ALL JOURNALS Flashcards

Question

What were the findings of a study by McMurray et al regarding focused assessment with sonography in nontraumatized dogs and cats in the emergency and critical care setting? JVECC 2016 26(1)

Answer 1

* Free fluid was identified on AFAST/TFAST in 33% of dogs and cats in the study, particularly in those who cardiovascularly unstable or dyspneic * Results support the use of AFAST/TFAST to detect free fluid in nontraumatized dogs and cats

Answer 2

* 36% of dogs required transfusion with pRBC being the most commonly administered product * Transfusion reasons periop hemodynamic support, tx shock, worsening anemia * Dogs receiving transfusion had a higher mean heart rate, blood lactate and ATT scores, with lower mean PCV/TS and rectal temp on admission than dogs who did not require transfusion * PCV/TS were specific but insensitive predictors of subsequent transfusion * 87% survived to discharge, although significantly fewer dogs receiving transfusions survived * 70% of dogs receiving massive transfusion survived to discharge

Answer 3

* Unlike hypercoagulability observed in human orthopedic patients, a hypercoagulable state measured by ROTEM did not develop in dogs following orthopedic surgery.

Answer 4

* 11 yo dog developed anuria following cholecystectomy; developed CV dysfunction, coagulation dysfunction, hypoglycemia * Hemodialysis, intensive care--survived

Answer 5

* Minimization of total anesthesia time, reversal of mu-opioid receptor agonists at the end of anesthesia and prevention of intraoperative decreases in blood oxygen saturation and postoperative decreases in HCt appeared to help maximize post-surgical survival time in cats undergoing renal transplant * mST 653 days * Cats \>12 had a lower overall survival rate than younger cats * No association between survival and anesthetic agent used, amount and type of fluid, physiologic abnormalities or blood product administration

Answer 6

* Urethral stents were effective treatment * Moderate to severe incontinence developed in 12% of dogs * Relieved obstruction in all dogs with an excellent long term outcome

Answer 7

* In healthy dogs, administration of both NaCl and tetrastarch resulted in a decrease in PCV/TP. Tetrastarch caused a larger immediate increase in HR/SBP and MAP compared to NaCl. * In dogs with LPS induced inflammation, increased HR and MAP with tetrastarch. PCV/TP and lactate decreased with both fluids. * Tetrastarch effectively increased COP (as compared to decreased with NaCl) in all dogs, although the total plasma protein decreased...

Answer 8

* Hepatotoxicosis was seen in 15% of dogs, with median onset of 14 days * Median 9-fold increase in ALT and 8-fold increase in ALP which stabilized or resolved with drug discontinuation/dose reduction * Thrombocytopenia/neutropenia seen in 8% of dogs with CBC follow-up, with median onset time of 53 days

Answer 9

The purpose was to compare the attenuation of the ANG1 induced BP response by once-daily oral administration of various doses of ARBS (ibersartan, telmisartan, losartan), benazepril, or placebo in clinically normal cats. Among drugs, telmisartan attenuated SBP to a significantly greater degree than benazepril and all other treatments. At 24 hours, telmisartan was more effective than benazepril. Results indicated that telmisartan may have advantages over benazepril for cats with renal/cardiovascular disease.

Answer 10

* The results of this study failed to demonstrate an improved survival rate in those patients who were administered appropriate empiric antimicrobial therapy in this patient population. * Prior treatment with antimicrobials did not show an association with outcome, however, was associated with a subsequent inappropriate antimicrobial choice * Recent abdominal surgery was also associated with a subsequent inappropriate antimicrobial choice * Study is small however, doesn't fit with results of large meta-analyses in people (i.e. survival 52% in people with appropriate antimicrobials, 10% survival in patients with inappropriate antimicrobials)

Answer 11

* Dogs received aspirin 1mg/kg PO q24 x 7d and platelet function was evaluated by aggregometry, PFA and determination urine 11-dehydro-thromboxane B2 concentration * 14 days after cessation of aspirin, PRP was incubated with acetylsalicylic acid and platelet function assessed * 13 dogs had aggregometry results athat were decreased by \>25% from baseline on days 3 and 7; 4 and 7 dogs had PFA closure times \>300 seconds on days 3 and 7 * Responsen to a low-dose aspirin regimen varied among healthy dogs

Answer 12

LA size is prognostically important in dogs with MMVD. LA vol/BW identified LAE in 12 cases in which the LAAo was normal; 7 of these dogs were in stage B1 and 5 in stage B2. No diagnostic discrepancies were apparent in dogs with a severe mitral regurgitation severity score. LA Vol/BW may be superior to LAAo for identification of mild LAE.

Answer 13

* Clinically healthy dogs carred CAV-2, CPIV, and B. bronchiseptica * Co-infections in affected dogs were common * Clinically healthy dogs can carry respiratory pathogens and act as infection sources for susceptible dogs

Answer 14

* GCSF treatment can impede renal fibrosis and increase proliferation of renal tubules after experimentally induced AKI

Answer 15

* Dog presented for limping, fever, vomiting, malaise. * Nonocclusive splenic vein thrombus identified, with histopathology of the spleen showing marked splenic infarctions and necrotizing vasculitis. * Bartonella was amplified by PCR and the dog recovered uneventfully with antimicrobial therapy. * Ideal treatment for bartonella (erythrocytic/endotheliotrophic bacteria) is not known, typically treated with multiantimicrobial therapy (enrofloxacin, doxycycline in this case) * Bartonella may play a role in the development of vasculitis and thromboembolism and as such, should remain a differential in cases of splenomegaly/thrombus.

Answer 16

* Alendronate treatment resulted in a decrease in iCa in all cats * Alendronate was well tolerated and decreased iCa in most cats for the 6 month period of observation

Answer 17

* No significant difference in bloodwork and APPLEfast scores were found * Survivors had significantly higher: * Total protein * Albumin * Antithrombin * Base excess * Survivors had significantly lower: * Lactate * Urea * Creatinine * APPLEfast scores (22 compared to 31) * Higher values of: creatinine, lactate, anion gap, APPLEfast, and ALT were significantly associated with an increased risk of death

Answer 18

* Refrigerated storage resulted in significant decreases in the activity of all clotting factors and a subsequent prolongation in clotting times, however, none of the values were outside of the reference intervals * Bacterial cultures of the units lead to no growth * Kept refrigerated for 14 days

Answer 19

* Compared systemic glucose and local (affected limb) glucose * Delta glucose and % delta glucose between the two are accurate markers of acute ATE in dogs and cats, being significantly higher in pets presenting with ATE as compared to those with acute limb paralysis secondary to orthopedic/neuro conditions, and ambulatory controls

Answer 20

* The DH view of the FAST exam was found to be clinically helpful for the detection of pericardial effusions. Looking into the thorax via DH during both TFAST and AFAST exams should be routine practice.

Answer 21

* HES used as a 24 hour CRI at 1ml/kg/hr and 2ml/kg/hr prolongs platelet CT in healthy dogs at 6,12, and 24 hours--HOWEVER--the median CT only exceeded the reference interval at 24 hours at 2ml/kg/h * No clinical evidence of spontaneous bleeding in any dog during the 24 hour infusion at either rate

Answer 22

* Platelet dysfunction occurred during hemorrhage in this model despite a stable platelet count * Significnt changes associated with hemorrhage were documented in aPTT (significantly prolonged), fibrinogen (decreased) and MA (altered). * Platelet function testing in dogs with naturally occurring hemorrhage warrants further investigation.

Answer 23

* Prolonged clot initiation was common in puffadder envenomated dogs * Snouted cobra envenomed dogs were normal to hypercoagulable at presentation * Within 24 hours, both groups progressed t a more hypercoagulable sate likely due to inflammation

Answer 24

* Autologous BM-MSCs may accelerate renal regeneration after experimentally induced AKI in dogs... * There was less fibrotic change and increased proliferation of renal tubular epithelial cells in the BM-MSC treated dogs * Lower expression of TNFalpha and TGFbeta in the treated dogs

Answer 25

* Median Na fractional excreation was an accurate predictor of AKI * Median UCRP, URBP and UNGAL were increased in all dogs with heatstroke and were significantly higher than in healthy control dogs * Damage occurs in both the tubules and glomeruli

Answer 26

* Leukoreduction was effective for removal of luekocytes (decreased by 99.9%) in all uinits * Significant increases in IL8 did not occur during storage * TNFalpha and IL1B concentrations were not significantly different

Answer 27

* The degree of sedation obtained with DMe and DMeMi was significantly higher than in the D group alone. * The required dose of propofol was lower in all groups (DMi, DMeMi, DMe) than in the control group * Recovery quality was not diffrent beteween gropus

Answer 28

* Study group was 39 dogs for which TEG was performed within 7 days of complete necropsy * Spayed females were significantly more likely to have thrombosis * No association between any TEG parameter and the presence of thrombosis on postmortem * D-dimers significantly higher in dogs with thrombosis, weak positive correlation between D-dimer value and number of sites of thrombosis * Dogs with WBC \>16 x 10^3 more likely to have thrombosis

Answer 29

* CHAOS: canine hemolytic anemia objective score. * A higher risk of death during hospitalization was associated with a CHAOS score of \>/= 3; CHAOS also associated with death within 30 days. * The Tokyo score was not determined to be statistically significant. * Three variables predictive of death in hospital: * ASA classification * Bilirubin * Urea * Three variables predictive of death by day 30: * ASA classification * Bilirubin * Creatinine

Answer 30

* Plasma iron has been shown to decrease in inflammatory conditions in both animals and people * Decrease in iron is thought to be mediated by hepcidine, produced by the liver in response to inflammatory cytokines * Induces the loss of ferroportin in different cell types and inhibits the export of iron from the cellular compartment to plasma * Progressive decrease in plasma iron input and the continued use of transferrin-bound iron results in hypoferremia. * Fibrinogen was increased in the dogs with SIRS/sepsis and local inflammation as compared to controls, but no significant difference btwn the 2 groups with inflammation * Plasma iron, CRP, and albumin all effectively differentiated dogs with SIRs/sepsis from those with local inflammation on presentation * Admission values did not discriminate survivors from non-survivors * Magnitude of increase in plasma iron and magnitude of decrease in CRP were higher in survivors than nonsurvivors within the SIRs/sepsis gropu. * Concluded that hypoferremia is a sensitive marker of systemic inflammation in dogs * An increase in iron during the hospitalization period was associated with a better prognosis * Plasma iron in combination with CRP and albumin concentrations may be a useful monitoring tool

Answer 31

Agreement between transcutaneous and arterial PO2 and PCO2 measurements in the dogs studied were inferior to those reported in the human literature The cutaneous monitor consistently overestimated both PO2 and PCO2 and should not be used to replace arterial blood gas monitoring

Answer 32

* Alteplase was effective at improving the function of central venous cahteters used to provide RRT, however, the results were short-lived--24% had to be treated multiple times (median time to second treatment was 8 days)

Answer 33

* 56% of cats had abdominal effusion on survey abdominal radiographs * Sample was not tested, so do not know source/type * No cat was diagnosed with bladder rupture * Survival to discharge (91%), duration of catheterization (27.9h) and length of hospitalization (40 hours) similar to previous reports

Answer 34

* CAR significantly lower in dogs with HA compared to healthy dogs or those with diseases that mimic HA * Overlap between groups, however, with CAR \>0.01, high sensitivity/specificity (100%/99%)

Answer 35

* Longer duration of pRBC storage was asociated with development of new/progressive coagulation failure and thromboembolic disease * No association between duration of pRBC storage and survival for all dogs overall, HOWEVER.... * In dogs with hemolytic anemia, for every 7 day increase in length of storage, there was a 0.79 lesser odds of 30 day survival

Answer 36

* Porposed 2 models that were applicable for objective assessment of severity and prognosis of heatstroke, however, require independent validation * Factors including acute collapse, seizures, neurologic abnormalities and petechiation were associated with higher risk of mortality * Shock, AKI, DIC--\>higher risk of death

Answer 37

Regarding both size and function, the LA has a strong correlation with the prognosis of dogs with CMVHD. The most significant independent predictor of mortality in this study was the LA active fractional area change (LAFACact).

