Intravenous lipid emulsion therapy in 2 dogs and 2 cats with vitamin D toxicosis.

Vitamin D toxicosis can lead to severe and prolonged hypercalcemia resulting in multi-organ damage and even death. Current treatment often involves prolonged hospitalization and may require medications with potential for adverse effects. The objective of this case series was to describe reductions in serum ionized calcium concentrations following intravenous lipid emulsion therapy in vitamin D toxicosis. Two dogs and 2 cats with vitamin D toxicosis were treated with intravenous lipid emulsion therapy in addition to standard treatment regimens. Ionized hypercalcemia was lower following intravenous lipid emulsion therapy despite a more than 24-hour delay in initiating treatment in 3 of the 4 patients, and no adverse reactions were observed. Additionally, 2 of the 4 animals in this case series had long-term monitoring of 25-hydroxyvitamin D concentrations that revealed persistent elevations at 6 d in a dog and 5 mo in a cat, despite earlier resolution of their ionized hypercalcemia. Key clinical message: This is the first documented serial report of reduction of serum ionized calcium concentrations after administration of intravenous lipid emulsion, in addition to other standard therapies, in 2 dogs and 2 cats with vitamin D toxicosis. Furthermore, a chronically elevated plasma 25-hydroxyvitamin D concentration was documented in 2 of the 4 patients, including the first report in a cat. In these 2 cases, ionized calcium concentrations normalized despite persistently elevated 25-hydroxyvitamin D concentrations.

Thérapie par émulsion lipidique intraveineuse chez 2 chiens et 2 chats atteints de toxicose à la vitamine D. La toxicose à la vitamine D peut entraîner une hypercalcémie grave et prolongée entraînant des lésions à plusieurs organes, voire la mort. Le traitement actuel implique souvent une hospitalisation prolongée et peut nécessiter des médicaments susceptibles d'entraîner des effets indésirables. L'objectif de cette série de cas était de décrire les réductions des concentrations sériques de calcium ionisé par suite d'un traitement par émulsion lipidique intraveineuse dans le traitement de la toxicose à la vitamine D. Deux chiens et 2 chats atteints d'une toxicose à la vitamine D ont été traités par émulsion lipidique intraveineuse en plus des protocoles thérapeutiques standards. L'hypercalcémie ionisée était plus faible après un traitement par émulsion lipidique intraveineuse malgré un retard de plus de 24 heures dans le début du traitement chez 3 des 4 patients, et aucun effet indésirable n'a été observé. De plus, 2 des 4 animaux de cette série de cas ont fait l'objet d'une surveillance à long terme des concentrations de 25-hydroxyvitamine D qui ont révélé des concentrations élevées persistantes à 6 jours chez un chien et à 5 mois chez un chat, malgré une résolution plus précoce de leur hypercalcémie ionisée.Message clinique clé :Il s'agit du premier rapport documenté d'une série de réduction des concentrations sériques de calcium ionisé après l'administration d'une émulsion lipidique intraveineuse, en plus d'autres traitements standards, chez 2 chiens et 2 chats atteints de toxicose à la vitamine D. De plus, une concentration plasmatique chroniquement élevée de 25-hydroxyvitamine D a été documentée chez 2 des 4 patients, y compris le premier rapport chez un chat. Dans ces 2 cas, les concentrations de calcium ionisé se sont normalisées malgré des concentrations constamment élevées de 25-hydroxyvitamine D.(Traduit par Dr Serge Messier).

Chronic frames of social inequality: How mainstream media frame race, gender, and wealth inequality.

How social inequality is described­as advantage or disadvantage­critically shapes individuals' responses to it [e.g., B. S. Lowery, R. M. Chow, J. R. Crosby, J. Exp. Soc. Psychol. 45, 375­378, 2009]. As such, it is important to document how people, in fact, choose to describe inequality. In a corpus of 18,349 newspaper articles (study 1), in 764 hand-coded news media publications (study 2), and in a preregistered experiment of 566 lay participants (study 3), we document the presence of chronic frames of race, gender, and wealth inequality. Specifically, race and gender inequalities are more likely to be framed as subordinate groups' disadvantages than as dominant groups' advantages, and wealth inequality is more likely to be described with no frame (followed by dominant group advantage, then subordinate group disadvantage). Supplemental lexicon-based text analyses in studies 1 and 2, survey results in study 3, and a preregistered experiment (study 4; N = 578) provide evidence that the differences in chronic frames are related to the perceived legitimacy of the inequality, with race and gender inequalities perceived as less legitimate than wealth inequality. The presence of such chronic frames and their association with perceived legitimacy may be mechanisms underlying the systematic inattention to White individuals' and men's advantages, and the disadvantages of the working class.

Retrospective evaluation of fluid production at the time of thoracostomy tube removal following elective and emergency surgery in dogs (2010-2017): 185 cases.

