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Background Thromboembolism has recently been described as a complication following treatment for idiopathic thrombocytopenic purpura ( ITP). This pilot study was undertaken to determine whether dogs suffering from ITP experience hypercoagulability during treatment and recovery. Study design Thromboelastograms ( TEG) were performed on dogs with ITP within 24 hours of admission to the hospital, the first day the platelet count exceeded 40 × 109/L (Day 1), and on Days 4, 7, and 14. Key findings All dogs had hypocoagulable TEG tracings on initial admission to the hospital, but developed TEG tracings suggestive of hypercoagulability during the study period as indicated by increased maximum amplitude. Significance Dogs with ITP developed changes on TEG consistent with hypercoagulability during the study period. Many factors are likely to contribute to these changes. The clinical risk of thrombosis in these patients is unknown. [ABSTRACT FROM AUTHOR]

The article reports on emergency medicine for veterinary patients and offers suggestions for diagnosis and treatment. It is informed that only serious problems cause pleural effusion in pets. It is stated that pericardial effusion is more common than people think. It is opined that migrating foreign bodies are evil, particularly porcupine quills.

Objective-To evaluate whole blood hemostasis by means of thromboelastography in dogs with primary immune-mediated hemolytic anemia (IMHA) to determine whether these dogs had evidence of hypercoagulability prior to the administration of immunosuppressant medications, blood transfusion products, or anticoagulant agents. Design-Evaluation study. Animals-il client-owned dogs admitted to a teaching hospital for management of primary IMHA and 20 clinically normal dogs. Procedures-Citrated whole blood samples were obtained from all dogs for performance of kaolin-activated thromboelastography. Citrated plasma was harvested from blood samples of dogs with IMHA for plasma-based coagulation testing, including activated partial thromboplastin time, prothrombin time, D-dimer concentration, fibrinogen concentration, and antithrombin activity. Results-Compared with control dogs, dogs with primary IMHA had evidence of hypercoagulability as indicated by a significantly lower median (range) clot formation time (0.8 seconds 10.8 to 2.0 seconds] vs 1.9 seconds 11.3 to 3.8 seconds]), higher median angle (76.1° [59.2° to 84.6°] vs 64.0° [45.4° to 71.0°]), higher median maximum amplitude (75.9 mm [66.3 to 86.3 mm] vs 55.7 mm [49.9 to 63.6 mm]), and higher median clot strength (15,000 dyne/cm2 [9,900 to 31,400 dyne/cm2] vs 6,100 dyne/cm2 [4,900 to 8,700 dyne/cm2]). Conclusions and Clinical Relevance-Dogs with primary IMHA had hypercoagulability as demonstrated by thromboelastography at the time of initial diagnosis and prior to treatment. Such hypercoagulability may be a precursor to clinically evident thrombosis as a complication of the disease process. [ABSTRACT FROM AUTHOR]

To characterize the clinical course of disease and identify prognostic indicators for immune-mediated thrombocytopenia in dogs. Design-Retrospective cohort study. Animals-73 dogs treated for immune-mediated thrombocytopenia at the Foster Hospital for Small Animals at the Tufts Cummings School of Veterinary Medicine and the Tufts Veterinary Emergency Treatment and Specialties Hospital. Procedures-Medical records from the period of January 2002 through June 2008 were reviewed to identify dogs with a diagnosis of immune-mediated thrombocytopenia. Data collected included signalment, clinical signs, results of initial diagnostic tests, treatment, complications, and survival duration. Results-Dog ages ranged from 5 months to 15 years (median, 8.1 years). Cocker Spaniels were overrepresented, compared with their distribution in the entire hospital population during the same period. Sixty-one of the 73 (84%) dogs survived to discharges. Seven (11%) of those dogs were lost to follow-up. Five of the remaining 54 (9%) dogs had a relapse of the disease. The presence of melena or high BUN concentration at admission to the hospital was significantly correlated with a decreased probability of survival. Conclusions and Clinical Relevance-Immune-mediated thrombocytopenia is a serious yet treatable disease, which may have a lower rate of recurrence than previously reported. The presence of melena or high BUN concentration in the study suggested a poor prognosis for affected dogs. [ABSTRACT FROM AUTHOR]

