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Objective: To use a point-of-care viscoelastic coagulation monitoring device (VCM-Vet; Entegrion) and traditional tests to assess hemostatic changes during hemorrhagic shock in dogs., Methods: 8 healthy, purpose-bred Beagles were enrolled in a hemorrhagic shock model conducted from September through December 2021. Dogs were anesthetized, had baseline hemostatic variables measured after blood pressure was stabilized at 70 to 80 mm Hg for 10 minutes (T1), had blood withdrawn from a jugular vein to achieve a mean blood pressure of 40 ± 5 mm Hg for 10 minutes (T2), were resuscitated with 100% shed blood, and then had hemostatic variables evaluated 10 minutes later (T3). At each time point, hemostatic variables were measured with traditional tests (Hct, WBC count, platelet count, mean platelet volume, prothrombin time, activated partial thromboplastin time [aPTT], and concentrations of fibrinogen, antithrombin, and D-dimer) and the VCM-Vet device (clot time, clot formation time, α-angle, maximum clot formation, amplitude at 10 minutes [A10], amplitude at 20 minutes [A20], clot lysis index at 30 minutes [LI30], and clot lysis index at 45 minutes [LI45])., Results: All dogs survived without complication. At T2 and T3 (vs T1), samples had significantly higher coagulability (increased median α-angle, A10, and A20) and fibrinolysis (decreased median LI30 and LI45) and significantly longer aPTT; however, all values remained within reference limits., Conclusions: The use of VCM-Vet helped identify complex hemostatic disturbances in dogs with hemorrhagic shock., Clinical Relevance: The use of VCM-Vet shows promise in aiding veterinarians in optimizing resuscitation strategies based on real-time clotting data.

Background: Accurate assessment of intravascular volume is critical for precise fluid prescription. In people, bedside or point of care ultrasound is used to measure the inferior vena cava, with or without paired aortic measurement, to estimate intravascular volume., Objective: To determine if point of care ultrasound measurement of the caudal vena cava (CVC) diameter or the CVC diameter to the abdominal aorta (Ao) diameter (CVC:Ao) at the paralumbar view are associated with changes in intravascular volume, mean arterial pressure (MAP), or cardiac output in normovolemic and hypovolemic dogs., Animals: 8 purpose-bred dogs., Methods: Pressure-targeted hemorrhagic shock was induced in purpose-bred dogs under general anesthesia. Dogs were exsanguinated to a mean arterial pressure of 40 mmHg, or a maximum 60% blood volume lost, then auto-transfused shed blood. At a left paralumbar view, longitudinal plane measurements of the abdominal CVC diameter and aortic diameter were obtained. Measurements were performed at 4 timepoints: baseline under anesthesia (TP1), after hemorrhagic shock was induced (TP2), after ½ of shed blood had been re-transfused (TP3), and post-resuscitation with completed re-transfusion (TP4). Additional variables collected included cardiac output using thermodilution and arterial blood pressure., Results: CVC:Ao was not significantly different between timepoints and was not associated with changes in CO ( p  = 0.28) or MAP ( p  = 0.50). CVC diameter was significantly different between baseline (TP1) and hemorrhagic shock (TP2). CVC diameter was significantly different at TP2 compared to TP1 after controlling for the effect of CO ( p  = 0.03) and MAP ( p  = 0.001). Aortic diameter was also significantly different at TP2 ( p  = 0.002, p = 0.001) and TP3 ( p  = 0.023, p  = 0.017) compared to TP1 after controlling for CO and MAP., Conclusions and Clinical Importance: Obtaining point of care ultrasound images for CVC:Ao measurement was feasible. With a marked decrease in intravascular volume, both CVC and Ao diameter decreased, resulting in an unchanged CVC:Ao. Despite changes in CVC and Ao diameters, these changes were not associated with measured changes in CO, emphasizing that CO is not a direct estimate of intravascular volume and is affected by many compensatory mechanisms. Additional studies are needed to determine the most accurate method for bedside measurement of intravascular volume status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cardillo, Zersen and Cavanagh.)

