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Abstract
Significance: Cancer-associated tissue-specific lactic acidosis stimulates and mediates tumor invasion and metastasis and is druggable. Rarely, malignancy causes systemic lactic acidosis, the role of which is poorly understood. Recent Advances: The understanding of the role of lactate has shifted dramatically since its discovery. Long recognized as only a waste product, lactate has become known as an alternative metabolism substrate and a secreted nutrient that is exchanged between the tumor and the microenvironment. Tissue-specific lactic acidosis is targeted to improve the host body's anticancer defense and serves as a tool that allows the targeting of anticancer compounds. Systemic lactic acidosis is associated with poor survival. In patients with solid cancer, systemic lactic acidosis is associated with an extremely poor prognosis, as revealed by the analysis of 57 published cases in this study. Although it is considered a pathology worth treating, targeting systemic lactic acidosis in patients with solid cancer is usually inefficient. Critical Issues: Research gaps include simple questions, such as the unknown nuclear pH of the cancer cells and its effects on chemotherapy outcomes, pH sensitivity of glycosylation in cancer cells, in vivo mechanisms of response to acidosis in the absence of lactate, and overinterpretation of in vitro results that were obtained by using cells that were not preadapted to acidic environments. Future Directions: Numerous metabolism-targeting anticancer compounds induce lactatemia, lactic acidosis, or other types of acidosis. Their potential to induce acidic environments is largely overlooked, although the acidosis might contribute to a substantial portion of the observed clinical effects. Antioxid. Redox Signal. 37, 1130-1152.
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Affiliation(s)
- Petr Heneberg
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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2
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Kadwa AR, Grace JF, Zeiler GE. Sources of error in acid-base analysis from a blood gas analyser result: a narrative review. J S Afr Vet Assoc 2022; 93:89-98. [DOI: 10.36303/jsava.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- AR Kadwa
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - JF Grace
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - GE Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
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3
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Buck RK, Tordiffe ASW, Zeiler GE. Ketamine-medetomidine compared to tiletamine-zolazepam-medetomidine for immobilisation of semi-captive cheetahs (
Acinonyx jubatus
). J S Afr Vet Assoc 2022. [DOI: 10.36303/jsava.2022.93.1.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- RK Buck
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
| | - ASW Tordiffe
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria,
South Africa
| | - GE Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
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4
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Rauserova-Lexmaulova L, Prokesova B, Blozonova A, Vanova-Uhrikova I, Rehakova K, Fusek M. Effects of the Administration of Different Buffered Balanced Crystalloid Solutions on Acid-Base and Electrolyte Status in Dogs with Gastric Dilation-Volvulus Syndrome: a randomized clinical trial. Top Companion Anim Med 2021; 46:100613. [PMID: 34737069 DOI: 10.1016/j.tcam.2021.100613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/22/2021] [Accepted: 10/29/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the effect of three different buffered balanced crystalloid solutions on acid-base status and electrolyte concentrations in dogs with gastric dilation-volvulus (GDV) syndrome. METHODS The study design was a prospective, randomized clinical trial of 40 dogs. The dogs were randomly assigned to one of three groups according to the fluid used: Hartmann's solution (H), Plasmalyte (PL), and Ringerfundin (RF). Hemoglobin, albumin, lactate, electrolyte, and acid-base parameters were determined before fluid administration (T0) and at the end of surgery (T1). Results were assessed by one-way ANOVA, Fisher's exact test, the Wilcoxon signed-rank test, the Kruskal-Wallis test, and a linear mixed-effect regression model. A significance level of 0.05 was used in all analyses. RESULTS Bicarbonate and base excess (BE) levels increased and chloride concentration decreased in the PL group; in contrast, strong ion difference apparent (SIDapp) decreased and chloride concentration increased in the RF group. The mixed-effect model confirmed a significant interaction between the type of solution and time on the changes in bicarbonate, BE, anion gap (AG), SIDapp, and chloride levels. CLINICAL SIGNIFICANCE Significantly different effects in acid-base parameters were observed in dogs after intravenous administration of H, PL, and RF. However, clinical significance of these changes is lacking, requiring further investigation in a larger randomized controlled clinical trial.