Answer 38

* Decreased platelet count was a risk factor for body cavity hemorrhage * Decreased platelet count, protein C activity, alpha angle, MA and G were risk factors for blood product administration * Nonsurviving dogs were hypocoagulable with prolonged apTT, decreased plasmin inhibition, decreased alpha angle and MA compared to surviving dogs * Prolonged aPTT was the strongest predictor of non-survival * Was positively correlated with APPLEfast score, lactate, and negative base excess * ATC was diagnosed in 15% of dogs ad admission, more common in dogs with increased disease severity, decreased systolic blood pressure and increased lactate

Answer 39

* Dogs with HAC had higher SPEC concentrations and more positive SMAP results than clinicaly healthy dogs with normal ACTH stim results * Interpret cautiously in dogs with HAC to avoid false diagnosis of concurrent pancreatitis

Answer 40

* Dogs with CHF (group C) had slightly higher CRP concentrations than other groups; severity of asymptomatic MMVD showed no association with CRP concentration.

Answer 41

* MEPA using arachidonic acide, adenosine diphosphate and collagen as agaonists was measured within 24 hours of a sepsis diagnosis * Compared to healthy dogs, platelete aggregation was reduced in dogs with septic peritonitis for all agonists * Overall mortality rate was 40% * MEPA in response to collagen was significantly reduced in nonsurvivors compared to survivors

Answer 42

SQ administration resulted in UOP/hr that peaked at 1 hour, with UOP/hr returning to baseline at 4 hours after injection. After IV injection, UOP/hr peaked at 1 hour, returned to baseline at 2 hours after injection. With PO administration, UOP/hr peaked at 2 hours, took 6 hours to return to baseline. With CRI administration, UOP/hr was delayed to 4 hours after injection, but UOP/hr maintained throughout administration. Did not evaluate IM administration... Concluded that SQ route may be an effective means for administration in dogs when IV access is difficult.

Answer 43

* Risk factors included thin body condition, prior periodontal disease, cystitis, anesthesaia or dehydration in preceding year, being a castrated male. * Recent weight loss should trigger assessment of cats for CKD.

Answer 44

The 25 cats in the study with a cardiac cause of dyspnea had a significantly higher blood cTnI concentration than the healthy cats or the 14 cats with a non-cardiac cause. Measurement of cTnI with a cage side assay in an emergency setting may be useful for differentiating cardiac from non-cardiac causes of dyspnea in cats. \*\*Did not provide a cut-off value...\*\*\*

Answer 45

* According to HH approach, the most common disorders were simple, with high anion gap metabolic acidosis the most cmoon. WIth quantitiative analysis, the majority were complex discorders with SIG acidosis and Atot alkalosis as the most common abnormalities. * Many imbalances detected using the quantitative approach were missed using HH.

Answer 46

* SDMA was determined to be stable and highly analytic * SDMA identified on average a \<20% decrease in GFR, which is lower than creatinine by any metod * Useful for early ID and monitoring of decreased renal function in dogs with CKD

Answer 47

* Omeprazole was shown to cause a significant increase in serum gastrin concentrations; famotidine induced a transient increase in serum gastrin that peaked at administration day 3 and declined thereafter * By day 7 after cessation of both drugs, the gastrin levels were the same as those obtained pre-treatment * A 7 day withdrawal from short-term administration (7 days) of famotidine or omeprazole is sufficient for serum gastrin to return to baseline concentrations

Answer 48

* Dogs with shortened PT or PTT had significantly more thrombus formation, supsicion of PTE, and increased D-dimer concentration compared to dogs with normal values * No significant findings compared to TEG values *

Answer 49

* There were no significant effects of leukoreduction/non-leukoreduction or storage time for IL-1B, IL-10, TNF-alpha. * IL-8 concentration was significantly increased over the storage period (35 days) in the NLR units and was significantly higher compared to the LR units on days 28 and 35.

Answer 50

* Prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. * Mortality rate was 33.3% for septic cats. * Results indicated that many cats have evidence of SIRS and some have sepsis, with a high mortality rate

Answer 51

* The combination of AMM resuled in intense sedation more frequently than AM or MM and provided the greatest sparing of propofol dose * Any protocl with acepromazine resulted in a decreased blood pressure, although not to the point of true hypotension

Answer 52

* Maropitant significantly decreasees the incidence of vomiting but does not improve signs of nausea, ptyalism or increased panting * Acepromazind showed significantly less panting

Answer 53

* Seropositivity for lepto was significantly different between the KD and healthy cats, although the PCR was not * Pomona and bratislava were the most commonly isolated serovars. * Risk factors for seropositivity included outdoor/hunting lifestyles, the presence of another cat in the houshold and the sampling period--most cases identified between July and August. * Seropositivity in cats with KD was significantly greater, suggesting that lepto should be considered higher on the list.

Answer 54

* There was a strong correlation throughout this study between StO2 and oxygen delivery (across all time points--hypovolemia, normovolemia, hypervolemia) suggesting that StO2 may be used to estimate oxygen delivery.

Answer 55

* Dogs undergoing liver lobectomy and/or splenectomy were significantly likely to receive a transfusion when compared to all other procedures (gastrectomy, rhinotomy, thyroidectomy, herniorrhpahy) * 42% of splenectomy dogs, 40% liver lobectomy dogs * A significant association was found between body weight and perioperative RBC transfusion--greater body weight, greater risk of transfusion * 61% overall survival rate * Dogs requiring transfusion were significantly less likley to survive to 2 weeks after surgery

Answer 56

* Myocardial injury frequently occured in dogs with snake envenomation (demonstrated by increased cTnI and increased CRP) * The degree of systemic inflammation was significantly correlated with degree of myocardial injury in V. berus envenomation at all time points, this was not the case in dogs envenomated by N. annulifera or B. arietans. *

Answer 57

PHT is common in dogs with MMVD; more commonly identified in stage C compared to B2. MST for entire study population (212 dogs) was 567 days. On univariate analysis, stage C heart failure, presence of PH, LA/Ao \>1.7, LVEDn \>1.73, tricuspid regurgitation pressure gradient (TRPG) \>55mmHg were associated with worse outcomes. On multivariate analysis, the presence of TRPG \>55mmHG and LA/Ao remained significant predictors of worse outcome. In dogs with MMVD, the presence of moderate to severe PH worsens outcome.

Answer 58

* Normal standard coagulation profiles were present in clinical dogs, asymptomatic dogs and a control group * ROTEM results did not fall outside of normal for all gropus

Answer 59

* If a voided sample is used, the cutoff of \>/=100,000 CFU/ml is appropriate for determining significant bacteriuria in the majority of dogs with suspected UTI if the samples are refrigerated and cultured on the day of collection * Cystocentesis cut-off \>1000 CFU/ml

Answer 60

* A moderate to severe metabolic acidosis developed in all cases, had a concurrent respiratory acidose in 88% of cases * Progressive increase in lactate was seen in all cases during CPR; the degree of elevation may reflect the efficacy of resuscitative efforts * Giving epinephrine may also contribute, as it accelerates glycolysis * Elevated PCO2 was seen in 88% of cases during CPR, 61% following ROSC * During CPR, PCO2 represents a low blood flow state and accumulation in the tissues rather than ventilation * Hyperkalemia occured in 65% of cases * Due to global ischemia causing failure of energy dependent cellular ion pumps and subsequent K+ efflux from cells * Hypocalcemia developed in 18% * Due to intracellular accumulation following ischemia/reperfusion injury * Hyperglycemia in 62% * Effects of exogenous and endogenous catecholamines No significant difference in any of the variables during the first 15 minutes of CPA versus the first 15 minutes after CPA. pH and PvO2 lower in the CPR gropu during the first 5 minutes of ROSC compared to during CPR.

Answer 61

* Proportion of dogs that survived for 48 hours after surgery was significantly higher for the patients treated with lidocaine (35/42) than for those treated with an opioid alone (20/33). * Intraoperative lidocaine increased the odds of short-term survival. *

Answer 62

* Reported complications that may arise with ABT included hypocalcemia, hemolysis, and prolonged coagulation times, although they were considered of minor clinical significance * ABT may be used as a bridge to definitive hemorrhage control, particularly when other blood products are not available or affordable.

Answer 63

* Bioavailability of ciprofloxacin seemed to be impacted by use of sucralfate * No significant difference in bioavailability of enrofloxacin was documented (even when sucralfate was given concurrently to the FQ)

Answer 64

* Intermittent E. ewingii rickettsemia persisted in 3 of 4 dogs for as long as 733 days. * Dogs infected with E. ewingii from tick feeding are capable of maintaining infection with this pathogen long-term and may serve as a reservoir host for the maintenance of E. ewingii in nature.

Answer 65

* Healthy research dogs given LPS or placebo; NTpCNP measured by ELISA as were cytokines/chemokines. * Serum NTpCNP did not differ significantly between the LPS or placebo group at any time point. * Certain serum cytokines/chemokines are significantly increased within 1-4 hours of LPS administration in healthy dogs and warrant further investigation as tools for detection/management of sepsis in dogs.

Answer 66

* Protamine prolonged clot formation time and decreased overall clot strength in a dose dependent manner * May contribute to a hypocoagulable state in dogs * Administration of protamine to reverse the effects of heparin should be performed with caution

Answer 67

* 58% of dogs recovered the ability to walk independently within the 3 months after surgery * No prognostic value was identified for any of the investigated factors... * A greater delay between onset of paraplegia nad referall evaluation was NOT associated with a poorer prognosis * Prognosis for recovery may instead be influenced by the precise nature of the inciting injury

Answer 68

* Uremic hypothermia is a clinical phenomenon occurring in cats and dogs; uremic patients are hypothermic compared to ill non-uremic patients and body temperatures increase when uremia is corrected with IHD in dogs and in cats \>5kg * In cats, UH seems to be more prevealent * Body weight in dogs is actually a more important predictor of body temperature in dogs with UH

Answer 69

* Fenoldopam is a dopamine-1 receptor agonist causing vasodilation in peripheral arteries and diuresis in the kidneys * With stimulation, DA-1 receptors result in conversion of AMP to cAMP, resulting in smooth muscle relaxation and vasodilation * Stimulation of renal DA-1 receptors likely responsible for increases in natriuresis, diuresis, renal blood flow and GFR in people * Used for management of hypertensive crises in AKI people * Study compared outcome in dogs and cats with AKI who received fenoldopam CRI (typically at 0.8ug/kg/min dogs, 0.5ug/kg/min cats) * Administration was safe, no significant adverse effects--hypotension was most commonly seen * NO significant difference between fenoldopam/non-fenoldopam group in survival, length of hospital stay, adverse effects, changes in creatinine, BUN or sodium concentrations

Answer 70

* 91.2% survival to discharge rate * GSD, Great Danes and English Bulldogs accounted for 50% of the cases * Septic peritonitis on presentation, intraoperative hemorrhage and postoperative development of respiratory distress were associated with death * Splenic neoplasia was not found on histopath in any case

Answer 71

* Transthoracic or transesophageal US revealed grass awns in the pulmonary parenchyma or the pleural space of 23 of the 43 dogs in the study * Surgical removal was successful in these cases * 20 dogs with suspicion for migrating grass awn did not have identified fb on initial US and were treated medically, however, 16 of them ultimately developed draining fistulas and awns that were identified with US at follow up visits were removed from the sublumbar retion or thoracic wall. * US may be considered a valuable and readily available diagnostic tool for monitoring dogs with suspected migrating intrathoracic grass awns

Answer 72

* Cats treated with the SC/IM protocol had significantly shorter time to resolution of hyperglycemia, ketonemia, and normalization of pH and bicarbonate * Cats in SC/IM group also had significantly shorter duration of hospitalization (54 compared to 111 hours!) * Time to first meal was not significantly different between groups

Answer 73

* Recommended formula: * **2(Na) + [glucose/18] + [BUN/2.8]** because it is easy to use and is reliable even when hyperglycemia or azotemia are present * Osmole gaps varied widely depending on the formula used to calculate osmolality...

