Development Of A Scoring System For The Veterinary Trauma Patient

An animal trauma triage (ATT) scoring system was devised to provide stratification of veterinary trauma patient populations based upon severity of injury. A retrospective population of 101 trauma patients and a prospective population of 88 patients were used to evaluate the predictive power of the ATT scoring system for survival seven days after initial presentation of the emergency service. In Both groups, the mean ATT score for survivors was significantly lower than the mean ATT score for non-survivors. In a logistic regression mode, the ATT score was found to be a significant predictor of the likelihood of survival seven days after initial presentation for both populartions. Each point increase in the ATT score resulted in a 2.3–2.6 times decreased likelihood of survival. The ATT scoring system is a useful objective classification scheme for predicting the likelihood to survive a traumatic incident and can serve as prototype for severity of injuroy scoring systems for the veterinary trauma patient.     

Failure mode and bending moment of canine pancarpal arthrodesis constructs stabilized with two different implant systems

Objective— To compare failure mode and bending moment of a canine pancarpal arthrodesis construct using either a 2.7 mm/3.5 mm hybrid dynamic compression plate (HDCP) or a 3.5 mm dynamic compression plate (DCP).
Study Design— Paired in vitro biomechanical testing of canine pancarpal arthrodesis constructs stabilized with either a 2.7/3.5 HDCP or 3.5 DCP.
Sample Population— Paired cadaveric canine antebrachii (n=5).
Methods— Pancarpal arthrodesis constructs were loaded to failure (point of maximum load) in 4-point bending using a materials-testing machine. Using this point of failure, bending moments were calculated from system variables for each construct and the 2 plating systems compared using a paired t-test. To examine the relationship between metacarpal diameter and screw diameter failure loads, linear regression was used and Pearson' correlation coefficient was calculated. Significance was set at P <.05.
Results— HDCP failed at higher loads than DCP for 9 of 10 constructs. The absolute difference in failure rates between the 2 plates was 0.552±0.182 N m, P =.0144 (95% confidence interval: −0.58 to 1.68). This is an 8.1% mean difference in bending strength. There was a significant linear correlation r=0.74 ( P -slope=.014) and 0.8 ( P -slope=.006) between metacarpal diameter and failure loads for the HDCP and 3.5 DCP, respectively.
Conclusion— There was a small but significant difference between bending moment at failure between 2.7/3.5 HDCP and 3.5 DCP constructs; however, the difference may not be clinically evident in all patients.
Clinical Relevance— The 2.7/3.5 HDCP has physical and mechanical properties making it a more desirable plate for pancarpal arthrodesis.     

Dog erythrocyte antigens 1.1, 1.2, 3, 4, 7, and Dal blood typing and cross‐matching by gel column technique

Background: Testing for canine blood types other than dog erythrocyte antigen 1.1 (DEA 1.1) is controversial and complicated by reagent availability and methodology. Objectives: The objectives of this study were to use available gel column technology to develop an extended blood‐typing method using polyclonal reagents for DEA 1.1, 1.2, 3, 4, 7, and Dal and to assess the use of gel columns for cross‐matching. Methods: Dogs (43–75) were typed for DEA 1.1, 1.2, 3, 4, 7, and Dal. Methods included tube agglutination (Tube) using polyclonal reagents, a commercially available DEA 1.1 gel column test kit (Standard‐Gel) using monoclonal reagent, and multiple gel columns (Extended‐Gel) using polyclonal reagents. Blood from 10 recipient and 15 donor dogs was typed as described above and cross‐matched using the gel column technique. Results: Of 43 dogs typed for DEA 1.1, 23, 25, and 20 dogs were positive using Standard‐Gel, Extended‐Gel, and Tube, respectively. Typing for DEA 1.2 was not achievable with Extended‐Gel. For 75 dogs typed for DEA 3, 4, and 7, concordance of Extended‐Gel with Tube was 94.7%, 100%, and 84%, respectively. Dal, determined only by Extended‐Gel, was positive for all dogs. Post‐transfusion major cross‐matches were incompatible in 10 of 14 pairings, but none were associated with demonstrable blood type incompatibilities. Conclusions: Gel column methodology can be adapted for use with polyclonal reagents for detecting DEA 1.1, 3, 4, 7, and Dal. Agglutination reactions are similar between Extended‐Gel and Tube, but are more easily interpreted with Extended‐Gel. When using gel columns for cross‐matching, incompatible blood cross‐matches can be detected following sensitization by transfusion, although in this study incompatibilities associated with any tested DEA or Dal antigens were not found.     

