The role of albumin replacement in the critically ill veterinary patient

Objective: To review the human and veterinary literature on the physiological role and effects of therapeutic albumin supplementation. Data sources: Data from human and veterinary literature was reviewed. Human data synthesis: Hypoalbuminemia often occurs in a variety of critical illnesses, and contributes to the development of life‐threatening complications, including pulmonary edema, delayed wound healing, feeding intolerance, hypercoaguability, and multiple organ dysfunction. Serum albumin concentration has been used as a prognostic indicator in cases of chronic hypoalbuminemia. The use of albumin replacement therapy in humans is sometimes controversial, but may be associated with improved morbidity and decreased mortality. Veterinary data synthesis: Unlike human literature, there is a paucity of controlled clinical studies in the literature regarding albumin supplementation in veterinary patients. Rather, the majority of published studies were performed in experimental animals or via retrospective analyses. One recent study evaluated the use of plasma to improve albumin concentration in dogs with hypoalbuminemia. Other older studies investigated wound healing in dogs with experimentally induced hypoalbuminemia. As in human medicine, serum albumin concentration may be helpful as a prognostic indicator in critically ill dogs. Conclusion: Albumin is one of the most important proteins in the body because of its role in maintenance of colloid oncotic pressure, substrate transport, buffering capacity, as a mediator of coagulation and wound healing, and free‐radical scavenging. Albumin replacement in veterinary medicine is difficult, but until prospective clinical trials determine the efficacy of albumin replacement are conducted, a suggested clinical guideline would be to maintain albumin concentration at or above 2.0 g/dl utilizing fresh frozen plasma.     

The effects of lactated Ringer's solution (LRS) or LRS and 6% hetastarch on the colloid osmotic pressure, total protein and osmolality in healthy horses under general anesthesia

ObjectiveTo investigate changes in colloid osmotic pressure (COP), total protein (TP) and osmolality (OSM) during anesthesia in horses given intravenous lactated Ringer’s solution (LRS) or LRS and hetastarch (HES).Study designProspective, clinical trial.AnimalsFourteen horses presented for surgery. Mean age 8.3 ± 1.9 years; mean weight 452 ± 25 kg.MethodsHorses were premedicated with xylazine intravenously (IV); anesthesia was induced with ketamine and diazepam IV, and maintained with sevoflurane. Butorphanol was administered IV with pre-medications or immediately after induction. Xylazine was administered IV for recovery if necessary. LRS was administered IV to all horses with a target rate of 5–10 mL kg^?1 hour^?1. Half of the horses also received 6% HES, 2.5 mL kg^?1 over 1 hour in addition to LRS. Horses that received LRS only were considered the LRS group. Horses that received both LRS and HES were considered the LRS/HES group. Blood was drawn pre- and post-anesthesia, immediately following induction, and every 30 minutes throughout anesthesia. COP, TP and OSM were measured.ResultsCOP and TP significantly decreased at similar rates for both treatment groups from pre-anesthetic values. Pre-anesthetic COP was significantly greater in the LRS group when compared to the LRS/HES group pre-, post- and throughout anesthesia. In the LRS group post-anesthetic OSM was significantly different than the pre-anesthesia value and that for the LRS/HES group.Conclusions and clinical relevanceAdministration of IV HES (2.5 mL kg^?1, over 1 hour) in combination with LRS does not attenuate the decrease in COP typically seen during anesthesia with crystalloid administration alone. Based on these results, administration of HES at this rate and total volume would not be expected to prevent fluid shifts into the interstitium through its effects on COP.     

Colloid Oncotic Pressure and the Clinical Use of Colloidal Solutions

The synthetic colloids, dextran and hydroxyethyl starch, have only recently enjoyed widespread use in critically ill veterinary patients. Plasma proteins normally provide colloid oncotic pressure and, thereby, are the primary force responsible for retaining fluid within the vasculature. Abnormally low plasma protein concentrations, common in the critically ill patient, are associated with excessive fluid loss from capillaries and development of peripheral or pulmonary edema. Infusion of colloid solutions decreases the potential for and severity of edema in hypooncotic states. Dextran and hydroxyethyl starch solutions also provide other positive hemodynamic benefits and are a preferable alternative to crystalloid usage in the resuscitation of selected patients from hypotensive and hypovolemic states. Potential side effects of synthetic colloid infusion include anaphylactoid reactions, increased risk of bleeding, interference with cross matching, and acute renal failure. Knowledge of the mechanisms responsible for these adverse effects minimizes their occurrence.     

