Objective:To evaluate the prevalence of acute kidney injury (AKI) in dogs with gastric dilatation and volvulus (GDV), identify risk factors associated with AKI diagnosed at presentation or that developed in hospital, and evaluate the association between AKI and selected nonrenal risk factors and mortality before discharge. Methods:Medical records of 106 dogs that underwent surgical correction of GDV between January 2013 and September 2023 were retrospectively reviewed. Dogs were categorized as presenting with or developing AKI in hospital, according to International Renal Interest Society criteria. Univariate and multivariate logistic regression were used to evaluate the association between selected risk factors and AKI or mortality. Results:In total, 20 of 106 dogs (18.9%) had AKI, with 18 of 106 dogs (17.0%) presenting with it. Sixteen dogs (15.1%) did not survive to discharge, of which 8 and 9 had AKI on presentation and at any time point, respectively. Dogs with AKI on presentation (OR, 7.90) or at any time point (OR, 9.23) had greater odds of not surviving to discharge. On multivariate analysis, preoperative lactate (OR, 1.13 for every 0.5 mmol/L higher) was significantly associated with presenting with AKI, and lowest mean arterial blood pressure during anesthesia (OR, 0.42 for every 10 mm Hg higher) and hetastarch infusion (OR, 4.00) were significantly associated with mortality. Conclusions:AKI, lowest mean arterial blood pressure during anesthesia, and hetastarch administration were associated with mortality in dogs with GDV. Clinical Relevance:Careful assessment of kidney function is recommended in dogs with GDV, as concurrent AKI is common and associated with outcome.

IntroductionHeartworm-infected dogs may have changes in platelet function which can manifest as either perioperative bleeding or thrombosis, reflecting either a prothrombotic state from platelet hyperreactivity or hypocoagulability secondary to consumptive coagulopathy. We aimed to evaluate surgical bleeding in heartworm-infected dogs undergoing ovariohysterectomy (OHE).MethodsHeartworm-infected (HWI, n = 11) and uninfected (UI, n = 21) dogs undergoing elective OHE were included. Dogs were anesthetized using a standard protocol, and platelet and coagulation function was evaluated using buccal mucosal bleeding time (BMBT), platelet function analyzer-100 (PFA-100), and thromboelastography (TEG). Bleeding from the initial skin incision was quantified using pre-weighed sponges. Variables between HWI and UI dogs were compared using t-tests or Mann-Whitney Rank Sum Tests as appropriate for data distribution.ResultsBlood loss measured by surgical sponge weight did not differ between groups: median (25–75th percentile) was 7 g (6–10 g) in HWI dogs and 7 g (6.3–9.8 g) in UI dogs (P = 0.490). PFA-100 closure times were 79.6 ± 15 s in HWI dogs and 83.7 ± 22 s in UI dogs (P = 0.571). Similarly, no significant differences were identified between groups for CBC or TEG measurements or BMBT.DiscussionHWI dogs did not experience increased incisional bleeding or quantifiable differences in platelet and coagulation function tests compared to UI dogs. HWI dogs undergoing ovariohysterectomy in this study did not display tendencies for perioperative hemorrhage or thrombosis.

