To examine weight estimations by veterinarians, veterinary nurses, and veterinary students to determine the accuracy of weight estimation in a veterinary emergency department. Secondary objectives ...included an initial evaluation of how body condition score (BCS), hair coat length, and hospital position of the estimator impacted accuracy of weight estimation.
101 dogs and 28 cats that presented to the emergency department from October 17, 2017, to September 3, 2019.
A written form was prospectively distributed to veterinarians, veterinary nurses, and veterinary students asking them to estimate a patient weight. Additional information about the patient, including estimated hair length and BCS, was recorded.
As dogs' weights increased, all estimators underestimated the patients' weight. As BCS increased, dogs' weights were underestimated by veterinary students. Longer hair coat statistically significantly impacted accurate weight estimation in dogs. In cats, as BCS increased, veterinarians and veterinary nurses overestimated patient weight. Only 32% (32/101) and 20% (6/28) of weight estimations in dogs and cats, respectively, were within 10% of the patient's actual weight.
Veterinarians, veterinary nurses, and veterinary students may not be reliable estimators of patient weight in the emergency department, especially with overweight animals. Prompt measurement of weight, if possible, is important for appropriate patient care.
Abstract
OBJECTIVE
To prospectively compare the effectiveness and any adverse effects of apo-morphine administered SC or IV for induction of emesis in dogs.
ANIMALS
42 client-owned dogs.
PROCEDURES
...Dogs for which emesis induction was deemed appropriate by the attending clinician were prospectively randomized to receive apomorphine (0.03 mg/kg 0.01 mg/lb) either SC (n = 20) or IV (22). Data collected included whether emesis was successfully induced, time from drug administration to emesis, number of emetic events, and adverse events (eg, sedation, protracted vomiting, or other).
RESULTS
Of the 20 dogs given apomorphine SC, 16 (80%) vomited. Of the 22 dogs given apomorphine IV, 18 (82%) vomited. With regard to route of administration, the number of dogs in which emesis was induced did not differ significantly. Median time to the first emetic event was 13.5 minutes (range, 3 to 32 minutes) in the SC treatment group and 2 minutes (range, 1 to 5 minutes) in the IV treatment group; the difference was significant. There was no significant difference in the number of emetic events or frequency of adverse events between the 2 groups.
CONCLUSIONS AND CLINICAL RELEVANCE
Apomorphine administered SC or IV reliably induced emesis in dogs. Compared with SC administration of apomorphine, the time from drug administration to emesis associated with IV administration was significantly shorter, a finding that has clinical importance. (
J Am Vet Med Assoc
2021;259:283–287)
Background
Working dogs exposed to narcotics might require reversal in the field.
Objective
To explore the pharmacokinetic and pharmacodynamic effects of naloxone administered intramuscularly (IM) or ...intranasally (IN) to reverse fentanyl sedation in working dogs.
Animals
Ten healthy, working dogs aged 1.7 ± 1 year and weighing 26 ± 3 kg.
Methods
In this randomized, controlled cross‐over study dogs received either 4 mg of naloxone IN or IM 10 minutes after fentanyl (0.3 mg IV) administration. Sedation was assessed at baseline and 5 minutes after fentanyl administration, then at 5, 10, 15, 20, 25, 30, 60 and 120 minutes after reversal with naloxone. Blood samples for naloxone detection were obtained at 0, 5, 10, 30, 60 and 120 minutes. Pharmacokinetic parameters and sedation scores were compared between IM and IN naloxone groups.
Results
There was a significant increase in sedation score from baseline (0.25 −4 to 1 IM; 0 −2 to 1 IN) after fentanyl administration (11 5‐12 IM; 9.25 4‐11 IN), followed by a significant reduction at 5 (0.5 −0.5 to 1.5 IM; 1.25 −1.5 to 4.5 IN) through 120 minutes (−0.5 −2 to 1 IM; 0 −4.5 to 1 IN) after reversal with naloxone. Route of administration had no significant effect on sedation score. Maximum plasma concentration was significantly lower after IN administration (11.7 2.8‐18.8 ng/mL IN, 36.7 22.1‐56.4 ng/mL IM, P < .001) but time to reach maximum plasma concentration was not significantly different from IM administration.
