Library of Articles

Fearful Dog and Cat

Medication for the Anxious, Fearful Dog and Cat Jill Sackman, DVM, PhD, DACVS Transporting and handling a fearful and anxious dog or cat in a veterinary practice can be challenging. It has been reported that nearly 80% of dogs that visit veterinary practices for examination exhibit signs of anxiety or fear (Doring, et al 2009). Fearful dogs and cats resist restraint and may display signs of aggression when handled. Although fear-based aggression in dogs and cats is not uncommon, one negative visit has the impact of making every subsequent visit even worse! Acepromazine is a dissociative agent; it inhibits logical environmental assessment. Often referred to as “ace,” acepromazine is routinely used to sedate fearful or aggressive dogs. Research has shown that acepromazine functions primarily as a chemical restraint without affecting the animal’s emotional behavior. However, while under the influence of “ace,” animals still have strong anxiety, avoidance or arousal responses, but they either don’t display these reactions, or they are delayed in reacting. The dog may appear calm but is still having an intense emotional reaction. Fear may intensify to a level in which it overrides the physiological sedative effects of “ace”; the animal seems ‘out of it,’ but the

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Blood Gases – Arterial

Arterial Blood Gas – Why don’t we do them more often? Jennifer Waldrop, DVM, DACVECC – Washington Myth 1: It’s too hard to obtain the sample. Arterial blood gases may seem hard to acquire but actually are no harder in medium to large dogs than sampling a vein. Because the artery has a thicker muscular wall, it is can be slightly more difficult to pierce, but by using your finger to anchor the artery, you can make it easier. The most common place to try is the dorsal pedal artery on the medial aspect of the metatarsus. Another common location is the femoral artery or the lingual artery if under anesthesia. The femoral artery must be held off manually for 5 minutes after sampling. When you have a large dog under anesthesia, use this time to practice feeling an artery and even trying to obtain a sample in more controlled circumstances.                 Myth 2: It’s too hard to handle the sample. Arterial samples are handled the same way as venous with a few exceptions. Do not agitate an arterial sample as it can falsely elevate your oxygen content. You do not need to

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Acute Abdomen: Clinical Approach

Acute Abdomen: Clinical Approach Adam R. Lancaster, DVM, DACVECC A patient with an acute abdomen can typically be identified by the presence of acute abdominal pain. Other signs such as vomiting and diarrhea may also be present. General causes of abdominal pain include distention of a hollow viscus or organ capsule, ischemia, traction and inflammation. Any of these causes may progress to necrosis and loss of organ function. There are numerous causes of acute abdominal pain including intestinal obstruction, septic peritonitis, hemoabdomen, pancreatitis, uroabdomen, gallbladder disease or rupture, GDV and ileus. This is not an exhaustive list but rather some of the more common causes. Once a patient has been identified as having acute abdominal pain, a primary survey of the patient should be completed. At this point, it is important to recognize and treat shock and other concurrent injuries quickly. Following initial stabilization, a thorough diagnostic evaluation should be performed to identify the underlying cause of the abdominal pain. A full physical examination should be performed and a careful and detailed abdominal palpation may occasionally locate the specific area of pain, such as a loop of intestine, the prostate, kidney or an abdominal mass. Frequently a specific area cannot

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Anesthesia – Managing Complications

Anesthetic Management of Commonly Encountered Complications Elizabeth Goudie-DeAngelis, DVM, MS The anesthetic plan was carefully formulated specifically for your patient. You took into account underlying pathologies and the procedure you are performing. The induction went well, but now that your patient is under general anesthesia you are encountering complications. Chances are your patient has hypotension, hypothermia, hypoventilation or a combination of the three. The best way to keep your procedures moving forward and your patient stable is to know how to predict, prevent and treat these three common anesthetic complications. Hypotension We do not have a way to easily, non-invasively, or accurately measure perfusion (the oxygenation of tissues at the capillary level), so in combination with hemoglobin saturation, we use blood pressure to make an approximation of tissue perfusion. Hypotension is defined as a systolic arterial blood pressure (SAP) under 90 mmHg. Ideally, we attempt to keep this number between 90 – 110 mmHg under general anesthesia because an SAP greater than 90 mmHg correlates to a mean arterial blood pressure (MAP) of 60 mmHg. The MAP is the number we are concerned with. With a MAP in the range of 60-120 mmHg the capillary beds of the kidneys and

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Analgesia – Pain Management

Indications for Local Analgesia Vicki L. Campbell, DVM, DACVECC, DACVAA (UT) Local analgesia is an underused technique that can greatly enhance the overall analgesia in a patient; lead to use of less systemic drugs; and may be used in situations in which sedation, heavy systemic analgesia or anesthesia is contraindicated. Many animals that present to emergency are in shock, and those that are not in decompensated shock may be in compensated shock. Those in compensated shock are able to compensate because their sympathetic nervous system is maintaining their blood pressure and helping to maintain their oxygen delivery. In the intensive care unit, critically ill animals are dynamic with potentially minute-to-minute changes in cardiac output, blood pressure and oxygen delivery. Almost all sedatives, analgesics and anesthetics blunt the sympathetic nervous system to some extent. This effect puts animals in the emergency department and critical care unit at risk for decompensation when receiving systemic drugs for analgesia, sedation or anesthesia. Local analgesic techniques may aid in decreasing systemic drug requirements in these patients. Although shock patients in general are at risk for systemic decompensation with systemic sedatives and anesthetics, there are specific conditions in which these drugs should be particularly avoided or

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