2014 abstracs.pdf

Journal of Veterinary Emergency and Critical Care
doi: 10.1111/vec.12227
Abstracts from the International Veterinary
Emergency and Critical Care Symposium and
the European Veterinary Emergency and
Critical Care Society Annual Congress, 2014
Table of Contents
IVECCS Abstracts presented
September 10–14, 2014 in Indianapolis,
Indiana, USA
IVECCS Small Animal Abstracts
(in alphabetical order of presenter) p. S4–S20
IVECCS Large Animal Abstracts
EVECCS Abstracts presented
June 12-15, 2014 in Prague, Czech Republic
At EVECCS Annual Congress
EVECCS Small Animal Abstracts
EVECCS Large Animal Abstracts
(in alphabetical order of presenter) p. S36
Author Index p. S37–S38
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Veterinary Emergency and Critical Care Society 2014

Abstracts
IVECCS Abstracts presented September
10–14, 2014 in Indianapolis, Indiana, USA
ACVECC Research Grant Award Winner
EVALUATION OF THE STERILITY OF
SINGLE-DOSE MEDICATIONS USED IN A
MULTIPLE-DOSE FASHION IN A VETERINARY
REFERRAL HOSPITAL SETTING
Martin, EP1, Sharp, C2, Sinnott, V1
1Cape Cod Veterinary Specialists, Buzzards Bay, MA, USA
2Tufts University Cummings School of Veterinary Medicine, North
Grafton, MA, USA
Introduction: The objective of this study was to assess the rate
of bacterial contamination associated with using single dose vials
(SDVs) of 5 veterinary drugs/solutions in a multi-dose fashion.
Methods: This experimental study was designed to reflect common
hospital practice. Containers of 50% dextrose (DEX), 7.5% hyper-
tonic saline (HTS), 5% hydroxyethyl starch (HES), mannitol, and
heparinized saline (h-saline) were stored in an open-top box in
a veterinary ICU and variably punctured to mimic differing fre-
quencies of clinical use (weekly, daily, 5 times/day). Samples were
cultured from each container at the time of opening, and 1, 7, 14
and 28 days. Positive controls were inoculated with approximately
300cfu/mL of Staphylococcus aureus and Pseudomonas aeruginosa, re-
spectively, and cultured at the same time points.
Results: No test vials (0/46) of HES, HTS, h-saline or mannitol
cultured positive throughout the study. One test vial (20%, 1/5)
of DEX cultured positive for Micrococcus luteus on day 7. Positive
control HES and h-saline grew P. aeruginosa on day 7, 14 and 28,
but not S. aureus. Positive control HTS, mannitol and DEX cultured
negative throughout the study.
Conclusion: Spontaneous contamination of 1 test vial of DEX
occurred during this study. Interestingly, DEX did not support
microbial growth in the positive control vials. When challenged
with a low burden of bacteria known to contaminate veterinary
drugs, HES and h-saline hosted proliferating colonies of Pseu-
domonas aeruginosa. HTS, Mannitol and DEX did not support bac-
terial growth.
PRELIMINARY REPORT OF EXOGENOUS
L-LACTATE CLEARANCE TESTING IN HORSES
WITH ACUTE GASTROINTESTINAL DISEASE∗
Vander Werf, KA1, Wilkins, PA1, Lascola, KM1, Sheahan, BJ1,
Gutierrez, S1, Foreman, JH1, Boston, RC2
1University of Illinois, Urbana, IL, USA
2Department of Clinical Studies-New Bolton Center, University of Penn-
sylvania School of Veterinary Medicine, Kennett Square, PA, USA
Introduction: Single or serial measurement of blood L-lactate con-
centration ([LAC]) is a reliable prognostic indicator in adult horses
with acute gastrointestinal (GI) diseases. True clearance of exoge-
nously administered LAC (exogenous lactate clearance [ExLC]) in
septic human patients is a useful prognostic indicator and mean
ExLC in healthy horses has been reported. One aim of this study
was to measure ClLAC in horses with acute GI disease and deter-
mine if it can provide similar prognostic value.
Methods: Thirty adult horses presenting for acute gastrointestinal
disease and requiring fluid resuscitation have been planned for
study. To date, eight horses have been enrolled. Horses were fluid
resuscitated prior to entering the study. Sodium L-lactate solution
(1.0 mmol/kg IV) was administered over 15 minutes and L-lactate
concentration [LAC] measured immediately prior to, during, and
post infusion. Disposition modeling will be performed using pro-
prietary software once data from all horses are collected.
Results: All eight horses survived. Four horses were explored surgi-
cally and lesions corrected while four horses were treated medically.
Four horses were mildly hyperlactemic ([LAC]1.2 mmol/L) at the
time of study; mean [LAC] immediately prior to infusion was 1.2
mmol/L (range 0.7–1.8). [LAC] at end-infusion was 2.55 mmol/L
(range 1.6–3.7) with a mean increase of 1.3 mmol/L (range 0.9–2.1).
Time to return to baseline was 251 min (range 45–555) and may be
prolonged in medical (345 min) vs. surgical (158 min) disease (P =
0.087).
Conclusion: Infusion of exogenous L-lactate 1.0 mmol/kg BW pro-
vides sufficient increase in [LAC] for future disposition modeling.
Veterinary Emergency and Critical Care
Foundation (VECCF) Research Grant Award
Winners
MULTICENTER IN VITRO TEG-ROTEM
STANDARDIZATION
Goggs, R1, Borrelli, A2, Brainard, BM3, Chan, DL4, de Laforcade,
A5, Goy-Thollot, I6, Jandrey, KJ7, Kristensen, AT8, Kutter, APN9,
Marschner, CB8, Rannou, B6, Sigrist, N9, Smith, SA10, Wagg, C11
1College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
2Department of Veterinary Science, University of Turin, Grugliasco, Italy
3College of Veterinary Medicine, University of Georgia, Athens, GA, USA
4Department of Clinical Science Services, The Royal Veterinary College,
North Mymms, UK
Grafton, MA, USA
6SIAMU, VetAgro Sup, Campus, University of Lyon, Marcy-l’Étoile,
France
7School of Veterinary Medicine, UC Davis, Davis, CA, USA
8Department of Veterinary Clinical and Animal Sciences, University of
Copenhagen, Frederiksberg, Denmark
9Department of Anesthesiology, Vetsuisse Faculty, University of Zurich,
Zurich, Switzerland
10Department of Biochemistry, University of Illinois, Urbana, IL, USA
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Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227

Abstracts
Table 1: Viscoelastic parameters from 9 centers performed in identical platelet-rich plasma samples
Kaolin / In-TEM TF (Innovin) / Ex-TEM
R / CT K / CFT ␣ / alpha MA / MCF R / CT K / CFT ␣ / alpha MA / MCF
Mean (min) Mean (min) Mean (o) Mean (mm) Mean (min) Mean (min) Mean (o) Mean (mm)
Center CV (%) CV (%) CV (%) CV (%) CV (%) CV (%) CV (%) CV (%)
TEG-1 3.2 1.0 77.2 64.1 3.0 1.0 75.4 63.0
23.6 22.5 3.2 7.6 9.4 11.2 2.6 7.5
TEG-2 9.0 - 12.7 3.5 6.9 - 9.0 2.9
23.5 - 48.2 31.5 30.1 - 42.3 19.9
TEG-3 2.1 1.0 77.0 62.4 3.4 1.3 71.2 64.1
12.2 12.2 1.2 5.1 8.9 7.6 2.4 3.5
TEG-4 2.7 0.9 77.0 53.7 3.2 5.8 46.4 27.3
6.3 14.2 3.1 12.1 7.7 73.9 25.5 34.1
TEG-5 1.6 6.6 67.1 35.4 3.3 4.4 53.5 35.0
31.1 73.0 11.6 20.3 8.0 36.1 18.6 16.2
TEG-6 3.2 1.4 73.2 58.4 2.5 1.3 74.1 57.0
14.2 17.5 2.6 3.3 8.7 8.1 2.4 2.7
ROTEM-1 3.5 - 70.3 8.7 0.6 - 71.5 8.4
19.2 - 4.8 24.5 18.3 - 7.3 15.2
ROTEM-2 3.0 - 62.8 9.3 0.6 - 65.5 9.6
52.6 - 23.7 22.1 30.8 - 17.7 21.2
ROTEM-3 3.5 2.63 67.7 46.0 0.5 - 70.3 12.8
17.4 16.5 4.7 10.7 7.3 - 8.2 11.5
11Department of Clinical and Diagnostic Sciences, University of Calgary,
Calgary, Alberta, Canada
Introduction: Veterinary patients with bleeding diatheses and
thromboembolic disorders are increasingly assessed with viscoelas-
tic coagulation tests. Guidelines have been developed to enable as-
say standardization, but evaluation of assay performance within
and between centers is important to assess data comparability. This
study aimed to establish and compare the repeatability and repro-
ducibility of activated TEG and ROTEM assays.
