Urinary syndecan-1 in dogs anesthetized with isoflurane or sevoflurane: A randomized, prospective study.

BACKGROUND: Syndecan-1 (SDC1) is an established marker of endothelial glycocalyx shedding. Most research on SDC1 has focused on plasma or serum concentrations, and little is known about urine concentrations. OBJECTIVES: Measure urinary SDC1 concentrations in dogs undergoing anesthesia with either sevoflurane or isoflurane and assess the effects of anesthesia duration and IV crystalloids on urinary SDC1 concentrations. ANIMALS: Thirty-one client-owned dogs undergoing anesthesia for magnetic resonance imaging (MRI) with or without surgery for suspected intervertebral disk disease (IVDD) were used. METHODS: Dogs with suspected IVDD were randomized to undergo anesthesia with either sevoflurane or isoflurane. Urine was collected before and immediately after anesthesia for the analysis of SDC1. Urinary creatinine concentrations also were measured, and the ratio of urinary SDC1 to urinary creatinine (USCR) was used to account for dilution. RESULTS: Median (range) USCR was significantly higher after anesthesia compared with baseline for all groups combined (P < .05). No significant difference was found between the groups for age, sex, weight, and type of anesthesia. Multiple regression analysis of the effect of the independent variables inhalant type, age, weight, sex, anesthesia time, surgery, and quantity of IV fluids on the dependent variable SDC1 found that only the quantity of IV fluids significantly predicted a change (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: The total volume of lactated Ringer's solution administered to anesthetized dogs may affect USCR. Further investigations are warranted to evaluate the relationship between IV fluids and SDC1.

Retrospective evaluation of the respiratory rate-oxygenation index to predict the outcome of high-flow nasal cannula oxygen therapy in dogs (2018-2021): 81 cases.

OBJECTIVE: To evaluate the respiratory rate-oxygenation index (ROX), modified ROX index (ROX-HR), and the ratio of pulse oximetry saturation (Spo2) to Fio2 (SF) to determine if these indices over time are predictive of outcome in dogs treated with high-flow nasal cannula oxygen therapy (HFNC). DESIGN: Retrospective study. SETTING: Two university teaching hospitals. ANIMALS: Eighty-one client-owned dogs treated with HFNC for hypoxemic respiratory failure. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The ROX was defined as the SF divided by the respiratory rate (RR), and the ROX-HR was defined as the ROX divided by the heart rate multiplied by 100. The overall success rate of HFNC was 44% (n = 36/81). Dogs weaned from HFNC had a significantly higher ROX (P < 0.0001) at 1-3, 5-10, 12, and 15 hours than dogs that failed HFNC. Both the ROX and SF showed excellent discriminatory power in predicting HFNC failure at 6 hours, with an area under receiver operating curve of 0.85 (95% confidence interval: 0.72-0.99; P < 0.002) and 0.86 (95% confidence interval: 0.73-0.99; P < 0.001), respectively. The optimal cutoff values for predicting HFNC failure at 6 hours were a ROX ≤3.68 (sensitivity 72%, specificity 92%) and an SF ≤143 (sensitivity 79%, specificity 93%). CONCLUSIONS: These results suggest that similar to people, the ROX and SF are useful predictors of HFNC failure. These indices are easy to measure at the bedside and may have clinical use. Future prospective studies are warranted to confirm the findings and to optimize cutoff values in a larger population of dogs undergoing HFNC.

Small animal veterinary clients prefer veterinarians to decide when to terminate resuscitation and to be informed after cardiopulmonary resuscitation efforts.

