Blog - Page 10 of 11

Dysnatremias: The role of urine sodium and osmolality

All living organisms originated in the sea. A constant salt concentration was important to maintain their vital functions. To overcome their dependency on the sea environment, a sophisticated renal system has developed in modern mammals that allows them to maintain a steady concentration of various electrolytes and water balance.

Understanding sodium and water balance is important for clinicians who treat animals with renal disorders, sodium derangements and other critical conditions. Not surprisingly, this topic may appear complex and daunting to the majority of veterinary practitioners.

Why I don’t use artificial colloids…

Currently, veterinary emergency and critical care practitioners (diplomates, residents and emergency veterinarians) are divided into two camps: those that don’t use artificial colloids and those that do. Each camp has its own arguments in favor or against the use of synthetic colloids (hydroxyethyl starches, specifically). The objective of this blog post is NOT to convince the other party that he or she is wrong and I am right, but an attempt to find out what is true and what to do about it. The reader should understand that there will be a lot of personal opinions in this post, and, as always, I recommend to exercise your critical thinking before taking these statements for granted. Ray Dalio, one of the most successful investors of all times, called this process “thoughtful disagreement”, which is “the process of having a quality back-and-forth in an open minded and assertive way so as to see things through each other’s eyes. This is powerful because it helps both parties see things they’ve been blind to. It also helps to remind people that those who change their minds are the biggest winners because they learned something, whereas those who stubbornly refuse to see the truth are losers. With practice, training, and constant reinforcement, anyone can get good at this”.

Furosemide use in management of acute kidney injury: magic bullet or fatal blow?

Furosemide is the most commonly used diuretic in critical care and is frequently used in the management of acute kidney injury (AKI). However, the benefits of furosemide administration in AKI has long been questioned and there are concerns over the possible harmful effects of furosemide including diuretic-induced AKI. To further evaluate the role of furosemide in management of AKI, let us consider a case.

A Practical Approach to Mechanical Ventilation in Small Animals

Hyperosmolar therapy in spontaneous intracerebral hemorrhage

A 7 year-old female spayed Pembroke Welsh Corgi was presented to a veterinary teaching hospital for evaluation of acute onset generalized clonic-tonic seizures, obtunded mentation and petechiation. Her primary veterinarian previously saw the dog two days ago when she developed anorexia. Multiple petechiations were noted on her skin at that time. Her initial blood work revealed severe thrombocytopenia at 5-10 K/uL (RI, 190-450 K/uL). The rest of the work-up (thoracic/abdominal radiographs and tick-borne disease testing) was unremarkable, and she was prescribed prednisone for suspected primary immune-mediated thrombocytopenia (ITP). The following day, she developed two clonic-tonic generalized seizures that lasted 1-2 minutes each. Her mentation became progressively worse, and she had several seizures on the day of presentation to the teaching hospital.