Journal of Veterinary Emergency and Critical Care doi: 10.1111/vec.12227

Abstracts from the International Veterinary Emergency and Critical Care Symposium and the European Veterinary Emergency and Critical Care Society Annual Congress, 2014 Table of Contents IVECCS Abstracts presented September 10–14, 2014 in Indianapolis, Indiana, USA IVECCS Small Animal Abstracts (in alphabetical order of presenter)

p. S4–S20

IVECCS Large Animal Abstracts (in alphabetical order of presenter)

p. S21–S26

EVECCS Abstracts presented June 12-15, 2014 in Prague, Czech Republic At EVECCS Annual Congress EVECCS Small Animal Abstracts (in alphabetical order of presenter)

p. S27–S35

EVECCS Large Animal Abstracts (in alphabetical order of presenter)

p. S36

Author Index

p. S37–S38

 C Veterinary Emergency and Critical Care Society 2014


IVECCS Abstracts presented September 10–14, 2014 in Indianapolis, Indiana, USA ACVECC Research Grant Award Winner EVALUATION OF THE STERILITY OF SINGLE-DOSE MEDICATIONS USED IN A MULTIPLE-DOSE FASHION IN A VETERINARY REFERRAL HOSPITAL SETTING Martin, EP1 , Sharp, C2 , Sinnott, V1 Cod Veterinary Specialists, Buzzards Bay, MA, USA 2 Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA

1 Cape

Introduction: The objective of this study was to assess the rate of bacterial contamination associated with using single dose vials (SDVs) of 5 veterinary drugs/solutions in a multi-dose fashion. Methods: This experimental study was designed to reflect common hospital practice. Containers of 50% dextrose (DEX), 7.5% hypertonic saline (HTS), 5% hydroxyethyl starch (HES), mannitol, and heparinized saline (h-saline) were stored in an open-top box in a veterinary ICU and variably punctured to mimic differing frequencies of clinical use (weekly, daily, 5 times/day). Samples were cultured from each container at the time of opening, and 1, 7, 14 and 28 days. Positive controls were inoculated with approximately 300cfu/mL of Staphylococcus aureus and Pseudomonas aeruginosa, respectively, and cultured at the same time points. Results: No test vials (0/46) of HES, HTS, h-saline or mannitol cultured positive throughout the study. One test vial (20%, 1/5) of DEX cultured positive for Micrococcus luteus on day 7. Positive control HES and h-saline grew P. aeruginosa on day 7, 14 and 28, but not S. aureus. Positive control HTS, mannitol and DEX cultured negative throughout the study. Conclusion: Spontaneous contamination of 1 test vial of DEX occurred during this study. Interestingly, DEX did not support microbial growth in the positive control vials. When challenged with a low burden of bacteria known to contaminate veterinary drugs, HES and h-saline hosted proliferating colonies of Pseudomonas aeruginosa. HTS, Mannitol and DEX did not support bacterial growth.

PRELIMINARY REPORT OF EXOGENOUS L-LACTATE CLEARANCE TESTING IN HORSES WITH ACUTE GASTROINTESTINAL DISEASE∗ Vander Werf, KA1 , Wilkins, PA1 , Lascola, KM1 , Sheahan, BJ1 , Gutierrez, S1 , Foreman, JH1 , Boston, RC2 1 University of Illinois, Urbana, IL, USA 2 Department of Clinical Studies-New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA Introduction: Single or serial measurement of blood L-lactate concentration ([LAC]) is a reliable prognostic indicator in adult horses with acute gastrointestinal (GI) diseases. True clearance of exoge-


nously administered LAC (exogenous lactate clearance [ExLC]) in septic human patients is a useful prognostic indicator and mean ExLC in healthy horses has been reported. One aim of this study was to measure ClLAC in horses with acute GI disease and determine if it can provide similar prognostic value. Methods: Thirty adult horses presenting for acute gastrointestinal disease and requiring fluid resuscitation have been planned for study. To date, eight horses have been enrolled. Horses were fluid resuscitated prior to entering the study. Sodium L-lactate solution (1.0 mmol/kg IV) was administered over 15 minutes and L-lactate concentration [LAC] measured immediately prior to, during, and post infusion. Disposition modeling will be performed using proprietary software once data from all horses are collected. Results: All eight horses survived. Four horses were explored surgically and lesions corrected while four horses were treated medically. Four horses were mildly hyperlactemic ([LAC]>1.2 mmol/L) at the time of study; mean [LAC] immediately prior to infusion was 1.2 mmol/L (range 0.7–1.8). [LAC] at end-infusion was 2.55 mmol/L (range 1.6–3.7) with a mean increase of 1.3 mmol/L (range 0.9–2.1). Time to return to baseline was 251 min (range 45–555) and may be prolonged in medical (345 min) vs. surgical (158 min) disease (P = 0.087). Conclusion: Infusion of exogenous L-lactate 1.0 mmol/kg BW provides sufficient increase in [LAC] for future disposition modeling.

Veterinary Emergency and Critical Care Foundation (VECCF) Research Grant Award Winners MULTICENTER IN VITRO TEG-ROTEM STANDARDIZATION Goggs, R1 , Borrelli, A2 , Brainard, BM3 , Chan, DL4 , de Laforcade, A5 , Goy-Thollot, I6 , Jandrey, KJ7 , Kristensen, AT8 , Kutter, APN9 , Marschner, CB8 , Rannou, B6 , Sigrist, N9 , Smith, SA10 , Wagg, C11 1 College of Veterinary Medicine, Cornell University, Ithaca, NY, USA 2 Department of Veterinary Science, University of Turin, Grugliasco, Italy 3 College of Veterinary Medicine, University of Georgia, Athens, GA, USA 4 Department of Clinical Science & Services, The Royal Veterinary College, North Mymms, UK 5 Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA 6 SIAMU, VetAgro Sup, Campus, University of Lyon, Marcy-l’Etoile, ´ France 7 School of Veterinary Medicine, UC Davis, Davis, CA, USA 8 Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark 9 Department of Anesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland 10 Department of Biochemistry, University of Illinois, Urbana, IL, USA  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227


Table 1: Viscoelastic parameters from 9 centers performed in identical platelet-rich plasma samples Kaolin / In-TEM


TF (Innovin) / Ex-TEM

R / CT Mean (min) CV (%)

K / CFT Mean (min) CV (%)

␣ / alpha Mean (o) CV (%)

MA / MCF Mean (mm) CV (%)

R / CT Mean (min) CV (%)

K / CFT Mean (min) CV (%)

␣ / alpha Mean (o) CV (%)

MA / MCF Mean (mm) CV (%)

