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Simple Summary: Thoracic point-of-care ultrasound (T-POCUS) is an important tool for examining pulmonary disorders and has been used to diagnose a wide range of canine and feline respiratory problems. Its non-invasive nature, portability, and ability to produce real-time images make it ideal for veterinary practice. Scanning procedures, probe selection, and picture settings all contribute to accurate interpretation. T-POCUS can be used to diagnose a variety of pleural and pulmonary problems, including pneumothorax, pleural effusion, pneumonia, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, lung lobe torsion, pulmonary fibrosis, pulmonary hemorrhage, pulmonary thromboembolism, and malignancies. B-lines, shred sign, and tissue-like sign are key ultrasound findings that help in diagnosis. T-POCUS is also useful for evaluating illness development and response to therapies. Despite its strengths, further studies are needed to establish its diagnostic accuracy, as well as standardized protocols and proper terminology. Thoracic point-of-care ultrasound (T-POCUS) has grown in popularity and usage in small animal emergencies and critical care settings due to its non-invasive nature, mobility, and ability to acquire images in real time. This review summarizes current understanding about T-POCUS in dogs and cats with respiratory illnesses, including normal thoracic ultrasonography appearance and numerous pathological situations. The basics of T-POCUS are covered, including equipment, scanning procedures, and picture settings. Practical applications in patients with respiratory distress are discussed, with an emphasis on pleural space abnormalities and lung diseases. Ultrasound results define pulmonary disorders such as pneumonia, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, lung lobe torsion, pulmonary fibrosis, pulmonary thromboembolism, pulmonary neoplasms, and pulmonary bleeding. The evaluation focuses on T-POCUS diagnostic skills in a variety of clinical settings. Limitations and the need for more study to standardize techniques, establish agreed terminology, and create specialized educational routes are highlighted. [ABSTRACT FROM AUTHOR]

Background: Periparturient reproductive complications appear to be common in hospitalized goats. More information is needed about periparturient reproductive complications and survival in goats with these conditions. Objective: Identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. Animals: A total of 198 periparturient does presented to 9 university veterinary hospitals from October 2021 to June 2022. Methods: Multicenter, matched case‐control study. Conditional logistic regression was used to identify exposure factors associated with nonsurvival in periparturient does hospitalized ≤1 day or ≥2 days. Results: Overall doe survival was 79% (156/198). Survival in the 1st day of hospitalization was 71% (52/73) and survival in does hospitalized ≥2 days was 83% (104/125). Among goats hospitalized ≤1 day, labor duration before admission (odds ratio [OR] = 4.8; P =.04), uterine tears (OR = 48.2; P <.001), and vaginal/perineal trauma diagnosed during hospitalization (OR = 6.2; P =.03) were associated with nonsurvival. Among goats hospitalized ≥2 days, factors associated with nonsurvival included labor duration before admission (OR = 6.2; P =.004), pregnancy toxemia (OR = 6.07; P =.04), and Cesarean section (OR = 11.35; P =.02). Conclusions and Clinical Importance: Longer labor duration before admission is an important predictor of nonsurvival in hospitalized does. Clients should be educated that early detection and veterinary care are critical for improving outcome in periparturient does. [ABSTRACT FROM AUTHOR]

Objective: To report summative data from the American College of Veterinary Emergency and Critical Care (ACVECC)‐Veterinary Committee on Trauma (VetCOT) registry, with further individual evaluation of university and private practices and level I and II Veterinary Trauma Centers (VTCs). Design: Multi‐institutional registry data report, January 1, 2020, to December 31, 2021. Setting: VTCs identified and verified by ACVECC‐VetCOT. Animals: Dogs and cats with evidence of trauma. Interventions: Data were input to a web‐based data capture system (REDCap) by data entry personnel trained in registry software use and operational definitions of data variables. Patient data on demographics, trauma type, preadmission care, trauma severity assessment at presentation (modified Glasgow Coma Score and Animal Trauma Triage score), key laboratory parameters, interventions, and outcome were collected. Summary descriptive data for each species are reported. Measurements and Main Results: Twenty‐two VTCs contributed data to the VetCOT registry during a 24‐month period, culminating in a total of 9758 complete trauma case records for dogs and 11734 for cats. Head trauma in dogs and cats was seen at a higher percentage in both university‐only VTCs (encompassing both level I and II) (20.1% and 24.1%, respectively) and level I‐only VTCs (24.3% and 24.1%, respectively), in comparison to private‐only VTCs (encompassing both level I and II) (13.5% and 16.2%, respectively) and individual level II VTCs (14.1% and 18.9%, respectively). Canine and feline surgical procedures were performed at a higher percentage at university VTCs (50% and 40.5%, respectively) compared to private VTCs (39.2% and 28.6%, respectively). Overall survival to discharge for dogs and cats remains high at 93.1% and 83.6%, respectively. Conclusions: The VetCOT registry has continued to show powerful potential in collating a large, multifaceted, international dataset in trauma for both dogs and cats. As published in previous VetCOT registry reports, survival to discharge has remained static across both university and private practice veterinary hospitals; however, further breakdown has identified university and level I VTCs admitting and managing a higher number of head traumas, as well as university VTCs performing a higher proportion of surgical procedures. Data from this registry will continue to aid in the design of clinical trials, prospective observational studies, and translational research, which will improve the understanding and outcome of trauma patients. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of veterinary emergency service pause systems (VESPSs) and describe aspects of implementation and perceived impact. Design: Electronic questionnaire Setting: Membership of the Veterinary Emergency and Critical Care Society (VECCS). Animals: None. Interventions: None. Measurement and Main Results: A questionnaire was distributed to 6176 VECCS members with 1168 responses. Seventy‐six percent of the respondents were veterinarians. Ninety‐one percent of respondents practice in the United States, with 74% of them working at 24/7 multispecialty practices. Eighty‐seven percent of respondents indicated patient volume had increased, and 75% reported that a VESPS had been implemented between September 2020 and December 2021. Sixty‐two percent reported that their emergency service had been paused or closed once per week or more. The top reasons for implementing a VESPS included excessive caseload and staffing shortages. A variety of methods were utilized to implement a pause. Sixty‐nine percent reported their VESPS was less than ideal for effectiveness. Pause systems were reported to be highly supported by medical staff. Seventy‐seven percent reported increased client frustration and complaints, and 57% reported staff were stressed from denying care. Of those who do not currently have a VESPS in place, 74% would prefer to have one. Conclusions: VESPSs were in widespread use at the time of this survey, and most have been implemented between September 2020 and December 2021. The majority of VESPSs were employed to mitigate increased caseload and staffing shortages. Although VESPSs are largely supported by medical staff, drawbacks may include staff stress and client frustrations, and improvements are warranted. [ABSTRACT FROM AUTHOR]