Activated charcoal (AC) is a convenient, effective method for gastrointestinal decontamination, typically supplied as either activated charcoal powder (pAC) or proprietary mixtures in granules or suspension (e.g., Toxiban®, Tox). We compared the adsorptive capacity for common veterinary toxicants of a new resin-bound activated charcoal product (Ready Rescue™; RR) to PAC and Tox. We hypothesized that RR is equivalent to Tox and PAC in binding of these toxicants. Solutions of simulated low pH (pH = 1.5) and neutral (pH 6–7) environments were incubated at 38 °C with continuous agitation. Commercial products containing the following toxicants (final concentration) were evaluated: Naproxen (8.8 mg/mL), ivermectin (1.1 mg/mL), bromethalin (0.028 mg/mL), xylitol (17.9 mg/mL), ethylene glycol (400 mg/mL), Delta-9 THC (1.5 mg/mL), baker’s chocolate (567 mg/mL), roquefortine (500 mg/mL of cheese), tartaric acid (133 mg/mL). Toxicants were incubated in separate reaction mixtures for 30 min before the equivalent of 15 g of charcoal product (RR, PAC, or Tox) was added. The reaction mixtures were sampled prior to charcoal addition, and at 30, 60, and 240 min after, and assayed for toxicant concentration. The different AC formulations decreased concentrations of the assayed toxicant in most tested conditions, in both acidic and neutral pH environments. Exceptions included tartaric acid, bromethalin, ethylene glycol, and xylitol, which showed variable changes in concentration. In general, the rate of decrease was similar between AC products with the exception of Delta-9 THC in the neutral environment, where Tox showed a more rapid rate of decrease than RR. In this in vitro system, the three tested AC products effectively decreased concentration of most toxicants over a 4 h period, with pAC and Tox showing a more rapid rate of decline for some toxicants compared to RR.

OBJECTIVE:To describe the epidemiology of, and injuries associated with, low- versus higher-speed vehicular trauma and to identify risk factors associated with mortality. DESIGN:Retrospective study from January 2015 to November 2020. SETTING:University teaching hospital. ANIMALS:A total of 150 dogs with low-speed (<20 mph) vehicular rollover (LSVRO) trauma and 272 dogs with other vehicular trauma (hit by car [HBC]). INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Eighty-five percent of vehicles causing LSVRO trauma were driven by owners or family members of the dogs. Dogs in the LSVRO group were older (median: 4 vs. 2 years, p = 0.001), smaller (median weight: 11 vs. 21.5 kg, p = 0.001), and more often female (53.3% vs. 40.1%, p = 0.005) than the HBC group. Pelvic fractures, sacroiliac luxation, prepubic tendon rupture, and vertebral fractures were more common in the LSVRO group, and more soft tissue surgical procedures were required than in the HBC group (18.0% vs. 8.85%, p = 0.02). Within the LSVRO group, abdominal injuries (e.g., abdominal hernia, prepubic tendon rupture), pelvic fractures, and traumatic brain injury were all associated with increased mortality. Surviving dogs had higher ionized calcium concentration (1.26 ± 0.1 mmol/L) than those that died (1.18 ± 0.1 mmol/L, p = 0.003). There was a 40% reduction in survival odds for every 1-point increase in animal trauma triage score (p < 0.001). Blood product requirement and each soft tissue surgery increased mortality by 98% (p < 0.001) and 74% (p = 0.001), respectively, while orthopedic surgery conferred a 25-fold increase in odds of survival (p < 0.001). CONCLUSIONS:LSVRO trauma is characterized by a specific constellation of injuries compared with HBC trauma. Veterinary practitioners should be aware of the differences between the two trauma types and focus triage, resuscitation, and diagnostic tests in dogs with LSVRO trauma accordingly.

The reported incidence of blood product transfusion reaction (TR) in cats varies greatly. Evaluate the incidence and practices surrounding acute TRs in cats receiving feline blood products, using Transfusion Reaction Small Animal Consensus Statement (TRACS) definitions. Cats ( n  = 444) that received feline blood products ( n  = 608) between March 2022 and January 2024. Prospective, multicenter observational study at referral hospitals ( n  = 14) in the United States, United Kingdom, and Australia documenting the incidence of acute TRs in cats receiving allogenic blood transfusions. Acute TR incidence was 7.8% (95% confidence interval [CI], 5.6–10.6) for red blood cell (RBC)-containing products and 1.1% (95% CI, 0.0–5.9) for plasma products. Febrile nonhemolytic transfusion reactions (FNHTRs) were the most common in RBC-containing products (incidence, 5.7%; 95% CI, 3.8–8.1). Age of RBC unit (adjusted odds ratio [aOR], 1.04 per day; 95% CI, 1.00–1.07) and administering a RBC unit with an infusion pump rather than a syringe driver (aOR, 4.7; 95% CI, 1.43–15.54) were associated with an increased odds of FNHTR. Of transfusions discontinued ( n  = 28) because of a potential TR, 46.4% did not fulfill TRACS criteria for any TR. Death occurred within 24 h of a transfusion event in 18.3% but was not associated with the development of a TR (odds ratio [OR], 0.76; 95% CI, 0.29–1.99). Transfusion reaction incidence in cats, as defined using TRACS guidelines, is reported. Febrile nonhemolytic TRs were the most common and were associated with increasing RBC unit age and administering RBC via an infusion pump.

