the pandemic period. The total number of gunshot wound cases increased by 77.8% in the pandemic period. The total number of hospital patient visits, however, decreased by 12.2% in the pandemic period as compared to the prepandemic period: 65,168 versus 74,262 patients, respectively. Injuries were predominantly localized to the extremities (55%) in the prepandemic period versus maxillofacial (56%) in the pandemic period. CLINICAL RELEVANCE: There was an increased number of gunshot wound injuries in companion animals presenting to an urban level 1 veterinary trauma center during the COVID-19 pandemic. A shift in the predominant location of injury was also identified during the pandemic period. This study highlights the ramifications that societal dynamics can have on animal health and welfare.
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COVID-19 , Doenças do Gato , Doenças do Cão , Ferimentos por Arma de Fogo , Humanos , Gatos , Cães , Animais , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/veterinária , Ferimentos por Arma de Fogo/cirurgia , COVID-19/epidemiologia , COVID-19/veterinária , Pandemias , Estudos Retrospectivos , Incidência , Doenças do Gato/epidemiologia , Doenças do Cão/epidemiologiaRESUMO
BACKGROUND: Traditional management of non-steroidal anti-inflammatory drug (NSAID) intoxication includes gastrointestinal decontamination, intravenous administration of fluids (IVF), and gastroprotection. Intravenous administration of lipid emulsion (ILE) and therapeutic plasma exchange (TPE) are popular novel therapeutic strategies. HYPOTHESIS: Compare outcomes of dogs treated with IVF, ILE, and TPE for NSAID intoxications and evaluate outcome predictors for drug subgroups. ANIMALS: Four hundred thirty-four dogs with NSAID intoxications (2015-2020). METHODS: Multicenter retrospective study of ibuprofen, carprofen, and naproxen intoxication. An ordinal outcome was defined as mild gastrointestinal, moderate kidney, or signs of severe central nervous system disease. RESULTS: Signs of neurological disease were overrepresented and acute kidney injury underrepresented in the TPE group among dogs exposed to kidney- or CNS-toxic doses (P = .05), though all TPE dogs with signs of neurological disease had evidence of neurotoxicity at presentation. Dogs treated with IVF had a higher maximal creatinine concentration (median, 1.1 mg/dL; range, 0.4-8.44 mg/dL) compared with IVF + ILE (median, 0.9 mg/dL; range, 0.4-6.2 mg/dL; P = .01). Increased maximum time to presentation (P < .001), higher baseline creatinine (P < .001) and PCV (P = .007), and absence of induced emesis (P < .001) were associated with greater clinical severity. Ibuprofen toxicosis was associated with more severe clinical signs compared with carprofen (P = .03). Overall survival rate was 99%. CONCLUSIONS AND CLINICAL IMPORTANCE: NSAID toxicosis generally carries an excellent prognosis in dogs. Despite similar outcomes of lower incidence of AKI in the TPE group, and slightly lower maximal creatinine concentration in dogs treated with ILE vs IVF alone, ILE and TPE should be considered in the management of severe NSAID toxicosis.
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Doenças do Cão , Ibuprofeno , Cães , Animais , Ibuprofeno/efeitos adversos , Troca Plasmática/veterinária , Estudos Retrospectivos , Creatinina , Emulsões/efeitos adversos , Anti-Inflamatórios não Esteroides/efeitos adversos , Hidratação/veterinária , Doenças do Cão/induzido quimicamente , Doenças do Cão/terapia , Doenças do Cão/diagnóstico , LipídeosRESUMO
Viscoelastic testing methods such as thromboelastography (TEG) are becoming increasingly available to veterinarians in a clinical setting. TEG is useful in determining therapeutic transfusion needs and assessing global abnormalities of hemostasis of patients, given that it provides a more comprehensive assessment of coagulation than traditional tests. TEG is standardly performed at 37°C, which is considered a normal body temperature for human patients; however, 37°C is lower than normal body temperature for most canine patients. In an in vitro study, we investigated the potential effect that this difference in body temperature and test temperature might have on TEG results. Citrated blood samples were collected from clinically normal, as well as sick, dogs with various body temperatures. Samples were analyzed concurrently at the patient's body temperature and at 37°C. There was very high correlation between TEG performed at body temperature and at 37°C for R (min) and MA (mm), high correlation for K (min) and alpha angle (deg), and moderate correlation for LY30 (%) and LY60 (%). For canine patients with normal to mildly abnormal body temperatures, performance of TEG at the standard 37°C is acceptable.
