The gastrointestinal microbiome is a diverse consortium of bacteria, archaea, fungi, protozoa, and viruses that inhabit the gut of all mammals. Studies in humans and other mammals have implicated the microbiome in a range of physiologic processes that are vital to host health including energy homeostasis, metabolism, gut epithelial health, immunologic activity, and neurobehavioral development. The microbial genome confers metabolic capabilities exceeding those of the host organism alone, making the gut microbiome an active participant in host physiology. Recent advances in DNA sequencing technology and computational biology have revolutionized the field of microbiomics, permitting mechanistic evaluation of the relationships between an animal and its microbial symbionts. Changes in the gastrointestinal microbiome are associated with diseases in humans and animals including inflammatory bowel disease, asthma, obesity, metabolic syndrome, cardiovascular disease, immune‐mediated conditions, and neurodevelopmental conditions such as autism spectrum disorder. While there remains a paucity of data regarding the intestinal microbiome in small animals, recent studies have helped to characterize its role in host animal health and associated disease states. This review is intended to familiarize small animal veterinarians with recent advances in the field of microbiomics and to prime them for a future in which diagnostic tests and therapies will incorporate these developments into clinical practice.

Objective -To present a series of evidence-based, consensus guidelines for veterinary CPR in dogs and cats. Design -Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Questions in five domains were examined: Preparedness and Prevention, Basic Life Support, Advanced Life Support, Monitoring, and Post-Cardiac Arrest Care. Standardized worksheet templates were used for each question, and the results reviewed by the domain members, by the RECOVER committee, and opened for comments by veterinary professionals for 4 weeks. Clinical guidelines were devised from these findings and again reviewed and commented on by the different entities within RECOVER as well as by veterinary professionals. Setting -Academia, referral practice and general practice. Results -A total of 74 worksheets were prepared to evaluate questions across the five domains. A series of 101 individual clinical guidelines were generated. In addition, a CPR algorithm, resuscitation drug-dosing scheme, and postcardiac arrest care algorithm were developed. Conclusions -Although many knowledge gaps were identified, specific clinical guidelines for small animal veterinary CPR were generated from this evidence-based process. Future work is needed to objectively evaluate the effects of these new clinical guidelines on CPR outcome, and to address the knowledge gaps identified through this process. (J Vet Emerg Crit Care 2012; 22(S1): 102-131)

Use of viscoelastic point-of-care (POC) coagulation instrumentation is relatively new to veterinary medicine. In human medicine, this technology has recently undergone resurgence owing to its capacity to detect hypercoagulability. The lack of sensitive tests for detecting hypercoagulable states, along with our current understanding of in vivo coagulation, highlights the deficiencies of standard coagulation tests, such as prothrombin and partial thromboplastin times, which are performed on platelet-poor plasma. Viscoelastic coagulation analyzers can provide an assessment of global coagulation, from the beginning of clot formation to fibrinolysis, utilizing whole blood. In people, use of this technology has been reported to improve management of hemostasis during surgery and decrease usage of blood products and is being used as a rapid screen for hypercoagulability. In veterinary medicine, clinical use of viscoelastic technology has been reported in dogs, cats, foals, and adult horses. This article will provide an overview of the technology, reagents and assays, applications in human and veterinary medicine, and limitations of the 3 viscoelastic POC analyzers in clinical use.

Evidence-based guidelines for the performance of thromboelastography in companion animals were generated through this process. Some of these guidelines are well supported while others will benefit from additional evidence. Many knowledge gaps were identified and future work should be directed to address these gaps and to objectively evaluate the impact of these guidelines on assay comparability within and between centers.

For TEM of canine blood samples, coagulation time was primarily a function of coagulation factor concentrations, whereas other variables were dependent on platelet and fibrinogen concentrations. Sample Hct strongly influenced the results of TEM, likely because RBCs act as a diluent for plasma coagulation factors. Thromboelastometry appeared to be affected by abnormalities of coagulation factors, platelet concentrations, and RBC mass. In samples from anemic patients, results of TEM indicative of hypercoagulability may be artifactual because of low RBC mass.