3.2 23.6 9.0 23.5 2.1 12.2 2.7 6.3 1.6 31.1 3.2 14.2 3.5 19.2 3.0 52.6 3.5 17.4

1.0 22.5 1.0 12.2 0.9 14.2 6.6 73.0 1.4 17.5 2.63 16.5

77.2 3.2 12.7 48.2 77.0 1.2 77.0 3.1 67.1 11.6 73.2 2.6 70.3 4.8 62.8 23.7 67.7 4.7

64.1 7.6 3.5 31.5 62.4 5.1 53.7 12.1 35.4 20.3 58.4 3.3 8.7 24.5 9.3 22.1 46.0 10.7

3.0 9.4 6.9 30.1 3.4 8.9 3.2 7.7 3.3 8.0 2.5 8.7 0.6 18.3 0.6 30.8 0.5 7.3

1.0 11.2 1.3 7.6 5.8 73.9 4.4 36.1 1.3 8.1 -

75.4 2.6 9.0 42.3 71.2 2.4 46.4 25.5 53.5 18.6 74.1 2.4 71.5 7.3 65.5 17.7 70.3 8.2

63.0 7.5 2.9 19.9 64.1 3.5 27.3 34.1 35.0 16.2 57.0 2.7 8.4 15.2 9.6 21.2 12.8 11.5

11 Department of Clinical and Diagnostic Sciences, University of Calgary,

Calgary, Alberta, Canada Introduction: Veterinary patients with bleeding diatheses and thromboembolic disorders are increasingly assessed with viscoelastic coagulation tests. Guidelines have been developed to enable assay standardization, but evaluation of assay performance within and between centers is important to assess data comparability. This study aimed to establish and compare the repeatability and reproducibility of activated TEG and ROTEM assays. Methods: Sixty, identical 5mL aliquots of canine platelet-rich plasma collected by apheresis, frozen in 6% DMSO were obtained from a commercial blood bank. Frozen study samples, quality controls, reagents and consumables were distributed to participating centers (7 TEG, 4 ROTEM) in 7 countries. TEG centers analyzed study samples with kaolin and tissue factor

 C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

activated assays; ROTEM centers ran proprietary In-TEM and ExTEM assays. All machines underwent quality control prior to study sample analyses. Within-center coefficients of variation (CVs) were calculated, where CV = SD / mean. Results: At time of writing, data was available from 9/11 centers (6 TEG, 3 ROTEM). Mean values and CVs from 20 repeated assays are presented in Table 1 above. Conclusion: CVs from some assays, from some TEG centers, were acceptable and the mean values comparable. Variation was unacceptably high in some centers, however. Data from the ROTEM centers was of insufficient quality to permit evaluation of assay reproducibility. Feedback from test centers suggests much of this variability was inherent in the test samples, rather than the assays themselves. Refinement of the standardized test material will be necessary to fully evaluate the repeatability and reproducibility of these assays in veterinary medicine and follow-up work is ongoing.



Oral Presentations Listing of Small Animal IVECCS Abstracts (in alphabetical order of presenter) RELATIONSHIP BETWEEN METATARSAL PULSE PALPATION AND SYSTOLIC DOPPLER BLOOD PRESSURE IN DOGS PRESENTING TO AN EMERGENCY SERVICE Ateca, LB, Reineke, EL, Drobatz, KJ University of Pennsylvania, Philadelphia, PA, USA Introduction: Anecdotally, some clinicians report that a palpable metatarsal pulse indicates a systolic blood pressure of at least 80–90 mmHg. However, these claims have never been objectively evaluated. The purpose of this study was to describe the relationship between systolic Doppler blood pressure (DBP) measurement and digital palpation of metatarsal pulses in dogs presenting to an emergency service. Methods: Any dog with a physical examination and systolic DBP measured upon presentation to an emergency service was eligible for inclusion in the study excluding clinically evident hindlimb thromboembolism. Metatarsal pulse quality was prospectively assessed as either present or absent. Results: Median systolic DBP for all 93 dogs was 140 mmHg (range 40 – 230 mmHg). Median DBP for dogs with absent and present metatarsal pulses was 90 mmHg (range: 40–170 mmHg) and 140 mmHg (range: 40 – 230 mmHg), respectively (P = 0.0016). Receiver operating curve analysis showed that a systolic DBP cutoff of 55 mmHg maximized the area under the ROC curve (0.82, 95% CI: 0.66, 0.99). Two dogs (2/6; 33%) with systolic DBP 55 mmHg had absent metatarsal pulses. Conclusion: A systolic DBP cut point of 55 mmHg optimized the clinician’s ability to predict blood pressure based on digital palpation of metatarsal pulses. However, since there was overlap in the systolic DBP between dogs with absent and present metatarsal pulses and the cut point for palpable metatarsal pulses was relatively low, pulse palpation should not replace an actual blood pressure measurement.

CLINICAL SAFETY EVALUATION OF F(Ab)2 ANTIVENOM FOR TREATMENT OF CROTALIDAE ENVENOMATION IN DOGS Bandt, C, Bolfer, L, Schaer, M, Buckley, G University of Florida, Gainesville, FL, USA Introduction: The goal of this prospective study was to test the potential benefits, safety, side effects and efficacy of a new antivenom product for the treatment of Crotalidae envenomation in dogs. Methods: Between May 2013 and April 2014, dogs with evidence of envenomation by a North American Crotalidae snake and a Snakebite Severity Score (SSS) of >6 were enrolled in the study. Exclusion criteria included presenting more than 6 hours after envenomation, previous antivenom therapy or use of glucocorticoids. SSS was assessed at presentation, 2 hours, 6 hours, 12 hours, at discharge and 10 days after treatment. Results: 48 dogs were presented with Crotalidae envenomation of which 23 cases were eligible for the study. The mean SSS at presentation was 9.5. The mean amount of antivenom administered


was 4.39 vials. The initial SSS correlated strongly (r = 0.92) with the amount of antivenom used in each patient. One dog developed anaphylaxis and one dog experienced mild urticaria following antivenom administration. Overall, there was an improvement in SSS in all dogs following treatment. The mean SSS decreased from 9.5 to 7.4 within 2 hours and all dogs had negative SSS at 10 days post treatment. Two dogs died despite treatment. Conclusion: The F(Ab)2 antivenom was well tolerated in most dogs. 92% of dogs showed no side effects, despite administration of up to 16 vials of antivenom. The improvement in SSS demonstrated efficacy all surviving animals. The reported side effects of antivenom administration were similar to other reported studies.

