Handbook of Canine and Feline Emergency Protocols

Maureen McMichael

• Publisher: Wiley-Blackwell
• Year: 2014
• eBook ISBN: 9781118558966
• Edition: 2
• Topic: Medicine
• Subtopic: Veterinary Medicine

Handbook of Canine and Feline Emergency Protocols, Second Edition offers practical step-by-step guidance to managing emergency cases in small animal practice. Presenting more than 165 complete protocols for triaging, stabilizing, and managing emergent patients, the book is designed for fast access in an emergency situation, with tabs to make it easy to flip to the relevant section. An ideal resource for veterinary practitioners seeking a quick reference for dog and cat emergencies, this Second Edition provides enhanced imaging information to increase the book's diagnostic usefulness and full updates throughout.

Logically organized alphabetically by category of emergency, the book includes useful chapters on procedures, shock, toxicology, and trauma in addition to a procedures chapter. Video clips, additional images, review questions, formula calculations, and quick reference guides are available on a companion website. Handbook of Canine and Feline Emergency Protocols, Second Edition provides a user-friendly daily reference for any small animal practitioner.

Chapter 1
Acute Abdomen

Maureen McMichael

ACUTE ABDOMEN DIFFERENTIAL DIAGNOSES

Gastrointestinal

1. Gastric dilatation +/− volvulus
2. Gastritis/enteritis/ulceration
3. Gastric/intestinal obstruction
4. Hemorrhagic gastroenteritis
5. Intestinal/mesenteric volvulus
6. Intussusception
7. Obstipation

Hepatic

1. Bile duct obstruction/rupture
2. Gallbladder rupture
3. Hepatic abscess
4. Hepatic neoplasia
5. Hepatitis/cholangiohepatitis
6. Hepatic lipidosis

Intervertebral Disc Disease

Occasionally dogs with back pain present with clinical signs that mimic abdominal pain

Pancreatitis

Peritonitis

Prostate

1. Prostatic abscess
2. Prostatitis

Renal

1. Acute renal failure
2. Pyelonephritis
3. Renal calculi
4. Ureteral obstruction

Reproductive

1. Dystocia
2. Metritis/pyometra
3. Orchitis/epididymitis
4. Uterine/testicular torsion

Splenic

1. Rupture/neoplasia
2. Torsion

Toxin

1. Arsenic
2. Lead
3. Zinc

Urinary

1. Bladder rupture
2. Urethral obstruction/rupture

HEMOABDOMEN

History

If chronic, (neoplasia) often has a history of lethargy with intermittent periods of improvement. Occasionally PU/PD, distended abdomen, and vomiting. If acute, (neoplasia, trauma, and coagulopathy) can present in shock.

Clinical Signs

Pale mucous membranes, tachycardia, may have systolic heart murmur (anemia), bounding or weak pulses, and palpable abdominal fluid wave. May be tachypneic, weak, depressed. Sudden loss of volume is not often reflected in HCT/TS. A normal HCT with slightly low TS is often encountered on presentation with the HCT dropping as fluid administration and redistribution of body fluid occurs.

Diagnostics

1. Minimally: MDB, abdominocentesis (PCV, cytology, fluid analysis).
2. 1^st Tier: PT or ACT or coagulation panel, CBC + retic count.
3. 2^nd Tier: Blood type and crossmatch, chem panel, CXR (metastasis check), AUS.

Treatment

1. Oxygen supplementation.
2. IV catheter (largest catheter possible for rapid replacement).
3. Administer isotonic crystalloid bolus:
   1. Dogs: 20 ml/kg (up to 90 ml/kg) and then reassess perfusion.
   2. Cats: 10 ml/kg (up to 45 ml/kg) and then reassess perfusion.
4. Synthetic colloids (HES):
   1. Dogs: 5 ml/kg bolus over 15–20 min and reassess perfusion. Give up to 20 ml/kg total.
   2. Cats: 2–5 ml/kg bolus over 20–30 min and reassess perfusion. Do not bolus colloids rapidly in cats.
   Blood:
   With clinical anemia (i.e., lethargy, tachycardia, and tachypnea) and normal albumin level, administer crossmatched pRBCs at 6–12 ml/kg over 1–4 h. With clinical anemia and hypoalbuminemia, administer crossmatched fresh whole blood at 10–20 ml/kg over 1–4 h or pRBCs and FFP.
   Coagulopathy:
   If prolonged PT this may be anticoagulant rodenticide. Although this rarely presents as hemoabdomen (more commonly presents as retroperitoneal bleed or hemothorax), it is most likely in young dogs with significantly prolonged PT. If ACT or aPTT is prolonged and the pet has signs of inflammatory disease, consider DIC. Plasma administration may be helpful to replace coagulation factors.
   Monitoring:
   End points of fluid/blood/colloid resuscitation are normalizing of HR, pulse quality, mentation, lactate, HCT/TS, CVP, and urine output.

Prognosis

Prognosis depends on the underlying disease. Prognosis is good for trauma that responds to fluid resuscitation (surgery may not be needed). May need surgical correction of lacerated vessel if not stabilized by transfusion/fluid therapy. Prognosis is guarded to poor for ruptured splenic or liver masses due to hemangiosarcoma. Prognosis guarded for ruptured adr...

Table of contents

• Cover
• About the companion website
• Title Page
• Copyright
• Dedication
• List of Contributors
• Acknowledgments
• Introduction
• Abbreviations
• Chapter 1: Acute Abdomen
• Chapter 2: Allergic Reactions
• Chapter 3: Cardiac Emergencies
• Chapter 4: Endocrine Emergencies
• Chapter 5: Gastrointestinal Emergencies
• Chapter 6: Hematologic Emergencies
• Chapter 7: Hepatic Emergencies
• Chapter 8: Infectious Disease
• Chapter 9: Neoplasia
• Chapter 10: Neurologic Emergencies
• Chapter 11: Ophthalmologic Emergencies
• Chapter 12: Pediatric and Neonatal Emergencies
• Chapter 13: Procedures and Protocols
• Chapter 14: Pulmonary/Respiratory Emergencies
• Chapter 15: Renal and Urinary Emergencies
• Chapter 16: Reproductive Emergencies
• Chapter 17: Shock and Sepsis
• Chapter 18: Toxicology
• Chapter 19: Trauma/Environmental Emergencies
• Index
• End User License Agreement