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Girol-Piner AM, Moreno-Torres M, Herrería-Bustillo VJ. Prospective evaluation of the Animal Trauma Triage Score and Modified Glasgow Coma Scale in 25 cats with high-rise syndrome. J Feline Med Surg 2022; 24:e13-e18. [PMID: 35293820 PMCID: PMC11104235 DOI: 10.1177/1098612x221080903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The purpose of this study was to prospectively evaluate the prognostic utility of the Animal Trauma Triage Score (ATTS) and Modified Glasgow Coma Scale (MGCS) in cats with high-rise syndrome. METHODS ATTS and MGCS were obtained upon arrival from 25 client-owned cats presented for high-rise syndrome. Cases were followed during hospitalisation and several variables, including outcome, were recorded. RESULTS The mortality rate in this cohort of cats with high-rise syndrome was 16%. Univariate statistical analysis showed that lactate (P = 0.022), creatinine (P = 0.01), body weight (P = 0.036) and ATTS (P = 0.02) were higher and MGCS (P = 0.011) lower among non-survivors. Multivariable statistical analysis showed that ATTS was the only factor significantly associated with mortality (odds ratio 2.41, 95% confidence interval [CI] 1.02-5.71; P = 0.046). A receiver operating characteristics curve showed that ATTS was an excellent predictor of mortality (area under the curve 0.917, 95% CI 0.8-1.0; P = 0.009). An ATTS cut-off of 6.0 had a 75% sensitivity and 90% specificity for non-survival and a cut-off of 10 had a 25% sensitivity and 100% specificity for non-survival. CONCLUSIONS AND RELEVANCE ATTS is predictive of severity and outcome in cats with high-rise syndrome and can help facilitate decision-making by owners and veterinarians.
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Affiliation(s)
- Ana Miriam Girol-Piner
- Emergency and Critical Care Department, Veterinary Hospital, Catholic University of Valencia (UCV), Valencia, Spain
| | - Matías Moreno-Torres
- Emergency and Critical Care Department, Veterinary Hospital, Catholic University of Valencia (UCV), Valencia, Spain
| | - Vicente J Herrería-Bustillo
- Emergency and Critical Care Department, Veterinary Hospital, Catholic University of Valencia (UCV), Valencia, Spain
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2
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Frezoulis PS, Oikonomidis IL, Saridomichelakis MN, Kasabalis D, Pappa A, Bouza-Rapti P, Chochlios T, Tsouloufi TK, Kritsepi-Konstantinou M, Soubasis N. Prevalence, association with systemic inflammatory response syndrome and outcome of stress hyperglycaemia in sick cats. J Small Anim Pract 2021; 63:197-202. [PMID: 34796970 DOI: 10.1111/jsap.13445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/19/2021] [Accepted: 09/26/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To determine the prevalence of stress hyperglycaemia in sick cats, and to investigate the association of stress hyperglycaemia with systemic inflammatory response syndrome and outcome. MATERIALS AND METHODS Medical records (2004 to 2013) from sick cats admitted to the Medicine Unit of a Veterinary Teaching Hospital were retrospectively reviewed. Cases were enrolled if a serum glucose measurement and a complete medical record were available. Cats that were healthy, hypoglycaemic, diabetic, sedated or had a previous administration of drugs (apart from vaccination and deworming) were excluded. RESULTS The study included 647 cats; stress hyperglycaemia (serum glucose >8.3 mmol/L) was found in 194 (30%) cats, while 453 (70%) cats were normoglycaemic. The prevalence of systemic inflammatory response syndrome was significantly higher in cats with stress hyperglycaemia (25/174, 14.4%) compared to normoglycaemic cats (26/399, 6.5%). Significantly, more cats with stress hyperglycaemia were hospitalised [97/194 (50.0%)] compared to normoglycaemic cats [171/453 (37.7%)]. However, the median duration of hospitalisation was not significantly different [4 (1 to 26) days and 4 (1 to 24) days, respectively]. The prevalence of cats with negative outcome was not significantly different between the two groups (cats with stress hyperglycaemia: 37.1%, normoglycaemic cats: 33.9%). Nonetheless, when modelling of outcome prediction included breed, age, stress hyperglycaemia and disease category as factors, cats with stress hyperglycaemia had 2.8 times the odds to have a negative outcome (95% confidence interval: 1.3 to 6.4). CLINICAL SIGNIFICANCE Based on the cut-off employed in this study, Stress hyperglycaemia, as defined by the cut-off is common in sick cats. Stress hyperglycaemia is associated with systemic inflammatory response syndrome development and seem to be a negative prognostic indicator.