Methods: Sixty, identical 5mL aliquots of canine platelet-rich
plasma collected by apheresis, frozen in 6% DMSO were ob-
tained from a commercial blood bank. Frozen study samples,
quality controls, reagents and consumables were distributed to
participating centers (7 TEG, 4 ROTEM) in 7 countries. TEG
centers analyzed study samples with kaolin and tissue factor
activated assays; ROTEM centers ran proprietary In-TEM and Ex-
TEM assays. All machines underwent quality control prior to study
sample analyses. Within-center coefficients of variation (CVs) were
calculated, where CV = SD / mean.
Results: At time of writing, data was available from 9/11 centers
(6 TEG, 3 ROTEM). Mean values and CVs from 20 repeated assays
are presented in Table 1 above.
Conclusion: CVs from some assays, from some TEG centers, were
acceptable and the mean values comparable. Variation was unac-
ceptably high in some centers, however. Data from the ROTEM
centers was of insufficient quality to permit evaluation of assay
reproducibility. Feedback from test centers suggests much of this
variability was inherent in the test samples, rather than the assays
themselves. Refinement of the standardized test material will be
necessary to fully evaluate the repeatability and reproducibility of
these assays in veterinary medicine and follow-up work is ongoing.
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Veterinary Emergency and Critical Care Society 2014, doi: 10.1111/vec.12227 S3

Abstracts
Oral Presentations
Listing of Small Animal IVECCS Abstracts
(in alphabetical order of presenter)
RELATIONSHIP BETWEEN METATARSAL PULSE
PALPATION AND SYSTOLIC DOPPLER BLOOD
PRESSURE IN DOGS PRESENTING TO AN
EMERGENCY SERVICE
Ateca, LB, Reineke, EL, Drobatz, KJ
University of Pennsylvania, Philadelphia, PA, USA
Introduction: Anecdotally, some clinicians report that a palpable
metatarsal pulse indicates a systolic blood pressure of at least 80–90
mmHg. However, these claims have never been objectively eval-
uated. The purpose of this study was to describe the relationship
between systolic Doppler blood pressure (DBP) measurement and
digital palpation of metatarsal pulses in dogs presenting to an emer-
gency service.
Methods: Any dog with a physical examination and systolic DBP
measured upon presentation to an emergency service was eligi-
ble for inclusion in the study excluding clinically evident hindlimb
thromboembolism. Metatarsal pulse quality was prospectively as-
sessed as either present or absent.
Results: Median systolic DBP for all 93 dogs was 140 mmHg (range
40 – 230 mmHg). Median DBP for dogs with absent and present
metatarsal pulses was 90 mmHg (range: 40–170 mmHg) and 140
mmHg (range: 40 – 230 mmHg), respectively (P = 0.0016). Receiver
operating curve analysis showed that a systolic DBP cutoff of 55
mmHg maximized the area under the ROC curve (0.82, 95% CI:
0.66, 0.99). Two dogs (2/6; 33%) with systolic DBP 55 mmHg had
palpable metatarsal pulses while 5 dogs (5/87; 6%) with systolic
DBP 55 mmHg had absent metatarsal pulses.
Conclusion: A systolic DBP cut point of 55 mmHg optimized the
clinician’s ability to predict blood pressure based on digital pal-
pation of metatarsal pulses. However, since there was overlap in
the systolic DBP between dogs with absent and present metatarsal
pulses and the cut point for palpable metatarsal pulses was rel-
atively low, pulse palpation should not replace an actual blood
pressure measurement.
CLINICAL SAFETY EVALUATION OF F(Ab)2
ANTIVENOM FOR TREATMENT OF CROTALIDAE
ENVENOMATION IN DOGS
Bandt, C, Bolfer, L, Schaer, M, Buckley, G
University of Florida, Gainesville, FL, USA
Introduction: The goal of this prospective study was to test the po-
tential benefits, safety, side effects and efficacy of a new antivenom
product for the treatment of Crotalidae envenomation in dogs.
Methods: Between May 2013 and April 2014, dogs with evidence
of envenomation by a North American Crotalidae snake and a
Snakebite Severity Score (SSS) of 6 were enrolled in the study.
Exclusion criteria included presenting more than 6 hours after en-
venomation, previous antivenom therapy or use of glucocorticoids.
SSS was assessed at presentation, 2 hours, 6 hours, 12 hours, at dis-
charge and 10 days after treatment.
Results: 48 dogs were presented with Crotalidae envenomation of
which 23 cases were eligible for the study. The mean SSS at pre-
sentation was 9.5. The mean amount of antivenom administered
was 4.39 vials. The initial SSS correlated strongly (r = 0.92) with
the amount of antivenom used in each patient. One dog developed
anaphylaxis and one dog experienced mild urticaria following an-
tivenom administration. Overall, there was an improvement in SSS
in all dogs following treatment. The mean SSS decreased from 9.5
to 7.4 within 2 hours and all dogs had negative SSS at 10 days post
treatment. Two dogs died despite treatment.
Conclusion: The F(Ab)2 antivenom was well tolerated in most
dogs. 92% of dogs showed no side effects, despite administration
of up to 16 vials of antivenom. The improvement in SSS demon-
strated efficacy all surviving animals. The reported side effects of
antivenom administration were similar to other reported studies.
DECREASING MORBIDITY ASSOCIATED WITH
DIAGNOSTIC AIRWAY LAVAGE IN CATS
Bernhard, C, Masseau, I, Dodam, J, Outi, H, Krumme, S, Grob-
man, M, Kerl, M, Reinero, C
University of Missouri, Columbia, MO, USA
Introduction: Bronchoalveolar lavage (BAL) may induce hypox-
emia and anesthesia-induced atelectasis. We hypothesized that
lung function and computed tomography (CT) evidence of atelec-
tasis would be modified by altering inspired oxygen concentration
and applying positive end expiratory pressure (PEEP) in cats un-
dergoing BAL.
Methods: Six experimentally asthmatic cats underwent BAL, each
under four randomized treatment conditions: (1) 100% oxygen, no
PEEP, (2) 30% oxygen, no PEEP, (3) 100% oxygen, PEEP = 2 cmH2O
and (4) 30% oxygen, PEEP = 2 cmH2O. Pulse oximetry was used
to measure oxygen saturation (SpO2). Baseline ventilator-acquired
pulmonary mechanics and CT scans were acquired prior to BAL,
and at 1, 5, and 15 minutes post-BAL.
Results: While receiving 100% oxygen, no cat had SpO2 below 91%
during or after BAL. Although cats treated with 30% oxygen had
substantial desaturation, nearly all (22 out of 24 trials) had SpO2
greater than 90% by 1 minute post-BAL. Following BAL, all cats
in all treatment groups had increased airway resistance, decreased
lung compliance, and CT evidence of increased attenuation and
decreased lung volume. Treatment (2) had significantly lower min-
imum compliance following BAL than treatments (3) and (4) (P
0.05). For maximum airway resistance and percentage increase of
airway resistance over baseline, there was no significant difference
between treatments (P = 0.40 and 0.12, respectively). Preliminary
CT data suggested less attenuation and higher lung volumes with
the addition of PEEP.