DECREASING MORBIDITY ASSOCIATED WITH DIAGNOSTIC AIRWAY LAVAGE IN CATS Bernhard, C, Masseau, I, Dodam, J, Outi, H, Krumme, S, Grobman, M, Kerl, M, Reinero, C University of Missouri, Columbia, MO, USA Introduction: Bronchoalveolar lavage (BAL) may induce hypoxemia and anesthesia-induced atelectasis. We hypothesized that lung function and computed tomography (CT) evidence of atelectasis would be modified by altering inspired oxygen concentration and applying positive end expiratory pressure (PEEP) in cats undergoing BAL. Methods: Six experimentally asthmatic cats underwent BAL, each under four randomized treatment conditions: (1) 100% oxygen, no PEEP, (2) 30% oxygen, no PEEP, (3) 100% oxygen, PEEP = 2 cmH2 O and (4) 30% oxygen, PEEP = 2 cmH2 O. Pulse oximetry was used to measure oxygen saturation (SpO2 ). Baseline ventilator-acquired pulmonary mechanics and CT scans were acquired prior to BAL, and at 1, 5, and 15 minutes post-BAL. Results: While receiving 100% oxygen, no cat had SpO2 below 91% during or after BAL. Although cats treated with 30% oxygen had substantial desaturation, nearly all (22 out of 24 trials) had SpO2 greater than 90% by 1 minute post-BAL. Following BAL, all cats in all treatment groups had increased airway resistance, decreased lung compliance, and CT evidence of increased attenuation and decreased lung volume. Treatment (2) had significantly lower minimum compliance following BAL than treatments (3) and (4) (P < 0.05). For maximum airway resistance and percentage increase of airway resistance over baseline, there was no significant difference between treatments (P = 0.40 and 0.12, respectively). Preliminary CT data suggested less attenuation and higher lung volumes with the addition of PEEP. Conclusion: Pulse oximetry may not correlate with expected changes in pulmonary mechanical function or lung anatomy. Addition of PEEP may improve lung compliance and decrease CT evidence of atelectasis after BAL.


1 University

 C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227


Introduction: This study aimed to determine whether the VetMouseTrap (VMT) can be used to safely obtain diagnostic quality computed tomography pulmonary angiography (CTPA) images of the thorax in awake, dyspneic dogs, and to determine whether the imaging can be used to confirm/exclude pulmonary thromboembolism (PTE). Methods: Client-owned dogs were prospectively enrolled if they had dyspnea, hypoxemia, evidence of hypercoagulability or fibrinolysis, and there was a high clinical suspicion of PTE. Enrolled dogs were placed in the VMT, flow-by oxygen was delivered and continuous monitoring was performed. Sedation was provided as necessary. Animals were scanned using a 16-slice multiple detector computed tomography system and iodinated contrast medium was injected (400mg I/kg) using a power injector. Results: Eight dogs met the inclusion criteria, with enrollment ongoing. Despite dyspnea, all dogs tolerated the VMT without adverse events. Head movement was managed with mild sedation in 7 dogs. The median time in the VMT was 20 minutes (15 – 40 minutes). All images were of good quality. PTE was confirmed in 1 dog, strongly suspected in 3 dogs, and questionable filling defects were noted in 2 additional dogs. The location of the PTE was the right caudal lobar artery [n = 3], left caudal lobar artery [n = 1] and caudodorsal branches of the right caudal pulmonary artery [n = 1]. Six dogs survived to discharge. Necropsy occurred in 1 case within 4 days of imaging, but no PTE was identified. Conclusion: VMT is well tolerated by awake, dyspneic patients. CTPA images are of diagnostic quality. PTE was visualized or suspected in 75% of enrolled dogs.

THE EFFECT OF STORAGE ON AMMONIA AND CYTOKINE CONCENTRATIONS IN FELINE WHOLE BLOOD Cummings, KA, Abelson, AL, Rozanski, EA, Sharp, CR Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA Introduction: Stored whole blood (SWB) is used commonly in feline transfusion medicine. The aims of the study were to assess changes in the concentrations of ammonia, interleukin(IL)-6, IL10, and WBC count in units of feline SWB weekly for 4 weeks of refrigerated storage. Methods: Blood was collected into citrate-phosphate-dextrose from five healthy adult blood donor cats. Ammonia, IL-6, and IL-10 concentrations, along with WBC counts were measured in the 5 units of SWB. Ammonia concentration and WBC counts were assessed in the hospital clinical pathology laboratory with the Cobas 600 and Advia 120 Hematology System, respectively. Cytokine concentrations were determined with commercially available, previously validated ELISAs. Changes in ammonia concentration and WBC counts were evaluated over time with a linear regression model. A P-value < 0.05 was considered significant. Results: The ammonia concentration increased linearly with the duration of storage, from a median of 48 mmol/L (range = 25– 74) on day 0, to 417mmol/L (324–457) on day 28 (R2 = 0.98). This increase was similar for all 5 SWB units; however, one unit demonstrated a statistically significant difference in slope (P = 0.0037). No relationship was observed between WBC count and storage duration. IL-6 and IL-10 were undetectable at all time points. Conclusion: Results of this study indicate that ammonia concentration increases significantly with blood storage time. Further work is  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

needed to investigate the clinical impact of ammonia on cats receiving SWB transfusions. Although IL-6 and IL-10 remained below the detection limits, evaluation of other pro-inflammatory cytokines in SWB should be evaluated.

EVALUATION OF HIGH FLOW OXYGEN THERAPY IN NORMAL DOGS: A PILOT STUDY Daly, JL1 , Keir, I2 , Guenther, CL1 Veterinary Specialty & Emergency Center, Pittsburgh, PA, USA 2 Center for Critical Care Nephrology, CRISMA, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA

1 Pittsburgh

Introduction: Traditional oxygen therapy (TOT) has limited flow rates due to nasal and lower airway irritation caused by room temperature, non-humidified oxygen. High flow oxygen therapy (HFOT) uses medical grade vapor humidification and heated oxygen allowing for higher oxygen flow rates. A pilot study was undertaken to evaluate the safety and efficacy of HFOT in normal sedated dogs. Methods: Six healthy dogs undergoing routine dental prophylaxis were sedated with butorphanol and dexmedetomidine for placement of an esophageal balloon catheter, nasal cannula and arterial catheter. Dogs were placed in right lateral recumbency and randomized to receive nasal oxygen using TOT at 100ml/kg/min (TOT-100), and HFOT at 20L/min (HF-20) and 30L/min (HF-30). Arterial blood gas and transpulmonary pressure were measured after a six minute acclimation period at baseline and for each oxygen delivery method. Radiographs were performed pre and post oxygen therapy to evaluate for gastric distension. Results: Compared to TOT-100, the median PaO2 was significantly higher with HF-20 (P < 0.05; 177.6mmHg vs 521.45 mm Hg) and HF-30 (P < 0.05; 177.6 mm Hg vs 540.05 mm Hg). There was no significant difference in PaO2 between HF-20 and HF-30. There was no significant difference in PaCO2 or change in transpulmonary pressure between baseline and any oxygen delivery method. One of six dogs showed radiographic evidence of gastric distension. Conclusion: HF-20 and HF-30 provides improved arterial oxygenation as compared to TOT-100; however, there was no significant improvement in PaO2 between the higher flow rates. HFOT appears safe and effective in sedated healthy dogs. Further studies are needed to evaluate HFOT in hypoxic patients.

