Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats.

OBJECTIVE To evaluate the effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction (UO) and durations of urinary catheter retention and hospitalization for male cats. DESIGN Randomized controlled clinical trial. ANIMALS 137 male cats with UO. PROCEDURES Following random allocation, cats either did (flush group; n = 69) or did not (no-flush group; 68) undergo urinary bladder lavage with saline (0.9% NaCl) solution after alleviation of the obstruction and placement of a urethral catheter. Signalment, prior history of UO, presence of crystalluria, difficulty of urinary tract catheterization, in-hospital UO recurrence rate, and durations of urinary catheter retention and hospitalization were compared between the flush and no-flush groups. RESULTS Baseline characteristics did not differ significantly between the 2 treatment groups. The in-hospital UO recurrence rate (9/69 [13%]) and median durations of urinary catheter retention (37 hours; range, 3 to 172 hours) and hospitalization (3 days; range, 0.5 to 12 days) for the flush group did not differ significantly from the in-hospital UO recurrence rate (13/68 [19%]) and median durations of urinary catheter retention (36 hours; range, 1 to 117 hours) and hospitalization (3 days; range, 1 to 9 days) for the no-flush group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, for male cats with UO, urinary bladder lavage at the time of urethral catheterization had no significant effect on in-hospital recurrence rate of the condition, duration of urinary catheter retention, or duration of hospitalization; however, additional studies are necessary to validate or refute these findings.

Transfusion practices for treatment of dogs hospitalized following trauma: 125 cases (2008-2013).

OBJECTIVE: To describe transfusion practices for treatment of dogs hospitalized because of traumatic injuries. DESIGN: Retrospective case series. ANIMALS: 125 client-owned dogs. PROCEDURES: Medical records of dogs that sustained trauma and were hospitalized for ≥ 24 hours after emergency stabilization were reviewed. Admission characteristics and transfusion-specific data were assessed. Receiver operating characteristic curves were plotted to evaluate diagnostic utility of PCV and serum total solids concentration as predictors of transfusion in the study population. RESULTS: 45 of 125 (36%) dogs received transfusions. Packed RBCs were the most commonly administered blood product (42/45 [93%]). Common reasons for transfusion included perioperative hemodynamic support and treatment of shock or worsening anemia. Dogs that underwent transfusion had higher mean heart rate, blood lactate concentration, and animal trauma triage scores, with lower mean PCV, serum total solids concentration, and rectal temperature at admission than dogs that did not undergo transfusion. Total solids concentration and PCV at admission were specific but insensitive predictors of subsequent transfusion. Most (109/125 [87%]) dogs survived to hospital discharge. Significantly fewer dogs that had transfusions survived, compared with dogs that did not have transfusions. Seven of 10 dogs that received massive transfusions survived to discharge. CONCLUSIONS AND CLINICAL RELEVANCE: Apparent clinical triggers for the decision to perform blood transfusion in dogs hospitalized following traumatic injury included evidence of shock or worsening anemia on admission and requirement for perioperative hemodynamic optimization. Although dogs that received transfusions had a lower survival rate than dogs that did not, this was likely attributable to greater severity of injuries in the transfusion group.

Hypoperfusion and acute traumatic coagulopathy in severely traumatized canine patients.

OBJECTIVE: To determine the incidence of acute traumatic coagulopathy in dogs suffering severe trauma and to investigate the association of markers of hypoperfusion with coagulation abnormalities. DESIGN: A prospective observational study performed June, 2009 to February, 2011. SETTING: A university teaching hospital. ANIMALS: Thirty client-owned dogs weighing >5 kilograms that were presented to the Tuft's Cummings School of Veterinary Medicine following severe trauma as defined by an animal trauma triage score (ATT) ≥5 and having received no resuscitation with IV fluids or blood products prior to blood sampling. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Prior to resuscitation, data obtained at the time of admission to the emergency service included HCT, platelet count, lactate concentration, pH, base excess, thromboelastrogram (TEG), prothrombin time, activated partial thromboplastin time, fibrinogen level, and protein C activity. Rectal temperature and ATT were recorded for all dogs. Neither HCT nor platelet count was significantly decreased in any of the dogs. Based on G values as measured by TEG, 10/30 dogs (33%) showed evidence of hypercoagulability. Hypocoagulability as determined by prothrombin time, activated partial thromboplastin time, or TEG was not shown in any of the 30 dogs. CONCLUSION: Dogs with severe trauma may experience hypercoagulability that is unrelated to fluid resuscitation or transfusion therapy. Future studies are warranted to better characterize coagulation changes in dogs with severe trauma, particularly in relationship to fluid therapies and/or hemorrhage.