Critical role of the vascular endothelial cell in health and disease: a review article

Objective: To review the human and veterinary literature on the role of the vascular endothelial cell in health, as well as during hypoxic and inflammatory disease states. Data sources: Data from human and veterinary literature were reviewed through a Pubmed search and a manual search of the references listed in articles covering some aspect of vascular endothelial cell function. Human data synthesis: The development of techniques that allow the maintenance and growth of endothelial cells in culture has produced an explosion of new research in the area of endothelial cell physiology. This plethora of data has revealed the critical role that vascular endothelial cells play in both health and disease states. Interspecies variations can occur with respect to the vascular endothelial cell physiology and its response to pathologic conditions. Veterinary data synthesis: There is a paucity of information regarding the role of the vascular endothelial cell in health or disease of small animals. Many human studies use species cared for by veterinarians, providing information that may be applied to small animals and that may be used to construct future studies. Conclusion: An organ system itself, the vascular endothelium is an essential component of all organs in the body. The endothelial cell lining functions to maintain selective permeability between the blood and the tissue it supplies, regulate vascular tone, sustain blood fluidity through regulation of coagulation, and modulate interaction of leukocytes with the interstitium and inflammatory reactions. During disease states, the endothelial cell functions locally to limit the boundaries of the disease process. If these functions are not controlled, they can become a part of the pathogenic process, contributing to blood stasis and thrombosis, potentiation of local inflammation and interstitial edema formation, subsequent tissue hypoxia, and multiple organ dysfunction. Pharmacological investigations targeting the modulation of endothelial function during disease states have not yet advanced treatment protocols. Since all critically ill animals are at risk for some degree of endothelial cell dysfunction, treatment regimens should focus on promoting capillary blood flow and tissue oxygen delivery.     

Effects of isovolemic resuscitation with hemoglobin-based oxygen carrier Hemoglobin glutamer-200 (bovine) on systemic and mesenteric perfusion and oxygenation in a canine model of hemorrhagic shock: a comparison with 6% hetastarch solution and shed blood

OBJECTIVE: To study Hemoglobin glutamer-200 bovine (Hb-200), 6% hetastarch (HES) and shed whole blood (WB) resuscitation in canine hemorrhagic shock. STUDY DESIGN: Prospective laboratory investigation. Animals Twelve adult dogs [29 +/- 1 kg (mean +/- SD)]. METHODS: Anesthetized dogs were instrumented for recording systemic and mesenteric hemodynamic parameters and withdrawal of arterial, mixed and mesenteric venous blood, in which hematological, oxygenation, blood gas and acid-bases variables were determined. Recordings were made before [baseline (BL)], after 1 hour of hypovolemia and immediately and 3 hours post-resuscitation with 30 mL kg(-1) of either Hb-200, HES, or WB. RESULTS: Blood withdrawal (average 34 +/- 2 mL kg(-1)) caused significant hemodynamic changes, metabolic acidosis and hyperlactatemia characteristic for hemorrhagic shock. Only WB transfusion restored all variables. Hemoglobin glutamer-200 bovine infusion returned most hemodynamic parameters including cardiac output and mesenteric arterial blood flow to BL but increased mean arterial pressure above BL (p < 0.05). However, Hb-200 failed to restore total Hb and arterial oxygen content (CaO2), leaving systemic (DO2I) and mesenteric O2 delivery (DO2Im) below BL (p < 0.05). Nevertheless, acid-base variables recovered completely after Hb-200 resuscitation, and met-hemoglobin (Met-Hb) levels increased (p < 0.05). Hetastarch resuscitation returned hemodynamic variables to or above BL but further decreased total Hb and CaO2, preventing recovery of sDO2I and mDO2I (p < 0.05). Thus, systemic and mesenteric O2 extraction stayed above BL (p < 0.05) while acid-base variables recovered to BL, although slower than in Hb-200 and WB groups (p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Resuscitation with Hb-200 seemed to resolve metabolic acidosis and lactatemia more rapidly than HES, but not WB; yet it is not superior to HES in improving DO2I and DO2Im. The hyperoncotic property of solutions like Hb-200 that results in rapid volume expansion with more homogenous microvascular perfusion and the ability to facilitate diffusive O2 transfer accelerating metabolic recovery may be the key mechanisms underlying their beneficial effects as resuscitants.     