Conclusion: Pulse oximetry may not correlate with expected
changes in pulmonary mechanical function or lung anatomy. Ad-
dition of PEEP may improve lung compliance and decrease CT
evidence of atelectasis after BAL.
PROSPECTIVE STUDY OF THE USE OF THE
VETMOUSETRAP DEVICE FOR THORACIC
COMPUTED TOMOGRAPHIC IMAGING WITHOUT
ANESTHESIA IN CRITICALLY ILL
CLIENT-OWNED DOGS WITH SUSPECTED
PULMONARY THROMBOEMBOLISM:
PRELIMINARY RESULTS
Corsi, R1, O’Brien, RT2, Mai, W1, King, L1
1University of Pennsylvania, Philadelphia, PA, USA
2University of Illinois, Champaign-Urbana, IL, USA
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Abstracts
Introduction: This study aimed to determine whether the Vet-
MouseTrap (VMT) can be used to safely obtain diagnostic quality
computed tomography pulmonary angiography (CTPA) images of
the thorax in awake, dyspneic dogs, and to determine whether the
imaging can be used to confirm/exclude pulmonary thromboem-
bolism (PTE).
Methods: Client-owned dogs were prospectively enrolled if they
had dyspnea, hypoxemia, evidence of hypercoagulability or fibri-
nolysis, and there was a high clinical suspicion of PTE. Enrolled
dogs were placed in the VMT, flow-by oxygen was delivered and
continuous monitoring was performed. Sedation was provided as
necessary. Animals were scanned using a 16-slice multiple detec-
tor computed tomography system and iodinated contrast medium
was injected (400mg I/kg) using a power injector.
Results: Eight dogs met the inclusion criteria, with enrollment on-
going. Despite dyspnea, all dogs tolerated the VMT without ad-
verse events. Head movement was managed with mild sedation
in 7 dogs. The median time in the VMT was 20 minutes (15 – 40
minutes). All images were of good quality. PTE was confirmed in 1
dog, strongly suspected in 3 dogs, and questionable filling defects
were noted in 2 additional dogs. The location of the PTE was the
right caudal lobar artery [n = 3], left caudal lobar artery [n = 1]
and caudodorsal branches of the right caudal pulmonary artery
[n = 1]. Six dogs survived to discharge. Necropsy occurred in 1
case within 4 days of imaging, but no PTE was identified.
Conclusion: VMT is well tolerated by awake, dyspneic patients.
CTPA images are of diagnostic quality. PTE was visualized or sus-
pected in 75% of enrolled dogs.
THE EFFECT OF STORAGE ON AMMONIA AND
CYTOKINE CONCENTRATIONS IN FELINE
WHOLE BLOOD
Cummings, KA, Abelson, AL, Rozanski, EA, Sharp, CR
Tufts University Cummings School of Veterinary Medicine, North
Grafton, MA, USA
Introduction: Stored whole blood (SWB) is used commonly in fe-
line transfusion medicine. The aims of the study were to assess
changes in the concentrations of ammonia, interleukin(IL)-6, IL-
10, and WBC count in units of feline SWB weekly for 4 weeks of
refrigerated storage.
Methods: Blood was collected into citrate-phosphate-dextrose from
five healthy adult blood donor cats. Ammonia, IL-6, and IL-10 con-
centrations, along with WBC counts were measured in the 5 units
of SWB. Ammonia concentration and WBC counts were assessed
in the hospital clinical pathology laboratory with the Cobas 600
and Advia 120 Hematology System, respectively. Cytokine concen-
trations were determined with commercially available, previously
validated ELISAs. Changes in ammonia concentration and WBC
counts were evaluated over time with a linear regression model. A
P-value 0.05 was considered significant.
Results: The ammonia concentration increased linearly with the
duration of storage, from a median of 48 mmol/L (range = 25–
74) on day 0, to 417mmol/L (324–457) on day 28 (R2 = 0.98). This
increase was similar for all 5 SWB units; however, one unit demon-
strated a statistically significant difference in slope (P = 0.0037).
No relationship was observed between WBC count and storage
duration. IL-6 and IL-10 were undetectable at all time points.
Conclusion: Results of this study indicate that ammonia concentra-
tion increases significantly with blood storage time. Further work is
needed to investigate the clinical impact of ammonia on cats receiv-
ing SWB transfusions. Although IL-6 and IL-10 remained below the
detection limits, evaluation of other pro-inflammatory cytokines in
SWB should be evaluated.
EVALUATION OF HIGH FLOW OXYGEN THERAPY
IN NORMAL DOGS: A PILOT STUDY
Daly, JL1, Keir, I2, Guenther, CL1
1Pittsburgh Veterinary Specialty Emergency Center, Pittsburgh, PA,
USA
2Center for Critical Care Nephrology, CRISMA, Department of Critical
Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
Introduction: Traditional oxygen therapy (TOT) has limited flow
rates due to nasal and lower airway irritation caused by room
temperature, non-humidified oxygen. High flow oxygen therapy
(HFOT) uses medical grade vapor humidification and heated oxy-
gen allowing for higher oxygen flow rates. A pilot study was un-
dertaken to evaluate the safety and efficacy of HFOT in normal
sedated dogs.
Methods: Six healthy dogs undergoing routine dental prophylaxis
were sedated with butorphanol and dexmedetomidine for place-
ment of an esophageal balloon catheter, nasal cannula and arte-
rial catheter. Dogs were placed in right lateral recumbency and
randomized to receive nasal oxygen using TOT at 100ml/kg/min
(TOT-100), and HFOT at 20L/min (HF-20) and 30L/min (HF-30).
Arterial blood gas and transpulmonary pressure were measured
after a six minute acclimation period at baseline and for each oxy-
gen delivery method. Radiographs were performed pre and post
oxygen therapy to evaluate for gastric distension.
Results: Compared to TOT-100, the median PaO2 was significantly
higher with HF-20 (P 0.05; 177.6mmHg vs 521.45 mm Hg) and
HF-30 (P 0.05; 177.6 mm Hg vs 540.05 mm Hg). There was no
significant difference in PaO2 between HF-20 and HF-30. There was
no significant difference in PaCO2 or change in transpulmonary
pressure between baseline and any oxygen delivery method. One
of six dogs showed radiographic evidence of gastric distension.
Conclusion: HF-20 and HF-30 provides improved arterial oxygena-
tion as compared to TOT-100; however, there was no significant
improvement in PaO2 between the higher flow rates. HFOT ap-
pears safe and effective in sedated healthy dogs. Further studies
are needed to evaluate HFOT in hypoxic patients.
USE OF THE THUNDERSHIRT TO CONTROL
CANINE ANXIETY IN THE ICU
Damon, M, Rozanski, E, Spagnoletti, C, Sharp, C
Grafton, MA, USA
Introduction: Apparent anxiety is common in dogs hospitalized in
the ICU. Uncontrolled anxiety is considered detrimental to patient
recovery, and may also be stressful for other hospitalized patients
and for caregivers. Common methods of controlling anxiety in-
clude: covering cages/run, sitting with anxious pets, and the use
of pharmacological agents. The THUNDERSHIRT is a propriety
product marketed for treating thunderstorm phobias, as well as
separation and situational anxiety. The goal of this study was to
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Abstracts
evaluate the use of the THUNDERSHIRT for treating anxiety in
hospitalized dogs.
Methods: Dogs demonstrating anxiety while hospitalized in the
ICU that persisted for 30 minutes were enrolled in the study.
A baseline numeric assessment of anxiety was made, including
separate scores for vocalization, pacing, chewing and ability to be
calmed on a scale of 0–3. A size appropriate THUNDERSHIRT was
placed and the dogs were rescored in one hour. The pre and post
scores were compared using a Wilcoxan Signed Rank with a P value
of 0.05 considered significant.
