Cardiovascular and Toxicological Emergencies Flashcards
Cardiovascular Emergencies
Heart disease is often diagnosed in small animals as they get older
More often in dogs than in cate
Heart disease my go undiagnosed until obvious signs of heart failure are observed by the animal’s owner
Technicians are involved in performing diagnostic tests on heart disease patients, monitoring their condition while in the hospital, and administering treatments to stabilize them
Most forms of heart disease result in heart failure, which is…
the inability of the heart to supply adequate blood flow needed to meet the metabolic needs of body tissues (low-output/forward failure)
or to provide adequate flow only by excessive increases in ventricular filling pressure (congestive/backward failure)
Congestive heart failure
Characterized by increased pulmonary and/or systemic venous pressure
Leads to leakage of fluid from capillaries leading to edema and effusions
Clinical signs of congestive heart failure
Heart murmur, irregular pulse
Pulmonary edemaà dyspnea, tachypnea, exercise intolerance, cyanosis, weakness (Left Heart)
Pleural effusion, severe ascites, hepatomegaly, venous distension, weakness, weight loss (Right Heart)
Diagnostic tests for congestive heart failure
Radiographs
Echocardiogram
Electrocardiogram
Emergency treatment of congestive heart failure
Oxygen supplementation
Decrease venous pressure/preload– furosemide, nitroglycerin
Decrease afterload– hydralazine, sodium nitroprusside (enalapril, benazepril)
Improve contractility– dobutamine, dopamine, amrinone
Toxicologic Emergencies
A toxicity (i.e. exposure to a poison by an animal) must always be considered when an animal presents with clinical abnormalities that have no obvious cause
Clinical signs of toxicity can be similar to those caused by metabolic diseases involving various organ systems
Owner confirmation of animal exposure to a toxin is very important in the management of these patients
Management of animal toxicities
Animal should be brought to the veterinary hospital immediately
Owner should protect themselves against toxin exposure and injury when handling the animal
Owner should bring a sample of the toxin or its container to the veterinary hospital
Animal should be brought to the veterinary hospital immediately
OK for owner to bathe animal with topical toxin exposure prior to bringing to hospital, if animal is stable
Directing owner to administer an emetic at home prior to bringing the animal to the hospital is done at the veterinarian’s discretion
On arrival to the veterinary hospital
Perform triage assessment of animal
Implement any measures necessary to stabilize the animal’s condition
Collect a thorough history and try to determine what toxin the animal was exposed to
Topical exposure
Bathe animal with mild liquid dishwashing detergent
Wear protective clothing (gloves, apron, mask, goggles) to avoid self-contamination
Vacuum animal prior to bathing if exposed to a powdered toxin
Ocular exposure
Rinse eyes with large volumes of physiologic saline for 20-30 minutes
Ingested toxins
Induce emesis
Gastric lavage
Adsorbents
Induce emesis
Apomorphine 0.04 mg/kg IV or 1.5-6 mg tablet, dissolved and placed subconjunctivally in dogs
Hydrogen peroxide (3%) PO 1 tablespoon per 20 lbs. (difficult to administer to cats)
Xylazine 0.44 mg/kg IM or SC in cats
Gastric lavage
Washing out the stomach using tepid water infused through a large bore orogastric tube
Performed 2-4 hours after toxin ingestion