USE OF THE THUNDERSHIRT TO CONTROL CANINE ANXIETY IN THE ICU Damon, M, Rozanski, E, Spagnoletti, C, Sharp, C Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA Introduction: Apparent anxiety is common in dogs hospitalized in the ICU. Uncontrolled anxiety is considered detrimental to patient recovery, and may also be stressful for other hospitalized patients and for caregivers. Common methods of controlling anxiety include: covering cages/run, sitting with anxious pets, and the use of pharmacological agents. The THUNDERSHIRT is a propriety product marketed for treating thunderstorm phobias, as well as separation and situational anxiety. The goal of this study was to



evaluate the use of the THUNDERSHIRT for treating anxiety in hospitalized dogs. Methods: Dogs demonstrating anxiety while hospitalized in the ICU that persisted for >30 minutes were enrolled in the study. A baseline numeric assessment of anxiety was made, including separate scores for vocalization, pacing, chewing and ability to be calmed on a scale of 0–3. A size appropriate THUNDERSHIRT was placed and the dogs were rescored in one hour. The pre and post scores were compared using a Wilcoxan Signed Rank with a P value of 0.9), including BFG, BFL, and ratios between peripheral and abdominal fluid WBC count. Conclusion: No objective laboratory markers were identified to predict the need for relaparotomy. BFG and BFL differences should not be used as predictors of SP in dogs with CSAD that undergo GI surgery.

EARLY COMPARED TO DELAYED INITIATION OF ENTERAL NUTRITION FOR CANINE POST-OPERATIVE SEPTIC PERITONITIS Hoffberg, JE, Koenigshof, AM Michigan State University, East Lansing, MI, USA Introduction: In critically ill humans, initiation of enteral nutrition within 24 hours of hospitalization has been shown to be of benefit but this has not been investigated prospectively in veterinary patients. We prospectively evaluated the safety of early enteral nutrition (EEN) compared to delayed enteral nutrition (DEN) in dogs with septic peritonitis. Methods: Twenty dogs were randomized to time to initiation of nasogastric (NG) tube feeding either within 12 hours of surgery (EEN) or after 48 hours (DEN). Gastrointestinal complications (GICs) of high gastric residual volume, vomiting, regurgitation or diarrhea were recorded. All NG intake and voluntary intake were recorded for calorie determination. Results: There were 9 dogs in the EEN group and 11 dogs in the DEN group. Dogs in the EEN group were fed a median of 4 hours post-surgery and DEN at a median of 48 hours post-surgery (P < 0.001). EEN dogs had significantly higher NG intake on days 0–3 and significantly higher voluntary intake on day 4 compared to DEN. There was no difference in overall GICs, prokinetic use, need for EN stoppage, dehiscence or survival between groups. More dogs in EEN ate 1/2 RER and full RER and dogs that ate full RER in



EEN did so earlier (3 days vs 6 days) but this was not statistically significant. Conclusion: There was no difference in occurrence of GIC between groups indicating the safety of initiating EEN in septic peritonitis. Larger prospective studies are needed to elucidate the benefits of EEN.

RELATIONSHIP BETWEEN DIRECT MEASUREMENT OF INTRACRANIAL PRESSURE AND OPTIC NERVE SHEATH DIAMETER IN DOGS Ilie, LA-M1 , Thomovsky, EJ1 , Johnson, PA1 , Bentley, RT1 , Heng, HG1 , Lee, CH2 , Moore, GE1 1 Purdue University Veterinary Teaching Hospital, West Lafayette, IN, USA 2 College of Veterinary Medicine, Gyeongsang National University, Jinju, Gyeongnam, Republic of Korea Introduction: Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is a reliable method to assess increased intracranial pressure (ICP) in people. The aim of this pilot study was to evaluate the association between ONSD and acute increases in ICP in an experimental canine model. Methods: An epidural intracranial pressure monitoring system (EICPMS) was used to measure ICP in four young healthy dogs under general anesthesia. The EICPMS was connected to a transducer/invasive pressure monitor system to generate a continuous ICP waveform. A 22 gauge intravenous catheter was inserted into the brain parenchyma through a burr hole in the contralateral parietal bone and successive injections of 0.5–2 mL of anticoagulated autologous blood were performed every 4–6 minutes. At baseline and following each injection, the ICP was recorded and three ultrasound images of the optic nerve of each eye were obtained with a 5–12 MHz linear transducer. The maximum nerve diameter that could be measured was recorded as the ONSD. Results: A positive correlation was found between ICP and ONSD. For ICP values 40 mm Hg, the mean ONSD was 3.47 ±0.40 mm. Conclusion: This study demonstrates that increased ICP can be measured in dogs with the EICPMS and is positively correlated with increased ultrasonographic measurement of the maximum ONSD. This study supports using ultrasonographic measurement of the maximum ONSD as a non-invasive bedside monitoring tool for evaluation of increased ICP in dogs.

CLINICAL EVALUATION OF PLETHYSMOGRAPHIC VARIABILITY INDEX ON AWAKE SPONTANEOUSLY BREATHING CANINE PATIENTS Ilie, LA-M, Thomovsky, EJ, Johnson, PA, Ko, JC, Moore, GE Purdue University Veterinary Teaching Hospital, West Lafayette, IN, USA Introduction: Plethysmographic Variability Index (PVI) has been proven to help clinicians assess fluid responsiveness in both awake and anesthetized mechanically ventilated human patients. Low PVI (ࣘ14%) values indicate that human patients will not respond to fluid therapy whereas PVI ࣙ14% indicates patients will improve


their stroke volume and blood pressure after fluid challenge. Our goal was to investigate the relationship of PVI and perfusion index (PI) with traditional parameters used to determine the need for IV fluid therapy in awake spontaneously ventilating canine patients. We hypothesized that PVI is a useful bedside tool to predict fluid responsiveness in these dogs. Methods: Prospective observational study using 66 dogs. Based on physical exam and severity of underlying disease, dogs were assigned to 1 of 3 groups: dehydrated, overhydrated, and normal (control). Heart rate (HR), systolic blood pressure (SBP), oxygen saturation (SpO2 ), packed red blood cell volume (PCV), total protein (TP), body weight (WT), PVI and PI were measured. A regression model was used for data analysis. Results: A positive correlation was found between PVI and PI (0.44; P < 0.001), while the PVI was negatively correlated with HR (−0.43; P < 0.001). Hydration status, PCV, TP, SBP, and SpO2 values were not significantly correlated with PVI or PI readings. Decreases in PVI were not observed after fluid administration in the dehydrated patients. Conclusion: Plethysmographic variability index could not be used as a bedside tool to predict the need for fluid therapy due to its poor correlation with traditional parameters used to gauge patient hydration status.

