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OBJECTIVE: To determine the effect of high‐flow nasal cannula (HFNC) oxygen therapy on cardiorespiratory variables and outcome in dogs with acute hypoxemic respiratory failure. DESIGN: Prospective, sequential clinical trial. SETTING: University veterinary teaching hospital. ANIMALS: Twenty‐two client‐owned dogs that failed to respond to traditional oxygen support. INTERVENTIONS: Initiation of HFNC therapy after traditional oxygen supplementation failed to increase Spo₂ > 96% and Pao₂ > 75 mm Hg or improve respiratory rate/effort. MEASUREMENTS AND MAIN RESULTS: Physiological variables, blood gas analyses, and dyspnea/sedation/tolerance scores were collected prior to HFNC initiation (on traditional oxygen support [time 0 or T0]), and subsequently during HFNC oxygen administration at time 30 minutes, 60 minutes, and 7 ± 1 hours. Relative to T0, use of HFNC resulted in a decreased respiratory rate at 1 hour (P = 0.022) and 7 hours (P = 0.012), a decrease in dyspnea score at all times (P < 0.01), and an increase in Spo₂ at all times (P < 0.01). There was no difference in arterial/venous Pco₂ relative to T0, although Paco₂ was correlated with flow rate. Based on respiratory assessment, 60% of dogs responded to HFNC use by 30 minutes, and 45% ultimately responded to HFNC use and survived. No clinical air‐leak syndromes were observed. CONCLUSIONS: HFNC use improved oxygenation and work of breathing relative to traditional oxygen therapies, without impairing ventilation. HFNC use appears to be a beneficial oxygen support modality to bridge the gap between standard oxygen supplementation and mechanical ventilation.

Background Brachycephalic airway syndrome can pose a risk of complicated recovery from anesthesia as a result of irritation to the excess pharyngeal andlaryngeal tissue present in affected dogs. High-flow nasal cannula (HFNC) oxygen therapy is a respiratory support modality that offers provision of continuous positive airway pressure via high gas flow rates. The HFNC system actively warms and humidifies inspired gases, which improves comfort and facilitates tolerance of the high flow rates in people and dogs. HFNC oxygen therapy was applied to brachycephalic dogs that developed increased work of breathing or hypoxemia in the recovery phase of anesthesia to determine if this device would be tolerable and effective for relief of upper respiratory difficulty. Key findings The HFNC nasal prong interface is well suited to the brachycephalic facial structure. The application of HFNC was found to reduce dyspnea scores in patients with signs of upper airway obstruction after general anesthesia. Aerophagia and changes in PCO2 were noted. Significance Application of HFNC in the recovery period may result in improved airflow during times of somnolent obstructive breathing, not unlike the use of continuous positive airway pressure therapy in sleep-disordered breathing in people.

Objective To characterize and compare current canine and feline transfusion practices at private referral hospitals (PRH) and veterinary teaching hospitals (VTH), including information regarding blood donor screening; blood product collection, storage, and administration; recipient screening; and monitoring during transfusions. Design Internet-based survey. Subjects Sixty-five board-certified specialist veterinarians, 3 veterinarians, and 5 veterinary technicians from 53 PRH and 20 VTH. Methods A survey was disseminated via email LIST-SERVs; 1 survey response per hospital was included. Main Results Survey results revealed that PRH more commonly obtained canine and feline blood products solely from blood banks (P 72 hours (P = 0.046). The use of client-owned canine donors (P = 0.043), administration of precollection 1-deamino-8-d-arginine vasopressin to canine donors (P = 0.041), and storage of blood products in a dedicated refrigerator (P = 0.003) and −20°C or −80°C freezer (P = 0.044) were more common in VTH than PRH. However, the use of a refrigerator freezer (P = 0.001), single bag canine collection systems (P = 0.021), and agglutination cards for feline blood typing (P = 0.032), as well as warming of blood products prior to administration (P = 0.021) were more commonly reported by PRH compared to VTH. Conclusions Although some transfusion practices including the method and length of storage of blood products, use and screening of blood donors, and administration methods varied between VTH and PRH, most transfusion practices were similar. The information reported from this survey could aid the development of future veterinary transfusion consensus statements.