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Affiliation(s)
- Leona Rauserova-Lexmaulova
- Department of Surgery and Orthopedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Czech Republic.
| | - Barbara Prokesova
- Department of Surgery and Orthopedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Czech Republic
| | - Aneta Blozonova
- Department of Surgery and Orthopedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Czech Republic
| | - Ivana Vanova-Uhrikova
- Small Animal Clinical Laboratory, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Czech Republic
| | - Kristina Rehakova
- Small Animal Clinical Laboratory, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Czech Republic
| | - Michal Fusek
- Department of Mathematics, Faculty of Electrical Engineering and Communication, Brno University of Technology, Czech Republic
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Donati PA, Londoño L, Benavides G, Mouly J, González S, Otero PE. Clinicopathological factors associated with the presence of hypercapnia at admission in hospitalised cats with decompensated chronic kidney disease. N Z Vet J 2021; 69:343-348. [PMID: 34085906 DOI: 10.1080/00480169.2021.1939188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To evaluate associations between clinicopathological variables and hypercapnia measured in cats with decompensated chronic kidney disease (CKD) on admission to a veterinary hospital. METHODS This is a retrospective, cross-sectional study of cats (n = 39) that presented to a tertiary veterinary hospital in Argentina between June 2015 and December 2017 with blood creatinine concentrations >140 μmol/L, and abdominal ultrasound results consistent with CKD. Data recorded included venous partial pressure of CO2 (PvCO2), blood pH, haematocrit and concentrations of glucose, potassium, sodium, corrected sodium (Na+c), and ionised calcium in blood. A logistic regression model was used to assess associations between the presence of hypercapnia (PvCO2 ≥ 44.7 mmHg) and the other clinicopathologic variables. The duration of hospitalisation was compared in cats with and without hypercapnia using the Wilcoxon Rank Sum test. RESULTS The final study population comprised 39 cats. Eleven cats (28.2%) had hypercapnia. In the logistic regression model, two independent variables were associated with the presence of hypercapnia at admission in cats with CKD: the concentration of creatinine in blood (OR = 1.06 (95% CI = 1.016-1.108); p = 0.007) and Na+c (OR = 1.33 (95% CI = 1.08-1.63); p = 0.005). There were no statistically significant differences in the length of hospital stay between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE There appears to be an association between elevated concentrations of creatinine and Na+c in blood, and hypercapnia in cats with CKD, suggesting careful assessment of blood gas and electrolyte parameters during hospitalisation is required. Further prospective studies are needed to evaluate the mechanisms behind this association and the association of hypercapnia with disease outcome including mortality.
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Affiliation(s)
- P A Donati
- UCICOOP, Ciudad Autónoma de Buenos Aires, Argentina.,Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - L Londoño
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - G Benavides
- UCICOOP, Ciudad Autónoma de Buenos Aires, Argentina
| | - J Mouly
- Veterinaria del Sol, La Plata, Provincia de Buenos Aires, Argentina
| | - S González
- Cátedra de Patología Clínica y Enfermedades Médicas, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - P E Otero
- Cátedra de Anestesiología y Algiología, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Osborne LG, Burkitt-Creedon JM, Epstein SE, Hopper K. Semiquantitative acid-base analysis in dogs with typical hypoadrenocorticism. J Vet Emerg Crit Care (San Antonio) 2020; 31:99-105. [PMID: 33251763 DOI: 10.1111/vec.13016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/04/2019] [Accepted: 03/29/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the semiquantitative acid-base status of dogs with untreated naturally occurring typical hypoadrenocorticism and to compare this to the status determined by traditional acid-base analysis. DESIGN Retrospective study. SETTING University teaching hospital. ANIMALS Thirty-three dogs with newly diagnosed typical hypoadrenocorticism between 2000 and 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Dogs were included if they had newly diagnosed hypoadrenocorticism, post-ACTH stimulation serum cortisol concentration <2 μg/dL, and blood collected within 6 hours of presentation for acid-base, electrolyte, and serum biochemical assays. Dogs were excluded if the Na+ :K+ ratio was ≥28 or the dog had received a mineralocorticoid-containing corticosteroid medication within the preceding month. Traditional acid-base analysis identified normal acid-base status in 1 dog, simple respiratory acid-base abnormalities in 2 of 33 dogs, and simple metabolic acidosis in 14 of 33 dogs. A mixed disorder was most common, noted in 16 of 33 dogs. The semiquantitative approach identified metabolic abnormalities in all cases. All dogs had ≥1 acidifying process, and 29 of 33 had both acidifying and alkalinizing processes. Acidosis attributable to excess free water was present in all dogs, and an acidifying phosphate effect was present in 27 of 33. Hyperlactatemia contributed to the acidosis in 8 of 33 dogs, with a median (range) lactate concentration of 1.5 mmol/L (13.5 mg/dL) (0.3-4.2 mmol/L [2.7-37.8 mg/dL]). CONCLUSIONS Dogs with untreated Addison's disease have complex acid-base derangements. The semiquantitative approach to acid-base analysis provides greater insight into the underlying mechanisms of metabolic acid-base abnormalities in these dogs, particularly because lactic acidosis appears to be a minor influence in most cases.
