Thanks as always to Lara Brunori DVM CertAVP MRCVS
- Binvel, M. et al. (2017) ‘Endoscopic and surgical removal of oesophageal and gastric fishhook foreign bodies in 33 animals’. Journal of Small Animal Practice, doi: 10.1111/jsap.12794 (Early view)
- Klainbart, S., et al. (2017) ‘Retrospective evaluation of 140 dogs involved in road traffic accidents’. Veterinary Record doi: 10.1136/vr.104293 (Early view)
- Hernon, T. et al (2018) ‘A retrospective study of feline trauma patients admitted to a referral centre’. Journal of Small Animal Practice, doi: 10.1111/jsap.12815 (Early view)
- Lennon, E. M. et al. (2018) ‘Urine sodium concentrations are predictive of hypoadrenocorticism in hyponatraemic dogs: a retrospective pilot study’. Journal of Small Animal Practice, doi: 10.1111/jsap.12792 (Early view)
- Brisson, B.A. et al. (2018) ‘Risk factors and prognostic indicators for surgical outcome of dogs with esophageal foreign body obstructions’. Journal of the American Veterinary Medical Association, 252(3), pp. 301-308.
Clinical case report:
Barrand, K.R. (2018) ‘A case of canine intestinal obstruction due to ingestion of a superabsorbent polymer bead’ Journal of Small Animal Practice, doi: 10.1111/jsap.12812 (Early view)
Hill, C. (2018) ‘Small Animal Emergency and Critical Care’ Veterinary Record 182(1), p. 27.
Pick of the Month
As voted for by members of our private Facebook group.
A retrospective study of feline trauma patients admitted to a referral centre
Hernon, T. et al (2018) Journal of Small Animal Practice, doi: 10.1111/jsap.12815 (Early view)
Trauma patients are a common presentation in both first opinion and referral veterinary practices.
This study aims to:
- Document the initial management of trauma patients in primary care practices
- Identify prognostic indicators for feline trauma patients
- Give recommendation for initial management of feline trauma patients
- 185 cats were enrolled in the study. The population consisted of cases seen in primary care practices for injuries due to traumatic events, then referred as emergencies to North-West Veterinary Specialists (Cheshire, UK).
The authors classified patients according to a previously described Severity Score (SS) system (Rochlitz, 2004).
- RTA was the most common cause of trauma (56%) followed by unknown origin (27%), falls (10%) and dog attacks (3%)
- According to the referring veterinary surgeons (RVSs) 35% of cats were in circulatory shock, 45% received antibiotics prior to referral, 72% were administered NSAID either alone or in combination with opioids and 4% received corticosteroids
- SS4 cats were the most frequently referred cases (nearly 50%) followed by SS3 (28%) and SS5 (21%)
- The length of hospitalisation increased with SS with an overall mean time of 7 days
- 33% of the cases developed complications during hospitalisation, the more common of which were: sciatic nerve dysfunction (10%), tissue necrosis (4%) and urinary incontinence (3%)
- Cats involved in RTAs had a higher rate of complications and mortality compared to other traumatic events
- 12% of cats did not survive to discharge - 54% were euthanised and 91% were patients presenting with multiple injuries
- Mortality rate increased with increasing SS, with SS5 having a 43% rate of death compared to 3% for both SS3 and SS4
- 21% of cats initially diagnosed with circulatory shock by the RVS died vs 7% of those who were not
- An injury based scoring system might be useful in the initial assessment of cats following a traumatic event and could provide some prognostic indications regarding mortality in these patients
- The duration of hospitalisation was closely related to SS, this may be useful when discussing expectations and financial commitments with owners
- Early identification and stabilisation of circulatory shock is a key step to improve survival in trauma patients prior to referral, however clear guidelines regarding resuscitation end-points are still lacking
- Analgesia was widely used by RVSs, however, the administration of NSAID in potentially haemodynamically unstable patients was also very frequent, furthermore, some RVSs still used corticosteroids in these cases.
- Lack of standardised treatment protocols prior to referral
- No unanimous definition of circulatory shock amongst RVSs
- Variability in amount and thoroughness of clinical data provided by RVSs prior to referral
- Potential population bias due to intermediate SS being more likely to be referred than very low or very high SS
- Definition of mortality was limited to discharge without any follow-up available and included euthanised patients
Rochlitz , I. ( 2004 ) ‘Clinical study of cats injured and killed in road traffic accidents in Cambridgeshire'. Journal of Small Animal Practice 45(8), 390 - 394.
For a copy of any of the papers mentioned in this post (personal education purposes only), including details of the scoring system, please email email@example.com.