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Tromboelastografia , Animais , Cães , Humanos , Temperatura , Tromboelastografia/veterináriaRESUMO
OBJECTIVE: Compare changes in intra-abdominal pressure (IAP), abdominal perfusion pressure (APP), hemodynamics, and clinicopathological variables in nonpregnant and late-term pregnant queens undergoing elective ovariohysterectomy (OHE) and evaluate the effect of patient positioning on IAP and APP measurements. ANIMALS: 18 late-term pregnant queens and 25 nonpregnant controls. PROCEDURES: Temperature, heart rate (HR), Doppler blood pressure (DBP), IAP (dorsal and right lateral), PCV, total protein (TP), and lactate were recorded preoperatively, at abdominal wall closure (dorsal IAP only), and postoperatively under general anesthesia. Uterine weight, blood loss, and surgical duration were recorded. Abdominal perfusion pressure was calculated as DBP minus IAP. RESULTS: Pre- and postoperatively, pregnant queens had lower DBP, APP, and PCV compared to controls (P < 0.001). IAP was higher in pregnant queens preoperatively (P < 0.001). Controls had a decrease in HR and increase in IAP, while both groups had a decrease in body temperature, DBP, APP, and lactate over time (P < 0.05). Pregnant queens had a decrease (P = 0.029), and controls had an increase in TP (P = 0.001). Blood loss and surgical time were greater for pregnant queens (P < 0.001). Dorsal IAP and APP were higher and lower than right lateral measurements (P < 0.001), respectively, and correlation was strong. CLINICAL RELEVANCE: Hemodynamics and APP are impaired in late-term pregnant queens undergoing OHE, and increased monitoring is warranted. Although strongly correlated, feline IAP and APP measurements in dorsal and right lateral recumbency are not interchangeable.
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Abdome , Histerectomia , Abdome/cirurgia , Animais , Pressão Sanguínea/fisiologia , Gatos , Feminino , Histerectomia/veterinária , Lactatos , Perfusão/veterinária , GravidezRESUMO
BACKGROUND: Creatinine is a universally important blood parameter used to detect and monitor acute and chronic kidney disease. Reliable measurements at the bedside remain a challenge in human and veterinary medicine. Despite its potential, a trustworthy point-of-care creatinine biosensor has yet to be established. OBJECTIVES: We aimed to determine the precision and accuracy of the StatSensor (SS) and StatSensor Xpress (SSX) handheld creatinine measurement devices in dogs. METHODS: Paired creatinine samples from dogs with normal (creatinine ≤159 µmol/L), moderate (159-354 µmol/L), and marked (>354 µmol/L) azotemia were compared with a commercial enzymatic analyzer. Within-day precision and linearity studies were performed prior to method comparison studies. Method comparison was evaluated using Bland-Altman, concordance correlation coefficient, Deming, and Passing-Bablok regression analysis. RESULTS: Seventy-eight dogs were enrolled in the study, including 28 (35%), 25 (32%), and 26 (33%) with normal, moderate, and marked azotemia. Total error surpassed recommendations for all devices, and linearity deviated from identity for the SS1 and SS2. The concordance correlation coefficients of the SS1, SS2, SSXI, and SSX2, were 0.69, 0.59, 0.82, and 0.44, respectively. Bland-Altman analyses showed a high variation in the differences, and relationships showed high heteroskedasticity with negative systemic bias among high creatinine concentrations. CONCLUSIONS: Neither the SS and SSX are considered acceptable for clinical applications in dogs. Further research is indicated for the development of a reliable, cost-effective, point-of-care creatinine analyzer to improve the rapid detection and monitoring human and veterinary patients.
