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This study aims to determine whether the use of the word, Quiet increases veterinary emergency service triage traffic or hospital admissions. Days were randomized to be a control or test phrase day. On control days, the phrase, Have a nice day! was announced to the entire hospital staff. On test days, the phrase, Have a quiet day! was announced. No statistical difference in mean number of the patients presenting to the emergency service for triage (test phrase 30.1 ± 10.4 cases vs control phrase 30.3 cases ± 10.5, p = 0.91) or hospital admissions (test phrase 3.5 ± 1.9 cases vs control phrase 4.3 ± 2.4 cases, p = 0.13) was found for 24-h following phrase utterance. No statistical difference in mean number of patients presenting to the emergency service for triage (test phrase 2.7 ± 1.4 cases vs control phrase 2.6 ± 1.9 cases, p = 0.84) or hospital admissions (test phrase 0.3 ± 0.5 cases vs control phrase 0.5 ± 0.8 cases, p = 0.08) was found in the 2-h window immediately following phrase announcement. Despite popular myth, using the word, Quiet does not increase veterinary emergency service triage traffic or hospital admissions. [ABSTRACT FROM AUTHOR]

Objective--To determine whether dogs with head trauma have a greater incidence of seizures than the general canine patient population. Design--Retrospective case series. Animals--259 client-owned dogs. Procedures--Medical records of dogs evaluated for head trauma at The Ohio State University Veterinary Medical Center from 1999 to 2009 were reviewed. Data were collected regarding the cause of the head trauma, physical examination and neurologic examination findings, comorbidities, and the development of seizures during hospitalization. A telephone survey was conducted to question owners regarding the development of seizures after discharge. Relationships between the nature of the head trauma and the development of seizures were then examined. Results--3.5% of dogs with head trauma developed in-hospital seizures, and 6.8% of dogs with head trauma for which follow-up information was available developed seizures after hospital discharge, compared with an epilepsy rate of 1.4% in our hospital. Dogs that developed in-hospital seizures were significantly more likely to have been hit by a car or experienced acceleration-deceleration injury. Additionally, 10% of dogs with traumatic brain injury had in-hospital seizures. No visit or patient characteristics were significantly associated with the development of out-of-hospital seizures. Conclusions and Clinical Relevance--Dogs with head trauma may develop seizures at a greater rate than dogs in the general canine patient population. Particularly in the immediate to early posttraumatic period, clinicians should remain vigilant for the development of posttraumatic seizures and treat patients accordingly. [ABSTRACT FROM AUTHOR]

Objective-To compare cardiac index (Cl), oxygen delivery index (D̊o2I), oxygen extraction ratio (O2ER), oxygen consumption index (V̊o2I), and systemic vascular resistance index (SVRI) in dogs with naturally occurring sepsis with published values for healthy dogs; compare those variables in dogs with sepsis that did or did not survive; and compare Cl and D̊o2I in dogs with sepsis with values in dogs with nonseptic systemic inflammatory response syndrome (nSIRS). Design-Cohort study. Animals-10 dogs with naturally occurring sepsis and 11 dogs with nSIIRS. Procedures-Over 24 hours, Cl, D̊o2I, O2ER, V̊o2I, and SVRI were measured 4 and 5 times in dogs with sepsis and with nSIRS, respectively. The mean values of each variable in each group were compared over time and between groups; data for dogs with sepsis that did or did not survive were also compared. Results-Mean D̊o2I was significantly decreased, and mean Cl, O2ER, V̊o2I, and SVRI were not significantly different in dogs with sepsis, compared with published values for healthy dogs. Mean Cl and D̊o2I in dogs with sepsis were significantly greater than valyes in dogs with nSIRS. Among dogs with sepsis that did or did not survive, values of Cl, D̊o2I, O2ER, V̊o2I, and SVRI did not differ significantly. Conclusions and Clinical Relevance-Compared with values in healthy dogs, only D̊o2I was significantly lower in dogs with sepsis. Values of Cl and D̊o2I were significantly higher in dogs with sepsis than in dogs with nSIRS, suggesting differing degrees of myocardial dysfunction between these groups. [ABSTRACT FROM AUTHOR]