Answer 74

* Seasonal patterns for seropositivity to lepto differ by geographic region (higher rates were found in the MW and the NE in the second half of the year, earlier rates in CS and SC regions)

Answer 75

Cough, exercise intolerance, decreased appetite, breathlessness, syncope, murmur \>III, absence of a respiratory sinus arrhythmia. A clinical severity score system was developed, ranging from none to severe. Dogs with 3-4 risk factors were considered to be at intermediate risk and had a survival time of 1000 days, whereas dogs with 5\> risk factors were considered to be severe and had a MST of 167 days.

Answer 76

Chronic mitral valvular insufficiency is common in dogs and may cause clinical signs of congestion and poor tissue perfusion, which may lead to pancreatitis and elevated serum cPLI concentrations. An increase in serum cPLI concentrations were identified in dogs with increasing severity of heart diesease (54 ug/L in control group; 223 ug/L in severe group). Suggests periodic monitoring of serum cPLI may be useful in dogs with heart failure.

Answer 77

Tricuspid annular plane systolic excursion is a useful estimate of RV function in humans. Quantitative estimate of longitiduinal RV shortening. TAPSE was lower in Boxers with \>50 VPCs/24h than in Boxers without. TAPSE

Answer 78

* Gastric lesions consistent with ulceration/edema/or fibrinoid changes were not observed in cats with CKD * Gastric fibrosis and gastric mineralization of varying severity were identified * CKD cats were more likely to have these findings than nonazotemic controls * CaP product was correlated with disease severity, with severely azotemic CKD cats having significantly higher CaP than nonazotemic * Gastrin concentrations were significantly higher in cats with CKD than compared to controls, however, increased concentrations were not associated with gastric ulceration * Perhaps gastroprotectants/antacids aren't necessary

Answer 79

* Dogs with SHP have evidence of hypocoagulability, protein C deficiency, and hyperfibrinolysis * The parameters of hyperfibrinolysis were related to plasma lactate concentration and the volume of plasma transfused during hospitalization * Derangements resemble those found in people with acute coagulopathy of trauma/shock; activation of protein C may be common to both syndromes

Answer 80

Myocardial injury as detected by CTnI and T in cardiac disease is associated with increased risk of death in humans and dogs. In cat, troponin concentrations at admission were prognostic for death as were the last available concentrations of each. The final cTnT concentration was a significant predictor of death even when adjusting for admission concentration. Low sensitivities and specificities of these findings however prevent outcome prediction in individual cats.

Answer 81

* The procoagulant phospholipid concentration gradually increased during the storage period, however, leukoreduction reduced the development of increased procoagulant activity over time * Presence of PPL in canine ECs may be associated with procoagulant and proinflammatory effects in vivo, which could have adverse consequences for dogs treated with EC

Answer 82

* Cervical US has high sensitivity and moderate specificity for ET intubation and may be a useful tool to confirm intubation in dogs

Answer 83

* In non-ADP treated samples, crtically ill and control dogs had no difference in platelet activation. * Critically ill dogs had significantly increased platelet activation in response to 2,6, and 10um ADP * Critically ill dogs had significantly increased MA, alpha angle, and global clot strength along with significantly decreased clot formation time. * Critically ill dogs had significantly increased fibrinogen concentration, PT, and PTT and signficantly decreased AT concentration. * No difference betweeen survivors and non survivors * Concluded that critically ill dogs had hyperreactive platelets which may have contributed to the high incidence of hypercoagulability in this patient population

Answer 84

* Mean platelet volume was higher in IMT dogs * The platelet distribution width was not significantly different amon the groups * The median time for PCT to reach threshold (selected at 75,000 platelets/uL) in confirmed responders to therapy was faster (3 days) compared to platelet count (4 days) * PCT may be a useful platelet parameter for monitoring dogs with ITP

Answer 85

* MMF usage enables reduction of prednisone treatment and in some cases, complete withdrawal * GI side effects are possible *

Answer 86

* Compared to spontaneous ventilation, both modes significantly improved gas exchange without hemodynamic impairment. * PCV resulted in higher lung static compliance and lower PIP as compared to VCV

Answer 87

* FGF 23 secreted primarily by osteocytes/osteoblasts in response to hyperphosphatemia and increased plasma calcitriol * Acts in kidneys to inhibit calcitriol production and to increase phophaturia; acts in the parathyroid to decrease PTH production and secretion. * Survival in cats was negatively associated with the plasma creatinine and FGF 23 concentrations, UPC and age. * FGF 23 was found to be a novel independent predictor of CKD progression

Answer 88

* 50% had higher hostpial sample UPCs, 38% had identical UPCs and 12% had lower hospital sample UPCs. * For the samples as a whole, the UPCS of the hospital samples were higher than the home samples for the total population * Setting and circumstances of urine collection is associated with UPC differences, usually higher in hospital than at home

Answer 89

* For dogs with AF, MST was 142 days as compared to those without AF (234 days). * MST significantly prolonged for dogs with AF whose rates were adequately controlled when compared to dogs that failed to respond to negative chronotropic agents.

Answer 90

* Omeprazole (either a fractionated tablet or a reformulated paste) was superior to famotidine in regards to acid suppression * The fractionated tablet of omeprazole appeared to be an effective acid suppressant despite disruption of the enteric coating

Answer 91

* A daily evaluation to check readiness for weaning combined with a spontaneous breathing test reduced the MV duration for children on MV for \>24 hours without increasing the extubation failure rate or the need for non-invasive ventilation

Answer 92

* A prior history of UO and a longer duration of clinical signs may be important risk factors for the development of severe anemia in cats with UO * Median PCV of all cases at presentation was 28% and \<20% in those who required a transfusion. * UO-A cats appeared to be more severely affected, as evidenced by lower BP, more severe metabolic acidosis, higher BUN and creatinine, and a worse outcome.

Answer 93

* 73% of dogs with DKA had concurrent pancreatic injury based on PLI results * Fair agreement between serum PLI activity and AUS findings * Concurrent pancreatic injury is common in dogs with DKA, but did not affect prognosis in this population

Answer 94

* 7.6% of dogs died in the perioperative period; thrombotic and coagulopathic syndromes and uncontrolled bleeding from metastatic lesions were the most common cause of death. * For each decrease in platelet count by 10,000, odds of death increased by 6% * Dogs with PCV \<30% were twice as likely to die * Dogs developing ventricular arrhythmias intra-op were twice as likely to die

Answer 95

* Hypernatremia was found infrequently (6% dogs, 8% cats), but patients with hypernatremia were significantly more likely to die than those with normal blood sodium * Hypernatremia was associated with a higher case fatality rate than hyponatremia

Answer 96

* TEG results defined dogs as hypocoagulable, normocoagulable, and hyperoagulable. * Hyperfibrinolysis was also identified in a portion of dogs. * Dogs with acute liver failure had greater increases in K and LY20, along with decreases in MA, G and PC activity than dogs with less severe hepatic impairment. * Results for mA and LY30 were positively correlated with serum biliubin and WBC count and negatively correlated with serum cholesterol

Answer 97

* Serum big ET-1 was elevated in dogs with HSA significantly compared to other dogs.

Answer 98

* IN the steroid group, 43% of the cases developed a major severity complication compared to 18% of the control group * Purulent discharge, tube dislodgement, chewing of tube at stoma site were major complications * Overall, complication rate was similar between two groups

Answer 99

SAS is one of the most common congenital defects in dogs; severe SAS is often treated with a beta blocker, but this is largely empirical. STudy found that only age at diagnosis and pressure gradient at diagnosis affected survival time, with only PG influencing survival time in the cardiac mortality analysis. Treatment with a beta-blocker did not influence survival time in all-cause or cardiac cause mortality analysis.

Answer 100

* Morphine, buprenorphine and fentanyl all promoted LPS or LTA-induced TNF alpha and IL-10 production, but did not actually alter the ratios of these cytokines * Morphine, buprenorphine and fentanyl all inhibited neutrophil apoptosis, which was not concentration dependent in nature * Opioids alter immune and apoptotic pathways in dogs and these effects should be considered when designing studies and interpreting outcomes of studies involving opioid administration

Answer 101

* Expression of IL1 alpha and beta, TGF-beta and the enzyme 5-LO was clearly increaed in dogs with renal disease, suggesting these markers are part of an inflammatory response in dogs wtih AKI/CKD * No significant difference between the renal disease groups was detected for inflammatory markers and laboratory variables, degree of azotemia or the cause of impaired renal function

Answer 102

* 9.3% of dogs had incidental adrenal masses * Dogs with incidental masses were significantly older than those without * Histo evaluation was only performed in 3 of the dogs; 2 had cortical adenomas, 1 had a pheo

Answer 103

* Cats with DKA were more likely to be Siamese than those with uncomplicated DM * Poor outcome associated with: * Increased initial creatinine, BUN, total magnesium and total bilirubin * Cats treated with a higher concentration of IV insulin CRI had a better outcome than those treated with a lower concentration

Answer 104

* PPV was increased by hemorrhage only in dogs under iso anesthesia thate were hypotensive * PPV returned to baseline after volume replacement * Administration of dexmedetomidine lead to increases in systemic vascular resistance (in both hypotensive and normotensive dogs) and prevented theincrease in PPV with hemorrhage * Because dexmedetomidine prevented the increase in PPV that was associated with hypovolemia, PPV should not be used to guide volume replacement in dogs that had been administered dexmedetomidine

Answer 105

* Median resting energy requirement provided by ProcalAmine was 33% * Hyponatremia as the most common adverse effect, hyperglycemia, hypochloremia, azotemia, metabolic alkalosis, hyperkalemia and metabolic acidosis * Appears to be a safe/viable option for parenteral nutrtion in ill/injured dogs; due to potential for electrolyte derangements and other metabolic complications, daily bloodwork evaluation recommended

Answer 106

* At presentation, GFR was not significantly different in the survival/non-survival groups, but did significantly increase over time in the group that survived. * The fractional clearance of sodium decreased significantly over time in the surviving but not in the non-surviving dogs. * The excretion ratio and the fractional clearance of solutes were highly correlated to one another * The excretion ratio may be useful in a clinical setting to follow trends in solute excretion * Increased GFR, urine production and dcreased fractional clearance of sodium were markers of renal recovery (FC of Na is a simple, non-invasive and cost-effective measure that can be used to evaluate recovery of renal function)

Answer 107

* Brain herniation can be quantified on MRI * Clinical signs attributable to brain herniation are often absent * More severe caudal transtentorial herniation based on TTX is associated with a worse short-term outcome

Answer 108

* None of the diets analyzed met all of the minimum nutrition requirements for cats * Short-term feeding may not be of concern for individual patients, however, potential nutritional limitations exist when feeding enteral diets to ill or injured cats

Answer 109

Cytology was non-diagnostic in 93% of cases. Overall cytologic analysis of PE diagnostic utility was 7.u7% and increased to 20% if the effusion HCt was

Answer 110

* Regardless of time of processing (8,12,24 hours after collection), the units all contained therapeutic coagulation factors and hemostatic proteins * FP prepared after 24 hours had a significantly higher factor VIII and X when compared to 8 hour plasma. * Greyhound blood lead to lower levels of factor X, fibrinogen and vWF than blood evaluated from other breeds, although this does not preclude them as donors.

