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Background: Reported incidence of blood transfusion reactions (TR) varies greatly., Objective: To prospectively evaluate the incidence of acute TRs in dogs receiving allogenic blood products, using consensus definitions, and to assess factors associated with TRs., Animals: Dogs (n = 858) administered allogenic blood products (n = 1542) between March and November 2022., Methods: Prospective, multicenter surveillance study occurring in referral hospitals in the United States, United Kingdom, and Australia recording TRs in dogs administered blood products as defined by the consensus guidelines published by The Association of Veterinary Hematology and Transfusion Medicine in 2021., Results: The incidence of acute TR was 8.9% (95% CI 7.0-11.1) for packed red blood cells (pRBCs) and 4.5% (95% CI 2.9-6.6) for plasma products. The most frequently reported TRs were febrile nonhemolytic TRs (FNHTR; 4%, 95% CI 2.8-5.5) when administering pRBCs and allergic TRs (3.2%, 95% CI 1.80-5.10) when administering plasma products. A higher dose of pRBC (adjusted odds ratio [aOR] 1.04 [95% CI 1.00-1.08]) was associated with a higher odds of TR. Administration of pRBCs stored for longer than 28 days was associated with higher odds of FNHTR (aOR 4.10 [95% CI 1.58-10.65]) and acute hemolytic TR (AHTR; OR 15.2 [95% CI 3.35-68.70]) when compared with pRBCs stored for 14 days or fewer. Leukoreduction of pRBC was not associated with lower odds of developing a TR (OR 1.47 [95% CI 0.89-2.42])., Conclusions and Clinical Importance: Clinicians should be mindful of the age and dose of pRBC prescribed to dogs., (© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

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 conservative management and outcome of gastrointestinal metallic sharp-pointed straight foreign bodies in dogs and cats., Materials and Methods: Clinical records of dogs and cats presented to a university teaching hospital between 2003 and 2021 with gastrointestinal metallic sharp-pointed straight foreign bodies (e.g. needles, pins, nails) were reviewed. Conservative management was defined as leaving the foreign body in situ. Cases were excluded if the foreign body was identified outside of the gastrointestinal tract (including oropharynx and oesophagus) or if it was removed by endoscopy or surgery as the first treatment choice. Patient signalment, presenting complaint, foreign body location, treatment, complications, gastrointestinal transit time, length of hospitalisation and outcome were recorded., Results: A total of 17 cases (13 dogs and four cats) were included in the study, being treated with primary conservative therapeutic approach (11) or following failure of endoscopy (two), surgery (three) or both (one). Clinical signs associated with the foreign body were reported in three (17.6%) cases. Conservative management was successful in 15 (88.2%) cases, with no complications reported. Patients were clinically and radiographically monitored with variable supportive care. In two (11.8%) cases, surgery was subsequently performed as the foreign body failed to progress on repeated radiographs after 24 hours. Mean foreign body gastrointestinal transit time for patients treated conservatively was 59.2 (±31.4) hours. All patients survived to discharge., Clinical Significance: Conservative management is a treatment option for clinically stable cats and dogs with metallic sharp-pointed straight gastrointestinal foreign bodies in the absence of perforation., (© 2023 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