Objective: To describe the use of a novel wound dressing that delivers nitric oxide (NO) to naturally occurring traumatic wounds in dogs., Animals: 24 client-owned dogs with 30 wounds., Methods: Dogs were presented with acute traumatic wounds requiring open wound management. Wounds were bandaged with a novel NO wound dressing and reassessed as needed for continued open wound management until wounds healed by second intention or wound closure was recommended. Dogs could be removed from the study at any point at the clinician's discretion., Results: All wounds had the novel NO wound dressing used during open wound management until wound closure was recommended. Median time to wound closure was 6 days (range, 2 to 42). There were no complications directly attributed to the use of the novel wound dressing that clinically affected the dogs. Three wounds dehisced following wound closure. Wound healing was confirmed in 19 dogs with 25 wounds, with 3 dogs lost to follow-up prior to suture removal. Only 7.1% of wounds had clinical signs consistent with wound infection following wound closure., Clinical Relevance: The novel NO wound dressing was easy to use and well tolerated in dogs with naturally occurring traumatic wounds. It can be used throughout all phases of wound healing, simplifying open wound management.

Objective: To determine if tissue oxygen saturation (StO2) correlates with oxygen delivery (DO2) and/or cardiac output (CO) in a canine hemorrhagic shock model., Animals: 8 healthy purpose-bred dogs., Methods: Dogs were anesthetized, and hemorrhagic shock was induced by withdrawing up to 60% of total blood volume, targeting a mean arterial pressure (MAP) of 40 mm Hg. The withdrawn blood was returned to the patient in 2 equal aliquots. Data was collected at 4 time points: 10 minutes after MAP was stabilized under anesthesia (time point [TP]-1), 10 minutes after up to 60% of blood volume was removed to target a MAP of 40 mm Hg (TP2), 10 minutes after the return of 50% of shed blood (TP3), and 10 minutes after the return of the remaining 50% of shed blood (TP4). Total blood volume withdrawn, StO2, CO, heart rate, and MAP were recorded, and DO2 was calculated at each TP., Results: Mean StO2 significantly decreased between TP1 (77.8% [± 9.54]) and TP2 (44.8% [± 19.5]; P < .001 vs TP1). Mean StO2 increased to 63.1% (± 9.85) at TP3, but remained significantly lower compared to TP1 (P = .002). There was no difference between mean StO2 at TP4 (82.5% [± 12.6]) versus TP1 (P = .466). StO2 has a strong, positive correlation to both CO (r = 0.80; P < .001) and DO2 (r = 0.75; P < .001)., Clinical Relevance: A decrease in StO2 may be used in conjunction with physical examination findings and diagnostic parameters to support a diagnosis of shock. The return of shed blood was correlated with increases in StO2, DO2, and CO, suggesting that StO2 may be used as a marker of adequate resuscitation.

Objective: To identify risk factors associated with peripheral intravenous catheter (PIVC) complications in cats hospitalized in the critical care unit (CCU)., Animals: 120 cats admitted to the CCU between October 2022 and September 2023., Methods: This prospective, observational study was performed at a single veterinary teaching hospital. Cats hospitalized in the CCU for ≥ 24 hours were evaluated for enrollment. Peripheral intravenous catheters were placed by trained personnel following a standardized protocol and monitored for complications. PIVC complications were classified as extravasation, phlebitis, dislodgement, occlusion, line breakage, or patient removal., Results: Median PIVC dwell time was 42.25 hours (range, 24.25 to 164.25 hours). Overall PIVC complication rate was 18.3% (22/120), with extravasation (7/120 [5.8%]) and dislodgement (7/120 [5.8%]) being the most frequently recorded complications. Multivariable analysis identified that for each kilogram increase in body weight there is a higher likelihood of a PIVC complication (OR, 1.46; 95% CI, 1.03 to 2.05; P = .03). Additionally, use of a larger-gauge (20-gauge vs 22-gauge) PIVC is associated with a significantly lower likelihood of a PIVC complication (OR, 0.13; 95% CI, 0.03 to 0.56; P = .006)., Clinical Relevance: These results suggest that smaller-gauge (22-gauge) PIVCs and greater body weights are associated with an increased risk of complications in cats hospitalized in the CCU. When possible, a larger-gauge (20-gauge) PIVC should be placed in cats admitted to the CCU.

The purpose of this study was to evaluate plasma ondansetron (OND) concentrations in a population of dogs with naturally occurring nausea after oral OND administration. Twenty-four dogs were randomly assigned to receive one of the following doses of oral OND: 0.5 mg/kg q8h, 0.5 mg/kg q12h, 1 mg/kg q8h, or 1 mg/kg q12h. Blood samples for plasma OND measurements were collected at baseline and 2, 4, and 8 h after administration of the first dose of OND. OND concentrations averaged over an 8 h time period were not significantly different between dose groups (0.5 mg/kg group: median 8.5 ng/mL [range 1-96.8 ng/mL], 1 mg/kg group: median 7.4 ng/mL [range 1-278.7 ng/mL]). The mean maximum concentrations in the 0.5 mg/kg and 1 mg/kg groups were 35.8 ± 49.0 ng/mL and 63.3 ± 121.1 ng/mL, respectively. OND concentrations were below the lower limit of quantification (LLOQ) in 50% (18/36) of samples in the 0.5 mg/kg groups and 39% (14/36) of samples in the 1 mg/kg groups. Six dogs (6/24, 25%) did not have OND detected at any time. The mean nausea scores at baseline were similar amongst all groups and decreased over time. The bioavailability of oral OND appears to be poor. Despite low plasma OND concentrations, nausea scores improved over time.

