Companion Animal Key Parameters Flashcards
HR (dog)
- 60 - 140 bpm (size dependent) / 70 - 180 bpm?
- Emergency: > 160 bpm / < 60 bpm
- Shock -> inc HR
HR (cat)
- 170 - 200 bpm / 150 - 210 bpm?
- Emergency: < 160 bpm / > 240 bpm
- Shock -> dec HR
CRT
- < 2 s
- Emergency: < 1 s / > 3 s
Resp rate (dog)
- 10 - 20 bpm
- Emergency: > 50 bpm
Resp rate (cat)
- 20 - 40 bpm
- Emergency: > 50 bpm
Urinary output
- 1 - 2 mL/kg/h
Temp (dog)
- 37.5 - 39.5 C
Temp (cat)
- 37.5 - 39.5 C
PCV (dog)
- 25 - 40%
- Emergency: > 50%
Albumin
- 70 - 80%
Bolus fluid therapy
- Over 10 - 20 min
- 10 - 20 mL/kg
Maintenance FT
- (BW x 30) + 70
Mean arterial pressure (MAP)
- > 60 mmHg
- Dec w/ dec perfusion of organs
- Dec BP - vasodilation
- Inc BP - vasoconstriction
Blood glucose (dog)
- 3.3 - 5.5 mmol/L
Anaemia
- Low RBC, HCT, HGB
- TP unchanged, PCV dec
- If dehydrated - PCV may appear normal, TP raised
Regenerative anaemia
- Inc reticulocytes
- Inc MCV - polychromatophils are larger in size compared to erythrocytes
- Dec MCHC - reticulocytes have lower cytoplasmic Hb
- Inc RDW - reticulocytes are larger in size
Iron deficiency anaemia
- Normo to microcytosis (dec MCV)
- Hypochromasia (dec MCH, will dec MCHC)
- Inc platelet count
Non-regenerative anaemia
- Normocytic (normal MCV)
- Normochromic (normal MCHC)
- MCV, RDW, MCH and MCHC within their reference ranges
Stress leucogram
- Mature neutrophilia (inc segmented neutrophils)
- Lymphopenia (dec lymphocytes)
- Eosinopoenia
- Monocytosis
Hyperproteinaemia - inc protein synthesis, inflammation
- Dec albumin (dec negative APPs)
- Inc globulins (inc positive APPs)
Hyperproteinaemia - haemoconcentration/dehydration
- Inc albumin
- Inc globulin (can be normal in many cases)
- Erythrocystosis
- Pre-renal azotaemia (hypovolemia)
- Concentrated urine (inc urine SG)
Hypoproteinaemia - protein-losing nephropathy (PLN)
- Dec albumin
- Normal globulins (may get dec)
- Marked proteinuria dominated by albuminuria
- Possible evidence of renal insufficiency
- Hypercholesterolaemia + peritoneal effusion - transudate
Hypoproteinaemia - protein-losing enteropathy (PLE)
- Dec albumin
- Dec globulins, or normal globulins
Azotaemia
- Inc urine (or urea nitrogen)
- And/or inc creatinine
Canine hypothyroidism (specific)
- Low total T4
- Inc TSH
Canine hypothyroidism (non-specific)
3/4 of dogs:
- Hypercholesterolaemia
- Hypertriglyceridaemia
1/3 - 1/4 of dogs:
- Mild, non-regenerative (normocytic and normochromic) anaemia
- Inc ALP
- Inc CK
Feline hyperthyroidism (non-specific)
- Inc liver enzyme activities (ALP, ALT, AST) (most common)
- Erythrocytosis
- Macrocytosis (inc volumes of RBC, inc in MCV)
- Stress leucogram - neutrophilia, lymphopenia, eosinopenia
- Azotaemia
- Hyperglycaemia
- Inc fructosamine
Canine hyperadrenocorticism (Cushing’s disease)
- Leucocytosis
- Stress leucogram - neutrophilia, eosinopoenia, lymphopoenia, monocytosis
- Thrombocytosis
- Inc ALP - only dogs have isoenzyme of ALP induced by glucocorticoids
- Inc ALT, less elevated than ALP
- Hypercholesterolaemia
- Dec circulating total T4 (normal endogenous TSH)
