Pulmonary thromboembolism in dogs and cats: to lyse or not to lyse? 

An 8-year-old neutered male dachshund was presented to the emergency department for evaluation of respiratory distress. The dog was previously diagnosed with a heartworm disease and was currently undergoing treatment with a “slow kill” method. Physical examination revealed tachycardia at 160/min, right-sided pulmonary crackles, and tachypnea with increased respiratory effort. The point-of-care blood work showed hyperlactatemia at 4.5 mmol/L, PCV/TS of 53%/7.8 g/dl, mild metabolic acidosis, normal electrolytes and renal values. The arterial blood pressure (Doppler) was at 130 mm Hg. 

As the dog was getting flow-by oxygen, an abbreviated thoracic point-of-care ultrasound (T-POCUS) was performed (see below). 

Continue reading “Pulmonary thromboembolism in dogs and cats: to lyse or not to lyse? “

How to teach veterinary students to diagnose shock?

“Shock” is one of the most frequently used words in a small animal emergency room and ICU. Despite this fact, a lot of veterinary students and new graduates have only superficial understanding of this term. This lack of understanding may lead to inaccurate diagnosis and mismanagement of patients in shock. 

Continue reading “How to teach veterinary students to diagnose shock?”

Citrate Toxicity Calculator for Dogs

Those of you who have ever participated in canine blood donation might have encountered a situation when the blood flow through a sampling line has significantly slowed down or even completely stopped, and despite your best efforts, you had to abort the mission. As a result, the blood bag may end up being half full and contain only 200-250 ml of blood. Since the majority of commercially available donor bags contain 63-70 ml of citrate-based anticoagulant, they are designed to be filled up with 400-450 ml of donor blood to maintain a 1:7 – 1:9 citrate-to-blood ratio. If not, the citrate-to-blood ratio goes up, which creates a risk for citrate toxicity during a blood transfusion. In this situation, a clinician or technician may elect to waste this blood product and send this donor home since collecting another full bag of blood will not be safe for the donor animal. On the other hand, there is an extreme shortage of blood products in veterinary medicine, and, if possible, any waste should be avoided.  In this blog post, I will give you a tool that may help you decide on whether a blood product with a high citrate-to-blood ratio should be discarded or safely given to a prospective recipient. 

Continue reading “Citrate Toxicity Calculator for Dogs”

Mechanical GI Obstruction: Fake News?

A 2-year-old spayed female standard poodle was referred to a specialty private practice for evaluation of a suspected small intestinal mechanical obstruction. Two weeks prior, the dog started vomiting and stopped eating. The initial diagnostic work-up performed by her primary veterinarian showed normal bloodwork, and the dog received regular supportive care on an outpatient basis. Due to the presence of persistent vomiting and inappetence, the abdominal survey radiographs were performed, and they were consistent with the gastrointestinal obstruction as it was interpreted by a board-certified radiologist.

Continue reading “Mechanical GI Obstruction: Fake News?”

Do All Cats with “HCM” have HCM?

A 7-month-old female spayed domestic shorthair was presented to an emergency service (ER) for increased respiratory rate and effort. The cat got spayed at her primary veterinarian 6 days prior to this episode, and had been doing well otherwise up until the evening of presentation. The owner reported no previous medical conditions. 

The initial triage examination showed tachypnea and moderately increased respiratory effort with increased bronchovesicular sounds in dorsal lung fields. No heart murmur or other abnormal physical examination findings were noted at that time. An emergency clinician performed thoracic radiographs (Figure 1 and 2) and point-of-care blood work that was within normal limits.  

Continue reading “Do All Cats with “HCM” have HCM?”