A COMPARISON OF CARDIOPULMONARY FUNCTION, RECOVERY QUALITY, AND TOTAL DOSAGES REQUIRED FOR INDUCTION AND TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL VERSUS A PROPOFOL-KETAMINE COMBINATION IN HEALTHY UNPREMEDICATED DOGS Kennedy, MJ, Smith, LJ School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA Introduction: The use of ketamine-propofol anesthesia has been described for minimally invasive procedures in human emergency settings. The objective of this study was to compare cardiopulmonary function, recovery quality, and total dosages required for 60 minutes of total intravenous anesthesia (TIVA) with propofol (P) versus 1:1 mg/mL of propofol and ketamine (KP). Methods: Ten Beagles (9.4 ± 1.8 kg) received P or KP for TIVA in a blinded randomized crossover design. Treatment drug was administered to effect and maintained by a continuous infusion (CRI) for 60 minutes. Dogs were intubated and spontaneously breathed room air. Salivation scores and noninvasive cardiovascular and respiratory parameters were recorded every 5 minutes. Arterial blood gas analysis was performed at 10, 30, and 60 minutes, and after recovery. Results: KP required significantly less propofol for induction (3.98 ± 0.97 mg/kg KP versus 5.32 ± 1.14 mg/kg P) and maintenance (0.34 ± 0.11 mg/kg/min KP versus 0.55 ± 0.12 mg/kg− /min P). P resulted in decreased MAP with no change in HR or oxygenation; KP resulted in significantly higher HR and attenuated some of the decline in MAP but with hypoxemia and hypercapnia at some time points. Both TIVA methods resulted in minimal salivation, no difference in time to extubation, and acceptable recovery quality. Conclusion: TIVA in healthy dogs with ketamine and propofol in a 1:1 mg/mL combination results in significant propofol dose  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227


reduction, higher HR, improved MAP, no difference in recovery quality, but more significant respiratory depression compared to propofol alone.

LABORATORY FINDINGS IN CATS WITH NATURALLY-OCCURING SEPSIS Klainbart, S, Agi, L, Aroch, I, Kelmer, E Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem., Rehovot, Israel Introduction: Sepsis is a severe, often fatal syndrome, resulting from the systemic inflammatory response to infection. The aims of this study were to characterize the hematological, biochemical and hemostatic findings in cats with naturally-occurring sepsis. Methods: Prospective study; 31 client-owned cats that met set criteria for sepsis (ie, 2/4 criteria of systemic inflammatory response syndrome with confirmed infection); 34 healthy staff-owned control cats. Blood samples were collected within 24 hours from presentation for CBC, serum biochemistry, prothrombin time, activated partial thromboplastin time (PT and aPTT, respectively), D-dimer and fibrinogen concentrations, and activities of protein C (PCA) and antithrombin (ATA) determination. Results: Septic cats were significantly more anemic, had higher nucleated red blood cell count, lower serum albumin, total protein and total calcium concentrations, and higher serum bilirubin concentration and, aspartate- transaminase and creatine-kinase activities (P < 0.008 for all) compared to the controls. Septic cats had significantly prolonged aPTT, and increased D-dimer, and lower PCA and ATA (P ࣘ 0.001 for all) activities, and had a lower platelet count compared to the controls (P = 0.037). Neutrophil cytoplasmic toxicity was common in septic cats. The 10-day survival rate of the septic cats was 65%, serum urea concentration was significantly higher (P = 0.04), and ATA and PCA activities tended to be lower (P = 0.06) in non-survivors compared to survivors. Conclusion: Naturally-occurring sepsis in cats is characterized by anemia, neutrophil toxicity, hypoalbuminemia, increased muscle enzymes activity, hyperbilirubinemia and hemostatic derangement, manifested by prolonged aPTT, low PCA and ATA activities, increased plasma D-dimer concentration and thrombocytopenia.

PREDICTORS OF SHORT-TERM MORTALITY IN DOGS WITH PRIMARY IMMUNE-MEDIATED HEMOLYTIC ANEMIA: A MULTICENTER STUDY Lamb, J1 , OToole, T1 , Schoeffler, G2 , Hanel, R3 , Woolcock, A4 , Jutkowitz, A5 , Puglia, G6 , Guenther, C7 , Guillaumin, J8 , Stoneham, A9 , Bacek, L10 , Stewart, S11 , Gest, J12 , McMichael, M13 , Fossett, F13 , Monaghan, K14 , Abelson, A1 , Whelan, M15 , Lester, C16 , Price, LL17 1 Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA 2 Cornell University College of Veterinary Medicine, Ithaca, NY, USA 3 College of Veterinary Medicine at North Carolina State University, Raleigh, NC, USA 4 UGA College of Veterinary Medicine, Athens, GA, USA 5 Michigan State University College of Veterinary Medicine, East Lansing, MI, USA 6 Hope Veterinary Specialists, Malvern, PA, USA  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

7 Pittsburgh

Veterinary Specialty & Emergency Center, Pittsburgh, PA, USA 8 The Ohio State University Veterinary Medical Center, Columbus, OH, USA 9 VCA Veterinary Referral Associates, Gaithersburg, MD, USA 10 Auburn University College of Veterinary Medicine, Auburn, AL, USA 11 Animal Internal Medicine & Specialty Services, San Francisco, CA, USA 12 The Animal Medical Center, New York, NY, USA 13 University of Illinois College of Veterinary Medicine, Urbana, IL, USA 14 Alpenglow Veterinary Specialty + Emergency Center, Boulder, CO, USA 15 Angell Animal Medical Center, Boston, MA, USA 16 Ocean State Veterinary Specialists, East Greenwich, RI, USA 17 Tufts University Medical School, Boston, MA, USA Introduction: Canine immune-mediated hemolytic anemia (IMHA) has a mortality of 20–70%. This study aimed to construct a model to predict mortality during their initial hospitalization. Methods: Data for newly diagnosed dogs with IMHA was retrospectively collected based on PCV < 35% and spherocytosis, auto-agglutination or a positive Coomb’s test. Dogs with an underlying disease, a platelet count < 30,000/uL, or if no treatment was attempted were excluded. Outcome was defined as survival to discharge. Candidate variables were selected a priori and the model was developed using multivariate logistic regression with stepwise backwards elimination (P < 0.05). Point estimates were used to establish scores. Results: Four hundred and nine dogs were included with an overall mortality of 22%. The variables remaining and scores in our model are blood transfusion (yes = 2; no = 0), age (< 8 years = 0; 8–12 = 0.5; >12 years = 1), bilirubin (< 12 mg/dL = 0; 12–18 = 3; >18 = 3.5), ALT (< 800 = 0; >800 = 1), and platelet count (30–90 k/uL = 2; 90–180 = 0.5; >180 = 0). The area under the receiver operating characteristic curve was 0.69. The predicted probability of mortality for a combined score greater than 6 was 62.8% with a specificity of 99.4%, sensitivity of 10%, and positive predictive value of 81.8%. Conclusion: We identified significant risk factors and built a predictive model that reasonably discriminates between dogs that died and survived. Examining changes in laboratory values over time may aid in better prognosticating.