Results: 16 dogs were enrolled in the study. The median pre-
THUNDERSHIRT score was 5 (3–10) and the post-score was signif-
icantly lower at 0 (0–4) (p 0.001) All but one dog had a decreased
anxiety score, with the median decrease in score being 4.6 (0–9). All
dogs appeared to tolerate the THUNDERSHIRT well. One critically
ill dog arrested while wearing the THUNDERSHIRT and during
CPR, the shirt was identified as very tightly placed. No other po-
tential complications were observed.
Conclusion: THUNDERSHIRT use may have a role in treating anx-
iety in hospitalized dogs.
MEASUREMENT OF INTRA-GASTRIC PRESSURE
IN DOGS WITH GASTRIC DILITATION-VOLVULUS:
A PILOT STUDY
Davies, RK1, Rozanski, E1, Hammond, TN2, Paul, AL2
Grafton, MA, USA
2TuftsVETS, Walpole, MA, USA
Introduction: Gastric dilatation-volvulus (GDV) is a common
emergency condition in large breed dogs. While most dogs sur-
vive with intensive supportive care, gastric decompression, and
surgical correction, some dogs suffer gastric necrosis necessitat-
ing partial gastrectomy or intra-operative euthanasia. It is diffi-
cult to predict pre-operatively those dogs with gastric necrosis. We
hypothesized that increased intra-gastric pressures (IGP) would
be associated with gastric necrosis. Normal IGP is unknown, but
intra-abdominal pressure (IAP) is 5mm Hg. The primary goal
of this pilot study was to determine if measurement of IGP at
time of gastric trocharization was possible, with a future goal to
determine if this provides useful information concerning gastric
viability.
Methods: Dogs with confirmed diagnosis of GDV were eligible.
All dogs underwent conventional pre-operative stabilization. IGP
was measured using an electronic pressure transducer system, typ-
ically used for direct blood pressure monitoring. The highest pres-
sure recorded was reported for each patient. Measurements were
made in sternal recumbency. Gastric wall viability was determined
visually.
Results: Nine dogs were enrolled. The median IGP was 24 mm Hg,
with a range of 10–40 mm Hg. Two dogs had gastric necrosis, one
with gastric rupture and a pressure of 10 mm Hg and one with an
IGP of 40 mm Hg.
Conclusion: Measurement of IGP at gastric decompression using
a modified pressure transducer system was feasible. Gastric pres-
sures were increased in dogs with GDV in this pilot study as com-
pared to normal IAP. Further investigation is required to determine
the utility of measuring IGP in dogs with GDV and if elevation is
of predictive value.
INCIDENCE OF ACUTE IMMUNOLOGIC
TRANSFUSION REACTIONS IN DOGS
RECEIVING PACKED RED CELL AND FRESH
FROZEN PLASMA TRANSFUSIONS (2008–2012)
Evans, NA, Walker, JM
University of Wisconsin-Madison School of Veterinary Medicine, Madi-
son, WI, USA
Introduction: The aim of this study was to determine the fre-
quency of acute immunologic transfusion reactions in dogs receiv-
ing packed red blood cell (pRBC) and fresh frozen plasma (FFP). We
hypothesized that higher administration rates, and increased age
of product would be associated with a higher rate of transfusion
reactions.
Methods: Medical records were searched for dogs receiving pRBC
or FFP (2008–2012). The presence or absence of acute immunologic
transfusion reactions was recorded.
Results: A total of 719 transfusions were administered to 390 dogs
over the study period. There were 347 transfusions (237 pRBC, 110
FFP) from 231 dogs included in the final analysis. Seventeen reac-
tions were identified for a total reaction rate of 4.9%. There were
9 acute febrile non-hemolytic reactions, 2 hypersensitivity reac-
tions characterized by facial edema and hives, 2 acute hemolytic
reactions, and 4 unclassified reactions with vomiting. Median
ages of blood products were 10 days (0–42 days) for pRBC, and
88 days (0–332 days) for FFP. The median administration rates were
3.1mL/kg/hr (1.14–46.37 mL/kg/hr) for pRBC and 3.03mL/kg/hr
(1.47–36.51mL/kg/hr) for FFP. There was no difference in transfu-
sion rate (P = 0.23 for pRBC, P = 0.72 for FFP), or age of product
between reactors and non-reactors (P = 0.57 for pRBC, P = 0.32 for
FFP).
Conclusion: Transfusion reactions were infrequently identified.
Neither transfusion rate nor age of transfused product was associ-
ated with acute immunologic reactions.
VALIDATION OF A SMARTPHONE-BASED
POINT-OF-CARE HEMOGLOBIN ASSAY FOR USE
IN DOGS
Farrell, KS1, Sullivan, LA1, Ehrenkranz, JR2, Chapman, P1
1Colorado State University, Fort Collins, CO, USA
2i-calQ LLC, Salt Lake City, UT, USA
Introduction: Point-of-care (POC) testing for hemoglobin (Hgb)
concentration provides rapid results. The purpose of this study was
to investigate whether a smartphone-based spectrophotometric as-
say for bedside measurement of Hgb concentration has sufficient
accuracy and reproducibility for use with canine blood samples.
Methods: Blood samples were obtained using EDTA tubes submit-
ted to the clinical pathology laboratory for a complete blood count
(CBC). Each sample was run on the smartphone device in duplicate
on each of two strips, for a total of four readings per dog (139 dogs
total).
Results: A plot of the average of four POC readings per dog versus
reference CBC values showed a linear relationship, but with higher
variability at higher values. Therefore, the calibration equation
was estimated using a weighted linear regression. The standard
deviation of percent errors was 7.9% overall, and 6.7%, 8.9%,
and 6.5% for Hgb concentration groups, low (13 g/dL), normal
(13 g/dL-20 g/dL) and high (20 g/dL), respectively. The standard
deviation of percent errors was also calculated using individual
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Abstracts
POC values, with result 8.8%. The average coefficient of variability
(CV) among the four individual POC readings was 3.4%, and CVs
were relatively constant across size groups.
Conclusion: Data demonstrate that a POC smartphone-based
method for measuring blood Hgb concentration represents a useful
alternative to a standard laboratory Hgb measurement. There was
excellent intra-sample reproducibility on the smartphone, indicat-
ing good repeatability. After calibration, estimates based on a single
POC reading had standard deviation of percent errors of 8.8%, and
percent errors were relatively constant across Hgb concentration
ranges.
CLINICAL FEATURES OF PRECURSOR-
TARGETED IMMUNE-MEDIATED ANEMIA IN
DOGS: 65 CASES (2004–2013)
Gravelyn, TD, Jutkowitz, AL, Koenigshof, A, Lucidi, C, Scott, M
Michigan State University, East Lansing, MI, USA
Introduction: The goal of this study was to describe the clinical
features of precursor-targeted immune-mediated anemia (PIMA)
in dogs.
Methods: Medical records (2004–2013) for dogs with a clinical
diagnosis of PIMA were reviewed. Dogs were eligible for inclu-
sion if they had a persistent nonregenerative anemia (reticulocytes
76,000/␮L and PCV31%), bone marrow findings consistent with
PIMA, and absence of underlying disease.
Results: Sixty-five dogs met the inclusion criteria. Forty-one were
female and 24 were male. The median age was 6 years (range
0.5–12). The median duration of clinical signs prior to presenta-
tion was 14 days (range 1–270). On presentation, the median PCV
was 12% (range 4–28%) and the median reticulocyte concentration
was 10,200/uL (range 1900–75,000/␮L). Rubriphagocytosis was re-
ported in 67.6% (44/65) of bone marrow samples and 37% (24/65)
had myelofibrosis. All dogs were treated with prednisone. Ninety-
four percent received a blood transfusion and 30.7% received 2 or
more transfusions. Thirty-seven dogs had a documented regenera-
tive response (reticulocytes 76,000/␮L) with a median time until
response of 24 days (range 7–111). Thirty dogs reached clinical re-
mission (PCV / = 35%) with a median time of 68.5 days (range
23–223) from the onset of treatment. Nine of 28 dogs experienced
relapse during or after steroid tapering. The median survival time
was 1365 days. Forty out of the 55 dogs with available follow-up
survived 60 days.
