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Background: There is little information on the prevalence of auscultatory abnormalities in anemic cats. This study aimed to describe the prevalence of cardiac murmurs and gallop sounds in a population of anemic and nonanemic cats presenting to an emergency room (ER) and to assess whether the prevalence of auscultatory abnormalities was influenced by the severity of anemia., Key Findings: Records of cats presenting to an ER between May 2021 and May 2022 or receiving a blood transfusion between September 2019 and January 2022 were retrospectively analyzed for presence of a murmur or gallop sound. Cats with known structural heart disease were excluded. A murmur was found in 56 of 185 (30%) anemic cats compared with 11 of 102 (11%) nonanemic cats (p < 0.001), with a higher proportion in cats with PCV <16% (p < 0.001). Twenty-five of 185 (14%) anemic cats had a gallop compared with 4 of 102 (4%) nonanemic cats (p = 0.009), with the highest proportion in cats with PCV 11%-20% (p < 0.001). Echocardiography was performed on 17 of 185 anemic cats; 8 had normal echocardiograms and 9 demonstrated evidence of chamber dilation without left ventricular wall thickening, consistent with anemia., Conclusions: Abnormalities on auscultation are common in anemic cats presenting to the ER, with a higher prevalence in more severely anemic cats., (© Veterinary Emergency and Critical Care Society 2024.)

Objectives: To describe the presentation, etiology, and outcome of dogs and cats diagnosed with gastrointestinal pneumatosis (GP)., Design: Retrospective study., Setting: Three referral institutions., Animals: Twenty-six dogs and 4 cats., Interventions: None., Measurements and Main Results: The most common sites of GP were the stomach (n = 19), followed by the colon (n = 8) and small intestine (n = 2). One case had pneumatosis of both the stomach and the colon. GP was most commonly associated with gastrointestinal disease in dogs (18/26 [69%]) and cats (3/4 [75%]), with common diagnoses including gastric dilatation and volvulus (n = 5), acute hemorrhagic diarrhea syndrome (n = 4), and gastrointestinal ulceration (n = 4). Of the 4 cases of gastrointestinal ulceration, 3 were dogs with a history of glucocorticosteroid or nonsteroidal anti-inflammatory drug administration and vomiting and diarrhea. Six of 30 cases (20%), all of which were dogs, were determined to have a surgical indication for exploratory celiotomy, although not solely on the basis of diagnosis of GP. Five cases underwent exploratory celiotomy, of which 1 (20%) survived to hospital discharge. Of the medically managed cases, 13 of 24 (54%) survived to hospital discharge. Overall, 14 of 30 cases (47%) survived to hospital discharge., Conclusions: GP is an uncommon diagnostic imaging finding that is associated with a variety of disease processes. Its development is often related to primary gastrointestinal diseases. In the absence of other surgical disease, exploratory celiotomy based solely on the diagnosis of GP is unlikely to be indicated., (© Veterinary Emergency and Critical Care Society 2024.)

Objective: To describe the use of small-bore wire-guided catheters in the management of peritoneal effusion in cats and dogs and to detail any associated adverse events., Design: Retrospective study., Setting: University teaching hospital ANIMALS: Forty-five client-owned animals that had peritoneal catheters placed for management of peritoneal effusion between July 2010 and June 2021., Interventions: None., Measurements and Main Results: Forty-five cases were included (25 dogs and 20 cats). Twenty-eight animals had the catheter placed to aid management of a uroabdomen, 8 of which recovered without surgical management, 11 had the catheter placed to allow autotransfusion of hemoabdomen, 3 had peritonitis, and 3 had ascites secondary to cardiac disease. Twenty-seven cases (15 dogs and 12 cats) received sedation (n = 24) or local anesthesia alone (n = 3) to facilitate catheter placement, and 6 cases had the catheter placed while under general anesthesia. Median length of catheter persistence was 24 hours (range: 2-144 h). The most common adverse events reported were impaired drainage (n = 7) and leakage at the insertion site (n = 4)., Conclusions: Peritoneal catheters can be inserted percutaneously for management of peritoneal effusion. Indications include stabilization and conservative management of uroabdomen, and autotransfusion. They can often be placed with minimal or no sedation and adverse events appear infrequent in occurrence., (© 2022 The Authors. Journal of Veterinary Emergency and Critical Care published by Wiley Periodicals LLC on behalf of Veterinary Emergency and Critical Care Society.)

Objective:  To evaluate the seasonality of canine tetanus in England., Methods:  Medical records of a single referral hospital in England were reviewed. Dogs diagnosed with localized or generalized tetanus between January 2006 and June 2017 were studied., Results:  Forty-nine cases were included. The prevalence of tetanus in England was significantly higher in the winter when compared with the summer (P = 0.002) and autumn (P = 0.024), with the highest number of cases recorded in February., Conclusions:  The prevalence of canine tetanus in England was significantly higher in winter months, especially in February., (© 2021 The Authors. Journal of Veterinary Emergency and Critical Care published by Wiley Periodicals LLC on behalf of Veterinary Emergency and Critical Care Society.)