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Objective: To describe the use of a synthetic hemostatic dressing, QuikClot Combat Gauze (QCG), in dogs with bleeding wounds. Case Series Summary: Two dogs presented with bleeding traumatic wounds, and QCG was used to achieve hemostasis during stabilization of these dogs. In the other 2 dogs, QCG was used to help attenuate bleeding associated with a surgical procedure. New or Unique Information Provided: While hemostatic dressings have been widely studied and used in human medicine, there is minimal information on the use and efficacy of these hemostatic dressings in veterinary medicine. This case series describes the use of QCG in dogs with hemorrhaging wounds. QCG could be a valuable resource in veterinary emergency and critical care settings. [ABSTRACT FROM AUTHOR]

The article provides an overview of the recent updates to the RECOVER CPR guidelines, which offer evidence-based consensus guidelines for veterinary CPR. The guidelines cover various aspects of CPR, including chest compressions, ventilation, monitoring, IV access, reversals, defibrillation, and antiarrhythmics. The updates offer more specific guidance on compression technique, stress the importance of minimizing interruptions to compressions, recommend the use of tight-fitting face masks and manual resuscitators for ventilation, and suggest the administration of naloxone in cases of opioid-related cardiac arrests. The article also mentions ongoing updates to the guidelines for preparedness and prevention, as well as post-cardiopulmonary arrest care. The sources cited in the text provide further information and recommendations on post-cardiac arrest care and advanced life support for small animals. [Extracted from the article]

Venous blood gases were analyzed with ABL90 FLEX in two cats with Heinz bodies in approximately 60% of the erythrocytes. The instrument demonstrated an inability to correctly report standard bicarbonate (stHCO3−), hematocrits, and hemoglobin concentrations by indicating an OXI spectrum mismatch alarm (ie, the spectrum of measured hemoglobin forms differed from the spectrum of calculated forms). Actual bicarbonate (aHCO3−) did not indicate any errors. The ABL90 FLEX uses spectrophotometry to measure hemoglobin, and the presence of Heinz bodies interfered with the measurement in these cases. Because hemoglobin is included in the formula for calculating stHCO3−, the instrument gave an alarm for stHCO3−. At follow‐up, Heinz bodies were present in only 2%–3% of the erythrocytes, and the ABL90 FLEX did not indicate any alarm messages. To the authors' knowledge, these are the first cases reported that have interference in stHCO3− measurements due to Heinz body formation using the ABL90 FLEX, a common blood gas instrument used in both veterinary and human critical care. The methodology used for evaluating acid–base status should be taken into consideration, and caution is needed when interpreting acid–base results in cats with Heinz bodies. [ABSTRACT FROM AUTHOR]

This document is an editorial published in the journal Frontiers in Veterinary Science. It discusses the importance of mechanical ventilation in anesthesia and critical care for animal patients. The editorial highlights the advancements and challenges in this field and emphasizes the need for a comprehensive understanding of mechanical ventilation in order to provide high-quality care to animals. The document also mentions four new papers that focus on mechanical ventilation in horses and dogs, discussing issues such as alveolar recruitment maneuvers and the use of positive end-expiratory pressure. The studies emphasize the importance of monitoring and avoiding lung injuries and hemodynamic dysfunctions during mechanical ventilation. [Extracted from the article]

This article serves as an introduction to blood transfusions in veterinary medicine, with a focus on the importance of careful consideration and risk assessment. It recommends blood typing and crossmatching, particularly for cats, before transfusions. The administration of blood products should be done slowly and closely monitored for potential reactions. The article also discusses potential transfusion reactions and the significance of following proper protocols to minimize them. It provides information on various complications that can occur during blood transfusions in small animals, such as delayed hemolytic reactions, sepsis, and febrile non-hemolytic reactions. The document emphasizes the role of veterinary nurses in providing intensive monitoring and care during transfusions. [Extracted from the article]