Severe malaria remains a major public health concern in regions of moderate to high Plasmodium falciparum transmission. Women and young children are especially vulnerable to two clinical manifestations of severe P. falciparum malaria, known as placental malaria (PM) and cerebral malaria (CM). Both PM and CM have been characterized as procoagulant states; however, the role of coagulation in galvanizing poor health outcomes is incompletely understood. Moreover, the contribution of tissue factor (TF), the primary driver of the extrinsic pathway of coagulation, to the pathogenesis of PM and CM has not been fully explored. This work utilizes experimental murine models of PM (EPM) and CM (ECM) to explore the impact of anticoagulant treatment and tissue-specific or global reduction in TF expression on disease outcomes. In EPM, we show that treatment of wild-type mice with dalteparin, an anticoagulant class that is safe to use in humans during pregnancy, prevented malaria-induced pregnancy loss, significantly improved embryo viability, and decreased placental fibrin deposition at midgestation. Similarly, mice deficient for endothelial/hematopoietic TF, TFTie2Δ, exhibited a superior ability to maintain their pregnancies at midgestation compared to TF-intact littermate controls, who unequivocally lost their pregnancies. Uterus weight and embryo viability were significantly improved in TFTie2Δ dams despite experiencing similar parasite burdens as controls. In ECM, dalteparin treatment promoted preservation of the blood-brain barrier (BBB) and protected against the development of neurological signs. Likewise, mice genetically modified to have low TF expression (LTF) exhibited less perivascular leakage in the brain and significantly increased survival probability compared to their littermate controls (TFhet). Together, these data show that anticoagulant treatment can successfully protect against poor health outcomes in two murine models of severe malaria and identify a potentially universal role of TF in driving severe malaria pathogenesis.

OBJECTIVE:To compare the measurement of axillary temperature (AT) with rectal temperature (RT) in dogs and cats and to identify the influence of physical parameters on the difference between their measurement using a veterinary-specific thermometer. DESIGN:Prospective study (2022-2024). SETTING:University teaching hospital. ANIMALS:A total of 106 dogs and 101 cats aged ≥4 months. INTERVENTIONS:Body temperatures were measured contemporaneously using a veterinary-specific, calibrated, dual-thermistor axillary thermometer (AT) and a calibrated medical thermometer (RT). Data were evaluated for bias as a whole set and after stratification based on various physical parameters (species, body weight, haircoat length, body condition score [BCS]). A machine learning (ML) model was subsequently applied, and bias was reevaluated. MEASUREMENTS AND MAIN RESULTS:A Bland-Altman analysis comparing the measurement of AT with RT showed a bias of 1.01°C (1.82°F) and 95% limits of agreement (LOA) -0.66°C to 2.68°C (-1.19°F to 4.83°F) in dogs and a bias of 0.23°C (0.42°F) and 95% LOA of -2.61°C to 3.08°C (-4.71°F to 5.55°F) in cats. Animals weighing <10 kg had a bias of 0.33°C (95% LOA: -2.29°C to 2.96°C), animals with BCS <5 had a bias of 0.09°C (95% LOA: -2.92°C to 3.11°C), and those with shorter haircoats had a bias of 0.49°C (95% LOA: -2.03°C to 3.00°C). The ML model overestimated RT when using AT and physical parameters in its algorithm (dogs: -0.57°C [95% LOA: -2.18°C to 0.99°C]; cats -0.84°C [95% LOA: -2.62°C to 0.93°C]). CONCLUSIONS:Animals weighing <10 kg, with lower BCS, and shorter haircoats had less bias when AT was compared with RT. Cats exhibited a lower bias between AT and RT than dogs. ML models can be programmed to account for various physical characteristics, improving the predictive impact of AT for directly measured RT, especially in categories of animals where closer prediction does not already exist.

