jaaha.org / JAAHA 49.3, MAY/JUNE 2013
21
VETERINARY PRACTICE GUIDELINES 2013 AAHA Fluid Therapy Guidelines
H Davis, T Jensen, A Johnson, P Knowles, R Meyer, R Rucinsky, H Shafford
Fluid therapy is important for many medical conditions in veterinary patients. The assessment of patient history, chief complaint, physical exam findings, and indicated additional testing will determine the need for fluid ther- apy. Fluid selection is dictated by the patient’s needs, including volume, rate, fluid composition required, and location the fluid is needed (e.g., interstitial versus IV). Therapy must be individualized, tailored to each patient, and constantly re-evaluated and reformulated accord- ing to changes in status. Needs may vary according to the existence of either acute or chronic conditions, pa- tient pathology (e.g., acid-base, oncotic, electrolyte abnormalities), and comorbid conditions. All patients should be assessed for three types of fluid disturbances: changes in volume, changes in content, and/or changes in distribution. The goals of these guidelines are to assist the clinician in prioritizing goals, selecting appropriate fluids and rates of administration, and assessing patient response to therapy. These guidelines provide recom- mendations for fluid administration for anesthetized patients and patients with fluid disturbances.
RETROSPECTIVE STUDY Postoperative Complications Following TECA-LBO in the Dog and Cat
RE Spivack, AD Elkins, GE Moore, GC Lantz D Gagnon, B Brisson
The medical records for 133 total ear canal ablations combined with lateral bulla osteotomies (TECA-LBOs) performed on 82 dogs (121 ears) and 11 cats (12 ears) between 2004 and 2010 were reviewed to determine if the duration of preoperative clinical signs was asso- ciated with the incidence of postoperative facial nerve injury and Horner’s syndrome. Other perioperative complications, such as a head tilt, nystagmus, incisional drainage, draining tracts, hearing loss, as well as bac- terial culture results, were noted. Postoperative facial nerve paresis occurred in 36 of 133 ears (27.1%), and paralysis occurred in 29 of 133 ears (21.8%), with no significant difference between species. Thus, postopera- tive facial nerve deficits occurred in 48.9% of ears. The median duration of clinically evident temporary facial nerve deficits was 2 wk for dogs and 4 wk for cats. Dogs had a significantly longer duration of preoperative clini- cal signs and were less likely than cats to have a mass in the ear canal. Dogs were less likely to have residual (> 1 yr) postoperative facial nerve deficits. The incidence of postoperative Horner’s syndrome was significantly higher in cats than dogs. The duration of preoperative clinical signs of ear disease was not associated with postoperative facial nerve deficits.
The purposes of this retrospective study were to review cases of colonic torsion/volvulus between July 1992 and August 2010 and to determine if any predisposing factors exist for the development of this condition. Six dogs were diagnosed with colonic torsion/volvulus during the study period. Four dogs had a history of previous gastric dila- tion-volvulus (GDV) with prophylactic gastropexy. Three of six dogs diagnosed with colonic torsion/volvulus had large intestinal entrapment and strangulation around the gastropexy site at the time of surgery. The history, clini- cal signs, physical examination, and radiologic findings were not specific for colonic torsion/volvulus in any dog. Early exploratory laparotomy was indicated to confirm the diagnosis and perform surgical correction of the affected bowel segments. Three of five dogs that underwent sur- gery had a left abdominal wall colopexy performed. All five dogs that underwent surgery in this study survived postoperatively. One patient was euthanized without surgical
intervention.Results suggest that colonic torsion/ volvulus should be considered in any large-breed dog with nonspecific gastrointestinal clinical signs and a his- tory of previous gastropexy. Early recognition and prompt treatment of this condition may result in a good outcome.
JAAHA is available in print and online. Log on to
jaaha.org for more information. Trends magazine, May 2013
RETROSPECTIVE STUDY Predisposing Factors for Colonic Torsion/ Volvulus in Dogs: A Retrospective Study of Six Cases (1992–2010)
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60