Journal of Small Animal PracticeVolume 54, Issue 2 p. E2-E2 BOOK REVIEW Veterinary Disaster Medicine: Working Animals - edited by Wayne E. Wingfield, Sherrie L. Nash, Sally B. Palmer, Jerry J. Upp Wayne E. Wingfield, Wayne E. WingfieldSearch for more papers by this authorSherrie L. Nash, Sherrie L. NashSearch for more papers by this authorSally B. Palmer, Sally B. PalmerSearch for more papers by this authorJerry J. Upp, Jerry J. UppSearch for more papers by this author Wayne E. Wingfield, Wayne E. WingfieldSearch for more papers by this authorSherrie L. Nash, Sherrie L. NashSearch for more papers by this authorSally B. Palmer, Sally B. PalmerSearch for more papers by this authorJerry J. Upp, Jerry J. UppSearch for more papers by this author First published: 01 February 2013 https://doi.org/10.1111/jsap.1216Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume54, Issue2February 2013Pages E2-E2 RelatedInformation

SummaryVenous blood lactate concentrations were measured on 109 ill dogs and 20 clinically normal dogs. Ill dogs were grouped into survivor and nonsurvivor groups, and categorized based on their primary problem. Ninety‐five percent of ill dogs had lactate concentrations higher than clinically normal dogs and published normal values. Seventy‐six percent of ill dogs with increased lactate concentrations survived to be discharged. Lactate concentrations were significantly higher in nonsurvivors than in survivors and clinically normal dogs. Lactate concentrations in dogs with major trauma and intoxications, and with cardiopulmonary, gastrointestinal, and neurologic problems were significantly higher than in clinically normal dogs and dogs with other problems. (Vet Emerg & Crit Care, 1998; 8: 117–127)

SummaryWe report a case of diphenhydramine intoxication in a dog. A five month old intact male Labrador Retriever was presented after ingesting approximately 36 diphenhydramine tablets (50 mg/tablet; approximate ingested dose of 1800 mg or 67 mg/kg). Physical examination findings included severe ataxia, profound disorientation, severe continuous spastic muscle tremors, hyperthermia, tachycardia, tachypnea, and hyperesthesia. The dog was unresponsive to intravenous diazepam and phenobarbital, but rapidly responded to an intravenous bolus and subsequent continuous infusion of guaifenesin and supportive fluid therapy. The serum diphenhydramine level on admission was 537 ng/ml. The toxic level is not reported for dogs, but is considered>60 ng/ml in people. The dog was discharged 24 hours after admission with no apparent residual effects.

SummaryThe purpose of this study is to report the aterial blood gas findings in dogs with bacterial pneumonia. Arterial blood gas samples were collected from 62 dogs with culture‐confirmed bacterial pneumonia. These results were compared with 46 normal dog arterial blood gas samples. Results demonstrated that respiratory acidosis was not a problem in dogs with pneumonia in this study. Significant evidence of hypoxemia was noted with abnormal mean values in PaO2 (P<0.001) and the Alveolar‐arterial (A‐α) gradient (P<0.001).

SummaryApparent restihg energy expenditure (AREE) and respiratory quotient (RQ) were determined by open flow indirect calorimetry in a group of 104 apparently resting, critically ill, postoperative and severely traumatized dogs. The evaluations were conducted in a calm, temperature‐controlled environment after at least a 12‐hour fast. Subjects were allowed to acclimilate to the monitoring equipment prior to beginning the study. The clinical patients were compared to a group of 20 clinically normal, apparently resting, client owned dogs (NC). The data was also compared to published normals (NP) for energy expenditure of apparently resting dogs. Measurements were indexed to actual body weight in kilograms (BW) as well as to metabolic body size(BW0.75). Measurements of VO2(VO2/kg and VO2/kg0.75) and VCO2(VCO2/kg and VCO2/kg0.75) were used to calculate the RQ and the AREE. Critically ill, postperative and severely lower RQ values AREE/kg or AREE/kg0.75(p=0.39). The PO&T dogs did exhibit significantly lower RQ values (p<0.0001) than either the (NC) or (NP) groups. Measured AREE of the PO&T dogs was significantly less than a calcualted value using the illness/injury/infection energy requirement (IER), (p<0.0001). Energy expenditure in typical trauma and postoperative patients may commonly be overstimated by the IER method. Conclusion: The AREE of critically ill, postoperative and severly trumatized dogs was not higher than healthy dogs as has been previously suggested in the literature.

Summary Elevation in blood lactate concentration, with or without accompanying metabolic acidosis, is a hallmark finding in patients with circulatory compromise, and is also consistently noted in other conditions affecting critically ill or injured individuals. Little is reported in a veterinary literature regarding lactate measurement in the emergency and critical care setting, despite impressive reports of the clinical usefulness of lactate measurement in people. The purpose of this article is to review lactate kinetics and the clinical utility of lactate measurement. Limitations to lactate evaluation will also be discussed.

SummaryThe usefulness of venous blood in determining the acid‐base status of seriously ill animals has not been investigated. The purpose of this study was to determine whether a useful relationship exists between the acid‐base parameters of central venous and arterial blood in ill dogs.Paired arterial and venous blood samples were obtained from 46 dogs seen in the Critical Care Unit of the Veterinary Teaching Hospital of Colorado State University irregardless of their hemodynamic status. Cardiopulmonary arrest patients were not included in the study.Results of this study indicate venous blood samples can be used in the assessment of acid‐base status. Statistical significance was seen in comparing arterial versus venous pH (P < 0.001), PCO2 (P < 0.001), and bicarbonate (P < 0.001). Linear regression equations will allow one to predict arterial values from venous samples.