Objective-To determine whether changes in presurgical plasma lactate concentration (before and after initial fluid resuscitation and gastric decompression) were associated with short-term outcome for dogs with gastric dilatation-volvulus (GDV). Design-Retrospective case series. Animals-64 dogs. Procedures-Medical records were reviewed, and signalment, history, resuscitative treatments, serial presurgical lactate concentrations, surgical findings, and short-term outcome were obtained for dogs with confirmed GDV. Results-36 of 40 (90%) dogs with an initial lactate concentration ⩽9.0 mmol/L survived, compared with only 13 of 24 (54%) dogs with a high initial lactate (H IL) concentration (>9.0 mmol!L). Within HIL dogs, there was no difference in mean ± SD initial lactate concentration between survivors and nonsurvivors (10.6 ± 2.3 mmol/L vs 11.2 ± 2.3 mmol/L, respectively); however, there were significant differences in post-treatment lactate concentration, absolute change in lactate concentration, and percentage change in lactate concentration following resuscitative treatment. By use of optimal cutoff values within HIL dogs, survival rates for dogs with final lactate concentration > 6.4 mmol/L (23%), absolute change in lactate concentration ⩽4 mmol/L (10%), or percentage change in lactate concentration ⩽42.5% (15%) were significantly lower than survival rates for dogs with a final lactate concentration ⩽6.4 mmol/L (91 %), absolute change in lactate concentration > 4 mmol/L (86%), or percentage change in lactate concentration > 42.5% (100%). Conclusions and Clinical Relevance-Calculating changes in plasma lactate concentration following initial treatment in dogs with GDV may assist in determining prognosis and identifying patients that require more aggressive treatment. [ABSTRACT FROM AUTHOR]

Objective-To evaluate whether games of popular professional football teams have an effect on small animal emergency room caseload and percentage of dogs and cats that subsequently are hospitalized, are euthanatized, or die following admission to veterinary emergency rooms located within a dedicated fan base. Design-Prospective study. Animals-818 dogs and cats admitted to the emergency room. Procedures-During the 2007 New England Patriots (NEP) football season, small animal emergency room caseload was recorded for Sunday (4-hour blocks, 8:00 AM until 12:00 mid- night) and Monday night (7:00 PM to 11:00 PM). Number of dogs and cats that subsequently were hospitalized, died, or were euthanatized was recorded. Mean game importance rating (GIR) was determined for NEP games (scale, 1 [mild] to 3 [great]). Results-Percentage of dogs and cats admitted from 12:00 noon to 4:00 PM on Sundays during NEP games (mean GIR, 1.7) versus non-NEP games was not different. Mean ± SD percentage of dogs and cats admitted from 4:00 PM to 8:00 PM on Sundays during NEP games (mean GIR, 2.4) versus non-NEP games was significantly different (18 ± 5% and 25 ± 7% of daily caseload, respectively). Percentage of dogs and cats admitted from 8:00 PM to 12:00 midnight on Sundays during NEP games (mean GIR, 2.1) versus non-NEP games was not different. Game type (NEP vs non-NEP) during emergency room admission did not influence whether dogs and cats subsequently were hospitalized, died, or were euthanatized. Conclusions and Clinical Relevance-Professional sporting events may influence veterinary emergency room caseloads. [ABSTRACT FROM AUTHOR]

