The Veterinary clinics of North America. Small animal practice
-
Vet. Clin. North Am. Small Anim. Pract. · Jul 2011
ReviewCritical illness-related corticosteroid insufficiency in small animals.
Critical illness-related corticosteroid insufficiency (CIRCI) describes endocrine abnormalities associated with illness. CIRCI is characterized by an inadequate production of cortisol in relation to an increased demand during periods of severe stress, particularly in critical illnesses such as sepsis or septic shock. ⋯ Corticosteroid treatment can be indicated in patients with CIRCI. This article reviews the physiology and pathophysiology of the corticosteroid response to critical illness and the incidence, clinical features, diagnosis, and treatment of CIRCI.
-
Vet. Clin. North Am. Small Anim. Pract. · Jul 2011
ReviewGoal-directed therapy in small animal critical illness.
Monitoring critically ill patients can be a daunting task even for experienced clinicians. Goal-directed therapy is a technique involving intensive monitoring and aggressive management of hemodynamics in patients with high risk of morbidity and mortality. ⋯ One example is early goal-directed therapy for severe sepsis and septic shock. The components and application of goals in early goal-directed therapy are discussed.
-
Vet. Clin. North Am. Small Anim. Pract. · Jul 2011
ReviewDefects in coagulation encountered in small animal critical care.
Critically ill small animals are at risk for developing coagulation abnormalities. The processes of inflammation and coagulation are intertwined, and severe inflammation can lead to disturbances of coagulation. ⋯ Pathophysiology, diagnosis, and treatment of coagulation dysfunction are discussed. Defects in coagulation in small animal patients are complex and a consensus on diagnosis and treatment has yet to be reached.
-
Vet. Clin. North Am. Small Anim. Pract. · Jul 2011
Gastrointestinal complications of critical illness in small animals.
The gastrointestinal (GI) tract is one of the shock organs in dogs. GI dysfunction in critically ill veterinary patients manifests in mild problems such as hypomotility, anorexia, and nausea to more serious problems such as intractable vomiting, severe diarrhea, and septicemia. Septicemia is a serious complication of GI dysfunction because intestinal flora gains access to a patient's bloodstream, leading to infections in other organ systems and a systemic inflammatory response. The therapy for GI dysfunction is mainly supportive, treating nausea and dehydration although supporting the ailing GI tract with adequate enteral nutrition and, in some cases, dietary supplements and antibiotics.
-
Vet. Clin. North Am. Small Anim. Pract. · Jul 2011
Cardiovascular dysfunction in sepsis and critical illness.
Myocardial dysfunction is commonly encountered in humans, and presumably in dogs with sepsis and critical illness. This dysfunction contributes to increased mortality. ⋯ Clinical findings, proposed pathophysiologic mechanisms, and current treatment considerations are discussed. Further study is needed to find practical ways to identify myocardial dysfunction and to determine whether timed interventions intended to augment cardiac performance will reduce mortality in this patient population.