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Affiliation(s)
- Laura G Osborne
- Small Animal Emergency and Critical Care, Western Veterinary Specialist and Emergency Centre, Calgary, Alberta, Canada
| | - Jamie M Burkitt-Creedon
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Steven E Epstein
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
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Midazolam Alters Acid-Base Status Less than Azaperone during the Capture and Transport of Southern White Rhinoceroses ( Ceratotherium simum simum). Animals (Basel) 2020; 10:ani10081323. [PMID: 32751806 PMCID: PMC7460343 DOI: 10.3390/ani10081323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
Acidemia represents a major life-threatening factor during rhinoceros capture. The acid-base status during rhinoceros transport is unknown. The purpose of this study was to describe changes in acid-base status during rhinoceros capture and transport and compare these changes between rhinoceroses sedated with azaperone or midazolam. Twenty-three wild white rhinoceros bulls were road-transported 280 km for reasons unrelated to this study. Rhinoceroses were captured with etorphine-azaperone (Group A) or etorphine-midazolam (Group M). During transport, azaperone (Group A) or midazolam (Group M) was re-administered every 2 h and venous blood collected. Changes in blood pH and associated variables were compared over time and between groups using a general linear mixed model. Rhinoceroses of both groups experienced a respiratory and metabolic acidosis during capture (pH 7.109 ± 0.099 and 7.196 ± 0.111 for Group A and Group M, respectively) that was quickly compensated for by the start of transport (pH 7.441 ± 0.035 and 7.430 ± 0.057) and remained stable throughout the journey. Rhinoceroses from Group M showed a smaller decrease in pH and associated variables at capture than rhinoceroses from Group A (p = 0.012). The use of midazolam instead of azaperone could therefore improve the success of rhinoceros capture and thus, contribute to the outcome of important conservation translocations.
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Libin MB, Weltman JG, Prittie J. A Preliminary Investigation into the Association of Chloride Concentration on Morbidity and Mortality in Hospitalized Canine Patients. VETERINARY MEDICINE-RESEARCH AND REPORTS 2020; 11:57-69. [PMID: 32766124 PMCID: PMC7369501 DOI: 10.2147/vmrr.s253759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/05/2020] [Indexed: 11/23/2022]
Abstract
Purpose To evaluate whole blood chloride concentration and hospital-acquired AKI in hospitalized canine patients. Secondary outcome measures included the volume-adjusted chloride load, in-hospital mortality and length of ICU stay. Patients and Methods This is a prospective, observational study. Sixty dogs admitted to the ICU and receiving IV fluid therapy for >24 hours from February 2018 to July 2019. Corrected chloride and creatinine concentrations were obtained twice daily. Total volume of IV fluid and total chloride load were recorded. Volume-adjusted chloride load (VACL) was calculated by dividing the chloride administered by the volume of fluid administered. Hospital-acquired AKI was defined as an increase in creatinine of ≥26.5 μmol/L (0.3 mg/dL) or 150% from baseline to maximum. Survival to hospital discharge or non-survival and ICU length of stay were also recorded. Results Fifteen out of 60 patients developed hospital-acquired AKI. Maximum corrected chloride was significantly different in AKI group (median 122.3 mmol/L) vs non-AKI group (median 118.1 mmol/L; p=0.0002). Six out of 60 patients developed hyperchloremia. Hyperchloremic patients were significantly more likely to develop in-hospital AKI (p=0.03). Patients hospitalized ≥2 days had a significantly higher [Cl−]max compared to those with shorter ICU stay (121.8 ± 5.9 mmol/L vs 117.5 ± 4.3 mmol/L; p=0.002). Eight out of 60 patients were non-survivors. Maximum corrected chloride and creatinine concentrations were not significantly different between survivors and non-survivors. VACL was not significantly different between AKI or mortality groups. Conclusion Maximum corrected chloride concentration was significantly higher in dogs with hospital-acquired AKI, even amongst dogs without hyperchloremia. Additionally, maximum corrected chloride concentrations were significantly higher in dogs hospitalized in the ICU longer compared to those hospitalized for fewer than two days. There was no significant difference in VACL in any of the outcome groups. Results from this study suggest alterations in chloride may be observed alongside the development of acute kidney injuries. Future studies in critically ill dogs are warranted.