OBJECTIVE: To determine the accuracy of pet owners, veterinary technicians, house officers (interns and residents), and attending clinicians at estimating dog weights in a veterinary emergency room. ANIMALS: 272 dogs weighing over 2 kg presenting to the emergency room between June 1 and July 29, 2022. METHODS: Pet owners, veterinary technicians, house officers, and attending clinicians recorded the dogs' weight estimations on individual data collection cards. Pet owners were also asked to estimate their dogs' weight during the triage period. The dogs' actual weights were then obtained and recorded. RESULTS: Pet owners were more accurate than veterinary professionals at providing weight estimates for dogs. Weight estimates were accurate to within 10% of the dogs' actual weights for 67.9% (181/267) of pet owners. Forty-one percent (112/270) of attending clinicians, 35.3% (95/269) of house officers, and 35.4% (96/271) of veterinary technicians' weight estimates were within 10% of the dog's actual weight. There was no difference noted in the length of veterinary experience and ability to closely estimate the patient's weight. Overall, veterinary professionals were more likely to closely estimate the weight of large dogs compared to small dogs. CLINICAL RELEVANCE: The pet owner is most likely to provide an accurate weight for dogs and questions about the dog's weight should be directed to the client for situations in which a weight cannot be rapidly obtained. [ABSTRACT FROM AUTHOR]

This document provides an overview of the use of prazosin in the treatment of recurrent urethral obstruction (rUO) in cats. It reviews three studies that examined the effectiveness of prazosin in preventing rUO. The studies found no significant difference in the development of rUO between prazosin administration and a placebo, but did report shorter urinary catheterization time with prazosin. However, the small sample sizes and limitations of the studies make it difficult to draw definitive conclusions. Further clinical studies with larger sample sizes are needed to determine the effectiveness of prazosin in preventing rUO in cats. [Extracted from the article]

Introduction: This study aimed to determine the incidence of canine and feline tick paralysis cases presenting to two veterinary emergency hospitals before and after the introduction of new generation prophylactic acaricides. Methods: This was a retrospective study, investigating the number of tick paralysis cases presenting to two emergency and critical care veterinary hospitals in South‐East Queensland, from 2008 to 2021. A total of 10,914 dogs and 3696 cats were included over the course of the study. To assess if the introduction of new generation prophylactics in 2015 has coincided with any variation in case numbers, data for each species were analysed graphically and numerically in the first instance, then interrupted time series analyses were performed for the dog and cat data independently. Results: Accounting for seasonal and climatic variation, we estimated a 54.8% reduction in dog (95% CI 45.3%–62.7%) and 44% reduction in cat (95% CI 19.5%–46%) tick paralysis cases presenting to these two clinics. This reduction corresponded with the timing of new generation prophylactic agents being introduced, including isoxazolines and imidacloprid/flumethrin impregnated collars. Conclusion: In the population studied, a significant reduction in the incidence of tick paralysis cases treated by veterinarians has occurred from 2015 onwards and was found to be associated with the timing of the release of new generation acaricidal products. [ABSTRACT FROM AUTHOR]

Disease categories included: S ( I n i = 459, 29.8%); U ( I n i = 211, 13.7%); CV ( I n i = 52, 3.4%); M ( I n i = 817, 53.1%). EVALUATING THE EFFICACY OF SHELF STABLE BLOOD PRODUCTS FOR RESUSCITATION IN A CANINE HEMORRHA... Ryan M SP 1 sp , Ford R SP 2 sp , Hall K SP 1 sp , Venn E SP 3 sp , Hoareau G SP 2,4 sp SP 1 sp Colorado State University, Fort Collins, Colorado, USA SP 2 sp University of Utah, Salt Lake City, Utah, USA SP 3 sp U.S. Army Institute for Surgical Research, San Antonio, Texas, USA SP 4 sp The Nora Eccles-Harrison Cardiovascular and Research Training Institute, University of Utah, School of Medicine, Salt Lake City, Utah, USA B Introduction b : Hemorrhagic shock is a significant cause of morbidity and mortality in canine trauma patients. Listing of Small Animal IVECCS Abstracts (in alphabetical order of presenter) ORAL PRESENTATIONS POINT-OF-CARE FELINE SERUM AMYLOID A AND FSAA:ALBUMIN RATIO IN CATS Allen AA, Destefano IM, Rozanski EA Tufts University, Cummings School of Veterinary Medicine, Grafton, Massachusetts, USA B Introduction b : Feline serum amyloid A (fSAA) is an inflammatory biomarker that increases early in a variety of diseases. Seventy-eight dogs received treatment for hypocoagulability and hemorrhage including transfusion of packed red blood cells ( I n i = 45), plasma products ( I n i = 28), or fresh whole blood ( I n i = 6); administration of tranexamic acid ( I n i = 37); and surgical hemostasis ( I n i = 21). [Extracted from the article]