Objective: To assess the agreement between cardiac output (CO) estimated via evaluation of the arterial pressure waveform by a novel monitoring system (Edwards Acumen IQ sensor and HemoSphere Advanced Monitor Platform [HS-IQ]; Edwards LifeSciences) and measured by thermodilution (TD) in anesthetized, normovolemic, and hypovolemic dogs. To assess the agreement between the HS-IQ CO measurements in the radial artery and dorsal metatarsal artery., Animals: 8 purpose-bred Beagles., Methods: Dogs were placed under general anesthesia. CO was measured via TD and via the HS-IQ at radial and dorsal metatarsal arterial catheters. CO measurements were obtained at 4 time points including normovolemic and multiple hypovolemic states. Paired measurements of CO were evaluated via the method of Bland and Altman with acceptable limits of agreement (LOA) defined as < 30%., Results: A total of 24 (dorsal metatarsal) and 21 (radial) paired measurements were collected in 8 dogs. The overall bias (CI) for comparison of TD to radial arterial HS-IQ CO measurements was -0.09 L/min. LOA and proportional LOA were -2.66 to 2.49 L/min and -140.72% to 104.94%. The overall bias (CI) for comparison of TD to dorsal metatarsal arterial HS-IQ CO measurements was -0.26 L/min. LOA and proportional LOA were -2.76 to 2.24 L/min and -135.96% to 93.25%. The overall proportional error for radial arterial was -17.9% and for dorsal metatarsal was -21.4%., Clinical Relevance: CO measurements with the HS-IQ were easy to obtain but did not produce results within a clinically acceptable range for either measurement site, with a very wide LOA. The CO estimations from the HS-IQ are not appropriate for clinical use at this time.

Objective: To define reference intervals (RIs) for arterial blood gas (aBG) measurements in healthy, nonsedated, dolichocephalic, and mesocephalic (nonbrachycephalic) dogs at approximately 1,535 m above sea level and compare these findings with healthy, nonsedated, brachycephalic dogs living at the same altitude., Animals: 120 adult nonbrachycephalic dogs and 20 adult brachycephalic dogs., Methods: Cases were prospectively enrolled from October 2021 to June 2022. Dogs were enrolled from the community or after presentation for wellness examinations or minor injuries including lacerations, nail injuries, and lameness. Physical examinations and systolic blood pressure (sBP) measurements were obtained before blood sample collection. Arterial blood was collected from the dorsal pedal artery or femoral artery. After data collection, brachycephalic dogs underwent pre- and postexercise tolerance assessments., Results: The mean and RI values for arterial pH (7.442; 7.375 to 7.515), partial pressure of oxygen in arterial blood (Pao2; 78.3; 59.2 to 92.7 mm Hg), partial pressure of carbon dioxide in arterial blood (Paco2; 28.0; 21.5 to 34.4 mm Hg), saturation of arterial oxygen (Sao2; 98.4; 84.3% to 101.4%), HCO3 (18.9; 14.9 to 22.4 mmol/L), concentration of total hemoglobin (ctHb; 17.5; 13.4 to 21.1 g/dL), and sBP (133; 94 to 180 mm Hg) were established for healthy nonbrachycephalic dogs at 1,535-m altitude. All aBG measurements were statistically and clinically different from those previously reported for dogs at sea level. Brachycephalic dogs had significantly lower Pao2 and Sao2 (P = .0150 and P = .0237, respectively) and significantly higher ctHb (P = .0396) compared to nonbrachycephalic dogs acclimatized to the same altitude; the nonbrachycephalic RIs were not transferable to the brachycephalic dogs for Pao2., Clinical Relevance: This study represents the first collation of aBG measurements for healthy nonbrachycephalic dogs acclimatized to an altitude of 1,535 m. Additionally, this study identified differences in arterial oxygenation measurements between brachycephalic and nonbrachycephalic dogs. RIs in brachycephalic dogs need to be established.