Conclusion and Clinical Importance
Although IM administration resulted in higher naloxone plasma concentrations compared to IN, reversal of sedation was achieved via both routes after administration of therapeutic doses of fentanyl.
Background
Ureteral stent and subcutaneous ureteral bypass (SUB) placement are commonly used for managing ureteral obstructions. Urinary tract infection (UTI) is a recognized complication.
Objectives
...To determine postoperative incidence of positive urine cultures in cats undergoing ureteral stent and SUB placement and to identify risk factors associated with positive urine cultures.
Design
Retrospective study.
Animals
Forty‐three cats that underwent 48 surgical events.
Procedures
Medical records were reviewed. Cats were included if urine cultures were performed before and after surgery. Variables were compared to identify risk factors.
Results
Urine cultures were positive postoperatively pre‐discharge in 5/20 (25%) cats. Median duration of follow‐up post‐discharge was 209 days (range, 11‐2184 days), with a total of 143 urine cultures performed in cats post‐discharge. Of these, 16 (11%) were positive in 12/48 (25%) cats. Nine different bacteria were identified; Enterococcus spp. (n = 8) predominated as monomicrobic or mixed infections. In 14/16 instances of positive urine cultures, affected cats had lower urinary tract signs, signs of pyelonephritis or both. Cats that received antibiotics postoperatively were significantly less likely to have a positive urine culture compared to those that did not (odds ratio, 0.2, 95% confidence interval, 0.05, 0.8, P = 0.02). Chronic kidney disease, renal implant type and postoperative urinary catheterization were not associated with positive urine cultures.
Conclusions and Clinical Relevance
Postoperatively, occurrence of positive urine cultures was similar to previous reports. Subclinical bacteriuria was less common than UTI. Postoperative urinary catheterization has been speculated to increase risk of bacteriuria, but this was not the case in this cohort.
This volume offers an in-depth understanding of emergency disease processes and the underlying rationale for the diagnosis, treatment, monitoring, and prognosis for these conditions in small animals.
Objective—To compare the use of dexmedetomidine hydrochloride, xylazine hydrochloride, and hydrogen peroxide for emesis induction in cats. Design—Retrospective case series. Animals—43 client-owned ...cats for which emesis induction was attempted because of known or suspected toxicant ingestion or recent ingestion of a string foreign body. Procedures—Data collected from the cats’ medical records included type, dose, and route of administration of emetic agent; outcome of attempted emesis induction; time until emesis or postemesis administration of a reversal agent (to counter sedative effects of the emetic agent); and adverse events. Results—Emesis induction was attempted by oral administration of hydrogen peroxide (n = 3) or IM or IV administration of xylazine (25 including 1 cat that had already received hydrogen peroxide) or dexmedetomidine (16). No cat that received hydrogen peroxide vomited. Emesis was induced in 11 of 25 xylazine-treated cats and in 13 of 16 dexmedetomidine-treated cats. Dexmedetomidine was more likely to cause vomiting than xylazine (OR, 5.5; 95% confidence interval, 1.1 to 36). The median dose of dexmedetomidine that caused emesis was 7. 0 μg/kg (3.2 μg/lb; range, 0.96 to 10.0 μg/kg 0.44 to 4.55 μg/lb). The elapsed time until emesis or postemesis reversal agent administration was recorded for 5 xylazine-treated cats (median interval, 10 minutes range, 5 to 175 minutes) and 10 dexmedetomidine-treated cats (median interval, 5 minutes range, 1 to 12 minutes). Sedation was the only adverse effect, occurring in 2 xylazine-treated cats and 1 dexmedetomidine-treated cat. Conclusions and Clinical Relevance—Results indicated that dexmedetomidine can be used successfully to induce emesis in cats.
OBJECTIVE To assess the utility of ultrasonography to detect the cause and location of ureteral obstruction in cats and to identify factors associated with agreement between ultrasonographic and ...surgical findings. STUDY DESIGN Retrospective case series. ANIMALS 71 cats. PROCEDURES Medical records were searched to identify cats that had ureteral obstruction diagnosed ultrasonographically and that subsequently underwent exploratory laparotomy. Patient signalment, ultrasonographic findings, interventions performed, and surgical findings were recorded. Cause and location of ureteral obstruction as assessed by ultrasonography were compared with surgical findings. Sensitivity, specificity, and positive predictive value of ultrasonography for detection of ureteroliths and strictures were calculated. Statistical analysis was performed to identify factors associated with agreement between ultrasonographic and surgical findings. RESULTS There was significant, moderate agreement between ultrasonographic and surgical findings for the cause and location of ureteral obstruction. Signalment variables, ureter affected (left vs right), and presence of retroperitoneal effusion were not associated with this agreement. Sensitivity was 98% and 44%, specificity was 96% and 98%, and positive predictive value was 98% and 88% for detection of ureteroliths and strictures, respectively, by ultrasonography. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasonography was highly sensitive for detection of ureteroliths that caused ureteral obstruction but was considerably less sensitive for detection of ureteral strictures in the study population. Future prospective studies are needed to determine the role of advanced imaging in assessing cats with ureteral abnormalities. (J Am Vet Med Assoc 2019;254:710-715).
To characterize clinical signs, diagnostic test results, foreign body location, treatment, and outcome for dogs and cats with sewing needle foreign bodies.
Retrospective case series.
65 dogs and cats ...with sewing needle foreign bodies.
Medical records of 27 dogs and 38 cats examined because of sewing needle foreign bodies from January 2000 to February 2012 were reviewed for signalment, medical history, physical examination findings, diagnostic test results, interval from witnessed exposure and radiographic imaging to definitive treatment, definitive treatment, sewing needle location, complications, and outcome.
7 (10.8%) animals had sewing needles in extragastrointestinal locations that were not causing clinical signs. The remaining 58 (89.2%) animals had known sewing needle exposure or acute clinical signs associated with ingestion. The esophageal and gastric regions were the most common location for a sewing needle (10/21 47.6% dogs; 19/37 51.4% cats), followed by the oropharynx (7/21 33.3% dogs; 11/37 29.7% cats) and small and large intestines (4/21 19.0% dogs; 7/37 18.9% cats). Gastrointestinal perforation was detected in 10 of 58 (17.2%) animals (5/21 23.8% dogs; 5/37 13.5% cats). Sewing needles in the esophagus and stomach were successfully removed endoscopically in 8 of 9 dogs and 18 of 19 cats. Survival rate was 98.1% (51/52) for animals receiving definitive treatment.
Endoscopic removal of ingested sewing needles was highly successful and should be recommended to prevent gastrointestinal tract perforation and associated morbidity. Prognosis for dogs and cats receiving definitive treatment for sewing needle foreign body ingestion was excellent.
Objective
To evaluate preoperative diagnostics in dogs with gastrointestinal foreign body (GIFB) obstruction and to identify clinical variables associated with the performance of simple enterotomy ...(EO) versus enterectomy (EC).
Design
Retrospective case control study from October 2013 to January 2016.
Setting
Veterinary Teaching Hospital.
Animals
Eighty‐two client‐owned dogs diagnosed at the time of surgery with GIFB obstruction.
Measurements and Main Results
Data were collected from medical records regarding history, initial physical examination, clinicopathologic testing, diagnostic imaging, and surgical reports. Based on univariate analysis, dogs that required EC were ill (P < 0.0001) and anorexic (P = 0.0007) for a longer duration; had a higher vomiting severity score (P = 0.005); and had worse perfusion parameters (mucous membrane color P = 0.028 and quality P = 0.032, poorer pulse quality P = 0.0015, relatively lower blood pressure P = 0.0328, greater heart rates P = 0.0011). Dogs undergoing EC were more likely to have altered peritoneal detail on radiographs (P = 0.0014; odds ratio OR = 25.5; 95% confidence interval CI: 2.4, 275.7) and echogenic peritoneal effusion on ultrasound (P = 0.0101; OR = 12.5; 95% CI: 1.3, 120.9), compared to the EO group. Heart rate (adjusted P = 0.028; OR = 1.07; 95% CI: 1.0, 1.1) and vomiting severity score (adjusted P = 0.028; OR = 5.6; 95% CI: 1.2, 26.1) maintained significance after multiple logistic regression.
Conclusions
Multiple factors in the preoperative clinical evaluation were different between dogs undergoing EO versus EC for GIFB obstruction. However, many of these variables become insignificant with multiple logistic regression. The presence of an increased heart rate or increased vomiting severity score at presentation was independently associated with undergoing enterectomy. Prospective studies with greater number of animals are warranted to validate these results.
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.
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