A pilot study evaluating the utility of a novel tube cricothyrotomy technique in providing ventilation in small animals using a live porcine model.

BACKGROUND: Tube cricothyrotomy has been suggested as a first-choice for emergency surgical airway access in small animals, rather than the more commonly accepted procedures of tracheotomy and needle cricothyrotomy. METHODS: A small pilot study of tube cricothyrotomy in a live porcine model was conducted to evaluate this method. The technique was modified to permit the use of commonly available equipment and ease of application. Following ethics approval, a tube cricothyrotomy was performed on 9 live pigs. The endpoints were the efficacy of ventilation through the tube as measured by end-tidal carbon dioxide, successful placement of the tube and the time taken for placement. RESULTS: Of the nine pigs, eight had a tube placed successfully, with the median procedure time being 111.5 seconds (range: 35-240 seconds). After 10 mins, the mean end-tidal carbon dioxide was 58.3 mmHg (95% CI: 55.2-61.3 mmHg), with a range of 54-64 mmHg. Tube cricothyrotomy holds promise as a means of rapidly obtaining tracheal access in small animals and temporarily sustaining ventilation in an emergency. CONCLUSION: Further detailed investigation is warranted to assess the use of this technique in the small animal emergency setting.

Diagnostic accuracy of the SNAP and Spec canine pancreatic lipase tests for pancreatitis in dogs presenting with clinical signs of acute abdominal disease.

OBJECTIVES: To (i) assess the clinical diagnostic accuracy of SNAP canine pancreatic lipase (cPL) and specific canine pancreatic lipase (Spec cPL) and (ii) assess the agreement of an abnormal test result between SNAP cPL and Spec cPL in dogs presenting with acute abdominal disease. DESIGN: Prospective observational cohort study. SETTING: University teaching hospital emergency center. ANIMALS: Thirty-eight client-owned dogs that presented with acute abdominal disease, with a known final diagnosis between March 2009 and April 2010. Dogs were retrospectively assigned into 2 groups, dogs with acute pancreatitis (AP) (Group 1) and dogs without AP (Group 2). INTERVENTIONS: Paired serum samples obtained within 24 hours of presentation were analyzed using the SNAP cPL test and Spec cPL assay. MEASUREMENTS AND RESULTS: SNAP cPL clinical sensitivity and specificity was 82% (9/11 dogs of group 1) and 59% (16/27 dogs of group 2), respectively. Spec cPL clinical sensitivity and specificity was 70% (7/10 dogs of group 1) and 77% (20/26 dogs of group 2), respectively. Accuracy of the SNAP and Spec cPL for a clinical diagnosis of pancreatitis was found to be 66% and 75%, respectively. Agreement between a positive SNAP (cPL ≥ 200 µg/L) and a clinical diagnosis pancreatitis resulted in κ = 0.33. Agreement between an increased Spec (cPL ≥ 400 µg/L) and a clinical diagnosis of pancreatitis resulted in a κ = 0.43. The agreement between SNAP and Spec cPL (cPL ≥ 200 µg/L) for the entire cohort resulted in κ = 0.78. CONCLUSION: SNAP cPL and Spec cPL results may provide a "false positive" diagnosis of pancreatitis in up to 40% of dogs presenting with acute abdominal disease. There is good overall agreement between SNAP cPL and Spec cPL; however, there were 4/38 dogs with positive SNAP cPL and "normal" Spec cPL.

Use of intravenous lipid therapy in three cases of feline permethrin toxicosis.

OBJECTIVE: To describe the use of intravenous lipid emulsion (IVLE) as an adjunctive therapy in 3 cats with permethrin toxicosis. CASE SERIES SUMMARY: Three cats with permethrin toxicosis were treated with IVLE in addition to the current accepted treatment regime. All 3 cats demonstrated a subjective rapid clinical improvement after the administration of IVLE, with no adverse reactions observed. NEW OR UNIQUE INFORMATION PROVIDED: This is the first reported use of IVLE for feline permethrin toxicosis, with encouraging results. A possible reduction in costs associated with treatment may contribute to a reduction in euthanasia. Further investigation of the use of IVLEs in permethrin toxicosis is warranted.