Plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in dogs with anaemia.

BACKGROUND: Gastrointestinal bleeding is a cause of anaemia in dogs. A reliable, non-invasive biomarker to differentiate gastrointestinal bleeding from other causes of anaemia would be advantageous to direct clinical decisions in anaemic patients. Plasma urea:creatinine ratio is an accepted biomarker of upper gastrointestinal bleeding in human medicine. OBJECTIVES: The objective of this study was to evaluate plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in a population of dogs with anaemia. METHODS: This was a prospective cross-sectional study of dogs with anaemia presenting to referral centres for the investigation of anaemia. Cases were categorised as having overt gastrointestinal bleeding (melena on presentation), occult gastrointestinal bleeding (historical and diagnostic findings consistent with gastrointestinal bleeding without melena at presentation) or anaemia of other cause (confident diagnosis other than gastrointestinal bleeding reached, normal diagnostic imaging of gastrointestinal tract). Urea:creatinine ratio at presentation was calculated by dividing urea (mg/dL) by creatinine (mg/dL). RESULTS: Ninety-five dogs were included. Plasma urea:creatinine ratio was not significantly different between dogs with overt or occult gastrointestinal bleeding or those with anaemia of other cause (median urea:creatinine ratio 25.8, 20.7 and 22.5, respectively). No significant difference in urea:creatinine ratio was found between dogs with upper and lower gastrointestinal bleeding (median urea:creatinine ratio 19.4 and 24.6, respectively). CONCLUSIONS: Plasma urea:creatinine ratio was not helpful in differentiating between dogs with anaemia resulting from gastrointestinal bleeding (overt or occult) and those with other causes of anaemia.

Changes in adherence to cardiopulmonary resuscitation guidelines in a single referral center from January 2009 to June 2013 and assessment of factors contributing to the observed changes.

BACKGROUND: This retrospective study reviewed compliance to cardiopulmonary resuscitation (CPR) teaching at a small animal referral center from January 2009 to June 2013. CPR training commenced in October 2009. This was a lecture format by European specialists in veterinary anesthesia and analgesia. Teaching was originally based on published guidelines. Changes made to the content of the lectures after publication of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines in 2012 are discussed. KEY FINDINGS: Data regarding basic life support and monitoring equipment were collected from all cases requiring CPR. A Mann-Kendall test for trend showed a significant increased use of both capnography (P = 0.017) and suction to aid tracheal intubation (P = 0.017) over the period of study. There was a significant increase in capnography use in 2011 (P = 0.046), 2012 (P = 0.002), and 2013 (P = 0.002) compared to 2009 (1/15). SIGNIFICANCE: The sequential increase in capnography use without any change to the number or availability of capnography units provides evidence that CPR teaching has altered clinical practice. The publication of the RECOVER guidelines provided an evidence base upon which to refine and improve teaching of CPR.