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.
BackgroundViscoelastic coagulation devices are a useful adjunct to the evaluation of hemostasis in veterinary patients. VCM Vet is a point‐of‐care device that is simple in operation and could be used to diagnose and trend hemostatic abnormalities in sick patients. VCM Vet does not use activators.ObjectivesWe aimed to establish reference intervals (RIs) for VCM Vet in a healthy adult canine population and concurrently perform thromboelastographic (TEG) analysis on these samples with and without tissue factor (TF) activation for RI comparisons.MethodsDuplicate VCM Vet tests were performed immediately upon sample collection. Two concurrent TEG tests were performed on the remaining blood, one citrated, untreated (CU), and one activated with TF at a 1:3600 dilution.ResultsFifty‐two dogs were enrolled in the study. The following RIs were generated for VCM Vet machine 1 and 2, respectively: clot time (CT) (seconds) 163‐480 and 172‐457; clot formation time (CFT) (seconds) 104‐288 and 94‐252, α‐angle (degrees) 41‐65 and 44‐66, and maximum clot firmness (MCF) (no units) 27‐43 and 30‐46. Moderate to good correlations were observed between the two machines with Lin’s concordance correlation coefficients of 0.51‐0.9 and a P < 0.002. TEG RIs were similar to previously reported values.ConclusionsVCM Vet RIs were generated. Each VCM Vet device should have a unique RI established due to inter‐device variability. Direct correlations of VCM Vet values with TEG parameters were not performed due to the narrow range of the normal values and the need to evaluate patients with a wide range of hemostatic abnormalities.
Objective -To describe the patient population, microbiological findings, treatment and outcome in dogs with severe soft tissue infections (SSTIs) and to compare survivors to nonsurvivors. Design -Retrospective study. Animals -Forty-seven dogs with confirmed soft tissue infections originating from the SC tissues, muscle or fascia.
Interventions -None.Measurements and Main Results -Physical and clinicopathologic data on presentation, microbiological and histopathological findings, antimicrobial treatment and outcome. Dogs with SSTIs were predominantly large breed dogs with a median body weight of 35.6 kg. Incidence of pre-existing conditions (immunomodulating diseases, blunt trauma, injections, clean surgical procedures) that could have contributed to development of SSTIs was 34%. Abnormal physical examination and diagnostic parameters on presentation included increased body temperature (median temperature 39.5 1C [103.1 1F]) and low arterial blood pressure (median systolic blood pressure 103.5 mm Hg). While Streptococcus species were the most commonly isolated bacteria, the incidence of polymicrobial infections differed between antemortem (38.7%) and postmortem (57.1%) cultures. The overall survival rate was 46.8%. Survivors had a higher body weight and higher respiratory rate on presentation than nonsurvivors. Nonsurvivors had a significantly lower WBC count and higher lactate, BUN, aspartate aminotransferase, and bilirubin concentrations. Histopathologic examination of tissue specimens showed that the degree of necrosis was higher in survivors compared with nonsurvivors. Conclusions -SSTIs in dogs are serious conditions associated with high mortality, significant inflammatory changes, and cardiovascular compromise. A number of conditions, including those that compromise skin integrity and immunomodulating diseases have been identified in our patient population and could have contributed to development of SSTIs. Polymicrobial infections occurred in many cases, necessitating broadspectrum antimicrobial coverage.
Dilution of WB with HES 670/0.75 and HES 130/0.4 resulted in changes in primary and secondary hemostasis. Although there were small differences between saline and HES 670/0.75, no differences between HES solutions were evident in this small study. This may suggest there would be minimal increases in bleeding risk when either solution is administered to dogs at low doses. Clinical relevance of our findings requires further investigation.
Objectives: To systematically evaluate the evidence supporting the timing and mechanisms of permanent or temporary discontinuation of antiplatelet or anticoagulant medications in small animals Design: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality (poor, fair, or good), and development of consensus on conclusions via a Delphi-style survey for application of the concepts to clinical practice. Settings: Academic and referral veterinary medical centers.Results: Databases searched included Medline via PubMed and CAB abstracts. Two specific courses of inquiry were pursued, one focused on appropriate approaches to use for small animal patients receiving antiplatelet or anticoagulant drugs and requiring temporary discontinuation of this therapy for the purposes of invasive procedures (eg, surgery), and the other aimed at decision-making for the complete discontinuation of anticoagulant medications. In addition, the most appropriate methodology for discontinuation of heparins was addressed.
Conclusions:To better define specific patient groups, a risk stratification characterization was developed. It is recommended to continue anticoagulant therapy through invasive procedures in patients at high risk for thrombosis that are receiving anticoagulant therapy, while consideration for discontinuation in patients with low to moderate risk of thrombosis is reasonable. In patients with thrombosis in whom the underlying cause for thrombosis has resolved, indefinite treatment with anticoagulant medication is not recommended. If the underlying cause is unknown or untreatable, anticoagulant medication should be continued indefinitely. Unfractionated heparin therapy should be slowly tapered rather than discontinued abruptly.
K E Y W O R D Saspirin, clopidogrel, CURATIVE, heparin, rivaroxaban 88
Anaemia is common in cats hospitalised in the intensive care unit. Systemic inflammation is also common in these cats. Iron status in anaemic cats suggests that anaemia of inflammatory disease may be a significant contributor to anaemia in this patient population.
Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence-based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology. Any notable thoracic change in the radiology report was considered important and evaluated in this study. One hundred and sixty-six of these included patients were dogs and 65 were cats. Of the 166 dog radiographs evaluated, 120 (72.3%) had normal thoracic radiographs, while 46 (27.7%) had radiographic abnormalities. Of the sixty-five cats included, 36 (55.4%) had normal radiographs, while 29 (44.6%) had abnormal radiographs. Canine patients with abnormal radiographs had a significantly higher lactate level (P-value 0.0348) and feline patients with abnormal radiographs had a significantly lower packed cell volume (P-value 0.012). A large proportion of patients that had screening thoracic radiographs (32.5%) had documented abnormalities, but a relatively low percentage (6.5%) of our total population had their clinical plan changed as a consequence of detection of these abnormalities. Findings indicated that abnormal screening thoracic radiographs are more likely in dogs with an elevated lactate and cats with anemia, or a low normal hematocrit.
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