OBJECTIVE: To identify the preferences of small animal veterinary clients for the timing of communication during CPR and whether these clients prefer the veterinarian or pet owner to decide on the termination of resuscitation. SAMPLE: Surveys (n = 1,648) were completed between January 20 and February 3, 2023, by clients of the Wilford and Kate Bailey Small Animal Teaching Hospital. METHODS: This cross-sectional observational study used an anonymous internet-based survey distributed to 28,000 clients of an academic small animal veterinary hospital. The survey included 16 questions asking for the respondents' demographics, healthcare professional status, questions pertaining to CPR, and preference for timing of communication during CPR, veterinary team members to speak to, and the decision on termination of resuscitation. An optional open comment section was provided. RESULTS: The response rate was 7.5%, including 2,127 responses, with 1,648 complete responses used for further analysis. Of the respondents, 56% and 63% (when asked using a short and long scenario question, respectively) would prefer to be informed about their pet undergoing CPR after CPR has ended. Most clients (84%) wanted the veterinarian to decide when to stop CPR. In the comments section, clients predominantly emphasized that patient care should always be prioritized over client communication. CLINICAL RELEVANCE: This study contributes to a better understanding of veterinary clients' preferences and may help improve client communication and decision-making during CPR. More studies are warranted to reach a wider population before broad recommendations can be made.

Intraobserver and interobserver reliability of standardized capillary refill time in dogs is high following observer training.

OBJECTIVE: To assess intraobserver and interobserver reliability of capillary refill time (CRT) measurement in dogs using a standardized technique after training. ANIMALS: 20 dogs presented to the emergency room. METHODS: Dogs presented to the emergency room were prospectively recruited. Using a timing device and standardized technique, CRT was measured at the oral mucosa of the inner lip. Measurements were performed by 2 emergency and critical care residents (observer 1 [Ob1] and observer 2 [Ob2]) and repeated 3 times by each observer for each dog. CRT values and signalment were recorded. Intraobserver and interobserver reliability were analyzed by calculation of the coefficient of variation (CV%), intraclass correlation coefficient (ICC), and minimal detectable difference. Reliability was considered high if CV% was lower than 10% and ICC was between 0.9 and 1. RESULTS: Median CRT for Ob1 was 1.22 seconds and for Ob2 was 1.19 seconds. Intraobserver reliability was high, evidenced by a median CV% of 6.2% (range, 1.0% to 18.6%) and 9.5% (range, 1.3% to 22.6%) and an ICC of 0.97 (95% CI, 0.94 to 0.99) and 0.95 (95% CI, 0.90 to 0.98) for Ob1 and Ob2, respectively. Between observers, the CV% was 4.4% (range, 0.8% to 17.5%) and the ICC was 0.98 (95% CI, 0.94 to 0.99), indicating high interobserver reliability. The minimal detectable differences for intraobserver and interobserver were 0.30 and 0.34 seconds, respectively. CLINICAL RELEVANCE: The reported high reliability of CRT despite its subjective nature enhances its usefulness in daily practice. However, further research on the validity of CRT is warranted.

Estimation of percent body surface area in cats with use of computed tomography.

OBJECTIVE: To establish a baseline reference and create a user-friendly chart for normal body surface area (BSA) in the adult domestic cat similar to the "Rule of Nines" chart. DESIGN: Prospective cadaveric study. SETTING: University Teaching Hospital. ANIMALS: Seven adult domestic short-haired feline cadavers of normal body condition (4-6/9) and body weight. INTERVENTION: Individual whole-body computed tomography (CT) scan was performed on all cats. Images were analyzed with 3-dimensional technology to measure the BSA. A chart was created, illustrating the individual surface area of each body part. MEASUREMENTS AND MAIN RESULTS: Obtained measurements of the cats are different from surface areas of people and dogs. Percentage of total BSA for cats was as follows: head 13%, neck 5%, thorax 20%, abdomen 15%, pelvis and tail 9%, front legs 7% each, and pelvic legs 12% each. CONCLUSION: The distribution of BSA between body parts is different in cats compared to dogs and people. A species-specific chart was created to assure a more accurate estimation of BSA in cats.

Pathophysiology of hemorrhagic shock.

BACKGROUND: Hemorrhagic shock is a common condition that may lead to hemodynamic instability, decreased oxygen delivery, cellular hypoxia, organ damage, and ultimately death. CLINICAL IMPORTANCE: This review addresses the pathophysiology of hemorrhagic shock. Hemorrhagic shock can be rapidly fatal and is the leading cause of death in human trauma patients. Understanding the pathophysiology of hemorrhagic shock is imperative in understanding the current hemostatic and resuscitative strategies and is foundational to the development of new therapeutic options. KEY POINTS: Shock is a state of inadequate cellular energy production and can be triggered by many causes Both traumatic and non-traumatic causes of hemorrhage can lead to the development of hemorrhagic shock Prompt recognition and attenuation of hemorrhage is paramount in preventing the onset or potentiation of hemorrhagic shock Acute hemorrhage produces distinct physiological responses depending on the magnitude and rate of hemorrhage. Hemorrhagic shock may be directly related to the initial injury but may also be exacerbated and complicated by a post-traumatic coagulopathy, termed acute traumatic coagulopathy.