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Azotemia , Doenças do Cão , Insuficiência Renal Crônica , Humanos , Cães , Animais , Creatinina , Sistemas Automatizados de Assistência Junto ao Leito , Azotemia/diagnóstico , Azotemia/veterinária , Insuficiência Renal Crônica/veterinária , Doenças do Cão/diagnósticoRESUMO
BACKGROUND: Therapeutic plasma exchange (TPE) is gaining popularity for the management of nonsteroidal anti-inflammatory drug (NSAID) overdose in dogs. HYPOTHESIS/OBJECTIVES: Describe a population of dogs treated with TPE for NSAID overdose. ANIMALS: Sixty-two dogs with NSAID overdose treated with TPE. METHODS: Multicenter retrospective study of dogs treated with TPE for ibuprofen, carprofen, or naproxen overdose. RESULTS: The median dose of ibuprofen, carprofen or naproxen ingested was 533 mg/kg (range, 36-4857 mg/kg), 217 mg/kg (range, 88-625 mg/kg) and 138 mg/kg (range, 26-3000 mg/kg), respectively. Based on previously established toxic ranges for each NSAID, 2 (3.2%), 14 (22.6%), and 46 (74.2%) dogs ingested a gastrointestinal, renal, and neurological toxic dose, respectively. The median time between ingestion and presentation was 4 hours (range, 1-20 hours). The median number of plasma volumes processed was 1.6 (range, 0.4-2.2). The median TPE session duration was 2 hours (range, 1-4.5 hours). Circuit clotting developed during 8 (12.9%) sessions. Patient adverse events reported during 21 (33.8%) sessions consisted of urticaria (12.9%), asymptomatic hypocalcemia (9.6%), and hypotension (9.6%). The median duration of hospitalization was 2.25 days (range, 1-11 days). Sixty-one (98.4%) dogs survived to discharge, and none were rehospitalized. Thirty-one (91.1%) of the 34 dogs with at least 1 follow-up visit were not azotemic at the time of reevaluation. CONCLUSIONS AND CLINICAL IMPORTANCE: This population of dogs managed with TPE had excellent outcomes, even in cases of high NSAID dose ingestion. When TPE is available and the time frame is appropriate, this extracorporeal modality should be considered for the management of NSAID overdose.
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Doenças do Cão , Overdose de Drogas , Animais , Anti-Inflamatórios não Esteroides/efeitos adversos , Doenças do Cão/tratamento farmacológico , Doenças do Cão/terapia , Cães , Overdose de Drogas/terapia , Overdose de Drogas/veterinária , Ibuprofeno/efeitos adversos , Naproxeno/uso terapêutico , Troca Plasmática/veterinária , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate the effectiveness of intravenous fluid resuscitation in hypotensive cats in an emergency room setting. Secondary objectives were to investigate changes in heart rate (HR) and body temperature (BT) in response to fluid resuscitation, and the association of these changes with patient survival. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: Eighty-two cats with confirmed hypotension. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records from 2012 to 2019 were searched for cats that had documented systemic arterial hypotension (blood pressure measured using a Doppler ultrasonic flow probe [DBP] < 90 mm Hg) on presentation to the emergency room. Data collected included patient characteristics and DBP, HR, and BT before and after fluid resuscitation, type and volume of fluids administered, and outcome. The median DBP before and after resuscitative fluid therapy in all cats was 65 mm Hg (range, 20-85 mm Hg) and 80 mm Hg (range, 20-128 mm Hg), respectively (P < 0.001). However, only 30 cats (37%) were classified as responders to fluid resuscitation (DBP ≥ 90 mm Hg following bolus therapy). The mean HR and median BT before resuscitative fluid therapy was 159/min and 36.7°C. Following fluid resuscitation, where measured, the mean HR and median BT was 154/min (P = 1.00) and 35.9°C (P = 1.00). No significant differences in HR and BT were identified between responders and non-responders. Cats had a low survival rate of 7%. All survivors (n = 5) were initially bradycardic (HR < 160/min), compared to only 45% of non-survivors (P = 0.4). CONCLUSIONS: Bolus fluid resuscitation effectively increases blood pressure in hypotensive cats; however, it does not result in normalization of blood pressure, HR, or BT in the majority of cases.