Objective: To identify risk factors associated with peripheral intravenous catheter (PIVC) complications in dogs hospitalized in the critical care unit (CCU)., Animals: 107 dogs admitted to the CCU between October 2022 and March 2023., Methods: This prospective, observational clinical trial was performed at a single veterinary teaching hospital. Dogs hospitalized in the CCU for at least 24 hours were evaluated for enrollment. PIVC were placed following a standardized protocol and monitored for complications. PIVC complications were classified as extravasation, phlebitis, dislodgement, occlusion, line breakage, or patient removal., Results: Median PIVC dwell time was 46.50 hours (range, 24.25 to 159.25 hours). Overall PIVC complication rate was 12.1% (13/107), with phlebitis (4/107 [3.7%]) and extravasation (4/107 [3.7%]) being the most frequently recorded complications. Multivariable analysis identified increasing length of hospitalization (LOH; OR, 1.43; 95% CI, 1.04 to 1.97; P = .029), an acute patient physiologic and laboratory evaluation full (APPLEFULL) score > 35 (OR, 4.66; 95% CI, 1.09 to 19.90; P = .038), and having 2 PIVCs placed at admission (OR, 10.92; 95% CI, 1.96 to 60.73; P = .006) as risk factors for PIVC complication., Clinical Relevance: Increasing LOH, an APPLEFULL score > 35 and having 2 PIVCs placed at admission were associated with increased odds for PIVC complication in this study. Although these are independent risk factors for PIVC complication, the combination of increasing LOH, an APPLEFULL score > 35, and having 2 PIVCs placed at admission may represent a more severely ill population, drawing attention to a vulnerable group of dogs at risk for PIVC complication.

Objective: To investigate the effects of hemorrhagic shock and fresh whole blood resuscitation on the microcirculation and endothelial glycocalyx using sidestream dark field (SDF) imaging and plasma biomarkers., Animals: 8 purpose-bred dogs., Methods: Pressure-targeted hemorrhagic shock was induced in anesthetized dogs. SDF measurement of perfused boundary region and microcirculatory variables (RBC flow, total vessel density, and relative and absolute capillary blood volume), biomarker measurement (heparan sulfate, hyaluronan, VE-cadherin, and syndecan-1), mean arterial blood pressure, and cardiac output measurement were performed before anesthesia (TP0), after induction (TP1), after hemorrhagic shock (TP2), and after 50% retransfusion (TP3) and 100% retransfusion (TP4)., Results: At TP1, TP2, TP3, and TP4, mean arterial blood pressure was 74.25 ± 7.17 mm Hg, 49.50 ± 13.74 mm Hg, 63.50 ± 13.29 mm Hg, and 71.38 ± 8.77 mm Hg, and cardiac output was 2.57 ± 1.01 L/min, 0.8 ± 0.36 L/min, 1.81 ± 0.57 L/min, and 2.93 ± 1.22 L/min, respectively. Heparan sulfate, hyaluronan, syndecan-1, and VE-cadherin ranges were 24.80 to 77.72 ng/mL, 5.77 to 105.06 ng/mL, below detection to 1,545.69 pg/mL, and 0 to 2.52 ng/mL, respectively. Perfused boundary region, RBC flow, total vessel density, and relative and absolute capillary blood volume ranges were 1.75 to 2.68 µm, 89.6 to 584.5 µm/s, 51.7 to 1,914.3 mm/m2, 0.94 to 1.53 103 μm3, and 1.50 to 94.30 103 μm3, respectively. Heparan sulfate decreased significantly over time (P = .016). No significant differences were found for microcirculatory variables, perfused boundary regions, or other biomarkers., Clinical Relevance: This was the first study to assess microvascular dysfunction and endothelial shedding in a canine hemorrhagic shock model using SDF microscopy (Glycocheck) and plasma biomarkers. Further studies are needed to determine clinical relevance.

The primary goals of positive end-expiratory pressure (PEEP) are to restore functional residual capacity through recruitment and prevention of alveolar collapse. Through these mechanisms, PEEP improves arterial oxygenation and may reduce the risk of ventilator-induced lung injury (VILI). Because of the many potential negative effects associated with the use of PEEP, much research has concentrated on determining the optimal PEEP setting. Arterial oxygenation targets and pressure-volume loops have been utilized to set the optimal PEEP for decades. Several other techniques have been suggested, including the use of PEEP tables, compliance, driving pressure (DP), stress index (SI), transpulmonary pressures, imaging, and electrical impedance tomography. Each of these techniques has its own benefits and limitations and there is currently not one technique that is recommended above all others., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zersen.)