Retrospective evaluation of the relationship between admission variables and brain herniation in dogs (2010-2019): 54 cases.

OBJECTIVE: To document the admission systolic blood pressure (SBP), heart rate (HR), and modified Glasgow coma scale (MGCS) score in dogs with and without brain herniation and to determine their relationship with brain herniation. DESIGN: Retrospective study between 2010 and 2019. SETTING: University veterinary teaching hospital. ANIMALS: Fifty-four client-owned dogs with brain herniation and 40 client-owned dogs as a control group, as determined on magnetic resonance imaging. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: SBP, HR, MGCS score, and outcome were extracted from medical records. MGCS score was retrospectively calculated based on initial neurological examination in dogs with adequate available information. Dogs with brain herniation had a significantly higher SBP (P = 0.0078), greater SBP-HR difference (P = 0.0006), and lower MGCS score (P < 0.0001) compared to control dogs. A cutoff value of an SBP ≥ 178 mm Hg, SBP-HR ≥ 60, and MGCS score ≤ 14 each provides a specificity of 90%-98%. A combination of an SBP > 140 mm Hg and HR < 80/min provided 24% sensitivity and 100% specificity to diagnose dogs with brain herniation (P < 0.0001). CONCLUSIONS: A high SBP, a greater difference between SBP and HR, a combination of higher SBP and lower HR, and a low MGCS score were associated with brain herniation in dogs presenting with neurological signs upon admission. Early recognition of these abnormalities may help veterinarians to suspect brain herniation and determine timely treatment.

Body mapping chart for estimation of percentage of body surface area in mesocephalic dogs.

OBJECTIVE: To create a chart for estimating body surface area (BSA) for use in canine burn victims, similar to the human Rule of Nines. DESIGN: Prospective study, from 2016 to 2017. SETTING: University teaching hospital. ANIMALS: Nine adult, medium-sized, mesocephalic dogs (5 females, 4 males). INTERVENTIONS: Sedated dogs and fresh cadavers underwent full-body computed tomography (CT) scans. A 3-dimensional technique was used to calculate the surface area of specific body parts, as well as the surface area of the whole body. With the obtained measurements, a BSA chart was created. MEASUREMENTS AND MAIN RESULTS: Estimates for percent of total BSA obtained with CT images were as follows: head and abdomen 14%, respectively, neck and each of the thoracic limbs 9%, thorax 18%, pelvic limbs 11% each, and pelvis including the tail 5%. The most considerable differences between dogs and people in respect to the Rule of Nines chart were noticed in the head, the pelvic limbs, as well as in the groin region in people as compared with the pelvic/tail area in dogs. The surface areas of the front legs and thorax were the only body parts that corresponded with that of human body surfaces. CONCLUSIONS: A chart for estimating canine body surface was created. Given the diversity of dog breeds, sizes, and body conformation, our results cannot be generalized to all dogs. Studies of more diverse populations are warranted.

Relationship between admission vitals and brain herniation in 32 cats: a retrospective study.

