Vicki L. Campbell

Evaluation of open versus closed urine collection systems and development of nosocomial bacteriuria in dogs

OBJECTIVE To determine whether use of a closed urine collection system would decrease the incidence of nosocomial bacteriuria in hospitalized dogs, compared with use of an open urine collection system (used, sterile IV bags). DESIGN Randomized controlled trial. ANIMALS 51 hospitalized dogs requiring indwelling urinary catheterization for >or= 24 hours. PROCEDURES Dogs were randomly assigned to an open or closed urine collection system group. A standardized protocol for catheter placement and maintenance was followed for all dogs. A baseline urine sample was collected via cystocentesis for aerobic bacterial culture, with additional urine samples obtained daily from the urine collection reservoir. RESULTS 27 dogs were assigned to the open urine collection system group, and 24 were assigned to the closed urine collection system group. The incidence of nosocomial bacteriuria in dogs with open urine collection systems (3/27 [11.1%]) was not significantly different from incidence in dogs with closed urine collection systems (2/24 [8.3%]). Median duration of catheterization was 2 days for dogs in both groups; the range was 1 to 7 days for dogs in the open group and 1 to 5 days for dogs in the closed group. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that for dogs requiring short-term indwelling urinary catheterization, the type of urine collection system (open vs closed) was not associated with likelihood of developing nosocomial bacteriuria. Use of a strict protocol for urinary catheter placement and maintenance was likely key in the low incidence of nosocomial bacteriuria in the present study.

Comparison of continuous arterial pressure waveform analysis with the lithium dilution technique to monitor cardiac output in conscious dogs with systemic inflammatory response syndrome

OBJECTIVE To assess the agreement between cardiac output (CO) measured by use of arterial pressure waveform analysis (PulseCO) and lithium dilution (LiDCO) in conscious dogs with systemic inflammatory response syndrome (SIRS). ANIMALS 14 dogs with naturally occurring SIRS. PROCEDURES Pulse power analysis was performed on critically ill patients with a PulseCO monitor. All measurements were obtained with an indwelling arterial line and in accordance with the manufacturers instructions. Intermittent measurements of CO were obtained with the LiDCO method to validate the PulseCO measurements at initial calibration (baseline; time 0) and at 4, 8, 16, and 24 hours. The 2 methods for measuring CO were compared by use of Bland-Altman analysis. An error rate for the limits of agreement between the 2 methods of < 30% was defined as being acceptable. RESULTS Bland-Altman analysis did not indicate good agreement between measurements obtained by use of the PulseCO and LiDCO methods, despite no significant change in cardiac index (CI) over time as measured with the LiDCO method. The percentage error for the overall difference in CI values between the PulseCO and LiDCO measurements was 122%, which indicated that the PulseCO method was not an acceptable means of CO measurement when compared with the LiDCO method for this patient population. CONCLUSIONS AND CLINICAL RELEVANCE Agreement between the PulseCO and LiDCO methods for measurement of CO was not acceptable at 4- and 8-hour intervals after calibration in conscious dogs with naturally occurring SIRS.

Respiratory Complications in Critical Illness of Small Animals

The percentage of emergency patients with respiratory problems treated at veterinary emergency and critical care facilities is poorly defined. Regardless of whether an animal has a primary lung disease or develops a secondary lung disease during hospitalization, acute respiratory distress syndrome (ARDS) is a common sequela to the failing lung. ARDS is a frequent sequela to sepsis, systemic inflammatory response (SIRS), and disseminated intravascular coagulation and is frequently the pulmonary manifestation of multiple organ dysfunction syndrome (MODS). ARDS, acute lung injury, SIRS, sepsis, and MODS are serious syndromes with grave consequences. Understanding the pathophysiology and consequences of these syndromes is imperative to early recognition.

Comparison of tissue oxygen saturation in ovariohysterectomized dogs recovering on room air versus nasal oxygen insufflation

OBJECTIVE To compare tissue oxygen saturation in ovariohysterectomized dogs recovering postoperatively on room air versus nasal oxygen insufflation. DESIGN Prospective clinical study. SETTING University teaching hospital. ANIMALS Twenty dogs undergoing ovariohysterectomy. INTERVENTIONS Dogs were randomized to breathe either room air or 100 mL/kg/min of nasal oxygen insufflation for 2 hours postoperatively. Tissue oxygen saturation (StO(2)) was evaluated at 2 mm and 20 mm lateral to the surgical incision, as well as in the inguinal region using a noninvasive tissue oximeter. MEASUREMENTS AND MAIN RESULTS In dogs recovered on nasal oxygen insufflation (n = 10), tissue oxygen saturation was significantly higher--20 mm from the surgical site (88.44 ± 2.50%, P = 0.02) and in the inguinal region (83.56 ± 1.91%, P = 0.032)-- compared to dogs recovered on room air (n = 10, 79.11% ± 2.50 and 77.12% ± 1.91, respectively). CONCLUSIONS In ovariohysterectomized dogs, oxygen supplementation for 2 hours postoperatively improves tissue oxygen saturation 20 mm adjacent to the linea alba and in the inguinal region. Oxygen supplementation in postoperative dogs is an inexpensive and easily applicable method to improve tissue oxygen saturation.