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Affiliation(s)
- Madeline B Libin
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
| | - Joel G Weltman
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
| | - Jennifer Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, USA
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9
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Hasuda A, Flaiban K, Lisbôa J, Gomes L, Polizelli I, Santana L. Identifying hydric, electrolytic and acid-base imbalances through traditional and quantitative approaches in dogs with hemorrhagic gastroenteritis. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Vomiting and diarrhea are two important clinical signs that can cause significant electrolytic and acid-base imbalances. The purposes of this study were to characterize hydric, electrolytic and acid-base disorders presented by puppies with hemorrhagic gastroenteritis and to compare the traditional and quantitative approaches to acid-base status interpretation. Sixty-one animals with a history of vomiting and/or diarrhea were used in this study and the following tests were performed: complete blood count, total plasma protein concentration and hemogasometry. Mean, standard deviation and Kappa values were calculated. The imbalances characterized by both approaches were: 42 (69%) animals without imbalance, 17 (28%) with metabolic alkalosis and 2 (3%) with metabolic acidosis by the traditional approach and 17 (28%) dogs without imbalance, 26 (43%) with metabolic alkalosis and 18 (29%) with metabolic acidosis by the quantitative approach. The agreement calculated between two approaches coincide in 28 cases, with a moderate Kappa value equivalent to 0.459. The most found imbalances were metabolic alkalosis, hypokalemia, and mild dehydration. Most of acid-base disturbances were not identified by the traditional approach, whereas by the quantitative approach, they were easily determined. Thus quantitative approach proved to be superior in identification of possible acid-base imbalances.
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Affiliation(s)
- A.L. Hasuda
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | | | | | - L.A. Gomes
- Universidade Estadual de Londrina, Brazil
| | - I.G. Polizelli
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | - L.S. Santana
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
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10
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Rosenstein PG, Tennent-Brown BS, Hughes D. Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement. J Vet Emerg Crit Care (San Antonio) 2018. [PMID: 29533512 DOI: 10.1111/vec.12708] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To review the current literature with respect to the physiology, pathophysiology, and measurement of lactate. DATA SOURCES Data were sourced from veterinary and human clinical trials, retrospective studies, experimental studies, and review articles. Articles were retrieved without date restrictions and were sourced primarily via PubMed, Scopus, and CAB Abstracts as well as by manual selection. HUMAN AND VETERINARY DATA SYNTHESIS Lactate is an important energy storage molecule, the production of which preserves cellular energy production and mitigates the acidosis from ATP hydrolysis. Although the most common cause of hyperlactatemia is inadequate tissue oxygen delivery, hyperlactatemia can, and does occur in the face of apparently adequate oxygen supply. At a cellular level, the pathogenesis of hyperlactatemia varies widely depending on the underlying cause. Microcirculatory dysfunction, mitochondrial dysfunction, and epinephrine-mediated stimulation of Na+ -K+ -ATPase pumps are likely important contributors to hyperlactatemia in critically ill patients. Ultimately, hyperlactatemia is a marker of altered cellular bioenergetics. CONCLUSION The etiology of hyperlactatemia is complex and multifactorial. Understanding the relevant pathophysiology is helpful when characterizing hyperlactatemia in clinical patients.
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Affiliation(s)
- Patricia G Rosenstein
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Brett S Tennent-Brown
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Dez Hughes
- Department of Veterinary Clinical Sciences, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
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Buck RK, Tordiffe ASW, Zeiler GE. Cardiopulmonary effects of anaesthesia maintained by propofol infusion versus isoflurane inhalation in cheetahs ( Acinonyx jubatus ). Vet Anaesth Analg 2017; 44:1363-1372. [DOI: 10.1016/j.vaa.2017.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 04/06/2017] [Accepted: 05/30/2017] [Indexed: 11/28/2022]
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Gillespie Í, Rosenstein PG, Hughes D. Update: Clinical Use of Plasma Lactate. Vet Clin North Am Small Anim Pract 2016; 47:325-342. [PMID: 27914760 DOI: 10.1016/j.cvsm.2016.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself. This article reviews lactate biochemistry, kinetics, pathophysiology, some practical aspects of measuring lactate, as well as its use in diagnosis, prognosis, and monitoring.