Objective: To determine whether shock index (SI) positively correlates with percentage blood loss and negatively correlates with cardiac output (CO) in a canine hemorrhagic shock model and whether SI and metabolic markers may be used as end point targets for resuscitation., Animals: 8 healthy Beagles., Procedures: Between September and December 2021, dogs underwent general anesthesia for experimental induction of hypotensive shock, with the total volume of blood removed, CO, heart rate, systolic blood pressure, base excess, blood pH, and concentrations of hemoglobin, lactate, ionized calcium recorded, and SI calculated at 4 time points (TPs): after anesthetic induction when the dog had been stable for 10 minutes (TP1), 10 minutes after the mean arterial pressure stabilized to a target of 40 mm Hg following jugular removal of up to 60% blood volume to induce hemorrhagic shock (TP2), 10 minutes after autotransfusion of 50% of the removed blood (TP3), and 10 minutes after autotransfusion of the remaining 50% of the removed blood (TP4)., Results: Mean SI increased between TP1 (1.08 ± 0.35) and TP2 (1.90 ± 0.73) and did not return to the prehemorrhage values for TP3 or TP4. SI correlated positively with percentage blood loss (r = 0.583) and negatively with CO (r = -0.543)., Clinical Relevance: An increase in SI may support diagnosis of hemorrhagic shock; however, SI cannot be used as the sole end point of resuscitation. Significant differences in blood pH, base excess, and lactate concentration suggested they may be useful markers of hemorrhagic shock and need for blood transfusion.

Objective: To report the incidence and type of peripheral intravenous catheter complications in hospitalised dogs., Methods: A prospective, observational trial was performed. Peripheral intravenous catheters were monitored for complications. Complications were documented and classified as extravasation, phlebitis, dislodgement, occlusion and line breakage. If phlebitis was present, the Visual Infusion Phlebitis Scale was used to assign a grade (0 to 5). Fisher's exact test was used to compare the type of complications between the critical care unit and the intermediate care unit. A univariate logistic model was used to compare the incidence of complications between the critical care unit and the intermediate care unit and adjusted odds ratios were used to compare the groups., Results: The incidence of peripheral intravenous catheter complications was 24.2% in the Critical Care Unit and 13.1% in the Intermediate Care Unit, with an overall incidence of 19.9%. Phlebitis was the most common peripheral intravenous catheter complication in the Critical Care Unit, and line breakage was the most common complication in the Intermediate Care Unit. Length of hospitalisation and weight had a significant effect on the likelihood of complication. In a multivariable logistic regression model, the odds of a peripheral intravenous catheter complication was not significantly higher in CCU than IMCU, accounting for length of hospitalisation and weight (adjusted odds ratio, 1.84; 95% confidence interval, 0.98 to 3.48)., Clinical Significance: Peripheral intravenous catheter complications are common in hospitalised dogs and may result in an increased expense for owners, failure to deliver prescribed treatments, venous depletion (lack of peripheral vessels for intravenous catheter placement) and pain experienced by the patient. Techniques to reduce peripheral intravenous catheter complications should be further evaluated and may include the use of peripheral intravenous catheter placement and maintenance checklists, use of force-activated separation devices, or patient sedation., (© 2022 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.)

A 4-year-old dog was evaluated at the Colorado State University Veterinary Teaching Hospital for lethargy and hyporexia of 24 hours duration. On presentation, she had a marked normocytic, normochromic, nonregenerative anemia (HCT 14%; RI 40-55). Her serum iron concentration (1651 μg/dL; RI 73-245) and serum ferritin concentration (1337 ng/mL; RI 89-489) were markedly elevated. Bone marrow aspirate and core biopsy were consistent with a diagnosis of precursor-directed immune-mediate anemia. To the authors' knowledge, these are the highest reported serum iron and ferritin concentrations in a patient with precursor-directed immune-mediate anemia. The iron concentration improved significantly after treatment, supporting the theory that the hyperferremia was due to hemolysis and ineffective erythropoiesis., (© 2022 The Authors. Veterinary Clinical Pathology published by Wiley Periodicals LLC on behalf of American Society for Veterinary Clinical Pathology.)