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Affiliation(s)
- P S Frezoulis
- Southfields Veterinary Specialists, Essex, SS15 6TP, UK
| | - I L Oikonomidis
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | | | - D Kasabalis
- Faculty of Veterinary Science, University of Thessaly, 431 00, Karditsa, Greece
| | - A Pappa
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | - P Bouza-Rapti
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | - T Chochlios
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | - T K Tsouloufi
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | - M Kritsepi-Konstantinou
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
| | - N Soubasis
- Faculty of Health Sciences, School of Veterinary Science, Aristotle University of Thessaloniki, 541 24, Thessaloniki, Greece
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Hickey MC, Gray R, van Galen G, Ward MP. Distribution of mortality patterns in cats with naturally occurring trauma: A Veterinary Committee on Trauma registry study. Vet J 2021; 278:105765. [PMID: 34715365 DOI: 10.1016/j.tvjl.2021.105765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 10/20/2022]
Abstract
A greater understanding of the prognostic variables that affect the timing of death for cats with trauma may help clinicians select treatments and monitoring plans. This study investigated the mortality rate and its distribution pattern in a large population of cats to identify variables associated with the timing of trauma-related deaths. Clinical data was retrieved from the Veterinary Committee on Trauma database to determine mortality rates and timing of deaths, defined as early death (ED; <1 day post-presentation) or delayed death (DD; ≥1 day post-presentation). Multivariable logistic regression analyses were performed to identify characteristics and interventions that best predicted timing of death. Overall mortality rate for 6703 feline trauma patients with complete records was 17.2%, with 7.6% due to natural death and 92.3% due to euthanasia. Among the subset of 543 cats with trauma that died after presentation or required euthanasia due to a grave prognosis (representing an 8.1% mortality rate), EDs were more common (71.7%) than DD and the cause of death was not significantly associated with the timing of death. Clinical pathology parameters were unable to identify animals more likely to die or to require euthanasia due to a poor prognosis during hospitalisation. Factors that were significantly different for cats with ED vs. DD included the median cumulative results for the Modified Glasgow Coma Scale (MGCS) score and the Animal Trauma Triage (ATT) score, the presence of spinal trauma, administration of blood products and undertaking surgical procedures. An increased likelihood of DD rather than ED was associated with the administration of blood products (odds ratio [OR], 3.959; P = 0.019) vs. not, performing a surgical procedure (OR, 6.055; P < 0.001) vs. not, and a cumulative MGCS of 15-17 or 18 (OR, 1.947 and 3.115; P = 0.031 and P = 0.01, respectively) vs. a cumulative MGCS ≤ 11.
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Affiliation(s)
- M C Hickey
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia.
| | - R Gray
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
| | - G van Galen
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
| | - M P Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
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Cameron S, Weltman JG, Fletcher DJ. 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. J Vet Emerg Crit Care (San Antonio) 2021; 32:75-82. [PMID: 34432934 DOI: 10.1111/vec.13108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the association between admission point-of-care parameters and survival to discharge in dogs and cats with traumatic brain injury (TBI). DESIGN Retrospective study 2007-2010. SETTING A rural university teaching hospital and an urban private practice teaching hospital. ANIMALS One hundred thirty-one dogs and 81 cats admitted to the emergency service with evidence of head injury based on history from the owner or physical exam. MEASUREMENTS AND MAIN RESULTS In dogs, nonsurvivors had significantly higher glucose concentrations at admission than survivors (median = 8.49 mmol/L [153 mg/dl] vs 6.83 mmol/L [123 mg/dl], p = 0.039). In cats, there was no significant difference in admission glucose between survivors and nonsurvivors (median = 10.21 mmol/L [184 mg/dl] vs 10.93 mmol/L [197 mg/dl], p = 0.17). Modified Glasgow Coma Scale (MGCS) score was available for 105 of the 131 dogs (80%) and was significantly higher in survivors than in nonsurvivors (median = 16 vs 11, p < 0.0001). MGCS was available for 45 of the 81 cats (56%) and was significantly higher in survivors than in nonsurvivors (median = 17 vs 14, p = 0.0005). The relative prognostic value of the admission point-of-care testing parameters and MGCS were assessed using a stepwise linear regression model, which included admission glucose, pH, base excess, sodium, and MGCS. In dogs, only admission glucose was an independent predictor of survival (odds ratio = 1.027, 95% confidence interval, 1.0042-1.05, p = 0.019). CONCLUSIONS These results suggest that, as in people with TBI, increased blood glucose concentrations may have prognostic significance in dogs with TBI but not in cats. In addition, MGCS score may be predictive of survival in both dogs and cats with TBI.