- Low SG <1.015
- Proteinuria
- UTI, blood, protein, pH changes, active sediment or occult UTI
Feline hyperthyroidism (specific)
- Elevated circulating total T4 conc
- Total T4 in reference interval
- Low TSH
Canine hypoadrenocorticism (Addison’s disease)
- Azotaemia
- Dec sodium : potassium ratio (inc intracellular electrolytes, dec extracellular electrolytes)
- Inc potassium
- Dec sodium
- Dec chloride
- Hypercalcaemia
- Hypoglycaemia
- Normal to mild non-regenerative anaemia
- ABSENCE of Stress leucogram
Striated muscle injury
- Inc CK (max inc 6-12 hours after injury, returns to reference interval within 48 - 72 hours)
- Serum AST activity inc slower than serum activities of CK and LDH
- Serum LDH activity inc following muscle injury = less apparent for CK and AST
- Myoglobinuria - associated with inc CK
- Hyperkalaemia - degeneration of large area of skeletal muscle (more commonly associated w/ acid-base + electrolyte balance disorders)
- Muscle damage
Relative erythrocytosis
- Dehydration
- Inc total protein
- Inc albumin
Epinephrine (adrenaline)-mediated response
- Mild neutrophilia/heterophilia (no left shift)
- Lymphocytosis (may be more significant in some species, e.g. cats, birds)
- Monocyte, eosinophil and basophil counts usually within the reference interval
- E.g. A young healthy animal which has experienced fear or excitement (lymphocytosis is a common finding in puppies)
- E.g. 2 Blood sample taken shortly after seizuring activity, or strenuous exercise
Corticosteroid-induced response (cortisol)
- Stress leucogram
- Neutrophilia/heterophilia (usually without a left shift)
- Lymphopenia (inc in cats)
- Eosinopenia
- Monocytosis in the dog and occasionally in the cat
- Inc ALP, GGT, ALT
Inflammation/infection
- Neutrophilia/heterophilia of various severity (a left shift may be present)
- Lymphopenia and eosinopenia may (or may not) be present (endogenous release of cortisol may contribute to these changes)
- Monocytosis may be present (some forms of inflammation e.g. granulomatous inflammation are commonly associated with monocytosis)
Leucocyte summary response in dogs and cats, acute inflammation
- Inc WBC
- Inc segmented neutrophils
- Inc band neutrophils
- Variable change in lymphocytes
Leucocyte summary response in dogs and cats, chronic inflammation
- Variable change in WBC, segmented neutrophils, band neutrophils and lymphocytes
Leucocyte summary response in dogs and cats, overwhelming inflammation
- Dec in WBC
- Dec in segmented neutrophils
- Variable changes in band neutrophils
- Variable changes in lymphocytes
Muscle damage
- Inc CK
- Inc AST
Liver damage
- Normal CK
- Inc AST
- Inc liver enzymes - ALT, ALP
Disproportional change between creatinine (dec) and urea (inc)
- More urea-producing substances e.g. GI H+, ulceration, severe nosebleed absorbed as blood is swallowed -> inc urea in blood
Albumin + TP elevated
- GI loss of proteins
Only albumin elevated
- Renal loss of proteins
Inc ALP
- Inc bile acid
- Steroid therapy
- Inc w/ growing bones
Hypocalcaemia/eclampsia
- Total calcium < 1.6 mmol/L