Objective--To assess the agreement between cardiac output (CO) measured by use of arterial pressure waveform analysis (PulseCO) and lithium dilution (LiDCO) in conscious dogs with systemic inflammatory response syndrome (SIRS). Animals--14 dogs with naturally occurring SIRS. Procedures--Pulse power analysis was performed on critically ill patients with a PulseCO monitor. All measurements were obtained with an indwelling arterial line and in accordance with the manufacturer's instructions. Intermittent measurements of CO were obtained with the LiDCO method to validate the PulseCO measurements at initial calibration (baseline; time 0) and at 4, 8, 16, and 24 hours. The 2 methods for measuring CO were compared by use of Bland-Altman analysis. An error rate for the limits of agreement between the 2 methods of < 30% was defined as being acceptable. Results--Bland-Altman analysis did not indicate good agreement between measurements obtained by use of the PulseCO and LiDCO methods, despite no significant change in cardiac index (CI) over time as measured with the LiDCO method. The percentage error for the overall difference in CI values between the PulseCO and LiDCO measurements was 122%, which indicated that the PulseCO method was not an acceptable means of CO measurement when compared with the LiDCO method for this patient population. Conclusions and Clinical Relevance--Agreement between the PulseCO and LiDCO methods for measurement of CO was not acceptable at 4- and 8-hour intervals after calibration in conscious dogs with naturally occurring SIRS. [ABSTRACT FROM AUTHOR]

Objective– To describe a case of barbiturate toxicosis in a dog secondary to ingestion of a previously buried euthanized goat carcass and to discuss the utility of urine drug testing in diagnosing barbiturate toxicosis. Case Summary– A 6-year-old neutered male Border Collie was presented to a university veterinary teaching hospital for evaluation of ataxia and acute collapse. Past pertinent history included Addison's disease that had been managed for 1 year. A companion dog was seen 12 hours earlier chewing on the partially decomposed head of a goat that had been euthanized 47 days previously and buried on the owner's property. The dog was laterally recumbent, unresponsive to stimuli, and hypothermic on physical examination. Initial blood work revealed hyponatremia and hyperkalemia, with a Na/K ratio of 18.5. The dog was volume resuscitated and received an injection of dexamethasone sodium phosphate due to a suspected Addisonian crisis. Despite this treatment, the dog remained laterally recumbent and unresponsive to stimuli. A urine drug screen was performed and was positive for barbiturates. A diagnosis of barbiturate toxicosis secondary to ingestion of a euthanized goat carcass was made. The dog was treated supportively over 12 hours with IV fluids and activated charcoal. The dog was able to walk 11 hours after presentation and was subsequently discharged from the hospital. New or Unique Information Provided– Urine drug testing is a fast, easy, and point-of-care test that may be useful in dogs to assist in the diagnosis of barbiturate intoxication. Proper disposal of euthanized animals is necessary to prevent toxicosis and possible death of companion animals and wildlife. [ABSTRACT FROM AUTHOR]