OBJECTIVES: The aim of the study was to evaluate whether any admission vitals correlated with the presence of brain herniation diagnosed via MRI in cats presenting with neurologic signs. METHODS: Medical records at two veterinary university referral centers were reviewed to identify cats that underwent brain MRI between 2010 and 2019. A control group of cats with intracranial lesions without concurrent brain herniation was analyzed for comparison. Data relating to signalment, vitals on admission, abnormalities observed on initial neurologic examination, underlying etiology, advanced imaging findings and outcome were reviewed. A Modified Glasgow Coma Scale (MGCS) score was determined retrospectively based on initial neurologic examination. Logistic regressions were performed to investigate the relationship between each risk factor and the odds of brain herniation as diagnosed on MRI. RESULTS: Thirty-two cats with brain herniation and 44 cats with abnormal brain MRI without evidence of herniation (as a control group) based on MRI findings were included. Cats with intracranial neoplasia vs other diagnoses were found to be at increased risk of herniation (odds ratio [OR] 4.8, 95% confidence interval [CI] 1.8-13.8; P = 0.001). The odds of herniation increased with age (OR 1.1, 95% CI 1.01-1.2; P = 0.031). Cats with herniation had a significantly lower level of consciousness in their MGCS score (P <0.0001) than cats without herniation. There was no significant difference in either motor activity or brainstem reflexes between the groups (P >0.05). CONCLUSIONS AND RELEVANCE: Admission heart rate and blood pressure were not associated with brain herniation. Cats with herniation were presented with a significantly lower level of consciousness in their MGCS score; however, this clinical feature cannot be directly attributable to and predictive of herniation. Older cats with intracranial neoplasia are more likely to have brain herniation.

Assessment of prehospital care in canine trauma patients presented to Veterinary Trauma Centers: A VetCOT registry study.

OBJECTIVE: To analyze the epidemiology of veterinary care in canine trauma patients prior to presentation to a Veterinary Trauma Center (VTC). DESIGN: Retrospective observational cross-sectional study. METHODS:  Retrospective descriptive analysis from 22,998 canine case records from the Veterinary Trauma Registry from September 2013 through April 2018. Analysis was focused on the type of injury, care provider, and care provided prior presentation to a VTC (pre-VTC care). A log-likelihood ratio test was used to test for association of outcome and pre-VTC care. Mann-Whitney U tests were used to compare modified Glasgow Coma Scale and Animal Trauma Triage (ATT) scores between pre-VTC and non-pre-VTC care groups. MEASUREMENTS AND MAIN RESULTS: Pre-VTC care was provided in 5636 out of 22,998 dogs (24.5%) by veterinarians (81%), owners (19.6%), and first responders (0.03%). The most common nonveterinary interventions included wound care and bandaging in 42% and 39% of the patients, respectively. Mortality was higher in the pre-VTC care group (8.7% vs 7.5%); dogs receiving pre-VTC care were 1.5 times (95% confidence interval [CI], 1.15-1.88) more likely to die and 1.2 times (95% CI, 1.07-1.37) more likely to be euthanized. The ATT scores were significantly higher in dogs receiving pre-VTC care (mean = 2.53 vs 1.78; p < 0.0001). CONCLUSION: Our data demonstrate that the majority of more severely injured dogs receiving pre-VTC care obtained care by a veterinarian. Dogs receiving pre-VTC care possessed a greater mortality rate but also a greater ATT score; therefore, mortality rate is more likely related to severity of trauma rather than reception of pre-VTC care. We propose that these data should prompt further research and education about prehospital care in veterinary medicine.

Small Animal Transfusion Medicine.

Transfusion medicine can be a lifesaving intervention. Component therapy has expanded the availability and blood products available. Patient safety and minimizing risk is important and can be accomplished through proper donor screening, collection, storage, compatibility testing, administration, and monitoring. The pros and cons of available products must be considered and tailored to each individual patient. Recent discoveries include new antigens and blood types, microbial effects on blood type, and the association between blood type and disease prevalence.

Pharmacokinetics of Pimobendan and Its Metabolite O-Desmethyl-Pimobendan Following Rectal Administration to Healthy Dogs.

