Fluid therapy is a crucial part of the treatment of patients in the emergency room and the critical care unit. Though it has great ability to help our patients, like any medical intervention, it has the potential to do harm as well. Having a greater understanding of the fluid balance within the body, the effect of different disease states on this fluid balance, and the fluid choices available for treating our patients is vital to maximizing patient benefit, while minimizing side effects of therapy.
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Synthetic colloids are a combination of water, electrolytes and large molecular weight molecules that contribute to the oncotic force (colloid osmotic pressure, COP) of the intravascular space. This post covers the pros and cons of their use.
This post reviews the pillars of patient blood management, including maximizing red cell mass, optimizing hemostasis, and techniques to recover active hemorrhage.
Corneal ulceration is one of the most common ophthalmic problems seen in our canine and feline patients. This post covers the causes and diagnosis of corneal ulceration in dogs and cat, as well as medical and surgical treatment.
With improved imaging techniques, the number of adrenal masses detected in animals with problems unrelated to adrenal function is common.
One of the most common causes of spinal cord injury in dogs is intervertebral disc herniation (IVDH). This post updates the use of methylprednisolone and PEG in the treatment of spinal cord injury.
This post describes how to manipulate user controls to obtain better ultrasound images in veterinary medicine.
This post describes the use and pros/cons of H2 receptor antagonists and proton pump inhibitors.
Diseases of the head are often initially imaged with radiographs in the clinic. This article discusses the basics of feline head radiographic imaging.
With advances in human and veterinary medicine, new and innovative surgical techniques are constantly being devised, tested, and either discarded or adopted as the new standard.
With advances in veterinary medicine, we are more and more commonly seeing our pets living to a greater age than has been reported historically. Current estimates in the companion animal population indicate that there are more than 50 million senior and geriatric dogs over the age of 7 years. As such, advanced age in our pets and their associated illnesses have become a very important aspect in who and what we treat in our roles as general practitioners and specialists, alike.
Nicole Barrella, DVM Massachusetts Veterinary Referral Hospital, Woburn, MA Posted on 2016-10-18 Hemostasis The cell-based model of coagulation describes the three distinct, overlapping phases leading to clot formation as a result of platelet interaction with tissue factor (TF). The first phase, initiation, occurs when a TF-bearing cell, such as a sub-endothelial cell, is exposed to […]
General anesthesia provides us with unconciousness, amnesia, analgesia, muscle relaxation, and the ability to perform various procedures in our veterinary patients. The use of injectable anesthetic agents allows us to get our patients from premeded-awake to surgical plane of anesthesia, while minimizing the use of inhalant anesthesia and its associated cardiovascular and respiratory depression. This article discusses the more common induction single and combo agents.
Studies in human medicine over the past 30-40 years have shown consistent poor recall of medical information, with between 40-80% of all medical information being immediately forgotten. In fact, 48% of information that is “remembered” is either imagined or misconstrued. This article provides an overview of medical information recall studies.
Stephen Cital RVT, SRA, RLAT United Veterinary Specialty and Emergency, Oakland Zoo, San Francisco Zoo Posted on 2016-09-22 It feels like every year we are bombarded with new products that will “revolutionize” the way we practice medicine. A product called the V-gel® caught my eye as an exotics and anesthesia guy back in 2014. […]
In the emergency setting, the primary goal of diagnostic imaging is to help differentiate surgical from non-surgical conditions. The benefits and limitations of survey radiography and abdominal ultrasound are discussed in this post.
Hemoabdomen is the presence of free blood in the peritoneal cavity and is a frequent emergency in small animal medicine for dogs and cats. This article discusses nontraumatic and traumatic hemoabdomen.
The risk for anesthesia-related complications or death does not end when the vaporizer dial is turned off. In fact, it can be argued that the greatest risk occurs during the recovery period. Equal vigilance is required during anesthetic recovery.
The two most common types of congenital hepatic disease include portosystemic vascular anomalies (PSVA) and microvascular dysplasia (MVD, now technically termed portal vein hypoplasia without a macroscopic anomaly). The clinical course and treatment options differ depending on the underlying disease, and an accurate diagnosis is essential for future management and prognosis.
Intraoral radiology is an essential tool in the diagnosis and treatment of dental problems. It is perhaps the tool that separates mere “cleaning and pulling” from more comprehensive veterinary dentistry.
An important task during enterotomy surgery is testing for leaks following intestinal closure. The instructional video below demonstrates intestinal leak testing with and without instruments.
Laryngeal paralysis is one of the more common upper respiratory emergencies seen in our aging canine population. It is frequently diagnosed in the spring to summer time as the weather begins to warm and we are more active with our canine companions.
Icterus is the presence of yellow discoloration of non-pigmented body surfaces (i.e. mucous membranes, sclera, skin) or plasma, and this results from an accumulation of bilirubin in the blood stream.
Lymphoma is one of the most commonly encountered canine cancers, and it is seen frequently in clinical practice. Lymphoma arises from neoplastic lymphocytes. Typically it is first recognized in lymphoid organs (lymph nodes, liver, spleen, bone marrow); however, it can be seen in any location in the body.
Summer is at full steam, birds are chirping, stir crazy dog-owners and their trusty companions are hitting the trail and basking in the glorious Colorado sun; however, they have company out there on those rocky foothills trails.
Non-cardiogenic pulmonary edema (NCPE) is defined as a pathologic accumulation of fluid within the lungs of a patient without primary cardiac disease. It results from an increase in permeability at the alveolar-capillary bed coupled with an increased hydrostatic pressure in the vasculature surrounding the lungs.
It is common for dogs to be presented to their veterinarian for being “down” in the hind end, but it’s not always a spinal cord disorder. This post provides some tips for differentiating patients with spinal cord disease from other disorders, including non-neurological disease.