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Affiliation(s)
- Starr Cameron
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Joel G Weltman
- Emergency and Critical Care Department, Animal Medical Center, New York, New York, USA
| | - Daniel J Fletcher
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
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Colon VA, Di Girolamo N. Prognostic value of packed cell volume and blood glucose concentration in 954 client-owned chelonians. J Am Vet Med Assoc 2021; 257:1265-1272. [PMID: 33269969 DOI: 10.2460/javma.257.12.1265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the prognostic value of PCV and blood glucose concentration in chelonians presented for veterinary care and to develop risk categories on the basis of the interaction of these analytes. ANIMALS 954 client-owned chelonians (34 genera). PROCEDURES Medical records of 1,059 client-owned chelonians presented to 2 veterinary institutions between 2014 and 2018 were reviewed. Logistic regression models were developed to evaluate factors associated with death, including PCV and blood glucose concentrations. RESULTS There were 954 chelonians (34 genera) for which the data required to be included in the analysis were available. Both PCV and blood glucose concentration were significant prognostic indicators of death. Odds of death for chelonians with severe anemia (PCV, < 10%) and moderate anemia (PCV, 11% to 20%) were 6.8 times (adjusted odds ratio [aOR], 6.8; 95% CI, 3.8 to 12.3) and 1.6 times (aOR, 1.6; 95% CI, 1.01 to 2.7), respectively, the odds of death for chelonians with PCV within reference range. Odds of death for chelonians with severe hypoglycemia (< 30 mg/dL), moderate hyperglycemia (91 to 150 mg/dL), and severe hyperglycemia (> 181 mg/dL) were 5.3 times (aOR, 5.3; 95% CI; 2.4 to 11.4), 3 times (aOR, 3.0;95% CI, 1.4 to 6.3), and 4.3 times (aOR, 4.3; 95% CI, 2.4 to 7.6), respectively, the odds of death for chelonians with blood glucose concentration within reference range. Five risk categories were identified on the basis of PCV and blood glucose concentration. CONCLUSIONS AND CLINICAL RELEVANCE Derangements in PCV and blood glucose concentration in client-owned chelonians were associated with increased odds of death. On the basis of these results, more aggressive diagnostic testing and treatments may be indicated in chelonians with similar alterations.
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Cagnotti G, Ferrini S, Ala U, Bellino C, Corona C, Dappiano E, Di Muro G, Iulini B, Pepe I, Roncone S, D'Angelo A. Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus. Front Vet Sci 2020; 7:575551. [PMID: 33195572 PMCID: PMC7581674 DOI: 10.3389/fvets.2020.575551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/09/2020] [Indexed: 11/13/2022] Open
Abstract
Status epileptics (SE) and cluster seizures (CS) are serious neurological emergencies associated with poor outcome in epileptic patients. Data on risk factors associated with outcome in epileptic patients affected by CS and SE have not been studied extensively to date. In the present retrospective study potential risk factors predictive of negative outcome in a population of dogs affected by CS and SE were analyzed. Ninety-three dogs were included in the study: 21/93 patients (23%) presented with SE and 72/93 (77%) with CS. Based on multivariate statistical analysis, factors statistically associated with a poor outcome were the occurrence of the first epileptic seizure outside the defined idiopathic interval (6 months-6 years), a condition of hyperthermia at presentation and the absence of previous antiepileptic drugs (AEDs) in case of previous history of seizures. The results of the present study implement data on risk factors associated with poor outcome in dogs affected by CS or SE and can aid in the creation of an ad hoc scoring system, similar to systems currently applied in human medicine upon hospital admission to benchmark performances and establish protocols for triage and therapeutic management.
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Affiliation(s)
- Giulia Cagnotti
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Sara Ferrini
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Ugo Ala
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Claudio Bellino
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Cristiano Corona
- Istituto Zooprofilattico del Piemonte Liguria e Valle d'Aosta, Turin, Italy
| | - Elena Dappiano
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Giorgia Di Muro
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Barbara Iulini
- Istituto Zooprofilattico del Piemonte Liguria e Valle d'Aosta, Turin, Italy
| | - Ida Pepe
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Silvia Roncone
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Antonio D'Angelo
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
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Lyons BM, Ateca LB, Otto CM. Clinicopathological abnormalities associated with increased animal triage trauma score in cats presenting for vehicular trauma: 75 cases (1998-2009). J Vet Emerg Crit Care (San Antonio) 2020; 30:693-697. [PMID: 32918338 DOI: 10.1111/vec.13005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/06/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To document the clinical and clinicopathological changes in cats presenting with vehicular trauma (VT) and to determine whether the calculated animal trauma triage (ATT) score was associated with any clinicopathological abnormalities. DESIGN Retrospective descriptive study conducted between 1998 and 2009. SETTING University veterinary teaching hospital. ANIMALS Seventy-five client-owned cats that presented for VT to an urban veterinary hospital. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Pertinent history, physical examination findings, results of biochemical testing, and outcome were extracted from medical records. ATT score was calculated based on physical examination. Patients were classified as having either a low (<5) ATT (n = 30) or a high (≥5) ATT (n = 45) score. Male cats were overrepresented (60.0%), and a majority of cats had outdoor access (65.3%). Low PCV (P = 0.024), low total plasma protein concentration (P = 0.032), low venous blood pH (P = 0.047), high plasma lactate concentration (P = 0.047), low plasma bicarbonate concentration (P = 0.047), low base excess (P = 0.047), and high plasma glucose concentration (P = 0.047) were associated with higher ATT scores. In addition, low noninvasive blood pressure measurements (P = 0.008) were associated with higher ATT scores. CONCLUSIONS There was a significant association between lower PCV, lower total plasma protein concentration, lower venous blood pH, higher plasma lactate concentration, lower plasma bicarbonate concentration, lower base excess, higher whole blood glucose concentration, and lower noninvasive blood pressure and higher ATT scores at presentation in feline patients suffering from VT. Prospective evaluation of these values may prove useful in furthering understanding of the pathophysiology of trauma in cats.