Objective: This study describes the pharmacokinetics of parent pimobendan (PIM) and its active metabolite, o-desmethyl-pimobendan (ODMP), after oral and rectal administration of pimobendan to healthy dogs. Animals: A total of eight healthy privately owned dogs were used in this study. Procedures: The dogs received a single dose (0.5 mg/kg) of a commercially available pimobendan tablet per os (PO). Twelve blood samples were collected over a 12-h period for pharmacokinetic analysis. After a 24-h washout period, the dogs received the same dose of pimobendan solution per rectum (PR), and samples were obtained at the same time for analysis. Results: For PIM, PO vs. PR, respectively, the mean maximum plasma concentration (C max, ng/ml) was 49.1 ± 28.7 vs. 10.1 ± 2, the time to reach a maximum concentration (T max, h) was 2.1 ± 0.9 vs. 1 ± 0.4, the disappearance half-life (t 1/2, h) was 1.8 ± 0.8 vs. 2.2 ± 0.6, and the area under the concentration-time curve (AUC, ng*h/ml) was 148.4 ± 71.6 vs. 31.1 ± 11.9, with relative bioavailability (F, %) of 25 ± 8. For ODMP, PO vs. PR, respectively, C max was 30.9 ± 10.4 vs. 8.8 ± 4.8, T max was 3.2 ± 1.6 vs. 1.7 ± 1.1, and t 1/2 was 5.0 ± 2.7 vs. 8.3 ± 4.8, with AUC of 167.8 ± 36.2 vs. 50.1 ± 19.2 and F of 28 ± 6. The differences between PO and PR were significant (P < 0.03) for AUC and C max for both PIM and ODMP. Conclusions and Clinical Relevance: The pharmacokinetics of PIM and ODMP were described following PO and PR administration. The findings suggest that pimobendan PR might achieve effective concentrations and, as such, warrant future studies of clinical effectiveness in treating dogs with congestive heart failure and which are unable to receive medication PO.

Association between cardiac troponin I concentrations and electrocardiographic abnormalities in dogs with blunt trauma.

OBJECTIVE: To determine whether a normal cardiac troponin I (cTnI) concentration and normal ECG on entry rule out the development of a clinically significant cardiac arrhythmia (CSCA, defined as an arrhythmia requiring anti-arrhythmic treatment) in dogs that have sustained blunt trauma. DESIGN: Prospective, observational study. Client-owned dogs were enrolled between January 2015 and November 2016. SETTING: University teaching hospital. ANIMALS: Forty-seven client-owned dogs with a history of witnessed or suspected blunt trauma within 24 hours prior to presentation to the hospital. INTERVENTIONS: On admission to the emergency service, dogs had a standard 3-lead ECG and cTnI concentration (using a veterinary point-of-care device* ) performed. Animal Trauma Triage (ATT) scores, Modified Glasgow Coma Scale (MGCS), and the details regarding the nature and timing of the injury were recorded. The patients were monitored in the ICU for a minimum of 24 hours on continuous ECG telemetry. Cardiac rhythm was monitored every hour, and any abnormalities were noted. The need for anti-arrhythmic therapy was recorded. There were no treatment interventions. MEASUREMENTS AND MAIN RESULTS: Five of 47 dogs (10.6%) developed a CSCA during hospitalization after sustaining blunt trauma. A normal entry ECG and normal cardiac troponin concentration on entry had a 100% negative predictive value (NPV) for ruling out the development of a CSCA, although a normal cardiac troponin concentration alone also had an NPV of 100%. A normal entry ECG had an NPV of 95.3%. The prognosis for survival to discharge was 89.4% in this study population (42/47 dogs). CONCLUSIONS: In dogs with blunt trauma, an entry cTnI concentration or a combination of cTnI and ECG on entry may be useful in determining which patients are at a higher risk for the development of CSCA during the first 12 to 24 hours after the trauma.

Animal Lymphocyte Metaphase Chromosome Preparation.

Metaphase chromosome analysis of lymphocytes is the gold standard for biodosimetry to estimate the levels of radiation exposure in various animals as well as humans. Animals, including experimental, companion, and wild animals, are powerful and indispensable models for researching radiation injury, safety, and therapy. Moreover, biodosimetry of animal models can be used to support human biodosimetry data and may be useful for estimating environmental contamination by radioactive materials. The basic restraint procedure and venipuncture technique are different depending on each animal type. The general procedure evaluating metaphase chromosomes is similar to the human blood technique except for a minor modification in the initial culture. This chapter will introduce basic mouse, rat, rabbit, dog, cat, cow, horse, goat, pig, and wild boar venipuncture and blood sampling techniques for metaphase chromosome preparation and analysis.

Traumatic atlantoaxial subluxation in dogs: 8 cases (2009-2016).