Objective To determine the feasibility, degree of respiratory support, and safety of high flow nasal cannula (HFNC) oxygen therapy in sedated and awake healthy dogs, when compared to traditional nasal cannula (TNC) oxygen administration. Design Randomized experimental crossover study. Setting University research facility. Animals Eight healthy dogs. Interventions Variable flow rates (L/kg/min) were assessed, TNC: 0.1, 0.2, and 0.4 and HFNC: 0.4, 1.0, 2.0, and 2.5. HFNC was assessed in sedated and awake dogs. Measurements Variables measured included: inspiratory/expiratory airway pressures, fraction of inspired oxygen (FiO2 ), end-tidal oxygen (ETO2 ), end-tidal carbon dioxide (ETCO2 ), partial pressure of oxygen (PaO2 ), partial pressure of carbon dioxide (PaCO2 ), temperature, heart/respiratory rate, arterial blood pressure, and pulse oximetry. Sedation status, complications, and predefined tolerance and respiratory scores were recorded. Main results Using HFNC, continuous positive airway pressure (CPAP) was achieved at 1 and 2 L/kg/min. CPAP was not higher at 2.5 than 2 L/kg/min, with worse tolerance scores. Expiratory airway pressures were increased when sedated (P = 0.006). FiO2 at 0.4 L/kg/min for both methods was 72%. FiO2 with TNC 0.1 L/kg/min was 27% and not different from room air. The FiO2 at all HFNC flow rates ≥1 L/kg/min was 95%. PaO2 for HFNC 0.4 L/kg/min was lower than at other flow rates (P = 0.005). The only noted complication was aerophagia. PaCO2 was increased with sedation and use of HFNC when compared to baseline (P = 0.006; P Conclusions Use of HFNC in dogs is feasible and safe, provides predictable oxygen support and provides CPAP, but may cause a mild increase in PaCO2 . Flow rates of 1-2 L/kg/min are recommended. If using TNC, flow rates above 0.1 L/kg/min may attain higher FiO2 .

To characterize and compare current canine and feline transfusion practices at private referral hospitals (PRH) and veterinary teaching hospitals (VTH), including information regarding blood donor screening; blood product collection, storage, and administration; recipient screening; and monitoring during transfusions.Internet-based survey.Sixty-five board-certified specialist veterinarians, 3 veterinarians, and 5 veterinary technicians from 53 PRH and 20 VTH.A survey was disseminated via email LIST-SERVs; 1 survey response per hospital was included.Survey results revealed that PRH more commonly obtained canine and feline blood products solely from blood banks (P0.05) and VTH more commonly used hospital-run donor programs (P0.05). Canine cryo-poor plasma was more likely to be stored by VTH compared to PRH (P = 0.018) and VTH were more likely to store canine fresh platelet products for72 hours (P = 0.046). The use of client-owned canine donors (P = 0.043), administration of precollection 1-deamino-8-d-arginine vasopressin to canine donors (P = 0.041), and storage of blood products in a dedicated refrigerator (P = 0.003) and -20°C or -80°C freezer (P = 0.044) were more common in VTH than PRH. However, the use of a refrigerator freezer (P = 0.001), single bag canine collection systems (P = 0.021), and agglutination cards for feline blood typing (P = 0.032), as well as warming of blood products prior to administration (P = 0.021) were more commonly reported by PRH compared to VTH.Although some transfusion practices including the method and length of storage of blood products, use and screening of blood donors, and administration methods varied between VTH and PRH, most transfusion practices were similar. The information reported from this survey could aid the development of future veterinary transfusion consensus statements.