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BOOK
Emergency and Critical Care, An Issue of Veterinary Clinics of North America: Equine Practice, E-Book
(2014)
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Book Details
Abstract
Drs. Diana Hassel and Vanessa Cook have put together an expert team of authors focused on emergency and critical care topics. Articles include: Field Triage of the Neonatal Foal, CPR in the neonatal foal: has RECOVER changed our approach?, Update on the management of neonatal sepsis, SIRS or endotoxemia?, Ultrasound of the equine acute abdomen, Evaluation of the colic: Decision for referral, The utility of lactate in critically ill adults and neonates, Crystalloid and colloid therapy, Acute hemorrhage and blood transfusions, Coagulopathies, and more!
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Emergency andCritical Care | i | ||
Copyright | ii | ||
Contributors | iii | ||
Contents | vii | ||
Veterinary Clinics Of North America: Equine Practice | xi | ||
Preface | xiii | ||
Field Triage of the Neonatal Foal | 283 | ||
Key points | 283 | ||
Introduction | 283 | ||
Physical examination of the newborn foal | 283 | ||
Dysphagia/Loss of Suckle/Milk Regurgitation | 285 | ||
Triage of the weak neonatal foal | 286 | ||
Sepsis | 286 | ||
PAS | 286 | ||
Prematurity/Dysmaturity | 287 | ||
Specific Treatment of Sepsis | 287 | ||
Specific Treatment of PAS | 287 | ||
Specific Treatment of Prematurity | 288 | ||
General therapy for the weak recumbent foal | 288 | ||
Nutrition Support | 288 | ||
Partial parenteral nutrition | 289 | ||
Enteral feeds | 289 | ||
FPT | 290 | ||
IV Fluid Support of the Foal | 290 | ||
Maintenance fluid therapy | 290 | ||
Supportive Care | 291 | ||
Respiratory Support | 291 | ||
Other common disorders of the neonate | 292 | ||
Neonatal Isoerythrolysis | 292 | ||
Disorders of the Lungs | 292 | ||
Pneumonia | 292 | ||
Treatment | 292 | ||
Apneustic breathing | 293 | ||
CPR in the Neonatal Foal | 301 | ||
Key points | 301 | ||
What is RECOVER? | 301 | ||
Causes for CPA in equine neonates | 302 | ||
CPR training and team dynamics | 302 | ||
Preparation | 303 | ||
CPR—basic and advanced life support | 303 | ||
Basic life support | 303 | ||
What to Do | 304 | ||
Patient Positioning | 304 | ||
Ventilation | 304 | ||
RECOVER Recommendations for Ventilation | 305 | ||
Thoracic Compressions | 305 | ||
RECOVER Recommendations | 305 | ||
Recommendation | 306 | ||
Advanced life support | 306 | ||
Vasopressor and Vagolytic Therapy | 306 | ||
Epinephrine dose | 306 | ||
Vasopressin Versus Epinephrine | 307 | ||
Atropine | 307 | ||
Defibrillation | 307 | ||
Defibrillation Technique | 307 | ||
Antiarrhythmic Drug Therapy | 307 | ||
Electrolyte Therapy | 308 | ||
Other Therapies | 308 | ||
Intratracheal Drug Administration | 308 | ||
Open Chest CPR | 308 | ||
Monitoring | 309 | ||
Monitoring Patients During CPA | 309 | ||
When to Stop | 310 | ||
Post–cardiac arrest care | 310 | ||
Resuscitation at the time of foaling | 311 | ||
Summary | 311 | ||
References | 312 | ||
Update on the Management of Neonatal Sepsis in Horses | 317 | ||
Key points | 317 | ||
Introduction | 317 | ||
The septic neonatal foal | 318 | ||
Management strategies in neonatal sepsis | 321 | ||
Infection Control | 322 | ||
Antimicrobials | 322 | ||
Plasma therapy | 322 | ||
Hemodynamic Support | 324 | ||
Fluid therapy | 324 | ||
Vasoactive agents | 325 | ||
Respiratory support | 326 | ||
Antimediator Therapy | 327 | ||
Supportive therapy | 329 | ||
Tight Glucose Control | 330 | ||