OBJECTIVE: To demonstrate the utility of advanced imaging in dogs with traumatic atlantoaxial subluxation (TAAS), and to report the presentation, treatment, and outcome for these dogs. DESIGN: Retrospective study (2009-2016). SETTING: University teaching hospital. ANIMALS: Eight dogs diagnosed with TAAS with magnetic resonance imaging (MRI), computed tomography (CT), or both. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eight dogs met criteria for inclusion. Of these, 6 were male, median age was 4 years (range, 1.5-11 years), and median body weight was 4.9 kg (range, 3.0-25.0 kg). On presentation, 6/8 (75%) dogs were nonambulatory tetraparetic and the most common injury was trauma inflicted by another animal 5/8 (62.5%). Diagnosis of TAAS was made using a combination of imaging modalities including vertebral column radiographs in 7/8 (87.5%) (of which 71.4% were suspicious for TAAS), CT in 7/8 (87.5%), and MRI in 7/8 (87.5%). In 7/8 (87.5%) dogs, CT and/or MRI offered additional information regarding the extent of injuries. Vertebral fractures were identified in 62.5% (5/8) of dogs. The majority of dogs underwent surgical repair (7/8 [87.5%]). The most common complication was aspiration pneumonia (3/8 [37.5%]). All 8 dogs survived to discharge. At the time of discharge, 4/8 (50%) were ambulatory tetraparetic. The 4 dogs that were nonambulatory tetraparetic at discharge progressed to being ambulatory within 2 months of surgery. CONCLUSIONS: Although TAAS is an uncommon occurrence it should be considered a differential for any trauma patient that is presenting with signs of a cranial cervical myelopathy. CT and MRI have been shown to be useful to identify the extent of injuries and to facilitate surgical planning. With appropriate care, these dogs can have an excellent prognosis.

Effects of Ovariohysterectomy and Hyperbaric Oxygen Therapy on Systemic Inflammation and Oxidation in Dogs.

Introduction: Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen in a specialized compression chamber leading to hyperoxia. This treatment modality is associated with anti-inflammatory, antioxidant, and healing properties in people and laboratory animals. However, there are relatively few reports that evaluate the effects of HBOT in companion animals. The goal of this study was to investigate the physiological effects of HBOT on surgically induced systemic inflammation and oxidation in dogs. Material and Methods: Twelve healthy female beagle dogs were spayed and randomized into control and HBOT groups (n = 6). Both groups received conventional post-ovariohysterectomy therapy, and the HBOT group received two hyperbaric treatments at 2.0 atmosphere of absolute pressure and 100% oxygen for 35 min, 6 and 18 h after surgery. Blood samples were collected 3 h prior to ovariohysterectomy, 6, 18, and 30 h after surgery, prior to HBOT when applicable. Inflammatory biomarkers, including C-reactive protein, circulating cytokines, and changes in iron homeostasis were evaluated at each time point to determine the effects of surgery and HBOT on inflammation. Similarly, serum total oxidant status and total antioxidant status were measured to assess the oxidative stress. Pain and incision scores were recorded and compared between groups. Results: Following ovariohysterectomy, all dogs had significantly increased serum concentrations of C-reactive protein, KC-like, IL-6, and increased unsaturated iron-binding capacity compared to their pre-surgical values (p < 0.02), while serum iron, total iron-binding capacity and transferrin saturation were significantly decreased after surgery (p < 0.02). There was no significant difference between the control group and the HBOT group for any of the variables. There were no overt adverse effects in the HBOT group. Conclusion: This is the first prospective randomized controlled study to investigate the effects of HBOT on surgically induced systemic inflammation in dogs. While elective ovariohysterectomy resulted in mild inflammation, the described HBOT protocol portrayed no outward adverse effect and did not induce any detectable pro-inflammatory, anti-inflammatory, or antioxidant effects. Additional investigation is required to identify objective markers to quantify the response to HBOT and determine its role as an adjunctive therapy in dogs with more severe, complicated or chronic diseases.

Use of the Animal Trauma Triage Score, RibScore, Modified RibScore and Other Clinical Factors for Prognostication in Canine Rib Fractures.