Assessment of changes in blood volume in response to resuscitative fluid administration in dogs

Objective: To determine the continuous changes in blood volume in response to fluid administration using an in‐line hematocrit monitor. Design: Prospective study. Setting: Research laboratory. Animals: Four healthy dogs. Interventions: Each dog received intravenous boluses of 80 mL/kg of 0.9% saline (S), 4 mL/kg of 7.5% saline (HS), 20 mL/kg of dextran 70 (D), 20 mL/kg of hetastarch (HES), or no fluids (control, C) on separate occasions. Fluids were administered at 150 mL/min in the S, D, and HES groups, and at 1 mL/kg/min in the HS group. Measurements and main results: Blood volume changes were measured every 20 seconds for 240 minutes using an in‐line hematocrit monitor. There was a rapid rise in blood volume during all infusions. Immediately after the administration of crystalloid fluids, the rapid rise in blood volume ceased. Subsequently, there was a steep decline in blood volume for 10 minutes, and a slower decline thereafter. In contrast, the rise in blood volume continued for at least 10 minutes after the infusion of the colloids was complete, and a plateau was observed for the remainder of the experiment. The blood volume effect, as measured by area under the curve, was significantly greater in the saline group than the other groups during the infusion time and for the 0–240 minutes time period. The areas under the curve for the two colloid solutions were not significantly different from each other during any time periods. The percent increase in blood volume immediately following the infusions was 76.4±10.0 in the S group, 17.1±3.2 in the HS group, 23.0±10.5 in the D group, and 27.2±6.4 in the HES group. At 30 minutes from the start of the infusion, the mean percent increases in blood volumes were 35.2±9.3 in the S group, 12.3±0.9 in the HS group, 35.9±7.3 in the D group, and 36.8±6.5 in the HES group. At 240 h post‐infusion, the mean percent increases in blood volume were 18.0±9.7 in the S group, 2.9±6.1 in the HS group, 25.6±16.1 in the D group, and 26.6±8.6 in the HES group. The C group had a mean percent change in blood volume of ?3.7±3.4 at the end of the experiment. Conclusions: This study indicates that the rapid administration of saline at clinically relevant doses leads to the largest immediate increase in blood volume, although this change is transient because of rapid redistribution of the fluid. Despite a brief increase in blood volume that was almost 3 times the volume administered, hypertonic saline led to the smallest increase in blood volume post‐infusion. The synthetic colloid solutions increased the blood volume by an amount greater than that infused and the effect was sustained for a longer period of time than seen following crystalloid administration, but the maximum increase in blood volume was significantly less than saline. The measurement of continuous changes in blood volume, using an in‐line hematocrit monitor, was a useful means of assessing the dynamic effects of fluid administration in dogs in a research setting.     

饲用抗生素细菌耐药性的研究进展

饲用抗生素的不当使用,尤其是抗生素促长剂的滥用,导致动物体内细菌耐药性的产生并不断增强。耐药性细菌及其耐药基因会在动物、环境、人体之间水平传播,从而对人类健康造成了严重威胁。为此一些发达国家纷纷采取措施限制饲用抗生素的使用。研究表明,抗生素促长剂停用后,畜禽体内及动物性食品中耐药菌显著减少,相应地人体内耐药菌携带率亦随之显著下降。     

Effects of small- and large-volume resuscitation on coagulation and electrolytes during experimental endotoxemia in anesthetized horses