Objectives To (1) determine a reference interval for shock index (SI) [defined as heart rate (HR)/systolic blood pressure (SBP)], in a group of healthy dogs, and (2) compare SI in healthy dogs with dogs presenting to the emergency room (ER) deemed to be in or not in a state of shock. Design Prospective study. Animals Sixty-eight clinically normal dogs, 18 dogs that were presented to the ER deemed to be in shock and 19 dogs presenting to the ER not deemed to be in shock. Setting University teaching hospital. Interventions Peripheral or central venous blood sampling. Measurements and Main Results Heart rate and SBP were recorded on simulated presentation (healthy dogs), and emergency presentations for both dogs deemed to be in shock and dogs not deemed in shock. Dogs in shock had a median SI of 1.37 (0.87-3.13), which was significantly higher than both other groups; dogs not deemed in shock had median SI 0.73 (0.56-1.20), P < 0.0001 and healthy dogs had median SI 0.78 (0.37-1.30) P < 0.0001), respectively. Receiver operator characteristic curve analysis suggested a SI cut-off of 1.0, yielding an area under the receiver operator characteristic (AUROC) of 0.89 (Specificity (Sp) 89, Sensitivity (Sn) 90) when comparing dogs deemed in shock with healthy dogs, and 0.92 (Sp 95, Sn 89) when comparing dogs in shock with to dogs not deemed in shock. Conclusions The SI is an easy and noninvasive patient parameter that is higher in dogs that are deemed to be in shock than both healthy dogs and dogs presented as emergencies but not deemed to be in a state of shock. The measurement of SI may have some benefit in clinical assessment of emergency patients. [ABSTRACT FROM AUTHOR]

Case Description--An 8-month-old male Saint Bernard developed tetanic seizures and hyperthermia during evaluation of bilateral osteochondritis dissecans of the shoulder joints. Further investigation revealed that the dog was receiving an unbalanced homemade diet. Clinical Findings--Preliminary evaluation of the dog revealed bilateral signs of pain and mild muscle wasting in the shoulder joint areas. Serum biochemical analysis revealed severe hypocalcemia, hyponatremia, hypochloremia, hyperphosphatemia, vitamin D deficiency, and taurine deficiency. Diffuse osteopenia was identified on radiographs of the mandible and long bones, confirming bone demineralization. Analysis of the homemade diet revealed that the dog's diet was severely deficient in a variety of nutrients. Treatment and Outcome--The dog responded positively to treatment for hypocalcemia, hyperthermia, and seizures. The dog's diet was changed to a complete and balanced canine diet formulated for growth. Body weight and body condition were monitored, and dietary intake was adjusted to achieve optimal body condition during growth. After initial evaluation, serial monitoring of serum calcium and taurine concentrations revealed that values were within reference limits and the dog had no further clinical signs associated with dietary deficiency. Clinical Relevance--Findings in this puppy highlight the risks associated with feeding an unbalanced homemade diet during growth and the importance of obtaining a thorough dietary history from all patients. For owners who elect to feed a homemade diet, it is critical to have the homemade diet carefully formulated by a veterinary nutritionist to avoid severe nutrient imbalances, especially in young, growing dogs. [ABSTRACT FROM AUTHOR]

Objective--To determine reference values for kaolin-activated thromboelastography in echocardiographically normal cats. Animals--30 healthy cats without evidence of cardiomyopathy on echocardiographic examination. Procedures--All cats underwent echocardiographic examination, the findings of which were reviewed by a board-certified cardiologist. Cats that struggled (n = 10) received mild sedation with butorphanol and midazolam IM to permit phlebotomy without interruption in jugular venous blood flow. Blood samples were collected for analysis of thromboelastography variables, PCV, total solids concentration, platelet count, activated partial thromboplastin time, prothrombin time, fibrinogen concentration, and antithrombin concentration. Results--All 4 thromboelastography variables had < 5% mean intra-assay variability. Mean values were as follows: reaction time, 4.3 minutes; clotting time, 1.6 minutes; α angle, 66.5°; and maximum amplitude, 56.4 mm. Compared with nonsedated cats, cats that required sedation had a significantly shorter clotting time and greater α angle, whereas reaction time and maximum amplitude were not significantly different. Conclusions and Clinical Relevance--Kaolin-activated thromboelastography was a reliable test with unremarkable intra-assay variability in echocardiographically normal cats. Sedation may affect certain thromboelastography variables, but the effect is unlikely to be clinically important. It remains unknown whether subclinical cardiomyopathy has a significant effect on thromboelastography variables in cats. [ABSTRACT FROM AUTHOR]