OBJECTIVE: To report the rate of fluid production at the time of removal of thoracostomy tubes placed intraoperatively and to determine the association of this rate with specific patient factors, surgical factors, or clinical diagnosis. The secondary objective was to determine whether identification of pleural effusion within 2 weeks of thoracostomy tube removal was associated with the same variables. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: One hundred eighty-five client-owned dogs with thoracostomy tubes placed intraoperatively between January 2010 and March 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Thoracostomy tubes were removed at a median fluid production of 0.09 mL/kg/h (range, 0-7.0 m L/kg/h). Median fluid production at the time of thoracostomy tube removal was significantly higher in dogs with preoperative pleural effusion compared to dogs without preoperative pleural effusion (0.21 vs 0.05 mL/kg/h; P = 0.0001) and in dogs that had a median sternotomy compared to dogs that had a lateral thoracotomy (0.14 vs 0.09 mL/kg/h; P = 0.04). Of the 169 dogs available for follow-up, 12 (7.1%) had pleural effusion within 2 weeks of removal of the thoracostomy tube. Detection of pleural effusion during the follow-up period was significantly associated with the presence of preoperative pleural effusion (P = 0.0019) and the diagnosis (P = 0.01). A greater proportion of dogs with a lung lobe torsion (4/9, 44.4%) and idiopathic chylothorax (2/7, 28.5%) had pleural effusion within 2 weeks compared to other diagnoses. Reintervention was performed in 4.7% of dogs. CONCLUSIONS: Thoracostomy tubes were removed at pleural fluid production rates that frequently exceeded current veterinary guidelines. However, the fluid production rate at the time of thoracostomy tube removal was not associated with the detection of pleural effusion within 2 weeks of thoracostomy tube removal, and the overall need for reintervention following thoracostomy tube removal was low (4.7%).

Ventilatory failure in a cat following radical chest wall resection for feline injection site sarcoma.

CASE SUMMARY: A 12-year-old spayed female domestic shorthair cat presented for chest wall resection and radiation therapy following incomplete surgical excision of a feline injection site sarcoma. A CT scan for surgical planning was performed under general anesthesia and showed extensive tumor infiltration of the soft tissues of the right thorax. The cat recovered uneventfully from this anesthetic event. Nineteen days later, the patient was reanesthetized for forequarter amputation plus radical chest wall resection, including ribs 3-8 and all associated soft tissues plus adjacent spinous processes. Postoperatively, the patient developed acute respiratory failure secondary to hypoventilation. The cat was mechanically ventilated for 12 h prior to being successfully weaned from the ventilator. However, the improvement was transient and mechanical ventilation was reinitiated 6 h later owing to respiratory fatigue. On the second day, the cat developed unexplained central nervous system signs and was euthanized. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first case report to describe ventilatory failure secondary to radical chest wall resection in a cat. Hypoventilation with subsequent need for mechanical ventilation is a potential complication that should be considered during preoperative planning in patients requiring extensive chest wall resections.

Terms, Definitions, Nomenclature, and Routes of Fluid Administration.

Fluid therapy is administered to veterinary patients in order to improve hemodynamics, replace deficits, and maintain hydration. The gradual expansion of medical knowledge and research in this field has led to a proliferation of terms related to fluid products, fluid delivery and body fluid distribution. Consistency in the use of terminology enables precise and effective communication in clinical and research settings. This article provides an alphabetical glossary of important terms and common definitions in the human and veterinary literature. It also summarizes the common routes of fluid administration in small and large animal species.

Compensate a little, but punish a lot: Asymmetric routes to restoring justice.

Most people have a desire to live in a just world, a place where good things happen to good people and bad things happen to bad people. And yet, injustices do occur: good things happen to bad people and bad things happen to good people. Across four experiments, we show that people respond quite differently to correct these two types of injustices. When bad things happen to good people, individuals are eager to compensate a good person's losses, but only do so to a small degree. In contrast, when a good thing happens to a bad person, because the only perceived appropriate act of punishment is to fully strip the bad actor of all his or her illegitimate gains, few people choose to punish in this costly way. However, when they do, they do so to very large degrees. Moreover, we demonstrate that differential psychological mechanisms drive this asymmetry.

Taking Race Off the Table: Agenda Setting and Support for Color-Blind Public Policy.

Whites are theorized to support color-blind policies as an act of racial agenda setting-an attempt to defend the existing hierarchy by excluding race from public and institutional discourse. The present analysis leverages work distinguishing between two forms of social dominance orientation (SDO): passive opposition to equality (SDO-E) and active desire for dominance (SDO-D). We hypothesized that agenda setting, as a subtle hierarchy-maintenance strategy, would be uniquely tied to high levels of SDO-E. When made to believe that the hierarchy was under threat, Whites high in SDO-E increased their endorsement of color-blind policy (Study 1), particularly when the racial hierarchy was framed as ingroup advantage (Study 2), and became less willing to include race as a topic in a hypothetical presidential debate (Study 3). Across studies, Whites high in SDO-D showed no affinity for agenda setting as a hierarchy-maintenance strategy.

Deny, Distance, or Dismantle? How White Americans Manage a Privileged Identity.