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Affiliation(s)
- Íde Gillespie
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Patricia G Rosenstein
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia
| | - Dez Hughes
- Emergency and Critical Care Service, UVet Werribee Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Melbourne, Victoria 3030, Australia.
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13
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Zeugswetter FK, Pagitz M, Friedrich MS. Hypochloremia in cats - prevalence and associated diseases. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:237-44. [PMID: 27074163 DOI: 10.15654/tpk-150647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 01/07/2016] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To describe the prevalence and possible causes of hypochloremia in the local hospital cat population. MATERIAL AND METHODS Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes. Part A included an age and gender matched non-hypochloremic control group, whereas in part B acid-base status was assessed. RESULTS Hypochloremia was detected in 367 (27%) of 1363 blood samples. The application of a correction formula to adjust for free water changes decreased the number of hypochloremic cats to 253 (19%). Only a minority had received glucocorticoids or loop diuretics and the prevalence of vomiting was 44%. Common associated disorders were gastrointestinal and respiratory diseases, as well as azotemia and diabetes mellitus. Polyuria/polydipsia, dehydration, prednisolone or furosemide pretreatment, azotemia and diabetes mellitus increased, whereas fluid therapy and the diagnosis of neoplasia decreased the prevalence of hypochloremia. An inverse correlation was found between corrected chloride and standardized base excess (rs = -0.597, p = 0.001) as well as anion gap (rs = -0.4, p = 0.026). 99% of the hypochloremic cats had derangements of acid-base balance. CONCLUSION Hypochloremia is a common electrolyte disorder in the local cat population. The correction formula is necessary to adjust for changes in plasma osmolality. Although associated with metabolic alkalosis, most of the hypochloremic cats have a normal or decreased pH. The inverse correlation of chloride and anion gap als well as the high proportion of azotemic or diabetic animals support the concept of compensatory acidosis induced hypochloremia. CLINICAL RELEVANCE Hypochloremia should prompt the clinician to performe blood-gas analysis. Diabetes mellitus (especially ketoacidosis) and renal disease should be included in current algorithms for the evaluation of hypochloremic patients.
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Affiliation(s)
- Florian K Zeugswetter
- Florian K. Zeugswetter, University of Veterinary Medicine Vienna, University Clinic for Small Animals, Internal Medicine, Veterinärplatz 1, 1210 Vienna, Austria,
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14
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Olan NV, Prittie J. Retrospective evaluation of ProcalAmine administration in a population of hospitalized ICU dogs: 36 cases (2010-2013). J Vet Emerg Crit Care (San Antonio) 2015; 25:405-12. [PMID: 25900575 DOI: 10.1111/vec.12306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/08/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the use of ProcalAmine as a source of parenteral nutrition in hospitalized dogs and to report complications possibly referable to its use. DESIGN Retrospective study. SETTINGS Private veterinary teaching hospital. ANIMALS Thirty-six dogs hospitalized in ICU receiving ProcalAmine between October 2010 and March 2013. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The most common underlying disease process in this population of dogs was trauma (n = 8). Median duration of administration was 4 days and median resting energy requirement provided via ProcalAmine was 33%. ProcalAmine was administered via central catheters in 86% of cases and via peripheral catheters in 14% of cases. The overall mechanical complication rate was 19%. Metabolic complications possibly associated with ProcalAmine administration were documented in 12/36 dogs. Hyponatremia was most commonly identified (n = 6) followed by hyperglycemia (n = 4), hypochloremia (n = 2), azotemia (n = 2), metabolic alkalosis (n = 2), hyperchloremia (n = 1), and metabolic acidosis (n = 1). CONCLUSION ProcalAmine appears to be relatively safe and a viable option for parenteral nutrition in ill and injured dogs. Due to the potential for electrolyte derangements and other metabolic complications, daily monitoring of these parameters is advisable.