BACKGROUND:The reported incidence of blood product transfusion reaction (TR) in cats varies greatly. OBJECTIVE:Evaluate the incidence and practices surrounding acute TRs in cats receiving feline blood products, using Transfusion Reaction Small Animal Consensus Statement (TRACS) definitions. ANIMALS:Cats (n = 444) that received feline blood products (n = 608) between March 2022 and January 2024. METHODS:Prospective, multicenter observational study at referral hospitals (n = 14) in the United States, United Kingdom, and Australia documenting the incidence of acute TRs in cats receiving allogenic blood transfusions. RESULTS:Acute TR incidence was 7.8% (95% confidence interval [CI], 5.6-10.6) for red blood cell (RBC)-containing products and 1.1% (95% CI, 0.0-5.9) for plasma products. Febrile nonhemolytic transfusion reactions (FNHTRs) were the most common in RBC-containing products (incidence, 5.7%; 95% CI, 3.8-8.1). Age of RBC unit (adjusted odds ratio [aOR], 1.04 per day; 95% CI, 1.00-1.07) and administering a RBC unit with an infusion pump rather than a syringe driver (aOR, 4.7; 95% CI, 1.43-15.54) were associated with an increased odds of FNHTR. Of transfusions discontinued (n = 28) because of a potential TR, 46.4% did not fulfill TRACS criteria for any TR. Death occurred within 24 h of a transfusion event in 18.3% but was not associated with the development of a TR (odds ratio [OR], 0.76; 95% CI, 0.29-1.99). CONCLUSIONS AND CLINICAL IMPORTANCE:Transfusion reaction incidence in cats, as defined using TRACS guidelines, is reported. Febrile nonhemolytic TRs were the most common and were associated with increasing RBC unit age and administering RBC via an infusion pump.

OBJECTIVE To assess the impact of clopidogrel or rivaroxaban administration on recurrence of arterial thromboembolism (ATE) in cats that have recovered from cardiogenic ATE. METHODS This multicenter prospective double-masked protocol enrolled 45 cats that had recovered from cardiogenic ATE and were randomized to receive either clopidogrel (18.75 mg/cat, PO; n = 19) or rivaroxaban (2.5 mg/cat, PO; 26) as sole anticoagulant therapy for up to 2 years after the initial ATE. Primary outcome measures included recurrent ATE or death from any cause. In addition to bimonthly internet-based surveys of animal quality of life, echocardiograms were performed by veterinary cardiologists at 2, 6, 12, and 18 months after initial ATE. RESULTS 17 cats experienced ATE recurrence: 7 of 19 (37%) in the clopidogrel group and 10 of 26 (39%) in the rivaroxaban group. Three cats in each group survived for the entire 2-year study without recurrence. In the clopidogrel group, median (95% CI) time to ATE recurrence was 663 days (150 to not calculable) and in the rivaroxaban group, 513 days (242 to not calculable). Median time from enrollment to death from cardiac or noncardiac causes was also not dif- ferent between treatment groups. CONCLUSIONS Single-agent antithrombotic therapy with rivaroxaban in cats recovered from cardiogenic embolism delayed recur- rence of ATE for a similar time period as single-agent therapy with clopidogrel. CLINICAL RELEVANCE In cats that have recovered from cardiogenic ATE, either rivaroxaban or clopidogrel may be used for single-agent thromboprophylaxis to delay ATE recurrence.