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Hidratação , Hipotensão , Animais , Pressão Sanguínea , Hidratação/veterinária , Hipotensão/terapia , Hipotensão/veterinária , Ressuscitação/veterinária , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate clinicopathological prognostic indicators associated with survival based on hematology and serum biochemistry profile findings at presentation of dogs with canine parvoviral enteritis (CPE). Secondary objectives were to describe the signalment, history, physical examination findings, and progression of disease while in hospital and correlate them to survival. DESIGN: Retrospective study from medical records of dogs diagnosed with CPE between 2001 and 2018. SETTING: University teaching hospital. ANIMALS: Three hundred twenty-two dogs diagnosed with CPE that received in-hospital treatment. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 322 hospitalized dogs, 294 dogs (91%) survived infection with a median hospitalization time of 79 hours. Multivariable analysis showed that glucose (P = 0.04), total magnesium (P = 0.011), and the dichotomized variable of a low HCT (P = 0.033) on presentation were significantly associated with survival. For every 1 mmol/L (18 mg/dL) decrease in glucose concentration, cases had 1.85 lower odds of survival. For every 0.1 mmol/L (0.2 mEq/L) increase in total magnesium concentration, cases had 2.50 lower odds of survival. Cases with a low HCT had 10.69 lower odds of survival. On univariable analyses, non-survivors had a lower median body weight (P = 0.006) and presented more commonly for diarrhea (P = 0.015). At least 1 episode of diarrhea (P = 0.003) and hematochezia or melena (P < 0.001) in hospital were negatively associated with outcome, in addition to the persistence of diarrhea (P = 0.026) and hyporexia (P = 0.018) in hospital for 5 to 6 days. CONCLUSIONS: Survival rates of 91% were achieved with in-hospital treatment in this cohort of dogs. Negative biochemical prognostic indicators affecting survival include a low HCT, decreased blood glucose concentrations, and increased total serum magnesium concentrations at presentation.
Assuntos
Doenças do Cão/virologia , Enterite/veterinária , Infecções por Parvoviridae/veterinária , Parvovirus Canino , Animais , Diarreia/veterinária , Doenças do Cão/sangue , Doenças do Cão/patologia , Cães , Enterite/virologia , Masculino , Prognóstico , Estudos RetrospectivosRESUMO
OBJECTIVE: To assess the relationship between various physical and clinicopathologic parameters and the capillary refill time (CRT) using a standard method; to evaluate the influence of emergency room (ER) versus ICU hospital location on CRT; and to identify latent subgroups among the CRT distribution. DESIGN: Prospective, observational study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs in the ER (n = 40) and ICU (n = 71). INTERVENTIONS: The CRT was defined as the duration required for the oral mucosa of the upper lip to return to its original color after blanching for 4 seconds. The CRT was recorded in seconds to the 10ths place by a single observer using an automated recording device. MEASUREMENTS AND MAIN RESULTS: Median CRT for all dogs was 1.1 seconds (ER, 1.2 s; ICU, 1.1 s; P = 1.000). The CRT was significantly associated with rectal temperature (P = 0.004), systolic blood pressure (P = 0.028), body weight (P = 0.031), mucous membrane color (P = 0.007), skin turgor (P = 0.039), and acute patient physiologic and laboratory evaluation mentation score (P = 0.019) for all dogs. The CRT was related to a greater number of variables in the ER than in the ICU patient population. In general, the total population of dogs had CRTs belonging to 1 of 2 groups: either ≤1.2 or ≥1.7 seconds. A statistically significant association was found between body weight CRT ≥1.3 seconds (P = 0.02). CONCLUSIONS: A CRT following blanching for 4 seconds may provide insight into the hydration status and hemodynamic stability of canine patients. Further research into its clinical application is warranted.
