Survival Following Cardiopulmonary Resuscitation in Dogs and Cats

Dogs and cats receiving cardiopulmonary resuscitation (CPR) were evaluated for factors leading to cardiac arrest and for survival following the procedure. One-hundred-thirty-five canine and forty-three feline patients seen at the University of California, Davis Veterinary Medical Teaching Hospital that received CPR between August 1987 and December 1991 were studied. Initial resuscitation attempts were unsuccessful in 72% of dogs and 58% of cats. Five dogs and one cat were still alive 3 days after CPR. Ultimately only four dogs and one cat were discharged from the hospital alive. These five patients with uniquely longer survival all had cardiac arrests associated with drug and/or anesthetic reactions.     

Causes of cardiopulmonary arrest, resuscitation management, and functional outcome in dogs and cats surviving cardiopulmonary arrest

Objective: To describe the functional outcome of canine and feline survivors of cardiopulmonary arrest (CPA) and the clinical characteristics surrounding their resuscitation. Design: Retrospective study. Setting: Veterinary teaching hospital. Animals: Client‐owned dogs (15) and cats (3) with CPA. Interventions: None. Measurements and main results: Eighteen animals were identified to have survived to discharge following CPA. Cardiopulmonary arrest was associated with anesthesia with or without pre‐existing disease in 10 animals, cardiovascular collapse in 5 animals, and chronic disease with an imposed stress in 3 animals. All CPAs were witnessed in the hospital. The most common initial rhythm at CPA was asystole (72%). Return of spontaneous circulation (ROSC) was achieved in less than 15 minutes from the onset of cardiopulmonary cerebral resuscitation (CPCR) in all animals. No animals had a recurrence of CPA after the initial CPA. Animals were of a wide range of ages (0.5–16 years) and breeds. Two animals were neurologically abnormal at discharge, one of which was normal at 2 months following CPA. Conclusions: A good functional recovery after CPCR was documented in the small number of CPA survivors presented in this study. This may be due to the reversible nature of their inciting cause of CPA, early detections of CPA (‘witnessed’), and/or the animal's underlying normal health status.     

Indications for and outcome of positive-pressure ventilation in cats: 53 cases (1993-2002)

OBJECTIVE: To determine indications for and outcomes of positive-pressure ventilation (PPV) in cats, document ventilator management, and identify factors associated with outcome. DESIGN: Retrospective study. ANIMALS: 53 cats that underwent PPV. PROCEDURE: Information on signalment, history, concurrent diseases, clinical findings, results of venous blood gas analyses and clinicopathologic testing, treatment, ventilator settings, and outcome was retrieved from the medical records. Data for cats that survived were compared with data for cats that died or were euthanatized while undergoing PPV RESULTS: PPV was initiated for management of respiratory failure (36 cats [68%]), cardiac arrest (9 [17%]), neurologic impairment (6 [11%]), and nonresponsive hypotension (2 [4%]). Eight cats (15%) survived, 19 (36%) died, and 26 (49%) were euthanatized while undergoing PPV. Cats that survived had a longer duration of ventilation than did those that died or were euthanatized and had a significantly higher incidence of ventilator-associated pneumonia. Signalment and ventilator settings were not associated with outcome. Cats that had no clinical evidence of pulmonary disease but required PPV because of primary neurologic disease had a higher survival rate (2/6) than did cats that required PPV because of respiratory failure (5/36), cardiac arrest (1/9), or nonresponsive hypotension (0/2). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the survival rate for cats requiring PPV may be lower than reported survival rates for dogs. Death was attributable to progressive respiratory failure, non-responsive hypotension, kidney failure, or neurologic impairment.     