Background: Removal of leukocytes (LR) has been shown to eliminate or attenuate many of the adverse effects of transfusion in experimental animals and humans.Hypothesis/Objectives: Transfusion of stored packed red blood cells (pRBCs) is associated with an inflammatory response in dogs and prestorage LR attenuates the inflammatory response.Animals: Thirteen random-source, clinically healthy, medium and large breed dogs. Methods: Experimental study. On day 0, animals were examined and baseline blood samples were collected for analysis. Whole blood was then collected for processing with and without LR, and stored as pRBC. Twenty-one days later, stored pRBCs were transfused back to the donor. Blood samples were collected before and 1 and 3 days after transfusion.Results: In the dogs that received non-LR pRBCs (n 5 6) there was a significant increase from baseline in white blood cell count from a mean (SD) of 8.20 (2.74) to 13.95 (4.60) Â 10 3 cells/mL (P o .001) and in segmented neutrophil count from a mean (SD) of 5.76 (2.70) to 11.91 (4.71) Â 10 3 cells/mL (P o .001). There were also significant increases in fibrinogen from a mean (SD) of 129.7 (24.2) to 268.6 (46.7) mg/dL (P o .001) and C-reactive protein from a mean (SD) of 1.9 (2.1) to 78.3 (39.3) mg/mL (P o .001). There was no significant increase from baseline in any of the markers in the dogs that received LR pRBC (n 5 5).Conclusions and Clinical Importance: There is a profound inflammatory response to transfusion in normal dogs, which is eliminated by LR of the pRBC units.

The objective of the present study was to systematically evaluate the impact of methodology on thromboelastometry with canine whole blood. Thromboelastometry was performed on citrated blood using a variety of combinations of clotting activators [ex-tem (tissue factor or TF), in-tem (ellagic acid), diluted TF from Innovin, or Ca (recalcification only)] and storage times. Thromboelastometry was also performed using diluted TF from Innovin on blood collected into a contact inhibitor. Ex-vivo contact activation was compared between canine and human blood. Clotting activator had a marked impact on coagulation time, a minor impact on alpha angle, and no impact on clot formation time or maximum clot firmness. When ex-tem or in-tem was the clotting activator, sample storage up to 30 min did not affect results. With diluted TF from Innovin or Ca, sample storage was associated with the development of increased coagulability (as indicated by shorter coagulation time and clot formation time and higher alpha angle) due to ex-vivo contact activation. Canine blood underwent markedly more ex-vivo contact activation than did human blood. Canine blood undergoes significant ex-vivo contact activation during and after collection, which influences thromboelastometry results when a weak clotting activator (such as low TF or recalcification) is used. Thromboelastometry with a strong activator (such as ex-tem or in-tem) is less influenced by ex-vivo changes, and, therefore, likely to be more reflective of in-vivo hemostatic capabilities and to provide consistently interpretable and comparable results.

Objective To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. Design Multi-institutional veterinary trauma registry data report Setting VetCOT identified veterinary trauma centers (VTCs) Animals Dogs and cats with evidence of trauma presented to VTCs with data entered in the VetCOT trauma registry September 1, 2013 – March 31, 2017 Interventions VetCOT created a standardized data collection methodology for dog and cat trauma. Data was input to a web-based data capture system (REDCap) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type (blunt versus penetrating), pre-admission care, hospitalization and intensive care requirement, trauma severity assessment at presentation (e.g., modified Glasgow coma scale [MGCS] and animal trauma triage [ATT] score), key laboratory parameters, necessity for surgical intervention and case outcome were collected. Summary descriptive data for each species are reported. Measurements and main results Twenty-nine VTCs in North America. Europe, and Australia contributed information from17,335 dog and 3,425 cat trauma cases during the 42-months reporting period. A large majority of cases presented directly to the VTC after injury (80.4% dogs, 78.1% cats). Blunt trauma was the most common source for injury in cats (56.7%); penetrating trauma was the most common source for injury in dogs (52.3%). 43.8% of dogs and 36.2% of cats were reported to have surgery performed. The proportion surviving to discharge were 92.0% (dogs) and 82.5% (cats). Conclusions The VetCOT registry proved to be a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. While overall survival to discharge was quite high, further evaluation of data on subsets of injury types, patient assessment parameters, interventions and associated outcome are warranted.