Corticosteroid Replacement Therapy | 330 | ||
Summary | 332 | ||
References | 333 | ||
Is it the Systemic Inflammatory Response Syndrome or Endotoxemia in Horses with Colic? | 337 | ||
Key points | 337 | ||
Introduction | 337 | ||
SIRS | 338 | ||
The innate immune system | 339 | ||
Pattern-recognition receptors and their role in equine SIRS | 339 | ||
TLR4 and its interactions with LPS | 340 | ||
Signaling pathways initiated by TLR4 activation | 340 | ||
Other equine TLRs and their PAMPs | 341 | ||
Mediators released via TLR activation and their physiologic effects | 343 | ||
Differences in responses of equine cells to TLR activation | 344 | ||
Responses of Equine TLR4 to LPS | 344 | ||
Agonist/Antagonist LPS Responses | 344 | ||
Equine-Specific Cellular Responses to Flagellin | 345 | ||
The focus on endotoxemia | 345 | ||
Detection of LPS | 347 | ||
SIRS or endotoxemia? | 347 | ||
Treatment | 347 | ||
Current Treatment Approach | 347 | ||
Caution Regarding Extrapolating Future Treatments to Horses | 348 | ||
References | 348 | ||
Ultrasound of the Equine Acute Abdomen | 353 | ||
Key points | 353 | ||
Introduction and clinical indications | 353 | ||
Technique and Equipment | 354 | ||
Patient preparation | 355 | ||
Transducers and ultrasound machines | 355 | ||
Scanning technique | 355 | ||
Limited examination | 355 | ||
FLASH technique | 355 | ||
Full examination | 356 | ||
Machine settings | 356 | ||
Examiner experience and diagnostic complexity | 356 | ||
Normal Ultrasonographic Anatomy of the Equine Abdomen | 356 | ||
Left abdomen | 357 | ||
Right abdomen | 357 | ||
Ventrum | 358 | ||
Gastric Abnormalities | 359 | ||
Small Intestinal Abnormalities | 360 | ||
Small intestinal strangulating obstructions | 360 | ||
Intussusception | 360 | ||
Proximal enteritis | 361 | ||
Other small intestinal lesions | 362 | ||
Duodenal abnormalities | 362 | ||
Large Intestinal Abnormalities | 363 | ||
Left dorsal displacement | 363 | ||
Right dorsal displacement | 364 | ||
Colon torsion | 365 | ||
Colitis | 366 | ||
Intussusception | 366 | ||
Sand/Enteroliths | 367 | ||
Peritoneal Fluid | 367 | ||
Masses, Neoplasia, and Abscessation | 370 | ||
Abdominal neoplasia | 370 | ||
Abdominal abscessation | 371 | ||
Other | 373 | ||
Urolithiasis | 373 | ||
Cholelithiasis | 374 | ||
Thoracic and cardiac causes of colic | 376 | ||
Pleuritis | 376 | ||
Pericarditis | 376 | ||
Aortic root disease | 376 | ||
Diaphragmatic hernia | 377 | ||
References | 378 | ||
Evaluation of the Colic in Horses | 383 | ||
Key points | 383 | ||
Introduction: nature of the problem | 383 | ||
Patient history and signalment | 384 | ||
Physical examination | 385 | ||
Pain Assessment and General Appearance | 387 | ||
Heart Rate | 387 | ||
Temperature | 388 | ||
Gastrointestinal Motility | 388 | ||
Rectal Palpation | 388 | ||
Presence of Gastric Reflux | 389 | ||
Imaging and additional testing | 390 | ||
Transabdominal Ultrasound | 390 | ||
Abdominocentesis | 391 | ||
Lactate | 393 | ||
Glucose | 394 | ||
Summary | 395 | ||
References | 395 | ||
Blood Lactate Measurement and Interpretation in Critically Ill Equine Adults and Neonates | 399 | ||
Key points | 399 | ||
Introduction | 399 | ||
Measuring lactate concentrations | 400 | ||
Lactate metabolism in the healthy animal | 401 | ||
Lactate metabolism in disease | 402 | ||
Increased Na+/K+–Adenosine Triphosphatase Activity in Response to Inflammatory Mediators | 402 | ||
Inhibition of PDH | 403 | ||
Lactate Production by Leukocytes | 403 | ||
Decreased Hepatic Clearance | 403 | ||
Other Potential Causes of Hyperlactatemia | 404 | ||