Indications, management, and outcome of long-term positive-pressure ventilation in dogs and cats: 148 cases (1990-2001)

OBJECTIVE: To determine outcome of positive-pressure ventilation (PPV) for 24 hours or longer and identify factors associated with successful weaning from PPV and survival to hospital discharge in dogs and cats. DESIGN: Retrospective case series. ANIMALS: 124 dogs and 24 cats that received PPV for 24 hours or longer. PROCEDURES: Medical records were reviewed for signalment, primary diagnosis, reason for initiating PPV, measures of oxygenation and ventilation before and during PPV, ventilator settings, complications, duration of PPV, and outcome. Animals were categorized into 1 of 3 groups on the basis of the reason for PPV. RESULTS: Group 1 patients received PPV for inadequate oxygenation (67 dogs and 6 cats), group 2 for inadequate ventilation (46 dogs and 16 cats), and group 3 for inadequate oxygenation and ventilation (11 dogs and 2 cats). Of the group 1 animals, 36% (26/73) were weaned from PPV and 22% (16/73) survived to hospital discharge. In group 2, 50% (31/62) were weaned from PPV and 39% (24/62) survived to hospital discharge. In group 3, 3 of 13 were weaned from PPV and 1 of 13 survived to hospital discharge. Likelihood of successful weaning and survival to hospital discharge were significantly higher for group 2 animals, and cats had a significantly lower likelihood of successful weaning from PPV, compared with dogs. Median duration of PPV was 48 hours (range, 24 to 356 hours) and was not associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that long-term PPV is practical and successful in dogs and cats.     

The prevalence of antibodies against Toxoplasma gondii among hospitalized animals and stray dogs.

Hospitalized animals and stray dogs were serologically tested for antibodies against Toxoplasma gondii. In addition, the data were examined for the possibility of toxoplasmosis infection being associated with the clinical diagnosis and with the discharge status (alive vs. dead). Among 1056 hospitalized animals, 17 (20%) of 86 cats, 112 (14%) of 804 dogs, 34 (26%) of 133 horses and 6 (18%) of 33 cattle had serological evidence of infection with T. gondii. Only 22 (6%) of 342 young (median age = one year) stray dogs were seropositive. The difference in antibody prevalence between hospitalized and stray dogs was thought to be due to age and dietary factors. Of 249 dogs grouped by clinical diagnosis, there was significantly (p less than 0.01) higher prevalence of seropositives among dogs with diseases of the kidney or with adrenocortical hyperfunction than among dogs hospitalized for other diseases. Of 19 dogs with diseases of the kidney and 12 with adrenocortical hyperfunction 37% and 42%, respectively, were seropositive.. There was higher risk of being discharged from the hospital dead among seropositive dogs, cattle and horses than among seronegative animals of the same species. The exception was cats, where of 69 seronegative cats 29% were dead at discharge and where of 17 seropositive cats 18% were dead at discharge. The possible effects of stress due to hospitalization need further research.     

Retrospective study of 28 cases of cholecystoduodenostomy performed using endoscopic gastrointestinal anastomosis stapling equipment

Medical records were reviewed of 24 dogs and four cats that underwent cholecystoduodenostomy to relieve extrahepatic biliary obstruction. These procedures had been performed using a 30-mm endoscopic gastrointestinal anastomosis stapler. At presentation, most animals had clinical signs of vomiting and anorexia, and total bilirubin was elevated in both dogs (n=21) and cats (n=4). Pancreatitis (n=13), cholangiohepatitis (n=7), and neoplasia (n=6) were the most common underlying conditions. Sixteen dogs and two cats survived to their 2-week reevaluation. The most common cause of death was euthanasia (n=9) secondary to neoplasia (n=4), peritonitis (n=3), or respiratory arrest (n=2).     

Evaluation of freshwater submersion in small animals: 28 cases (1996-2006)

OBJECTIVE: To determine clinical characteristics, treatments, and outcome in dogs and cats evaluated after submersion in freshwater. DESIGN: Retrospective case series. ANIMALS: 25 dogs and 3 cats. PROCEDURES: Medical records were reviewed for signalment; causes, location, and month of submersion; physical examination findings at admission; results of blood gas analysis; treatments administered; duration of hospitalization; and outcome, including evidence of organ failure or compromise. RESULTS: All submersions involved bodies of freshwater. Fourteen animals were submerged in man-made water sources, 13 were submerged in natural water sources, and the body of water was not recorded in 1 case. Twenty (71%) submersions occurred from May through September. Cause was identified in 16 animals and included extraordinary circumstances (n = 6), falling into water (5), breaking through ice (3), and intentional submersion (2). Twelve animals were found submerged in water with unclear surrounding circumstances. Treatment included administration of supplemental oxygen, antimicrobials, furosemide, corticosteroids, and aminophylline and assisted ventilation. Respiratory dysfunction was detected in 21 animals. Neurologic dysfunction was detected in 12 animals, hepatocellular compromise was detected in 6 animals, and cardiovascular dysfunction was detected in 4 animals. Three dogs had hematologic dysfunction, and 2 dogs had acute renal dysfunction. Eighteen (64%) animals survived to hospital discharge, but all of the cats died. In 9 of 10 nonsurvivors, respiratory tract failure was the cause of death or reason for euthanasia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that submersion is an uncommon reason for veterinary evaluation but is associated with a good prognosis in dogs in the absence of respiratory tract failure.     

