Retrospective evaluation of the use of small-bore wire-guided catheters for the management of peritoneal effusion in cats and dogs

Objective

To describe the use of small-bore wire-guided catheters in the management of peritoneal effusion in cats and dogs and to detail any associated adverse events.

Design

Retrospective study.

Setting

University teaching hospital

Animals

Forty-five client-owned animals that had peritoneal catheters placed for management of peritoneal effusion between July 2010 and June 2021.

Interventions

None.

Measurements and Main Results

Forty-five cases were included (25 dogs and 20 cats). Twenty-eight animals had the catheter placed to aid management of a uroabdomen, 8 of which recovered without surgical management, 11 had the catheter placed to allow autotransfusion of hemoabdomen, 3 had peritonitis, and 3 had ascites secondary to cardiac disease. Twenty-seven cases (15 dogs and 12 cats) received sedation (n = 24) or local anesthesia alone (n = 3) to facilitate catheter placement, and 6 cases had the catheter placed while under general anesthesia. Median length of catheter persistence was 24 hours (range: 2–144 h). The most common adverse events reported were impaired drainage (n = 7) and leakage at the insertion site (n = 4).

Conclusions

Peritoneal catheters can be inserted percutaneously for management of peritoneal effusion. Indications include stabilization and conservative management of uroabdomen, and autotransfusion. They can often be placed with minimal or no sedation and adverse events appear infrequent in occurrence.     

Parenteral Anticholinergics in Dogs With Normal and Elevated Intraocular Pressure

Dogs given parenteral anticholinergic drugs have been thought to be at risk for development or exacerbation of elevated intraocular pressure (IOP). In a randomized, blinded, placebo-controlled study, we evaluated the effect of intramuscular glycopyrrolate (0.01 mg/kg) on pupil diameter and IOP in unanesthetized normal dogs. Treatment with glycopyrrolate did not change pupil diameter or IOP from baseline, nor were there differences between glycopyrrolate and saline-treated (control) dogs. In addition, the authors retrospectively reviewed the medical records of 2,828 dogs undergoing general anesthesia between April 1987 and September 1990 to determine if there was an association between parenteral anticholinergic medication and postanesthetic elevation in IOP. The authors also determined the frequency of bradycardia requiring anticholinergic therapy during anesthesia in dogs with glaucoma. Of the 2,828 cases reviewed, the records of 46 dogs coded for glaucoma were examined in detail. The 46 dogs underwent 62 episodes of anesthesia, with 23 episodes including exposure to an anticholinergic drug. An increase in IOP from preanesthetic to postanesthetic measurement occurred in three dogs. One of these dogs received anticholinergic medication for bradycardia during anesthesia. The postanesthetic elevation in IOP in this dog was probably not drug related. Preanesthetic anticholinergic administration did not affect the incidence of anticholinergic administration for bradycardia during the anesthetic episode. Anticholinergic therapy during anesthesia was more frequent when the preanesthetic medication included an opiate drug. These studies do not indicate an association between parenteral anticholinergic administration and elevations in IOP.     

Age, Tibial Plateau Angle, Sex, and Weight as Risk Factors for Contralateral Rupture of the Cranial Cruciate Ligament in Labradors

Objective— To compare rates of contralateral cranial cruciate ligament rupture (CCLR) in Labradors based on age and weight at initial rupture, sex, and tibial plateau angle (TPA) and to determine whether Labradors that rupture their initial cranial cruciate ligament (CCL) at an earlier age (<4 years) are more likely to rupture their contralateral side within a certain period of time. Study Design— Case series. Animals— Labradors (n=94) that had tibial plateau leveling osteotomy (TPLO). Methods— Two groups: no contralateral rupture (NR) and contralateral rupture (CR) were compared for significant (P<.05) differences in percentage of subsequent cruciate tears using a Wilcoxon's rank‐sum tests for continuous variables and Fisher's exact test for sex. Adjusted odds ratios for likelihood of subsequent cruciate tears (yes/no) were estimated using logistic regression. Associations of these characteristics with time to subsequent rupture were assessed using Kaplan–Meier survival analysis estimation. Predictors of presentation with bilateral ruptures (BR) versus single rupture were also evaluated using Wilcoxon's rank‐sum tests and a generalized Fisher's exact test. Results— Subsequent CCLR occurred in 45 dogs (48%), and BR on admission were identified in 10 dogs (10.6%). Comparing NR and CR dogs, there were no significant differences between age or weight at initial rupture, sex or TPA; however there were associations toward longer time to CR for dogs older than the median age and female dogs (intact and spayed). There were no significant differences in age, sex, weight, or TPA of dogs with bilateral CCL ruptures compared with initial unilateral ruptures; however, there was a trend toward dogs presenting at an older age and with lower TPA's in the BR group. Among the 84 NR/CR dogs, the median time to rupture of the contralateral CCL was 5.5 months (95% CI 5.2–5.7). Conclusions— Age and weight at initial rupture, sex, and TPA does not affect likelihood or rate of contralateral CCL rupture or presentation with bilateral CCL ruptures. Clinical Relevance— Approximately 50% of Labradors will rupture the contralateral CCL within 5.5 months of the initial rupture but age, weight, sex, and TPA cannot be used as predictive features.     

Use of continuous renal replacement therapy for treatment of dogs and cats with acute or acute-on-chronic renal failure: 33 cases (2002–2006)

Objective: To describe the indications, clinical features, outcomes and complications associated with use of continuous renal replacement therapy (CRRT) in 17 client-owned dogs and 16 client-owned cats with acute or acute-on-chronic renal failure refractory to aggressive medical management.
Series summary: Twenty-nine percent of dogs and 44% of cats had evidence of pre-existing chronic kidney disease (CKD). Median duration of CRRT was 16.3 hours (range 0.3–83.0 hours) in dogs and 11.5 hours (range 1.0–35.5 hours) in cats. Median canine blood urea nitrogen (BUN) improved from 41.0 mmol/L (115.0 mg/dL) to 11.8 mmol/L (33.0 mg/dL) and creatinine from 636.5 mmol/L (7.2 mg/dL) to 274 mmol/L (3.1 mg/dL). Median feline BUN improved from 46.4 mmol/L (130 mg/dL) to 13.9 mmol/L (39.0 mg/dL) and creatinine from 1069.6 mmol/L (12.1 mg/dL) to 291.7 mmol/L (3.3 mg/dL). Metabolic acidosis resolved in 80% of affected dogs and 71% of affected cats. Hyperkalemia resolved in 100% of affected dogs and 88% of affected cats. Complications noted with CRRT included iatrogenic hypokalemia, iatrogenic metabolic alkalosis, clinical hypocalcemia, total hypercalcemia, filter clotting, anemia, hypothermia, and neurologic complications. Forty-one percent of dogs and 44% of cats survived to discharge. No dogs and only 1 cat developed newly diagnosed CKD.
New or unique information provided: CRRT can be a viable option for the management of acute or acute-on-chronic renal failure in dogs and cats that are refractory to aggressive medical management. The frequency of complications associated with CRRT in this study warrants further experience with this modality before its widespread use can be recommended.