Acute abdominal pain (colic) is one of the major equine health threats worldwide and often necessitates intensive veterinary medical care and surgical intervention. Equine coronavirus (ECoV) infections can cause colic in horses but are rarely considered as a differential diagnosis. To determine the frequency of otherwise undetected ECoV infections in horses with acute colic, fresh fecal samples of 105 horses with acute colic and 36 healthy control horses were screened for viruses belonging to the Betacoronavirus 1 species by RT-PCR as well as for gastrointestinal helminths and bacteria commonly associated with colic. Horses with colic excreted significantly fewer strongyle eggs than horses without colic. The prevalence of anaerobic, spore-forming, gram-positive bacteria (Clostridium perfringens and Clostridioides difficile) was significantly higher in the feces of horses with colic. Six horses with colic (5.7%) and one horse from the control group (2.8%) tested positive for Betacoronaviruses. Coronavirus-positive samples were sequenced to classify the virus by molecular phylogeny (N gene). Interestingly, in three out of six coronavirus-positive horses with colic, sequences closely related to bovine coronaviruses (BCoV) were found. The pathogenic potential of BCoV in horses remains unclear and warrants further investigation. [ABSTRACT FROM AUTHOR]

The article discusses a rare case of protruding type thrombus on the left ventricle free wall in Labrador Retriever dogs. The study conducted in India highlights the diagnosis and treatment of this unusual condition in two Labrador dogs with dilated cardiomyopathy. The authors emphasize the importance of ruling out intra-cardiac thrombi in cases of respiratory distress and cardiac issues using echocardiography. The article provides insights into the diagnosis, treatment, and management of this rare condition in dogs, shedding light on a unique aspect of veterinary cardiology. [Extracted from the article]

Objective: To evaluate the reporting of key items associated with risk of bias and weak study design over a 10‐year period. Design: Literature survey. Setting: Not applicable. Animals: Not applicable. Interventions: Papers published in the Journal of Veterinary Emergency and Critical Care between 2009 and 2019 were screened for inclusion. Inclusion criteria consisted of prospective experimental studies describing in vivo or ex vivo research (or both), containing at least 2 comparison groups. Identified papers had identifying information (publication date, volume and issue, authors, affiliations) redacted by an individual not involved with paper selection or review. Two reviewers independently reviewed all papers and applied an operationalized checklist to categorize item reporting as fully reported, partially reported, not reported, or not applicable. Items assessed included randomization, blinding, data handling (inclusions and exclusions), and sample size estimation. Differences in assessment between reviewers were resolved by consensus with a third reviewer. A secondary aim was to document availability of data used to generate study results. Papers were screened for links to access data in the text and supporting information. Measurements and Main Results: After screening, 109 papers were included. Eleven papers were excluded during full‐text review, with 98 papers included in the final analysis. Randomization was fully reported in 31.6% of papers (31/98). Blinding was fully reported in 31.6% of papers (31/98). Inclusion criteria were fully reported in all papers. Exclusion criteria were fully reported in 60.2% of papers (59/98). Sample size estimation was fully reported in 8.0% of papers (6/75). No papers (0/99) made data freely available without a requirement to contact study authors. Conclusions: There is substantial room for improvement in reporting of randomization, blinding, data exclusions, and sample size estimations. Evaluation of study quality by readers is limited by the low reporting levels identified, and the risk of bias present indicates a potential for inflated effect sizes. [ABSTRACT FROM AUTHOR]

The article focuses on the RECOVER Initiative's release of updated CPR guidelines for veterinary medicine, aiming to improve survival outcomes for veterinary patients through evidence-based protocols. Topics include enhanced chest compression techniques for small animals, revised breathing support methods for non-intubated patients, and updated medication dosages and CPR procedures to optimize care during emergencies.

Objective: To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. Design: Multi‐institutional registry data report, April 1, 2017 to December 31, 2019. Setting: VetCOT identified and verified Veterinary Trauma Centers (VTCs). Animals: Dogs and cats with evidence of trauma. Interventions: Data were input to a web‐based data capture system (Research Electronic Data Capture) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type, preadmission care, trauma severity assessment at presentation (modified Glasgow Coma Scale and Animal Trauma Triage score), key laboratory parameters, interventions, and case outcome were collected. Summary descriptive data for each species are reported. Measurements and Main Results: Thirty‐one VTCs contributed data from 20,842 canine and 4003 feline trauma cases during the 33‐month reporting period. Most cases presented directly to a VTC (82.1% dogs, 82.1% cats). Admission to hospital rates were slightly lower in dogs (27.8%) than cats (32.7%). Highest mortality rates by mechanism of injury in dogs were struck by vehicle (18.3%), ballistic injury (17.6%), injured inside vehicle (13.2%), nonpenetrating bite wound (10.2%), and choking/pulling injury (8.5%). Highest mortality rates by mechanism of injury in cats were struck by vehicle (43.3%), ejected from vehicle (33.3%), nonpenetrating bite wound (30.7%), ballistic injury (27.8%), and choking/pulling injury (25.0%). The proportion of animals surviving to discharge was 93.1% (dogs) and 82.5% (cats). Conclusions: The VetCOT registry is a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. Overall survival to discharge was high indicating low injury severity for most recorded cases. Further evaluation of data on subsets of injury types, patient assessment parameters, interventions, and associated outcome are warranted. Data from the registry can be leveraged to inform clinical trial design and justification for naturally occurring trauma as a translational model to improve veterinary and human trauma patient outcome. [ABSTRACT FROM AUTHOR]

