bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICAL AND LABORATORY FACTORS ASSOCIATED WITH PROGNOSIS IN IMHA CASES – A PROSPECTIVE STUDY
Authors: Davidow EB , Oncken A 
Published: September 2004

Because of the cost and complexity of treating immune‐mediated hemolytic anemia (IMHA) cases, it is important to find accurate prognostic factors. Most information to date has come from retrospective university studies with varying treatment protocols. To better identify prognostic indicators in cases diagnosed with IMHA, a prospective study with a standardized treatment protocol was undertaken. Diagnosis of IMHA was based on standard published criteria and effective rule out of other diseases. For each IMHA case admitted, historical, treatment and clinical data were documented during hospitalization. All discharged cases were followed for at least 3 months.Of 31 cases originally enrolled in the study, 26 cases were available for analysis in determining chance for discharge and 21 cases were available in determining longer term prognosis. All cases were autoagglutinating. Eighteen cases were discharged (69%), 1 case died, and 7 cases were euthanized in the hospital due to a grave prognosis. Cases that died or were euthanized in the hospital had a significantly higher maximum total bilirubin (Tbili) level than those that were discharged (33.5 versus 4.8, p=0.0004). Between cases that were discharged and those that died or were euthanized, there was no difference in age, packed cell volume, white blood cell count (WBC), platelet count or Tbili on admission, or the presence of hemoglobinuria or hemoglobinemia. The number of transfusions received and hospitalization time were not significantly different between the 2 groups. Only 3 animals had been vaccinated within 2 months; of those, 1 was euthanized and 2 were discharged.Three‐month follow‐up information was available for 13 of the 18 cases discharged. Of the 13, 7 cases were still alive at 3 months (7/21, 33%). There was no difference in age, PCV, WBC, platelet count, total bilirubin at admission, number of transfusions received, or hospitalization time between survivors and non‐survivors. None of the animals that lived over 3 months had hemoglobinemia or hemoglobinuria during their hospitalization. Maximum Tbili was significantly higher in non‐survivors versus survivors (23.7 versus 1.9, p=0.0005). A total bilirubin of greater than 5.16 during hospitalization was associated with an extremely poor prognosis.
RISK FACTORS FOR DEVELOPMENT OF IMHA – A PROSPECTIVE CASE‐CONTROL STUDY
Authors: Davidow EB , Oncken A 
Published: September 2004

A prospective case‐control study was undertaken at DLEAH from May, 2001 to February, 2003 to examine risk factors for development of immune‐mediated hemolytic anemia (IMHA). A questionnaire was filled out by the attending doctor for each IMHA case diagnosed. The diagnosis of IMHA was made based on a PCV <25%, effective rule out of other diseases, and the presence of at least 2 of the following: spherocytosis; regenerative response with elevated reticulocytes or polychromasia; hemolysis characterized by bilirubinuria, hyperbilirubinemia, hemoglobinuria or hemoglobinemia; positive slide agglutination or positive Coombs' test. To provide case controls, the same questionnaire was filled out for the next canine patient admitted after diagnosis. Age, breed, vaccine history, previous illness, and medication history were examined. Date of admission was compared to total hospital case numbers to look for seasonality.The study contained 31 cases and 29 controls. Cases were significantly older than controls (7.45 years versus 5.1 years, p=0.01). Cocker spaniels and Cocker mixes were significantly more likely to be cases than controls (7/31 IMHA versus 1/29 controls, p=0.05). Medication and illness history for the 2 months prior to presentation was not significantly different between cases and controls. None of the IMHA cases had received antibiotics previously reported to be associated with IMHA. In contrast to previous studies, vaccination history was not significantly different between cases and controls. Five out of 31 cases had received vaccines in the previous 2 months; 4 of 9 controls had received vaccines in that same period. At least one case presented each month of the year. Although cases presented more frequently in the summer months, overall hospital case load was also elevated during these times. The monthly distributions of IMHA cases and total hospital case load were not significantly different.
COMPARISON OF SIX NON‐INVASIVE SUPPLEMENTAL OXYGEN TECHNIQUES IN DOGS AND CATS
Authors: Engelhardt MH , Crowe DT 
Published: September 2004