BACKGROUND: Small-volume resuscitation (SVR) has been advocated in place of large-volume isotonic resuscitation for the treatment of endotoxemia in horses. The effects of this type of therapy during experimental endotoxemia on electrolytes and coagulation have not been evaluated in the horse. As part of a larger project, the objective of this study was to determine the effects of SVR (hypertonic saline solution [HSS] plus hetastarch [HES]) on coagulation and serum electrolytes concentration, and to compare SVR with large- and small-volume isotonic resuscitation during experimental endotoxemia in anesthetized horses. HYPOTHESIS: SVR does not affect coagulation parameters or serum electrolyte concentrations when compared with either small- or large-volume isotonic crystalloids. ANIMALS: Horses were randomly assigned to 1 of 3 groups. Under halothane anesthesia, endotoxemia was induced by administering 50 microg/kg Escherichia coli endotoxin i.v. The horses were treated for 30 minutes with 15 mL/kg of balanced polyionic crystalloid solution (control), 60 mL/kg of balanced polyionic crystalloid solution (ISO), or 5 mL/kg of HSS followed by 10 mL/kg HES (HSS-HES). METHODS: Prospective randomized trial. RESULTS: Significant differences in coagulation parameters were not found among the groups. Thrombocytopenia was severe in all 3 groups. Serum ionized calcium concentration significantly decreased from baseline in control and ISO groups but not in the HSS-HES group. CONCLUSIONS AND CLINICAL IMPORTANCE: These results suggest that the HSS-HES combination, at the dosage used in this study had no adverse effects on coagulation beyond those produced by endotoxemia. HSS-HES may have a protective effect against endotoxemia-induced ionized hypocalcemia.     

The Effect of Hetastarch (670/0.75) on Urine Specific Gravity and Osmolality in the Dog

Background: Urine specific gravity (USG) is used clinically to estimate urine osmolality (UOsm). Although USG has been shown to have a linear correlation with UOsm in dogs, the relationship is altered when there are significant numbers of high molecular weight (MW) molecules in the urine.
Hypothesis: USG would no longer predict UOsm in dogs given intravenous hetastarch (670/0.75)(HES).
Animals: Eight healthy employee-owned adult dogs.
Methods: Prospective, controlled experimental study. USG and UOsm were measured every 30 minutes from t=0 minutes to t=360 minutes. Dogs were administered 20mL/kg of either NaCl 0.9% (control group, n=4) or HES (treatment group, n=8) IV over 1 hour starting at t=90 minutes.
Results: There was a decrease in UOsm in both groups starting at t=120 minutes and continuing for the study duration, and there was no significant difference in UOsm between treatment and control groups across all time points. There was an appropriate decrease in USG from t=120 minutes for the control group. In the treatment group, USG increased significantly at t=120 minutes ( P = .0006), t=150 minutes ( P = .0002), and t=180 minutes ( P = .0044). The largest increase in USG occurred at t=150 minutes with a mean USG of 1.070 ± 0.021 (range 1.038-1.104).
Conclusions and clinical importance: Urine specific gravity should not be used to estimate urine solute concentration in dogs following the administration of 20mL/kg of HES. In a clinical setting, the evaluation of USG following this dose of HES may lead to an overestimation of urine concentration.     

The effect of Hetastarch (670/0.75) in vivo on platelet closure time in the dog

Objective – To evaluate the effect of 6% hydroxyethyl starch (HES) solution in vivo, with an average molecular weight of 670 kDa and degree of substitution of 0.75, on canine platelet function.
Design – Prospective, controlled-experimental study.
Setting – University of California, Davis, Veterinary Medical Teaching Hospital.
Animals – Seven healthy employee-owned dogs.
Interventions – Seven dogs were included in the treatment group. Four of these dogs also served as the control group. Platelet closure time (CT) was measured using a platelet function analyzer and collagen/ADP cartridges. Dogs were given 20 mL/kg of either sodium chloride 0.9% (control group, n =4) or HES (treatment group, n =7) IV over 1 hour. CT was measured before the infusion, and at 1, 3, 5, and 24 hours after the start of the infusion.
Measurements and Main Results – There was a significant change over time from 0 to 24 hours ( P <0.001), a significant difference between groups across time ( P <0.001), and a significant group-by-time interaction ( P =0.007). At 3 hours, mean CT for the treatment group was 122.3±18.1 seconds, which was significantly different ( P <0.001) from the control group (71.0±3.5 s). At 5 hours, mean CT for the treatment group was 142.7±33.9 seconds, which was significantly different ( P =0.001) from the control group (75.0±8.6 s). Mean CT at 24 hours was within the reference interval for both the control and treatment group (66.0±2.9 and 81.8±11.9 s, respectively); however, CT in 3 individual dogs in the treatment group at this time point remained prolonged.
Conclusions – A clinically relevant dose of HES 670/0.75 prolongs CT in dogs for up to 24 hours. This may be due to platelet dysfunction in addition to the effects of hemodilution, and therefore, may increase the risk of bleeding.     