Background: While there has been extensive investigation into the selection and retention of human blood donors, veterinary research in this area is limited. This study aimed to identify the reasons for the rejection and withdrawal of canine and feline blood donors from a blood donation programme., Methods: Records of cats and dogs presenting as prospective blood donors and/or donating between 2014 and 2019 were analysed. Reasons for rejection at sign-up were categorised into medical and temperament. Reasons why animals left before retirement age were categorised into medical, temperament and owner related., Results: Data from 362 dogs and 134 cats were analysed. Cats (20.8%) were more likely to be rejected than dogs (5.2%) at sign-up, mostly due to medical reasons. Both species often left the blood donor service early due to temperament reasons. Owner and medical reasons for leaving early were also common., Limitation: This was a retrospective study with subjective assessment of temperament., Conclusions: Inability to donate due to temperament and medical reasons is common. When recruiting blood donors, it should be recognised that a fairly high proportion will not be successful. Owner understanding and motivation are essential to ensure successful selection and retention of donors, which allows amortisation of recruitment costs., (© 2023 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Objectives: To determine the causative organisms, clinical features and outcome of canine infective endocarditis in the UK., Materials and Methods: Medical records of three veterinary referral hospitals were searched for dogs with infective endocarditis between December 2009 and December 2019. Signalment, clinical signs, causative organism, valve affected, treatment and survival data were recorded., Results: Seventy-seven cases with possible or definite infective endocarditis (according to the modified Duke criteria) were included. The majority were large breed (40/77 - 51.9%). There were 47 of 77 (61%) male dogs and the mean age was 7.3 ±3 years. A causative organism was identified in 26 of 77 (33.8%) cases. The most common organisms were Escherichia coli (7/27 - 25.9%), Pasteurella spp. (5/27 - 18.5%), Staphylococcus spp. (4/27 - 14.8%) and Corynebacterium spp. (4/27 - 14.8%). Bartonella spp. were not detected in any patients. The mitral valve was most commonly affected (48/77 - 62.3%). Clinical features were non-specific, with lethargy being the most common clinical sign observed (53/77 - 68.8%). Fifty-three dogs (68.8%) survived to discharge. The median survival time post discharge was 425 days (2 to 3650 days). The development of congestive heart failure was associated with a poorer outcome. Cardiac troponin concentration, antithrombotic use and the development of thromboembolism or arrhythmias were not significantly associated with outcome., Clinical Significance: Some dogs with infective endocarditis that survive to discharge can have a long lifespan. The inability to detect an underlying organism is common and Bartonella spp. may be a less prevalent cause of canine infective endocarditis in the UK than in the USA., (© 2022 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

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.)

Objectives: The aim of this study was to report the incidence of transfusion reactions in cats, including acute haemolysis (AH), occurring within 24 h of receiving a xenotransfusion. An additional aim was to determine whether cases with AH could be classified as having an acute haemolytic transfusion reaction (AHTR) as per the definition provided by the Association of Veterinary Haematology and Transfusion Medicine's Transfusion Reaction Small Animal Consensus Statement., Methods: Medical records of cats that received canine packed red blood cells (PRBCs) between July 2018 and September 2020 at a veterinary hospital were reviewed. The incidence of AH, AHTRs, febrile non-haemolytic transfusion reactions (FNHTRs), transfusion-associated circulatory overload and septic transfusion reactions were recorded., Results: The medical records of 53 cats were retrospectively evaluated. Twenty-three (43%) cats had transfusion reactions. Thirteen (25%) cats had AH; however, only four (8%) met the definition of an AHTR. Ten (19%) cats were determined to have FNHTRs. Survival to discharge of cats affected by AH was 50% (25% for cases that met the definition of an AHTR). Survival to discharge of cats not suffering from AHTR was 40%., Conclusions and Relevance: This report indicates that a higher proportion of cats undergo AH (25%) when administered canine PRBCs than previously reported, although many could not be classed as having an AHTR due to an apparently adequate packed cell volume rise. Challenges with sourcing feline blood in emergency situations occasionally necessitates the use of xenotransfusion in transfusion medicine. Clinicians should be aware that haemolysis after xenotransfusion can occur within 24 h and that a repeat feline transfusion may be required sooner than anticipated in some cases.

Objectives: This study aimed to determine if dogs and cats presenting as an emergency had improved tolerance of intravenous catheterisation following the application of vapocoolant spray when compared to a saline control., Materials and Methods: A randomised controlled trial of client-owned dogs and cats presenting as an emergency and requiring intravenous catheterisation was performed. Patient signalment and mentation score were recorded. All animals were restrained and had their fur clipped over the catheterisation site. They were then randomly allocated to either have a swab saturated with vapocoolant spray (treatment) or a swab saturated with saline (control) applied to the clipped area before intravenous catheterisation. The procedure was video recorded and a single blinded observer reviewed the recordings and assigned reaction scores (0 to 3) at four time points (initial restraint, limb handling, swab application and skin puncture)., Results: Between October 2020 and January 2021, a total of 100 patients (79 dogs, 21 cats) were enrolled, with 50 in each group. No significant difference in species, age, breed, sex or mentation score was detected between the two groups. There was no significant difference in reaction scores between the groups at any time point with the exception of a significantly increased swab application reaction score in the treatment group compared to the control group., Clinical Significance: The indirect application of vapocoolant spray via a swab before catheterisation does not significantly reduce the reaction of dogs and cats to intravenous catheterisation in an emergency setting., (© 2022 British Small Animal Veterinary Association.)