Objective: To determine the amount of time required to reach the highest concentrations of oxygen at the patient's face and to determine what these highest concentrations of oxygen were with various non‐invasive methods of providing supplemental oxygen using a commercial oxygen content analyzer.Procedure: Three healthy cats and 3 healthy dogs were each individually given supplemental oxygen by 6 different means, each done at 2 rates (5 L and 15 L per minute). The methods tested were: 1) Plastic sheet over conventional cage door (PSCD); 2) Blow‐by where the tubing delivering the oxygen was held 8 cm from the face (BB); 3) Large plastic bag covering the patient (BAG); 4) Anesthesia induction chamber (AIC); 5) Synder oxygen cage (SOC); and 6) Crowe Oxygen E‐Collar (COC). Prior to the testing, the commercial oxygen content analyzer (Mini‐Ox) was calibrated.Results: Significant repeatable differences were consistently observed between the 6 methods of oxygen delivery. Results of both 5 L and 15 L/min oxygen flow rates consistently indicated that the highest oxygen concentrations were achieved with the anesthesia induction chamber and large plastic bag with oxygen concentrations reaching approximately 95% and 90%, respectively between 5 to 15 min. The BAG method had the advantage of allowing additional room for patient manipulation and the ability to place intravenous catheters while continuing to give supplemental oxygen. The plastic sheet covering a conventional cage door provided oxygen concentrations of 50% and 60% at 15 and 45 min, respectively. The Crowe Oxygen E‐Collar achieved oxygen concentrations of 70% in 1.5 min. Blow‐by was found to be the simplest method. It increased FiO2 to 40% within 2 min. The Synder oxygen cage was able to achieve 45% oxygen concentration within 30 min with an oxygen flow rate of 15 L/min. It was able to achieve 60% at 45 min (similar to the plastic bag on the cage).Conclusion: The order of effectiveness of providing non‐invasive oxygen supplementation, from the highest to the lowest concentrations, was AIC, BAG, COC, PSCD, SOC, and BB. The fastest to the slowest increases in oxygen concentrations followed the same order at both 5 L and 15 L/min oxygen flow rate and they were BB, COC, AIC, BAG, PSCD, and SOC. SOC was the most inefficient means of providing oxygen while AIC, BAG and COC were the most efficient.
INDICATIONS, MANAGEMENT AND OUTCOME OF LONG TERM POSITIVE PRESSURE VENTILATION IN DOGS AND CATS: 152 CASES (1991–2001)
Authors: Hopper K , Haskins SC , Rezende M 
Published: September 2004

Objective: To retrospectively evaluate the indications, management and outcome of 152 cases of long‐term positive pressure ventilation (PPV).Methods: Medical records of patients maintained on PPV for 24 hours or longer, from 1991 to 2001 were reviewed. All cases were categorized into 3 groups according to the reason they required PPV: animals with pulmonary parenchymal disease that were not adequately oxygenating (1), animals with neuromuscular or large airway disease that were not adequately ventilating (2), or animals with both inadequate oxygenation and ventilation (3).Results: A total of 152 ventilator episodes were identified represented by 124 dogs and 24 cats. The median duration of ventilation was 49 hours (range 24–356 hours). Overall, 41.4% of cases were weaned, and 27% of cases survived to discharge. There were 78 cases with inadequate oxygenation (Group 1), of which 37.2% were weaned and 20.5% survived to discharge. There were 62 cases with inadequate ventilation (Group 2), of which 50% were weaned and 38.7% survived to discharge. In Group 3, 10 cases were identified; 25% were weaned and 8.3% survived to discharge. Arterial blood gases were collected in 61.2% of cases prior to PPV. Venous blood gases were collected in 10.5% of cases and an SpO2 was recorded on 2% of cases. In 26.3% of cases, no blood gas or SpO2 measurements were performed prior to PPV. The mean PaCO2 prior to PPV was 46.9±15.5 mmHg in Group 1, 72.6±26.9 mmHg in Group 2, and 64.3±14.1 mmHg in Group 3. In Groups 1, 2 and 3, the mean PaO2/FIO2 ratio was 101.7±67.6, 262.6±210.9 and 115.7±75.9, respectively. Pentobarbital, with or without diazepam, was the most common induction (28.9%) and maintenance (61.8%) agent utilized. Most cases (91.4%) were initially stabilized with volume or pressure control. Of the animals weaned from PPV, synchronous intermittent mandatory ventilation was used in 46% of cases and continuous positive airway pressure was used in 22.2%. Complications included pneumothorax (6.6%), oral ulceration (5.9%), and corneal ulceration (3.9%).Conclusion: Long‐term PPV can be both practical and successful in veterinary medicine. Patients that require PPV due to pulmonary parenchymal disease had lower weaning and survival rates than those without.
USE OF LITHIUM DILUTION AND PULSE CONTOUR ANALYSIS CARDIAC OUTPUT DETERMINATION IN ANAESTHETISED HORSES – A CLINICAL EVALUATION
Authors: Hallowell Gayle D , Corley Kevin TT 
Published: September 2004