Effects of nutritional support on hospital outcome in dogs and cats

Objective – Investigate the effects of assisted nutritional support on hospital outcome in dogs and cats, and the relationship between hospital outcome and energy intake, body condition score (BCS), physical status score, and type of nutritional support used. Design – Retrospective analysis of hospitalized animals. Setting – Teaching Veterinary Hospital. Animals – Four hundred and sixty‐seven dogs and 55 cats. Interventions – Routine clinical nutritional support. Measurements and Main Results – The following variables were recorded for each animal: energy intake, body weight at admission and discharge, BCS, physical status score, and type of nutritional support used. Disease severity was negatively associated with hospital outcome and energy intake (P=0.009). Energy intake was positively associated with hospital discharge (P<0.001). Outcome may be related to BCS, with discharge rates of 73% for animals with low BCS, and 84.7% for those at an ideal BCS or overweight (P=0.04). Sixty‐four percent of animals showed voluntary food intake (92.9% were discharged), 19.0% received enteral support (71.8% were discharged), 7.0% were forced fed (75.0% were discharged), 6.0% received parenteral support (61.9% were discharged), and 4.0% did not receive calories (38.4% were discharged), suggesting a possible relationship between the type of nutritional support, energy intake, and outcome (P=0.009). Conclusions – Energy supply, even if modest and close to resting energy requirements appears to be positively associated with hospital discharge. However, disease severity was the main negative factor on outcome and also had a negative effect on energy intake, making it difficult to separate the effects of both factors when interpreting hospital discharge. Thin animals with low BCS had greater mortality.     

Successful cardiopulmonary resuscitation and use of short-term mechanical ventilation following inadvertent ketamine overdose in a cat

Objective: To describe the clinical manifestations and successful outcome following an inadvertent overdose of ketamine to a cat. Case summary: A 4‐year‐old neutered male domestic shorthair cat was evaluated for a urethral obstruction. Because of an inadvertent miscalculation of ketamine, 20 times the intended dose was administered intravenously, which resulted in cardiopulmonary arrest. Cardiopulmonary‐cerebral resuscitation was successful, and short‐term mechanical ventilation, fluids and intensive monitoring were utilized to achieve full recovery and subsequent discharge of the animal. New or unique information provided: Ketamine is a common anesthetic agent used in cats that is considered to have a wide therapeutic index and minimal cardiopulmonary depressant effects at recommended doses. Successful management of inadvertent ketamine overdose has been reported in children, but not in cats. Prompt CPCR and short‐term mechanical ventilation may be necessary to treat a significant ketamine overdose. In cats, yohimbine may act as a partial antagonist of ketamine.     

Prevalence and factors associated with initial and subsequent shockable cardiac arrest rhythms and their association with patient outcomes in dogs and cats undergoing cardiopulmonary resuscitation: A RECOVER registry study

Objective

To report the prevalence of initial shockable cardiac arrest rhythms (I-SHKR), incidence of subsequent shockable cardiac arrest rhythms (S-SHKR), and factors associated with I-SHKRs and S-SHKRs and explore their association with return of spontaneous circulation (ROSC) rates in dogs and cats undergoing CPR.

Design

Multi-institutional prospective case series from 2016 to 2021, retrospectively analyzed.

Setting

Eight university and eight private practice veterinary hospitals.

Animals

A total of 457 dogs and 170 cats with recorded cardiac arrest rhythm and event outcome reported in the Reassessment Campaign on Veterinary Resuscitation CPR registry.

