Development of a novel scoring system to predict mortality in canine patients with infection.

Objectives: To develop a novel illness severity scoring system to identify canine patients with infection that are at higher risk of mortality.

Key Findings: Mentation (Modified Glasgow Coma Scale and the Acute Patient Physiologic and Laboratory Evaluation mentation score), heart rate, pH, Pco, potassium, and total plasma protein were found to be associated with mortality on univariate analysis. Logistic regression found that mentation, heart rate, and Pco combined to form the following score: [(100 × mentation score) + (3 × heart rate) + (10 × Pco], which was predictive of mortality (area under the receiver operating characteristic curve: 0.

Seizures in 3 juvenile dogs after intravenous anesthetic drug withdrawal during weaning from mechanical ventilation suspected to be a sign of iatrogenic withdrawal syndrome.

Objective: To describe seizure activity in juvenile dogs successfully weaned from long-term mechanical ventilation.

Case Series Summary: Three juvenile dogs (all approximately 3 months old) underwent long-term mechanical ventilation with IV anesthesia for suspected noncardiogenic pulmonary edema. Within 24 hours of extubation and within 10 hours of discontinuing midazolam continuous infusions, all dogs experienced seizures, which is 1 sign of iatrogenic withdrawal syndrome.

Defining sepsis in small animals.

Objective: To discuss the definitions of sepsis in human and veterinary medicine.

Design: International, multicenter position statement on the need for consensus definitions of sepsis in veterinary medicine.

Setting: Veterinary private practice and university teaching hospitals.

Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography.

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.

Hepatic abscessation in dogs: A multicenter study of 56 cases (2010-2019).

Objective: To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.

Design: Retrospective cohort study from 2010 to 2019.

Setting: Multicenter study.

Neutrophil-to-lymphocyte ratio is increased in dogs with acute congestive heart failure secondary to myxomatous mitral valve disease compared to both dogs with heart murmurs and healthy controls.

Objective: To retrospectively evaluate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as a biomarker for severity and short-term outcomes of congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD) in dogs.

Animals: 47 dogs with CHF secondary to MMVD, 47 dogs with presumptive preclinical MMVD, and 47 control dogs.

Methods: Medical record data (signalment, physical examination findings, medical treatments instituted, American College of Veterinary Internal Medicine MMVD stage, length of hospitalization, outcome, and hospital re-presentation due to CHF) from March 2012 through March 2022 for each dog were collected.

Comparison of a viscoelastic point-of-care coagulation monitor with thromboelastography in sick dogs with hemostatic abnormalities.

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).

Evaluation of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in critically ill dogs.

Objective: To evaluate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are accurate prognostic indicators and correlate with illness severity scores in critically ill dogs.

Design: Prospective observational study from December 2016 to May 2017.

Setting: ICU at a veterinary teaching hospital.

Assessment of changes in intra-abdominal pressure and abdominal perfusion pressure in late-term pregnant queens undergoing elective ovariohysterectomy.

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.

Comparison of Mean Arterial Blood Pressure and Heart Rate Changes in Response to Three Different Randomized Isotonic Crystalloid Boluses in Hypotensive Anesthetized Dogs.

The aim of this prospective, randomized, nonblinded, controlled clinical trial was to compare mean arterial blood pressure (MAP) and heart rate (HR) during an intravenous bolus of three different balanced isotonic crystalloid solutions in euvolemic, anesthetized dogs with hypotension. Thirty healthy dogs (American Society of Anesthesiologists Physical Status I-II) weighing at least 15 kg that presented for elective orthopedic or dental surgical procedures at the Ryan Veterinary Hospital for Small Animals of the University of Pennsylvania were included in this study. Anesthetized hypotensive patients (defined as a MAP ≤ 65 mmHg), were administered an infusion of Lactated Ringer's solution (LRS), Plasma-Lyte (PLYTE) or Canadian Plasma-Lyte (PLYTECA), selected at random.