- Ionised calcium < 0.8 mmol/L
PCV in whelping bitch
- 30%
Neonate temp
- Birth: 36 C
- > 1 w: 37 - 38 C
Neonate HR
- 200 - 220 bpm
- May have soft functional murmur
Neonate respiration rate
- 15 - 35 bpm
- Lung sounds louder than adult
CVS dysfunc
- Hypotension
- Arrhythmia
Renal dysfunc
- Oliguria
- Anuria
- Azotaemia
Haematological dysfunc
- Thrombocytopoenia
- DIC
- Anaemia
GI dysfunc
- Ileus
- V+
- D+
Liver dysfunc
- ALP, ALT vs SBA (serum bile acid conc)
- Ammonia
- Albumin
- Glucose
Nervous sytem dysfunc
- Seizures
- Coma
- Hypoglycaemia
Systolic BP
- > 80 mmHg
Critically ill patient’s biochem
- Hypokalaemia
- Hypocalcaemia
Refeeding syndrome
- Hypoglycaemia
- Hypokalaemia
- Hypophosphataemia
- Hypomagnesaemia
Diabetic ketoacidosis
- Hypokalaemia
- Hypophosphataemia
Renal failure
- Hyperphosphataemia
- Hyper / hypokalaemia
Dehydration
- Inc PCV
- Inc TP
- Inc albumin
Polycythaemia/normal (greyhounds)
- Inc PCV
- Normal TP
Hyperglobulinaemia/lab error
- Normal PCV
- Inc TP
Hypoalbuminaemia / Hypoglobulinaemia
- Normal PCV
- Dec TP
Chronic anaemia, haemolytic anaemia
- Dec PCV
- Normal TP
Bleeding, anaemia w/ hypoproteinaemia
- Dec PCV
- Dec TP
Oliguria
- < 0.5 - 1 mL/kg/h urine
Polyuria
- > 2 mL/kg/h
Salmon, pink mm
- Normal
Pale mm
- Vasoconstriction (hypovolaemic/cardiogenic shock), anaemia
- Anticoagulant rodenticide, onion/garlic poisoning
Blue/cyanotic mm
- Prolonged state of shock, lack of O2 - anything that causes seizures, resp problems or anaemia
Yellow mm
- Icterus = liver affected
- Sago palm, cycads, paracetamol poisoning
Dirty/brown mm
- Methaemoglobinaemia
- Paracetamol poisoning
Adult maintenance fluid requirement
- 50 mL/kg/day
- Anaesthesia/Sx = 1 - 2 x normal requirement
Neonate maintenance fluid requirement
- 100 mL/kg/day
Blood volume (dog)
- 80 mL/kg
- Maintenance = 2 mL/kg/hr
- (Same in horse 80 - 90 mL/kg)
Crystalloid fluid required
- 4 x blood vol deficit (only 1/4 stays in intravascular space after 1 h)
On-going loses
- 1 mL/kg/hr
Resting Energy Requirement (RER)
- Dog: RER = (BW x 30) + 70 = kcal
Maintenance energy requirement (MER)
- Dog: RER X factor (e.g. if entire 1.8; neutered: 1.6; obese 1.4)
Paediatric giving set
- 60 drops/mL
Standard giving set
- 20 drops/mL
Neoplasia
- Inc globulins
Pre-renal azotaemia
- Dehydration
- 2y to V+
- High protein meal - starve for 12 h to reduce interference
- GI H+ may result in elevations
Post-renal azotaemia
- Obstruction - full bladder, Hx stranguria
- Ruptured bladder - post obstruction/RTA
Renal azotaemia
- Azotaemia (inc urea + inc creatinine) + isothenuric urine (USG: 1.008 - 1.012)
- Most concerning finding
- AKD/CKD
Hepatocellular damage
Inc enzymes
- ALT
- GLDH
- SDH
- (AST/LDH)
Cholestasis
Inc
- ALP
- GGT
- Inc bilirubin (hepatic, post-hepatic)
Transient inc ALT
- RTA - liver or muscle damage, not corresponding to degree of damage
Inc ALP
- Not specific for cholestasis, but sensitive
- Bone isoform - growing animals + bone path
- Canine - steroid-induced
- Gut - transient inc
Inc GGT
- Cholestasis + biliary tract disease
