Application of Airway Pressure Therapy in Veterinary Critical Care: Part I: Respiratory Mechanics and Hypoxemia

Over the past several decades, recognition of acute respiratory failure as the cause of death in patients suffering from various clinical conditions has prompted aggressiv investigation into the area of respiratory physiology and supportive respiratory care. With the evolution of emergency medicine and critical care services in both human and veterinary medicine, many patients previously considered unsalvageable due to the severity of their underlying disease are now being resuscitated and successfully supported, creating a new population of critically ill patients. Where only a decade ago these patients would have succumbed to their underlying disease, they now survive long enough to manifest the complications of shock and tissue injury in the form of acute respiratory failure. Investigation into the pathophysiology and treatment of this acute respiratory distress syndrom (ARDS) has facilitated increased clinical application of respiratory theerapy and machanical ventilation.¹ The purpose of this paper is to provide a basic review of respiratory mechanics and the pathophysiology of hypoxemia as they relate to airway pressure therapy in veterinary patients and to review the use of airway pressure therapy in veterinary patients This paper is divided into two parts; part I reviews respiratory mechanics and hypoxemia as they apply to respiratory therapy, while part II deals specifically with airway pressure therapy andits use in clinical cases.     

Essential Fatty Acids and the Cat

Abstract— The physiology of essential fatty acid metabolism in the cat is reviewed. Emphasis is placed on those aspects of the n:6 and n:3 fatty acids, their metabolites and interactions, which relate primarily to the skin. The functional roles, if known, of the fatty acids are discussed. Recent clinical research into the use of essential fatty acid supplements in the management of feline dermatoses is presented. Current indications for the therapeutic supplementation with essential fatty acids are summarised.     

An Epidemiologic and Economic Study of Respiratory Diseases in Two Conventional Danish Swine Herds. I: Prevalence of Respiratory Lesions at Slaughter and Their Effects on Growth

A total of 578 slaughter pigs from 2 Danish conventional farrow-to-finish operations (Herds A and B) were followed from an age of 14 days to slaughter. Pigs were weighed at 3 weeks intervals and at slaughter and an extended post mortem examination of the plucks was done. Comparison of growth rates in pigs with and without specific types of lesions by the t-test and those with multiple lesions with regression models demonstrated that Mycoplasma-like pneumonia, complicated pneumonia, anterio-ventral pleuritis, fissures and atrophic rhinitis significantly reduced mean daily gain and increased the time required to reach slaughter weight. The total impact of the lesions in Herd A was an estimated reduction in mean daily gain of 27 grams and a 2 day increase in the interval from 14 days of age until slaughter (MDG14). Decreases in MDG14 in Herd B were more substantial, 98 grams and 16.7 days. Reductions in mean daily gains during the interval from the fourth weighing until slaughter were 31 grams in Herd A and 137 grams in Herd B. Chronic dorso-caudal and parietal pleuritis, without other lesions present, had no significant adverse effects on growth rates in either herd. Interactions between lesions did not significantly alter the estimates. The R² values obtained for the regression models showed that the presence, absence or extent of lesions at slaughter explained only 13-27% of the variations in growth rates in the 2 herds.     

Quantitative analysis of canine plasma lipoproteins

A combined ultracentrifugationl/precipitation method for the measurement of lipoprotein cholesterol concentrations was developed and validated for use with canine plasma. Very low density lipoproteins (VLDL) were isolated by flotation ultracentrifugation and low density lipoproteins (LDL) separated from high density lipoproteins (HDL) by precipitation with heparin-manganese chloride. Effective separation of these classes was confirmed by agarose gel electrophoresis of native lipoproteins and by sodium dodecyl sulphate polyacrylamide gel electrophoresis of their apolipoprotein distributions. There was trace contamination of the LDL precipitate with HDL, but this represented less than 4 and 9 per cent of the total plasma HDL in normo- and hypercholesterolaemic dogs, respectively. The intra-assay and interassay coefficients of variation for LDL- and HDL-cholesterol concentrations were between 3·3 and 6·9 per cent, and 7·2 and 9·0 per cent, respectively, for plasma cholesterol concentrations between 2·67 and 8·14 mmoll/litre. The intra-assay coefficient of variation for VLDL-cholesterol was 53·8 and 18·4 per cent at plasma cholesterol concentrations of 2·67 and 8·14 mmol/litre, respectively. The interassay coefficient of variation for VLDL was 22·5 per cent. Storage of plasma at -20°C for between two and eight weeks did not affect VLDL-cholesterol concentrations, but led to an increase in LDL-cholesterol and a decrease in HDL-cholesterol concentrations of approximately 10 per cent. The method described is appropriate for the measurement of lipoprotein concentrations in plasma from normo- and hypercholesterolaemic dogs, but samples should not be subjected to prolonged storage before analysis.     