OBJECTIVES: To characterize the clinical features among dogs sustaining rib fractures and to determine if age, type and severity of injury, entry blood lactate, trauma score and rib fracture score were associated with outcome. METHODS: A retrospective study was performed to include dogs that were presented with rib fractures. Risk factors evaluation included breed, age, body weight, diagnosis, presence of a flail chest, bandage use, puncture wound presence, rib fracture number, location of the fracture along the thoracic wall, hospital stay length, body weight, other fractures, pleural effusion, pulmonary contusions, pneumothorax and occurrence of an anaesthetic event. A retrospective calculation of an animal trauma triage (ATT) score, RibScore and Modified RibScore was assigned. RESULTS: Forty-one medical records were collected. Motor vehicular trauma represented 56% of the rib fracture aetiology, 41% of patients sustained dog bites and one case was of an unknown aetiology. Significant correlations with risk factors were found only with the ATT score. All patients that died had an ATT score ≥ 5. The ATT score correlated positively with mortality (p < 0.05) with an ATT score ≥ 7 was 88% sensitive and 81% specific for predicting mortality. A 1-point increase in ATT score corresponded to 2.1 times decreased likelihood of survival. Mean hospital stay was 3 days longer for dog bite cases. CLINICAL SIGNIFICANCE: There was no increased mortality rate in canine patients that presented with the suspected risk factors. The only risk factor that predicted mortality was the ATT score.

Head Trauma.

Head trauma is a common cause of significant morbidity and mortality in dogs and cats. Traumatic brain injury may occur after head trauma. Understanding the pathophysiology of primary and secondary injury after head trauma is essential for management. This article reviews the pathophysiology of head trauma, patient assessment and diagnostics, and treatment recommendations.

Metastatic neuroendocrine carcinoma of aortic body origin in a cat.

An 8-year-old, female spayed Domestic Shorthair cat was presented to the Auburn University Emergency and Critical Care service for evaluation of pleural effusion and a suspected intrathoracic mass. Computed tomography was performed which confirmed the presence of a large intrathoracic mass, likely heart-based. Fine-needle aspirates were obtained and a cytologic diagnosis of a neuroendocrine tumor was made. Treatment with toceranib phosphate was briefly attempted at home by the owners. The cat died at home approximately 6 weeks after diagnosis. Necropsy and subsequent histopathologic examination revealed a metastatic neuroendocrine carcinoma of aortic body origin. Aortic body tumors are extremely rare in cats and to the authors' knowledge, a neuroendocrine carcinoma of aortic body origin with distant metastases has not yet been reported in a cat.

A pilot study evaluating the use of cervical ultrasound to confirm endotracheal intubation in dogs.

OBJECTIVE: To assess the accuracy and usability of cervical ultrasound as a means to confirm endotracheal (ET) intubation in dogs. DESIGN: Randomized pilot study. SETTING: University teaching hospital. ANIMALS: Six recently euthanized cadaver dogs. INTERVENTIONS: Endotracheal and esophageal intubations were randomly performed. The investigators performing the ultrasound examinations were blinded to the type of intubation. Ultrasound examinations were performed in right and left lateral recumbency. The time taken to obtain the images was recorded. MEASUREMENTS AND MAIN RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value with their correspondent 95% confidence intervals (CI) were 91.7% (CI, 82.7-96.7), 72.7% (CI, 60.4-84.0%), 78.6% (CI, 68.3-86.8%), and 88.9% (CI, 77.4-95.8%), respectively. The overall test accuracy with its correspondent 95% CI was 82.8% (CI, 75.4-88.1%). The mean time for confirmation with ultrasound was 20.2 seconds (standard deviation, 14.3 s). Cervical ultrasound was significantly more accurate at recognizing ET intubations than esophageal intubations (odds ratio, 4.52; 95% CI, 1.43-14.27; P = 0.010). There was a significant relationship between increase in body weight and accuracy, indicating that the test is more accurate in larger dogs (odds ratio, 1.04; 95% CI, 1.00-1.08; P = 0.042). CONCLUSIONS: Cervical ultrasound has high sensitivity and moderate specificity for ET intubation, and may be a useful tool to confirm ET intubation in dogs.