Causes of mortality in military working dog from traumatic injuries.

Introduction: This study aimed to identify the pathophysiologic causes of death following traumatic injuries in military working dogs (MWDs) and determine the risk factors associated with mortality in MWD following traumatic injuries. The results of this study will allow for better targeting of interventions to ameliorate these pathophysiologic causes of death and inform research priorities directed at the pathophysiology that leads to the death of MWDs. Methods: The final dataset for this study was compiled by using two previously established datasets. Based on review of available data and supplemental records (when available), MWDs in which a definitive cause of death could be determined were included in the study population. These MWDs were assigned a cause of death based on categories previously identified in studies evaluating service member casualties. A group of MWDs who survived their traumatic injury and had similar mechanisms of injury and types of injury to the deceased MWDs were included to allow for comparison and establishment of risk factors associated with MWD death. Variables collected included breed, age, sex, mechanism of injury, survival/non-survival, type of trauma, mechanism of injury, pathophysiology that led to death and pre-hospital care provided. Statistical analysis included Fishers exact test for categorical variables and univariable and multivariable logistic regression to identify factors associated with the MWD death. Results: A total of 84 MWDs (33 non-survivors and 51 survivors) were included in this study. Of the 33 MWDs that died, 27 (81.8%) were noted to be dead on arrival. The pathophysiologic causes of death were found to be hemorrhage (45.5% [n = 15]), head trauma (21.2% [n = 7]), catastrophic tissue destruction (15.2% [n = 5]), pneumothorax (9.1% [n = 3]) and one (3% [n = 1]) of each of the following: septic shock, asphyxiation and burns. Military working dogs that did not receive non-DVM care were 3.55 times more likely to die than those that did receive non-DVM care (95% CI 1.03-12.27). The majority of MWDs died of their injuries before reaching veterinary care. Discussion: To increase the survival of MWDs on the battlefield, further research should focus on developing new interventions and techniques to mitigate the effects of the pathophysiology noted to cause MWD death. Furthermore, given that care by a non-DVM was found to be associated with survival, the implementation of pre-hospital care and early resuscitation techniques should be a continued priority for those treating MWDs at both the point of injury and in the prehospital setting.

Response of the VCMVet viscoelastic coagulation monitor to veterinary environmental simulation challenges.

BACKGROUND: Traditional viscoelastic clotting tests are significantly impacted by the operator and environmental variation. The VCMVet coagulation monitor could provide a more user-friendly alternative for veterinary practices. OBJECTIVES: We aimed to determine if environmental vibration commonly encountered in veterinary practice alters the results of a point-of-care viscoelastic device, the VCMVet. METHODS: Nine fresh whole blood samples from healthy dogs were evaluated simultaneously using VCMVet instruments under four environmental conditions: (normal) alone and undisturbed on a raised tabletop, (centrifuge) on a countertop 6 inches from a centrifuge that operated at 12 000 rpm for 10 minutes every 20 minutes, (workspace) on a tabletop workspace in proximity to two heavy-use computers, and (gurney) on a rolling gurney at a walking pace for 10 minutes every 20 minutes. Results were compared between conditions using a Friedman test, and if this was significant (P-value < .05), it was followed by a Wilcoxon test for paired samples. RESULTS: Analysis of samples on a rolling gurney created obvious movement artifacts, and this condition was excluded from statistical analysis. The centrifuge condition resulted in a significantly higher alpha angle (median 49 degrees, interquartile range 4) than the normal condition (median 46 degrees, interquartile range 5, P = .0078). Other viscoelastic parameters were not significantly different between the normal, centrifuge, and workspace conditions. CONCLUSIONS: The VCMVet is suitable for use in a busy veterinary environment but should be protected from vibration. The instrument does not produce reliable results when operated on a moving gurney, and it should be stationary during sample analysis.

Evaluation of two benchtop blood gas analyzers for measurement of electrolyte concentrations in venous blood samples from dogs.

OBJECTIVE: To assess agreement between 2 benchtop blood gas analyzers developed by 1 manufacturer (BGA 1 and BGA 2 [a newer model with reduced maintenance requirements]) and a reference chemistry analyzer for measurement of electrolyte (sodium, chloride, and potassium) in blood samples from dogs. ANIMALS: 17 healthy staff- and student-owned dogs and 23 client-owned dogs admitted to an emergency and intensive care service. PROCEDURES: Blood collected by venipuncture was placed in lithium heparin-containing tubes. Aliquots were analyzed immediately with each BGA. Samples were centrifuged, and plasma was analyzed with the reference analyzer. Results for each BGA were compared with results for the reference analyzer by Passing-Bablok regression analysis. Percentage differences between BGA and reference analyzer results were compared with published guidelines for total allowable error. RESULTS: Proportional bias was detected for measurement of chloride concentration (slope, 0.7; 95% CI, 0.7 to 0.8), and constant positive bias was detected for measurement of chloride (y-intercept, 34, mmol/L; 95% CI, 16.9 to 38 mmol/L) and potassium (y-intercept, 0.1 mmol/L; 95% CI, 0.1 to 0.2 mmol/L) concentrations with BGA 1. There was no significant bias for measurement of potassium or chloride concentration with BGA 2 or sodium concentration with either BGA. Differences from the reference analyzer result exceeded total allowable error guidelines for ≥ 1 sample/analyte/BGA, but median observed measurement differences between each BGA and the reference analyzer did not. CONCLUSIONS AND CLINICAL RELEVANCE: Good agreement with reference analyzer results was found for measurement of the selected electrolyte concentrations in canine blood samples with each BGA.

Outcome and medical management in dogs with lower motor neuron disease undergoing mechanical ventilation: 14 cases (2003-2009).

OBJECTIVE: To describe the application of intermittent positive pressure ventilation (IIPV) in dogs with lower motor neuron disease (LMND). DESIGN: Multi-institutional, retrospective study (2003-2009). SETTING: Intensive care units at multiple university teaching hospitals. ANIMALS: Fourteen dogs with LMND that underwent IIPV. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The ventilatory logs of 4 teaching hospitals were searched for dogs undergoing IIPV in association with a diagnosis of acute LMND. The medical records were evaluated for signalment, specific LMND, ventilatory management and duration, complications associated with ventilation, duration of hospitalization, and outcome. Descriptive statistics were used as indicated. Fifteen records were evaluated, 1 dog was excluded since it experienced cardiopulmonary arrest (CPA) before commencement of IIPV. The median age was 7.0 years (range 10 mo to 12 y). There were 5 Labrador retrievers, 4 mixed breeds, and 5 other breeds were each represented once. Five dogs were diagnosed with myasthenia gravis, 4 dogs with polyradiculoneuritis, and 5 dogs had an undetermined LMND. Clinical signs of weakness before ventilation were present for a median of 36 hours (range 6 h to 14 d). Dogs were ventilated for a median of 109 hours (range 5-261 h). Nine dogs had temporary tracheostomies performed, and 8 dogs received nutritional support. Five dogs developed ventilator associated pneumonia. Six dogs were successfully weaned from the ventilator with a median ventilatory time of 49 hours (range 25-192 h). Three dogs survived to discharge. No single LMND was associated with a better outcome. CONCLUSIONS: High euthanasia rates and iatrogenic complications limit the ability to accurately prognosticate for affected dogs in this retrospective study, but in dogs with LMND that is severe enough to require IIPV, support may be required days to weeks.