The Association of Propofol Usage With Postoperative Wound Infection Rate in Clean Wounds: A Retrospective Study

OBJECTIVE: To determine if the use of propofol influences the postoperative infection rate of clean surgical wounds in dogs and cats. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 863 dogs and cats undergoing clean surgical procedures. METHODS: Medical and anesthetic records of surgical cases used as part of a previously described epidemiologic study on postoperative wound infection rates were reviewed. The records of all animals with clean surgical wounds were reviewed to determine if propofol had been used for anesthetic induction or maintenance during the procedure. To determine the effect of propofol use on wound infection rate, data were analyzed using Fisher's exact test, followed by multiple logistic regression to adjust for various factors, including surgery time, time from clipping to surgery, antibiotic usage, coexisting distant infection, endocrine disease, and the use of immunosuppressive drugs in the perioperative period. RESULTS AND CONCLUSIONS: Of 863 dogs and cats with clean surgical wounds, 46 received propofol as part of the anesthetic protocol. A total of 6 of 46 animals (13%) receiving propofol developed postoperative wound infections, compared with 33 of 817 animals (4%) not receiving propofol (P = .014; % difference = 9%; 95% CI = 0.5% to 24%). Adjusting for all other factors evaluated, animals receiving propofol were 3.8 times more likely to develop postoperative wound infections compared to animals not given propofol (95% CI = 1.5-9.9). CLINICAL IMPLICATIONS: Propofol is a lipid-based emulsion capable of supporting microbial growth. Administration of a potentially contaminated solution may contribute to surgical wound infection or other patient morbidity or mortality. Strict aseptic technique in the preparation of the solution and prompt disposal of unused drug are imperative to curtail the potential for extrinsic contamination.     

COMPARISON OF ULTRASONOGRAPHIC AND RADIOGRAPHIC MEASUREMENTS OF CANINE PROSTATE DIMENSIONS

The purposes of this study were to: 1) compare prostatic dimensions measured on radiographic and ultrasonographic images and 2) compare a subjective radiographic assessment of prostate size with a previously-described objective method. Thirty-four male dogs undergoing investigation of prostatic disorders were used. Prostate length and depth were measured from ultrasonographic and radiographic images. A subjective assessment of prostate size ('small', 'normal', or 'enlarged') was made in 29 animals by one of the authors who was unaware of radiographic or ultrasonographic measurements. In addition, the distance from sacral promontory to the pubic brim was also measured. A prostate length or depth of >70% of this distance was defined as 'enlarged' and <70% as 'normal'. After the effects of magnification on radiographic measurements were eliminated, there were no significant differences between prostatic length measured by the two methods. However, a significant difference was obtained between prostatic depth measurements. The subjective assessment agreed with a previously described objective assessment of prostatic size in 21/29 dogs for prostate length but in only 12/29 for depth. Prostatic length varied from 46.6 to 116.4% (mean 75.7%) of the distance from the pubic brim to the sacral promontory. Prostatic depth varied from 33.0% to 94.6% (mean 59.7%) of the same distance. It is recommended that prostate length, rather than depth, be used when evaluating prostate size from lateral abdominal radiographs.     

Efficacy of two dichlorvos formulations against larval and adult Hyostrongylus rubidus in swine.

Coated (V-13) and uncoated (V-22) formulations of dichlorvos were used to treat experimentally established Hyostrongylus rubidus infections of pigs at intervals after exposure to infective larvae. Both dichlorvos formulations were efficacious against the adult stomach worm H rubidus, but showed little or no activity against 5- or 15-day-old worms. Neither formulation was as effective against H rubidus in sows as in barrows and gilts.     

Comparison of regular insulin infusion doses in critically ill diabetic cats: 29 cases (1999–2007)

Objective – To compare biochemical parameters, neurologic changes, length of hospital stay, and clinical improvement in 3 groups of cats with diabetic ketosis/diabetic ketoacidosis (DK/DKA) prescribed varied doses of regular insulin as a continuous rate of infusion (CRI). Design – Retrospective study. Setting – University teaching hospital. Animals – Twenty‐nine client‐owned cats with DK/DKA prescribed a regular insulin CRI. Interventions – Cats were grouped as follows: 7 cats each in Group 1 and 2, (prescribed 1.1 and 2.2 U/kg/d, respectively), and 15 cats in Group 3 (prescribed increasing doses as needed). Measurements and Main Results – None of the groups received the total prescribed dose of insulin. The mean actual dose administered/kg/d ranged from 0.30 (0.21) to 0.87 (0.32) U/kg/d in Groups 1, 2, and 3. There was no difference in mean minimum blood glucose (BG) per 4 hours or change in BG from baseline per 4 hours between Groups 1 and 2 (P=0.63, 0.50). There was no difference between groups regarding the time required to reach a BG ≤13.9 mmol/L (250 mg/dL), serum phosphorus or potassium concentrations relative to baseline values (P=0.53, 0.90), length of time until urine or serum ketones were no longer detected (P=0.73), the animal commenced eating (P=0.24), or length of hospital stay (P=0.63). Four of the cats had declining mentation during hospitalization; there were no relationships between osmolality at presentation, either prescribed or administered insulin dose, and mentation changes. Three of the 4 cats with declining mentation survived. Twenty‐seven of the 29 cats (93%) survived to discharge. Conclusions – In this study, prescribing the published canine dose (2.2 U/kg/d) of regular insulin to cats with DK/DKA does not appear to increase the frequency of adverse neurologic or biochemical sequelae compared with cats that are prescribed the published cat dose (1.1 U/kg/d). The use of a sliding scale for determination of infusion rates significantly reduces the amount of insulin cats receive in this setting. Determination of whether adverse sequelae would occur more frequently if cats with DK/DKA received the full insulin prescribed doses of 1.1, 2.2, or >2.2 U/kg/d is warranted. Further controlled studies are necessary to determine if higher doses of insulin are associated with beneficial effects on morbidity or mortality.