Retrospective evaluation of cardiopulmonary arrest and resuscitation in hospitalized birds: 41 cases (2006-2019).

OBJECTIVE: To describe circumstances and outcomes following cardiopulmonary arrest (CPA) in hospitalized birds. DESIGN: Retrospective case study. SETTING: Academic medical center. METHODS: The hospital medical records system was searched for avian cases that underwent CPR. Medical records were reviewed; data retrieved included association of CPA with anesthesia or handling, use of external compressions and intubation, drug administration, rates of return of spontaneous circulation (ROSC), and outcome. Cases with incomplete medical records were excluded. RESULTS: Forty-one cases of avian CPR were identified. Anesthesia-related arrest was reported in 26 of 41 cases. The remainder of CPA events occurred during an examination (6/41) or were observed during hospitalization for treatment of disease or injury (11/41). Compressions were performed in 14 birds and manual ventilation performed in 21 of 41 cases via intubation (19/21), tight-fitting face mask (1/21), or air sac cannulation (1/21). Vascular access was achieved in 24 of 41 cases. Emergency drug administration was documented in 22 of 41 cases and included epinephrine (20/22), atropine (19/22), glycopyrrolate (3/22), doxapram (2/22), dextrose (3/22), mannitol (1/22), and furosemide (1/22). Fluid therapy was administered in 24 of 41 cases. There were 3 documented cases of ROSC (7%), all in patients under general anesthesia, and 1 (2%) CPA survivor. CONCLUSIONS: There was no standardized approach to avian CPR in this study, and ROSC was rare. When ROSC was achieved, birds were under general anesthesia with direct monitoring by a clinician, were ventilated, and were administered anesthetic reversals and anticholinergic or catecholamine emergency medications. These poor outcomes suggest that further research and an updated standardized approach to avian CPR, with special consideration of the physiological differences from mammals, are needed.

Successful xenotransfusion in a domestic ferret with spontaneous hemoperitoneum using feline packed red blood cells.

OBJECTIVE: To describe the diagnosis, management, and outcome of a ferret with spontaneous hemoperitoneum with surgical intervention and xenotransfusion of type A feline packed red blood cells (pRBCs). CASE SUMMARY: A domestic ferret diagnosed with a spontaneous hemoperitoneum secondary to a hepatic mass received isotonic crystalloids, hypertonic saline, and an allogenic blood transfusion perioperatively. Postoperatively, the ferret developed progressive anemia and tachycardia refractory to fluid therapy and, given a lack of additional allogenic blood sources, received a xenotransfusion of feline pRBCs. The ferret was hospitalized for 4 days postoperatively and developed a presumed delayed transfusion reaction characterized by transient hyperbilirubinemia. At a 6-month recheck, the ferret was doing well clinically. NEW OR UNIQUE INFORMATION PROVIDED: This is the first reported case of successful xenotransfusion of feline pRBCs in a ferret. Although xenotransfusion of ferrets with feline blood products is not recommended as a routine procedure, it remains a viable option in critical situations in which ferret blood is unavailable.

Comparison of 3 intraosseous catheter sites and methods of determining placement success in cadaver rabbits.

The study goals were to determine if intraosseous (IO) catheters can be placed with greater success into the humerus, femur, or tibia of cadaver rabbits, and to evaluate the accuracy of perceived success (PS) and objective clinical success (OCS) criteria against true intramedullary catheterization confirmed by fluoroscopy. This was a prospective study utilizing 12 rabbit cadavers. Twenty-two participants attempted IO catheter placement at 3 sites. Perceived success, OCS, and fluoroscopic true success (FTS) were recorded. A Fisher's exact test was used to compare PS, OCS, and FTS, and FTS rates between sites (P < 0.05). A Wilcoxon test was used to compare speed of placement (P < 0.05). Overall, of 66 attempts, PS was reported in 86.4%, OCS was documented in 62.1%, FTS was confirmed in 43.9%. Perceived success and OCS overestimated FTS (P ≤ 0.01 and P = 0.027, respectively). Confirmation of FTS occurred in 10/22 (45.5%) humeral, 5/22 (22.7%) femoral, and 14/22 (63.6%) tibial (P = 0.03) attempts. Median time until placement for the humerus was 37.5 seconds (range: 15 to 125 seconds); the femur 135 seconds (range: 91 to 148 seconds); the tibia 49 seconds (range: 19 to 150 seconds). The humerus and tibia were faster to catheterize than the femur (P = 0.01 and 0.03, respectively). Participant PS and OCS criteria overestimated FTS. The humerus or tibia may be more successful and are faster to catheterize.

Les objectifs de la présente étude étaient de déterminer si des cathéters intra-osseux (IO) peuvent être placés avec plus de succès dans l'humérus, le fémur ou le tibia de cadavres de lapins, et d'évaluer la précision des critères du succès perçu (PS) et du succès clinique objectif (OCS) versus le cathétérisme intramédullaire réel confirmé par fluoroscopie. Il s'agissait d'une étude prospective utilisant 12 cadavres de lapin. Vingt-deux participants ont tenté le placement des cathéters IO aux trois sites. Le PS, l'OCS et le succès réel par fluoroscopie (FTS) furent notés. Un test exact de Fisher fut utilisé pour comparer PS, OCS, et FTS, et les taux de FTS entre les sites (P < 0,05). Un test de Wilcoxon a été utilisé pour comparer la vitesse de placement (P < 0,05). Globalement, des 66 essais, PS a été rapporté dans 86,4 % des cas, OCS a été documenté dans 62,1 % des cas, et FTS a été confirmé dans 43,9 % des cas. Le PS et l'OCS surestimaient le FTS (P ≤ 0,01 et P = 0,027, respectivement). La confirmation de FTS s'est produite dans 10/22 (45,5 %) des essais sur l'humérus, 5/22 (22,7 %) des essais sur le fémur, et 14/22 (63,6 %) des essais sur le tibia (P = 0,03).Le temps médian du placement pour l'humérus était de 37,5 secondes (écart : 15 à 125 secondes); pour le fémur de 135 secondes (écart : 91 à 148 secondes); et pour le tibia de 49 secondes (écart : 19 à 150 secondes). Le cathétérisme de l'humérus et du tibia étaient plus rapides que celui du fémur (P = 0,01 et 0,03, respectivement). Les critères pour le PS et l'OCS des participants surestimaient le FTS. L'humérus et le tibia sont plus rapides à cathétériser et le taux de succès est meilleur.(Traduit par Docteur Serge Messier).

