Journal of the American Animal Hospital Association
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J Am Anim Hosp Assoc · Jan 2014
Clinical TrialComparison of propofol and propofol/ketamine anesthesia for evaluation of laryngeal function in healthy dogs.
Thiopental is an excellent choice for evaluation of laryngeal function. Unfortunately, thiopental is no longer manufactured. In its absence, the ideal anesthetic protocol for laryngoscopy has not been determined. ⋯ Ketamine did not allow for a reduction in propofol dose and caused increased respiratory depression, making ketamine a poor addition to propofol for laryngeal function examination. Regardless of the protocol used, laryngeal function should be determined in conjunction with the respiratory phase and depth of respirations. Patients with either absent or shallow respirations should receive doxapram for accurate evaluation of laryngeal function.
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J Am Anim Hosp Assoc · Nov 2013
Case ReportsIatrogenic pneumothorax associated with inadvertent intrapleural NGT misplacement in two dogs.
This case report presents two cases of inadvertent intrapleural nasogastric tube (NGT) misplacement with consequent creation of a bronchopleural fistula and the development of an iatrogenic pneumothorax in dogs. Due to the simplicity and relative ease of NGT placement and the lack of reported life-threatening complications in the veterinary literature, the serious risks associated with this procedure are often overlooked. Although pulmonary complications with NGT misplacement have been previously reported in the human literature, serious and potentially fatal complications have not been currently described in veterinary patients. Both of the cases described herein were medically managed with successful outcomes; however, one case was associated with significant morbidity.
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J Am Anim Hosp Assoc · May 2013
Practice Guideline2013 AAHA/AAFP fluid therapy guidelines for dogs and cats.
Fluid therapy is important for many medical conditions in veterinary patients. The assessment of patient history, chief complaint, physical exam findings, and indicated additional testing will determine the need for fluid therapy. Fluid selection is dictated by the patient's needs, including volume, rate, fluid composition required, and location the fluid is needed (e.g., interstitial versus intravascular). ⋯ All patients should be assessed for three types of fluid disturbances: changes in volume, changes in content, and/or changes in distribution. The goals of these guidelines are to assist the clinician in prioritizing goals, selecting appropriate fluids and rates of administration, and assessing patient response to therapy. These guidelines provide recommendations for fluid administration for anesthetized patients and patients with fluid disturbances.
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This report discusses the diagnosis and treatment of afibrinogenemia in a Chihuahua. Prolongations of prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin clotting time (TCT) together with fibrinogen assay results of either no or trace amounts of fibrinogen support a diagnosis of afibrinogenemia. Differential diagnoses include common coagulopathies, liver failure, and disseminated intravascular coagulation (DIC). ⋯ In this case, the bleeding was stabilized for up to 2 mo after administering > 54 mL/kg plasma. In human medicine, either cryoprecipitate or fibrinogen concentrate is used to increase blood fibrinogen levels to 100 mg/dL for minor bleeding and 200 mg/dL for major bleeding. Further studies are needed; however, the author of this report suggests that aggressive transfusions and monitoring are needed in veterinary afibrinogenemia cases.
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IV lipid emulsion (ILE) therapy is emerging as a potential antidote for lipophilic drug toxicities in both human and veterinary medicine. ILE has already gained acceptance in human medicine as a treatment of local anesthetic systemic toxicity, but its mechanism of action, safety margins, and standardized dosing information remains undetermined at this time. Experimental and anecdotal use of ILE in the human and veterinary literature, theorized mechanisms of action, current dosing recommendations, potential adverse effects, and indications for use in human and veterinary emergency medicine are reviewed herein.