Survey of academic veterinarians' clinical practice in cardiopulmonary–cerebral resuscitation

Objective: To document the clinical practice of cardiopulmonary–cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert‐style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision‐making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long‐term prognosis, then short‐term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.     

Cardiopulmonary resuscitation in small animal medicine: an update

In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may impact how CPCR is performed in veterinary medicine is the recommendation to avoid administration of excessive ventilatory rates because this maneuver severely decreases myocardial and cerebral perfusion, decreasing the chance of survival. The new guidelines also emphasize the importance of providing well-executed, continuous, uninterrupted chest compressions. Interruption of chest compressions should be avoided and, if necessary, should be minimized to <10 seconds. During defibrillation, immediate resumption of chest compressions for 2 minutes after a single shock, before reassessment of the rhythm by ECG, is recommended. This recommendation replaces previous recommendations for the delivery of 3 defibrillatory shocks in rapid succession. Allowing permissive hypothermia postresuscitation has been found to be beneficial and may increase success rate. Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed. The application of the new guidelines to veterinary medicine as well as a review of cardiopulmonary resuscitation in small animals is provided.     

Treating wounds in small animals with maggot debridement therapy: a survey of practitioners

Many small animals succumb to complications of serious wounds. Sometimes infection and sepsis overwhelm the animal; sometimes the costs of intensive care overwhelm the owner. Maggot therapy, a method of wound debridement using live fly larvae, could provide effective, simple, low cost wound care. All eight US veterinarians who had been provided with medicinal maggots were surveyed to determine if this treatment was being used for small animals, and for what indications. At least two dogs, four cats and one rabbit were treated with maggot therapy between 1997 and 2003. The most common indications for using maggot therapy were to effect debridement and control infection, especially if the wound failed to respond to conventional medical and/or surgical therapy. Practitioners reported the treatments as safe and often beneficial. Amputation and euthanasia may have been avoided. It is concluded that maggot therapy may have utility for small animals, and should be evaluated further.     

Overall welfare assessment of laying hens: Comparing science‐based,environment‐based and animal‐based assessments

To increase the validity of evaluations and facilitate expansion and maintenance of assessment systems, we constructed a database of studies on the welfare of laying hens around the world. On the basis of this database, we devised a science‐based welfare assessment model. Our model includes measurements, levels and weightings based on the scientific studies in the database, and can clarify the advantages and disadvantages of housing systems for laying hens from the viewpoint of the five freedoms. We also evaluated the usefulness of our model by comparing it with environment‐based Animal Needs Index (ANI), another science‐based model called FOWEL, and animal‐based measurements. Our model showed that freedom from injury, pain and disease, and freedom from discomfort were more secure in the cage system, while non‐cage systems scored better for natural behavior and freedom from fear and distress. A significant strong‐positive correlation was found between the animal‐based assessment and the total scores of ANI (rs = 0.94, P < 0.05), FOWEL (rs = 0.99, P < 0.05) or our model (rs = 0.99, P < 0.05), which indicate that these different approaches to welfare assessment may be used almost interchangeably to ‘measure’ a common property (‘overall laying hen welfare’). However, assessments using our model and FOWEL were more sensitive than ANI and can be applied to cage systems, which suggest that our model and FOWEL may have added value.