Use of vasopressors for treatment of vasodilatory hypotension in dogs and cats by Diplomates of the American College of Veterinary Emergency and Critical Care.

Objective: To identify the most common practices of Diplomates of the American College of Veterinary Emergency and Critical Care (DACVECCs) as they relate to the recognition and treatment of hypotension in dogs and cats, particularly concerning the use of vasopressors in vasodilatory shock states.

Design: A survey regarding vasopressor use was sent to all active DACVECCs using the Veterinary Information Network. Questions focused on respondent characteristics, method of recognition of hypotension, triggers for initiation of vasopressor therapy, first- and second-line vasopressor choice, and methods of determining response to therapy.

Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease.

Objective: To evaluate carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels in dogs and cats with respiratory disease in the ICU.

Design: Retrospective study.

Setting: University veterinary teaching hospital.

Owner experiences with and perceptions of owner-witnessed CPR in veterinary medicine.

Objective: To examine owner experiences with and perceptions of owner-witnessed resuscitation (OWR) in veterinary medicine and to determine if previous experience with family-witnessed resuscitation (FWR) influenced perceptions.

Design: Multicenter survey.

Setting: Two academic and 2 private practice referral hospitals in the United States.

Effectiveness of orally administered maropitant and ondansetron in preventing preoperative emesis and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate.

Objective: To compare effectiveness of maropitant and ondansetron in preventing preoperative vomiting and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate.

Animals: 88 dogs owned by rescue organizations.

Procedures: Dogs received maropitant (n = 29) or ondansetron (28) PO 2 hours prior to premedication or did not receive an antiemetic (31; control).

Indications and outcomes for puppies undergoing mechanical ventilation: 59 cases (2006 to 2020).

The medical records of 59 puppies from 6 hospitals undergoing mechanical ventilation (MV) between 2006 and 2020 were reviewed to describe the signalment, underlying disease, duration of ventilation, and outcome. The most common underlying diseases were pneumonia ( = 18), non-cardiogenic pulmonary edema ( = 16), and trauma ( = 8). Twenty-six (44%) puppies were weaned from the ventilator.

Standardized capillary refill time and relation to clinical parameters in hospitalized dogs.

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.

Fluid Therapy and the Microcirculation in Health and Critical Illness.

Fluid selection and administration during shock is typically guided by consideration of macrovascular abnormalities and resuscitative targets (perfusion parameters, heart rate, blood pressure, cardiac output). However, the microcirculatory unit (comprised of arterioles, true capillaries, and venules) is vital for the effective delivery of oxygen and nutrients to cells and removal of waste products from the tissue beds. Given that the microcirculation is subject to both systemic and local control, there is potential for functional changes and impacts on tissue perfusion that are not reflected by macrocirculatory parameters.

Effectiveness of intravenous fluid resuscitation in hypotensive cats: 82 cases (2012-2019).

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.

Establishment of normal reference intervals in dogs using a viscoelastic point-of-care coagulation monitor and its comparison with thromboelastography.

Background: Viscoelastic coagulation devices are a useful adjunct to the evaluation of hemostasis in veterinary patients. VCM Vet is a point-of-care device that is simple in operation and could be used to diagnose and trend hemostatic abnormalities in sick patients. VCM Vet does not use activators.

Retrospective evaluation of the influence of azotemia on plasma lactate concentrations in hypotensive dogs and cats (2008-2018): 337 cases.

Objective: To evaluate the relationship between azotemia and plasma lactate concentration in hypotensive dogs and cats presented to an emergency department.

Design: Retrospective case-control study.

Setting: University veterinary teaching hospital.

Evaluation of the placement and maintenance of central venous jugular catheters in critically ill dogs and cats.

Objective: To describe problems noted during central venous jugular catheter (CVJC) placement, conditions associated with unsuccessful catheterization, and CVJC maintenance complications.

Design: Prospective observational study from September 2014 to September 2015.

Setting: University veterinary teaching hospital.