Source of Lactate During Disease | 404 | ||
Interpretation of blood lactate concentrations in critically ill horses | 404 | ||
Lactate Measurement and Interpretation in Adult Horses | 405 | ||
Lactate Measurement and Interpretation in Equine Neonates | 406 | ||
Limitations in the Clinical Use of Blood Lactate Concentrations | 408 | ||
Summary | 409 | ||
References | 409 | ||
Crystalloid and Colloid Therapy | 415 | ||
Key points | 415 | ||
Hyperchloremia | 416 | ||
Colloid research revisited | 417 | ||
The No-Absorption Rule | 417 | ||
Retraction of Studies Supporting Colloid Use | 418 | ||
Remaining Evidence Addressing Colloid Use | 418 | ||
Fluid overload | 419 | ||
Treatment of Fluid Overload | 420 | ||
The basic components of a fluid therapy plan | 421 | ||
Are Intravenous Fluids Indicated? | 421 | ||
Type of Fluid | 422 | ||
Initial Resuscitation Fluid | 422 | ||
Rate of Fluid Administration | 422 | ||
End Points to Fluid Administration | 422 | ||
References | 423 | ||
Acute Hemorrhage and Blood Transfusions in Horses | 427 | ||
Key points | 427 | ||
Introduction | 427 | ||
Acute hemorrhage | 427 | ||
Recognizing Acute Hemorrhage in the Horse | 427 | ||
Physiologic Hemostasis and Medical Management | 428 | ||
Surgical and Topical Hemostasis | 429 | ||
Blood transfusion | 430 | ||
Criteria for Transfusion | 430 | ||
Blood Products | 430 | ||
Blood Donors and Pretransfusion Testing | 431 | ||
Blood Collection and Storage | 431 | ||
Transfusion Volume and Technique | 433 | ||
Adverse Effects | 433 | ||
Alternative Sources of Blood | 434 | ||
Summary | 434 | ||
References | 434 | ||
Coagulopathies in Horses | 437 | ||
Key points | 437 | ||
Introduction | 437 | ||
Nature of the Problem | 437 | ||
Definitions | 437 | ||
Normal hemostasis | 437 | ||
Coagulopathy | 439 | ||
Clinical findings | 440 | ||
Physical Examination | 440 | ||
Excessive bleeding | 440 | ||
Excessive thrombosis | 440 | ||
DIC | 440 | ||
Underlying Disease | 441 | ||
Diagnostics | 441 | ||
Clinical Pathology | 441 | ||
Other Tests | 441 | ||
Decision Algorithms | 444 | ||
Treatment options | 445 | ||
For Excessive Bleeding | 445 | ||
For Excessive Thrombosis | 445 | ||
References | 449 | ||
Trauma and Wound Management | 453 | ||
Key points | 453 | ||
Introduction | 453 | ||
Classification of wounding potential | 454 | ||
Impact energy | 454 | ||
Bullet design | 456 | ||
Tissues involved | 457 | ||
Bullet wound classification system | 458 | ||
Energy | 458 | ||
Vital structures involved | 459 | ||
Wound | 459 | ||
Fractures | 459 | ||
Contamination | 459 | ||
Treatment of bullet wounds | 460 | ||
Head, neck, and spine injuries | 461 | ||
Thoracic wounds | 462 | ||
Abdominal wounds | 463 | ||
Soft tissue injuries and musculoskeletal trauma | 463 | ||
Legal considerations | 464 | ||
Acknowledgments | 465 | ||
References | 465 | ||
Infection Control in Equine Critical Care Settings | 467 | ||
Key points | 467 | ||
Importance of infection control in the critical care setting | 467 | ||
General infection control concepts | 468 | ||
Challenges of infection control in the critical care setting | 469 | ||
Risks Associated with Caretaker-Patient Contacts | 469 | ||
Risks Associated with Intravenous Catheterization | 470 | ||
Special Considerations When Managing Critically Ill Foals | 470 | ||
Risks associated with managing critical care patients | 470 | ||
What Are the Risks? | 470 | ||
Specific Agents of Concern | 471 | ||
Eliminating Environmental Persistence of Potential Pathogens | 471 | ||
Summary | 472 | ||
References | 472 | ||
Index | 475 |