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Critical Care

Sepsis

Sepsis is a life-threatening syndrome that occurs when inflammatory substances produced by the body to help fight infection overwhelm the body’s ability to maintain normal body function. This inflammation can potentially lead to a chain of events that damages internal organs and results in organ failure. Septic shock occurs when sepsis leads to significant decreases in blood pressure which is usually difficult to treat.

Common diseases which may lead to sepsis include pneumonia, kidney infections (pyelonephritis), uterine infections (pyometra), perforation of the gastrointestinal tract with leakage of intestinal contents, viral infections (e.g., parvovirus) and severe trauma or wounds due to dog/cat bites.

Based on the pet’s history and exam, diagnostic testing may include bloodwork, urinalysis, infectious disease testing and imaging (ultrasound and radiographs). Cultures of urine, bodily fluids and/or blood may also be performed.

Antibiotics and fluid therapy are important first-line treatments for sepsis. Surgery may also be indicated to help control the source of infection. In severe cases and in septic shock, medications to help maintain blood pressure are required.

Respiratory Distress

Respiratory disease and labored breathing are frequently seen by the critical care service. We commonly manage respiratory diseases such as pneumonia, feline asthma, pulmonary edema (fluid in the lungs), pulmonary contusions, pneumothorax (air outside of lungs in the chest cavity) and pleural effusion (fluid in the chest cavity).

A diagnostic plan is determined based on the pet’s history and physical exam findings. Typical testing may include bloodwork, arterial blood gas evaluation, evaluation of airway samples via tracheal wash, aspirates of chest fluid, radiographs, ultrasound and CT scans. We’ll also collaborate with the Internal Medicine department for tests such as bronchoscopy.

Treatment plans are tailored to each patient’s disease process. Oxygen therapy is available for all patients if needed by way of an oxygen cage or nasal oxygen administration.

Blood Transfusions

Transfusions are commonly indicated for a variety of disease processes. We stock packed red blood cells and fresh frozen plasma for dogs and cats. Packed red blood cells are a concentrated solution of red blood cells used to treat acute and chronic anemias and blood loss. Plasma is typically used to correct some types of bleeding disorders and occasionally to help support patients with low blood protein (albumin).

Dogs have multiple blood groups, but fortunately, they are not born with pre-formed antibodies against other blood groups. This means that dogs will rarely have an acute transfusion reaction with their first transfusion even if not cross-matched or typed.

Cats have three major blood types: A, B, AB. More than 90% of cats are Type A. Type B is considered uncommon and type AB is very rare. Unlike dogs, most cats have naturally occurring antibodies against other blood groups. Therefore, they must be blood typed, and in some cases crossmatched, prior to receiving a transfusion. Administration of an incompatible blood type may cause a severe, and possibly fatal, transfusion reaction. We only stock type A blood but can obtain type B blood from a blood bank within 24-72 hours when needed.

Common conditions where a packed red blood cell transfusion may be indicated:

  • Severe hemorrhage secondary to trauma, such as dog fight injuries and vehicular trauma
  • Internal hemorrhage secondary to ruptured tumors
  • Hemorrhage due to bleeding disorders, such as anticoagulant rodenticide toxicity
  • Immune-mediated hemolytic anemia
  • Bone marrow disease
  • Severe gastrointestinal bleeding, common with ulcers or immune-mediated disease

Common conditions where a fresh frozen plasma transfusion may be indicated:

  • Anticoagulant rodenticide toxicity
  • Disseminated intravascular coagulation (DIC)
  • Liver failure resulting in a bleeding disorder
  • Severe hypoalbuminemia