Objective: To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats., Design: Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated., Results: Definitions with imputability criteria were developed for 14 types of transfusion reactions., Conclusions: The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research., (© Veterinary Emergency and Critical Care Society 2021.)

Objective: To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion-associated reactions in dogs and cats., Design: Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi-style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication., Results: Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion-associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus., Conclusions: This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine., (© Veterinary Emergency and Critical Care Society 2021.)

Objective: To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats., Design: Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated., Results: Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine., (© Veterinary Emergency and Critical Care Society 2021.)

Objective: To compare the safety and efficacy of pericardial catheter placement with needle pericardiocentesis in dogs with pericardial effusion (PE) DESIGN: Prospective, randomized clinical trial., Setting: University teaching hospital., Animals: Thirty client-owned dogs requiring pericardiocentesis between January 2017 and August 2019., Interventions: Dogs were randomized to undergo PE drainage via indwelling pericardial catheter placement (catheter group) followed by elective drainage every 4-6 hours or needle pericardiocentesis (needle group) repeated as necessary., Measurements and Main Results: Fifteen dogs were allocated to the catheter group and 15 to the needle group. Data collected included signalment, cause of effusion, occurrence of arrhythmias pre-, during, and post-pericardiocentesis, procedural length, and details of repeated drainages. There was no significant difference between mean procedural times for pericardial catheter placement (17.7 min [±11.8]) and needle pericardiocentesis (12.1 min [±8.6]) (P = 0.192) or the rate of new arrhythmias in the catheter (36%) and needle (64%) groups (P = 0.24). Pericardial catheters were kept in situ for a median of 21 hours (range, 14-85). Three of 15 (20%) dogs in the needle group required repeated pericardiocentesis within 24 hours of initial pericardiocentesis. Pericardial catheters enabled repeated large volume PE drainage in 4 cases (median, 10.6 mL/kg; range, 8-5-10.6)., Conclusions: Pericardial catheters appear to offer a safe alternative to needle pericardiocentesis. Minimal sedation is required for placement, and they can be placed quickly. Their indwelling nature and use was not associated with a higher rate of arrhythmia compared to that of needle pericardiocentesis alone, and may be beneficial in the event that clinically significant PE recurs., (© Veterinary Emergency and Critical Care Society 2020.)

Objective: To describe patient recovery in dogs that had undergone mechanical ventilation (MV) and received atracurium as a continuous rate infusion (CRI)., Case Series Summary: Three dogs were treated with atracurium CRI while mechanically ventilated and were successfully weaned. All were pediatric patients (2-3 months old) ventilated due to respiratory fatigue and hypoxemia. All dogs experienced seizure activity in the initial 24 h following extubation and were treated with various anticonvulsant protocols; no patients experienced documented seizures after 48 h of discontinuation from MV., New or Unique Information Provided: All three successfully weaned dogs that had received an atracurium CRI experienced new onset seizures in their recovery from MV. Atracurium use in long-term MV has not been described previously, and seizures in dogs following atracurium administration has not been described in the clinical setting. Although causation cannot be proven in this case series, atracurium use should be carefully considered and be monitored appropriately when used for a prolonged duration., (© Veterinary Emergency and Critical Care Society 2020.)

Objective: To characterize a population of cats with pelvic trauma and evaluate factors influencing transfusion requirement and outcome., Design: Retrospective case series (2009-2014)., Setting: University teaching hospital., Animals: One hundred twelve client-owned cats with pelvic trauma., Interventions: None., Measurements and Main Results: Twenty-one (18.8%) cats received a transfusion. Most cats required only 1 fresh whole blood transfusion (85.8%). Packed cell volume at admission was significantly lower in cats that required transfusion but was not associated with hospitalization time or survival to discharge. Increasing Animal Trauma Triage (ATT) score at admission was significantly associated with transfusion requirement (P = 0.0001) and nonsurvival to discharge (P = 0.03). Number of pelvic fractures was not associated with transfusion requirement but cats with sacroiliac luxations and pubic fractures were more likely to require a transfusion (P = 0.0015 and P = 0.0026, respectively). However, fracture type was not associated with survival to discharge. Most cats (86%) required a surgical procedure and half of transfusions were administered preoperatively. No surgical comorbidities were associated with transfusion requirement or survival. Transfusion requirement was associated with longer length of hospitalization but not survival to discharge., Conclusions: Transfusion requirement in this population of cats with pelvic fractures was fairly high. Transfusion requirement was associated with lower packed cell volume, higher ATT score at admission, longer length of hospitalization, and certain types of pelvic fractures. Transfusion requirement was not associated with surgical comorbidities, surgical intervention, or survival to discharge. Lower ATT score at admission was associated with survival to discharge., (© Veterinary Emergency and Critical Care Society 2019.)