An 11-year-old spayed female Basset Hound was presented to the Colorado State University Veterinary Teaching Hospital for evaluation of a 7-week history of intermittent collapse, waxing and waning lethargy, and hyporexia. Abdominal ultrasound revealed a 6-mm hypoechoic splenic nodule that, on cytologic evaluation, revealed marked neutrophilic inflammation with intracellular and extracellular bacterial rods frequently producing oval subterminal to terminal endospores, suggestive of Clostridium. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) performed on bacteria isolated from this nodule initially identified a Clostridium species, which was eventually confirmed with 16 s rDNA sequencing. Computed tomography (CT) and exploratory laparotomy subsequently identified a 2.5-cm diameter tubular structure beginning at the caudal aspect of the right kidney and coursing caudally containing gas and fluid, consistent with a retroperitoneal abscess, which was resected and also cultured Clostridium spp. The dog was discharged 3 days postoperatively and was alive at the time of writing, 7 months after discharge. This case highlights a previously unrecognized bacterial agent in a retroperitoneal abscess. The use of cytologic evaluation yielded a diagnosis of endospore-forming bacteria suggestive of Clostridium sooner than culture and histopathology, which allowed for adjustment in the antibiotic protocol., (© 2022 American Society for Veterinary Clinical Pathology.)

The purpose of this study was to evaluate the pharmacokinetics of intravenous (IV) ondansetron in a population of hospitalized dogs exhibiting clinical signs of nausea. The causes of nausea included pancreatitis, gastroenteritis, endocarditis, chemotherapy-induced nausea, diabetes mellitus and ketoacidosis, acute kidney injury with aspiration pneumonia, pyometra, uroabdomen, neoplasia, and hepatopathy. Twenty-four dogs were randomly assigned to one of the following IV ondansetron protocols: 1 mg/kg q12h, 0.5 mg/kg q12h, 1 mg/kg q8h, 0.5 mg/kg q8h. Serum was collected at 0, 0.25, 0.5, 1, 2, 4, 8, 16, and 24 h after the first dose, and nausea scores were recorded at multiple time points. Ondansetron and arginine vasopressin (AVP) concentrations were measured via high-performance liquid chromatography coupled to tandem mass spectrometry and ELISA, respectively. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Ondansetron displayed linear pharmacokinetics. In the 0.5 mg/kg group, mean C max  = 214 ng/ml, AUC 0-8h  = 463 ng/ml*h, and calculated half-life was 1.9 h. In the 1 mg/kg group, mean C max  = 541 ng/ml, AUC 0-8h  = 1057 ng/ml*h and calculated half-life was 1.6 h. Serum ondansetron concentrations were not significantly different between dogs that required rescue anti-nausea medication (non-responders) and dogs that did not require rescue therapy (responders). In total, 83.3% of patients in the 0.5 mg/kg q8h, 0.5 mg/kg q12h, and 1 mg/kg q8h groups had improvement in nausea scores. In total, 66.7% of patients in the 1 mg/kg q12h group had improvement in nausea scores. In total, 33% of patients had resolution of nausea in the 0.5 mg/kg q8h, 1 mg/kg q8h, and 1 mg/kg q12h groups, and 16% of patients had resolution of nausea in the 0.5 mg/kg q12h group. AVP concentrations were highly variable and did not correlate with nausea scores. Nausea scores significantly decreased regardless of dosage protocol. AVP was not a reliable biomarker of nausea in this group of dogs., (© 2022 The Authors. Journal of Veterinary Pharmacology and Therapeutics published by John Wiley & Sons Ltd.)

Objective: To determine whether the use of a force-activated separation device (FASD) lowers the incidence risk of peripheral intravenous catheter (PIVC) complications in hospitalized dogs., Animals: 367 dogs that were hospitalized and received IV fluids between January 11 and March 25, 2021., Procedures: A prospective, randomized controlled clinical trial was performed. Dogs hospitalized and receiving IV fluids for at least 24 hours were randomized to the FASD group or control group. PIVCs were placed following a standardized protocol. Dogs in the FASD group had the FASD device attached to their PIVC according to manufacturer instructions. For both groups, all PIVC complications were documented, and each complication was classified as extravasation, phlebitis, dislodgement, occlusion, or line breakage., Results: Results from 367 dogs (FASD group = 180, control group = 187) underwent analysis. The proportion of PIVC complications was significantly (P = .004) lower for the FASD group (8.9% [16/180]) versus the control group (24.6% [46/187]). Following adjustment for differences in hospitalization time, the odds of a dog in the FASD group having a PIVC complication was approximately one-third the odds of those in the control group (OR, 0.33; 95% CI, 0.17 to 0.63; P = .001)., Clinical Relevance: Results indicated that the use of a FASD in hospitalized dogs receiving IV fluids is warranted to lower the incidence of PIVC complications and may also limit patient discomfort, owner expense, and staff time devoted to managing PIVC complications. Further research investigating its use in cats and other species should be considered.