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Affiliation(s)
- Bridget M Lyons
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura B Ateca
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cynthia M Otto
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Hagley SP, Hopper K, Epstein SE. Etiology and prognosis for dogs with abnormal blood glucose concentrations evaluated in an emergency room. J Vet Emerg Crit Care (San Antonio) 2020; 30:567-573. [PMID: 32896093 DOI: 10.1111/vec.12996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/24/2018] [Accepted: 01/28/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the prevalence of glucose abnormalities in nondiabetic dogs presenting to a veterinary emergency room (ER) and their association with underlying disease processes, previous glucocorticoid administration, and overall mortality. DESIGN Single-center, retrospective study from January 2013 to December 2014. SETTING University Teaching Hospital. ANIMALS A total of 660 dogs presenting to an ER with a blood glucose concentration measured within 6 hours of presentation. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records from dogs with a blood glucose concentration measured within 6 hours of hospital admission were reviewed. Medications administered prior to blood sampling, the presence of shock, final clinical diagnosis, and survival were recorded. Hypoglycemia and hyperglycemia were defined as a blood glucose <4.4 mmol/L (80 mg/dL) and >6.7 mmol/L (120 mg/dL), respectively. Diabetic patients were removed from analysis. Hyperglycemia was found in 40.1% of dogs, whereas hypoglycemia was present in 9.0%. Hyperglycemia was most often associated with gastrointestinal disease, trauma, neoplasia, and respiratory disease. The most common diseases associated with hypoglycemia were sepsis, gastrointestinal disease, and neoplasia. Dogs in shock or with hyperlactatemia had higher blood glucose values than dogs with normal perfusion and plasma lactate concentrations (P = 0.016 and P < 0.0001, respectively). Mortality was higher in dogs with hyperglycemia (33.2%, P = 0.03) or hypoglycemia (44.6%, P = 0.0024) compared to those with normoglycemia (24.9%). CONCLUSION Dysglycemia in nondiabetic dogs evaluated in an ER was associated with a higher mortality rate than dogs in the same population with normoglycemia. Hyperglycemia in this population was common and may represent a stress response.
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Affiliation(s)
- Simon P Hagley
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, California
| | - Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, Davis, California
| | - Steven E Epstein
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, Davis, California
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Riese F, Rohn K, Hoppe S, Tipold A. Hypernatremia and Coagulopathy May or May Not Be Useful Clinical Biomarkers in Dogs with Head Trauma: A Retrospective Study. J Neurotrauma 2018; 35:2820-2826. [PMID: 30088439 DOI: 10.1089/neu.2016.4620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study was performed to evaluate clinical biomarkers as prognostic values in dogs with traumatic brain injury (TBI) based on findings in human patients. Sodium levels of 158 dogs with TBI and 169 patients with trauma without involvement of the head except head trauma (EHT) were examined. TBI patients with hypernatremia had a slightly higher risk of dying (22.03 %) than dogs with normal sodium levels (19.76%). However, there was no significant correlation between sodium levels and outcome in TBI patients (p = 0.6357). Dogs with sodium levels >160 mmol/L were non-survivors. In dogs with late-onset post-traumatic epilepsy (PTE) more often hyponatremia was measured, and in dogs with immediate PTE mild hypernatremia or normal sodium levels were measured after the trauma. Evaluation of coagulation parameters in a subpopulation of dogs showed a strong correlation between partial thromboplastin time/prothrombin time (PTT/PT) and the Modified Glasgow Coma Scale (MGCS) (p = 0.0006; p = 0.0306). In conclusion, unlike in human patients, sodium levels displayed no significant correlation with survival in dogs with TBI in the current study. However, in cases with severe TBI, dog owners often elect euthanasia before severe hypernatremia can be measured. Late PTE was observed in cases with initial hyponatremia. Because of a significant correlation between PTT/PT and MGCS, coagulopathy might be considered as a prognostic clinical biomarker in canine TBI patients.