Answer 111

* ALF associated with multiple etiologies and a high mortalitiy rate; only 14% of dogs in the study survived to discharge * Survivors had higher ALT activity and were more likely to maintain normal albumin concentrations and not develop clinical bleeding or ascites during hospitalization

Answer 112

* As PCV decreased the POC glucose falsely increased (compared to lab value) * As PCV increased the POC glucose falsely decreased (compared to lab value) * Using the formula, the corrected POC glucose had a significantly improved correlation with lab glucose * Corrected POC glucose = POCglucose + ([1.6 X PCV] - 81.3)

Answer 113

* High flow oxygen was delivered by high flow nasal prongs to dogs assessed clinically to be failing TOTs. * HFOT was able to significantly improve PaO2 compared to TOT in severely hypoxemic dogs. * Complications included discomfort requiring light sedation in 1/6 dogs and persistence of a pneumo in one dog

Answer 114

A substantive influence of circulating serotonin on MMVD stages prior to CHF development in CKCS was not supported by this study. Highly activated platelets with pronounced serotonin binding was strongly associated with thrombocytopenia but not with MMVD.

Answer 115

* Intrajejunal feeding period was 2.1 days * Most received feeding with 24 hours of surgery * Of the dogs that ate voluntarily concurrently with J tube feeding, most survived to discharge * GI signs were most common complication; no life-threatening complications * Fecal scores were high and were not significantly different beteween the 2 liquid diets studied

Answer 116

* Cntorlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT * Both HES 130/0.4 and 0.9% NaCl after administration after induction of shock increased PCT * Results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution

Answer 117

* New blood types are Kai 1 and Kai 2. Unrelated to DEA 1,3,4,7 and Dal. * Kai 1+/Kai2- dogs were most commonly found in North America. * Clinical relevance in transfusion medicine is unknown currently

Answer 118

* Study suggested an association between estrus and the onset of seizures in intact bitches with presumptive idiopathic epilepsy * Two hormonally based patterns: * One during heat and one during a specific time point at the end of diestrus * Could be explained by the proconvulsive effects of estrogen or loss of protective effect against seizures of progesterone...

Answer 119

* Compared RIV to clopidogrel+low dose aspirin * No adverse drug reaction, evidence of hemorrhage, significant prolongation of PT or aPTT, or increase in transfusion requirements comparing RIV to CL+LDA * No significant difference between groups with respect to thrombotic events, survival rates to discharge at 1 and 3 months from diagnosis

Answer 120

* E. coli, staph, enterococcus most common isolates * In vitro susceptibility was higher in uncomplicated versus complicated infections * Administration of amoxi, doxy, enro but NOT amoxi/clav in preceding 30 days was associated with a resistance to that antimicrobial * MDR e.coli and staph were more common in dogs with complicated than complicated UTIs

Answer 121

* All 5 cats had lab evidence of overt DIC * Thrombocytopenia, low protein C activity, prolonged PT * No cats had low AT, which is in contrast to human/dog sepsis models of DIC * None of the cats had clinical signs of hemorrhage despite thrombocytopenia, coag factor deficiency and TEG evidence of hypocoagulability

Answer 122

* At enrollment, blasto urine antigen was positive in 21/21 dogs and serum 18/20. * At 2-4 months of treatment, blasto urine antigen was more sensitive for clinically detectable disease. * Urine blasto antigen testing has high sensitivity for active disease at the time of diagnosis and during treatment and moderate sensitivity with high specificity for clinical relapse. * Urine testing should be used.

Answer 123

* 38% of initially hypotensive canine shock patients had post-resuscitation ScVO2 \<70% despite normalization of traditional perfusion parameters and clearance of venous hyperlactatemia * Patients with a low ScVO2 were significantly more anemic (34%) than patients with a \>70% ScVO2 (41%) * Decreased oxygen carrying capacity will adversely impact CaO2 and potentially DO2 if increase in cardiac output can't compensate * The persistence of a low ScVO2 in the face of high CVP, normal BP, perfusion parameters indicates need to evaluate for/address inadequecies in CaO2 (i.e. decreased PCV, PaO2), consider inotropic support to increase CO and DO2

Answer 124

* Not mixing the fluid bag led to the measured K+ being significantly higher than the intended K+ * Inadequate mixing following K+ supplementation of fluid bags can lead to potentially life threatening IV infused K. Standard protocols for K+ supplementation should be established to ensure adequate mixing.

Answer 125

* No cats died/euthanized during the perioperative period * 84% of cats had no associated long term effects * 7% developed renal insufficiency or died of urinary tract disease

Answer 126

Study evaluated the use of a readily available, lipid free PN in a clinical setting. Metabolic complications developed in 43/67 dogs; only hyperkalemia was associated with a poor outcome (death or euthanasia). Mechanical complications developed in 28 dogs. Septic complications were confirmed in 5 dogs. Suitable for clinical use, but is associated with a high rate of complications.

Answer 127

* Combination of ACEI with aldosterone receptor antagonist can increase serum potassium and magnesium and lower serum sodium. * Study evaluated two drugs in dobermans * NO significant changes in sodium or creatinine. Serum magnesium, potassium, BUN increased significantly over time, however, these increases were of no apparent clinical relevance.

Answer 128

* Cats are as susceptible as dogs to envenomation * Lower body weight, rectal temperature and hematocrit at presentation were associated with nonsurvival

Answer 129

* A puppy presented for hypotension and GI signs, with a fluid filled mass associated with the mid-jejunum identified on AUS. * Ex lap removed the tissue which was shown to be heterotropic gastric mucosa and abscessation with growth of e.coli. * First report of abscess formation

Answer 130

* Peritoneal fluid cPLI concentration was highly sensitive as a complementary diagnostic tool in dogs with suspected AP * Peritoneal fluid lipase activity was not as sensitive as cPLI concentrations

Answer 131

* There was no significant difference in the mean percentage of time the intragastric pH was \>/= 3 or 4 between groups of patients treated either with pantoprazole alone or a combination of pantoprazole and famotidine * Pantoprazole alone (at 1mg/kg IV q12h) achieved pH goals that have been established for human patients with acid-related disorders * Short-term combination treatment with famotidine/pantoprazole is not superior to pantoprazole alone for increasing intragastric pH in dogs

Answer 132

* Poor outcome in acute B. canis may be suspected in dogs presenting with moderate anemia, severe thrombocytopenia, mild/moderate leukopenia, hyperlactatemia, moderately increased serum phosphate and triglyceride concentrations and moderately decreased total serum protein concentrations

Answer 133

* Dogs with sacral fractures were more likely to have IA than dogs without sacral fractures * Dogs were more likely to require a transfusion if they had IA or hemoabdomen specificically * Pelvic fracture characterization had no bearing on the presence of IA (pubic ischial, SI lux etc)

Answer 134

* Dialysis disequilibrium syndrome is characterized by neurologic symptoms resulting from overly rapid decrases in peripheral osmolality during a dialysis procedure * With rapid decreases in blood osmolality, cerebral edema develops due to the gradient between cerebral tissues and the blood, leading to an acute increase in ICP * Describes a cat who developed seizures during POD period; had a marked decrease in BUN (250-56), and serum osmolality (429 to 359). * Treated with hypertonic saline, supportive care * Patient recovered within 48 hours

Answer 135

* 1ml/kg instilled saline is recommended for standardized IAP measurement in dogs. * IAP in clinically normal dogs was not affected by abdominal surgery

Answer 136

In dogs with progressive DMVD leading to CHF, it can be anticipated that increased pulmonary venous pressure associated with venous enlargement would cause an increase in the PV/PA ratio. Right parasternal long axis 4 chamber view used to visualize longitudinal section of medial PV and right PA in cross section. In dogs, was determined that PV/PA increases with increasing stages of CHF. Using a cut off value of 1.7 in 2D, PV/PA permitted acute discrimination of dogs in CHF from asymptomatic dogs.

Answer 137

* The presence of pre-operative pneumonia was not a risk factor for post-operative development of aspiration * Postoperative megaesophagus and postoperative administration of opioid analgesics prior to discharge were significant risk factors for long term development of AP * Perioperative metoclopramide did not significantly decrease the risk for development of AP

Answer 138

* EN is the new gold standard of nutritional therapy in people with acute pancreatitis * Has advantages of prevention of mucosal atrophy, decreased risk of bacterial translocation and sepsis * Postpyloric feeding is likely unnecessery--increased concentrations of CCK, gastrin, secretin did NOT induce an increased risk of pancreatic enzymes that was previously thought to be the reason for pancreatic autodigestion * Supplementation of glutamine may prevent atrophy of pancreatic acinar cells leading to improved pancreatic exocrine function and improved outcome following critical illness * Immune-enhanced diets given to critically ill people lead to a reduced hospital stay and infection rate but had no effect on overall mortality * In fact, possible increase in mortality seen in patients treated with high doses of glutamine and anti-oxidants

Answer 139

* Peripheral pulse quality assessment correlates with SBP. * With progressive decreases in blood pressure, metatarsal pulses will disappear and only with severe hypotension that femoral pulses are absent * Cats with absent metatarsal and femoral pulses had median SBP of 30mmHg * Cats with strong metatarsal pulses had SBP of 135mmHg

Answer 140

* Treatment with the NMB cisatricurium for 48 hours early in the course of severe ARDS improved the adjusted 90-day survival rate, increased the numbers of ventilator free days and days outside the ICU and decreased the incidence of barotruama during the first 90 days. * It did not significantly improve the overall 90 day mortality.

Answer 141

* Lower survival between the HES group (66%) and the crystalloid group (88% survival) * No significant difference in creatinine at any time point between the two gropus and there was no significant difference in the creatinine specifically in the group of dogs subclassified as having SIRS or sepsis * Looked as far out as 2-12 weeks

Answer 142

Optimal treatment to ensure successful short and long-term outcome, including the avoidance of recurrence, is unknown Prognosis can be good 83% survival in dogs, 62% in cats

Answer 143

* pRBC dose, cross-match status and pretransfusion PCV were independent predictors of change in PCV with transfusion * The PCV increase post-transfusion (scaled by dose) was significantly greater for cross-match compatible transfusions * Administration of type-specific, cross-match compatible pRBC transfusions resulted in significantly greater increases in the posttransfusion PV when compared to administration of typed, noncross-matched pRBCs

Answer 144

* 21 dogs with IMHA were treated with enoxaparin (0.8mg/kg SQ q6h) as the sole anticoagulation therapy starting at hospital admission * Only 2 dogs had minor hemorrhagic complications associated with enoxaparin * Frequency of thrombosis was not assessed * Long term survival was comparable to other anti-coagulation protocols reported for dogs with primary IMHA * Don't know if it reduces mortality and thrombotic complications

Answer 145

* Neurogenic pathways mediated by tachykinins that bind NK1 receptors may induce cough and airway inflammation * Maropitant seemed to have anti-tussive properties resulted in perceived clinical improvement, however, on repeated BAL, markers of airway inflammation were not decreased, therefore, it is not a suitable method to treat canine chronic bronchitis.

Answer 146

* AKI was defined as at least a 2 fold increase in baseline creatinine or a new onset of oliguria/anuria persisting for \>/= 12 hours. * HEW was associated withan increased risk of mortality or AKI, both in unadjusted analysis and after adjusted analysis controlling for illness severity, admission type and concurrent administration of blood products

Answer 147

* Early group patients (starting insulin = 6 hours after admission) had more rapid resolution of DK/DKA (36 hours versus 55 hours) * No difference in duration of hospitalization or complications * DK/DKA took longer to resolve with more severe ketonuria

Answer 148

* Measurement of NT-proBNP using a quantitative ELISA in plasma and pleural fluid, or a POC test in plasma but NOT pleural fluid, distinguishes cardiac from non-cardiac causes of pleural effusion.