Are Endocrine Disrupting Compounds a Threat to Farm Animal Health,Welfare and Productivity?

Contents The sources and characteristics of endocrine disrupting compounds (EDCs) are reviewed and discussed with respect to their potential effects on farm animal health, welfare and productivity. The importance of certain properties of these compounds in relation to the expression of their biological effects is addressed together with potential routes of exposure. It is concluded that little is known of factors affecting the tissue concentrations of EDCs in farm animals, the concentrations that are required to perturb physiological function in these species, the effects of prolonged exposure to low doses, the effect of cocktails of EDCs and other pollutants or the responses of specific organs and physiological systems that are affected by EDCs. Much of the available information pertaining to EDCs is derived from epidemiological studies of wildlife species and from laboratory animal studies and while these studies have significant limitations, they are considered to be valuable indicators of potential effects in farm animal species. The results of such studies, together with the small amounts of data from studies of ruminants, indicate that there may be significant effects of exposure to environmental levels of EDCs on farm animal health, even although effects are not generally apparent in practice, at this time.     

Reducing blood volume requirements for clinical pathology testing in toxicologic studies—points to consider

In preclinical safety assessment, blood volume requirements for various endpoints pose a major challenge. The goal of this working group was to review current practices for clinical pathology (CP) testing in preclinical toxicologic studies, and to discuss advantages and disadvantages of methods for reducing blood volume requirements. An industry‐wide survey was conducted to gather information on CP instrumentation and blood collection practices for hematology, clinical biochemistry, and coagulation evaluation in laboratory animals involved in preclinical studies. Based on the survey results and collective experience of the authors, the working group proposes the following “points to consider” for CP testing: (1) For most commercial analyzers, 0.5 mL and 0.8 mL of whole blood are sufficient for hematology and biochemistry evaluation, respectively. (2) Small analyzers with low volume requirements and low throughput have limited utility in preclinical studies. (3) Sample pooling or dilution is inappropriate for many CP methods. (4) Appropriate collection sites should be determined based on blood volume requirements and technical expertise. (5) Microsampling does not provide sufficient volume given current analyzer and quality assurance requirements. (6) Study design considerations include: the use of older/larger animals (rodents), collection of CP samples before toxicokinetic samples, use of separate subsets of mice for hematology and clinical biochemistry testing, use of a priority list for clinical biochemistry, and when possible, eliminating coagulation testing.     

Alpharma Beef Cattle Nutrition Symposium: nutrition and the genome

It has long been appreciated that animals fed the same diet may perform differently. This is due to the ability of nutrients to interact with and affect molecular pathways that result in differences in BW gain, production performance, or disease resistance. To understand these effects, studies are being undertaken to discover how the differential expression and function of genes occur with different diets. These studies are using new technologies, genomic resources, and analysis techniques that have recently become available for domestic animals. Nutrigenomics and nutrigenetics are new research approaches that strive to optimize health by looking beyond the diet to understand the effects of food at the genetic and epigenetic levels. Nutrigenomics is focused on the effects of diet on health through an understanding of how bioactive chemicals in foods and supplements alter gene expression or the structure of the genome of an animal. Nutrigenetics focuses on how the genetic composition (i.e., genetic variation) of an animal influences their response to a given diet. Results from these studies will aid in formulating nutritionally appropriate diets that may be optimized for animals based on their genomic underpinnings. Nutrigenomics and nutrigenetics unite many fields: nutrition, bioinformatics, molecular biology, genomics, functional genomics, epidemiology, and epigenomics. The use of multi-disciplinary tools promises new opportunities to investigate the complex interactions of the genome and the diet of an animal. Through these new approaches, the partnerships of the genome and nutrition will be revealed resulting in improved efficiency of diets, enhanced sustainability of animals as a protein source, and improved methods for preventing illnesses.     

