Metabolic alkalosis in animals with upper GI obstruction

If you are presented with an acutely vomiting canine or feline patient who happened to have a metabolic alkalosis on the blood gas analysis, an upper gastrointestinal (GI) obstruction should be suspected. Lozano et al. (Texas A&M University, JSAP 2023) recently published a study that looked at the prevalence of various acid-base and electrolyte disorders in this population of dogs.  A total of 115 dogs were included in the study, with 22% of dogs showing either a simple metabolic alkalosis or a mixed metabolic alkalosis before surgery. While 37% of dogs had a normal acid–base status on presentation. 

Continue reading “Metabolic alkalosis in animals with upper GI obstruction”

Should you recommend euthanizing canine patients with spontaneous hemoperitoneum based on CT results alone?

As emergency veterinarians, one of the most critical decisions we face is whether to recommend humane euthanasia in canine patients with spontaneous (non-coagulopathic) hemoperitoneum based solely on CT results. A recent study shed light on the limitations of CT imaging in distinguishing between benign and malignant lesions in such cases (Parry et al. JVECC 2023). Understanding the study’s findings is crucial for making well-informed decisions and providing optimal care for our canine patients. In this blog post, we will explore the study’s results, particularly the concerning frequency of benign lesions being misinterpreted as malignant, and discuss the implications for our decision-making process.

Continue reading “Should you recommend euthanizing canine patients with spontaneous hemoperitoneum based on CT results alone?”

“Arterialization” of the venous blood for the blood gas analysis

Can you achieve “arterialization” of the venous blood in a dog with normal cardiovascular status by heating its paw to 37C (=98.6F) for measurement of blood gas variables? 

In both human and veterinary medicine, venous blood samples have been used to estimate acid-base balance as an alternative to arterial blood samples. In human medicine, a technique called “arterialization” of the dorsal hand vein is established, where warming the hands to 42-43°C (=107-109.4F) for 10-15 minutes makes venous blood more similar to arterial blood. 

Continue reading ““Arterialization” of the venous blood for the blood gas analysis”

Antiemetics in pets with foreign body obstruction

Does administration of antiemetic medications to dogs and cats with gastrointestinal foreign body obstruction delay  time to definitive care (surgery or endoscopy) and increases the risk of complications? 

Puzio et al., JVECC 2023 (Blue Pearl, Wisconsin, USA) performed a retrospective study on 440 dogs and 97 cats to answer this question. The study found that, while antiemetic administration prolonged the time from clinical signs to definitive care (3.2 days vs. 1.6 days; P < 0.001), it did not significantly increase the risk of complications related to foreign body obstruction. However, the use of antiemetics was associated with a longer hospitalization period (1.6 days  vs. 1.1 days; P < 0.001). The study suggests that antiemetics are not inherently contraindicated in gastrointestinal foreign body obstruction cases, but veterinarians should advise clients to closely monitor their pets for symptom progression and seek follow-up care accordingly.

Continue reading “Antiemetics in pets with foreign body obstruction”

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?

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