Answer 149

Administration of high doses of enalapril and benazepril (1mg/kg PO q12h) significantly inhibited ACE activity, but did not prevent increases in mean urine and serum and aldosterone concentrations resulting from furosemide activation of RAAS. Suggests that aldosterone breakthrough from ACE inhibition is a dose-independent effect of ACEI.

Answer 150

* 360 dogs with MMVD (LaAO \>1.6; VHS \>10.5) * Median time to primary endpoint (development of CHF, cardiac related death or euthanasia) was 1228 days in pimo group compared to 766 in placebo group. * Dogs in pimo group lived longer (1059 days) compared to placebo group (902 days) * Administration of pimo to dogs with MMVD and echocardiographic/radiographic evidence of cardiomegaly results in prolongation of the preclinical period and is safe and well-tolerated. * Prolongation of the preclinical period is substantial (15 months) and represents substantial clinical benefit.

Answer 151

Overall survival to discharge was 62.5%. Survival rates for patients treated after 2005 and not receiving pentobarbital was 77% Mean duration of PPV was 31+-/21 hours; average time from presentation for CHF to initiation of PPV was 6 hours. Azotemia at the time of ventilation, development of anuria/oliguria, and use of pentobarbital were significantly associated with outcome. No significant effect attributed to age, sex, weight, species, cause of heart disease, furosemide dose, length of ventilation, use of vasopressors, first-time CHF events or plasma lactate concentrations on survival to discharge.

Answer 152

* Dogs that received cPC were significantly more likely to have a platelet trigger for cPC transfusion, lower platelet count, and Hct and presentation, as well as a lower Hct after cPC * Statistically significant increase in platelet count from pre to post-cPC transfusion, however, cPC was not found to be effective in improving clinical bleeding or increasing survival compared to the control group.

Answer 153

* As compared with pre-CPAP and post-CPAP periods, during CPAP the PaCO2, AA gradient, and respiratory rate significantly decreased and the PaO2 was higher compared to pre and post * Tolerance and sedation scores were similar across all time periods * Suggests that noninvasive CPAP is feasible and effective

Answer 154

* SErum concentrations of leptin, resistin, visfatin, IL6, 8 and 10 were significantly higher in dogs with acute pancreatitis, whereas adiopnectin concentration was significantly lower * Dysregulation of adipokines may be involved in the pathogenesis of AP * Significant differences in the serum concentrations of leptin and adiponectin in survivors and nonsurvivors

Answer 155

* 58% of animals achieved ROSC * 32% had ROSC \>20 min * 10% alive at 24 hours * 5% survived to discharge * Associated with ROSC * Presence of IVC at arrest * Presence of palpated pulses during CPR * Associated with failure to achieve ROSC * Neurologic cause for arrest * Increased time from CPA to initiation of CPR * Longer duration of CPR

Answer 156

* MRIs were scored from I (normal) to VI (bilateral lesions affect brainstem with or without lesions of lower grade) * mGCS was negatively correlated with MRI score (higher mGCS, lower MRI score..) * The degree of midline shift, the MIR grade, and the % of intraparenchymal lesions were negatively correlated with follow-up scores * mGCS lower in dogs with brain herniation * Follow-up scores were significantly lower in dogs that had brain herniation or skull fractures * The possibility of having seizures was associated with higher percentage of intraparenchymal lesions

Answer 157

* Serumalbumin concentration, administration of prophylactic gastroprotectant drugs, and specific institution were significantly associated with development of hemorrhagic GI disease in dogs * Development of hemorrhagic GI disease and placement of a feeding tube were significantly associated with mortality during hospitalization in dogs

Answer 158

* MA determined by TEG was significantly elevated by addition of concentrations of lipid that are several orders of magnitude higher than clinically relevant levels in dogs * Lipid treatment appears to have no significant effect on hemostatic variables in dogs, although clinical studies should be performed to confirm these in vitro findings

Answer 159

* Exenatide ER is a glucagon-like peptide-1 analogue that increases insulin secretion, inhibits glucagon secreation and induces satiation in humans with type 2 DM; it stimulates insulin secretion in cats * It appears safe in diabetic cats and does not result in weight gain * There may be potential for induction of diabetic remission with this drug in cats

Answer 160

* Esophageal and gastric regions most common location for a sweing needle * GI perfo identified in 17% of animals * Sewing needles in the esophagus and stomach were successfully removed endoscopically in 8/9 dogs and 18/19 cats * Endoscopy is highly successfully and should be recommended to prevent GI tract perforation and associated morbidity

Answer 161

* 51.3% had a false negative fecal antigen ELISA result * ELISA negative dogs had a significantly shorter time until presentation, lower frequency of defecation, lower fecal virus load, and higher serum antibody concentrations than ELISA positive dogs. * Low fecal CPV load and antibodies binding to CPV antigen in feces are likely to be important reasons for false negative results

Answer 162

* A CEUS study identified active renal hemorrahge resulting in hemoretroperitoneum and hemoperitoneum * A nematode larva was found in the renal parenchyma at nephrectomy

Answer 163

* The incidenc of wound infection is low and the use of prophylactic antimicrobials is not recommended * Reserve for wounds with necrosis or abscess

Answer 164

11 animals underwent successful TAPs for lung lobectomy without observed intraoperative complication. TAPS may offer a more technically feasible approach as compared to thoracotomy because it provides the benefits of minimally invasive thoracic surgery without the necessity of 1 lung ventilation.

Answer 165

* Suspicion of NAI: * Presence of multiple fractures * Fracutres on more than one region of the body * Transerve fractures * Delayed presentation * Multiple fractures in different stages of healing * Staffordshire bull terriers were overrepresented in the NAI group

Answer 166

Cats (with HCM or HOCM) receiving pimobendan had a significant benefit in survival time. MST of case cats receiving pimo was 626 days whereas MST of cats not receiving pimo was 103 days. No significant difference was detected in any other variable. The addition of pimo to traditional treatment for CHF may provide a substantial benefit in survival time for HCM-affected cats with CHF and possibly HOCM-affected cats with CHF.

Answer 167

* 37% of dogs had transfusion complications (febrile reaction etc/AKI/ALI, pneumonia, volume overload, new infection) * Risk for transfusion reaction was higher in dogs receiving products other than pRBCs * A higher pre-transfusion PCV and a larger dose of pRBCs administered were risk fcators for nonsurvival * The age of the packed pRBC was not identified as a risk factor for transfusion associated complications

Answer 168

* Minimum concentrations for complete inhibition of fibrinolysis in dogs were 511 ug/ml for EACA and 145ug/ml for TEA * For people, 122ug/ml and 15ug/ml * Results supported the concept that dogs are hyperfibrinolytic compared to humans and that higher doses of EACA and TEA may be required to fully inhibit fibrinolysis in dogs.

Answer 169

* 180ml/kg LRS administered over 60 min and lactate concentrations measured * Significant increases in plasma lactate were identified after 10 minutes and returned to baseline 60 minutes after cessation of therapy * Could have implications in how plasma lactate concentration is interpreted with respect to prognosis in patients receiving resuscitative rates of LRS

Answer 170

* Cases had leukocytosis compared to controls; hyperfibrinogenemia and increased thrombin-antithrombin complexes * Hypercoagulable as evaluated by thromboelastometry * Hypercoagulability in blastomycosis dogs may lead to microemboli in the pulmonary circulation, contributing to inadequate O2 supply

Answer 171

The combination the respiratory and cardiac cycles induced a maximal difference in VHS of 0.97 and 1.11 VU in the inspiratory and expiratory phases respectively. In addition to allowing optimal pulmonary assessment, consistently taking radiographs at end-inspiratory tidal volume may help to limit VHS variability due to the respiratory cycle.

Answer 172

* Two patients developed an acute reaction * Two had a delayed reaction * Corticosteroid administration did not seem to affect the occurrence of adverse reactions * Administration of 25% HSA to dogs with moderate to severe hypoalbuminemia from PLE resulted in severe or fatal adverse events in some cases

Answer 173

CPV may cause myocarditis in puppies that are infected in utero or in the first weeks of life. Generally no GI signs, respiratory distress occurs acutely. Treatment typically unsuccessful due to severe cardiac damage, however, dogs that survive the acute phase may go on to develop chronic cardiac changes and juvenile DCM. Rapid fecal parvo tests will usually be negative. Myocardial parvo should be a ddx in young pupies and juveniles who present with acute respiratory signs and heart failure.

Answer 174

* Cats with renal infarcts were 4.5 times more likely to have HCM compared to cats without * Cats with renal infarcts were 0.7 times LESS likely to have a diagnosis of neoplasai * There was no association with hyperthyroidism * Cats with renal infarcts were 8 times more likely to have distal aortic thromboembolism than cats without

Answer 175

* Eptifibitide caused a significant reduction in platelet aggregation in vivo for healthy cats, but there was no identifiable antiplatelet effect for abciximab * Have different binding and inhibitory actions; theorized that abciximab would be ineffective in cats because of lack of receptor binding, reduced binding kinetics or lack of downstream signaling

Answer 176

* Two or more were highly suggestive of increased ICP * Compression of suprapineal recess * Compression of third or fourth ventricle * Effacement of the cerebral sulci * Caudal transposition of the lamina quadrigemina

Answer 177

* 12% of dogs developed post-operative regurgitation/vomiting * Risk factors included GI surgery, premedication without strong sedatives, ASA score of 4, history of vomiting or regurg, emergency surgery, neuro surgery, sevo anesthesia and being sexually intact.

Answer 178

* Ketamine is an NMDA receptor antagonist with sympathomimetic properties * Has been shown to improve survival and decreased production of TNFalpha and IL6 with use * In dogs with pyometra treated with a low dose ketamine CRI, the serum cocnetrations of CRP were significantly increased in the control group compared to decreased in the ketamine gropu at 48 hours after surgery * No significant difference in survival to discharge/length of hospitalization

Answer 179

* Significant decreases in the propofol MIR required to prevent movement in response to the noxious stimuli when dogs were anesthetized with propofol and either high or low dose ketamine

Answer 180

* Hypertonic solutaions affect platelet function and whole blood coagulation to a greater extent than saline and HES * HTS + HES 130, HES 600, HES 200 * At dilutions that are clinically relevant, only platelet closure time was markedly more affected by the hypertonic solutions than by saline * At high dilutions, HES significantly affects coagulation but to no greater extent than saline at clinically relevant dilutions

Answer 181

* Treated cats had no signs of hemorrhage or clinicopathologic off-target adverse effects * Dose dependent prolongations of coagulation times and increase in aXa with peak effect at 3 hours post administration * Oral RVX was well tolerated by helathy cats with predictable pharmacokinetics and anticoagulant effects

Answer 182

Secondary causes include asthma, heartworm, neoplasia, PTE, abscesses... Asthma was the most common cause of SSP in this study (25%); had a good prognosis for survival to discharge with medical management only Clinical assessment, imaging and invasive diagnostics were required to differentiate AASSP from NAASSP

Answer 183

This study did not confirm a role of hypothyroidism in the etiology or progression of DCM. Treatment of hypothyroidism did not improve the clinical outcome.

Answer 184

Dog presented for respiratory distress 12 days after an episode of exertional heat stroke CT showed bilateral pneumothorax and consolidation of lung lobes; sternotomy showed multifocal consolidation at the periphery of multiple lung lobes which was resected Histopath confirmed necrotizing pneumonitis, grew Pseudomonas Necrotizing myopathy was found on a pectoral muscle biopsy; Multifocal necrotizing pneumonia with/without pneuothorax should be considered as a differential in dogs that develop respiratory distress following severe systemic illness.