Social scientists have traditionally argued that whiteness-the attribute of being recognized and treated as a White person in society-is powerful because it is invisible. On this view, members of the racially dominant group have the unique luxury of rarely noticing their race or the privileges it confers. This article challenges this "invisibility thesis," arguing that Whites frequently regard themselves as racial actors. We further argue that whiteness defines a problematic social identity that confronts Whites with 2 psychological threats: the possibility that their accomplishments in life were not fully earned (meritocratic threat) and the association with a group that benefits from unfair social advantages (group-image threat). We theorize that Whites manage their racial identity to dispel these threats. According to our deny, distance, or dismantle (3D) model of White identity management, dominant-group members have three strategies at their disposal: deny the existence of privilege, distance their own self-concepts from the White category, or strive to dismantle systems of privilege. Whereas denial and distancing promote insensitivity and inaction with respect to racial inequality, dismantling reduces threat by relinquishing privileges. We suggest that interventions aimed at reducing inequality should attempt to leverage dismantling as a strategy of White identity management.

Appeasement: Whites' strategic support for affirmative action.

This article explores the possibility that dominant-group members will attempt to appease subordinate groups to protect the hierarchy. In four studies, we find that (a) prohierarchy Whites perceive more intergroup threat when they believe ethnic minorities hold Whites in low regard, (b) prohierarchy Whites respond to ethnic minorities' low regard for Whites by increasing their support for redistributive policies (e.g., affirmative action), (c) the increase in support only occurs when prohierarchy Whites perceive the hierarchy to be unstable, and (d) prohierarchy Whites perceive the hierarchy to be more stable if they believe Whites support redistributive policies. These results suggest that prohierarchy dominant-group members' support for redistributive policies can stem from a concern about maintaining the hierarchical status quo, and provides evidence that support for redistributive policies can be a hierarchy-enhancing strategy.

Paying for positive group esteem: how inequity frames affect whites' responses to redistributive policies.

This article finds that, when faced with racial inequity framed as White advantage, Whites' desire to think well of their racial group increases their support for policies perceived to harm Whites. Across 4 studies, the article provides evidence that (a) relative to minority disadvantage, White advantage increases Whites' support for policies perceived to reduce their group's economic opportunities, but does not increase support for policies perceived to increase minority opportunities; and (b) the effect of White advantage on Whites' esteem for their ingroup drives the effect of inequity frame on support for policies perceived to reduce Whites' opportunities.

On the malleability of ideology: motivated construals of color blindness.

The authors propose that the content of certain sociopolitical ideologies can be shaped by individuals in ways that satisfy their social motivations. This notion was tested in the context of color-blind ideology. Color blindness, when construed as a principle of distributive justice, is an egalitarian stance concerned with reducing discrepancies between groups' outcomes; as a principle of procedural justice, however, color blindness can function as a legitimizing ideology that entrenches existing inequalities. In Study 1, White people high in antiegalitarian sentiment were found to shift their construal of color blindness from a distributive to a procedural principle when exposed to intergroup threat. In Studies 2, 3A, and 3B, the authors used manipulations and a measure of threat to show that antiegalitarian White people endorse color blindness to legitimize the racial status quo. In Study 3B, participants' endorsement of color-blind ideology was mediated by increases in their preference for equal treatment (i.e., procedural justice) as a response to threat. In the Discussion section, the authors examine implications of the present perspective for understanding the manner in which individuals compete over the meaning of crucial ideologies.

Evaluation of peripheral and central venous pressure in awake dogs and cats.

OBJECTIVE: To determine whether peripheral venous pressure (PVP) was correlated with central venous pressure (CVP) when measured by use of different catheter sizes, catheterization sites, and body positions in awake dogs and cats. ANIMALS: 36 dogs and 10 cats. PROCEDURES: Dogs and cats with functional jugular and peripheral venous catheters were enrolled in the study. Peripheral venous catheters (18 to 24 gauge) were placed in a cephalic, lateral saphenous, or medial saphenous vein. Central venous catheters (5.5 to 8.5 F) were placed in the jugular vein and advanced into the cranial vena cava. Catheters were connected to pressure transducers and a blood pressure monitor capable of displaying 2 simultaneous pressure tracings. For each animal, the mean of 5 paired measurements of PVP and CVP was calculated. The relationship between PVP and CVP when measured by use of different catheter sizes, catheterization sites, and body positions was determined. RESULTS: Mean +/- SD PVP was 5.7 +/- 5.8 mm Hg higher than CVP in dogs and 6.0 +/- 6.9 mm Hg higher than CVP in cats. However, results of multiple regression analysis did not indicate a significant correlation between PVP and CVP, regardless of catheter size, catheter position, or body position. The relationship was weak in both dogs and cats. CONCLUSIONS AND CLINICAL RELEVANCE: The PVP was poorly correlated with CVP when different catheter sizes, catheterization sites, and patient positions were evaluated. Peripheral venous pressure should not be used to approximate CVP in awake dogs and cats.