Objective: To determine whether premature death occurred among dogs with nonmalignant splenic histopathologic findings after splenectomy for nontraumatic hemoabdomen., Animals: 197 dogs with nontraumatic hemoabdomen that underwent splenectomy and histopathologic evaluation between 2005 and 2018., Procedures: Information was obtained from electronic medical records, dog owners, and referring veterinarians to determine patient characteristics, histopathologic findings, survival information, and cause of death. Dogs were grouped based on histopathological diagnosis and outcome, and median survival times (MSTs) and risk factors for death were determined., Results: Histopathologic findings indicated malignancy in 144 of the 197 (73.1%) dogs with nontraumatic hemoabdomen. Hemangiosarcoma was diagnosed in 126 dogs (87.5% of those with malignancies and 64.0% of all dogs). Nine of 53 (17%) dogs with nonmalignant histopathologic findings had an adverse outcome and premature death, with an MST of 49 days. Risk factors for this outcome included low plasma total solids concentration, an elevated hemangiosarcoma likelihood prediction score, and a medium or high hemangiosarcoma likelihood prediction score category., Conclusions and Clinical Relevance: This study showed that there is a group of dogs with nontraumatic hemoabdomen due to splenic disease that have nonmalignant histopathologic findings after splenectomy, but nonetheless suffer an adverse outcome and die prematurely of a suspected malignancy. Further evaluation of potential at-risk populations may yield detection of otherwise overlooked malignancies.

Objective: To assess the diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in dogs with nontraumatic hemoabdomen., Animals: 106 dogs with a nontraumatic hemoabdomen that underwent abdominal ultrasonography and splenectomy with histologic examination of splenic lesions between 2005 and 2018., Procedures: Medical records were reviewed for abdominal ultrasonographic and histologic findings. Diagnostic performance of ultrasonographic description of a splenic mass or nodule as cavitated as evidence of hemangiosarcoma or any malignancy was evaluated., Results: Ultrasonographic description of splenic lesions as cavitated had poor diagnostic utility in predicting presence of hemangiosarcoma or malignancy. Sensitivity and specificity of this test were 41.9% (95% CI, 30.5% to 54.3%) and 51.2% (95% CI, 36.8% to 65.4%), respectively, for detecting hemangiosarcoma, with positive and negative predictive values of 55.3% (95% CI, 41.2% to 68.6%) and 37.9% (95% CI, 26.6% to 50.8%), respectively. Results were similar for detecting malignancy. Cavitated lesions outside of the spleen were too rare for statistical analysis to be of value., Conclusions and Clinical Relevance: Results suggested that relying on ultrasonographic description of cavitation to diagnose splenic lesions as malignant in dogs with nontraumatic hemoabdomen is unfounded. Other preoperative diagnostic tests may be more valuable in determining short- and long-term prognoses.

Objective: To report the development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound with aspiration pneumonia., Case Summary: A 9-month-old intact female Irish Wolfhound was presented for clinical signs consistent with aspiration pneumonia. Evaluation of her pedigree and clinical signs prompted suspicion of Irish Wolfhound rhinitis bronchopneumonia syndrome as a contributing factor. Despite supportive care for bronchopneumonia, progressive hypoxemia and increased work of breathing required mechanical ventilation (MV). Development of a pneumothorax 36 hours after initiation of MV necessitated bilateral thoracostomy tubes. Cardiovascular decline persisted despite resolution of the pneumothorax and 1 hour later the dog was humanely euthanized. On necropsy, severe pneumomediastinum was identified without other evidence of barotrauma. Necropsy results suggested tension pneumomediastinum as the cause of pneumothorax and cardiovascular deterioration., New or Unique Information Provided: Pneumomediastinum has not been described in dogs receiving MV. This case highlights the importance of rapid detection of pneumomediastinum during MV, as the complication can quickly become life-threatening., (© Veterinary Emergency and Critical Care Society 2020.)

Objective: To determine the success rate and complications associated with inducing emesis in dogs that have ingested foreign material., Design: Retrospective case series, 2010-2014., Setting: Private practice and referral center., Animals: Sixty-one client-owned dogs that had emesis induced for the treatment of ingestion of foreign material., Interventions: None., Measurements and Main Results: Emesis was successfully induced in 59 of 61 (97%) dogs administered an emetic. Of those 59 dogs, 46 (78%) produced the foreign body. There were no complications reported in any of the dogs in which emesis was successfully induced. Dogs in which emesis was successfully induced were likely to produce the foreign body (P = 0.01)., Conclusion: Based on the results of this study, emesis appears to be a safe and effective means for the removal of certain gastric foreign bodies in dogs., (© Veterinary Emergency and Critical Care Society 2020.)

