Acute liver failure in dogs and cats.

OBJECTIVE: To define acute liver failure (ALF), review the human and veterinary literature, and discuss the etiologies and current concepts in diagnostic and treatment options for ALF in veterinary and human medicine. ETIOLOGY: In veterinary medicine ALF is most commonly caused by hepatotoxin exposure, infectious agents, inflammatory diseases, trauma, and hypoxic injury. DIAGNOSIS: A patient may be deemed to be in ALF when there is a progression of acute liver injury with no known previous hepatic disease, the development of hepatic encephalopathy of any grade that occurs within 8 weeks after the onset of hyperbilirubinemia (defined as plasma bilirubin >50 µM/L [>2.9 mg/dL]), and the presence of a coagulopathy. Diagnostic testing to more specifically characterize liver dysfunction or pathology is usually required. THERAPY: Supportive care to aid the failing liver and compensate for the lost functions of the liver remains the cornerstone of care of patients with ALF. Advanced therapeutic options such as extracorporeal liver assist devices and transplantation are currently available in human medicine. PROGNOSIS: The prognosis for ALF depends upon the etiology, the degree of liver damage, and the response to therapy. In veterinary medicine, the prognosis is generally poor.

Measurement of intra-abdominal pressure in dogs and cats.

OBJECTIVE: To review and summarize the human and veterinary literature on intra-abdominal pressure measurement techniques. DATA SOURCES: Human and veterinary clinical studies, research articles, reviews, and textbooks with no date restrictions with a focus on techniques for intra-abdominal pressure (IAP) measurement and their limitations. HUMAN DATA SYNTHESIS: Human literature has established the intravesicular method as the gold standard for indirect measurement of IAP. However, current research has explored the intragastric method as a valid alternative. Recently, debate has focused on the shortcomings of the various measurement methods. VETERINARY DATA SYNTHESIS: Early human literature using dogs as models contributed to the original data for IAP measurements in small animals. Since that time, a number of clinical studies and 1 case report have contributed to that original information. A reference interval for IAP measured by the intravesicular method has recently been determined in healthy cats. CONCLUSIONS: Further studies investigating IAP in critically ill veterinary patients are required to establish the optimal technique for this measurement in veterinary medicine.