Objectives: To describe clinical cases of aspiration pneumonitis and pneumonia in dogs, which were successfully managed without antimicrobials., Materials and Methods: Retrospective case review of dogs presenting to a referral teaching hospital between February 2014 and February 2021. Cases were included when a clinical diagnosis of aspiration pneumopathy was made (requiring one or more of the following: radiographic evidence of an aspiration pneumopathy, endotracheal airway sampling consistent with aspiration and/or a positive endotracheal airway sample culture) which was not treated with antimicrobial therapy., Results: Fourteen cases were identified of which nine had respiratory signs including increased respiratory rate or effort (n=8), arterial hypoxaemia (n=2), or a clinician-determined requirement for oxygen therapy (n=4). Where haematology was performed, five of nine displayed a normal neutrophil count with toxic changes, three displayed neutrophilia and one displayed neutropenia with toxic changes. Endotracheal airway sample cytology in four cases revealed neutrophilic inflammation with bacteria, plant material, yeasts and unidentified foreign material. Where respiratory signs were present, these resolved within 12 to 36 hours., Clinical Significance: In this case series, immunocompetent dogs sustaining aspiration events, even with classical evidence of pneumonitis or pneumonia, have been managed successfully without antimicrobials. Radiography alone cannot be used to determine the requirement for antimicrobials. Better characterisation of the pathogenesis and clinical trajectory of aspiration pneumopathy is required, which may enable a reduction in inappropriate antimicrobial prescriptions., (© 2021 British Small Animal Veterinary Association.)

This article discusses the usefulness of ultrasound examinations in the management of the patient with an emergency urinary tract disorder. It discusses the use of previously described point-of-care ultrasound protocols such as the abdominal focused assessment with sonography for trauma, triage, and tracking protocol in the unstable azotemic patient. Point-of-care ultrasound examination can help direct investigations and expedite the diagnosis of specific causes of azotemia. The limitations of point-of-care ultrasound assessment of the kidneys, ureter, bladder, and urethra are also addressed, emphasizing that point-of-care ultrasound examination should complement and not replace a complete urinary tract ultrasound examination., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Tetanus can lead to respiratory complications, and the outcome of dogs affected by this disease is still largely unknown. This retrospective study aimed to evaluate the frequency and outcome of 53 dogs with tetanus and respiratory complications between February 2006 and January 2019. Medical records from dogs diagnosed with tetanus admitted to a referral teaching hospital were reviewed. Fifty-three dogs were diagnosed with tetanus and respiratory complications were observed in 26.4% (14/53) of dogs; 8 developed aspiration pneumonia (AP), 5 developed upper airway obstruction (UAO) and 1 dog developed both. A total of 5 AP dogs were mechanically ventilated. Three dogs with UAO had tracheostomy tubes placed. Dogs with respiratory complications had a poorer outcome, with only 14.3% (2/14) surviving to discharge, compared to 94.8% (37/39) for dogs with no respiratory complications. Respiratory complications such as AP and UAO were common in dogs with tetanus, and this was associated with a poorer outcome., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

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.)

Background: Leukoreduction of blood products is commonly performed in human medicine, but its effect on outcome or incidence of transfusion reactions (TRs) in dogs is unknown., Objectives: To prospectively evaluate the incidence of acute TRs in, and the outcome of, dogs receiving either leukoreduced (LR) or nonleukoreduced (N-LR) packed red blood cells (PRBC)., Animals: Dogs (n = 194) administered PRBC between August 2017 and June 2020., Methods: Prospective randomized double-blinded clinical trial. Dogs were randomized to receive either LR or N-LR PRBC and clinicians, nurses and investigators were blinded to the group allocations. The incidence of TRs, change in PCV, hospitalization duration, and survival to discharge were recorded., Results: Out of the 194 dogs, 96 received LR and 98 received N-LR PRBCs. The mean 12-hour change in PCV value was +9.22% (SD 5.27%) for dogs that received N-LR and +10.69% (SD 6.44%) for dogs that received LR PRBC (effect size 0.26, 95% confidence interval [CI] -0.02 to 0.55), which was not significantly different (P = .08). TRs were documented in 16/194 (8.24%) dogs, with 1/194 (0.51%) being a mild allergic reaction, while 15/194 (7.73%) had suspected febrile nonhemolytic TRs (FNHTRs). FNHTR incidence was not significantly different between the LR (6/96, 6.25%, 95% CI 2.8-13.56) and N-LR (9/98, 9.18%, 95% CI 4.92-17.11) groups (P = .81). Of the 156 dogs that survived to discharge, 80/156 received N-LR PRBC and 76/156 received LR PRBC which was not significantly different (P = .66)., Conclusions and Clinical Importance: A clinical advantage of using LR over N-LR PRBC in terms of TRs and increase in PCV after transfusion was not detected., (© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