Answer 185

Tracheal collapse/obstruction was identified on radiographs in this patient, determined to be static on tracheoscopy Suppurative inflammation was found from an FNA of a fluid filled structure dorsal to the trachea identified with ultrasound Surgical exploration revealed an abscess in the dorsal tracheal membrane Post-operatively the dog developed a pneumothorax and pneumomediastinum, likely secondary to surgical approach worsened by PPV. Culture revealed Streptococcus. Dog recovered uneventfully.

Answer 186

* 25% of dogs and 49% of cats (4254 total population) presented with hyponatremia * Significantly higher risk of death in patients presenting with hyponatremia as compared to patienst with normal sodium (14% death rate). * Magnitude of hypnatremia linearly associated with fatatily * Patients with hyponatremia were less likely to die than the patients with hypernatremia in the same study population

Answer 187

ARVC is a disease of middle age dogs and frequently is associated with a striatin deletion. Syncope occurs in 1/3 of affected dogs. Systolic dysfunction is uncommon. The prognosis for many affected dogs is good.

Answer 188

* Myocardial injury detected by cTnI and cTnT has been associated with longterm death in the noncardiac human intensive care unit. * In dogs admitted to the ICU with evidence of systemic inflammation, blood samples were obtained for troponin measurement at admission and once daily throughout stay. * One year case fatality rate was 47%, with non-survivors having significantly higher concentrations of cTnI and cTnT at all time points than survivors. * Optimal cutoff, 1.17ng/mL peak cTnI and 23 ng/L admission CtnT. * Sensitivity and specificity for both low (72%/70% for cTnI and 72%/80% cTnT) * Troponins significantly related to 1 year case fatality, however, low sensitivities and specificities prevent their prediction of long term outcome in individual patients.

Answer 189

* Using urine SMDA as a biomarker for CKD allows earlier detection of kidney dysfunction in dogs than does measurement of serum Cr. * Earlier detection may desirable for initiating renoprotective interventions that may slow progression of CKD * SMDA concentration detected CKD in cats on average of 17 months before serum creatinine; in dogs, on average, 9.8 months sooner (range 2.2-27.0 months)

Answer 190

* Fewer poor quality recoveries were observed in the dexmedetomidine group, however, sedation was increased in this group * Pain scores were lower in the group receiving dexmedetomidine *

Answer 191

* A significantly higher TEG MA compared with baseline detected at 60 and 240 minutes. * At 240 minutes significantly less fibrinolysis for dogs receiving 100mg/kg as opposed to those receiving 20mg/kg * ACA may be useful for in vivo prevention of fibrinolysis in dogs

Answer 192

* Volume overload of the left ventricle (LVEDV/BSA \>91.3mL/m2) was the single best variable to predict sudden cardiac death. * Probability of SCD increases 8.5 fold for every 50ml/m2 unit increment in LVEDV/BSA * The presence of ventricular tachycardia, increased cTnI concentration, and fastest rate of VPCs (\>260bpm) were additional important variables to predict SCD

Answer 193

* Ammonia concentration increases with storage time in feline SWB * Clinical significance yet to be determined * CXCL-8 was also present, however, do not know if it can incite an inflammatory response in the recipient

Answer 194

* No significant prognostic indicators for dogs with recurrent peritonitis were identified * The mortality rate for dogs having more than one surgery for septic peritonitis is similar to that reported for a single surgery for septic peritonitis (44%)

Answer 195

* Dogs with renal azotemia had a significantly higher NGAL and urine NGAL to creatinine ratio than healthy dogs * Plasma NGAL concentration was significantly higher in dogs with AKI compared to dogs with CKD * Plasma NGAL could be helpful to differentiate AKI from CKD in dogs with renal azotemia

Answer 196

* Lipase may be useful for diagnosing AP * High AlT activity may be associated with prolonged duration of hospitalization * CRP may be useful as a biomarker for monitoring of recovery from AP *

Answer 197

* Two patients were treated with rivaroxaban for PE; decreases in thrombus size were obseved, but one patient suffered acute respiratory distress and was euthanized while the other continued to do well * Two patients were treated for systemic thromboses and had decreases in thrombus size

Answer 198

* Administration of maropitant to healthy cats !20 hours prior to administration of dexmed and morphine significantly decreased incidence of emesis, but did not decrease the incidence of signs of nausea

Answer 199

* LRS, HES, FFP * In vitro hemodilution of whole blood with LRS and HES but not FFP resulted in significant effects on coagulation with HES having a more profound effect. * No significant difference in any TEG parameter was found for FFP

Answer 200

* Cats received 14 injections of dalteparin (75 anti-Xa U/kg SQ) at 6 hour intervals * 2 hours after the second injection, the target peak anti-Xa activity range of ).5-1.0 U/ml was achieved in all ccats whereas median trough values remained below this range * Peak anti-Xa activity had only minimal effects on coagulation variables

Answer 201

Compared with dogs without a history of syncope, dogs with advanced MMVD and a history of syncope did not have a higher occurrence of arrhythmias, but had less sinus arrhythmia and had changes in heart rate variables representing decreased overall heart rate variability, decreased parasympathetic and increased sympathetic modulation of heart rate.

Answer 202

* SMD and creat significantly correlated to GFR * SMDA became increased before creatinine in most cats and had a higher sensitivity (100%) compared to creatinine (17%) but lower specificity and PPV. * SMDA allows for earlier detection of CKD in cats compared with sCR

Answer 203

* cTnI concentrations can predict myocardial injury, which appears to be a predictor of short term death in critically ill patients, however, it is not known if the best time to measure is at admission or other time points. * Study measured cTnI in dogs with SIRs at admission and for several days afterwards. * Found that 41 dogs with SIRS that survived 28 days had a significantly lower cTnI concentration at admission than the 19 dogs who did not survive. * Area under the curve to predict survival was similar at admission and at the peak time point, correlated with a 0.754 APPLEfast score. * Increased cTnI in dogs with SIRS is associated with a poor outcome; daily follow up measurement provides no additional prognostic information for short-term mortality.

Answer 204

* Most common causative disease was insulinoma * Mean time period on glucagon CRI until normoglycemia was 7 hours * A CRI was found to effectively increase the BG wihtout recurrence of hypoglycemia after weaning * Glucagon CRI was accompanied by an increase in BG in hypoglycemic dogs; appears to be a safe method and can be readily utilized in most practice settings

Answer 205

* Median inital blood lactate concentration was 2.7. * Cats with white mucous membranes, abnormal peripheral pulses, and hypothermia had significantly higher lactate concentrations than cats without these findings. * Median lactate for cats with an SBP \<90mmHg was significantly higher (3.3mmol/L) than for cats with an SBP \>90mmHg (2.35) * Median initial lactate concentration at admission did not differ between cats that did and did not survive to discharge from the hospital. * Change in lactate concentration was not associated with outcome.

Answer 206

* KP treatment maintained mean arterial BP better than propofol alone and increased the HR, CO and oxygen delivery as did the KD treatment

Answer 207

* Serum NT-proCNP has been shown as a possible biomarker for sepsis, however, its sensitivity to diagnose dogs with septic peritonitis is low, thought to be because it may compartmentalize in the abdominal cavity. * This study evaluated serial concentrations of serum NT-proCNP along with abdominal fluid concentrations with an ELISA. * Found that the ELISA was able to successfully measure NT-proCNP in canine abdominal fluid and it consistently remained lower than the serum levels throughout the study period, essentially eliminating the theory of abdominal compartmentalization as a cause for the decreased levels.

Answer 208

* Decreases in ....were associated with non-survival: * Pulse ox * pH * Bicarbonate concentration * Base exess * Increases in ....were associated with non-survival: * Potassium * Lactate * BUN * ATT * Mentation socre * Decreased MCGS was the strongest predictor of non-survival, with a score of =11 84% sensitive and 73% specific for predicting non-survival * Dogs that did not survive following head trauma were more likely to have poor perfusion, severe concurrent injuries reflected by increased ATT scores, severe TBI as evidenced by decreased MGCS or increased mentation scores, or requirement of HS administration or endotracheal intubation

Answer 209

Pharyngeal collapse is a complex disease process that is likely secondry to long-term negative pressure gradients and anatomic/functional abnormalities. The most common concurrent disease processes in these dogs were mainstem bronchi collapse, tracheal collapse, and brachycephalic airway syndrome. Pharyngeal fluoroscopy may be a useful diagnostic test.

Answer 210

* TPAL was effective at enlarging the rima glottidis in the canine cadaveric model * It is rapid to perform and doesn't require specialized instrumentation * May be an alternative to temporary trach in dogs with severe resp distress related to lar par

Answer 211

Dogs with DMVD have an increase in HR and a decrease in heart rate variability over a year before death, with greater changes observed in dogs that died or were euthanized because of cardiac disease. Both heart rate and vasovagul tonus index (VVTI) can potentially be regarded as biomarkers for all-cause mortality.

Answer 212

62.5% success after 1 round, 87% after 1-2 additional times Success rate of thoracotomy/lobectomy for persistent pneumo is 88% in dogs; suggests that blood patch pleurodesis may be a viable alternative in dogs that are poor surgical candidates or for whom surgery is declined MOA suggested--\>eiter a true pleurodesis resulting in pleural adhesions (blood generates an inflammatory reaction that may contribute to adhesion between parietal and visceral pleura) versus sealing the site of the leakge with blood clots Most common complication in people is empyema; documented in 2/8 dogs in this study, resolved in one and other was euthanized.

Answer 213

* A cranial mediastinal mass was identified in 52% of the cats, higher than previously reported. * Abyssinian and Somali cats had an increased incidence of MG compared to mixed breeds/other breeds * Clinical outcome for cats with mediastinal masses did not differ between surgical or medical treatment * Acquired MG can occur in cats after treatment with methimazole because of the immunomodulatory properties of this medication

Answer 214

* NGAL is a protein whose production is highly upregulated with epithelial cell damage; concentration in urine increases 24-72 hours before serum creatinine, which enables earlier detection of AKI. Plasma/urine NGAL increased in people with sepsis. * Study measured serum/urine NGAL for detecting AKI in dogs with sepsis undergoing ex lap as compared to healthy dogs with IVDD surgery. * sNGAl was significantly higher in the study dogs at all time points, as was urine NGAL (normalized to creatinine). * Dogs that received any hydroxyethyl starch (at any time point) had a significantly higher UNCR (however, must be interpreted with caution as UNCR was higher in these patients even pre-op, prior to any HES administration) * sNGAL was not associated with mortality or corrleated with the severity of disease as assessed by APPLE or MODS development.

Answer 215

* The UNCR (urinary NGAL to urinary creatinine ratio) was an early marker of gentamicin induced AKI and its decrease was associated with onset of renal recovery * Allowed for earlier diagnosis of AKI based on a 7-fold increae in UNCR compared to a 50% increase in serum creatinine concentration

Answer 216

* 2/54 dogs (3.7%) developed VetALI * This was significantly less than then reported incidence of TRALI in humans (25%) and not significantly diferent from the reported incidence of ARDS in ill dogs not receiving transfusions (10%)

Answer 217

* 15% dogs had a TR; most common fever alone (53%) and vomiting alone (18%) * Six dogs died secondary to TR however * Development of TR was not related to age, sex, weight, or premedication administraiton * When premedication was evaluated alone, antihistamines decreased the incidence of acute allergic reactions * pRBCs were significantly associated with development of a TR, whiel plasma was least likely * The presence of immune-mediated disease was significantly associated with development of TR * Transfusion during the perioperative period was less likely to be associated with TR development

Answer 218

* The traditional approach did not find as many abnormalities as the physiochemical methods * The semiquantitative approach found abnormalities in all patients whereas the Stewart approach found them in less... * Many of the abnormalities were quite small and of unknown clinical significance

Answer 219

* Associated with poor outcome: * Decreased mentation at presentation * Presence of seizures * Increased neutrophil percentage on CSF analysis * More than 25% of dogs died within 1 week of diagnosis of MUA

Answer 220

* Only 19/67 (28%) of dogs survived and were discharged from the hospital * Hypotensive dogs wihtout hyperlactatemia had a significantly higher systolic blood pressure and were 3.23 times as likely to survive as compared to hypotensive dogs with hyperlactatemia. * i.e blood lactate was negatively associated with systolic blood pressure and survival probability * No other parameter differed significantly between hypotensive dogs with and without hyperlactatemia.