Conclusion: Myelofibrosis is common in dogs with PIMA. Given
the time from onset of treatment to regenerative response and clin-
ical remission, owners should be prepared for prolonged treatment
duration to avoid unnecessary euthanasia.
DAILY POST-OPERATIVE EVALUATION OF
PERIPHERAL BLOOD AND ABDOMINAL DRAIN
FLUID FROM DOGS WITH CLOSED SUCTION
ABDOMINAL DRAINS TO IDENTIFY SEPTIC
PERITONITIS FOLLOWING INTESTINAL
SURGERY
Guieu, L-VS1, Bersenas, AME1, Brisson, BA1, Holowaychuk,
MK2, Weese, JS1, Ammersbach, M1, Beaufrere, H1, Fujita, H3
1Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
2Critical Care Vet Consulting, Edmonton, AB, Canada
3Aikawa Small Animal Medical Center, Tokyo, Japan
Introduction: Septic peritonitis (SP) occurs in 6–35% of dogs fol-
lowing gastrointestinal (GI) surgery. Post-operative management
with closed-suction abdominal drains (CSAD) may alter abdomi-
nal fluid characteristics. The aim of this study was to identify, in
dogs with CSAD, objective laboratory markers to predict SP requir-
ing relaparotomy after intestinal surgery.
Methods: Client-owned dogs undergoing intestinal surgery with
placement of a CSAD were prospectively enrolled (January 2012
– March 2014). Abdominal fluid and peripheral blood were col-
lected pre-operatively and then daily until drain removal. Analysis
of all samples included inflammatory cell count, PCV/TS, glucose
(G), lactate (L), electrolytes and gases. Daily abdominal fluid anal-
ysis also included cytology, bacterial culture, and fluid volume.
Outcome was SP requiring relaparotomy. The association between
SP requiring relaparotomy and each laboratory variable including
blood-to-fluid (BF) differences and ratios for selected variables (G,
L, WBC and neutrophil count) was assessed using univariate mixed
logistic regression models.
Results: A heterogeneous population of 31 dogs was included
(n = 16 prior celiotomy, n = 24 pre-operative SP, n = 7 routine GI
surgery). 27 dogs had an uneventful recovery while 4 dogs required
relaparotomy. None of the blood and fluid laboratory variables had
a significant effect on the odds of needing relaparotomy (P0.9),
including BFG, BFL, and ratios between peripheral and abdominal
fluid WBC count.
Conclusion: No objective laboratory markers were identified to
predict the need for relaparotomy. BFG and BFL differences should
not be used as predictors of SP in dogs with CSAD that undergo GI
surgery.
EARLY COMPARED TO DELAYED INITIATION
OF ENTERAL NUTRITION FOR CANINE
POST-OPERATIVE SEPTIC PERITONITIS
Hoffberg, JE, Koenigshof, AM
Introduction: In critically ill humans, initiation of enteral nutrition
within 24 hours of hospitalization has been shown to be of ben-
efit but this has not been investigated prospectively in veterinary
patients. We prospectively evaluated the safety of early enteral nu-
trition (EEN) compared to delayed enteral nutrition (DEN) in dogs
with septic peritonitis.
Methods: Twenty dogs were randomized to time to initiation of na-
sogastric (NG) tube feeding either within 12 hours of surgery (EEN)
or after 48 hours (DEN). Gastrointestinal complications (GICs) of
high gastric residual volume, vomiting, regurgitation or diarrhea
were recorded. All NG intake and voluntary intake were recorded
for calorie determination.
Results: There were 9 dogs in the EEN group and 11 dogs in the
DEN group. Dogs in the EEN group were fed a median of 4 hours
post-surgery and DEN at a median of 48 hours post-surgery (P
0.001). EEN dogs had significantly higher NG intake on days 0–3
and significantly higher voluntary intake on day 4 compared to
DEN. There was no difference in overall GICs, prokinetic use, need
for EN stoppage, dehiscence or survival between groups. More
dogs in EEN ate 1
/
2 RER and full RER and dogs that ate full RER in
C

Abstracts
EEN did so earlier (3 days vs 6 days) but this was not statistically
significant.
Conclusion: There was no difference in occurrence of GIC between
groups indicating the safety of initiating EEN in septic peritonitis.
Larger prospective studies are needed to elucidate the benefits of
EEN.
RELATIONSHIP BETWEEN DIRECT
MEASUREMENT OF INTRACRANIAL PRESSURE
AND OPTIC NERVE SHEATH DIAMETER IN DOGS
Ilie, LA-M1, Thomovsky, EJ1, Johnson, PA1, Bentley, RT1, Heng,
HG1, Lee, CH2, Moore, GE1
1Purdue University Veterinary Teaching Hospital, West Lafayette, IN,
USA
2College of Veterinary Medicine, Gyeongsang National University, Jinju,
Gyeongnam, Republic of Korea
Introduction: Ultrasonographic measurement of optic nerve sheath
diameter (ONSD) is a reliable method to assess increased intracra-
nial pressure (ICP) in people. The aim of this pilot study was to
evaluate the association between ONSD and acute increases in ICP
in an experimental canine model.
Methods: An epidural intracranial pressure monitoring system
(EICPMS) was used to measure ICP in four young healthy dogs
under general anesthesia. The EICPMS was connected to a trans-
ducer/invasive pressure monitor system to generate a continuous
ICP waveform. A 22 gauge intravenous catheter was inserted into
the brain parenchyma through a burr hole in the contralateral pari-
etal bone and successive injections of 0.5–2 mL of anticoagulated
autologous blood were performed every 4–6 minutes. At baseline
and following each injection, the ICP was recorded and three ul-
trasound images of the optic nerve of each eye were obtained with
a 5–12 MHz linear transducer. The maximum nerve diameter that
could be measured was recorded as the ONSD.
Results: A positive correlation was found between ICP and ONSD.
For ICP values 20 mm Hg, the mean ONSD was 2.17 ±0.19 mm;
at 21–40 mmHg the mean ONSD was 3.08 ±0.65 mm; for ICP 40
mm Hg, the mean ONSD was 3.47 ±0.40 mm.
Conclusion: This study demonstrates that increased ICP can be
measured in dogs with the EICPMS and is positively correlated
with increased ultrasonographic measurement of the maximum
ONSD. This study supports using ultrasonographic measurement
of the maximum ONSD as a non-invasive bedside monitoring tool
for evaluation of increased ICP in dogs.
CLINICAL EVALUATION OF PLETHYSMO-
GRAPHIC VARIABILITY INDEX ON AWAKE
SPONTANEOUSLY BREATHING CANINE
PATIENTS
Ilie, LA-M, Thomovsky, EJ, Johnson, PA, Ko, JC, Moore, GE
Purdue University Veterinary Teaching Hospital, West Lafayette, IN,
USA
Introduction: Plethysmographic Variability Index (PVI) has been
proven to help clinicians assess fluid responsiveness in both awake
and anesthetized mechanically ventilated human patients. Low PVI
(ࣘ14%) values indicate that human patients will not respond to
fluid therapy whereas PVI ࣙ14% indicates patients will improve
their stroke volume and blood pressure after fluid challenge. Our
goal was to investigate the relationship of PVI and perfusion index
(PI) with traditional parameters used to determine the need for IV
fluid therapy in awake spontaneously ventilating canine patients.
We hypothesized that PVI is a useful bedside tool to predict fluid
responsiveness in these dogs.
Methods: Prospective observational study using 66 dogs. Based
on physical exam and severity of underlying disease, dogs were
assigned to 1 of 3 groups: dehydrated, overhydrated, and normal
(control). Heart rate (HR), systolic blood pressure (SBP), oxygen sat-
uration (SpO2), packed red blood cell volume (PCV), total protein
(TP), body weight (WT), PVI and PI were measured. A regression
model was used for data analysis.