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Affiliation(s)
- Franziska Riese
- 1 Department of Small Animal Medicine and Surgery, Epidemiology and Information Processing, University of Veterinary Medicine , Hannover, Germany
| | - Karl Rohn
- 2 Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine , Hannover, Germany
| | - Sonja Hoppe
- 1 Department of Small Animal Medicine and Surgery, Epidemiology and Information Processing, University of Veterinary Medicine , Hannover, Germany
| | - Andrea Tipold
- 1 Department of Small Animal Medicine and Surgery, Epidemiology and Information Processing, University of Veterinary Medicine , Hannover, Germany .,3 Centre for Systems Neuroscience , Hannover, Germany
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10
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Parratt CA, Firth AM, Boag AK, Allison GF, Boysen SR. Retrospective characterization of coma and stupor in dogs and cats presenting to a multicenter out-of-hours service (2012-2015): 386 animals. J Vet Emerg Crit Care (San Antonio) 2018; 28:559-565. [PMID: 30325574 DOI: 10.1111/vec.12772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 09/03/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the signalment, etiology, and short-term outcome of dogs and cats presenting in a coma or stupor. DESIGN Retrospective study conducted between May 2012 and February 2015. SETTING Multicenter out-of-hours emergency service provider. ANIMALS Three hundred eighty-six patients presenting in a coma or stupor to a multicenter out-of-hours emergency care provider. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Records were reviewed to determine the most likely etiology of coma or stupor. Short-term outcomes were defined as deceased (died or euthanized) or transferred (case handed over to a daytime clinic or discharged). There were 168 dogs (coma n = 112, stupor n = 56) and 218 cats (coma n = 148, stupor n = 70) identified. Coma and stupor were more prevalent in cats compared to dogs, and Chihuahuas were over represented. Blood glucose concentrations were frequently outside established reference intervals. Excluding undetermined causes, the most common causes in dogs included traumatic brain injury (TBI) 16.0% (n = 27, deceased n = 22), hypoglycemia 10.7% (n = 18, deceased n = 8), shock 10.1% (n = 17, deceased n = 16), seizure 9.5% (n = 16, deceased n = 13), and renal or hepatic dysfunction 5.3% (n = 9, deceased n = 7). For cats, the most common causes included TBI 21.6% (n = 47, deceased n = 38), renal or hepatic dysfunction 13.3% (n = 29, deceased n = 25), intoxication 10.1% (n = 22, deceased n = 18), hypoglycemia 6.0% (n = 13, deceased n = 4), and shock 5.0% (n = 11, deceased n = 8). When treatment was attempted, 46.0% of dogs (n = 44/96) and 41.2% of cats (n = 35/85) survived to be transferred. Compared to all other etiologies, death was less likely when coma or stupor was attributed to hypoglycemia. CONCLUSION In cases where a cause was determined, TBI was the predominant etiology of coma and stupor for both species. With the exception of coma and stupor attributed to hypoglycemia, the overall short-term prognosis was poor.
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Affiliation(s)
| | | | | | | | - Søren R Boysen
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
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12
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Klainbart S, Bibring U, Strich D, Chai O, Bdolah-Abram T, Aroch I, Kelmer E. Retrospective evaluation of 140 dogs involved in road traffic accidents. Vet Rec 2017; 182:196. [PMID: 29259067 DOI: 10.1136/vr.104293] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 10/19/2017] [Accepted: 11/11/2017] [Indexed: 11/03/2022]
Abstract
This study has retrospectively reviewed the medical records of 140 dogs sustaining road traffic accident (RTA), and has examined the population characteristics, medical history, injury type, physical examination, emergency laboratory tests and radiography findings, the animal trauma triage (ATT) score, the length of hospitalisation, the complications and the outcome. The survival rate was 83.2 per cent. Younger dogs sustained more frequently lung contusions and limb fractures, while larger dogs more frequently suffered limb fractures, and smaller dogs and older ones sustained more frequently pelvic fractures and sacroiliac luxation (P<0.05 for all). Dogs sustaining orthopaedic injuries required longer hospitalisation (P<0.001). The survival rates of non-ambulatory dogs (P<0.001) and those with neurological abnormalities (P<0.001), abnormal body temperature (P=0.001), hyperglycaemia (P=0.026) or hypoproteinaemia (P=0.04) at presentation were lower compared with those in which these were absent. The number of injured body systems was significantly (P<0.001) and positively associated with death. Dogs surviving RTA to presentation to the hospital have a good prognosis for survival to discharge. Older age, and high ATT score, abnormal body temperature, neurological deficits, hyperglycaemia and hypoproteinaemia at presentation, and occurrence of multiorgan trauma are negative prognostic indicators in such dogs.
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Affiliation(s)
- Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Uri Bibring
- Department of Radiology, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dalia Strich
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Neurology, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Tali Bdolah-Abram
- The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Koret School of Veterinary Medicine, Rehovot, Israel
| | - Itamar Aroch
- Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Abstract
Head trauma is a common cause of significant morbidity and mortality in dogs and cats. Traumatic brain injury may occur after head trauma. Understanding the pathophysiology of primary and secondary injury after head trauma is essential for management. This article reviews the pathophysiology of head trauma, patient assessment and diagnostics, and treatment recommendations.