Background: The effect of intravenous fluid (IVF) administration during cardiopulmonary resuscitation (CPR) is an unexplored factor that may improve cardiac output (CO) during CPR. The aim of this study was to determine the effect of IVF administration on CO and oxygenation during CPR. Methods: This experimental animal study was performed in a critical care animal laboratory. Twenty-two Landrace-Yorkshire female piglets weighing 27–37 kg were anesthetized, intubated, and placed on positive pressure ventilation. Irreversible cardiac arrest was induced with bupivacaine. CPR was performed with a LUCAS 3 mechanical compression device. Pigs were randomized into IVF or no-IVF groups. Pigs in the IVF group were given 20 mL/kg of Plasma-Lyte (Baxter International, Deerfield, IL USA), infused from 15 to 35 min of CPR. CPR was maintained for 50 min with serial measurements of CO obtained using ultrasound dilution technology and partial pressure of oxygen (PaO2). Results: A mixed-effects repeated measures analysis of variance was used to compare within-group, and between-group mean changes in CO and PaO2 over time. CO and PaO2 for the piglets were measured at 10-min intervals during the 50 min of CPR. CO was greater in the IVF compared with the control group at all time points during and after the infusion of the IVF. Mean PaO2 decreased with time; however, at no time was there a significant difference in PaO2 between the IVF and control groups. Conclusions: Administration of IVF during CPR resulted in a significant increase in CO during CPR both during and after the IVF infusion. There was no statistically significant decrease in PaO2 between the IVF and control groups. [ABSTRACT FROM AUTHOR]

Intensive Care Units (ICU) usually provide an excellent environment for the selection of pathogens associated with hospital-acquired infections (HAI), leading to increased mortality and hospitalization costs. Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is a major cause of HAI in dogs worldwide, but the risk factors and dynamics of colonization by MRSP are largely unknown. This study aimed to evaluate the risk factors associated with the acquisition of MRSP in dogs admitted to an ICU, and to report the antimicrobial resistance profiles and genetic relatedness of MRSP isolates. Sterile swabs from the nostril, axilla, and rectum were collected daily during the hospitalization of 54 dogs. Samples were subjected to Mannitol Salt Agar, and colonies were identified by MALDI-ToF, polymerase chain reaction (PCR), and sequencing of the rpoB gene. Antimicrobial susceptibility testing and PCR detection of mecA were performed. Staphylococcus spp. was isolated from 94% of the dogs, and the most frequently isolated species was S. pseudintermedius (88.2%). Carriage of multidrug resistant (MDR) staphylococci was observed in 64.4% of the dogs, and approximately 39% had methicillin-resistant Staphylococcus sp. (MRS), of which 21.6% had MRSP and 1.9% had methicillin-resistant S. aureus (MRSA). The acquisition of MRSP during ICU hospitalization was associated with sex (female), age (>7 years), and dogs that had previously been treated with antimicrobials. Animals colonized by MRSP resistant to ≥9 antimicrobial classes had longer hospital stays than those colonized by other MRS strains. Among the 13 MRSP isolates that were subjected to whole-genome sequencing, ten were classified as ST71. A single nucleotide polymorphism (SNP) analysis revealed three clones, including one that was detected in infected dogs outside the ICU. This study indicates novel risk factors associated with colonization by MRSP. The detection of the same MRSP clone causing HAI outside the ICU reinforces the need for improved infection prevention and control practices at veterinary hospitals in general and at the ICU in particular. [ABSTRACT FROM AUTHOR]

Improvement science must therefore be incorporated into veterinary education and training programs to better prepare veterinary professionals to deliver care safety and effectively in increasingly complex care delivery environments. Keywords: medical errors; patient safety; quality improvement; safety culture; systems-based approach EN medical errors patient safety quality improvement safety culture systems-based approach 11 15 5 01/27/23 20230101 NES 230101 ABBREVIATIONS HAC hospital-acquired conditions SSC surgical safety checklist WHERE WE ARE Let's start with the bad news: medical errors occur frequently in veterinary medicine. The JVECC Quality Improvement and Patient Safety feature will be a key contribution to building our collective knowledge base in patient safety and quality improvement. Therefore, veterinary professionals can look confidently to our human counterparts to inspire our basic quality tenets and the initial actions that will result in safer care delivery for our patients. [Extracted from the article]

OBJECTIVE: To examine factors that impact emergency veterinarians' decisions in selecting a place of employment and their perceptions of factors important in fostering a work environment conducive to long-term employment. SAMPLE: 433 Veterinary Information Network members who reported practicing emergency medicine in the US and were not diplomates of the American College of Veterinary Emergency and Critical Care. PROCEDURES: An electronic survey distributed via the Veterinary Information Network data collection portal, made available from May 25, 2022, through June 15, 2022. RESULTS: Factors rated as most important in selecting a place of employment included working with a highly trained support staff and collegiality of coworkers. Factor analysis was used to extract factors that can influence emergency medicine practitioners' views of a work environment conducive to long-term employment. The factor found to be most important was leadership. All factors, except for professional growth, were rated as more important by female practitioners when compared to male practitioners. CLINICAL RELEVANCE: Aspects promoted in emergency medicine veterinarian recruitment efforts should include, in addition to the innate nature of the position, the elements identified as most attractive to current practitioners. By better understanding the impact of gender, children status, and years practicing emergency medicine on the relative importance in creating workplace environments conducive to long term employment, hospitals can be better equipped to meet the needs of both their current employees as well as potential new hires. [ABSTRACT FROM AUTHOR]