Answer 221

* Severely affected animals tended to have hypochloremic alkalosis * Mildly affected puppies had hyperchloremic acidosis * Multiple factors, complex

Answer 222

* A DLS occurs when immature granulocyte precursors outnumber mature neutrophils. * In this study, cats with a DLS were 1.57 times more likely to die or be euthanized than cats without. * An increasing severity of DLS is associated with increased likelihood of death or euthanasia. * FeLV infected cats had a 3x higher risk of death or euthanasia than cats presented for any other reason * Purebred cats had a 1.3x lower risk of death/euthanasia than other breeds

Answer 223

* Using the simplified strong ion equation and the published values for Atot and Ka does not appear to provide a quantitative explanation for the acid-base status in dogs * Efficacy of substituting the effective SID in the simplified strong ion equation suggests the error lies in calculating the SID

Answer 224

* Median time to resolution of DKA in dogs treated with aspart CRI was 28 hours. * IV CRI of insulin aspart is a safe and effective treatment for dogs with DKA

Answer 225

* CSF TNFa and IL6 concentrations were significantly higher in dogs with sizures compared to the control group * Only TNFa was significantly higher in idiopathic epilepsy dogs when compared to the control group * CSF total protein counts were not different between the seizure and control groups

Answer 226

* Sought to determine effects of catheter shape, interelectrode spacing (IS), electrode size (ES) on pacing threshold (PT), extraneous muscular stimulation (EMS) and zone of capture (ZOC) for dogs undergoing transesophageal atrial pacing (TAP) * Results showed that a curved catheter with multiple 4mm electrodes providing for variable IS would be ideal for TAP in dogs. * In humans, TAP catheters are straight---perhaps curved cathters may reduce the PT.

Answer 227

* LiDCO and PiCCO_TD agreed well with PAC\_TD for measurement of CO under different hemodynamic conditions (normodynamic/hypo/hyper). * The PiCCO_TD appeared to be an accurate method for monitoring continuous CO as it was similar to pulse contour analysis

Answer 228

Plasma concentration of cTnI (cutoff 0.7ng/mL) is a predictor of cardiac death in cats that is independent of the presence of heart failure or LA dilatation. In univariable analysis, NTpBNP \>250pmol/L was associated with cardiac death, but this did not remain significant after controlling for the effect of clinical signs or LA size/function.

Answer 229

* Inhaled unfractionated sodium heparin was administered in doses ranging from 50k to 200k IU (even at doses higher than those known to be effective in people) * Even at high doses, inhaled heparin appears to have no detectable local or systemic anticoagulant effects in dogs

Answer 230

* The overall mortality rate in this study was 15% * Longer duration of anesthesia was associated with mortality * SIRS developed in 54% of the dogs and was significantly associated with mortality, with a mortality rate of 24% in dogs that developed SIRS * MODS developed in 27% of dogs and was significantly associated with mortality. A mortality rate of 67% was evident in dogs with dysfunction of 4 or more organs. * The respiratory system was most commonly affected * Cardiovascular dysfunction was highly predictive of mortality, as were coagulation and pancreatic dysfunction, a diagnosis of SIRS, and respiratory and hepatic dysfunction.

Answer 231

* Greyhounds appeared to be predisposed to ischemic stroke as compared to all other breeds evaluted * Coagulation abnormalities did not seem to contribute to stroke * Hypertension may have contributed, therefore, all greyhounds iwht ischemic stroke should have systolic BP measured *

Answer 232

Plasma NTproBNP was higher in CHF dogs than those with noncardiac respiratory distress. A cut-off of \>/= 2447pmol/L discriminated CHF from non-cardiac distress. Average NTBNP increased significantly as a function of heart disease severity using the ACVIM classification scheme.

Answer 233

Hyperthyroid cats and cats with HCM had plasma NTBNP and ctNI concentrations that were significantly higher than those of healthy cats, but there was no significant difference between hyperthyroid cats and cats with HCM with respect to concentration of either biomarker. Concentrations of both, as well as ventricular wall thickness, had decreased significantly in cats who were subsequently treated for hyperthyroidism. Neither NTpBNP nor cTNI can distinguish hypertrophy associated with hyperthyroidism from primary HCM.

Answer 234

* Moderate dental disease and severe dental disease predicted the development of CKD in cats * MOA unknown...

Answer 235

* Critically ill dogs developed a greater % of fluid overload (FO)( compared to stable. post-op dogs * Over half of the dogs with %FO \>12% died * A weak, but significant association between the % FO, illness severity, and mortality was identified. * Calculated %FO by: * 100 x ([fluid vol administered-fluid vol lost]/1000ml/L)-(% dehydration at admission)

Answer 236

* Orally administered cisapride may be of benefit in canine patients for whicn an increase in LES pressure is desired * Orally adminstered metoclopramide did not affect LES resting pressures in dogs * The LES pressures differed significantly only between the placebo and cisapride treatment groups

Answer 237

VSDs were isolated in 48% of patients and were membranous or perimembranous in 75%. Most isolated VSDs were subclinical. Most dogs and cats with isolated VSDs had a long survival time, few had clinical signs at diagnosis and none with follow-up developed clinical signs after diagnosis.

Answer 238

* Acepromazine exacerbated hypotension but there was no change in cardiac output in dogs anesthetized with propofol and isoflurane * Dexmedetomidine led to reduced CO, however, prevented propofol-isoflurane induced hypotension * Oxygen carrying capacity and PCV were generally higher in dexmedetomidine treated than in acepromazine treated dogs

Answer 239

* Chronic MMVD is associated with an increased prevalence of CKD and anemia in dogs. * Medical management of CHF may play a role in inducing CKD (dogs being treated for CHF had a significantly higher prevalence of CKD than did dogs that had not received treatment) * The class of heart disease and the IRIS stage were directly correlated. * The presence of cardiovascular-renal disorders decreased survival time compared to only the presence of MMVD alone. * Anemia did not appear to play a role in worsening heart function.

Answer 240

* Decreased total thyroxine (TT4) were documented in all dogs with sepsis/SIRs * No relationships were identified between thyroid hormone concentrations and survival * Dogs with increased APPLEfast scores were less likely to survive

Answer 241

* IV administration of 10ml/kg doses of LRS or hetastarch in a 5 minute period increased RA and PAP and CO when dogs were nonhypotensive or hypotensive compared to before fluid administration * Durations of these effects were greater after hetastarch * Overall, arterial BP measurements were a poor predictor of the hemodynamic response to fluid administration

Answer 242

* The incidence of hyperlactatemia in sick cats being admitted for hospitalization in a private referral center was 23% * Lactate concentration on admission and serial lactate measurements over time were not prognostic in this group of hospitalized cats

Answer 243

* Surgical treatment of CPSS in dogs resulted in significantly improved survival rate and lower frequency of ongoing clinical signs compared to medical management * Age at diagnosis did not affect survival rate and should not influence treatment choice

Answer 244

* CU are a rare embryological malformation resulting in ventral displacement of the caudal vena cava which cross the ureter which may lead to ureteral stricture * Long term prognosis is good for bening ureteral obstruction treated with a double pigtail stent or a SUB device * The SUB device reobstructed less commonly than the ureteral stent, particularly when a ureteral stricture was presetn

Answer 245

* NGAL is released from renal tubular cells after injury and are used in humans as a real-time indicator of kidney damage. * Serum and urine NGAL concentrations were significantly higher than in nonazotemic dogs and were highly correlated with serum creatinine concentration. * Among the dogs with CKD, death was associated with significantly higher sNGAL and uNGAL * sNGAL was actually better for predicting outcome for CKD dogs than screat * Best cuttoff 50.6ng/mL * Dogs with a higher concentration of sNGAL survived for a significantly shorter period of time

Answer 246

* Whole blood/peritoneal fluid glucose cutoff of \>20mg/dL (historical "standard") was NOT a sensitive indicator of septic peritonitis (sensitivity 42%, specificity 100%) * With a glucose concentration difference of \>38mg/dL for plasma-peritoneal fluid or plasma-peritoneal fluid supernatant, there was support for an accurate diagnosis of septic peritonitis in dogs and cats.

Answer 247

* Pneumomediastinum and leukopenia were negative prognostic factors for dogs being discharged from the hospital * Most common postop coplications were regurgitation and esophageal stricture formation * 90% of patients discharged from hospital * Dogs treated for more extensive lesions as well as those undergoing esophagectomy or R&A were more likely to develop post-op complications

Answer 248

Two indoor DSH from the same household were presented for severe respiratory signs; managed aggressively with one requiring mechanical ventilation Both were ultimately euthanized. Histopath revealed severe diffuse bronchointerstitial pneumonia; 2009 influenza AH1N1 testing by real time PCR was positive in one cat. Domestic felids are susceptible to this strain; should be considered in the ddx list. Seems possible that human-to-cat transmission can occur.

Answer 249

* Kidney injury molecule 1 is a biomarker in humans; was expressed in specific nephron segments and detected in urine of cats with AKI * May prove a useful indicator of tubular injury (urinary KIM-1) *

Answer 250

* Fenoldopam administration resulted in a significantly increaed GFR in healthy dogs cmpared with D5W administration * Fenoldopam also resulted in a significantly increased FE of NA, whereas infusion of D5W alone did not * Fenoldopam is a selective dopamine agonist, although the precise MOA is unknown

Answer 251

* Cats with SEC were at significantly increased risk of death as compared to those without SEC. * Cats with DCM, unclassified and hypertrophic cardiomyopathy were significantly more likely to have SEC compared to cats with other types of cardiac disease. * These cats may benefit from anticoagulant therapy due to the increased risk of SEC in these populations.

Answer 252

* There was not a statistically significant difference in whole blood/plasma COP in healthy cats, however, there were slight differences identifed * Prudent to maintain sample consistency for comparison's sake

Answer 253

Calcitriol promotes cardiac contractility by binding to vitamin D receptors on cardiomyocytes and affecting intracellular Ca handling. Also exerts anti-hypertrophic effects on cardiomyocytes. In humans, vitamin D deficiency has been determined to be an adverse reisk factor in patients with cardiovascular disease. Vitamin D concentrations were significantly lower in dogs with stage B2 and C/D heart disease than B1. Vitamin D status is associated with the degree of cardiac remodeling and serum concentrations begin to decrease before the onset of heart failure in dogs with CVHD.

Answer 254

* MgSO4 did not affect the MAC and did not potentiate the effects of propofol * MgSO4 appeared to be of no clinical advantage

Answer 255

* No sex/breed disposition * Cats age 2-5 years predisposed * Higher total bili concentration and age were negative prognostic factors; higher lymphocyte numbers/serum globulin concentration were positive prognostic factors

Answer 256

* Dogs treated with morphine-neostigmine needed less rescue analgesia than those treated with morphine alone or neostigmine alone in their epidural * Neostigmine may be a good adjuvant in epidurals

Answer 257

* Low dose aspirin inhibits cyclosporine induced thromboxane synthesis and concurrent use of these medications does not alter the antiplatelet effects of aspirin

Answer 258

61% of cats were euthanized on immediate presentation, with no factors identified that predicted euthanasia on presentation. 70% survived 24 hours, 44% survived for at least 7 days. Hypothermia, management by clinc #2 were independent predictors of 24 hour euthanasia/death. For cats surviving \>24 hours, hyothermia and failure to receive aspirin/clopidogrel or both were independent predictors of euthanasia/death within 7 days. For cats that survived \>7 days, MST was 94 days, with 6 cats alive 1 year post-presentation.