Clinical characteristics and short-term outcomes for rabbits with signs of gastrointestinal tract dysfunction: 117 cases (2014-2016).

OBJECTIVE: To describe the clinical findings and short-term outcomes for rabbits with signs of gastrointestinal tract dysfunction or rabbit gastrointestinal syndrome (RGIS). ANIMALS: 117 client-owned rabbits. PROCEDURES: The electronic medical records database of a veterinary teaching hospital was searched to identify rabbits that were examined because of altered or absent food intake and decreased or absent fecal output between June 1, 2014, and June 30, 2016. For each rabbit, information extracted from the record included history of prior episodes of gastrointestinal tract dysfunction, signalment, physical examination and diagnostic test results, and outcome. RESULTS: 117 of the 484 (24%) rabbits examined at the hospital during the study period met the inclusion criteria and were enrolled in the study. Fifty-nine and 58 rabbits were managed on an inpatient and outpatient basis, respectively. Gastrointestinal stasis without overt obstruction was diagnosed for 43 rabbits on the basis of abdominal radiographic, ultrasonographic, or necropsy results. Many rabbits had concurrent disease and biochemical abnormalities. Fifteen, 18, and 84 rabbits died, were euthanized, and survived to hospital discharge, respectively. Rabbits that were hypothermic (rectal temperature, ≤ 36.6°C [97.9°F]) during the initial examination were 5 times as likely to die or be euthanized as were euthermic rabbits, after controlling for potential confounders. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the prognosis was generally good for rabbits with signs of RGIS unless they were hypothermic during initial examination. Prospective studies are warranted to further elucidate and characterize RGIS and assess the efficacy of various treatments and outcomes for affected rabbits.

Evaluation of gastrointestinal activity in healthy rabbits by means of duplex Doppler ultrasonography.

OBJECTIVE: To use duplex Doppler ultrasonography to compare gastrointestinal activity in healthy sedated versus nonsedated rabbits and to evaluate agreement between B-mode and pulsed-wave Doppler (PWD) ultrasonographic measurements. ANIMALS: 10 healthy client-owned rabbits brought for routine physical examination and 11 brought for routine ovariohysterectomy or castration. PROCEDURES: Duplex Doppler ultrasonography of the gastrointestinal tract was performed once for the 10 rabbits that underwent physical examination and twice (before and after presurgical sedation) for the 11 rabbits that underwent routine ovariohysterectomy or castration. Mean number of peristaltic contractions during a 30-second period was determined for the stomach, duodenum, jejunum, cecum, and colon from B-mode and PWD ultrasonographic images that had been video recorded. Findings for the duodenum and jejunum were compared between B-mode and PWD ultrasonography and between sedated and nonsedated rabbits. RESULTS: Duodenal and jejunal segments had measurable peristaltic waves; however, the stomach, cecum, and colon had no consistent measurable activity. B-mode and PWD ultrasonographic measurements for the duodenum and jejunum had high agreement. No significant difference was identified between nonsedated and sedated rabbits in mean number of peristaltic contractions of the duodenum or jejunum. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that both B-mode and PWD ultrasonography of the duodenum and jejunum may be suitable for noninvasive evaluation of small intestinal motility in rabbits and that the sedation protocol used in this study had no impact on measured peristaltic values.

Reasons for evaluation on an emergency basis of and short-term outcomes for chickens from backyard flocks: 78 cases (2014-2017).

OBJECTIVE: To investigate the reasons for evaluation on an emergency basis of and short-term outcomes for chickens from backyard flocks. DESIGN: Retrospective case series. ANIMALS: 78 chickens. PROCEDURES: For chickens evaluated on an emergency basis at a New England veterinary teaching hospital in January 2014 through March 2017, information including age, sex, flock size, primary medical problem, final diagnosis, and immediate outcome was obtained from electronic medical records. Primary medical problems were classified as abnormal droppings, crop or gastrointestinal tract disease, lameness, neurologic disease, nonspecific signs (ie, undefined illness), respiratory tract disease, reproductive tract disease, and trauma. RESULTS: 78 chickens were evaluated on an emergency basis, of which 71 were females from small flocks. The median age of the chickens was 1 year (range, 0.1 to 7 years). The most common problem was trauma (n = 25), followed by nonspecific signs (11) and reproductive tract disease (10); 18 birds had neurologic disease (6), lameness (6), or gastrointestinal tract disease (6). Five birds had respiratory tract disease, and 3 had abnormal droppings. Six birds were brought to the emergency service for euthanasia only. Trauma, reproductive tract disease, and signs of Marek disease were most frequently identified in birds that were fully evaluated. Thirty-five (45%) chickens were discharged from the hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that backyard flock chickens were evaluated on an emergency basis most commonly because of trauma and reproductive tract disease. Although approximately half of the evaluated chickens were euthanized, the remainder were discharged from the hospital and required medical management. (J Am Vet Med Assoc 2019;254:1196-1203).