Results: A positive correlation was found between PVI and PI (0.44;
P 0.001), while the PVI was negatively correlated with HR (−0.43;
P 0.001). Hydration status, PCV, TP, SBP, and SpO2 values were
not significantly correlated with PVI or PI readings. Decreases in
PVI were not observed after fluid administration in the dehydrated
patients.
Conclusion: Plethysmographic variability index could not be used
as a bedside tool to predict the need for fluid therapy due to its
poor correlation with traditional parameters used to gauge patient
hydration status.
A COMPARISON OF CARDIOPULMONARY
FUNCTION, RECOVERY QUALITY, AND TOTAL
DOSAGES REQUIRED FOR INDUCTION AND
TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH
PROPOFOL VERSUS A PROPOFOL-KETAMINE
COMBINATION IN HEALTHY UNPREMEDICATED
DOGS
Kennedy, MJ, Smith, LJ
School of Veterinary Medicine, University of Wisconsin, Madison, WI,
USA
Introduction: The use of ketamine-propofol anesthesia has been
described for minimally invasive procedures in human emergency
settings. The objective of this study was to compare cardiopul-
monary function, recovery quality, and total dosages required for
60 minutes of total intravenous anesthesia (TIVA) with propofol (P)
versus 1:1 mg/mL of propofol and ketamine (KP).
Methods: Ten Beagles (9.4 ± 1.8 kg) received P or KP for TIVA in
a blinded randomized crossover design. Treatment drug was ad-
ministered to effect and maintained by a continuous infusion (CRI)
for 60 minutes. Dogs were intubated and spontaneously breathed
room air. Salivation scores and noninvasive cardiovascular and res-
piratory parameters were recorded every 5 minutes. Arterial blood
gas analysis was performed at 10, 30, and 60 minutes, and after
recovery.
Results: KP required significantly less propofol for induction (3.98
± 0.97 mg/kg KP versus 5.32 ± 1.14 mg/kg P) and maintenance
(0.34 ± 0.11 mg/kg/min KP versus 0.55 ± 0.12 mg/kg−/min P). P
resulted in decreased MAP with no change in HR or oxygenation;
KP resulted in significantly higher HR and attenuated some of
the decline in MAP but with hypoxemia and hypercapnia at some
time points. Both TIVA methods resulted in minimal salivation, no
difference in time to extubation, and acceptable recovery quality.
Conclusion: TIVA in healthy dogs with ketamine and propofol
in a 1:1 mg/mL combination results in significant propofol dose
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Abstracts
reduction, higher HR, improved MAP, no difference in recovery
quality, but more significant respiratory depression compared to
propofol alone.
LABORATORY FINDINGS IN CATS WITH
NATURALLY-OCCURING SEPSIS
Klainbart, S, Agi, L, Aroch, I, Kelmer, E
Hebrew University Veterinary Teaching Hospital, Koret School of Veteri-
nary Medicine, Hebrew University of Jerusalem., Rehovot, Israel
Introduction: Sepsis is a severe, often fatal syndrome, resulting
from the systemic inflammatory response to infection. The aims of
this study were to characterize the hematological, biochemical and
hemostatic findings in cats with naturally-occurring sepsis.
Methods: Prospective study; 31 client-owned cats that met set cri-
teria for sepsis (ie, 2/4 criteria of systemic inflammatory response
syndrome with confirmed infection); 34 healthy staff-owned con-
trol cats. Blood samples were collected within 24 hours from presen-
tation for CBC, serum biochemistry, prothrombin time, activated
partial thromboplastin time (PT and aPTT, respectively), D-dimer
and fibrinogen concentrations, and activities of protein C (PCA)
and antithrombin (ATA) determination.
Results: Septic cats were significantly more anemic, had higher
nucleated red blood cell count, lower serum albumin, total pro-
tein and total calcium concentrations, and higher serum bilirubin
concentration and, aspartate- transaminase and creatine-kinase ac-
tivities (P 0.008 for all) compared to the controls. Septic cats had
significantly prolonged aPTT, and increased D-dimer, and lower
PCA and ATA (P ࣘ 0.001 for all) activities, and had a lower platelet
count compared to the controls (P = 0.037). Neutrophil cytoplasmic
toxicity was common in septic cats. The 10-day survival rate of the
septic cats was 65%, serum urea concentration was significantly
higher (P = 0.04), and ATA and PCA activities tended to be lower
(P = 0.06) in non-survivors compared to survivors.
Conclusion: Naturally-occurring sepsis in cats is characterized
by anemia, neutrophil toxicity, hypoalbuminemia, increased mus-
cle enzymes activity, hyperbilirubinemia and hemostatic derange-
ment, manifested by prolonged aPTT, low PCA and ATA activities,
increased plasma D-dimer concentration and thrombocytopenia.
PREDICTORS OF SHORT-TERM MORTALITY IN
DOGS WITH PRIMARY IMMUNE-MEDIATED
HEMOLYTIC ANEMIA: A MULTICENTER STUDY
Lamb, J1, OToole, T1, Schoeffler, G2, Hanel, R3, Woolcock, A4,
Jutkowitz, A5, Puglia, G6, Guenther, C7, Guillaumin, J8, Stone-
ham, A9, Bacek, L10, Stewart, S11, Gest, J12, McMichael, M13,
Fossett, F13, Monaghan, K14, Abelson, A1, Whelan, M15, Lester,
C16, Price, LL17
Grafton, MA, USA
2Cornell University College of Veterinary Medicine, Ithaca, NY, USA
3College of Veterinary Medicine at North Carolina State University,
Raleigh, NC, USA
4UGA College of Veterinary Medicine, Athens, GA, USA
5Michigan State University College of Veterinary Medicine, East Lans-
ing, MI, USA
6Hope Veterinary Specialists, Malvern, PA, USA
USA
8The Ohio State University Veterinary Medical Center, Columbus, OH,
USA
9VCA Veterinary Referral Associates, Gaithersburg, MD, USA
10Auburn University College of Veterinary Medicine, Auburn, AL, USA
11Animal Internal Medicine Specialty Services, San Francisco, CA,
USA
12The Animal Medical Center, New York, NY, USA
13University of Illinois College of Veterinary Medicine, Urbana, IL, USA
14Alpenglow Veterinary Specialty + Emergency Center, Boulder, CO,
USA
15Angell Animal Medical Center, Boston, MA, USA
16Ocean State Veterinary Specialists, East Greenwich, RI, USA
17Tufts University Medical School, Boston, MA, USA
Introduction: Canine immune-mediated hemolytic anemia
(IMHA) has a mortality of 20–70%. This study aimed to construct
a model to predict mortality during their initial hospitalization.
Methods: Data for newly diagnosed dogs with IMHA was ret-
rospectively collected based on PCV 35% and spherocytosis,
auto-agglutination or a positive Coomb’s test. Dogs with an un-
derlying disease, a platelet count 30,000/uL, or if no treatment
was attempted were excluded. Outcome was defined as survival
to discharge. Candidate variables were selected a priori and the
model was developed using multivariate logistic regression with
stepwise backwards elimination (P 0.05). Point estimates were
used to establish scores.
Results: Four hundred and nine dogs were included with an overall
mortality of 22%. The variables remaining and scores in our model
are blood transfusion (yes = 2; no = 0), age ( 8 years = 0; 8–12 =
0.5; 12 years = 1), bilirubin ( 12 mg/dL = 0; 12–18 = 3; 18 =
3.5), ALT ( 800 = 0; 800 = 1), and platelet count (30–90 k/uL =
2; 90–180 = 0.5; 180 = 0). The area under the receiver operating
characteristic curve was 0.69. The predicted probability of mortality
for a combined score greater than 6 was 62.8% with a specificity of
99.4%, sensitivity of 10%, and positive predictive value of 81.8%.