Measurements and Main Results

Logistic regression was used to evaluate association of animal, hospital, and arrest variables with I-SHKRs and S-SHKRs and with patient outcomes. Odds ratios (ORs) were generated, and significance was set at P < 0.05. Of 627 animals included, 28 (4%) had I-SHKRs. Odds for I-SHKRs were significantly higher in animals with a metabolic cause of arrest (OR 7.61) and that received lidocaine (OR 17.50) or amiodarone (OR 21.22) and significantly lower in animals experiencing arrest during daytime hours (OR 0.22), in the ICU (OR 0.27), in the emergency room (OR 0.13), and out of hospital (OR 0.18) and that received epinephrine (OR 0.19). Of 599 initial nonshockable rhythms, 74 (12%) developed S-SHKRs. Odds for S-SHKRs were significantly higher in animals with higher body weight (OR 1.03), hemorrhage (OR 2.85), or intracranial cause of arrest (OR 3.73) and that received epinephrine (OR 11.36) or lidocaine (OR 18.72) and significantly decreased in those arresting in ICU (OR 0.27), emergency room (OR 0.29), and out of hospital (OR 0.38). Overall, 171 (27%) animals achieved ROSC, 81 (13%) achieved sustained ROSC, and 15 (2%) survived. Neither I-SHKRs nor S-SHKRs were significantly associated with ROSC.

Conclusions

I-SHKRs and S-SHKRs occur infrequently in dogs and cats undergoing CPR and are not associated with increased ROSC rates.     

Survey and molecular characterization of Cryptosporidium and Giardia spp. in owned companion animal, dogs and cats, in Japan

Compared with other countries, surveys of these parasites have been rarely performed in companion animals of Japan in spite of their significance for public health. Here, we investigated pet dogs and cats in Japan for the first time, and genetically analyzed the isolates to evaluate the risk of zoonotic infections. Seventy-seven fecal samples were collected from privately owned dogs and 55 samples from owned cats in Osaka city, Japan. Cryptosporidium oocysts were identified in 3/77 dogs (3.9%) and 7/55 cats (12.7%), and Giardia infection in 2/77 dogs (2.6%) and 1/55 cats (1.8%). Amplification of the target regions for genotyping was successful, Cryptosporidium isolates in dogs and cats were identified as C. canis and C. felis, respectively, and those of Giardia in dogs and cats were G. intestinalis Assemblages D and F. The discharge period of the oocysts varied within 3-16 weeks and that of the cysts was 12 weeks. To date, zoonotic types of both parasites have been identified in other animals in Japan, and further large-scale studies are needed to determine the distribution of zoonotic genotypes in these animals, especially those closely associated with humans.     

卫氏与斯氏并殖吸虫在实验动物体内分布的比较观察

目的 比较两种主要对人体致病的肺吸虫在实验动物肺内与肺外（胸、腹腔）的分布，为临床诊断及药物治疗提供参考。方法 粪检肺吸虫卵阴性的猫犬分别经口感染卫氏并殖吸虫（P．W）与斯氏并殖吸虫（P．S）囊蚴，饲养3个月后粪检肺吸虫卵阳性时对犬、猫进行解剖，观察与统计内肺外虫数。结果 猫犬解剖所获得P．W与P．S成虫均以左、右肺下叶寄生成虫数最多，猫、犬感染P．W后检获肺外期与左、右肺的童虫数均无显著性差异（P〉0．05）。猫感染P．S后所检获肺外期童虫数与左、右肺的童虫数有显著性差异（P〈0．05），而犬感染P．S所检获肺外期童虫数与左、右肺的童虫数有高度显著性差异（P〈0．01）。猫感染P．W与P．S囊蚴后虫体平均回收率为41．84％，39．85％；犬感染P．w与P．S囊蚴后虫体平均回收率分别为47．44％，24．57％。经统计学处理猫感染两种虫体回收率显著高于犬（P〈0．05）。结论 两种肺吸虫在实验动物犬、猫肺部的分布均以左、右肺下叶寄生成虫数最多，猫犬感染P．S所检获的肺外期童虫数与检获左、右肺内的童虫数分别为有显著性差异（P〈0．05）与高度显著性差异（P〈0．01），猫感染虫体的回收率明显高于犬。     

The Effect of Resuscitation Technique and Pre-Arrest State of Oxygenation on Blood–Gas Values during Cardiopulmonary Resuscitation in Dogs

Large mongrel dogs were anesthetized, instrumented, and subjected to electrically induced ventricular fibrillation after breathing either 100% oxygen (O2) or 10% O2 and 90% nitrogen for 10 minutes before arrest. Four minutes after arrest, open chest cardiopulmonary resuscitation (CPR) or intermittent abdominal compression closed chest CPR was initiated and continued for 20 minutes, at which time defibrillation was attempted. Central arterial and mixed venous blood samples were collected serially for the measurement of pH, carbon dioxide partial pressure (PCO2), and O2 partial pressure (PO2), and calculation of bicarbonate concentration and base excess. Mixed venous blood was collected serially for the measurement of lactate concentration. Hemodynamically variable resuscitation techniques and pre-arrest hypoxia or hyperoxia did not significantly influence blood-gas values during CPR. Mixed venous lactate concentrations after 20 minutes of CPR were significantly higher when hypoxia preceded the arrest and when intermittent abdominal compression closed chest CPR was used for resuscitation. Mixed venous PCO2 was significantly higher than arterial PCO2 in all dogs during CPR but was not significantly different before arrest.     

Epidemiologic factors, clinical findings, and vaccination status of rabies in cats and dogs in the United States in 1988. National Study Group on Rabies

Despite the availability of rabies vaccination through private veterinarians and government-sponsored rabies control programs, rabies was reported in an average of 338 cats and dogs per year from 1980 through 1987 in the United States. Information was collected on 90% of the 183 cats and 97% of the 119 dogs that were reported to have rabies in the continental United States in 1988. The median age of rabid cats and dogs was 1 year, and 81% were from rural areas. Compared with rabid cats, rabid dogs were more likely to have been male (66 vs 42%, odds ratio = 2.6), to have been kept as pets (84 vs 43%, odds ratio = 6.8), and to have had reported contact with wildlife before onset of illness (38 vs 14%, odds ratio = 3.8). Rabid cats accounted for a greater proportion of human rabies postexposure prophylaxis, bites to people, and exposures to other animals than did rabid dogs. Although the clinical signs of rabies varied, rabid cats were more likely than dogs to have had aggressive behavior (55 vs 31%, odds ratio = 2.8). In contrast, rabid dogs were more likely than cats to have had an illness consistent with a paralytic process. The median period between onset of illness and death was 3 days (range, less than 1 to 10) in rabid cats and dogs that were allowed to die of rabies. Vaccine failures were documented in 3 (1%) rabid animals (2 cats and 1 dog). All animals had received only a single dose of vaccine in their lifetime and were vaccinated when they were between 3 and 6 months old.     

Clinicopathologic features of an unusual outbreak of cryptococcosis in dogs, cats, ferrets, and a bird: 38 cases (January to July 2003)

OBJECTIVE: To determine clinical and pathologic findings associated with an outbreak of cryptococcosis in an unusual geographic location (British Columbia, Canada). DESIGN: Retrospective study. ANIMALS: 1 pink-fronted cockatoo, 2 ferrets, 20 cats, and 15 dogs. PROCEDURE: A presumptive diagnosis of cryptococcosis was made on the basis of serologic, histopathologic, or cytologic findings, and a definitive diagnosis was made on the basis of culture or immunohistochemical staining. RESULTS: No breed or sex predilections were detected in affected dogs or cats. Eleven cats had neurologic signs, 7 had skin lesions, and 5 had respiratory tract signs. None of 17 cats tested serologically for FeLV yielded positive results; 1 of 17 cats yielded positive results for FIV (western blot). Nine of 15 dogs had neurologic signs, 2 had periorbital swellings, and only 3 had respiratory tract signs initially. Microbiologic culture in 15 cases yielded 2 isolates of Cryptococcus neoformans var grubii (serotype A) and 13 isolates of C. neoformans var gattii (serotype B); all organisms were susceptible to amphotericin B and ketoconazole. Serologic testing had sensitivity of 92% and specificity of 98%. CONCLUSIONS AND CLINICAL RELEVANCE: Serologic titers were beneficial in identifying infection in animals with nonspecific signs, but routine serum biochemical or hematologic parameters were of little value in diagnosis. Most animals had nonspecific CNS signs and represented a diagnostic challenge. Animals that travel to or live in this region and have nonspecific malaise or unusual neurologic signs should be evaluated for cryptococcosis.     

Isolation of Microsporum canis from the hair coat of pet dogs and cats belonging to owners diagnosed with M. canis tinea corporis

Microsporum canis has been frequently isolated from human cases of tinea capitis and tinea corporis. The infection may be acquired from infected animals with cutaneous lesions but also from asymptomatic carriers or from the environment. As asymptomatic M. canis carriers are considered to be a critical factor in the epidemiology of dermatophytosis in humans, this study investigated the relationship between the presence of dermatophytes on the hair coats of dogs and cats without cutaneous lesions and the occurrence of the disease in their respective owners. A total of 136 dogs and 248 cats were sampled from January 1999 to January 2005. Seventy-eight animals (22 dogs and 56 cats) belonged to individuals affected by tinea corporis caused by M. canis and 306 (114 dogs and 192 cats) to individuals without dermatophytosis. Age, sex, breed, habitat and season were recorded for each animal and examined as potential risk factors. Dermatophytes were isolated from 20.5% of the dogs and 28.2% of the cats. Microsporum canis was isolated from 36.4% of dogs cohabiting with owners diagnosed with tinea corporis but it was never isolated from dogs whose owners had no lesions. By contrast, M. canis was isolated from 53.6% of cats cohabiting with owners diagnosed with tinea corporis and from 14.6% of cats whose owners had no signs of the disease. These results clearly indicate that both cats and dogs should be considered as a major source of pathogenic dermatophytes for humans even when they do not present clinical signs of dermatophytosis.     

Postoperative use of analgesics in dogs and cats by Canadian veterinarians.

Four hundred and seventeen Canadian veterinarians were surveyed to determine their postoperative use of analgesics in dogs and cats following 6 surgical procedures, and to determine their opinions toward pain perception and perceived complications associated with the postoperative use of potent opioid analgesics. Three hundred and seventeen (76%) returned the questionnaire. The percentage of animals receiving analgesics postoperatively ranged from 84% of dogs and 70% of cats following orthopedic surgery to 10% of dogs and 9% of cats following castration. In general, with the exception of orthopedic surgery, roughly equal percentages of dogs and cats received postoperative analgesics. Opioids were used almost exclusively to provide postoperative analgesia, with butorphanol the most commonly administered drug to both dogs and cats. Analgesics were usually administered either once or twice postoperatively. With regard to the administration of potent opioid agonists, the 3 major concerns included respiratory depression, bradycardia, and sedation in dogs, and excitement, respiratory depression, and bradycardia in cats. Seventy-seven percent of veterinarians considered their knowledge of issues related to the recognition and control of postoperative pain to be inadequate. Experience in practice is currently the major source of knowledge, with undergraduate veterinary school and research articles in journals ranked as the least important sources. Lectures or seminars delivered at the regional level were the preferred format for continuing education.     

Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax

Chylothorax is a devastating disease, and the success rates from either medical or surgical management are less than satisfactory. In some animals with chylothorax, a thickening of the pericardium occurs that is associated with chronic irritation induced by chyle. We hypothesized that pericardial thickening would lead to increased right-sided venous pressures and that abnormal venous pressures would act to impede the drainage of chyle via lymphaticovenous communications after thoracic duct (TD) ligation. We also hypothesized that serosanguineous effusions that occurred after TD ligation could effectively be treated or prevented by pericardectomy in affected animals. TD ligation plus pericardectomy was performed in 17 animals, and pericardectomy alone was performed in an additional 3 animals that presented during a 5.5-year period to the Texas A&M University (College Station, TX). Nineteen animals presented for an evaluation of idiopathic chylothorax (9 dogs and 10 cats), and 1 dog presented for serosanguineous pleural fluid after TD ligation that had been performed elsewhere. Echocardiography was normal in all animals, except for a subjectively thickened pericardium in 7 cats and 6 dogs. Clinical signs of pleural fluid accumulation resolved in 10 of 10 dogs and in 8 of 10 cats after surgery. The overall success rate for the surgical treatment of chylothorax (ie, the resolution of pleural fluid accumulation) in this study was 90% (100% in dogs and 80% in cats). These data suggest that TD ligation in conjunction with pericardectomy has a favorable outcome in animals with idiopathic chylothorax.