Objective: Compare cardiac index (CI) and oxygen delivery index (DO2I) in conscious, critically ill dogs to control dogs; evaluate the association of CI and DO2I with outcome. Design: Prospective non-randomized clinical study. Setting: Veterinary teaching hospital. Animals: Eighteen client-owned dogs with systemic inflammatory response syndrome (SIRS) and 8 healthy control dogs. Measurements and Main Results: CI of dogs with SIRS was measured using lithium dilution at times 0, 4, 8, 16, and 24 hours. Data collected included physical exam, arterial blood gas (ABG) and hemoximetry. CI of control dogs was measured 3 times with 1 measurement of ABG. Mean CI ± SE in SIRS patients was 3.32 ± 0.95 L/min/m2; lower than controls at 4.18 ± 0.22 L/min/m2 ( P<0.001). Mean DO2I ± SE in SIRS patients was 412.91 ± 156.67 mL O2/min/m2; lower than controls at 785.24 ± 45.99 mL O2/min/m2 ( P<0.001). There was no difference in CI ( P=0.49) or DO2I ( P=0.51) for dogs that survived to discharge versus those that did not. There was no difference in mean CI ( P=0.97) or DO2I ( P=0.50) of survivors versus non-survivors for 28-day survival. Survivors had lower blood glucose ( P=0.03) and serum lactate concentrations ( P=0.04) than non-survivors. Conclusions: CI and DO2I in conscious dogs with SIRS were lower than control dogs, which differs from theories that dogs with SIRS are in a high cardiac output state. CI and DO2I were not significantly different between survivors and non-survivors. Similar to previous studies, lactate and glucose concentrations of survivors were lower than non-survivors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the occurrence of abdominal effusion and its association with decompressive cystocentesis in male cats with urethral obstruction. Design: Prospective observational clinical study. Animals: Forty‐five male neutered, client‐owned cats with naturally occurring urethral obstruction. Procedures: Laboratory testing and point‐of‐care ultrasonography were performed. Presence of abdominal effusion was evaluated using the Focused Assessment with Sonography for Trauma (FAST) technique at presentation. Decompressive cystocentesis was then performed prior to catheterization by a standardized technique. Repeat FAST examination was performed 15 minutes after cystocentesis and the following day to further assess for the presence of abdominal effusion. Results: A mean volume of 92.3 ± 35.2 mL of urine was removed from each cat via cystocentesis prior to catheterization. At presentation, 15 of 45 (33%) had abdominal effusion (13/15 with scant effusion, 2/15 with mild), with an additional 7 cats developing scant effusion 15 minutes post‐cystocentesis. By the following day, 4 cats still had scant effusion present. No significant complications secondary to cystocentesis were reported. No association was found between severity of azotemia, or volume removed by cystocentesis, and the presence of effusion at presentation or after decompressive cystocentesis was performed. Conclusions and Clinical Relevance: A single decompressive cystocentesis prior to catheterization did not lead to development of clinically significant abdominal effusion or other discernable complications and appears to be a safe procedure in this population of patients. Abdominal effusion may be found at presentation in cats with urethral obstruction. The significance of this effusion remains to be determined. [ABSTRACT FROM AUTHOR]

Objective To: (1) determine the feasibility of using sidestream dark field microscopy (SDM) to measure microcirculatory parameters in healthy, anesthetized cats and (2) determine if surgical tissue manipulation and anesthesia time alter these parameters during ovariohysterectomy. Design Prospective observational study. Setting University teaching hospital. Animals Eighteen healthy female cats. Interventions Sublingual mucosa microcirculatory videos were obtained under general anesthesia preoperatively, intraoperatively, and postoperatively using an SDM device in healthy cats presenting for ovariohysterectomy. At each video acquisition point, macrovascular parameters (heart rate, blood pressure, pulse oximetry, end-tidal CO2) were recorded. Vascular analysis software was used to calculate standard microcirculatory parameters. Multivariate analysis was performed to compare microvascular and macrovascular parameters, as well as correlation with the effect of surgical manipulation and time under anesthesia. Measurements and Main Results Twelve of 18 cats were included in final video analysis; 6 were removed for poor video quality. Values for total vessel density (TVD, 47.7 ± 8.39 mm/mm2), proportion of perfused vessels (PPV, 88.2 ± 5.95%), perfused vessel density (PVD, 43.0 ± 9.00 mm/mm2), microcirculatory flow index (MFI, 2.33 ± 0.33) were determined preoperatively. There were no significant changes in TVD, PPV, and PVD across intervention points. The MFI increased significantly from preoperative to intra- and postoperative data collection points. No correlation between microcirculatory parameters and length of anesthesia or macrocirculatory values was found. Conclusions and Clinical Relevance This study demonstrated that SDM can be utilized to obtain sublingual microvascular parameters in healthy, anesthetized cats. Limitations include difficulty in obtaining high quality images, presumed need for general anesthesia, and need for off-line video analysis. This technology has potential as a tool in experimental and clinical monitoring of microcirculatory changes in felines. [ABSTRACT FROM AUTHOR]

