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.     

USE OF 123IODINE METAIODOBENZYLGUANIDINE SCINTIGRAPHY FOR THE DIAGNOSIS OF A PHEOCHROMOCYTOMA IN A DOG

A 13-year-old neutered female Yorkshire terrier presented with a history of progressive episodic weakness and disorientation of 4 months duration. Physical and neurologic examinations were normal at presentation. Abdominal ultrasound revealed a mass involving the right adrenal gland. Standard planar scintigraphy was performed at 4, 18, and 24 hours after intravenous injection 185 MBq (5mCi) of ¹²³I-labeled metaiodobenzylguanidine (¹²³I-MIBG). An area of focal intense uptake was identified in the area of the right adrenal gland. A pheochromocytoma was confirmed histologically after surgical excision.     

The ACVD task force on canine atopic dermatitis (VI): IgE-induced immediate and late-phase reactions, two inflammatory sequences at sites of intradermal allergen injections.

Intradermal testing is a common diagnostic procedure used in the evaluation of dogs with suspected atopic dermatitis (AD). To do this, most investigators assess the appearance of wheals that develop at the sites of intradermal allergen injections. However, wheals are rarely seen in dogs with naturally occurring AD. Furthermore, infiltration of inflammatory cells into the injection sites can occur 6-24h later, a phenomenon known as the late-phase reaction. The histological appearance of these late-phase reactions closely approximates that seen in the natural disease, suggesting that they might be more relevant than the immediate reactions. In this paper, we review the literature on immediate and late-phase reactions and re-assess the evidence for using current intradermal testing procedures as a diagnostic test in dogs.     

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.     

Compatible measurements of volumetric soil water content using a neutron probe and Diviner 2000 after field calibration

Field calibrations for a neutron probe and a capacitance sensor (Diviner 2000) for measuring the soil water content of a shrinking–swelling clay soil were substantially different from commonly used default values. Using our field calibrations, the two instruments estimated similar changes in the cumulative water content of a soil profile (0–1 m depth) over one growing season.     

Enhancement of resistance of lambs to Haemonchus contortus by previous infection with Ostertagia circumcincta

Two experiments were performed to determine whether previous infection of young lambs with Ostertagia circumcincta increased their resistance to the development of Haemonchus contortus and to explore alterations in the microenvironment of the abomasum related to the interaction. The parasitic infections were monitored with periodic fecal egg counts and by recovery and enumeration of parasites at necropsy of the lambs. Alteration of the microenvironment was examined by measurement of serum gastrin concentrations at critical times during both experiments. The results indicated that the numbers of H contortus were significantly (P less than 0.05) less in lambs which had O circumcincta infections before their exposure to H contortus. There was less reduction in lambs from which O circumcincta was removed (anthelmintic therapy) before their exposure to H contortus. Fecal egg counts also were significantly (P less than 0.05) less in the former group of lambs (exposed to both parasites) than those in lambs exposed only to H contortus. Serum gastrin values were significantly (P less than 0.05) increased in lambs infected with O circumcincta and indicated that the interaction observed could be due, in part, to alteration of abomasal pH.     

Effects of stable dust on farm animals--a review

The relationship between air quality--its dust content--and respiratory diseases of animals in the food industry and otherwise is examined. The correlation between dust content and incidence of disease in farm animals is also discussed. Lesions caused either directly or indirectly by dust-transported microorganisms are reviewed. Effects of dust on animal performance are included. This review is an attempt to compile available information on the natural occurrence of stable dust and the possibilities for its measurement and control.     

Hematological parameters and visceral lesions relationships in rabbit viral hemorrhagic disease.

Twenty rabbits were inoculated with a suspension of Viral Hemorrhagic Disease virus. Hemostatic functions were assessed every sixth hour from 6 to 60 hours post-inoculation. Tissue samples obtained at the same intervals allowed the study of the development of lesions throughout the experiment. Biological signs of Disseminated Intravascular Coagulation (DIC) were detected on and after 30 h post-inoculation and consisted of prolonged One Stage Prothrombin Time and Activated Partial Thrombin Time, the decrease of factors V, VII, and X and high levels of soluble fibrin monomer complexes and D-dimers. A reduction of thrombocyte numbers, heterophils and lymphocytes was associated. The close association of DIC and necrotizing hepatitis lesions suggested the hepatic lesions to be the most important DIC triggering factor. Other mechanisms are discussed.     

Alkaline phosphatase isoenzymes in feline serum using an agarose gel alkaline phosphatase kit method.

Total serum alkaline phosphatase (ALP) activity is the product of the combined activity of isoenzymes from a number of tissue sources. In this study, a commercially available kit for electrophoretic separation of ALP isoenzymes in an agarose gel was used to separate ALP isoenzymes in feline tissue extracts and serum. Five separate bands of ALP activity were identified. These bands were numbered 1 to 5 with band 1 having the most anodal migration. The tissue of origin corresponding to the migration position of the isoenzymes are as follows: Band 3 was the liver isoenzyme, band 4 was the bone isoenzyme and ALP isoenzymes of both intestine and kidney migrate in the position labelled band 5. Band 1 appears to be related to albumin and does not represent true ALP activity. The tissue source of band 2 (a and b) was not identified. Serum ALP activity of mature, healthy cats is primarily of liver origin. Immature cats (< 1 year of age) have a greater proportion of the bone isoenzyme in the serum.     

Dietary selenate versus selenite for cattle, sheep, and horses.

Food and Drug Administration regulations currently permit addition of .3 mg of Se per kilogram of diet for chickens, turkeys, ducks, swine, sheep, and cattle. However, field reports indicate that this level may not be adequate for ruminants in all situations. Because sodium selenite is the most common supplemental form and is known to be readily absorbed to particles or reduced to insoluble elemental Se or selenides in acid, anaerobic environments, studies were conducted with dairy cattle, sheep, and horses fed sodium selenate to determine whether Se from this source was more bioavailable than Se from sodium selenite. A 2-wk period of no Se supplementation was followed by 49 or 56 d of Se supplementation at .3 mg/kg of dietary DM. Serum Se concentrations and glutathione peroxidase (GSHPx) activities measured initially and periodically thereafter revealed no difference between Se forms in sheep and horses and only a small (P less than .05) advantage for selenate in supporting serum Se concentration in dairy cattle. Selenium concentrations in skeletal muscle and liver of sheep were not different between Se forms. Serum Se, but not GSHPx, increased with time, and .3 mg of supplemental Se per kilogram of dietary DM from either sodium selenate or sodium selenite supported normal serum Se concentrations in sheep, dairy cattle, and horses.