EVALUATION OF SHORT-TERM OUTCOME IN DOGS WITH NEWLY DIAGNOSED PRIMARY IMMUNE-MEDIATED HEMOLYTIC ANEMIA (IMHA): A MULTICENTER, RETROSPECTIVE STUDY Lamb, J1 , O’Toole, T1 , Schoeffler, G2 , Hanel, R3 , Woolcock, A3 , Jutkowitz, A4 , Puglia, G5 , Guenther, C6 , Guillaumin, J7 , Stoneham, A8 , Bacek, L9 , Stewart, S10 , Gest, J11 , McMichael, M12 , Fossett, F12 , Monaghan, K13 , Abelson, A1 , Whelan, M14 , Lester, C15 1 Tufts University Cummings School of Veterinary Medicine, North Grafton, MA, USA 2 Cornell University College of Veterinary Medicine, Ithaca, NY, USA 3 North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA 4 Michigan State University College of Veterinary Medicine, East Lansing, MI, USA 5 Hope Veterinary Specialists, Malvern, PA, USA


Abstracts 6 Pittsburgh

Veterinary Specialty & Emergency Center, Pittsburgh, PA, USA 7 The Ohio State University College of Veterinary Medicine, Columbus, OH, USA 8 VCA Veterinary Referral Associates, Gaithersburg, MD, USA 9 Auburn University College of Veterinary Medicine, Auburn, AL, USA 10 Animal Internal Medicine & Specialty Services, San Francisco, CA, USA 11 The Animal Medical Center, New York, NY, USA 12 University of Illinois College of Veterinary Medicine, Urbana, IL, USA 13 Alpenglow Veterinary Specialty + Emergency Center, Boulder, CO, USA 14 Angell Animal Medical Center, Boston, MA, USA 15 Ocean State Veterinary Specialists, East Greenwich, RI, USA Introduction: There are currently no standardized protocols for the optimal treatment of immune-mediated hemolytic anemia (IMHA). The aim of this study was to examine the outcome of different treatment strategies. Methods: Data for newly diagnosed dogs with IMHA was retrospectively collected based on PCV < 35% and spherocytosis, autoagglutination or positive Coomb’s test. Dogs with underlying disease, platelet count < 30,000/uL, or not treated were excluded. Outcome was defined as survival to discharge. Treatment groups included prednisone (P), or prednisone with azathioprine (PA), cyclosporine (PC), or mycophenolate (PM). Anticoagulants used included heparin, low-molecular-weight heparin, aspirin, and clopidogrel. Categorical variables were analyzed using the chi-squared test. Continuous variables were analyzed using the Kruskal-Wallis test. Statistical significance was determined by P < 0.05. Results: Four hundred and nine dogs were included with an overall mortality rate of 21.7%. There was no significant difference in mortality between the four treatment groups (p = 0.63). Dogs in the PC and PM treatment groups were hospitalized longer (P < 0.05) and required more blood transfusions (p < 0.01). There were no clinically relevant differences between treatment groups and laboratory data. There was no significant difference in mortality between dogs receiving thromboprophylaxis (21.5%) and those that did not (26.5%), P = 0.27. Mortality was significantly different between dogs with confirmed or suspected thromboembolism (60%) compared to dogs without (12.8%), P < 0.0001. Conclusion: No treatment combination proved more effective than prednisone alone for treatment of IMHA. Thromboembolism increases mortality and further studies are needed to determine the best thromboprophylactic protocol.

USE OF A PORTABLE OXYGEN CONCENTRATOR IN CLIENT OWNED HYPOXEMIC DOGS Letendre, J-A1,2 , Boysen, S1 , Stillion, J2 , Caulkett, N1 of Veterinary Clinical and Diagnostic Sciences, University of Calgary Veterinary Medicine, Calgary, AB, Canada 2 Western Veterinary Specialist and Emergency Centre, Calgary, AB, Canada

1 Department

Introduction: Oxygen therapy is commonly administered to small animals. Portable oxygen concentrators (POC) are widely used in human medicine for in-home oxygen therapy or as an alternative to compressed gas cylinders in developing countries and military units. The objective of this study was to determine if a POC would


increase partial pressure of arterial oxygen (PaO2 ) in hypoxemic canine patients. Methods: Ethics approval and owner consent was obtained for this study. Dyspneic dogs with PaO2 ࣘ 70 mm Hg on room air requiring supplemental oxygen via nasal prongs for any reason were included. Oxygen therapy was discontinued for 5 minutes and a baseline PaO2 (room air) obtained (T0). Oxygen supplementation using the EverGo POC (Respironics) was provided for 10 minutes and PaO2 measurement repeated (T10). POC oxygen supplementation was discontinued and a third PaO2 measurement taken 5 minutes later (T15). PaO2 values were compared using a one-way ANOVA, with post hoc Bonferonni. A Kolmogorov–Smirnov test was used for normality. Results are mean ± SD. Results: Five dogs were enrolled. Data were normally distributed. PaO2 values at T0, T10 and T15 were 58.4 ± 3.6, 92.2 ± 13.4, and 59.6 ± 4.6 mm Hg, respectively, which were statistically different (P = 0.0074). T10 was statistically higher than T0 and T15 (P < 0.05). T0 was not statistically different than T15. Conclusion: This pilot study supports the use of POC to improve arterial oxygenation in hypoxemic dogs. This may be useful in clinical settings where compressed oxygen is not available, or during transport of hypoxemic dogs to referral centers.

EVALUATION OF PLATELET FUNCTION USING MULTIPLE ELECTRODE PLATELET AGGREGOMETRY IN DOGS WITH SEPTIC PERITONITIS Li, RHL, Chan, DL Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, United Kingdom Introduction: Studies in people with sepsis have identified sepsisrelated changes in platelet function, which may contribute to development of multiple organ dysfunction (MODS) and increased mortality. It is unknown if similar findings are present in canine sepsis. The primary aim of this study was to assess platelet function via multiple electrode platelet impedance aggregometry (MEPA) in dogs with septic peritonitis compared to healthy controls. The secondary aim was to determine any prognostic ability of platelet dysfunction in septic dogs. Methods: Twenty dogs with septic peritonitis were enrolled and compared to 23 healthy dogs. Multiplate platelet function analysis using arachidonic acid (AA), collagen (COL) and adenosine diphosphate (ADP) as agonists of platelet aggregation were performed within 24 hours of diagnosis of septic peritonitis. Results: Compared to healthy dogs, platelet aggregation was significantly reduced in dogs with septic peritonitis when all three agonists were used (all P < 0.01). Platelet aggregation was significantly decreased in non-survivors compared to survivors when COL was used as an activator (P = 0.02). Impedance aggregometry using COL with a cut-off of 43.5 aggregation units had a sensitivity of 83% and specificity of 83% for predicting mortality. Platelet aggregometry was not significantly different amongst dogs with or without MODS. Conclusion: Results of the present study confirm platelet dysfunction in dogs with septic peritonitis. MEPA using COL as an activator may be a candidate assay for prediction of mortality in septic dogs. Further studies are warranted in identifying the pathophysiological  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227


mechanism of platelet dysfunction and the progression of sepsis in dogs.

ALANINE AMINOTRANSFERASE ACTIVITY (ALT) AS A MARKER FOR HEMOABDOMEN DETECTED BY ABDOMINAL FAST (AFAST) IN DOGS WITH AUTOMOBILE TRAUMA Lisciandro, GR Hill Country Veterinary Specialists, Emergency Pet Center, Inc., San Antonio, TX, USA Introduction: Serum alanine aminotransferase (ALT) activity have been used as a screening test for hemoabdomen in bluntly traumatized children. To the author’s knowledge, no studies in veterinary medicine have evaluated ALT activity as a predictor of hemoabdomen. Methods: Dogs with automobile trauma presenting to a private veterinary emergency center were prospectively studied. Upon admission, an abdominal FAST (AFAST) exam and an ALT activity were performed. Hemoabdomen was diagnosed by AFASTpositive and surviving without surgical intervention or by confirmatory abdominocentesis. AFAST-negative and positive dogs were compared for differences. Sensitivity and specificity of ALT predictive of hemoabdomen and receiver operator characteristics (ROC) analysis were calculated. Results: Of 74 dogs evaluated, 53 were AFAST-negative. Twentyone dogs were AFAST-positive; and 15 were confirmed with hemoabdomen by abdominocentesis. Mean and median ALT activities for AFAST-negative dogs were 479 and 249 U/L, respectively (CI 95%, 318, 641); and AFAST-positive dogs were 1067 and 989 U/L, respectively (CI 95%, 607, 1527). ALT activities between AFAST-negative and positive dogs were different (P = 0.003). Receiver operating characteristics analysis estimated an area under the curve of 0.744. Normal ALT (< 102 U/L) had sensitivity (Se) of 90%. Abnormal ALT over 1000 U/L had specificity (Sp) of 90%. Cut-off Se and Sp values were less clear; however, an ALT of 503 U/L had a Se and Sp of 67%. Conclusion: ALT activities may be used as a predictor of hemoabdomen in dogs with automobile trauma with higher activities predictive of its presence. These findings support the inclusion of ALT in the initial trauma work-up of bluntly traumatized dogs.

ENDOTHELIN-1 IN DOGS UNDERGOING HEMODIALYSIS AND ITS ROLE IN INTRADIALYTIC HYPERTENSION: A PILOT STUDY ˜ LA, Buckley, GJ, Bandt, C, Shmalberg, J Londono, University of Florida, College of Veterinary Medicine, Gainesville, FL, USA Introduction: Intradialytic hypertension affects 15% of humans undergoing hemodialysis; the role of endothelial dysfunction and increases in Endothelin-1 (ET-1) concentration are well documented. Changes in ET-1 concentration in veterinary hemodialysis patients have not been reported. This study prospectively measured ET1 in plasma of dogs with acute kidney injury (AKI) receiving hemodialysis.  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

Methods: Dogs requiring hemodialysis for management of AKI were recruited. ET-1 was assayed before, during and 6 hours postdialysis using Quantikine ELISA. Blood pressure was measured concurrently with each blood collection for ET-1 assay. Fluid gain or loss during hemodialysis was measured based on change in body weight. The first two treatments for each patient were included in the study. Results: ET-1 increased significantly from baseline to post hemodialysis (P = 0.0096) in all treatments. The increase from baseline during hemodialysis was significant for treatment 1 (P = 0.036) but not for all treatments (P = 0.352). A significant increase occurred from intra to post hemodialysis in all treatments (P = 0.0243). No correlation was found between ET-1 concentration and blood pressure or change in body weight. A significant negative correlation was found between initial blood pressure and percent change in ET-1 concentration (r = −0.77). Conclusion: Significant increases in ET-1 concentrations were identified in dogs undergoing hemodialysis but no correlation was identified with blood pressure. It is possible that the relationship is confounded by several factors including use of antihypertensive drugs, variable rates of ultrafiltration, starting volemic status and the activation of the RAAS system. Further studies would be required to elucidate the role of ET-1 in dogs undergoing long term hemodialysis.

DIAGNOSTIC UTILITY OF A MULTIBIOMARKER PANEL FOR DETERMING THE ETIOLOGY OF FEVER IN DOGS PRESENTING FOR EMERGENCY CARE Lynch, AM1 , Sharp, CR1 , Ringold, R2 , Gauthier, S2 University Cummings School of Veterinary Medicine, North Grafton, MA, USA 2 Veterinary Diagnostics Institute, Simi Valley, CA, USA

1 Tufts

Introduction: Identification of the cause fever in dogs may be challenging. Sepsis, non-infectious inflammation and neoplasia are some of the most common causes of fever. The aim of this study was to assess the diagnostic utility of three established biomarkers in identifying the cause of fever in dogs. Methods: Dogs presenting for emergency care with fever (>102.5°F) were eligible for inclusion. Blood was collected and serum frozen at -80°F for batch analysis of three biomarkers using previously validated ELISAs. Aminoterminal pro-C-type natriuretic peptide (NT-proCNP) was used as a marker of sepsis, C-reactive protein (CRP) as a non-specific inflammatory marker and thymidine kinase-1 (TK-1) as a neoplasia biomarker. A clinician blinded to the biomarker results made a diagnosis of sepsis, non-infectious non-neoplastic systemic inflammation, neoplasia, or ‘other’ in these dogs. Sepsis (SI) and neoplasia indices (NI) were calculated based on normalization of the measured biomarker values to predetermined cut-off values. An ROC curve analysis was performed, and AUC used to report biomarker performance. Results: Thirty-seven dogs with a definitive diagnosis were included. Fever was assessed as being due to sepsis in 14 dogs, noninfectious systemic inflammation in 16 dogs and neoplasia in 7 dogs. The AUC for the use of SI to identify sepsis as the cause of fever was 0.818. The AUC for the use of NI to identify neoplasia as the cause of fever was 0.936.



Conclusion: This pilot data suggests the use of these three biomarkers in concert may have a role in identifying the cause of fever in dogs.