Pulse contour analysis is a relatively new method of continuously monitoring cardiac output. The objective of this study was to evaluate the suitability of the human algorithm for calculation of continuous cardiac output from the pulse waveform, for use in anaesthetised horses. Cardiac output was measured in 27 anaesthetised clinical cases comparing lithium dilution (LiDCO) with a preceding, calibrated cardiac output measured from the pulse waveform (PulseCO) using a commercial system (LiDCOplus, LiDCO Ltd., Cambridge, UK). These comparisons were repeated every 20–30 min. Positive inotropes or vasopressors were administered when clinically indicated. Cardiac output values obtained ranged from 15.2–52.2 L/min, with cardiac indices from 30.7–114.9 ml/kg/min.Eighty‐nine comparisons were obtained. The mean bias was 0.24 ml/kg/min +/−6.48 ml/kg/min. The limits of agreement were −12.72–13.2 ml/kg/min. The 95% confidence interval for the upper limit of agreement was 12.07–14.33 ml/kg/min and for the lower limit of agreement was −11.59–13.85 ml/kg/min. Linear regression analysis demonstrated a correlation coefficient (r2) of 0.89 and produced an equation of PulseCO (mls kg−1 minute−1)=0.9226LiDCO (mls kg−1minute−1) +5.354.This method of pulse contour analysis is a relatively non‐invasive and reliable way of monitoring continuous cardiac output in the horse under anaesthesia. The ability to easily continuously monitor cardiac output may improve morbidity and mortality in the anaesthetised horse.
BIOCHEMICAL MARKERS OF CARDIAC INJURY IN NORMAL AND SURVIVING VERSUS NON‐SURVIVING SEPTICEMIC NEONATAL FOALS
Authors: Peek SF , Slack JA , Darien BJ , Semrad SD , Marques F , Risberg A , Erb HN , Apple FS , McGuirk SM 
Published: September 2004

Although myocardial injury can be a significant component of multiple organ dysfunction (MODS) in association with septicemia in critically ill human patients, it is as yet an undefined clinical entity in equine septicemia. With septicemia as the leading cause of death in neonatal foals, a better understanding of the pathophysiology, diagnosis and treatment of MODS will be important in further improving survival rates.We designed a prospective study to establish normal ranges for cardiac troponin I (cTnI), T (cTnT) and CKMB mass in healthy 24–48 hour old foals, as well as septicemic neonatal foals seen over a 2‐year period in a teaching hospital. We also performed a comparison of these biomarkers in surviving and non‐surviving septicemic foals. Sepsis was judged on the basis of the presence of any of the 3 following criteria: blood culture positive at admission, admission sepsis score ≥11, or 3 or more sites of infection during hospitalization in foals ≤14 days of age. cTnI was measured by the ACCESS® (Beckman Coulter), cTnT was measured using the Elecsys 2010® Immunoassay (Roche), and CKMB mass measurements were performed using the Elecsys 2010®. Each parameter was described using range and 95th and 50th percentile. Comparisons were made for each parameter between normal and septic foals as well as surviving and non‐surviving septic foals using the non‐parametric Wilcoxon's rank sum test. Significance was set at p<0.05.There were 52 control foals and 38 septic foals of which 22 survived. Significant differences were documented for CKMB between septicemic and normal foals, but not for cTnT or cTnI. However, CKMB and cTnT were significantly lower in surviving versus non‐surviving septicemic foals. The 50th and 95th percentiles alongside the ranges for the normal foal population were 0.14, 0.49, (0.01–0.51) μg/L for cTnI, 0.009, 0.03, (0.009–0.04) μg/L for cTnT and 2.3, 7.4, (0.4–9.3) μg/L for CKMB. Our findings suggest that myocardial injury is a component of MODS during septicemia in foals, and that quantitatively significant increases in CKMB and cTnT are seen in non‐surviving septicemic foals versus survivors.
A NEUROLOGICAL SCORE FOR HOSPITALIZED NEONATAL FOALS
Authors: Corley KTT 
Published: September 2004