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Affiliation(s)
- Natasha V Olan
- Department of Emergency and Critical Care, The Animal Medical Center New York, NY, 10065
| | - Jennifer Prittie
- Department of Emergency and Critical Care, The Animal Medical Center New York, NY, 10065
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15
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Hopper K, Epstein SE, Kass PH, Mellema MS. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 1: Comparison of three methods of acid-base analysis. J Vet Emerg Crit Care (San Antonio) 2014; 24:493-501. [DOI: 10.1111/vec.12215] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 07/04/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Kate Hopper
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Steven E. Epstein
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Philip H. Kass
- Population, Health and Reproduction; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Matthew S. Mellema
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
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16
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Torrente C, Manzanilla EG, de Gopegui RR. A comparison of traditional and quantitative analysis of acid-base imbalances in hypoalbuminemic dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:509-18. [PMID: 25142816 DOI: 10.1111/vec.12218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 07/13/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the traditional (HH) and quantitative approaches used for the evaluation of the acid-base balance in hypoalbuminemic dogs. DESIGN Prospective observational study. SETTING ICU of a veterinary teaching hospital. ANIMALS One hundred and five client-owned dogs. MEASUREMENTS AND MAIN RESULTS Jugular venous blood samples were collected from each patient on admission to determine: total plasma protein (TP), albumin (Alb), blood urea nitrogen (BUN), glucose (Glu), hematocrit (HCT), Na(+) , Cl(-) , K(+) , phosphate (Pi ), pH, PvCO2, bicarbonate (HCO3 (-) ), anion gap (AG), adjusted anion gap for albumin (AGalb ) or phosphate (AGalb-phos ), standardized base excess (SBE), strong ion difference (SID), concentration of nonvolatile weak buffers (Atot ), and strong ion gap (SIG). Patients were divided in 2 groups according to the severity of the hypoalbuminemia: mild (Alb = 21-25 g/L) and severe (Alb ≤20 g/L). All parameters were compared among groups. Patients with severe hypoalbuminemia showed significant decrease in TP (P = 0.011), Atot (P = 0.050), and a significant increase in adjusted AG (P = 0.048) and the magnitude of SIG (P = 0.011) compared to animals with mild hypoalbuminemia. According to the HH approach, the most frequent imbalances were simple disorders (51.4%), primarily metabolic acidosis (84.7%) associated with a high AG acidosis. However, when using the quantitative method, 58.1% of patients had complex disorders, with SIG acidosis (74.3%) and Atot alkalosis (33.3%) as the most frequent acid-base imbalances. Agreement between methods only matched in 32 cases (kappa < 0.20). CONCLUSIONS The agreement between the HH and quantitative methods for interpretation of acid-base balance was poor and many imbalances detected using the quantitative approach were missed using the HH approach. Further studies are necessary to confirm the clinical utility of using the quantitative approach in the decision-making process of the severely ill hypoalbuminemic patients.
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Affiliation(s)
- Carlos Torrente
- Servei d'Emergències i Cures Intensives de la Fundació Hospital Clínic Veterinari-UAB, Departament de Medicina i Cirurgia Animal, and Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Universitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, Spain
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Burchell RK, Schoeman JP, Leisewitz AL. The central role of chloride in the metabolic acid-base changes in canine parvoviral enteritis. Vet J 2014; 200:152-6. [PMID: 24613416 PMCID: PMC7128572 DOI: 10.1016/j.tvjl.2014.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 01/19/2014] [Accepted: 01/24/2014] [Indexed: 11/24/2022]
Abstract
The acid–base disturbances in canine parvoviral (CPV) enteritis are not well described. In addition, the mechanisms causing these perturbations have not been fully elucidated. The purpose of the present study was to assess acid–base changes in puppies suffering from CPV enteritis, using a modified strong ion model (SIM). The hypothesis of the study was that severe acid–base disturbances would be present and that the SIM would provide insights into pathological mechanisms, which have not been fully appreciated by the Henderson–Hasselbalch model. The study analysed retrospective data, obtained from 42 puppies with confirmed CPV enteritis and 10 healthy control dogs. The CPV-enteritis group had been allocated a clinical score, to allow classification of the data according to clinical severity. The effects of changes in free water, chloride, l-lactate, albumin and phosphate were calculated, using a modification of the base excess algorithm. When the data were summated for each patient, and correlated to each individual component, the most important contributor to the metabolic acid–base changes, according to the SIM, was chloride (P < 0.001). Severely-affected animals tended to demonstrate hypochloraemic alkalosis, whereas mildly-affected puppies had a hyperchloraemic acidosis (P = 0.007). In conclusion, the acid–base disturbances in CPV enteritis are multifactorial and complex, with the SIM providing information in terms of the origin of these changes.