Objective--To determine whether increasing the viscosity of a standard hemoglobin-based oxygen-carrying solution (HBOC) would offset its associated vasoconstrictive effects and result in improved microvascular perfusion in healthy splenectomized dogs with experimentally induced hemorrhagic shock. Animals--12 male American Foxhounds. Procedures--Each dog underwent anesthesia and splenectomy. Shock was induced by controlled hemorrhage until a mean arterial blood pressure of 40 mm Hg was achieved and maintained for 60 minutes. Dogs were then randomly assigned to receive either a standard or hyperviscous HBOC (6 dogs/group). Sidestream dark-field microscopy was used to assess the effects of shock and HBOC administration on the microcirculation of the buccal mucosa and the jejunal serosa. Video recordings of the microcirculation were collected before shock was induced (baseline) and at intervals up to 180 minutes following HBOC administration. Vascular analysis software was used to compute microcirculatory variables. Results--Compared with baseline findings, hemorrhagic shock resulted in decreases in all microvascular variables in the buccal mucosa and the jejunal serosa. At all time points following HBOC administration, microvascular variables were similar to initial values and no significant differences between treatment groups were detected. At all time points following HBOC administration, blood and plasma viscosities in dogs treated with the hyperviscous solution were significantly higher than values in dogs receiving the standard solution. Conclusions and Clinical Relevance--In splenectomized dogs with experimentally induced hemorrhagic shock, administration of a hyperviscous HBOC did not significantly affect microvascular variables, compared with effects of a standard HBOC. Microcirculatory flow returned to baseline values in both treatment groups, suggesting that marked HBOC-associated vasoconstriction did not occur. [ABSTRACT FROM AUTHOR]

Objective To assess the rate of bacterial contamination of fluid and ports in intravenous bags in a veterinary emergency room (ER) and intensive care unit (ICU). Design Experimental model. Setting Ninety intravenous fluid bags of lactated balanced-electrolytes solution (1 L) hung in a university hospital. Interventions Bags were hung in 2 different locations in the ER (sink and bins) and one location in the ICU (sink) for 11 days. Bags were punctured 3 times daily with a sterile needle to simulate clinical use. Injection ports were swabbed and 50 mL of fluid were collected in duplicates on days 0, 2, 4, 7, and 10. Aerobic bacterial cultures were performed on the fluid and injection port. Contamination was defined as bacterial growth of a similar phenotype across 2 consecutive times. Increase in the fluid contamination rate from day 0 was tested using an exact binomial test. Port contamination rate between locations was tested using Fisher's exact test. Main Results Combined bacterial growth on injection ports reached a mean (95% confidence interval) of 8.1 (0.005-16.2) cfu/port on day 10. The combined port contamination was 3.3%, 11.1%, 17.8%, and 31.1% on days 0, 2, 4, and 7, respectively. Port contamination was similar between ER and ICU. However, port contamination was higher in the sink versus the bins area (38.3% vs 16.7%, P = 0.032). No fluid bag was contaminated at days 0 and 2. The contamination rate of fluid bag was 1.1% and 4.4% on days 4 and 7, respectively. All bags with contaminated fluid were in the ER (6.7%, 95% exact binomial confidence interval 1.9-16.2%). Conclusions Injection port contamination reached 31.1% on day 7. Contamination was more likely when the bags were hung next to a sink. In our model of bag puncture, fluid contamination occurred between days 2 and 4. [ABSTRACT FROM AUTHOR]

Case Description--A 2.96-kg (6.5-lb) 9-month-old spayed female domestic longhair cat was admitted for removal of a tracheal foreign body. Clinical Findings--The cat had moderate respiratory distress but otherwise appeared to be healthy. Thoracic radiography revealed a foreign body in the trachea. Treatment and Outcome--The cat was anesthetized and endoscopy of the trachea was performed in an attempt to retrieve the foreign body. Endoscopic removal was unsuccessful because of the shape and smooth texture of the foreign body. Surgical removal of the foreign body was not considered ideal because of its location and the risks associated with tracheotomy. Fluoroscopic-guided placement of an over-the-wire balloon catheter caudal to the foreign body was followed by inflation of the balloon and gradual traction in an orad direction, which resulted in successful removal of the foreign body (identified as a piece of landscaping gravel). The cat required supplemental oxygen and supportive care following removal of the foreign body. Clinical Relevance--A fluoroscopic technique was used as a minimally invasive alternative to endoscopy or open-chest surgery for removal of a foreign body from the trachea of a cat. Use of this technique allowed uninterrupted ventilation of the cat throughout the procedure. [ABSTRACT FROM AUTHOR]