Conclusion: We identified significant risk factors and built a pre-
dictive model that reasonably discriminates between dogs that died
and survived. Examining changes in laboratory values over time
may aid in better prognosticating.
EVALUATION OF SHORT-TERM OUTCOME IN
DOGS WITH NEWLY DIAGNOSED PRIMARY
IMMUNE-MEDIATED HEMOLYTIC ANEMIA
(IMHA): A MULTICENTER, RETROSPECTIVE
STUDY
Lamb, J1, O’Toole, T1, Schoeffler, G2, Hanel, R3, Woolcock, A3,
Jutkowitz, A4, Puglia, G5, Guenther, C6, Guillaumin, J7, Stone-
ham, A8, Bacek, L9, Stewart, S10, Gest, J11, McMichael, M12, Fos-
sett, F12, Monaghan, K13, Abelson, A1, Whelan, M14, Lester, C15
Grafton, MA, USA
2Cornell University College of Veterinary Medicine, Ithaca, NY, USA
3North Carolina State University College of Veterinary Medicine,
Raleigh, NC, USA
4Michigan State University College of Veterinary Medicine, East Lans-
ing, MI, USA
5Hope Veterinary Specialists, Malvern, PA, USA
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Abstracts
USA
7The Ohio State University College of Veterinary Medicine, Columbus,
OH, USA
8VCA Veterinary Referral Associates, Gaithersburg, MD, USA
9Auburn University College of Veterinary Medicine, Auburn, AL, USA
10Animal Internal Medicine Specialty Services, San Francisco, CA,
USA
11The Animal Medical Center, New York, NY, USA
12University of Illinois College of Veterinary Medicine, Urbana, IL, USA
13Alpenglow Veterinary Specialty + Emergency Center, Boulder, CO,
USA
14Angell Animal Medical Center, Boston, MA, USA
15Ocean State Veterinary Specialists, East Greenwich, RI, USA
Introduction: There are currently no standardized protocols for the
optimal treatment of immune-mediated hemolytic anemia (IMHA).
The aim of this study was to examine the outcome of different
treatment strategies.
Methods: Data for newly diagnosed dogs with IMHA was retro-
spectively collected based on PCV 35% and spherocytosis, auto-
agglutination or positive Coomb’s test. Dogs with underlying dis-
ease, platelet count 30,000/uL, or not treated were excluded.
Outcome was defined as survival to discharge. Treatment groups
included prednisone (P), or prednisone with azathioprine (PA), cy-
closporine (PC), or mycophenolate (PM). Anticoagulants used in-
cluded heparin, low-molecular-weight heparin, aspirin, and clopi-
dogrel. Categorical variables were analyzed using the chi-squared
test. Continuous variables were analyzed using the Kruskal-Wallis
test. Statistical significance was determined by P 0.05.
Results: Four hundred and nine dogs were included with an over-
all mortality rate of 21.7%. There was no significant difference in
mortality between the four treatment groups (p = 0.63). Dogs in the
PC and PM treatment groups were hospitalized longer (P 0.05)
and required more blood transfusions (p 0.01). There were no
clinically relevant differences between treatment groups and lab-
oratory data. There was no significant difference in mortality be-
tween dogs receiving thromboprophylaxis (21.5%) and those that
did not (26.5%), P = 0.27. Mortality was significantly different be-
tween dogs with confirmed or suspected thromboembolism (60%)
compared to dogs without (12.8%), P 0.0001.
Conclusion: No treatment combination proved more effective than
prednisone alone for treatment of IMHA. Thromboembolism in-
creases mortality and further studies are needed to determine the
best thromboprophylactic protocol.
USE OF A PORTABLE OXYGEN CONCENTRATOR
IN CLIENT OWNED HYPOXEMIC DOGS
Letendre, J-A1,2, Boysen, S1, Stillion, J2, Caulkett, N1
1Department of Veterinary Clinical and Diagnostic Sciences, University
of Calgary Veterinary Medicine, Calgary, AB, Canada
2Western Veterinary Specialist and Emergency Centre, Calgary, AB,
Canada
Introduction: Oxygen therapy is commonly administered to small
animals. Portable oxygen concentrators (POC) are widely used in
human medicine for in-home oxygen therapy or as an alternative
to compressed gas cylinders in developing countries and military
units. The objective of this study was to determine if a POC would
increase partial pressure of arterial oxygen (PaO2) in hypoxemic
canine patients.
Methods: Ethics approval and owner consent was obtained for this
study. Dyspneic dogs with PaO2 ࣘ 70 mm Hg on room air requir-
ing supplemental oxygen via nasal prongs for any reason were
included. Oxygen therapy was discontinued for 5 minutes and a
baseline PaO2 (room air) obtained (T0). Oxygen supplementation
using the EverGo POC (Respironics) was provided for 10 min-
utes and PaO2 measurement repeated (T10). POC oxygen supple-
mentation was discontinued and a third PaO2 measurement taken
5 minutes later (T15). PaO2 values were compared using a one-way
ANOVA, with post hoc Bonferonni. A Kolmogorov–Smirnov test
was used for normality. Results are mean ± SD.
Results: Five dogs were enrolled. Data were normally distributed.
PaO2 values at T0, T10 and T15 were 58.4 ± 3.6, 92.2 ± 13.4, and
59.6 ± 4.6 mm Hg, respectively, which were statistically different (P
= 0.0074). T10 was statistically higher than T0 and T15 (P 0.05).
T0 was not statistically different than T15.
Conclusion: This pilot study supports the use of POC to improve
arterial oxygenation in hypoxemic dogs. This may be useful in clin-
ical settings where compressed oxygen is not available, or during
transport of hypoxemic dogs to referral centers.
EVALUATION OF PLATELET FUNCTION USING
MULTIPLE ELECTRODE PLATELET
AGGREGOMETRY IN DOGS WITH SEPTIC
PERITONITIS
Li, RHL, Chan, DL
Department of Clinical Science and Services, The Royal Veterinary Col-
lege, University of London, North Mymms, United Kingdom
Introduction: Studies in people with sepsis have identified sepsis-
related changes in platelet function, which may contribute to de-
velopment of multiple organ dysfunction (MODS) and increased
mortality. It is unknown if similar findings are present in canine sep-
sis. The primary aim of this study was to assess platelet function
via multiple electrode platelet impedance aggregometry (MEPA)
in dogs with septic peritonitis compared to healthy controls. The
secondary aim was to determine any prognostic ability of platelet
dysfunction in septic dogs.
Methods: Twenty dogs with septic peritonitis were enrolled and
compared to 23 healthy dogs. Multiplate platelet function anal-
ysis using arachidonic acid (AA), collagen (COL) and adenosine
diphosphate (ADP) as agonists of platelet aggregation were per-
formed within 24 hours of diagnosis of septic peritonitis.
Results: Compared to healthy dogs, platelet aggregation was sig-
nificantly reduced in dogs with septic peritonitis when all three
agonists were used (all P 0.01). Platelet aggregation was signif-
icantly decreased in non-survivors compared to survivors when
COL was used as an activator (P = 0.02). Impedance aggregometry
using COL with a cut-off of 43.5 aggregation units had a sensitiv-
ity of 83% and specificity of 83% for predicting mortality. Platelet
aggregometry was not significantly different amongst dogs with or
without MODS.
Conclusion: Results of the present study confirm platelet dysfunc-
tion in dogs with septic peritonitis. MEPA using COL as an activator
may be a candidate assay for prediction of mortality in septic dogs.
Further studies are warranted in identifying the pathophysiological
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Abstracts
mechanism of platelet dysfunction and the progression of sepsis in
dogs.
ALANINE AMINOTRANSFERASE ACTIVITY (ALT)
AS A MARKER FOR HEMOABDOMEN
DETECTED BY ABDOMINAL FAST (AFAST) IN
DOGS WITH AUTOMOBILE TRAUMA
Lisciandro, GR
Hill Country Veterinary Specialists, Emergency Pet Center, Inc., San
Antonio, TX, USA
Introduction: Serum alanine aminotransferase (ALT) activity have
been used as a screening test for hemoabdomen in bluntly trauma-
tized children. To the author’s knowledge, no studies in veterinary
medicine have evaluated ALT activity as a predictor of hemoab-
domen.