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.)

Objectives: To assess the accuracy of the lung ultrasound protocol Vet BLUE, using thoracic CT as the reference standard, for the detection of thoracic pathology in dogs and cats., Materials and Methods: Animals that had thoracic ultrasound and thoracic CT were prospectively recruited between May 2017 and September 2018. The Vet BLUE protocol was performed on animals at the time of admission by veterinarians with basic training in emergency ultrasound. A board-certified radiologist, blinded to the Vet BLUE findings, reviewed the CT images., Results: CT was abnormal in 64.5% (20/31) animals. The number of CT sites positive for alveolar-interstitial syndrome was 24.2% (60/248). When using CT as the reference standard, detection of ≥3 B lines with thoracic ultrasound had a sensitivity of 18.33% and specificity of 98.4% for detection of site specific alveolar-interstitial syndrome. The sensitivity of Vet BLUE to detect alveolar-interstitial syndrome increased to 56.9% when including the presence of any B line as abnormal. Overall accuracy for detection of alveolar-interstitial syndrome based on these two criteria was 79% and 73%, respectively. Vet BLUE correctly identified consolidation in 58.3% (14/24) sites, pleural effusion in 66.6% (2/3) cases, pneumothorax in 33.3% (1/3) cases and intrathoracic mass in 25% (1/4) cases., Clinical Significance: The Vet BLUE protocol is a useful technique to detect alveolar-interstitial syndrome and other thoracic pathology but should not be used as a sole imaging method. Detection of ≥3 B lines is highly suggestive of alveolar-interstitial syndrome and warrants further diagnostics., (© 2021 British Small Animal Veterinary Association.)

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.)

Background: Whether anemic cats and dogs with increased left heart dimensions are at higher risk of transfusion-associated circulatory overload, and the effect of blood transfusion on left heart dimensions in naturally occurring anemia is unknown., Hypothesis/objectives: To evaluate the effect of blood transfusion on left heart dimensions in clinically relevant anemia., Animals: Twenty dogs and 20 cats presenting to a university veterinary teaching hospital., Methods: In this prospective observational study, anemic dogs and cats requiring blood transfusion were included. Packed cell volume (PCV), total solids, and echocardiography were performed before and within 24 hours of blood transfusion. Signalment, bodyweight, disease process, transfusion duration and volume, and prior treatments were recorded. Nonparametric statistics were reported as median [range]. Post hoc Bonferroni correction set significance at P < .006., Results: After transfusion, PCV increased in cats (12% [6-16] to 18% [10-33], P = .001) and dogs (14% [7-24] to 25% [9-37], P = .001), heart rate decreased in dogs (104 bpm [86-166] to 87 bpm [56-138], P < .001), and fractional shortening decreased in cats (57.1% [36.0-84.7] to 41.0% [28.1-69.6], P = .002) and dogs (33.79% [19.33-62.79] to 31.89% [19.06-51.47], P = .006). Left ventricular internal diameter in systole increased in cats (6.5 mm [2.7-9.8] to 7.9 mm [5.3-11.1], P = .001). Normalized left ventricular internal diameter in diastole (1.48 [1.25-1.79] to 1.57 [1.33-2.00], P = .001) and systole (0.87 [0.58-1.19] to 1.00 [0.74-1.36], P = .001) increased in dogs. Incidence of volume overload did not differ before (14/20 cats, 70%; 9/20 dogs, 45%) or after (12/20 cats, 60%; 11/20 dogs, 55%) transfusion (P = .64)., Conclusions and Clinical Importance: Blood transfusion is well tolerated when signs of volume overload are present before transfusion., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.)