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Affiliation(s)
- Kendon W Kuo
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA.
| | - Lenore M Bacek
- Emergency and Critical Care, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA
| | - Amanda R Taylor
- Neurology/Neurosurgery, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL 36849- 5540, USA
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Gottlieb DL, Prittie J, Buriko Y, Lamb KE. Evaluation of acute traumatic coagulopathy in dogs and cats following blunt force trauma. J Vet Emerg Crit Care (San Antonio) 2016; 27:35-43. [PMID: 27689344 DOI: 10.1111/vec.12525] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 06/17/2015] [Accepted: 06/27/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate the presence of acute traumatic coagulopathy (ATC) in dogs and cats following blunt trauma and to relate coagulation variables with injury severity and admission variables. DESIGN Prospective, single center, observational study from 2013 to 2014. SETTING Urban private referral hospital. ANIMALS Eighteen and 19 client-owned dogs and cats, respectively, sustaining blunt trauma within 8 hours of presentation without prior resuscitation; 17 healthy staff and client-owned control cats METHODS: Blood samples were collected upon presentation for measurement of blood gas, lactate, blood glucose, ionized calcium, PCV, total plasma protein, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, platelet count, and thromboelastography. RESULTS ATC was diagnosed in 1 dog and 1 cat on presentation. Hypercoagulability was documented in 4/18 (22%) of dogs and 1/19 (5.3%) of cats. In dogs, prolongation of PT (P = 0.018), aPTT (P = 0.013) and decrease in maximum amplitude (MA) (P = 0.027) were significantly associated with injury severity as measured by the animal trauma triage (ATT) score. In cats, PT, aPTT, MA, and clot strength (G) were not associated with injury severity. In cats, increasing blood glucose and lactate were significantly associated with decreasing MA (P = 0.041, P = 0.031) and G (P = 0.014, P = 0.03). In both dogs (P = 0.002) and cats (P = 0.007), fibrinogen concentration was significantly correlated with G. CONCLUSIONS ATC is rare in minimally injured dogs and cats following blunt trauma. In dogs, ATT score is significantly associated with PT, aPTT, and MA, suggesting an increased risk of ATC in more severely injured animals. ATT score does not appear to predict coagulopathies in cats. Future studies including more severely injured animals are warranted to better characterize coagulation changes associated with blunt trauma.
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Affiliation(s)
- Dara L Gottlieb
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, 10065
| | - Jennifer Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, 10065
| | - Yekaterina Buriko
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, 10065
| | - Kenneth E Lamb
- Department of Emergency and Critical Care, Animal Medical Center, New York, NY, 10065
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15
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Cornelis I, Volk H, Van Ham L, De Decker S. Prognostic factors for 1-week survival in dogs diagnosed with meningoencephalitis of unknown aetiology. Vet J 2016; 214:91-5. [DOI: 10.1016/j.tvjl.2016.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/21/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
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16
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Chong SK, Reineke EL. Point-of-Care Glucose and Ketone Monitoring. Top Companion Anim Med 2016; 31:18-26. [PMID: 27451045 DOI: 10.1053/j.tcam.2016.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/19/2016] [Indexed: 11/11/2022]
Abstract
Early and rapid identification of hypo- and hyperglycemia as well as ketosis is essential for the practicing veterinarian as these conditions can be life threatening and require emergent treatment. Point-of-care testing for both glucose and ketone is available for clinical use and it is important for the veterinarian to understand the limitations and potential sources of error with these tests. This article discusses the devices used to monitor blood glucose including portable blood glucose meters, point-of-care blood gas analyzers and continuous glucose monitoring systems. Ketone monitoring options discussed include the nitroprusside reagent test strips and the 3-β-hydroxybutyrate ketone meter.
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Affiliation(s)
- Siew Kim Chong
- Emergency and Critical Care, Matthew J Ryan Hospital, University of Pennsylvania, Philadelphia, PA, USA.
| | - Erica L Reineke
- Emergency and Critical Care, Matthew J Ryan Hospital, University of Pennsylvania, Philadelphia, PA, USA
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17
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Abstract
Traumatic brain injury constitutes a significant proportion of cases requiring forensic examination, and it encompasses (1) blunt, nonmissile head injury, especially involving motor vehicle accidents, and (2) penetrating, missile injury produced by a range of high- and lower-velocity projectiles. This review examines the complex pathophysiology and biomechanics of both types of neurotrauma and assesses the macroscopic and histologic features of component lesions, which may be used to determine the cause and manner of death resulting from an intentional assault or accident. Estimation of the survival time postinjury by pathologic examination is also important where malicious head injury is suspected, in an attempt to ascertain a time at which the traumatic event might have been committed, thereby evaluating the authenticity of statements made by the alleged perpetrator.