HISTOPATHOLOGICAL CHANGES OF KIDNEYS FROM HOSPITALIZED DOGS DIAGNOSED WITH ACUTE KIDNEY INJURY Preston, AR, McLeland, S, Ehrhart, EJ, Chamney, N, Sullivan, LA Colorado State University, Fort Collins, CO, USA Introduction: Acute kidney injury (AKI) has been documented in critically ill dogs and several scoring systems for AKI severity have been proposed. The association between AKI severity and renal histopathological findings has not been described. The purpose of this study was to document renal histopathological changes in critically ill dogs that develop AKI and to determine if classification of AKI is associated with severity of histopathological disease. Methods: Retrospective evaluation of medical records from 27 dogs were reviewed for the development of hospital-acquired AKI based on Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria. Underlying disease, clinical severity score, time from hospitalization to onset of AKI, serial serum creatinine values, exposure to intrinsic causes of AKI, case outcome and histopathology report were recorded. Hematoxylin and eosin stains were evaluated for thrombus formation, tubular necrosis, apoptotic bodies and leukocyte infiltration. Special stains to confirm the presence of apoptosis using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) and caspase-3 were also performed. Results: Dogs with AKI exhibit a statistically significant increase in the number of TUNEL positive nuclei when compared to dogs that did not develop AKI (182.4 TUNEL positive tubular epithelial cells/10 hpf vs 91 TUNEL positive tubular epithelial cells/10 hpf, P < 0.0001). Conclusion: Critically ill dogs that develop AKI demonstrate an increase in the number of TUNEL positive cells compared to dogs that did not develop AKI. Special staining may provide insight regarding underlying apoptotic pathways, which could offer opportunity for further investigation and possibly therapeutic targeting.

LEUKOREDUCTION PREVENTS ACCUMULATION OF INTERLEUKIN-8 IN CANINE PACKED RED BLOOD CELLS DURING STORAGE Purcell, SL, Smart, L, Hosgood, G, Claus, M Murdoch University, Perth, Western Australia, Australia Introduction: Cytokines, interleukin-8 (IL-8), interleukin-1␤ (IL1␤) and tumor necrosis factor-␣ (TNF-␣) accumulate in human packed red blood cells (PRBCs) during storage resulting in recipient inflammation. Leukoreduction has been shown to prevent cytokine accumulation. The aim of this study was to measure IL-8, IL-1␤ and TNF-␣ concentrations in canine stored PRBCs over time and assess the effect of leukoreduction on these cytokine concentrations. Methods: Twelve healthy greyhounds were anesthetized and one unit of blood was collected from each greyhound and processed into PRBCs. Half of each unit was passed through a leukoreduction filter to produce a leukoreduced (LR) unit and a non-leukoreduced (NLR) unit. A complete blood count was performed on day 0 on all units, which were then stored at 2–6°C. Samples were collected


from the units at days 0, 10, 20, 30 and 37, which were centrifuged and the supernatant stored at -80°C. Canine TNF-␣ and canine IL-8 were assessed using Luminex xMAP technology and canine IL-1␤ was measured by ELISA. Results: Leukoreduction resulted in 100% reduction of leukocytes. Both TNF-␣ and IL-1␤ concentrations were not significantly different between LR and NLR units, and did not change significantly over time. Interleukin-8 concentration was significantly higher in NLR units compared with LR units at all time points (P = 0.0021). The IL-8 concentration increased at day 10 and remained increased at day 37 in NLR units but did not increase during storage in LR units. Conclusion: This study showed that leukoreduction of canine PRBCs prevented accumulation of IL-8 during storage.

THE ASSOCIATION OF LACTATE WITH PHYSICAL PERFUSION PARAMETERS, BLOOD PRESSURE, AND OUTCOME IN CATS PRESENTING TO AN EMERGENCY SERVICE: A PROSPECTIVE STUDY Reineke, EL, Rees, C, Drobatz, KJ University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA Introduction: In emergent patients, hyperlactatemia most commonly occurs when there is an imbalance between tissue oxygen delivery and oxygen consumption, which occurs in shock states. To date, no clinical studies exist evaluating the association of admission lactate with perfusion parameters and outcome in sick cats. Our hypothesis was that plasma lactate would be increased in cats with abnormal physical exam perfusion parameters and hypotension and admission hyperlactatemia would be associated with non-survival. Methods: Cats having a physical examination, systolic blood pressure (SBP), and a plasma lactate measured at emergency service admission and prior to any interventions were prospectively enrolled. Hypotension was defined as a SBP < 90 mm Hg. Outcome was defined as survival to hospital discharge, euthanized, or died. Results: The median lactate for the 111 study cats was 2.7 mmol/L (range: 0.5 – 19.3 mmol/L). Physical examination perfusion parameters significantly associated with an increased median lactate (>2.5 mmol/L) included white mucous membranes, poor femoral pulses, and absent metatarsal pulses (p < 0.01). The median lactate for hypotensive cats (3.3 mmol/L) was significantly higher than the median lactate for cats with SBP ࣙ 90 mm Hg (2.35 mmol/L) (P < 0.01). The median admission lactate was not significantly different between cats that survived to hospital discharge (2.45 mmol/L) and those that were euthanized (3.2 mmol/L) (P = 0.3858). Conclusion: Lactate may be a useful biomarker, along with the physical examination and SBP, in identifying abnormalities in tissue perfusion and oxygen delivery in cats. However, lactate clearance in response to therapy is likely more clinically useful than single lactate measurements in predicting outcome.

COMPARISON OF KAOLIN-ACTIVATED THROMBOELASTOGRAPHY BETWEEN HEALTHY AND HOSPITALIZED DOGS Rubanick, JV, Barr, JW, Bishop, MA, Pashmakova, MB Texas A&M University, College Station, TX, USA  C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227


Introduction: Hospitalized dogs are predisposed to hemostatic alterations from a variety of underlying conditions. Thromboelastography (TEG) is one of few available tests of global hemostasis and data comparing tissue factor-activated TEG between hospitalized and healthy dogs has been published. The purpose of this study was to compare kaolin-activated TEG between a heterogeneous population of hospitalized dogs and healthy controls. Methods: Thirty-four dogs admitted to the teaching hospital between July 2013–February 2014 with clinical conditions warranting coagulation testing and 30 control dogs were analyzed with kaolin-activated thromboelastography. Data was checked for normality and Mann–Whitney or unpaired t tests were used to compare groups. Alpha was set at 0.05.

 C Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

Results: There were statistically significant differences in the median values of K (1.20 vs 1.85; P = 0.002), alpha-angle (72.93 vs 64.47; P = 0.002), MA (62.25 vs 54.02; P = 0.001), and G (mean; 9.48 vs 6.14; P =

Abstracts from the International Veterinary Emergency and Critical Care Symposium and the European Veterinary Emergency and Critical Care Society Annual Congress, September 10-14, 2014, Indianapolis, Indiana.

Abstracts from the International Veterinary Emergency and Critical Care Symposium and the European Veterinary Emergency and Critical Care Society Annual Congress, September 10-14, 2014, Indianapolis, Indiana. - PDF Download Free
424KB Sizes 11 Downloads 20 Views