BackgroundMyocardial injury can be detected by cardiac troponin I (cTnI) concentration, which appears to be a predictor of short‐term death in critically ill patients. It is unknown if the best prognostic indicator of short‐term survival is cTnI measurement at admission or at later time points.Hypothesis/ObjectivesMeasuring cTnI with a high‐sensitivity (HS) test at different time points after admission may be a better short‐term prognostic indicator than a single cTnI measurement at admission in dogs with systemic inflammatory response syndrome (SIRS).AnimalsProspective, observational clinical study of 60 dogs with SIRS.MethodsCardiac troponin I concentration was measured in 133 serum samples, collected at days 1, 2, 3, and 5. Additionally, the acute patient physiologic and laboratory evaluation (APPLE) fast score was evaluated at admission. Prognostic capabilities of cTnI measurement and APPLE fast score for 28‐day mortality were assessed by receiver operating characteristic curve analysis.ResultsForty‐one dogs with SIRS that survived 28 days had significantly lower serum cTnI concentrations at admission (median, 0.09 ng/mL; P = .004) and at the peak time point (median, 0.23 ng/mL; P = .01) compared to 19 nonsurvivors (median at admission, 0.63 ng/mL; median at peak, 1.22 ng/mL). Area under the curve to predict survival, using cTnI was similar at admission (0.732) and at peak (0.708), and was 0.754 for the APPLE fast score.Conclusions and Clinical ImportanceIncreased cTnI concentration in dogs with SIRS is associated with poor outcome. Daily follow‐up measurement of cTnI concentration provides no additional prognostic information for short‐term mortality.
DPPG-TSL-DOX + HT is a promising treatment option for advanced feline STS by means of targeted drug delivery. As MTD was not reached further investigation is warranted to determine if higher doses would result in even better tumour responses.
Zusammenfassung Gegenstand und Ziel: Beim Hitzschlag handelt es sich um eine lebensbedrohliche Hyperthermie. Ziel der retrospektiven Untersuchung von Hunden mit Hitzschlag war, Ursachen, prädisponierende und prognostische Faktoren, klinische und labordiagnostische Befunde sowie deren Verlauf und geeignete Therapieoptionen zu dokumentieren. Material und Methoden: Die Auswertung erstreckte sich auf die Krankenakten von 12 Hunden mit der Diagnose Hitzschlag, die in einem Zeitraum von 5,5 Jahren an einer süddeutschen Klinik vorgestellt worden waren. Die Daten wurden mit den Kolmogorow-Smirnow-Test auf Normalverteilung getestet und mit T-Tests bzw. Chi-Quadrat-Test oder Mann-Whitney-U-Test analysiert. Als statistisch signifikant galten p-Werte < 0,05. Ergebnisse: Hitzschlag trat überwiegend in den Sommermonaten um den Nachmittagszeitraum auf. Die häufigste Ursache stellte eine Hitzeexposition im Auto dar. Brachyzephale Rassen waren deutlich überrepräsentiert. Als häufigste klinische Anzeichen fanden sich Polypnoe, Tachykardie, Hyperthermie, Seitenlage, gastrointestinale Symptome und neurologische Auffälligkeiten. Labordiagnostisch fielen Hämokonzentration, Thrombozytopenie, Hyperkaliämie, verlängerte aktivierte partielle Thromboplastinzeit und Azotämie auf. Die am häufigsten eingesetzten Therapiemaßnahmen waren Sauerstoffapplikation, Kühlen, Infusionen sowie Applikation von Magenschutztherapeutika, Antiemetika und Antibiotika. Der Klinikaufenthalt dauerte 1–6 Tage. Die Mortalität betrug 50%. Die meisten nicht überlebenden Patienten wurden innerhalb von 24–48 Stunden euthanasiert bzw. verstarben. Alle Tiere, die an Tag 3 noch lebten, konnten entlassen werden. Klinische Relevanz: Hitzschlag ist eine lebensgefährliche Erkrankung, die zu Schock, Sepsis, Gerinnungsstörungen und Multiorganversagen führen kann. Das frühe Erkennen und Einleiten einer geeigneten Therapie ist entscheidend für das Überleben der Patienten. Im Verlauf sind sorgfältiges Monitoring und Anpassung der Therapie notwendig.
Objectives Ultrasonography of the caudal vena cava (CVC) has been previously established to assess fluid status in dogs but not in cats. The aim of this study was to determine CVC diameter changes during feline blood donation. Methods Inter- and intra-observer variability were assessed in 11 client-owned cats. Minimal and maximal CVC diameters were assessed longitudinally in the subxiphoid view (SV) and right paralumbar view (PV), and transversely in the right hepatic intercostal view (HV). Eighteen client-owned, healthy, anaesthetised cats were evaluated during 21 blood donation procedures of 10 ml/kg in the same anatomical locations before (T0) and after (T1) blood donation, and after volume resuscitation with 30 ml/kg lactated Ringer’s solution (T2). The CVC index was calculated. Results Intra-observer variability was acceptable for all probe positions, except for the HV, whereas inter-observer variability was considered unacceptable for all probe positions. Complete measurements were obtained during 21 blood donations at T0, T1 and T2 at the SV, during 18/21 blood donations at the HV and during 16/21 blood donations at the PV. At the SV, the minimal CVC diameter between T1 and T2 ( P <0.001), and the maximal CVC diameter between T0 and T1 and between T1 and T2 ( P <0.001) were significantly different. At the HV, the minimal vertical diameter, maximal vertical diameter and minimal horizontal diameter were different between all timepoints ( P <0.001). The maximal horizontal diameter was different between T1 and T2 ( P = 0.002). At the PV, both diameters were different between all timepoints ( P <0.001). The CVC index was not different between timepoints. Conclusion and relevance Significant probe position dependent CVC diameter changes with marked overlap were observed before and after blood donation, and after fluid bolus. No absolute CVC diameter could be used to indicate hypovolaemia. Ultrasonographic assessment of the feline CVC is highly operator-dependent. The CVC index is not useful in cats.
The occurrence of nucleated red blood cells (NRBC) in the peripheral blood of critically ill human patients is associated with increased mortality. In dogs, the presence of NRBCs in peripheral blood has been used as a sensitive and specific marker of complications and outcome associated with heatstroke. However, no study has investigated their prevalence in critically ill dogs. Thus, the aim of this study was to determine the prevalence of NRBCs in the peripheral blood, and to evaluate their occurrence as a prognostic factor in critically ill dogs. One hundred and one dogs were prospectively included; the presence of NRBCs was studied on a daily basis from the time of admission until day 3 in the intensive care unit (or less if discharged or death occurred earlier). Dogs fulfilled at least two systemic inflammatory response syndrome (SIRS) criteria and suffered from various diseases. Survival was defined as being alive 28 days postdischarge from hospital. In 42 dogs, NRBCs were detected at least once; 59 patients were NRBC negative. Mortality was significantly higher in NRBC-positive than NRBC-negative patients (54.8 v 30.5 per cent) (P=0.014). However, this association was not present when anaemic dogs were excluded from the analysis. Detection of NRBCs in the peripheral blood may be an indicator for regenerative anaemia and may have potential for use as a prognostic tool or in addition to established scoring systems in critically ill dogs.
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