The evolution of technology has paved way for smart and improved healthcare. Invasive and contact-based methods, that have been the gold-standard for healthcare monitoring, are being replaced by contact-less methods to enable engagement-free and continuous remote patient monitoring. These methods are getting more and more popular, not just for humans, but for animals too. In our study, we develop an innovative contact-less monitoring system, CageDot, that uses geophone sensors for tracking animal activities and following infectious disease progress. The activity levels of the animals can act as a surrogate for animal health and help to document illness and recovery with treatment. Our proposed system was extensively tested by performing three multi-week experiments over a period of 1.5 years. The results show that the CageDot system can accurately and continuously track the animal activities and follow infectious disease progress in a non-invasive and contact-free way. This has a significant application and impact in the future drug and vaccine development, because the existing approach relies on daily health check by humans, which is time consuming and not continuous that may potentially skip important events.

OBJECTIVE:After the 2012 Reassessment Campaign on Veterinary Resuscitation (RECOVER) CPR Guidelines, this is an update of evidence-based consensus guidelines for Basic Life Support (BLS), advanced life support (ALS), and periarrest monitoring. DESIGN:These RECOVER CPR Guidelines were generated using a modified version of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for evidence evaluation and translation of this evidence into clear and actionable clinical instructions. Prioritized clinical questions in the Population, Intervention, Comparator, and Outcome (PICO) format were used as the basis to conduct systematic literature searches by information specialists, to extract information from relevant publications, to assess this evidence for quality, and finally to translate the findings into treatment recommendations. These recommendations were reviewed by the RECOVER writing group and opened for comment by veterinary professionals for 4 weeks. SETTING:Transdisciplinary, international collaboration in university, specialty, and emergency practice. RESULTS:A total of 40 worksheets were prepared to evaluate questions across the 3 domains of BLS, ALS and Monitoring, resulting in 90 individual treatment recommendations. High-dose epinephrine is no longer recommended, and atropine, if used, is only administered once. Bag-mask ventilation is prioritized over mouth-to-nose ventilation in nonintubated animals. In addition, an algorithm for initial assessment, an updated CPR algorithm, a rhythm diagnosis tool, and an updated drug dosing table are provided. CONCLUSIONS:While the majority of the BLS and ALS recommendations remain unchanged, some noteworthy changes were made due to new evidence that emerged over the past 10 years. Indirectness of evidence remains the largest impediment to the certainty of guidelines formulation and underscores an urgent need for more studies in the target species of dogs and cats.

Interest in the process of both normal and disordered hemostasis in the veterinary patient has experienced resurgence in recent years. This is due in part to the availability of newer tests and techniques that can better illustrate the process of coagulation. New understanding of the formation of clots in vivo has made it clear that traditional testing provides only a limited view into the actual mechanisms and pathophysiology of clot formation and platelet function. The cell-based model of hemostasis provides a framework for understanding the complex interactions between cellular components and soluble factors in the formation of a clot. Injectable anticoagulants that target aspects of the coagulation cascade are used and newer oral anticoagulants may provide a safer approach to providing adequate anticoagulation in veterinary patients. In animals that have developed venous or arterial thrombi and blood flow may be restored through the use of fibrinolytic drugs that encourage the dissolution of clots in vivo.

RBC aggregation and deformability characteristics are altered by inflammatory, microcirculatory, and hemorheologic disease. These changes can be indirectly evaluated using the erythrocyte sedimentation rate (ESR). Newer point-of-care devices employ syllectometry to evaluate RBC rheology, which can give information beyond the ESR. We evaluated 2 point-of-care rheometers (iSED and MIZAR; Alcor Scientific) in 52 dogs presented to a university teaching hospital. Whole blood samples were analyzed for correlation between the ESR using the Westergren (ESRw) method (measured at 1 h and 24 h) and the predicted ESR using iSED. Plasma fibrinogen and cell-free DNA concentrations were also measured as probable markers of inflammation. The iSED-predicted ESR was positively correlated to the ESRw method at 1 h (r = 0.74; p < 0.001) and 24 h (r = 0.62; p < 0.001). Comparing dogs with or without inflammation (defined as plasma fibrinogen concentration >3.5 g/L [350 mg/dL]), significant differences were seen in the MIZAR parameters of base point, amplitude, integral, and half-time. Median cell-free DNA concentrations were higher in the group of dogs with inflammation (117 [range: 51-266] ng/mL vs. 82.7 [range: 19-206] ng/mL; p = 0.024). The iSED-predicted ESR is a good predictor of the ESRw and was obtained more rapidly. Rheometric parameters measured by MIZAR may be useful in detecting inflammation and monitoring secondary morphologic and functional changes in canine RBCs.