Objective To determine agreement in bacterial culture and susceptibility ( BC&S) between deep oral swab ( DOS) and routine transoral tracheal wash ( TOTW) in dogs with pneumonia. Design Prospective study, performed between 2008 and 2010 with no follow-up period. Setting University teaching hospital. Animals Five puppies and 5 adult dogs with community or hospital-acquired pneumonia. Measurements and Main Results A DOS was collected from each patient; dogs were then briefly anesthetized with propofola for a routine TOTW. Routine microbiology techniques were used for culture. Positive culture results were obtained from all 20 swabs. Results of BC&S were compared between the 2 sites. In all puppies, there was no agreement between DOS and TOTW. In adult dogs, 2 patients with hospital-acquired infection ( HAI) had complete agreement between the BC&S results from DOS and TOTW. Two adult dogs had some similarity in BC&S results, and the final dog had no relationship between cultures. Conclusions DOS is not an appropriate alternative to TOTW to obtain samples for BC&S in puppies with pneumonia. In adult dogs, traditional TOTW remains the gold standard, but DOS may be considered in dogs with suspected HAI. Further work is needed to confirm this preliminary finding. [ABSTRACT FROM AUTHOR]

Objective-To determine whether multiple organ dysfunction syndrome (MODS) could be identified in dogs with sepsis secondary to gastrointestinal tract leakage, and whether the number of affected organ systems was significantly associated with mortality rate. Design-Multicenter retrospective case series. Animals-114 dogs. Procedures-Medical records for dogs treated surgically because of sepsis secondary to gastrointestinal tract leakage between 2003 and 2007 were reviewed. Sepsis was diagnosed on the basis of results of bacterial culture of peritoneal fluid, gross evidence of gastrointestinal tract leakage at surgery, or both. Renal dysfunction was defined as a ⩾ 0.5 mg/dL increase in serum creatinine concentration after surgery. Cardiovascular dysfunction was defined as hypotension requiring vasopressor treatment. Respiratory dysfunction was defined as a need for supplemental oxygen administration or mechanical ventilation. Hepatic dysfunction was defined as a serum bilirubin concentration > 0.5 mg/dL. Dysfunction of coagulation was defined as prolonged prothrombin time, prolonged partial thromboplastin time, or platelet count ⩽ 100,000/μt. Results-89 (78%) dogs had dysfunction of 1 or more organ systems, and 57 (50%) dogs had MODS. Mortality rate increased as the number of dysfunctional organ systems increased. Mortality rate was 70% (40/57) for dogs with MODS and 25% (14/57) for dogs without. Conclusions and Clinical Relevance-Results indicated that MODS, defined as dysfunction of at least 2 organ systems, can be identified in dogs with sepsis and that organ system dysfunction increased the odds of death. [ABSTRACT FROM AUTHOR]

Objective—To establish a focused assessment with sonography for trauma (FAST) protocol in dogs, determine whether FAST can be performed by veterinary clinicians without extensive ultrasonographic experience, and assess the frequency of free fluid (as determined via FAST) in the abdominal cavity of dogs following motor vehicle accidents (MVAs). Design—Prospective study. Animals—100 client-owned dogs evaluated within 24 hours of an MVA. Procedure—Dogs were placed in lateral recumbency for the FAST examination. To detect fluid in the abdomen, 2 ultrasonographic views (transverse and longitudinal) were obtained at each of 4 sites (just caudal to the xiphoid process, on the midline over the urinary bladder, and at the left and right flank regions). Results—In the 100 dogs evaluated via FAST, free abdominal fluid was detected in 45 dogs. In 40 of those 45 dogs, abdominocentesis was performed; hemoperitoneum and uroperitoneum were diagnosed in 38 and 2 dogs, respectively. Compared with dogs that had no free abdominal fluid detected via FAST, dogs that had free abdominal fluid detected via FAST had significantly higher heart rates and serum lactate concentrations and significantly lower PCVs and total solid concentrations. Conclusions and Clinical Relevance—Results indicate that FAST is a simple and rapid technique that can be performed on dogs in an emergency setting to detect intra-abdominal free fluid and can be performed by veterinary clinicians with minimal previous ultrasonographic experience. [ABSTRACT FROM AUTHOR]