Epidemiological study of enzootic pneumonia in dairy calves in Saskatchewan.

A field study involving 325 calves from 17 dairy herds in Saskatchewan was conducted to determine the risk of enzootic pneumonia and to assess its association with a number of factors. Two different case definitions of pneumonia were used in the analyses: the first was based on producers' treatment risk (CASE1) and the second was based on semimonthly clinical examinations of calves by the research veterinarian (CASE2). The risk of pneumonia based on CASE1 was 39% and on CASE2 was 29%. The measure of agreement between CASE1 and CASE2 at the calf level of analysis was poor (kappa = 0.24, SE = 0.02) and at the herd level of analysis was moderate (kappa = 0.40, SE = 0.12). The mortality risk from pneumonia was 1.8% and a variety of infectious organisms were isolated from pneumonic lungs. Twenty-seven percent of the calves had inadequate (total IgG < or = 800 mg/dL) levels of passively acquired antibodies as measured by radial immunodiffusion. The proportion of seropositive titers in calves within the first two weeks of age was 94% to parainfluenza 3 virus (PI3V) and bovine respiratory syncytial virus (BRSV), 73% to Pasteurella haemolytica (Ph), 68% to bovine viral diarrhea virus (BVDV), 67% to infectious bovine rhinotracheitis virus (IBRV), 46% to Mycoplasma dispar (Md), 44% to Haemophilus somnus (Hs), and 21% to Mycoplasma bovis (Mb). At the calf level of analysis and after adjusting for clustering, there was a negative association (p = 0.10) between the diagnosis of pneumonia based on CASE2 and total IgG levels and Ph titers (rPh).(ABSTRACT TRUNCATED AT 250 WORDS)     

Application of Airway Pressure Therapy in Veterinary Critical Care: Part II: Airway Pressure Therapy

As the specialties of emergency medicine and critical care have grown and evolved in both human and veterinary medicine, so has the need for more advanced care of patients with primary lung disease. Treatment of acute respiratory failure has been the focus of several articles in the human medical literature of the past few years.^1,8 This paper deals with airway pressure therapy and its application in cases of acute respiratory failure in veterinary medicine. The reader is referred to part I of this paper for a reveiw of respiratory mechanics and hypoxemia as they apply to respiratory therapy.     

Corneocyte Counts for Evaluation of Antiseborrheic Shampoos in Dogs

Abstract— An objective method for measuring corneocyte numbers before and after antiseborrheic shampoo therapy was assessed in dogs. Corneocytes were collected from six skin regions on the dorsal trunk of nine colony-raised beagles with clinically normal skin. Forty-eight collection sites were randomly assigned a treatment with one of seven medicated shampoos or water alone; six additional sites served as non-treated controls. Corneocytes were collected immediately before the first treatment, and 14 and 28 days after initiation of therapy with a 0.1% Tween 80 surfactant and a quantitative cup-scrub technique. Pretreatment corneocyte counts were not significantly different among the nine dogs nor among the randomly assigned treatment and control sites (3.55 · 10⁴ cells.cm^-2, SEM 0.17). Corneocyte counts increased in all treatment and control sites from days 0 to 14. Corneocyte counts were similar in the non-treated and water-treated sites from days 14 to 28. Corneocyte counts were not significantly different when the same treatments were compared on days 0, 14 and 28, or when different treatments were compared on the same day. The corneocyte collection technique used in this study proved to be a reliable method for assessing the rate of cell desquamation and cell surface cohesion in dogs.