SummarySerum magnesium (Mg) is an infrequnetly measured electrolyte in small animal patients. Currently, little is known about the prevalence and significance of abnormalities in serum Mg in animals. Therefore, a prospective study was performed to examine the incidence and clinical implications of abnormalities in serum Mg levels in critically ill dogs.Serum Mg and other electrolytes were measured in 93 normal dogs housed at the Purina Pet Care Center and in 48 ill dogs admitted to a small animal critical care unit. The normal reference range for canine serum Mg was determined to be 1.89 – 2.51 mg/dl. Based on this range, 54% of the critically ill dogs were hypomagnesemic (< 1.89 mg/dl) and 13% were hypermagnesemic (> 2.51 mg/dl). Of the electrolytes measured in these patients, serum Mg had the highest prevalence of abnormal values. Hypomagnesemic patients had a significantly higher incidence of concurrent hypokalemia and hyponatremia (p < 0.05), as well as a longer length of hospitalization (p < 0.05) than their normomagnesemic counterparts. Hypermagnesemic patients were 2.6 times more likely not to survive their illness when compared to patients with normal serum Mg levels.Abnormalities in serum Mg appear to be common in critically ill dogs. These patients commonly have other concurrent electrolyte abnormalities. Since serum Mg is not routinely measured, the presence of hypokalemia or hyponatremia should alert the clinician to the possibility of coexisting hypomagnesemia. The clinical implications of hypomagnesemia and hypermagnesemia in ill dogs appear to involve prolonged hospitalization and increased mortality, respectively: however, the exact etiology remains undetermined.

SummaryAs the specialties of emergency medicine and critical care have grown and evolved in both human and veterinary medicine, so has the need for more advanced care of patients with primary lung disease. Treatment of acute respiratory failure has been the focus of several articles in the human medical literature of the past few years.1,8 This paper deals with airway pressure therapy and its application in cases of acute respiratory failure in veterinary medicine. The reader is referred to part I of this paper for a reveiw of respiratory mechanics and hypoxemia as they apply to respiratory therapy.

SummaryMagnesium is the second most abundant intracelular cation, exceeded only by potassium. The majority of magnesium is found in bone and muscle. This cation is required for many metabolic functions, most notably as a coenzyme for the sodium‐potassium ATPase pump. Magnesium functions to maintain the electrolyte gradient across all membranes. Interference with this gradient may result in changes in the resting membrane potential and disturbances in repolarization, resulting in cardiovascular and neuromuscular abnormalities.Hypomagnesemia may be the most underdiagnosed electrolyte disorder. Incidence rates greater than 50 percent have been reported in critically ill human patients. Currently there is little or no information available regarding the incidence and significance of hypomagnesemia in hospitalized animals. Causes of magnesium deficiency can be divided into four general categories: gastrointestinal, renal, endocrine and miscellaneous. The diagnosis of magnesium depletion can be difficult since less than one percent of total body magnesium is located in serum. Alternative methods of evaluating magnesium status include determining ultrafilterable magnesium levels, mononuclear blood cell magnesium levels or by quantifying magnesium retention of an administered loading dose.

SummaryWith respiratory therapy in critically ill veterinary patients becoming more commonplace, a consistent Indicator of pulmonary function status is necessary. Although calculation of the pulmonary shunt fraction correlates well with the degree of pulmonary dysfunction, lts detetmination requires placement of a pulmonary arterial catheter, an invasive procedure that may not be practical in many clinical situations. Using Information obtained from the atterial blood gas, many other oxygen‐tension derived Indices have been suggested as noninvasive measurements of the efficiency of pulmonary gas exchange, lncluding the alveoiar‐arterial oxygen tension difference, the ratio of arterial to alveolar oxygen tension, the ratio of arterial to inspired oxygen tension, and the ratio of alveolar‐arterial gradient to arterial oxygen tension. A total of 427 blood gas values from 195 different patients were evaluated. A loglstic regression model using a stepwise algorithm was constructed to assess potential multicollinearity and interaction between factors. The only factors that contributed significantly to the model predictive of survival were age (p < 0.015), base excess (p < 0.029), and the alveolar‐arterial oxygen tension difference (p < 0.014).

Fifteen clinical cases of gunshot fractures were studied. A radiographic classification of the fractures was developed to aid in fracture evaluation. Type I fractures involved a simple transverse or oblique fracture with minimal soft tissue damage. Type II fractures were severely comminuted with no cortical bone defect and minimal soft tissue damage. Type III fractures were “shatter” fractures, characterized by severe comminution, cortical bone defects, and extensive soft tissue damage. Type I and Type II fractures (combined 26.7%) healed in 8 weeks or less. Eleven of the 15 cases evaluated (73.3%) were found to be Type III fractures, requiring more than 14 weeks for complete cortical healing. Osteomyelitis was associated with 3 cases of Type III tibial fractures, 2 of which developed after a second surgical intervention. Management, complications, and prognosis of gunshot fractures are discussed.

ABSTRACTAcute gastric dilatation and volvulus with dilatation were produced in 11 dogs anesthetized with halothane. Blood samples were taken during these procedures for biochemical analyses.Serum potassium did not change significantly during the experimental procedure, but there was a significant increase (p<0.05) after release of the dilatation with volvulus. Renal function was impaired with significant increases (p<0.05) in the serum concentration of urea nitrogen, phosphorus, and creatinine. Evidence of cellular damage was reflected by a significant elevation (P<0.05) in glutamic‐oxaloacetic transaminase activity. Serum glucose concentration increased significantly (P<0.05) during experimental gastric dilatation and dilatation with volvulus.