- Neonates = colostrum intake
- Steroid intake
Inc cholesterol
- Hepatic disease
- Endocrine disease, esp hypothyroidism
- Nephrotic syndrome
Dec cholesterol
- Malabsorption
- Hyperthyroidism (feline)
Inc creatine kinase (CK)
- Muscle cell leakage/damage
- Marked - aortic thromboembolism in cats
Inc amylase + lipase
- Marked elevation - pancreatitis (but may see no elevation)
- Elevation - other pancreatic disease, dec renal clearance (2 - 3 x), GI obstruction, dexamethasone (lipase, 5 x)
- DGGR lipase = more specific for pancreatitis than older lipase assays
Inc calcium + phosphorus
- Growing animals - bone met
Inc calcium
- Hypercalcaemia of malignancy
- Inc ionised Ca
- PTHrP produced by many neoplasms
Hyperglycaemia
- Transient - stress, up to 17 mmol/L - cats + young animals
- Persistent = diabetes mellitus
Hypoglycaemia
- False reading - storage/haemolysis in-vitro
- Insulinoma
- Hepatic disorder
- Sepsis
- Addison’s
Isothenuric urine USG
- 1.007 - 1.012
- Central diabetes insipidus
- Or nephrogenic diabetes insipidus - pyo, sepsis, unable to respond externally, unresponsive to ADH
Hyposthenuric urine USG
- <1.007
Conc of Urine USG
- Feline = > 1.035 (1.040)
- Canine = > 1.030
- Equine/large animal = > 1.020
Inc albumin
- Dehydration
- Corticosteroids
Dec albumin
- Inc loss - PLE, PLN
- Dec production - negative acute phase proteins inc in inflam = liver disease
(CRP + haptoglobin = positive APP, dec in inflam)
Inc globulin
- Lymphoid, plasma cell neoplasia
Dec globulin
- Loss
- H+
- PLE
- PLN
- Dec production and/or inc protein catabolism
Inc bilirubin
- Pre-hepatic - haemolysis, IMHA
- Hepatic, post hepatic - cholestasis, not able to excrete
Capnography CO2 conc
- 35 - 45 mmHg
- If too high - ventilate, squeeze bag to inc tidal vol, lungs not working enough
- If too low - hyperventilation, lungs working too well, patient becoming light, experiencing pain, running out of iso or heart not working well-enough, blood not delivering as much CO2
- Wiggly line = good, no wiggly line = bad
Acute haemorrhage
- Dec RBCs, proteins, plasma
- Initially PCV + TP normal
- As fluid drawn into circulation to restore vol, PCV + TP dec
- Splenic contraction may raise PCV levels to normal temporarily, TP levels will remain lower
BMBT
- Dog = 2 - 4 min
- Cat = 1 - 2.5 min
Hyposthenuric
- < 1.008, more dilute than glomerular filtrate
- Some renal tubular func as filtrate altered
Isosthenuric
- > 1.005 <1.015, equivalent conc to glomerular filtrate tubular - func unknown
Hypersthenuric
- > 1.015 - more conc than glomerular filtrate
- At least some renal tubular func
- Urine is normally hyperthenuric
Hepatocellular damage
- Inc AST
- Inc ALT
- Inc LDH
- Inc SDH
- Inc GLDH
Cholestasis/biliary hyperplasia
- Inc ALP
- Inc GGT
Corticosteroids
- Inc ALP
- Inc GGT
- Inc ALT
Phenobarbital
- Inc ALT
- Inc GLDH
- Inc ALP
- Inc GGT
Colostrum intake (not in foals)
- Inc ALP
- Inc GGT
Addison’s Na : K
- < 25 : 1
(Normal = 27 : 1 - 40 : 1)
RER (resting energy requirement for nutrition, calorie calculation)
- RER = (BW x 70)^0.75
OR - RER = (BW x 30) + 70