The prognostic value of admission point-of-care testing and modified Glasgow Coma Scale score in dogs and cats with traumatic brain injuries (2007-2010): 212 cases

Retrospective evaluation of shock index and mortality in dogs with head trauma (2015-2020): 86 cases

OBJECTIVE

To assess the relationship between shock index (SI) and mortality in dogs with head trauma (HT). A secondary objective was to compare SI with the animal trauma triage (ATT) score and Modified Glasgow Coma Scale (MCGS) score in HT cases. A tertiary aim was to assess if SI is predictive of survival to discharge or improvement in presenting neurologic signs.

DESIGN

Retrospective study from January 2015 to December 2020.

SETTING

Tertiary referral level II veterinary trauma center.

ANIMALS

Eighty-six dogs with evidence of HT presenting through emergency for various traumas compared to 60 healthy control dogs.

MEASUREMENTS AND MAIN RESULTS

SI was calculated using the quotient of heart rate over systolic blood pressure measured on presentation. SI was significantly higher in HT patients than healthy controls (P = 0.0019). SI was not significantly different between traumatic brain injury dogs that died or were euthanized and HT dogs that lived until the time of discharge (P = 0.98). SI was not significantly different between HT dogs that were neurologically normal at the time of discharge and HT dogs that were static or improved but not normal neurologically at the time of discharge (P = 0.84). In HT dogs, SI did not correlate with ATT score (P = 0.16) or MGCS score (P = 0.75). There was no significant difference in SI and length of hospitalization until death or discharge (P = 0.78).

CONCLUSIONS

SI was significantly higher in HT patients compared to control patients. Interestingly, SI was not correlated with ATT score or MGCS score. The use of SI in HT patients warrants further investigation to assess the efficacy in predicting mortality.

Incidence of concurrent systemic injuries with traumatic proptosis and its effect on outcome - 100 dogs

Objective

To evaluate the incidence of concurrent systemic injuries in dogs with traumatic ocular proptosis and their effect on survival to discharge. Additionally, to evaluate for associations between the type of trauma, each presenting vital signs, minimum laboratory database findings including packed cell volume, total solids, plasma glucose and lactate concentrations, and the diagnosis of concurrent systemic injury and survival.

Design

Retrospective study between the years 2017 and 2022.

Setting

One university teaching hospital and one large, private practice.

Animals

One hundred dogs presenting to the hospital with a diagnosis of traumatic ocular proptosis.

Measurements and main results

Medical records were retrospectively reviewed; signalment, breed, sex, age, weight, date of presentation, type of trauma sustained, time from trauma to presentation, vitals on presentation, and minimum laboratory database findings including packed cell volume (PCV), total solids (TS), plasma glucose concentration, and plasma lactate concentration were recorded. A modified animal trauma triage (ATT) score was retrospectively calculated. A total of 17 dogs (17%) had concurrent systemic injury. Compared to dogs without systemic injuries, dogs with systemic injuries had a significantly lower body temperature [median 101.1F (38.3C) vs. 101.6F (38.6C); P = 0.008], significantly higher plasma glucose concentrations (125 mg/dL, 6.9 mmol/L vs. 112 mg/dL, 6.2 mmol/L; P = 0.012) and approaching statistical significance, lower PCV values (median 40 vs. 46%; P = 0.051).

Conclusions

Dogs presenting with traumatic ocular proptosis do present with concurrent systemic, non-ocular injuries; however, these concurrent injuries do not seem to be associated with survival to discharge.

Neurologic Assessment and Critical Care of Exotic Animals: Approach to the Neurologic Exam, Species Differences, Prognostic Scales, Commonly Encountered Conditions, Ancillary Diagnostic Tests, and Caring for Neurologically Impaired Patients

Many disorders of other body systems have been well characterized in exotic species; however, data regarding neurologic conditions is limited. Across some of these species, correlates between feline and canine neurology can be made, but variations in the nervous system anatomy make evaluation more challenging. With accurate neurolocalization a focused list of differential diagnoses can be created. Performing the neurologic examination should be methodical for all patients, and the order and extent of examination may depend upon the patient's clinical condition and cooperation. Applications of objective scale measures (such as coma scales), and ancillary diagnostics (electrodiagnostics, advanced imaging, biopsy techniques, and BAER testing) complement physical assessment and clinicopathologic assessment in these neurologic patients. Once a neurolocalization, likely diagnosis, and prognosis have been established, specific considerations for hospitalization and care of neurologic patients can be implemented while treatment is instituted.