This article, published in Equine Veterinary Education, explores the effects of hand-walking exercise on intestinal motility in horses. Hand-walking is commonly used to improve gastrointestinal motility in horses after gastrointestinal surgery. The study involved eight healthy adult horses and used auscultation, transabdominal ultrasonography, and multi-channel electrointestinography (EIG) to measure intestinal motility. The results showed that hand-walking did not have a significant effect on intestinal contractility, slow wave activity, or rhythmicity. Therefore, the study suggests that hand-walking may not be an effective strategy to increase intestinal motility in horses. [Extracted from the article]

Dr. Kari Elaine Moore, a Veterinary Emergency and Critical Care diplomate, passed away after an 18-month battle with T-cell prolymphocytic leukemia. She was a strong advocate for promoting high standards of veterinary care and had an impressive career, including completing a residency in Small Animal Emergency and Critical Care at Tufts University and serving as a Regional Medical Director for multiple hospitals. Dr. Moore was also passionate about teaching and mentoring, and she was deeply respected as a member of the VCA Regional Medical Director team. She faced her cancer diagnosis with bravery and used her scientific training to document her care and treatment. Dr. Moore is survived by her husband, parents, sister, and many loved ones. She will be remembered for her generosity, vibrant spirit, and dedication to others. [Extracted from the article]

Objectives: To describe the perceived prevalence of zoological companion animal (ZCA) species being evaluated and treated by American College of Veterinary Emergency and Critical Care (ACVECC) diplomates and Emergency and Critical Care (ECC) residents in an emergency room (ER) setting and to assess potential interest in further training for the ACVECC community in the emergency treatment and stabilization of these species. Design: Internet-based survey. Subjects: One hundred and thirty-nine ACVECC diplomates and ECC residents. Procedure: An online survey was designed and administered to assess the perceived prevalence of ZCA species that were evaluated and treated in the veterinary ER and to gauge potential interest in advanced training opportunities in the emergency treatment of these patients. Results: One hundred and fifteen (83%) respondents reported that their hospital offered veterinary services to ZCA species during business hours and 120 (86%) reported that they offered veterinary services toZCAspecies during off-hours. Ninetyone (65%) respondents reported that ZCA patients were evaluated and treated through their ER with small mammals (n = 60/91 [66%]) and small birds (n = 48/91 [53%]) being the most common species presented. In hospitals with an available ZCA specialist (80/139 [56%]), primary case responsibility was maintained by the ZCA specialist 24-7 in 11 of 91 (14%) hospitals. Seventy-three (53%) ACVECC diplomate and ECCresident survey respondents reported clinical training specific toZCAspecies during veterinary school. A total of 84 of 139 (60%) survey respondents expressed interest in further training regarding ZCA species, with 73 of 84 (87%) those individuals specifying interest or potential interest in a formal ACVECC certificate or other type of advanced training. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of sex and neuter status on trauma survival in dogs. Design: Multi-institutional prospective case series, September 2013 to March 2019, retrospectively analyzed. Setting: Level I and II Veterinary Trauma Centers. Animals: Consecutive sample of 2649 dogs in the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma patient registry meeting inclusion criteria. For inclusion, dogs had to have complete data entries, be postpubertal (≥7 months age in females and ≥10 months age in males), and have sustained moderate to severe trauma (animal trauma triage [ATT] score ≥5/18). Dogs that were dead upon arrival, euthanized for financial or unknown reasons alone, or thatwere presented by a Good Samaritan but subsequently humanely euthanized were excluded. Measurements and Main Results: Data collected included age, sex, neuter status (intact, neutered), trauma type (blunt, penetrating, both), outcome (survived to hospital discharge, died, euthanized), and reason for euthanasia (grave prognosis, financial reasons, or both). Of 2649 eligible dogs, 56% survived to hospital discharge (n=1469). Neutered females had a significantly higher survival rate (58.3% vs 51.3%; P = 0.03) compared to intact females, and neutered males had a significantly higher survival rate (56.6% vs 50.7%; P = 0.04) compared to intact males. There was no significant difference in survival between intact females and intact males (P = 0.87) or between neutered females and neutered males (P = 0.46). Mean cumulative ATT score was higher in intact groups and was found to be a significant predictor of survival (P<0.01). Based on logistic models, overall odds of survival were 20.7% greater in neutered dogs. Conclusions: Gonadectomy is associated with lower ATT scores and improved survival after moderate to severe trauma in both female and male dogs. [ABSTRACT FROM AUTHOR]

Objective: To identify the most common practices of Diplomates of the American College of Veterinary Emergency and Critical Care (DACVECCs) as they relate to the recognition and treatment of hypotension in dogs and cats, particularly concerning the use of vasopressors in vasodilatory shock states. Design:Asurvey regarding vasopressor use was sent to all activeDACVECCs using the Veterinary Information Network. Questions focused on respondent characteristics, method of recognition of hypotension, triggers for initiation of vasopressor therapy, first- and second-line vasopressor choice, and methods of determining response to therapy. Subjects: A total of 734 DACVECCs were invited to participate, and 203 Diplomates (27.7%) completed the survey. Results: For both dogs and cats, the most common first-line vasopressor was norepinephrine (87.9% in dogs and 83.1% in cats). The most common second-choice vasopressor was vasopressin (44.2% in dogs and 39.0% in cats). Cutoff values for initiating vasopressor therapy varied between species and modality used for blood pressure measurement. In general, most DACVECCs chose to initiate vasopressor therapy at a Doppler blood pressure <90mmHg or amean arterial pressure of <60 or <65 mm Hg when using oscillometric or direct arterial blood pressure measurements in dogs and cats. Conclusions: Most DACVECCs adhere to published human guidelines when choosing a first-line vasopressor. However, there is significant variability in blood pressure measurement technique, cutoffs for initiation of vasopressor use, and choice of second-line vasopressors. [ABSTRACT FROM AUTHOR]