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.)

Background: Systemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs., Objective: To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH., Animals: Fifty-two dogs with AKI., Methods: Prospective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics., Results: The prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty-two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007)., Conclusions and Clinical Importance: Systemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.)

Background: Vestibular disease (VD), central or peripheral, can be a dramatic primary-care presentation. Current literature describes mostly dogs examined in referral centers., Hypothesis/objectives: Describe the prevalence, presentation, clinical management, and outcomes of VD in dogs under primary veterinary care at UK practices participating in VetCompass., Animals: Seven hundred and fifty-nine vestibular cases identified out of 905 544 study dogs., Methods: Retrospective cohort study. Potential VD cases clinically examined during 2016 were verified by reviewing clinical records for signalment, presenting clinical signs, treatments, and outcomes. Multivariable logistic regression was used to evaluate factors associated with VD., Results: The overall prevalence of VD was 8 per 10 000 dogs (95% CI = 7-9). Median age at first diagnosis was 12.68 years (interquartile range [IQR], 11.28-14.64). Compared with crossbreeds, breeds with the highest odds of VD diagnosis included French Bulldogs (odds ratio [OR] = 9.25, 95% CI = 4.81-17.76, P < .001), Bulldogs (OR = 6.53, 95% CI = 2.66-16.15, P < .001), King Charles Spaniels (OR = 4.96, 95% CI = 2.52-9.78, P < .001), Cavalier King Charles Spaniels (OR = 3.56, 95% CI = 2.50-5.06, P < .001), and Springer Spaniels (OR = 3.37, 95% CI = 2.52-4.52, P < .001). The most common presenting signs were head tilt (69.8%), nystagmus (68.1%), and ataxia (64.5%). The most frequently used treatments were antiemetics (43.2%), systemic glucocorticoids (33.1%), antimicrobials (25%), and propentofylline (23.25%). There were 3.6% of cases referred. Improvement was recorded in 41.8% cases after a median of 4 days (IQR, 2-10.25)., Conclusions: Our study identifies strong breed predispositions for VD. The low referral rates suggest that primary-care data sources offer more generalizable information for benchmarking to help clinicians review their own clinical activities., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Abnormal platelet activity can either lead to bleeding tendencies or inappropriate thrombus formation and can occur secondarily to a wide variety of disease processes, with a range of clinical consequences and severity. This article will discuss the pathophysiology of platelet function abnormalities and consider a logical diagnostic approach applicable to veterinary practice. Recent advances in platelet function testing will then be discussed, with regards to detection of platelet dysfunction and tailoring of pharmacological manipulation. Although many of these tests are still confined to research or academic institutions, techniques for indirectly assessing platelet function are starting to become more widely available. Although we still require further research to develop guidelines for the use of these tests in clinical decision-making, the recent advances in this field are an exciting step forward in being able to detect and manage platelet dysfunction in both primary care and referral practice., (© 2019 British Small Animal Veterinary Association.)

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 investigate incidence, clinical features, potential risk factors, and prognostic indicators for aspiration pneumonia in Pugs, French Bulldogs, and Bulldogs. DESIGN Retrospective, observational study. ANIMALS 41 brachycephalic dogs with aspiration pneumonia. PROCEDURES Medical records of a veterinary referral hospital were retrospectively searched to identify Pugs, French Bulldogs, and Bulldogs treated for aspiration pneumonia between 2006 and 2015. Signalment, clinical data, and outcomes were recorded. Variables of interest were analyzed for statistical associations with outcome. Incidence of aspiration pneumonia for the population of interest was compared with that for all other dog breeds and for the general hospital population of dogs during the study. RESULTS 41 of 2,141 (1.91%) dogs of the selected brachycephalic breeds and 396 of 80,137 (0.49%) dogs overall had a diagnosis of aspiration pneumonia. Relative risk of the disease in the population of interest was 3.77 times that for all other breeds. Median age at disease onset was greater for Pugs (83 months) than for French Bulldogs (8 months) and Bulldogs (6 months). History of gastrointestinal signs was the most commonly observed preidentified risk factor (27/41 [66%]) in these breeds. Neurologic disease was significantly more common in Pugs than in French Bulldogs and Bulldogs. On univariate analysis, increased age, male sex, obtundation, hypoalbuminemia, azotemia, and high liver enzyme activities were associated with nonsurvival; on logistic regression, increased age was associated with nonsurvival. CONCLUSIONS AND CLINICAL RELEVANCE Age at onset and presence of other risk factors for aspiration pneumonia may vary among brachycephalic dog breeds. Prospective studies are needed to determine common risk factors and prognostic indicators for aspiration pneumonia in the larger population of brachycephalic dogs.

