Owner experiences with and perceptions of owner-witnessed CPR in veterinary medicine.

OBJECTIVE: To examine owner experiences with and perceptions of owner-witnessed resuscitation (OWR) in veterinary medicine and to determine if previous experience with family-witnessed resuscitation (FWR) influenced perceptions. DESIGN: Multicenter survey. SETTING: Two academic and 2 private practice referral hospitals in the United States. SUBJECTS: Four hundred and seven clients presenting their small animal or exotic pet to the emergency service, or owners of patients hospitalized in the small animal ICU, April 1 to May 15, 2019. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Anonymous, online survey. Demographic variables, familiarity with CPR, previous experience with FWR or OWR, and open-ended questions and 4-point Likert items assessing level of agreement with statements on OWR were included. Scores equal or greater than 2 represented positive agreement. An overall OWR mean score was calculated from Likert items. Seventy-nine (19.4%; 95% confidence interval [CI], 15.7%-23.7%) participants reported having been involved with FWR, and 13 (3.2%; 95% CI, 1.8%-5.5%) reported having witnessed CPR on their pet. Owners were significantly more likely to participate in OWR if they had been present for FWR (P = 0.0004). Ninety-two percent of respondents who had been present for OWR would elect to be present again (95% CI, 62.1%-99.6%). Whether present for OWR or not, owners believed there may be benefits from witnessing CPR and had overall positive feelings toward the practice (OWR mean score, 2.87, SD 0.45 and 2.68, SD 0.54, respectively). Most respondents (78.6%; 95% CI, 74.2%-82.4%) felt that owners should be offered the opportunity to witness CPR on their pets. CONCLUSIONS: Owners expressed overall positive experiences with and attitudes toward OWR and believe the option for presence should be provided. As pet owners become more aware of FWR in human medicine, veterinarians may need to be prepared to entertain the possibility of OWR and owners' wishes to remain with their pet during CPR.

A prospective randomized, double-blinded clinical study evaluating the efficacy and safety of bupivacaine versus morphine-bupivacaine in caudal epidurals in cats with urethral obstruction.

OBJECTIVE: To investigate the efficacy and safety of the caudal epidural technique in cats with urethral obstruction (UO). DESIGN: Prospective, double-blinded, randomized, sham-controlled study. ANIMALS: Eighty-eight male cats with UO. INTERVENTIONS: Thirty cats randomized to bupivacaine epidural (BUP), 28 cats to bupivacaine-morphine epidural (BUP/MOR), and 30 cats to sham epidural (SHAM). MEASUREMENTS AND MAIN RESULTS: Time to perform the epidural and efficacy of the epidural was assessed by evaluation of tail and perineal responses. The amount of propofol for urinary catheterization and time to administration of rescue analgesia (buprenorphine) was recorded. Cats were monitored for epidural complications. The median time to perform the epidural was 2 min (range, 0.2-13 min and range, 0.5-13 min), with an epidural success rate of 70%. The median amount of propofol administered for urinary catheterization was significantly less in the BUP (2.1 mg/kg; range, 0-7.5 mg/kg) and MOR/BUP cats (1.85 mg/kg; range, 0-8.6 mg/kg) as compared to SHAM cats (4 mg/kg; range, 0-12.7 mg/kg) (P = 0.006, P = 0.0008, respectively). The median time to administration of rescue analgesia was also significantly longer in the BUP (10 h; range, 2-32 h) and MOR/BUP cats (10 h; range, 4-45 h) as compared to SHAM cats (4 h; range, 2-36 h) (P = 0.0026, P = 0.0004, respectively). There were no recognized complications related to the epidural. CONCLUSION: Caudal epidural appears to be safe, may reduce the amount of IV anesthesia needed to facilitate urinary catheterization, and can be used to provide long-term analgesia in the hospital.

Sewing needle foreign body ingestion in dogs and cats: 65 cases (2000-2012).

OBJECTIVE: To characterize clinical signs, diagnostic test results, foreign body location, treatment, and outcome for dogs and cats with sewing needle foreign bodies. DESIGN: Retrospective case series. ANIMALS: 65 dogs and cats with sewing needle foreign bodies. PROCEDURES: Medical records of 27 dogs and 38 cats examined because of sewing needle foreign bodies from January 2000 to February 2012 were reviewed for signalment, medical history, physical examination findings, diagnostic test results, interval from witnessed exposure and radiographic imaging to definitive treatment, definitive treatment, sewing needle location, complications, and outcome. RESULTS: 7 (10.8%) animals had sewing needles in extragastrointestinal locations that were not causing clinical signs. The remaining 58 (89.2%) animals had known sewing needle exposure or acute clinical signs associated with ingestion. The esophageal and gastric regions were the most common location for a sewing needle (10/21 [47.6%] dogs; 19/37 [51.4%] cats), followed by the oropharynx (7/21 [33.3%] dogs; 11/37 [29.7%] cats) and small and large intestines (4/21 [19.0%] dogs; 7/37 [18.9%] cats). Gastrointestinal perforation was detected in 10 of 58 (17.2%) animals (5/21 [23.8%] dogs; 5/37 [13.5%] cats). Sewing needles in the esophagus and stomach were successfully removed endoscopically in 8 of 9 dogs and 18 of 19 cats. Survival rate was 98.1% (51/52) for animals receiving definitive treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Endoscopic removal of ingested sewing needles was highly successful and should be recommended to prevent gastrointestinal tract perforation and associated morbidity. Prognosis for dogs and cats receiving definitive treatment for sewing needle foreign body ingestion was excellent.