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Affiliation(s)
- Richard K Burchell
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa.
| | - Johan P Schoeman
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa
| | - Andrew L Leisewitz
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa
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Mesa‐Sánchez I, Purzycka K, Isidoro‐Ayza M, Ruiz de Gopegui‐Fernández R. Fanconi syndrome in a Bichon Maltese dog: a quantitative approach to acid–base analysis. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2013-000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ignacio Mesa‐Sánchez
- Veterinary FacultyDepartment of Animal Medicine and SurgeryUniversitat Autònoma de BarcelonaBarcelona08193Spain
| | - Katarzyna Purzycka
- Veterinary FacultyDepartment of Animal Medicine and SurgeryUniversitat Autònoma de BarcelonaBarcelona08193Spain
| | - Marcos Isidoro‐Ayza
- Veterinary FacultyServei de Diagnòstic de Patologia VeterinàriaUniversitat Autònoma de BarcelonaBarcelona08193Spain
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Abstract
Acid-base abnormalities are common in critically ill veterinary patients. Rapid recognition of disturbances can be helpful in identifying the underlying cause of the patient's clinical signs, directing diagnostics, and monitoring response to therapy. If acid-base disturbances are left unidentified and untreated, severe physiologic consequences can result, including cardiovascular and neurologic dysfunction, protein and enzyme dysfunction, and electrolyte derangements. Treatment of acid-base disorders is aimed at correcting the underlying disease process.
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Affiliation(s)
- Andrea A Monnig
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH 43210, USA.
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Hopper K, Epstein S. Incidence, Nature, and Etiology of Metabolic Acidosis in Dogs and Cats. J Vet Intern Med 2012; 26:1107-14. [DOI: 10.1111/j.1939-1676.2012.00983.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 04/26/2012] [Accepted: 06/25/2012] [Indexed: 11/29/2022] Open
Affiliation(s)
- K. Hopper
- Department of Veterinary Surgical and Radiological Sciences; University of California, Davis; Davis; CA
| | - S.E. Epstein
- Department of Veterinary Surgical and Radiological Sciences; University of California, Davis; Davis; CA
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Fettig PK, Bailey DB, Gannon KM. Determination of strong ion gap in healthy dogs. J Vet Emerg Crit Care (San Antonio) 2012; 22:447-52. [PMID: 22809147 DOI: 10.1111/j.1476-4431.2012.00772.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 05/23/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine and compare reference intervals of the strong ion gap (SIG) in a group of healthy dogs determined with 2 different equations. DESIGN Prospective observational study. SETTING Tertiary referral and teaching hospital. ANIMALS Fifty-four healthy dogs. INTERVENTIONS None. MEASUREMENTS Serum biochemistry and blood gas analyses were performed for each dog. From these values, SIG was calculated using 2 different equations: SIG(1) = SID(a) {[Na (+)] + [K(+)] - [Cl(-)]+ [2 × Ca(2+)] + [2 × Mg(2+)] - [L-lactate]}- SID(e) {TCO(2) + A(-)} and SIG(2) = [albumin] × 4.9-anion gap. Reference intervals were established for each SIG equation using the mean ± 1.96 × standard deviation (SD). RESULTS For SIG(1), the median was 7.13 mEq/L (range, 1.05-11.30 mEq/L) and the derived reference interval was 1.85-10.61 mEq/L. Median SIG(2) was -0.22 mEq/L (range, -5.34-6.61 mEq/L) and the mean SIG(2) was -0.09 mEq/L (95% confidence interval for the mean, -0.82-0.65 mEq/L). The derived reference interval was -5.36-5.18 mEq/L. The results of the SIG calculations were significantly different (P < 0.0001) between the 2 equations used. CONCLUSION The 2 equations used to calculate SIG yielded significantly different results and cannot be used interchangeably. The authors believe SIG(2) to be a more accurate reflection of acid-base status in healthy dogs, and recommend that this calculation be used for future studies.