Use of dopamine in acute renal failure

Objective: To review the current understanding of dopamine and its use in the prevention and treatment of acute renal failure (ARF). Data sources: Original research articles and scientific reviews. Human data synthesis: Low‐dose dopamine administration has been shown to increase natriuresis and urinary output in both healthy individuals and in a few small studies in human patients with renal insufficiency. However, in several large meta‐analyses, dopamine treatment did not change mortality or the need for dialysis. Due to the potential side effects, the use of dopamine for prevention and treatment of ARF is no longer recommended in human medicine. Veterinary data synthesis: Low‐dose dopamine increases urinary output in healthy animals and animal models of ARF if given before the insult. There are no available studies looking at the effect of low‐dose dopamine therapy in naturally occurring ARF in dogs or cats. Conclusion: Due to the potential side effects of low‐dose dopamine therapy, the results from large human trials, and the lack of information in veterinary medicine, the use of dopamine for treatment of ARF in veterinary patients should be further evaluated.     

Balancing fact and fiction of novel ingredients: definitions, regulations and evaluation.

Veterinarians have an opportunity to help educate their clients regarding the safety and efficacy of novel ingredients used by their clients. This is no small task because of the lack of acceptable information. Clients should be counseled regarding the lack of scientific evidence and be encouraged to discriminate fact from fiction, including many testimonials. Safety should be of primary concern, and clients should be encouraged not to neglect traditional therapies in lieu of novel ingredients unless clinical evidence of efficacy exists. Quality assurance is equally important and cannot be underestimated. Clients are likely to resort to less expensive products. Clients should be directed to the advice offered by the Arthritis Foundation as follows: "When a supplement has been studied with good results, find out which brand was used and buy that." Although skepticism is encouraged regarding any unknown product with medicinal indications, open mindedness should also guide the veterinarian as these products are considered. Indeed, veterinarians should take actions to ensure that the use of these compounds is accomplished within the confines of the veterinary-client-patient relationship, thus ensuring the role of the veterinarian in the health and well-being of animals, regardless of the modality of therapy. The veterinary profession should support the development of standards that might guide manufacturers of novel ingredients to meet criteria that protect the consumer. Likewise, we should encourage manufacturers and agencies to fund veterinary clinical trials to provide evidence for the use of these potentially exciting compounds. Above all else, the veterinarian needs to become a credible resource of information about the possible role of these products. The lack of a regulatory mechanism that establishes the safety and efficacy of these products is not justification for ignoring the potential therapeutic benefit of some of these products. Veterinarians should follow the advice of the Arthritis Foundation, which notes: "Since glucosamine is self-prescribed ... health care professionals are not regarded [to have] objective advice. This situation must change. It is time for the profession to accommodate the possibility that many nutritional products may have valuable therapeutic effects" [61].     

Zoonotic Disease Surveillance – Inventory of Systems Integrating Human and Animal Disease Information

Although 65% of recent major disease outbreaks throughout the world have a zoonotic origin, there is still a sharp division among the disciplines into the human and animal health sectors. In the last few decades, a global integrative concept, often referred to as ‘One Health’, has been strongly endorsed. Surveillance and monitoring efforts are major components for effective disease prevention and control. As human health and animal health are inextricably linked, it is assumed that a cross‐sectoral data interpretation of zoonotic disease information will improve their prevention, prediction and control. To provide an overview of existing systems throughout the world which integrate information from humans and animals on zoonotic diseases, a literature review was conducted. Twenty projects were identified and described regarding their concepts and realization. They all vary widely depending on their surveillance purpose, their structure and the source of information they use. What they have in common is that they quite often use data which have already been collected for another purpose. Therefore, the challenges of how to make use of such secondary data are of great interest.     

In vitro comparison of the effects of two forms of hydroxyethyl starch solutions on platelet function in dogs