The short answer is fiction, “age itself is not a disease.” Many times I have heard, “why are we anesthetizing this 17-year-old dog?”, only to have them do amazing under anesthesia and be better than before.
With more and more veterinary practices transitioning to digital radiography, teleradiology consultations are on the rise. Ease of digital image transmission/submission, and quick turn-around times have greatly facilitated this trend in veterinary medicine. This article provides some tricks and tips that will help you get the most out of your teleradiology interpretations with fewer calls, emails, and repeat radiographs to follow up your interpretations.
Pemphigus foliaceus (PF) is one of the most common autoimmune skin diseases in the dog and cat. This article discusses diagnosis and treatment of this condition.
In the past, pain management among all veterinary species was overlooked or thought unnecessary. It was thought that the presence of pain and associated sedentary behavior would deter the patient from paying attention to the surgical site. Or, even worse, that some species do not feel pain. We now know that this is a myth. This article discusses basic analgesia in exotic animal species.
As exotic animals become increasingly popular, owners expect increasingly advanced treatment options for their unique pet. This article provide a brief overview of fluid therapy in exotics.
What is your radiographic diagnosis for this 2-year-old castrated male Maine Coon cat that was presented to the emergency department for evaluation following an acute onset of left hind limb lameness after being spooked and running away from a vacuum cleaner?
Management of seizures is an art. There is no “correct way” to treat seizures, and neurologists frequently have differences of opinion regarding anticonvulsants. The goals of this article are to answer many of the frequently asked questions about seizure treatment in dogs and cats and to provide information regarding the more commonly used anticonvulsants.
Appropriate systemic arterial blood pressure is vital for survival in any species. In practice, we are faced with many reasons and conditions to obtain and interpret a patient’s blood pressure, such as anesthesia, cardiovascular disease and kidney disease. This post provides tips to ensure accurate BP measurement.
Ophthalmic drugs can be confusing, (and difficult to spell!), in terms of their use and when to use which one. The goal of this article is to make practical recommendations for a selection of ophthalmic drugs used for common conditions.
Computed tomography (CT) is routinely used in human medicine to examine pulmonary, tracheobronchial and mediastinal abnormalities, and is the standard screening test for pulmonary metastasis. CT is more sensitive and accurate than radiography for detecting interstitial disease and pulmonary nodules even in the presence of pleural effusion. This article discusses thoracic CT in veterinary patients.
Small animal veterinary blood products have become much more accessible over the past decade. Check out this article on red blood cell transfusions.
Vomiting causes alarm and concern across species and is a common presenting complaint in our small animal patients. Read more about the pathophysiology and treatment of vomiting.
Hypoadrenocorticism is a life-threatening disease and is a result of failure of the adrenal glands to produce adequate hormones. Click on post title to read more about this potentially life-threatening, but manageable disorder.
Jennifer O. Brisson, DVM, DACVR Massachusetts Veterinary Referral Hospital Signalment: 12y MN DSH History: Patient has severe dental disease and was presented for dental cleaning and extractions. Adopted from shelter 2 years prior. Physical exam: Diffuse moderately increased bronchovesicular sounds bilaterally. Normal cardiac auscultation. Thin body condition.
Gastroprotectant and antacid therapies are commonly employed in veterinary medicine when we wish to prevent gastric ulceration or suspect gastric ulceration may be the cause of clinical signs in our canine and feline patients. Click post title to read more about GI protectant mechanisms and treatment of GI ulceration.
Keratoconjunctivitis sicca (KCS; “dry eye”) is one of the most common ophthalmic diseases affecting pet dogs. Despite its prevalence, it is underdiagnosed and therefore often not treated. My goal in writing this article is to encourage veterinarians to perform a Schirmer tear test regularly as part of a complete ophthalmic examination. Once a diagnosis of dry eye is established, treatment can be tailored to the individual patient’s needs.
Urolithiasis refers to the formation of stones anywhere within the upper and lower urinary tracts. It is a common problem among both canine and feline patients in veterinary medicine and one of the most common causes of lower urinary tract signs.
Blood transfusions are an ever-growing therapy in small animal practice. Transfusions offer patients a lifesaving option by giving us time to treat the underlying disease or correct hemodynamic imbalances. However, did you know you could use most of the same methods used in cats and dog blood transfusions in other species?
The use of stents in the veterinary patient is constantly expanding. Requests from owners for minimally invasive treatment options and palliative care options are steadily increasing. This article discusses some of the more common stents used in veterinary medicine.
In last week’s article, we discussed current diagnostic approaches to chronic diarrhea. In this newsletter we will discuss several different steps in treating chronic diarrhea, especially when diagnostics such as biopsies, either via surgery or endoscopy, are not possible due to the status of the patient.
At my practice we are growing and constantly have new people join our team. With every new person we do our best to instill a certain authority they have with the patients they are asked to watch during admission or shift change. Below is our hospital’s patient assessment checklist we emphasize during training. Each hospital should have something similar to help ensure patient safety and healing, while allowing the veterinary nurse to really take some ownership.
Diarrhea is described as an increase in fecal mass, specifically volume, frequency or fluidity, and it is an important clinical sign of intestinal disease. Diarrhea as a clinical sign can be found with both small and large intestinal disease. Part I of this two-part series discusses clinical signs and diagnosis. Part II, which discusses treatment, will published next week.
Alice Benedict, DVM, DACVIM VCA Shoreline Veterinary Referral and Emergency Center Many immunomodulating drugs have been developed over the past 50 or so years to treat immune-mediated disease and improve transplant success. In veterinary medicine most immunomodulation relies on chemotherapies such as glucocorticoids, azathioprine, leflunomide, cyclosporine and mycophenolate mofetil. As with many treatment modalities […]
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