Objective: To describe a case of documented serum sickness in a dog following administration of a single dose of a novel antivenin crotalidae polyvalent., Case Summary: A 4-year-old female neutered mixed breed dog developed recurrent signs of hypersensitivity (swelling, edema, urticaria/hives, gastrointestinal signs, vasculitis) at 1 and 2 weeks following administration of a single unit of a novel antivenin crotalidae polyvalent plasma product. Both episodes were treated with antihistamines and glucocorticoids and signs improved rapidly, with a prolonged course of glucocorticoids and antihistamines administered following the second occurrence. Diagnosis of serum sickness was based on clinical appearance of delayed hypersensitivity following exposure to novel biologic product, absence of other inciting cause of hypersensitivity, complement testing, and skin biopsies confirming vasculitis., New or Unique Information Provided: This case documents the first report of delayed hypersensitivity with a novel antivenin plasma product. This is the only case report of serum sickness to a single unit of antivenin. Additionally, the dog developed recurrence of hypersensitivity following the initial episode at 1 week; appropriate identification and prolonged treatment could have prevented recurrence and additional hospitalization. Cost and benefit analysis should be considered with antivenin administration., (© Veterinary Emergency and Critical Care Society 2019.)

Objective: To evaluate changes in serum creatinine and chloride concentrations in anesthetized dogs that received 6% hydroxyethyl starch (HES) 670/0.7., Design: Retrospective case series, 2002-2015., Setting: University veterinary teaching hospital., Animals: Two hundred forty-four client-owned dogs undergoing general anesthesia that received an HES solution., Interventions: None., Measurements and Main Results: Medical records of dogs that received an HES solution (6%, 670/0.7) while under general anesthesia during the study period were reviewed. Information obtained from the medical record included patient signalment, reason for anesthesia or diagnosis, body weight, amount of HES solution administered, pre- and postanesthesia creatinine value, pre- and postanesthesia chloride value, and day interval between measurements. Corrected chloride values were used for all statistical analysis. Dogs received a median dose of 6.3 mL/kg hetastarch during anesthesia. Median preanesthesia creatinine and corrected chloride values were 79.5 μmol/L (0.9 mg/dL) (range 8.8-689.5 μmol/L [0.1-7.8 mg/dL]) and 111 mmol/L (111 mEq/L) (range 80-123 mmol/L [80-123 mg/dL]), respectively. Median postanesthesia creatinine was 57.4 μmol/L (0.65 mg/dL) (8.8-716 μmol/L [0.1-8.1 mg/dL]). Median postanesthesia corrected chloride was 115 mmol/L (115 mEq/L) (range 87.5-129.6 mmol/L [87.5-129.6 mEq/L]). Mann-Whitney test analysis revealed a significant decrease in creatinine (Δ Cr 17.7 μmol/L [0.2 mg/dL], P < 0.01) and a significant increase in corrected chloride (Δ Cl 4.1 mmol/L [4.1mEq/L], P < 0.01) between pre- and postanesthesia values., Conclusions: In a mixed population of hospitalized dogs undergoing general anesthesia that received a median dose of 6 mL/kg of HES, creatinine was lower and chloride was higher in the postanesthetic than in the preanesthetic period. The clinical significance of these changes and the role that HES administration played in them relative to concurrent therapies is unknown., (© Veterinary Emergency and Critical Care Society 2019.)

Background: Coagulation has not been studied extensively in adult goats, and reference intervals (RIs) for coagulation variables have not yet been established and would be clinically useful., Objectives: The goal of this study was to establish coagulation variable RIs in adult goats for future coagulation interpretation., Methods: Blood samples from 40 healthy adult goats were collected, and assays for PT, APTT, D-dimers, antithrombin III, and fibrinogen were performed. Coagulation variable RIs were established using the Reference Value Advisor v2.1., Results: The RIs included: PT, 15.7-19.8 seconds; APTT, 16.2-24.3 seconds; D-dimer, 0-0.68 μg/mL; antithrombin III, 108.6%-156.5%; fibrinogen, 89.5-303.2 mg/dL., Conclusions: In this brief communication, we report the RIs for coagulation variables in healthy adult goats. Further research will be needed to identify coagulation changes that are associated with specific disease processes of goats., (© 2018 American Society for Veterinary Clinical Pathology.)