The objective of this study was to determine reference intervals for plasma protein fractions of normal appearing, wild Atlantic loggerhead sea turtles, Caretta caretta. Blood was collected into heparinized vacutainer tubes from the following groups of turtles: 1) ten adult males; 2) eleven adult females; 3) ten juvenile males; and 4) ten juvenile females. Plasma was removed and total protein content of each sample was determined using the biuret method. Plasma proteins were separated using gel electrophoresis and scanned using a laser densitometer. Reference ranges for albumin, alpha, beta, and gamma globulins were established for age and gender classes and statistically analyzed. Significant differences were found between beta globulins of adult and juveniles and between juvenile males and females. A subgroup of turtles had electrophoretograms with beta-gamma bridging and a single adult male loggerhead had a prealbumin fraction; however, these subgroups of turtles were excluded from statistical analysis.
Objective To describe the unique complication of hemoperitoneum associated with anaphylaxis. Design Retrospective case series from September 2012 to August 2017. Setting Two private emergency and specialty referral hospitals. Animals Eleven client‐owned dogs diagnosed with anaphylaxis and hemoperitoneum upon presentation or referral. Interventions None. Measurements and Main Results Inclusion criteria included clinical signs consistent with anaphylaxis (hypotension, tachycardia, vomiting, diarrhea, weakness, collapse, with or without the presence of dermal signs) due to witnessed or unwitnessed presumed bee sting, an elevated alanine aminotransferase (ALT), performance of abdominal FAST (AFAST) examination with an abdominal fluid score, the sonographic presence of gallbladder wall edema, and hemoperitoneum. All dogs (n=11) were managed medically without surgical intervention. 91% (n=10) of dogs survived to discharge. Conclusions Hemoperitoneum development can be seen with anaphylactic reactions, though the exact mechanism remains to be fully understood. Medical therapy is warranted and can be successful in these patients; surgery is not indicated to address hemoperitoneum.
Due to the lack of current evidence in the veterinary prehospital arena, best practice guidelines were developed as an initial platform. Recommendations were based on a review of pertinent human and available veterinary literature as well as a consensus of the authors' professional opinions. It is anticipated that evidence-based additions will be made in the future.
Background: Thrombocytopenia in dogs is common in critical care medicine, but availability of fresh platelet concentrates in veterinary medicine can be limiting. Lyophilized platelets have long shelf-lives and can be easily transported, stored, and administered in various settings. Objective: To evaluate the efficacy and safety of a novel trehalose-stabilized canine lyophilized platelet product in thrombocytopenic dogs with clinically-evident bleeding. Animals: Eighty-eight dogs with platelet counts <50 × 10 3 /μL and a standardized bleeding assessment tool (DOGiBAT) score ≥2. Methods: Multicenter, randomized, non-blinded, non-inferiority clinical trial comparing dimethyl sulfoxide (DMSO)-stabilized cryopreserved platelet concentrates (CPP) with trehalose-stabilized lyophilized platelets (LP) for control of bleeding in thrombocytopenic dogs. Dogs were randomized to receive 3 × 10 9 platelets/kg of LP or CPP. Primary outcome measures were change in DOGiBAT score, platelet count, need for additional red cell transfusion and all-cause mortality.
Objective To determine how veterinary emergency and critical care clinicians define IV fluid bolus therapy (FBT) and what constitutes a positive response to a fluid bolus. Design Online survey of 222 emergency and critical care veterinarians between December 17, 2018, and March 1, 2019. Interventions An online survey was provided to diplomates of the American College of Veterinary Emergency and Critical Care (ACVECC), residents of ACVECC‐approved training programs, as well as house officers and emergency clinicians of a corporate multicenter emergency and specialty care veterinary hospital. The survey investigated the administration of various crystalloid, colloid, and blood products for FBT, as well as expected physiological responses. Measurements and Main Results The majority of respondents considered balanced isotonic crystalloids appropriate for FBT (220/222 [99.1%]). Respondents showed greater variability in acceptance of 0.9% sodium chloride (105/222 [47.30%]), hypertonic (3‐7%) sodium chloride (131/222 [59.01%]), and hydroxyethyl starch solutions (90/222 [40.54%]). Most respondents did not consider physiological plasma (44/222 [19.82%]) an appropriate choice. The most commonly used parameters for monitoring FBT responses were heart rate (220/222 [99.10%]), blood pressure (217/222 [97.75%]), capillary refill time (192/222 [86.49%]), lactate (181/222 [81.53%]), pulse pressure (151/222 [68.02%]), and rectal temperature (145/222 [65.32%]). The majority of respondents perceived that 0–20% (165/222 [74.32%]) of hypotensive patients are nonresponsive to FBT. Conclusions Small animal emergency and critical care clinicians favored balanced isotonic electrolyte solutions and hypertonic sodium chloride solutions for FBT over other options. When monitoring responses to FBT, heart rate, blood pressure, capillary refill time, and plasma lactate were among the most commonly monitored parameters, and there was a lack of familiarity with others. Despite the widespread use of FBT, these findings outline the need for further prospective clinical trials regarding the ideal fluid type and rate, as well as the appropriate responses to FBT.
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