Assessment of oxygen transport and utilization in dogs with naturally occurring sepsis

OBJECTIVE To compare cardiac index (CI), oxygen delivery index (D(O(2))I), oxygen extraction ratio (O(2)ER), oxygen consumption index (V(O(2))I), and systemic vascular resistance index (SVRI) in dogs with naturally occurring sepsis with published values for healthy dogs; compare those variables in dogs with sepsis that did or did not survive; and compare CI and D(O(2))I in dogs with sepsis with values in dogs with nonseptic systemic inflammatory response syndrome (nSIRS). DESIGN Cohort study. ANIMALS 10 dogs with naturally occurring sepsis and 11 dogs with nSIRS. PROCEDURES Over 24 hours, CI, D(O(2))I, O(2)ER, V(O(2))I, and SVRI were measured 4 and 5 times in dogs with sepsis and with nSIRS, respectively. The mean values of each variable in each group were compared over time and between groups; data for dogs with sepsis that did or did not survive were also compared. RESULTS Mean D(O(2))I was significantly decreased, and mean CI, O(2)ER, V(O(2))I, and SVRI were not significantly different in dogs with sepsis, compared with published values for healthy dogs. Mean CI and D(O(2))I in dogs with sepsis were significantly greater than values in dogs with nSIRS. Among dogs with sepsis that did or did not survive, values of CI, D(O(2)I), O(2)ER, V(O(2))I, and SVRI did not differ significantly. CONCLUSIONS AND CLINICAL RELEVANCE Compared with values in healthy dogs, only D(O(2))I was significantly lower in dogs with sepsis. Values of CI and D(O(2))I were significantly higher in dogs with sepsis than in dogs with nSIRS, suggesting differing degrees of myocardial dysfunction between these groups.

Use of a point-of-care urine drug test in a dog to assist in diagnosing barbiturate toxicosis secondary to ingestion of a euthanized carcass

OBJECTIVE To describe a case of barbiturate toxicosis in a dog secondary to ingestion of a previously buried euthanized goat carcass and to discuss the utility of urine drug testing in diagnosing barbiturate toxicosis. CASE SUMMARY A 6-year-old neutered male Border Collie was presented to a university veterinary teaching hospital for evaluation of ataxia and acute collapse. Past pertinent history included Addisons disease that had been managed for 1 year. A companion dog was seen 12 hours earlier chewing on the partially decomposed head of a goat that had been euthanized 47 days previously and buried on the owners property. The dog was laterally recumbent, unresponsive to stimuli, and hypothermic on physical examination. Initial blood work revealed hyponatremia and hyperkalemia, with a Na/K ratio of 18.5. The dog was volume resuscitated and received an injection of dexamethasone sodium phosphate due to a suspected Addisonian crisis. Despite this treatment, the dog remained laterally recumbent and unresponsive to stimuli. A urine drug screen was performed and was positive for barbiturates. A diagnosis of barbiturate toxicosis secondary to ingestion of a euthanized goat carcass was made. The dog was treated supportively over 12 hours with IV fluids and activated charcoal. The dog was able to walk 11 hours after presentation and was subsequently discharged from the hospital. NEW OR UNIQUE INFORMATION PROVIDED Urine drug testing is a fast, easy, and point-of-care test that may be useful in dogs to assist in the diagnosis of barbiturate intoxication. Proper disposal of euthanized animals is necessary to prevent toxicosis and possible death of companion animals and wildlife.

Comparison of axillary and rectal temperatures for healthy Beagles in a temperature- and humidity- controlled environment

OBJECTIVE To compare axillary and rectal temperature measurements obtained with a digital thermometer for Beagles in a temperature- and humidity-controlled environment. ANIMALS 26 healthy Beagles (17 sexually intact males and 9 sexually intact females). PROCEDURES Dogs were maintained in a temperature- and humidity-controlled environment for 56 days before rectal and axillary temperatures were measured. Axillary and rectal temperatures were obtained in triplicate for each dog by use of a single commercially available manufacturer-calibrated digital thermometer. RESULTS Mean rectal and axillary temperatures of Beagles maintained in a temperature- and humidity-controlled environment were significantly different, with a median ± SD difference of 1.4° ± 0.15°C (range, 0.7° to 2.1°C). Mean rectal and axillary temperatures were 38.7°C (range, 37.6° to 39.5°C) and 37.2°C (range, 36.6° to 38.3°C), respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated that the historical reference of a 0.55°C gradient between rectal and axillary temperatures that has been clinically used for veterinary patients was inaccurate for healthy Beagles in a temperature- and humidity-controlled environment. Rectal and axillary temperatures can be measured in veterinary patients. Reliable interpretation of axillary temperatures may accommodate patient comfort and reduce patient anxiety when serial measurement of temperatures is necessary. Further clinical studies will be needed.