Background: Outcome prediction in dogs with immune-mediated hemolytic anemia (IMHA) is challenging and few prognostic indicators have been consistently identified., Objectives: An online case registry was initiated to: prospectively survey canine IMHA presentation and management in the British Isles; evaluate 2 previously reported illness severity scores, Canine Hemolytic Anemia Score (CHAOS) and Tokyo and to identify independent prognostic markers., Animals: Data from 276 dogs with primary IMHA across 10 referral centers were collected between 2008 and 2012., Methods: Outcome prediction by previously reported illness-severity scores was tested using univariate logistic regression. Independent predictors of death in hospital or by 30-days after admission were identified using multivariable logistic regression., Results: Purebreds represented 89.1% dogs (n = 246). Immunosuppressive medications were administered to 88.4% dogs (n = 244), 76.1% (n = 210) received antithrombotics and 74.3% (n = 205) received packed red blood cells. Seventy-four per cent of dogs (n = 205) were discharged from hospital and 67.7% (n = 187) were alive 30-days after admission. Two dogs were lost to follow-up at 30-days. In univariate analyses CHAOS was associated with death in hospital and death within 30-days. Tokyo score was not associated with either outcome measure. A model containing SIRS-classification, ASA classification, ALT, bilirubin, urea and creatinine predicting outcome at discharge was accurate in 82% of cases. ASA classification, bilirubin, urea and creatinine were independently associated with death in hospital or by 30-days., Conclusions and Clinical Importance: Markers of kidney function, bilirubin concentration and ASA classification are independently associated with outcome in dogs with IMHA. Validation of this score in an unrelated population is now warranted., (Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

A two-year-old female neutered Tibetan terrier was referred following a one-month history of lethargy, inappetence and pancytopenia, which had been poorly responsive to immunosuppressive and fluoroquinolone treatment. The dog was diagnosed with pure red cell aplasia and was found to be positive for Ehrlichia canis by both antibody titre measurement and polymerase chain reaction. The dog lived in London and had not travelled outside the UK. The dog was treated with doxycycline, prednisolone and ciclosporin, but died as a result of gastrointestinal tract haemorrhage. To the authors' knowledge, this represents the first reported case of Ehrlichia canis in a dog in the UK with no previous travel history., (© 2013 British Small Animal Veterinary Association.)

Objectives: To describe a method of faecal smear production and to determine the sensitivity and specificity of faecal smear for detection of parasitic larvae using Baermann sedimentation as a gold standard., Methods: Faecal smears were produced from samples submitted to the Royal Veterinary College Diagnostic Laboratory Service for Baermann sedimentation. An inexperienced and an experienced assessor each examined the smear for larvae for a maximum of five minutes., Results: One hundred and eighty six samples were analysed of which 28 were positive for Angiostrongylus vasorum on Baermann sedimentation. The experienced assessor had a faecal smear sensitivity of 61% and a specificity of 100%. The inexperienced assessor had a faecal smear sensitivity of 54% and a specificity of 95%., Clinical Significance: Faecal smear is an effective and cheap aid to diagnosis of canine angiostrongylosis which can be readily performed in general practice. Its use leads to a rapid detection of infection compared to other available methods. This could lead to swifter treatment of the disease and a decrease in inappropriate diagnostics. A further diagnostic method, such as Baermann sedimentation, is recommended whether the faecal smear result is positive or negative.

Patent ductus arteriosus (PDA) is one of the most common congenital cardiac abnormalities in the dog. Sodium nitroprusside has been proposed as an infusion during PDA ligation as the resultant nitric oxide production causes hypotension thereby facilitating surgical dissection and decreasing the risk of haemorrhage. This case report details how the method described did not decrease blood pressure and therefore had no beneficial effects. It is speculated that the lack of response may have been due to tachyphylaxis. Other drugs may be preferred to induce deliberate hypotension in the dog.