Answer 259

* Using e-tube in 3 dogs, PO in 1 dog * After initiation of suctioning, dogs survived for ~13.5 months; 2 dogs had no additional episodes of pneumonia

Answer 260

* The Stewart approach identified an incraesed SIG acidosis in 50% of cases with a strong correlation between the SIG and AG * Semiquantitivae approach identified increased unmeasured anions in 65% cases. * Moderate correlation between AG and XA and slightly stronger correlation between SIG and XA * Plasma lactate and XA were poorly correlated and there was no correlation between lactate and BE.

Answer 261

* SPV values \>4mmHg or \>4.5% predicted hemodynamic improvement in dogs with normal cardiovascular function * SPV is the maximum variation in systolic pressure values following a single PP breath delivered by CMV * SPV therefore may be used to predict a cardiovascular response (\>10% increase in MAP or \>10% decrease in heart rate)

Answer 262

* PaO2/FiO2 and SaO2/FiO2 had excellent correlation. * Further evaluation into the correlation between SaO2/FiO2 or pulse oximeter oxygen saturation (SpO2)/FIO2 with PaO2/FiO2 in healthy dogs and those with pulmonary dysfunction is warranted

Answer 263

* Treatment successful for 7 pred dogs and 7 cyclo dogs * Absence of synovial fluid cytologic abnormalities on day 45 found in 5 pred dogs and 8 cyclosporine dogs * Cyclosporine may be a suitable alternative to pred in dogs with IMPA

Answer 264

* CIN was identified as an increase in 0.5mg/dL from baseline creatinine concentration within 1 week following administration of an IV iodinated contrast * There was certainly a temporal association between contrast administration and renal injury, however, as the study was retrospective, a causal association cannot be determined * Creatinine post-contrast as well as the change in creatinine was significantly higher in the CIN group than in the non CIN group.

Answer 265

* 27 cats with CKD and 9 healthy cats developed hypertension \>/= 3 months after idagnosis of CKD * Helathy cats were at less risk than cats with CKD to become hypertensive; creatinine was an independent risk factor for development of hypertension

Answer 266

* Looked for an association between SIRS, GI hemorrhage, dietary indiscretion, constipation, furosemide treatment, azotemia, hypokalemia, hyponatremia, alkalosis and hyperammonemia--none identified * Treatment for presumed HE prior to hospital admission were significantly less likely to have clinical signs of disease at admission

Answer 267

Canine parainfluenza virus and canine respiratory coroonavirus were identified in 8/20 dogs with bacterial pneumonia. In dogs with bordatella tracheobronchitis, no respiratory viruses were dectected. Clinical variables and disease severity did not differ in dogs with BP with and without viral coinfection.

Answer 268

* CRP increased significantly from post-surgery samling to 18-22 hours postsurgery, while HMGB1 did not change over time. * There was a significant difference in HMGB1 between survivors and non-survivors * There was no significant difference in CRP between survivors/non-survivors * HMGB1 was significantly higher in dogs with gastric wall necrosis * Both parameters correlated only mildly with SIRS at presentation * HMGB1 appears to better reflect the severity of tissue injury in dogs with GDV than CRP

Answer 269

* Improved appetite compared to placebo * Seems to be an effective treatment for stimulation of appetite in dogs; is the first ghrelin receptor agonist effective for this indication

Answer 270

Dogs with bacterial pneumonia had significantly higher CRP concentrations (121) as compared to dogs with bacterial tracheobronchiis (23), chronic bronchitis, eosinophilic bronchopneumoathy, cardiogenic pulmonary edema or healthy controls. CRP is a major acute phase protein in dogs and has potential use as an additional biomarker when diagnosing BP.

Answer 271

* Concurrent administration of phenobarb, alone or in combination with bromide, increased levetiracetam clearance in epileptic dogs compared to bromide alone. * Dosage increases may be necessary when utilizing levetiracetam as an adjunct treatment with phenobarb.

Answer 272

Multidetector CT did not improve the detection of cardiac masses in dogs with PE over echocardiography. The benefit of CT was primarily in the detection of pulmonary metastasis and extracardiac lesions using a single imaging modality.

Answer 273

* Using a cut-off of =2 ug/dl, sensitivity and specificity of baseline cortisol to diagnose addison's were 100% and 63%; for a cut off of = 1, were 85% and 9!% * Measurement is useful as a screening tool using a cut-off of \<2ug/dL, with the disease being unlikely in dogs with higher levels * CANT be used for diagnosis, follow up with ACTH stim

Answer 274

* An 8 week old dog presented for care following resuscitation for CPA; had neuo deficits, marked PU, isosthenuria and low urine osmolality. * Treatment with DDAVP resulted in improvement of signs, suggesting a diagnosis of partial CDI.

Answer 275

* T2 and FLAIR images provided the best information * Dogs with injuries affecting the caudal fossa or affecting both the rostral and caudal fossae typically had worse outcomes

Answer 276

* Fluoro and US guidance to locate a gastropexy site on left lateral abdomen * Pexy using GI suture anchors * Over the wire catheter technique using fluoroscopic guidance to achieve jejunal access * 18F/8F dual lumen GJ feeding tube placed via serial over the wire dilation of the body wall using an 18F peel away introducer kit * Tube location determined radiographically on days 2,4 after emesis on day 4 and at time of GJ tube removal * Successful in all dogs, 53 minute total procedure time * Mild to no complications

Answer 277

* Terrier breeds were the most common canine types. * 90% of animals had clinical signs at time of TOF diagnosis, including cyanosis. * Most of the VSDs were large. * Median age at cardiac related death was 23.4 months (no sig diff between dogs and cats) * Cardiac related death occurred predominantly in young adult dogs and cats with TOF and most animals had severe clinical signs at time of diagnosis.

Answer 278

* Decreased renal excretion during experimental AKI did not cause any consistent or correlated increases in serum cPL, lipase activity or TLI in these dogs

Answer 279

* 44% of dogs required transfusion * Dogs that needed transfusion had significantly higher ISS, heart rate, resp rate and blood lactate concentration, and PT * Had lower PCV/TS, albumin, and base deficit * Dogs that required transfusion were more likely to have a hemoperitoneum and malignant disease * Higher odds of death/euthanasia while hospitalized; lower odds of surviving to 30 or 180 days following discharge

Answer 280

* Iatrogenic anemia from frequent phlebotomies is an important cause for increased transfusion requirement * Fewer phelbotomies and blood conserving strategies may help reduce the incidence of anemia and decrease transfusion requirements

Answer 281

PDA closure confers important survival benefits and results in long term reverse remodeling in most dogs. Clinical signs at presentation, concurrent congenital heart disease and severe mitral regurgitation significantly affect survival. Increased left ventricular systolic dimensions and systolic dysfunction at baseline correlated significantly with persistent remodeling.

Answer 282

* Cost and duration of hospitalization were greater in the group of dogs receiving antivenom * Difference was essentially the cost of the antivenom vial and administration * No significant benefit was associated with antivenom administered to dogs envenomated by C. viridus * However, specific c. viridis species are not used in the creation of the commercially available antivenoms...

Answer 283

* In dogs without DM, BOHB is significantly higher in dogs with acute pancreatitis compared to other dogs * Whatever this means clinically, who knows.

Answer 284

* Administration of TEA as a slow bolus at 10m/gkg followed by 10mg/kg/hr CRI was safe (higher doses led to vomiting) * TEA may enhance coagulation (decreased PT, R values on TEG), however, effect on fibrinolysis was inconsistent with what was expected * The TEG assay used in this study could not identify the presence of any fibrinolysis prior to TEA administration, therefore, it was likely difficult to assess any of the true effects of TEA

Answer 285

* Envenomation by viperinae can induce myocardial injury/arrhythmias--it is unknown if this arises due to a direct cardiotoxin or secondary to SIRS induced by toxins. * Dogs envenomated by V. berus had significant increases in cTnI compared to healthy dogs at 12 and 24 hours post admission. * Dogs that also had a CRP of \>35mg/dL at admit and 12-24 hours post had significantly higher cTnI than those with lower CRPs and normal dogs * No significant difference between dogs with/without arrhythmias * Significant increases in cTnI and CRP at all time points in dogs envenomated by B. arietans and N. annulifera, but no correlation between cTnI and CRP at any point. * Could be due to differences in toxic substances of the snake venoms or differences in the cytokines induced by the bites. * Myocardial injury occurs frequently in dogs with snake bite injury and may be a negative prognostic indicator. *

Answer 286

* Most common cause of injury was blunt trauma followed by penetrating trauma * 90% survival to discharge * Dogs with penetrating trauma more likely to survive compared to blunt trauma * ATT, MGCS and blood lactate at the time of admission were predictive of outcome * ATT 2.1 compared to 7.9 * MCGS 17.8 compared to 15.3 * Lactate 2.8 compared to 6.5 * Penetrating trauma, low blood lactate concentration and performance of surgical procedures were predictive of survival to hospital discharge

Answer 287

* Plasma lactate concentration is relevant in assessment of the degree of overt or occult hypoperfusion as well as in assessment of tissue DO2 (end product of anaerobic metabolism and circulating concentrations increased underconditions of tissue hypoxia) * "Lactime"--time lapsed from admisison to normalization of plasma lactate concentration * Admission plasma lactate \>2.5mmol/L was associated with mortality, with a significantly higher lactate in nonsurvivors than survivors * Patients with a higher median lactate were more likely to require transfusion/vasopressors * Plasma lactate clearance at 6 and 12 hours after admission was also a good predictor of mortality (lactate \>2.3 and 2.4 ;specificity 92% and 100%) * Admission plasma lactate concentration and lactate clearance (in particular) within a 6-12 hour window is associated with survival and persistent postoperative hyperlactatemia should raise concern.

Answer 288

* Plasma renin activity was significantly lower in hypertensive azotemic cats compared with non-azotemic normotensive cats. * Hypertensive azotemic cats had significantly higher plasma aldosterone concentrations than normotensive cats. * Plasma renin activity significantly increases with anti-hypertensive therapy * Need to determine the role of plasma aldosterone in the pathogenesis of hypertension and whether this relates to autonomous production/activation of RAAS

Answer 289

Endothelial dysfunction has been suggested to be associated with MMVD in dogs. Under conditions of oxidative stress, biopterin is oxidized to an inactive form and therefore, plasma concentrations of biopterin may reflect endothelial dysfunction and oxidative stress. Higher plasma concentrations of biopterin were found in dogs with CHF than all other groups. Females had higher concentrations. Biopterin was found to decrease with age. Cardiovascular risk factors such as passive smoking and increased body weight were associated with lower biopterin conditions.

Answer 290

* Administration of either saline or tetrastarch to healthy dogs AND dogs with LPS induced inflammation resulted in increases in PT and ACT. * In healthy dogs: * Tetrastarch--\>significant decrease in R * In BOTH healthy and dogs with LPS tetrastarch: * increased APTT, CL30 and K * Decreased platelet count, alpha angle, MA and vWF antigen * "Tetrastarch bolus administration to dogs with systemic inflammation resulted in a transient hypocoagulability characterized by a prolonged APTT, decreased clot formation speed and clot strength, and acquired type 1 vWD