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Affiliation(s)
- J W Finnie
- SA Pathology, Hanson Institute Centre for Neurological Diseases and School of Veterinary Science, University of Adelaide, Adelaide, Australia
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18
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Sharma D, Holowaychuk MK. Retrospective evaluation of prognostic indicators in dogs with head trauma: 72 cases (January-March 2011). J Vet Emerg Crit Care (San Antonio) 2015; 25:631-9. [DOI: 10.1111/vec.12328] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 04/25/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Diya Sharma
- Ontario Veterinary College Health Sciences Centre; University of Guelph; Guelph Ontario Canada
| | - Marie K. Holowaychuk
- Ontario Veterinary College Health Sciences Centre; University of Guelph; Guelph Ontario Canada
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Abstract
In human trauma patients, most deaths result from hemorrhage and brain injury, whereas late deaths, although rare, are the result of multiple organ failure and sepsis. A variety of experimental animal models have been developed to investigate the pathophysiology of traumatic injury and evaluate novel interventions. Similar to other experimental models, these trauma models cannot recapitulate conditions of naturally occurring trauma, and therefore therapeutic interventions based on these models are often ineffective. Pet dogs with naturally occurring traumatic injury represent a promising translational model for human trauma that could be used to assess novel therapies. The purpose of this article was to review the naturally occurring canine trauma literature to highlight the similarities between canine and human trauma. The American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma has initiated the establishment of a national network of veterinary trauma centers to enhance uniform delivery of care to canine trauma patients. In addition, the Spontaneous Trauma in Animals Team, a multidisciplinary, multicenter group of researchers has created a clinical research infrastructure for carrying out large-scale clinical trials in canine trauma patients. Moving forward, these national resources can be utilized to facilitate multicenter prospective studies of canine trauma to evaluate therapies and interventions that have shown promise in experimental animal models, thus closing the critical gap in the translation of knowledge from experimental models to humans and increasing the likelihood of success in phases 1 and 2 human clinical trials.
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20
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DiFazio J, Fletcher DJ. Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract 2013; 43:915-40. [PMID: 23747266 DOI: 10.1016/j.cvsm.2013.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurologic trauma, encompassing traumatic brain injury (TBI) and acute spinal cord injury (SCI), is a cause of significant morbidity and mortality in veterinary patients. Acute SCIs occurring secondary to trauma are also common. Essential to the management of TBI and SCI is a thorough understanding of the pathophysiology of the primary and secondary injury that occurs following trauma. This article reviews the pathophysiology of this primary and secondary injury, as well as recommendations regarding clinical assessment, diagnostics, pharmacologic and nonpharmacologic therapy, and prognosis.
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Affiliation(s)
- Jillian DiFazio
- Section of Emergency and Critical Care, Cornell University Hospital for Animals, Upper Tower Road, Ithaca, NY 14853, USA
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21
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Surman S, Fleeman L. Continuous Glucose Monitoring in Small Animals. Vet Clin North Am Small Anim Pract 2013; 43:381-406. [DOI: 10.1016/j.cvsm.2013.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Grohmann KS, Schmidt MJ, Moritz A, Kramer M. Prevalence of seizures in cats after head trauma. J Am Vet Med Assoc 2012; 241:1467-70. [DOI: 10.2460/javma.241.11.1467] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Garosi L, Adamantos S. Head trauma in the cat: 2. assessment and management of traumatic brain injury. J Feline Med Surg 2011; 13:815-23. [PMID: 22063206 PMCID: PMC10911298 DOI: 10.1016/j.jfms.2011.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
PRACTICAL RELEVANCE Feline trauma patients are commonly seen in general practice and frequently have sustained some degree of brain injury. CLINICAL CHALLENGES Cats with traumatic brain injuries may have a variety of clinical signs, ranging from minor neurological deficits to life-threatening neurological impairment. Appropriate management depends on prompt and accurate patient assessment, and an understanding of the pathophysiology of brain injury. The most important consideration in managing these patients is maintenance of cerebral perfusion and oxygenation. For cats with severe head injury requiring decompressive surgery, early intervention is critical. EVIDENCE BASE There is a limited clinical evidence base to support the treatment of traumatic brain injury in cats, despite its relative frequency in general practice. Appropriate therapy is, therefore, controversial in veterinary medicine and mostly based on experimental studies or human head trauma studies. This review, which sets out to describe the specific approach to diagnosis and management of traumatic brain injury in cats, draws on the current evidence, as far as it exists, as well as the authors' clinical experience.
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Affiliation(s)
- Laurent Garosi
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hertfordshire SG5 3HR, UK.
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24
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Hayes GM. Severe seizures associated with traumatic brain injury managed by controlled hypothermia, pharmacologic coma, and mechanical ventilation in a dog. J Vet Emerg Crit Care (San Antonio) 2010; 19:629-34. [PMID: 20017770 DOI: 10.1111/j.1476-4431.2009.00478.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the management and outcome of a dog presenting with intractable seizures associated with traumatic brain injury. CASE SUMMARY A spayed female Wheaten Terrier was presented to an emergency clinic with neurologic deficits (modified Glasgow coma scale of 10) shortly after a road traffic accident. Seizures were uncontrolled despite aggressive pharmacologic intervention. Controlled hypothermia to achieve a rectal temperature of 33-35 degrees C (91.4-95 degrees F) was initiated as a protective measure to reduce intracranial pressure and cerebral metabolic rate, and to assist with seizure control. Intubation and mechanical ventilation were required to protect the airway and manage hypercapnia associated with hypoventilation. The patient went on to make a full recovery, although behavioral changes were noted by the owners for an 8-week period following injury. NEW OR UNIQUE INFORMATION PROVIDED To the author's knowledge, this is the first instance of therapeutic hypothermia reported in the veterinary literature. A short review of this treatment modality is provided.