A 15‐point neurological score for foals was developed, and tested on foals (<8 days old) presenting to the Marion duPont Scott Equine Medical Center (n=75) and the Royal Veterinary College (n=11). The score consists of 2 scales, which are added together to provide the total score. The points and descriptors for the first scale are as follows: Bright, alert, nursing, follows mare (0); Depressed, nursing, follows mare (1); Depressed, nursing, wanders away from mare (2); Depressed, standing, not nursing, will not follow mare (3); Recumbent, able to maintain sternal recumbency part of the time, strong suckle reflex (4); Recumbent, unable to maintain sternal recumbency, suckle reflex (5); Recumbent, no suckle reflex, responds to finger in ear (6); Recumbent, no suckle reflex, legs extended most of the time and muscles tense (7); Comatose, muscles relaxed, no response to finger in ear (8). Foals with a physical cause of recumbency (e.g., flexural deformity) are scored on this scale as if they were standing. The second scale is as follows: No seizure activity (0); Single seizure of less than 10 seconds (3); Single seizure of more than 10 seconds or two seizures of less then 10 seconds (4); Multiple seizures (5); Status epilepticus (7). All scores were assigned at admission by a single investigator.The median admission neurological scores for hospital survivors and non‐survivors, and for blood culture positive and negative foals were compared with the Mann Whitney U‐test. The correlation of admission neurological scores and arterial lactate concentrations (measured on a NOVA Stat profile M or CCX analyzer) and mean arterial pressure (measured indirectly with a tail cuff) was tested with Spearman's rho coefficient. Analysis of these data was performed using SPSS version 12. Results for all tests were considered significant if the p value was less than 0.05. The median neurological score on admission of all 86 foals was 4, and the range was from 0 to 12. The median score of survivors (2) was less than that of non‐survivors (5) (p<0.001; n=86). There was no significant difference in median score between blood culture positive (4) and negative (3) foals (p=0.109; n=84). The neurological score was moderately correlated with admission lactate concentration (correlation coefficient 0.528, p<0.001, n=68), but only weakly correlated with mean arterial pressure (correlation coefficient −0.285, p=0.011, n=78). This neurological score is statistically associated with clinically important parameters (hospital survival, blood lactate concentration), and warrants further study, including investigation of inter‐observer variation in scoring.
EVALUATION OF A CUSTOMIZED INTESTINAL SUPPORT SOLUTION (GI BOOST) IN NORMAL HORSES AND CLINICAL CASES WITH ABDOMINAL INJURY – A PRELIMINARY REPORT
Authors: Van Hoogmoed Linda M. , Snyder Jack R. , Harmon Faye A. 
Published: September 2004

Our laboratory developed a customized solution containing various free‐radical scavengers, energy sources, and vasodilators in an attempt to attenuate intestinal injury following an ischemic insult. This solution has been evaluated with beneficial effects following low flow ischemia and reperfusion using in vitro and in vivo models using intra‐arterial and intraluminal administration. In both investigations, the solution minimized morphologic injury and decreased transmucosal leakage of albumin.Objective: To determine if the systemic administration of the solution (GI Boost) had any clinical effect on normal horses, and to summarize the outcome of horses undergoing colic surgery that received the solution intravenously and intraluminally.Animals: 5 healthy adult horses and at the time of submission the outcomes of 10 horses undergoing abdominal surgery for colic.Methods: 2 L of GI Boost was administered at concentrations of 25%, 50%, and 75% intravenously (IV) to 5 normal horses. Parameters evaluated included CBC, chemistry panel, blood pressure, and physical examination. In 10 clinical cases, GI Boost was administered IV (intra‐op and post‐op) and intraluminally via the enterotomy.Results: The administration of GI Boost did not produce any clinical or hematologic abnormalities in normal cases. None of the clinical cases developed any complications associated with the use of the solution. The majority of horses were discharged from the hospital and 1 died following large colon rupture.Clinical Relevance: The administration of GI Boost may have a beneficial effect in horses presented for colic. Additional cases continue to be acquired to determine if this solution has a beneficial effect relative to traditional methods of treatment.
QUANTITATIVE EEG TO EVALUATE DEPTH OF ANESTHESIA IN THE CAT
Authors: Fletcher DJ , Williams DC , Imai A , Ilkiw JE 
Published: September 2004