Objectives: To identify demographic information, epidemiological factors, and clinical abnormalities that differentiate cats with severe trauma, defined as an Animal Trauma Triage Score (ATTS) ≥3 from those withmild injury (ATTS 0-2). Design: Multicenter observational study utilizing data from the American College of Veterinary Emergency and Critical Care (ACVECC) Veterinary Committee on Trauma (VetCOT) registry. Setting: ACVECC VetCOT Veterinary Trauma Centers. Animals: A total of 3859 cats with trauma entered into the ACVECC VetCOT registry between April 1, 2017 and December 31, 2019. Interventions: None Measurements and Main Results: Cats were categorized by ATTS 0-2 (mild, 65.1%) and≥3 (severe, 34.9%). There was no age difference between categories. Male animals, particularly intact animals, were overrepresented. Blunt trauma was more common than penetrating, with blunt trauma and a combination of blunt and penetrating trauma being more common in the severe trauma group. While 96.6% of cats with ATTS 0-2 survived to discharge, only 58.5% with ATTS ≥3 survived. Only 46.8% of cats with severe trauma had a point-of-care ultrasound performed, of which 8.9% had free abdominal fluid noted. Hospitalization and surgical procedures were more common in the severe trauma group. Transfusions occurred more frequently in the severe trauma group but only in 4.1% of these cats. Other than ionized calcium, all recorded clinicopathological data (plasma lactate, base excess, PCV, total plasma protein, blood glucose) differed between groups. Conclusion: Feline trauma patients with an ATTS ≥3 commonly present to Veterinary Trauma Centers and have decreased survival to discharge compared to patients with ATTS 0-2. Differences exist between these groups, including an increased frequency of blunt force trauma (particularly vehicular trauma), head and spinal trauma, and certain clinicopathological changes in the ATTS ≥3 population. Relatively low incidences of point-of-care ultrasound evaluation and transfusions merit further investigation. [ABSTRACT FROM AUTHOR]

A RETROSPECTIVE ANALYSIS OF HEAD INJURY AND TRAUMATIC BRAIN INJURY IN CANINE TRAUMA PATIENTS B Sauerwein LK SP 1 sp , Tucker CD SP 2 sp , Rao S SP 2 sp , Hall KE SP 2 sp b I SP 1 sp College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA i I SP 2 sp Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA i B Introduction b : Head injury is common in canine trauma patients, but the epidemiology is poorly described. There were no significant differences found in esophageal (6.5 [1-96] vs. 7.5 [2-144], I P i = 0.56), gastric (1086 [907-5473] vs. 2293 [1065-10,414], I P i = 0.06), intestinal (1399 [1194-2406] vs. 1535 [928-2541], I P i = 0.92), and total GI transit times (3075 [2244-6674] vs. 3676 [2191-11,486], I P i = 0.06) between SAL and MET treatments, respectively. AKI (OR: 3.97; CI, 1.71-9.24; I P i = 0.0014), stupor/coma (OR: 8.43; CI, 1.33-53.25; I P i = 0.0234), PT (OR: 1.20; CI, 1.00-1.44; I P i = 0.0437), and BE (OR: 0.93; CI, 0.87-0.99; I P i = 0.0472) were the only variables retained in the multivariate model. PREVALENCE OF AZOTEMIA AND ITS ASSOCIATION WITH SEVERITY AND OUTCOME IN VETERINARY TRAUMA PAT... B Stacey EJ, Cortellini S, Cole LP b I Department of Clinical Science and Services, The Royal Veterinary College, Potters Bar, UK i B Introduction b : Acute kidney injury (AKI) is a common sequela to human trauma occurring in up to 25% of trauma patients with 10% of these requiring renal replacement therapy. [Extracted from the article]

Sepsis is the leading cause of critical illness and mortality in human beings and animals. Neutrophils are the primary effector cells of innate immunity during sepsis. Besides degranulation and phagocytosis, neutrophils also release neutrophil extracellular traps (NETs), composed of cell-free DNA, histones, and antimicrobial proteins. Although NETs have protective roles in the initial stages of sepsis, excessive NET formation has been found to induce thrombosis and multiple organ failure in murine sepsis models. Since the discovery of NETs nearly a decade ago, many investigators have identified NETs in various species. However, many questions remain regarding the exact mechanisms and fate of neutrophils following NET formation. In humans and mice, platelet-neutrophil interactions via direct binding or soluble mediators seem to play an important role in mediating NET formation during sepsis. Preliminary data suggest that these interactions may be species dependent. Regardless of these differences, there is increasing evidence in human and veterinary medicine suggesting that NETs play a crucial role in the pathogenesis of intravascular thrombosis and multiple organ failure in sepsis. Because the outcome of sepsis is highly dependent on early recognition and intervention, detection of NETs or NET components can aid in the diagnosis of sepsis in humans and veterinary species. In addition, the use of novel therapies such as deoxyribonuclease and non-anticoagulant heparin to target NET components shows promising results in murine septic models. Much work is needed in translating these NET-targeting therapies to clinical practice.

The European Veterinary Emergency and Critical Care Society (EVECCS) and the European College of Veterinary Emergency and Critical Care (ECVECC) announce the passing of Fabio Viganó, a highly respected member and leader in the field of veterinary emergency and critical care. Fabio, who battled illness for over six years, was known for his positive attitude and dedication to his work. He was a founding member and president of several veterinary societies in Italy, and his expertise and passion for education made him a key figure in the European veterinary community. Fabio's colleagues remember him as a mentor and a friend, and he will be greatly missed. He is survived by his wife and children. [Extracted from the article]

This article is a tribute to Jennifer J. Devey, a prominent figure in the field of veterinary emergency and critical care. After graduating from Ontario Veterinary College, she pursued a career in mixed animal practice before discovering her passion for ECC, particularly surgical emergencies and trauma. She became certified in ACVECC in 1996 and continued her learning journey by completing a surgical residency. Jen was also known for her enthusiasm for teaching and was involved in various educational initiatives, including serving as the Lab Coordinator for IVECCS. She was recognized for her exceptional commitment and contributions to the specialty of veterinary emergency and critical care. Outside of her professional life, Jen was involved in competitive sports, bird watching, gardening, and sailing. Her pursuit of knowledge and love for teaching had a significant impact on the veterinary profession. [Extracted from the article]

Background: Volume expansion and vasopressors for the treatment of shock is an intensive process that requires frequent assessments and adjustments. Strict blood pressure goals in multiple physiologic states of shock (traumatic brain injury, sepsis, and hemorrhagic) have been associated with improved outcomes. The availability of continuous physiologic data is amenable to closed-loop automated critical care to improve goal-directed resuscitation. Methods: Five adult swine were anesthetized and subjected to a controlled 30% estimated total blood volume hemorrhage followed by 30 min of complete supra-celiac aortic occlusion and then autotransfusion back to euvolemia with removal of aortic balloon. The animals underwent closed-loop critical care for 255 min after removal of the endovascular aortic balloon. The closed-loop critical care algorithm used proximal aortic pressure and central venous pressure as physiologic input data. The algorithm had the option to provide programmatic control of pumps for titration of vasopressors and weight-based crystalloid boluses (5 ml/kg) to maintain a mean arterial pressure between 60 and 70 mmHg. Results: During the 255 min of critical care the animals experienced hypotension (< 60 mmHg) 15.3% (interquartile range: 8.6–16.9%), hypertension (> 70 mmHg) 7.7% (interquartile range: 6.7–9.4%), and normotension (60–70 mmHg) 76.9% (interquartile range: 76.5–81.2%) of the time. Excluding the first 60 min of the critical care phase the animals experienced hypotension 1.0% (interquartile range: 0.5–6.7%) of the time. Median intervention rate was 8.47 interventions per hour (interquartile range: 7.8–9.2 interventions per hour). The proportion of interventions was 61.5% (interquartile range: 61.1–66.7%) weight-based crystalloid boluses and 38.5% (interquartile range: 33.3–38.9%) titration of vasopressors. Conclusion: This autonomous critical care platform uses critical care adjuncts in an ischemia–reperfusion injury model, utilizing goal-directed closed-loop critical care algorithm and device actuation. This description highlights the potential for this approach to deliver nuanced critical care in the ICU environment, thereby optimizing resuscitative efforts and expanding capabilities through cognitive offloading. Future efforts will focus on optimizing this platform through comparative studies of inputs, therapies, and comparison to manual critical care. [ABSTRACT FROM AUTHOR]

Objectives: To systematically review available evidence and establish guidelines related to the use of thrombolytics for the management of small animals with suspected or confirmed thrombosis. Design: PICO (Population, Intervention, Control, and Outcome) questions were formulated, and worksheets completed as part of a standardized and systematic literature evaluation. The population of interest included dogs and cats (considered separately) and arterial and venous thrombosis. The interventions assessed were the use of thrombolytics, compared to no thrombolytics, with or without anticoagulants or antiplatelet agents. Specific protocols for recombinant tissue plasminogen activator were also evaluated. Outcomes assessed included efficacy and safety. Relevant articles were categorized according to level of evidence, quality, and as to whether they supported, were neutral to, or opposed the PICO questions. Conclusions from the PICO worksheets were used to draft guidelines, which were subsequently refined via Delphi surveys undertaken by the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) working group. Results: Fourteen PICO questions were developed, generating 14 guidelines. The majority of the literature addressing the PICO questions in dogs is experimental studies (level of evidence 3), thus providing insufficient evidence to determine if thrombolysis improves patient‐centered outcomes. In cats, literature was more limited and often neutral to the PICO questions, precluding strong evidence‐based recommendations for thrombolytic use. Rather, for both species, suggestions are made regarding considerations for when thrombolytic drugs may be considered, the combination of thrombolytics with anticoagulant or antiplatelet drugs, and the choice of thrombolytic agent. Conclusions: Substantial additional research is needed to address the role of thrombolytics for the treatment of arterial and venous thrombosis in dogs and cats. Clinical trials with patient‐centered outcomes will be most valuable for addressing knowledge gaps in the field. [ABSTRACT FROM AUTHOR]