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Affiliation(s)
- Galina M Hayes
- Emergency Department, Western Veterinary Specialist Centre, Calgary, AB, Canada T3C 0J8.
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25
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Sande A, West C. Traumatic brain injury: a review of pathophysiology and management. J Vet Emerg Crit Care (San Antonio) 2010; 20:177-90. [DOI: 10.1111/j.1476-4431.2010.00527.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wessmann A, Chandler K, Garosi L. Ischaemic and haemorrhagic stroke in the dog. Vet J 2008; 180:290-303. [PMID: 18579421 DOI: 10.1016/j.tvjl.2007.12.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 12/13/2007] [Accepted: 12/20/2007] [Indexed: 11/24/2022]
Abstract
Cerebrovascular disease results from any pathological process of the blood vessels supplying the brain. Stroke, characterised by its abrupt onset, is the third leading cause of death in humans. This rare condition in dogs is increasingly being recognised with the advent of advanced diagnostic imaging. Magnetic resonance imaging (MRI) is the first choice diagnostic tool for stroke, particularly using diffusion-weighted images and magnetic resonance angiography for ischaemic stroke and gradient echo sequences for haemorrhagic stroke. An underlying cause is not always identified in either humans or dogs. Underlying conditions that may be associated with canine stroke include hypothyroidism, neoplasia, sepsis, hypertension, parasites, vascular malformation and coagulopathy. Treatment is mainly supportive and recovery often occurs within a few weeks. The prognosis is usually good if no underlying disease is found.
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Affiliation(s)
- Annette Wessmann
- Division of Companion Animal Science, Institute of Comparative Medicine, Faculty of Veterinary Medicine, University of Glasgow Veterinary School, 464 Bearsden Road, Bearsden, Glasgow G61 1QH, UK.
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27
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28
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Torre DM, deLaforcade AM, Chan DL. Incidence and Clinical Relevance of Hyperglycemia in Critically Ill Dogs. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb03051.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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29
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Schropp DM, Kovacic J. Phosphorus and phosphate metabolism in veterinary patients. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2006.00217.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Armitage-Chan EA, Wetmore LA, Chan DL. Anesthetic management of the head trauma patient. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2006.00194.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Idro R, Aketch S, Gwer S, Newton CRJC, Maitland K. Research priorities in the management of severe Plasmodium falciparum malaria in children. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2006; 100:95-108. [PMID: 16492357 DOI: 10.1179/136485906x91459] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Severe malaria is a common reason for admission to paediatric wards in hospitals across sub-Saharan Africa. Despite over 100 years of research, mortality remains high. Deaths are associated with severe metabolic acidosis, shock, severe anaemia, hypoglycaemia, impaired consciousness, raised intracranial pressure, and status epilepticus. Most inpatient deaths occur within 24 h of admission to hospital, before the beneficial effects of treatment with antimalarial drugs are achieved. This review covers the priority areas for research in the care of children with severe malaria, addressing each of the main risk factors associated with death, in a bid to reduce the inpatient mortality.
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Affiliation(s)
- R Idro
- Centre for Geographic Medicine Research - Coast, Kenya Medical Research Institute/Wellcome Trust Research Laboratories, P.O. Box 230, Kilifi, Kenya.
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Chan DL, Freeman LM, Rozanski EA, Rush JE. Alterations in carbohydrate metabolism in critically ill cats. J Vet Emerg Crit Care (San Antonio) 2006. [DOI: 10.1111/j.1476-4431.2005.00150.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Driessen B, Brainard B. Fluid therapy for the traumatized patient. J Vet Emerg Crit Care (San Antonio) 2006. [DOI: 10.1111/j.1476-4431.2005.00184.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Syring RS. Assessment and treatment of central nervous system abnormalities in the emergency patient. Vet Clin North Am Small Anim Pract 2005; 35:343-58, vi. [PMID: 15698914 DOI: 10.1016/j.cvsm.2004.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Disease of or injury to the central nervous system is a common rea-son for hospital admission on an emergency basis in veterinary medicine. Head injuries, seizures, and diseases that lead to intra-cranial hypertension frequently result in significant alteration of neurologic function. A thorough understanding of the pathophysiologic disturbances that occur during these conditions is para-mount for providing stabilizing emergent care. A detailed approach that focuses on meticulous physical evaluation, provision of timely and optimal stabilizing treatment, and continued monitoring can aid in improving outcomes in animals with signs and symptoms of neurologic disease or injury.
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Affiliation(s)
- Rebecca S Syring
- Section of Critical Care, Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, Ryan Veterinary Hospital, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
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36
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Panarello GL, Dewey CW, Barone G, Stefanacci JD. Magnetic resonance imaging of two suspected cases of global brain ischemia. J Vet Emerg Crit Care (San Antonio) 2004. [DOI: 10.1111/j.1476-4431.2004.04007.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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