Lactate Kinetics in veterinary Critical Care: A Review

Elevation in blood lactate concentration, with or without accompanying metabolic acidosis, is a hallmark finding in patients with circulatory compromise, and is also consistently noted in other conditions affecting critically ill or injured individuals. Little is reported in a veterinary literature regarding lactate measurement in the emergency and critical care setting, despite impressive reports of the clinical usefulness of lactate measurement in people. The purpose of this article is to review lactate kinetics and the clinical utility of lactate measurement. Limitations to lactate evaluation will also be discussed.     

The Effect of Storage on Ammonia Concentration in Canine Packed Red Blood Cells.

Objective: To determine the effect of storage on ammonia concentration in canine packed red blood cell (pRBC) units.
Design: In vitro and in vivo study.
Setting: University Veterinary Teaching Hospital.
Interventions: Ammonia concentration was measured in 7 units of canine pRBC prepared in citrate-phosphate-dextrose (CPD) and Adsol^a on Days 1 and 35 of storage. Ammonia was measured in 4 additional units of canine pRBC on Days 0, 7, 14, 21, 28, and 35. Plasma ammonia was also determined in 5 anemic dogs receiving pRBC.
Measurements and Main Results: Ammonia concentration increased from 73 ± 15 mmol/L (mean ± SD) on Day 1 to 800 ± 275 mmpl/L on Day (p<0.001). When measured every 7 days in 4 units of canine pRBC, ammonia concentration increased from 23 ± 8 mmol/L on Day 0 to 179 ± 13 mmol/L (Day 7), 276 ± 56 mmol/L (Day 14). 383 ± 47 mmol/L (Day21), 466 ± 30 mmol/L (Day 28), and 562 ± 27 mmol/L (Day 35) (p<0.05 for all comparisons). In a preliminary study, plasma ammonia concentration measured in blood samples from 5 anemic dogs without primary liver disease immediately before and after transfusion with 5–10 ml/kg of stored pRBC remained in the normal reference range.
Conclusions: The ammonia concentration in stored canine pRBC increased markedly with time. In this preliminary study, ammonia concentrations in dogs without primary liver disease did not increase above the reference range after transfusion with pRBC.     

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.     

动物肥厚性心肌病--人类疾病理想模型

动物肥厚性心肌病的临床所见、心脏超声波图、肉眼组织病理、冠状小动脉变化、胶原纤维组织变化等 ,与人类肥厚性心肌病非常相似 ;遗传学分析 ,人类及猫肥厚性心肌病均为家族性常染色体显性遗传类型。动物肥厚性心肌病可为理想模型来研究人类疾病 ,而且动物肥厚性心肌病小冠状动脉病变与人类冠状动脉粥样化血管切除或皮下血管内腔扩张术后小冠状动脉再阻塞相同 ,可为人类疾病之模型。尤其猪心脏血行、生理及形态均与人类心脏相似 ,故猪肥厚性心肌病实为人类肥厚性心肌病研究之理想动物模型。     

EXCRETORY UROGRAPHY BY INTRAOSSEOUS INJECTION OF CONTRAST MEDIA IN A RABBIT MODEL

There are many indications for an intravenous excretory urogram. However, where intravenous access is not available, the intraosseous route to the circulation may be an alternative. We found that safe and diagnostic excretory urograms could be obtained in rabbits following the injection of different contrast media via the intraosseous route. In fact, these excretory urograms were indistinguishable from ones obtained by the conventional intravenous route. While the rabbits did not develop any abnormal clinical signs following the procedure, there were postmortem histologic lesions of osteochondrosis in 5 of 22 (22.7%) tibias receiving an intraosseous needle, but in none of the 14 tibias that did not receive an intraosseous needle. Further, the use of diatrizoate was associated with the development of osteochondrosis while the use of iopamidol was not.     

THE SCINTIGRAPHIC EVALUATION OF SOLID PHASE GASTRIC EMPTYING IN NORMAL CATS

The gastric emptying half-time of solid food in normal cats was determined using a scintigraphic technique. ^99mTc-sulfur colloid was applied to dry food. Sequential images were acquired post prandial, and the gastric emptying half-time was determined for several different acquisition and processing parameters. Good correlation was found between different acquisition and processing methods, some of which made use of edge detection applications, while others used different views, or number of views from which the gastric emptying half-time was calculated. The mean ± standard deviation, (range) and median of the gastric emptying half-time determined using the geometric mean of total counts in hand-drawn regions of interest from the lateral and ventral images were 2.47 × 0.71, (1.42–3.61) and 2.37 hours respectably.     

A Comparison of the Cutaneous Trunci Myocutaneous Flap and Latissimus Dorsi Myocutaneous Flap in the Dog

Latissimus dorsi and cutaneous trunci myocutaneous flaps of equal dimension and location were randomly elevated on opposite sides of the thorax in 10 dogs (group 1) and resutured to their respective bed. The procedure was repeated in four additional dogs (group 2); however, the short perforating branches of the thoracodorsal artery and vein were divided at the base of each cutaneous trunci myocutaneous flap, whereas the cutaneous pedicle and underlying cutaneous trunci muscle were divided in the latissimus dorsi myocutaneous flaps to determine subsequent skin survivability and the major source of circulation of each myocutaneous flap. There was little difference in the percentage of skin survival between the latissimus dorsi and cutaneous trunci myocutaneous flaps in group 1 dogs. Circulation to the "skin island" of group 2 latissimus dorsi myocutaneous flaps originated from intramuscular anastomotic connections between the major branch of the thoracodorsal artery entering the latissimus dorsi muscle and the proximal lateral intercostal arteries perforating the muscle. Ligation of the short perforating branches of the thoracodorsal artery resulted in partial skin necrosis in all group 2 cutaneous trunci myocutaneous flaps. Results from this study indicate that it is unnecessary to elevate the latissimus dorsi muscle for major skin flap elevation and survival. The thicker latissimus dorsi myocutaneous flap is more difficult to develop surgically and appears to have no clinical major advantage over the more mobile cutaneous trunci myocutaneous flap or the adjacent thoracodorsal axial pattern flap for closure of large skin defects within the radius of flap rotation.     

Indirect measurement of blood pressure as a guide to the efficacy of fluid therapy in equine shock: A case report

A case of acute circulatory failure in a horse is described. The response to intravenous fluid therapy was monitored by measurement of heart and respiratory rates, and arterial and central venous pressures. Heart rate was an unreliable guide to improved circulatory status. Central venous pressure and indirect arterial blood pressure were valuable guides to the efficacy of fluid therapy.