Objective: To describe the use of pericardial catheters in dogs with pericardial effusion (PE), and detail any associated adverse events., Design: Retrospective study., Setting: University teaching hospital., Animals: Eighteen client-owned dogs that had pericardial catheters placed for pericardial fluid drainage between May 2007 and January 2015., Interventions: None., Measurements and Main Results: All pericardial catheters were placed within 5 hours of presentation, usually within 1 hour (median 72.5 min, range 45-300 min). Ten of 18 cases were sedated with butorphanol, and 4 with additional midazolam. Four had pericardial catheters positioned for single drainage only and were immediately removed. The other 14 pericardial catheters remained in situ for a median of 18 hours (range 2-88 h). Ten of the remaining 14 cases were redrained after pericardial catheter placement. The main adverse events reported were new arrhythmias in 6/18 cases, with 4 of these 6 patients being administered anti-arrhythmic therapy. No infectious or functional complications were reported. Ten patients were discharged, 1 died and 7 were euthanized., Conclusions: Thoracic drainage catheters inserted into the pericardial space via a modified-Seldinger technique can be positioned in dogs to aid management of PEs. The main associated adverse event is arrhythmia. Minimal sedation is required for placement, and dogs tend not to require postprocedural analgesia. Catheters can remain in situ for repeated drainage, potentially decreasing staffing time requirement and repeat sedation. Their use is associated with a rate of arrhythmia requiring treatment of 22%, compared to that of needle pericardiocentesis alone at 13%. They are easy to position using equipment available in many facilities., (© Veterinary Emergency and Critical Care Society 2019.)

Objective: To estimate the prevalence and risk factors for road traffic accidents (RTA) in dogs and describe the management and outcome of these dogs attending primary-care veterinary practices in the United Kingdom., Design: Retrospective cross-sectional study., Setting: Primary-care veterinary practices in the United Kingdom., Animals: The study population included 199,464 dogs attending 115 primary-care clinics across the United Kingdom., Measurements and Main Results: Electronic patient records of dogs attending practices participating in the VetCompass Programme were assessed against selection criteria used to define RTA cases. Cases identified as RTAs were identified and manually verified to calculate prevalence. Univariable and multivariable logistic regression methods were used to evaluate associations between risk factors and RTA. The prevalence of RTA was 0.41%. Of the RTA cases, 615 (74.9%) were purebred, 322 (39.2%) were female, and 285 (54.8%) were insured. The median age at RTA was 2.5 years. After accounting for the effects of other factors, younger dogs had increased odds of an RTA event: dogs aged under 3 years showed 2.9 times the odds and dogs aged between 6-9 years showed 1.8 times the odds of an RTA event compared with dogs aged over 14 years. Males had 1.4 times the odds of an RTA event compared with females. Overall, 22.9% of cases died from a cause associated with RTA. Of dogs with information available, 34.0% underwent diagnostic imaging, 29.4% received intravenous fluid-therapy, 71.1% received pain relief, 46.0% were hospitalized, and 15.6% had surgery performed under general anesthetic., Conclusions: This study identified important demographic factors associated with RTA in dogs, notably being young and male., (© Veterinary Emergency and Critical Care Society 2018.)

Objectives: Describe unexpected events (UEs) that occurred during blood donation in cats with and without sedation., Design: Retrospective observational study (2010-2013)., Setting: University teaching hospital., Animals: Client-owned healthy cats enrolled in a blood donation program., Interventions: None., Measurements and Main Results: Blood collection for transfusion was performed 115 times from 32 cats. Seventy donation events were in unsedated cats and 45 in sedated cats. For each collection, the anticipated blood volume to be collected, actual blood volume collected, sedation protocol, and any UE in the peridonation period were recorded. There were 6 categories of UEs: movement during donation, donor anxiety, inadequate collected blood volume, jugular vessel related UEs, additional sedation requirement, and cardiorespiratory distress. Fisher's exact test was used to compare the frequency of UEs between sedated and unsedated cats. UEs were recorded in 54 of 115 collections. In the donor population, movement was reported as an UE in 0 cats that donated under sedation and 24/70 (34.3%) cats that donated without sedation (P < 0.001). Donor anxiety occurred in 2/45 (4.4%) cats that donated under sedation and 14/70 (20.0%) cats that donated unsedated (P = 0.014). Unsedated donation did not increase the likelihood of inadequate donation volume, jugular vessel related UEs, or cardiorespiratory distress. Eight of 45 (17.8%) sedated donations required additional sedation., Conclusions: Movement during donation and signs of donor anxiety were more frequent in unsedated cats. These were considered minor issues, expected in unsedated cats being gently restrained. Blood collection from unsedated feline donors is a viable alternative to sedated donation., (© Veterinary Emergency and Critical Care Society 2017.)