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Mesa-Sanchez I, Zaldivar-Lopez S, Couto CG, Gamito-Gomez A, Granados-Machuca MM, Lopez-Villalba I, Galan-Rodriguez A. Haematological, blood gas and acid-base values in the Galgo Español (Spanish greyhound). J Small Anim Pract 2012; 53:398-403. [DOI: 10.1111/j.1748-5827.2012.01235.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- I. Mesa-Sanchez
- Department of Animal Medicine and Surgery; University of Cordoba; Córdoba; Spain
| | | | | | - A. Gamito-Gomez
- Department of Animal Medicine and Surgery; University of Cordoba; Córdoba; Spain
| | | | - I. Lopez-Villalba
- Department of Animal Medicine and Surgery; University of Cordoba; Córdoba; Spain
| | - A. Galan-Rodriguez
- Department of Animal Medicine and Surgery; University of Cordoba; Córdoba; Spain
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Robinson R, Schwendenwein I, Wacek S, Nell B, Mosing M. Plasma volume and electrolyte changes following intravenous infusion of hypertonic hydroxyethyl starch versus mannitol in healthy dogs. Vet J 2011; 190:268-272. [DOI: 10.1016/j.tvjl.2010.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 10/19/2010] [Accepted: 10/22/2010] [Indexed: 11/17/2022]
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Biochemical Variables in Free-ranging White-tailed Deer (Odocoileus virginianus) after Chemical Immobilization in Clover Traps or Via Ground-darting. J Zoo Wildl Med 2011; 42:18-28. [DOI: 10.1638/2009-0146.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bragg R, Hackett ES, Callan RJ, Holt TN, Hackett TB. Inadvertent transvaginal administration of sodium phosphate enemas in 2 alpaca crias. J Vet Emerg Crit Care (San Antonio) 2010; 20:623-7. [PMID: 21166985 DOI: 10.1111/j.1476-4431.2010.00583.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the clinical presentation and resultant metabolic disturbances following retroperitoneal administration of hyperphosphate enemas in alpaca crias. CASE OR SERIES SUMMARY Two crias presented to the Colorado State University Veterinary Teaching Hospital after inadvertent transvaginal retroperitoneal hyperphosphate enema administration. The first cria developed an acute onset of neurologic signs, severe hypernatremia, and died soon after presentation. The second cria developed severe hyperphosphatemia, hypocalcemia, and acidemia. The metabolic derangements normalized within 24 hours of intensive treatment with calcium supplementation and IV crystalloid fluid diuresis. The cria was discharged after 1 week in the hospital. NEW OR UNIQUE INFORMATION PROVIDED This report provides a description of electrolyte disturbances secondary to inadvertent transvaginal retroperitoneal administration of hyperphosphate enemas in 2 crias and attendant clinical signs of these disturbances. Management of hyperphosphatemia and hypocalcemia in 1 cria via aggressive fluid therapy with calcium supplementation led to a rapid and sustained normalization of phosphorus, calcium, and acid-base balance.
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Affiliation(s)
- Ryan Bragg
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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Basso PC, Raiser AG, Brun MV, Guizzo Junior N, Feranti JP, Motta AC, Bortolini CE, Muller DC. Biópsia pulmonar incisional por toracoscopia paraxifoide transdiafragmática com dois portais em cães. PESQUISA VETERINÁRIA BRASILEIRA 2010. [DOI: 10.1590/s0100-736x2010000700010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
As doenças respiratórias observadas na clínica médica de pequenos animais são numerosas, assim como as possibilidades diagnósticas, dentre as quais encontram-se os exames laboratoriais, os estudos radiográficos, os lavados broncoalveolares e as biópsias. Na presente pesquisa avaliaram-se os resultados da toracoscopia paraxifoide transdiafragmática para a realização de biópsia pulmonar em cães, sendo utilizados para tanto, 13 animais clinicamente sadios. Sob anestesia geral, produziu-se pneumotórax no volume de 30ml kg-1 de ar ambiente para cada hemitórax. O acesso foi obtido a partir de dois trocartes, posicionados entre o apêndice xifoide e o arco costal, os quais transfixaram o diafragma. O primeiro portal foi empregado para a passagem do endoscópio e o segundo para a utilização de pinça saca-bocado, empregada na obtenção de biópsia. Em seguida, a pinça foi removida e um dreno torácico foi posicionado através do portal. Durante os procedimentos, aferiram-se as frequências respiratória e cardíaca, a saturação de oxigênio, as pressões arterial média e venosa central e os parâmetros hemogasométricos. Os drenos foram removidos num período de até 48 horas de pós-operatório, verificando-se mínima produção de ar e/ou líquido. Concluiu-se se tratar de uma técnica rápida, segura e sem complicações trans e pós-operatórias, permitindo aquisição de material suficiente para a avaliação histológica do pulmão.
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