Methods: Dogs with automobile trauma presenting to a private
veterinary emergency center were prospectively studied. Upon ad-
mission, an abdominal FAST (AFAST) exam and an ALT activ-
ity were performed. Hemoabdomen was diagnosed by AFAST-
positive and surviving without surgical intervention or by confir-
matory abdominocentesis. AFAST-negative and positive dogs were
compared for differences. Sensitivity and specificity of ALT predic-
tive of hemoabdomen and receiver operator characteristics (ROC)
analysis were calculated.
Results: Of 74 dogs evaluated, 53 were AFAST-negative. Twenty-
one dogs were AFAST-positive; and 15 were confirmed with
hemoabdomen by abdominocentesis. Mean and median ALT ac-
tivities for AFAST-negative dogs were 479 and 249 U/L, respec-
tively (CI 95%, 318, 641); and AFAST-positive dogs were 1067 and
989 U/L, respectively (CI 95%, 607, 1527). ALT activities between
AFAST-negative and positive dogs were different (P = 0.003). Re-
ceiver operating characteristics analysis estimated an area under
the curve of 0.744. Normal ALT ( 102 U/L) had sensitivity (Se)
of 90%. Abnormal ALT over 1000 U/L had specificity (Sp) of 90%.
Cut-off Se and Sp values were less clear; however, an ALT of 503
U/L had a Se and Sp of 67%.
Conclusion: ALT activities may be used as a predictor of hemoab-
domen in dogs with automobile trauma with higher activities pre-
dictive of its presence. These findings support the inclusion of ALT
in the initial trauma work-up of bluntly traumatized dogs.
ENDOTHELIN-1 IN DOGS UNDERGOING
HEMODIALYSIS AND ITS ROLE IN
INTRADIALYTIC HYPERTENSION: A PILOT
STUDY
Londoño, LA, Buckley, GJ, Bandt, C, Shmalberg, J
University of Florida, College of Veterinary Medicine, Gainesville, FL,
USA
Introduction: Intradialytic hypertension affects 15% of humans un-
dergoing hemodialysis; the role of endothelial dysfunction and in-
creases in Endothelin-1 (ET-1) concentration are well documented.
Changes in ET-1 concentration in veterinary hemodialysis patients
have not been reported. This study prospectively measured ET-
1 in plasma of dogs with acute kidney injury (AKI) receiving
hemodialysis.
Methods: Dogs requiring hemodialysis for management of AKI
were recruited. ET-1 was assayed before, during and 6 hours post-
dialysis using Quantikine ELISA. Blood pressure was measured
concurrently with each blood collection for ET-1 assay. Fluid gain
or loss during hemodialysis was measured based on change in body
weight. The first two treatments for each patient were included in
the study.
Results: ET-1 increased significantly from baseline to post
hemodialysis (P = 0.0096) in all treatments. The increase from base-
line during hemodialysis was significant for treatment 1 (P = 0.036)
but not for all treatments (P = 0.352). A significant increase occurred
from intra to post hemodialysis in all treatments (P = 0.0243). No
correlation was found between ET-1 concentration and blood pres-
sure or change in body weight. A significant negative correlation
was found between initial blood pressure and percent change in
ET-1 concentration (r = −0.77).
Conclusion: Significant increases in ET-1 concentrations were iden-
tified in dogs undergoing hemodialysis but no correlation was iden-
tified with blood pressure. It is possible that the relationship is
confounded by several factors including use of antihypertensive
drugs, variable rates of ultrafiltration, starting volemic status and
the activation of the RAAS system. Further studies would be re-
quired to elucidate the role of ET-1 in dogs undergoing long term
hemodialysis.
DIAGNOSTIC UTILITY OF A MULTIBIOMARKER
PANEL FOR DETERMING THE ETIOLOGY OF
FEVER IN DOGS PRESENTING FOR
EMERGENCY CARE
Lynch, AM1, Sharp, CR1, Ringold, R2, Gauthier, S2
Grafton, MA, USA
2Veterinary Diagnostics Institute, Simi Valley, CA, USA
Introduction: Identification of the cause fever in dogs may be
challenging. Sepsis, non-infectious inflammation and neoplasia are
some of the most common causes of fever. The aim of this study
was to assess the diagnostic utility of three established biomarkers
in identifying the cause of fever in dogs.
Methods: Dogs presenting for emergency care with fever
(102.5°F) were eligible for inclusion. Blood was collected and
serum frozen at -80°F for batch analysis of three biomarkers us-
ing previously validated ELISAs. Aminoterminal pro-C-type na-
triuretic peptide (NT-proCNP) was used as a marker of sepsis,
C-reactive protein (CRP) as a non-specific inflammatory marker
and thymidine kinase-1 (TK-1) as a neoplasia biomarker. A clin-
ician blinded to the biomarker results made a diagnosis of sep-
sis, non-infectious non-neoplastic systemic inflammation, neopla-
sia, or ‘other’ in these dogs. Sepsis (SI) and neoplasia indices
(NI) were calculated based on normalization of the measured
biomarker values to predetermined cut-off values. An ROC curve
analysis was performed, and AUC used to report biomarker
performance.
Results: Thirty-seven dogs with a definitive diagnosis were in-
cluded. Fever was assessed as being due to sepsis in 14 dogs, non-
infectious systemic inflammation in 16 dogs and neoplasia in 7
dogs. The AUC for the use of SI to identify sepsis as the cause of
fever was 0.818. The AUC for the use of NI to identify neoplasia as
the cause of fever was 0.936.
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Conclusion: This pilot data suggests the use of these three biomark-
ers in concert may have a role in identifying the cause of fever in
dogs.
HISTOPATHOLOGICAL CHANGES OF KIDNEYS
FROM HOSPITALIZED DOGS DIAGNOSED WITH
ACUTE KIDNEY INJURY
Preston, AR, McLeland, S, Ehrhart, EJ, Chamney, N, Sullivan, LA
Colorado State University, Fort Collins, CO, USA
Introduction: Acute kidney injury (AKI) has been documented in
critically ill dogs and several scoring systems for AKI severity have
been proposed. The association between AKI severity and renal
histopathological findings has not been described. The purpose
of this study was to document renal histopathological changes in
critically ill dogs that develop AKI and to determine if classification
of AKI is associated with severity of histopathological disease.
Methods: Retrospective evaluation of medical records from 27 dogs
were reviewed for the development of hospital-acquired AKI based
on Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria. Under-
lying disease, clinical severity score, time from hospitalization to
onset of AKI, serial serum creatinine values, exposure to intrin-
sic causes of AKI, case outcome and histopathology report were
recorded. Hematoxylin and eosin stains were evaluated for throm-
bus formation, tubular necrosis, apoptotic bodies and leukocyte in-
filtration. Special stains to confirm the presence of apoptosis using
terminal deoxynucleotidyl transferase-mediated dUTP nick end la-
beling (TUNEL) and caspase-3 were also performed.
Results: Dogs with AKI exhibit a statistically significant increase
in the number of TUNEL positive nuclei when compared to dogs
that did not develop AKI (182.4 TUNEL positive tubular epithelial
cells/10 hpf vs 91 TUNEL positive tubular epithelial cells/10 hpf,
P 0.0001).
Conclusion: Critically ill dogs that develop AKI demonstrate an in-
crease in the number of TUNEL positive cells compared to dogs that
did not develop AKI. Special staining may provide insight regard-
ing underlying apoptotic pathways, which could offer opportunity
for further investigation and possibly therapeutic targeting.
LEUKOREDUCTION PREVENTS ACCUMULATION
OF INTERLEUKIN-8 IN CANINE PACKED RED
BLOOD CELLS DURING STORAGE
Purcell, SL, Smart, L, Hosgood, G, