Evaluation of resuscitative endovascular balloon occlusion of the aorta catheter placement and comparison to resuscitative thoracotomy with aortic clamping in cadaver dogs.

OBJECTIVE: To describe placement of an aortic occlusion catheter in aortic zone 1 (Z1) and aortic zone 3 (Z3) in dogs and to compare time to placement in these zones with and without external chest compressions (ECC). Additional evaluations of time to placement in Z1 with time for resuscitative thoracotomy with aortic clamping (RT-AC) were performed. DESIGN: Prospective ex vivo study. SETTING: University teaching hospital. ANIMALS: Ten canine cadavers. INTERVENTIONS: Ten cadaver dogs were obtained from client donation after euthanasia. Cadavers were randomized to have balloon catheter placement into the right or left femoral artery via cutdown, with or without ECC. The xiphoid was used as an external anatomical landmark for Z1, and the spinous process of the 5th lumbar vertebra was used for Z3. Balloon placement was confirmed with radiography. Time to balloon placement in Z1 and Z3 and time to RT-AC were recorded. MEASUREMENTS AND MAIN RESULTS: Median body weight was 23.5 kg (9-40 kg). Median time to Z1 placement was 6.6 minutes (4.6-12.4 minutes) with ECC and 6.9 minutes (3.3-13.1 minutes) without ECC and was not statistically different (P = 0.5). Median time to RT-AC was 1 minute (0.6-1.4 minutes), which was significantly faster than time to balloon placement in Z1 with or without ECC (P = 0.004 and P = 0.002, respectively). CONCLUSIONS: Endovascular balloon occlusion of the aorta can be achieved by cutdown with and without ECC, but RT-AC is faster. Successful balloon position in Z1 could be achieved with knowledge of external anatomical landmarks, but landmarks for Z3 need further study.

Retrospective evaluation of the clinical course and outcome following grape or raisin ingestion in dogs (2005-2014): 139 cases.

OBJECTIVE: To describe the prevalence of acute kidney injury (AKI), clinical course, decontamination procedures, and outcome in dogs following grape or raisin ingestion. DESIGN: Retrospective case series from 2005 to 2014. SETTING: Three university veterinary teaching hospitals. ANIMALS: One hundred thirty-nine client-owned dogs with known grape or raisin ingestion. MEASUREMENTS AND MAIN RESULTS: Among dogs with biochemical data, the prevalence of AKI was 6.7% (8/120). The prevalence of AKI in the early presentation (3/67) and late (5/53) presentation groups were 4.5% and 9%, respectively. The prevalence of AKI was not significantly different between groups (P = 0.27). Four dogs (3.3%) were azotemic at presentation and 4 dogs (3.3%) had increases in creatinine of ≥26.5 µmol/L (0.3 mg/dL) at recheck (3 from the early and 1 from the late group). Vomiting was the most common clinical sign (18/139). One hundred twenty-two dogs (88%) underwent gastrointestinal decontamination and significantly more dogs in the early group were decontaminated (P < 0.0001). Two dogs received continuous renal replacement therapy. One hundred thirty-eight dogs survived and 1 died. CONCLUSIONS: The prevalence of AKI and mortality was low in dogs with confirmed grape or raisin ingestion. Due to the retrospective nature of the study, conclusions about the utility of gastrointestinal decontamination and other therapies cannot be made.

Evaluation of the effects of time, temperature, and specimen storage on in vitro lactate concentrations in healthy dogs.

BACKGROUND: Lactate concentrations increase significantly under certain storage conditions, except for when glycolysis-arresting agents are used. Evaluation of time and storage conditions on heparinized whole blood lactate concentrations without glycolysis-arresting agents have not been evaluated in dogs. OBJECTIVES: The purpose of the study was to determine the effects of preanalytic storage conditions on the in vitro concentration of lactate in heparinized canine venous blood specimens. METHODS: In this prospective study, blood collected from 30 healthy dogs was aliquoted and stored under different conditions: anaerobic refrigerated (3°C), aerobic refrigerated, anaerobic room temperature (RT), and aerobic RT. Whole blood lactate was analyzed at 15-25, 30-40, 60-70, and 120-130 minutes from time 0 (T0) under all storage conditions. Percent increases from the T0 specimen were calculated. RESULTS: There were significantly increased lactate concentrations at all time points within the anaerobic refrigerated specimens compared to T0, and in the anaerobic RT specimens after 15-25 minutes. The aerobic refrigerated specimens did not have significant changes in lactate when compared to anaerobic refrigerated specimens, while the aerobic RT specimens had significant increases at all time points. Anaerobically refrigerated specimens stored < 40 minutes and aerobically refrigerated specimens stored < 25 minutes had in vitro lactate increases of < 20%. CONCLUSIONS: Results support analyzing lactate specimens immediately. If lactate analysis is delayed, anaerobic refrigerated specimens should be analyzed within 40 minutes, and aerobic refrigerated specimens should be analyzed within 25 minutes. Room temperature specimens stored either aerobically or anaerobically should be avoided as lactate concentrations may be falsely increased.