OBJECTIVE To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs. SAMPLE Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023. METHODS For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL. Therapies administered, primary diagnosis, and concurrent diseases were also recorded for each episode. A linear mixed model was used to determine the sodium correction factor per 100-mg/dL increase in glucose. Piecewise linear mixed models were also constructed for blood glucose measurements ≤ 400 mg/dL and > 400 mg/dL to explore potential correction factor differences between low and high glucose concentrations. RESULTS A sodium correction factor of a 1.6-mEq/L (95% CI, 1.3 to 1.9 mEq/L) decrease in sodium concentration per 100-mg/dL increase in blood glucose concentration was calculated. Differences in the correction factor between conditions of low and high glucose concentrations could not be determined due to a small sample size of blood glucose values > 400 mg/dL. Most dogs received similar treatments throughout the study period, including balanced isotonic crystalloids (97% [74/76]), electrolyte supplementation (84% [64/76]), and regular insulin (97% [74/76]). Almost all patients (93% [71/76]) had 1 or more concurrent diseases. CLINICAL RELEVANCE A sodium correction factor of 1.6 mEq/L (decrease in sodium per 100-mg/dL increase in glucose) is recommended for clinical use in hyperglycemic diabetic dogs.

Objective: To evaluate the sensitivity and specificity of a veterinary point-of-care (POC) luminometer-based kit for the diagnosis of septic peritoneal or pleural effusion in dogs and cats. Design: Prospective study performed between January 2020 and July 2021. Setting: University teaching hospital. Animals: Forty-eight animals with naturally occurring peritoneal or pleural effusion collected by aseptic abdominocentesis or thoracocentesis. Procedures: Effusion samples were split into filtered (using a 10-micron filter) and unfiltered aliquots and analyzed by the POC instrument according to the manufacturer's instructions and following variable incubation periods. Samples were also plated aerobically on standard and blood agar plates. Proprietary reagents were added to samples, causing bacterial ATP to generate bioluminescence that is detected by the luminometer. Bioluminescence values (relative light units [RLUs]) were recorded and compared with the presence of bacterial growth on the culture plates. Nucleated cell counts in native and filtered effusion samples were recorded. Results: Twenty-one samples were septic based on positive culture. RLUs were higher in septic effusions for filtered and native effusions compared with sterile effusions. The use of a filter reduced cell counts. In filtered samples incubated for 30 minutes before testing, the sensitivity and specificity of the luminometer for diagnosis of infection in cavitary effusions were 81% and 82%, respectively, using a cutoff of 12,202 RLUs. Conclusions: The luminometer kit evaluated in this study represents a viable screening tool for diagnosis of septic cavitary effusions and could be used in conjunction with other POC diagnostics to support the rapid diagnosis of infection.

Health monitoring is essential for both humans and animals in daily life. While numerous health monitoring systems have been developed, the majority are designed exclusively for either humans or animals, and most require direct physical contact. We have developed BedDot, a contactless health monitoring system for both humans and animals using a seismic sensor. BedDot can be deployed in various environments, such as bed and seat settings for humans, as well as in cages for animals, to monitor occupancy, heart rate (HR), respiratory rate (RR), and blood pressure (BP). Our system demonstrates high accuracy in the clinical experiments of 150 patients and 16 dogs and cats.