Assuntos
Hemodinâmica , Exame Físico , Animais , Pressão Sanguínea , Cães , Serviço Hospitalar de Emergência , Estudos ProspectivosRESUMO
OBJECTIVES: The objective of the study was to identify whether venous blood gas (VBG) variables may serve as a predictor of inflammatory lower airway disease (ILAD) in cats presenting with respiratory distress. A secondary objective of this study was to compare the diagnostic utility of patient signalment, history and physical examination findings, as compared with VBG variables. METHODS: The medical records of cats presenting with respiratory distress secondary to ILAD (54 cases) and non-ILAD (121 controls) were retrospectively reviewed. RESULTS: No admission VBG variables were predictive of a final diagnosis of ILAD. Comparatively, multivariable analysis identified a history of a cough (P <0.001), increased respiratory rate (P = 0.001), the presence of an abdominal component to respiration (P = 0.007) and the absence of pleural effusion (P <0.01) to be independently associated with a final diagnosis of ILAD. Cats with a history of a cough and an abdominal component to respiration had 7.86 and 5.81 greater odds of being diagnosed with ILAD, respectively. Cats with pleural effusion had 7.43 lower odds of having this final diagnosis. For every 10 breaths/min increase in respiratory rate, cats had 1.48 greater odds of being diagnosed with ILAD. Cats diagnosed with ILAD had a survival rate of 94% (95% CI 84-99%) vs 61% (95% CI 51-70%) for non-ILAD controls (P <0.001). CONCLUSIONS AND RELEVANCE: The results of this study found patient history and physical examination findings to be more useful predictors of a final diagnosis of ILAD in comparison with VBG variables at presentation. A history of a cough, an abdominal component to respiration and a lack of pleural effusion were found to be significant predictors of this diagnosis. Further investigation into the role of respiratory rate in ILAD is warranted.
Assuntos
Asma , Doenças do Gato , Síndrome do Desconforto Respiratório , Animais , Asma/veterinária , Estudos de Casos e Controles , Doenças do Gato/diagnóstico , Gatos , Serviço Hospitalar de Emergência , Síndrome do Desconforto Respiratório/veterinária , Estudos RetrospectivosRESUMO
Understanding physiological and behavioral mechanisms underlying the diversity of observed life-history strategies is challenging because of difficulties in obtaining long-term measures of fitness and in relating fitness to these mechanisms. We evaluated effects of experimentally elevated testosterone on male fitness in a population of dark-eyed juncos studied over nine breeding seasons using a demographic modeling approach. Elevated levels of testosterone decreased survival rates but increased success of producing extra-pair offspring. Higher overall fitness for testosterone-treated males was unexpected and led us to consider indirect effects of testosterone on offspring and females. Nest success was similar for testosterone-treated and control males, but testosterone-treated males produced smaller offspring, and smaller offspring had lower postfledging survival. Older, more experienced females preferred to mate with older males and realized higher reproductive success when they did so. Treatment of young males increased their ability to attract older females yet resulted in poor reproductive performance. The higher fitness of testosterone-treated males in the absence of a comparable natural phenotype suggests that the natural phenotype may be constrained. If this phenotype were to arise, the negative social effects on offspring and mates suggest that these effects might prevent high-testosterone phenotypes from spreading in the population.