OBJECTIVE: To evaluate the effect of 2 hydroxyethyl starch (HES) preparations (ie, HES solution with a molecular weight of 600 kd and a degree of substitution of 0.7 [HES 600/0.7] and a calcium-containing polyionic HES solution with a molecular weight of 670 kd and a degree of substitution of 0.75 [HES 670/0.75]) on canine platelet function. SAMPLE POPULATION: Blood samples from 10 healthy adult dogs. PROCEDURES: Dilution of citrated whole blood was performed with saline (0.9% NaCl) solution, HES 600/0.7, and HES 670/0.75 at ratios of 1:9 (ie, 1 part saline solution or colloid to 9 parts whole blood) and 1:3. Measurements of time to platelet plug formation in a capillary tube (ie, closure time) were made by use of a bench-top platelet function analyzer with collagen and ADP platelet agonists. RESULTS: Mean baseline closure time was 68.0 +/- 15.3 seconds. A 1:3 dilution of whole blood with saline solution, HES 600/0.7, and HES 670/0.75 resulted in mean closure times of 85.8 +/- 15.7 seconds, 100.6 +/- 18.6 seconds, and 101.6 +/- 16.2 seconds, respectively. Closure time following 1:3 dilution of whole blood with saline solution was significantly different from baseline and from 1:9 dilution with saline solution. Closure time following 1:3 dilution of whole blood with HES 670/0.75 was significantly different from baseline, 1:3 and 1:9 dilutions with saline solution, and 1:9 dilutions with HES 600/0.7 or HES 670/0.75. CONCLUSIONS AND CLINICAL RELEVANCE: Saline solution, HES 600/0.7, and HES 670/0.75 affect canine platelet function by prolonging closure times; HES solutions prolonged closure time to a greater extent than saline solution.     

Antimicrobial drug use in veterinary medicine

Recognizing the importance of antimicrobial resistance and the need for veterinarians to aid in efforts for maintaining the usefulness of antimicrobial drugs in animals and humans, the Board of Regents of the American College of Veterinary Internal Medicine charged a special committee with responsibility for drafting this position statement regarding antimicrobial drug use in veterinary medicine. The Committee believes that veterinarians are obligated to balance the well-being of animals under their care with the protection of other animals and public health. Therefore, if an animal's medical condition can be reasonably expected to improve as a result of treatment with antimicrobial drugs, and the animal is under a veterinarian's care with an appropriate veterinarian-client-patient relationship, veterinarians have an obligation to offer antimicrobial treatment as a therapeutic option. Veterinarians also have an obligation to actively promote disease prevention efforts, to treat as conservatively as possible, and to explain the potential consequences associated with antimicrobial treatment to animal owners and managers, including the possibility of promoting selection of resistant bacteria. However, the consequences of losing usefulness of an antimicrobial drug that is used as a last resort in humans or animals with resistant bacterial infections might be unacceptable from a public or population health perspective. Veterinarians could therefore face the difficult choice of treating animals with a drug that is less likely to be successful, possibly resulting in prolonged or exacerbated morbidity, to protect the good of society. The Committee recommends that voluntary actions be taken by the veterinary profession to promote conservative use of antimicrobial drugs to minimize the potential adverse effects on animal or human health. The veterinary profession must work to educate all veterinarians about issues related to conservative antimicrobial drug use and antimicrobial resistance so that each individual is better able to balance ethical obligations regarding the perceived benefit to their patients versus the perceived risk to public health. Specific means by which the veterinary profession can promote stewardship of this valuable resource are presented and discussed in this document.     

Management and herd performance of dairy herds with and without chronic wasting disease

'Chronic wasting' in cattle acquired a special meaning in the Netherlands in 1999. It was used to define animal health problems that were thought to be associated with the use of bovine herpesvirus 1 marker vaccine. Criteria have not been set by which an objectively independent inventory of the problems could be made. The objective of this study was to determine management factors associated with the problem of 'chronic wasting' prior to the use of the BHV1 marker vaccine. Knowledge about these factors could be helpful for generating additional hypotheses about the aetiology of chronic wasting in cattle. A total of 188 farms participated in the study, of which 94 had severe problems with chronic wasting. The other half consisted of control farms matched with the case farms that did not report problems after the use of the BHV1 marker vaccine. Data analyses were performed over the period before (and not at the time of) 'chronic wasting' problems. Data were collected from various sources. A questionnaire was used to collect information on farm management practice. In addition, information on laboratory submissions for 1996 to 1998, animal movements in 1998, roughage analyses of 1997 and 1998, expenses for animal health in 1998, and herd performance in 1995 to 1999 was collected. In the analyses, a distinction was made between information obtained objectively and subjectively. Herds with problems of 'chronic wasting' were larger than herds without wasting problems (animals, surface) but not more intensively managed. 'Wasting' herds had a lower performance in terms of fertility and udder health. In addition, these herds had more contact with other herds through the purchase of animals. There were no differences in farm management practices related to disease control and prevention. Additional studies are required with regard to the patho-physiology of chronic wasting cows. The role of herd size needs more study.