OBJECTIVE:To evaluate the effects of darbepoetin on platelet population and reactivity in healthy cats (HCs) and azotemic cats with remnant kidney (RK) model-induced chronic kidney disease. ANIMALS:12 purpose-bred domestic shorthair cats (n = 6 HCs and n = 6 RK). METHODS:In this pilot study, all cats received darbepoetin (1 µg/kg, SC) on days 0, 7, and 14. Blood was sampled at baseline and on days 3, 10, 15, 17, 20, and 21. At each time point, a CBC was performed, platelet aggregometry was assessed by impedance and optical methods, and platelet P-selectin (CD62P) was quantified before and after thrombin stimulation. Additionally, reticulated platelets were quantified using both thiazole orange staining and proprietary analysis by the CBC analyzer. For RK cats, systemic blood pressure (BP) was serially measured. RESULTS:No adverse effects of darbepoetin were seen. There was no statistically significant change in platelet count between or within groups at any time point. Hematocrit increased significantly over time in the RK but not the HC group. RBC reticulocyte numbers in both groups increased over time. Reticulated platelet percentage did not increase in either group. Differences in platelet reactivity within or between groups were not seen in the aggregometry or flow cytometric assessments. In RK cats, indirect BP did not significantly change during the study. CLINICAL RELEVANCE:This preliminary investigation did not find evidence that darbepoetin administration impacted platelet number, reactivity, nor reticulated platelet count. Anemic RK cats experienced increased hematocrit and RBC reticulocytes as expected with darbepoetin therapy.

IntroductionIn veterinary medicine there are few readily available products for platelet transfusion to patients with thrombocytopenia. Commercial tabletop platelet concentrating systems have recently become available to veterinarians, primarily directed towards uses associated with regenerative medicine. These systems could potentially be used to produce fresh concentrated platelets for use in transfusion medicine. This study evaluated the concentration, activation, and sterility of a double centrifugation platelet concentrate (PC) produced by a commercial benchtop system.MethodsTen healthy dogs were studied. Whole blood was collected and mixed with ACD-A in a 1:7.6 ratio of ACD-A to whole blood. 12 mL of this mixture was processed into PC via single centrifugation, while 60 mL of the anticoagulated whole blood was processed via a commercial double centrifugation system. Both types of PC were evaluated for platelet concentration, CD62P expression with and without thrombin stimulation, and for sterility.ResultsMean platelet count in the double centrifuged PC was 863 ± 352 × 103/μL, with very low white blood cell contamination (median of 0.47 × 103 leukocyte/μL (range 0.15–2.18 × 103/μL)). The double-centrifuged PC had similar baseline activation characteristics (as determined by P-selectin expression) as the single centrifuge PC (0.76% vs. 0.72% unstimulated, 30.5% vs. 34.9% stimulated, p = 0.432).DiscussionThe benchtop PC system studied here did not cause activation of platelets during production and produced a sterile product that can be further investigated as a source of fresh platelet concentrates for transfusion purposes.

OBJECTIVE:To systematically review evidence on and devise treatment recommendations for patient monitoring before, during, and following CPR in dogs and cats, and to identify critical knowledge gaps. DESIGN:Standardized, systematic evaluation of literature pertinent to peri-CPR monitoring following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were each reviewed by Evidence Evaluators, and findings were reconciled by Monitoring Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate to quality of evidence, risk:benefit relationship, and clinical feasibility. This process was implemented using an Evidence Profile Worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. A draft of these worksheets was distributed to veterinary professionals for comment for 4 weeks prior to finalization. SETTING:Transdisciplinary, international collaboration in university, specialty, and emergency practice. RESULTS:Thirteen questions pertaining to hemodynamic, respiratory, and metabolic monitoring practices for identification of cardiopulmonary arrest, quality of CPR, and postcardiac arrest care were examined, and 24 treatment recommendations were formulated. Of these, 5 recommendations pertained to aspects of end-tidal CO2 (ETco2) measurement. The recommendations were founded predominantly on very low quality of evidence, with some based on expert opinion. CONCLUSIONS:The Monitoring Domain authors continue to support initiation of chest compressions without pulse palpation. We recommend multimodal monitoring of patients at risk of cardiopulmonary arrest, at risk of re-arrest, or under general anesthesia. This report highlights the utility of ETco2 monitoring to verify correct intubation, identify return of spontaneous circulation, evaluate quality of CPR, and guide basic life support measures. Treatment recommendations further suggest intra-arrest evaluation of electrolytes (ie, potassium and calcium), as these may inform outcome-relevant interventions.