Introduction: Quantitative measures derived from the electroencephalogram (qEEG) have been used extensively in human medicine to assess the function of the brain under clinical manipulation (such as anesthesia and sedation), as well as in disease states (such as head trauma, coma and stroke). The goal of this study was to determine if qEEG measures could be used to predict the response of cats under isoflurane concentration to noxious stimuli.Methods: Twelve cats aged 1–2 years were included. Neurological and physical examination, blood chemistries and CBCs were normal in all cats. Anesthesia was induced with isoflurane (ISO) in O2, the cat was intubated and the femoral artery catheterized. The following physiologic data were collected continuously throughout the course of the experiment: temperature, blood pressure, respiratory rate, heart rate, and end‐tidal CO2 and ISO concentrations. An Aspect Medical Systems A‐1050 monitor was used to continuously record the raw electroencephalogram (EEG) and several qEEG measures including bispectral index (BIS), spectral edge frequency (SEF), burst suppression ratio (BSR), and total EEG power (POW). ISO concentration was maintained constant for 15 minutes, after which a tail clamp was applied for 1 minute. If the cat responded, the concentration was increased 10% and the procedure repeated. If the cat did not respond, the ISO concentration was decreased 10% and the procedure repeated. The minimum alveolar concentration (MAC) was the midpoint between a positive and negative response and, for each cat, this was determined three times.Results: BIS was significantly lower in cats at the lowest concentration at which there was no response (MAC−, 21.3±28.3) than at the highest concentration at which there was a response (MAC+, 63.4±22.1; p<.01, Wilcoxon signed rank). However, in 3/12 cats (25%), BIS was higher at MAC− than at MAC+. Of the other qEEG measures, only BSR was significantly different between MAC− and MAC+ (50.4±34.4 vs. 6.1±19.4, p<.01). Of the physiologic data collected, only respiratory rate was different between MAC− and MAC+ (29.4±10.0 vs. 45.3±17.9, p<.05).Conclusions: These results suggest that qEEG measures may be useful for anesthesia monitoring in cats, but measures that are less species‐specific than the BIS may hold more promise. In addition, this work suggests that further studies utilizing qEEG measures for evaluation of sedation during ventilation as well as outcome prediction in animals with head trauma and critical illnesses with CNS complications are indicated.
IN VITRO EVALUATION OF THE EFFECT OF OPIOID ANTAGONIST, N‐METHYLNALTREXONE ON MOTILITY IN THE EQUINE JEJUNUM AND PELVIC FLEXURE
Authors: Van Hoogmoed Linda M. , Boscan Pedro , Snyder Jack R. 
Published: September 2004

While potent analgesic agents, opioids reduce intestinal transport in the intestine, thereby increasing transit times and the potential for impaction colic. Methylnaltrexone is an opioid receptor antagonist which does not cross the blood‐brain barrier, does not reverse the analgesic effects of morphine, and directly stimulates isolated smooth muscle strips in humans.Objective: To determine if N‐methynaltrexone has an effect on contractile activity of the equine jejunum and pelvic flexure.Study Design: In vitro investigation using isolated circular smooth muscle strips.Animals: 8 adult horses (n=200 muscle strips).Methods: Increasing concentrations of N‐methylnaltrexone were added to tissue baths in the range of 1×10−9 M to 1×10−5 M, and contractile responses were recorded for 3 minutes. Data was analyzed using a repeated measures ANOVA with statistical significance as P<0.05.Results: The administration of N‐methylnaltrexone significantly increased the contractile frequency and amplitude at all concentrations relative to baseline (P <0.0001) for the jejunum. The response was greatest at 1×10−7 M (P=0.0005) with a mean difference from baseline of 0.341 mg/cm2. The highest concentration evaluated (1×10−5 M) had a mean contractile strength of 0.206 mg/cm2 which was significantly greater than baseline activity (P=0.04). A significant increase in contractile activity for the colon was detected at 3×10−6 M (P=0.027) and 1×10−5 M (P=0.002).Clinical Relevance: Potentially, this agent could be used in conjunction with morphine to provide more potent and effective analgesia without compromising intestinal function.