July 2023 - VETEMCRIT

From Novice to Expert: How to Master Small Animal Electrolyte and Acid-Base Disorders?

For emergency veterinarians, interns and residents, ECC and anesthesia technicians seeking to truly master emergency and critical care topics, traditional continuing education (CE) courses, webinars, and lectures may prove to be inadequate. These conventional methods often fall short in several key aspects, hindering effective learning and retention. Over the last 15 years, I have attended dozens of CE events and watched hundreds of hours of webinars, only to realize a week later that I can recall 5-10% of this information. Have you ever felt that way?

Breathing Patterns: All Eyes On That Chest

Stress-free examination of a dyspneic patient is key. A lot of information can be gathered just from observing a dyspneic animal. Assessment of the movement of the chest and abdominal wall relative to one another alongside breathing rate and effort can help refine your differentials and streamline your emergency diagnostics and emergency management.

Can both prolonged PT/PTT and shortened PT/PTT be indicative of a prothrombotic state?

In the field of veterinary medicine, standard clotting tests like prothrombin time (PT) and partial thromboplastin time (PTT) have traditionally been used to diagnose hypocoagulability, or a decreased ability of the blood to clot. However, recent research has raised the question of whether both prolonged and shortened PT/PTT can actually be indicative of hypercoagulability, a state where there is an increased tendency for blood clot formation.

Assessment of the intravascular volume status with point-of-care ultrasound

Assessment of the intravascular volume status is a critical skill for emergency veterinarians. Point-of-care ultrasonography (POCUS) is emerging as a valuable, noninvasive, cage-side diagnostic tool for objective evaluation of physiologic and hemodynamic parameters related to volume status, fluid tolerance, and responsiveness. Rapid cage-side sonographic evaluation can obtain qualitative data on cardiac function even when performed by non-cardiologists. POCUS involves answering focused clinical questions using cage-side ultrasonography and increases the sensitivity of the conventional physical examination.

That said, POCUS findings should be interpreted in conjunction with other clinical parameters—such as conventional perfusion parameters (heart rate, mentation, body temperature, mucous membrane color, CRT, pulse quality), urine output, blood pressure, and body weight —and not viewed as an alternative to physical examination or standard imaging studies.

In this blog post, I will describe the most commonly used views to assess volume status in dogs and cats: focused sonographic assessment of the heart (cardiac POCUS) and caudal vena cava (CVC POCUS).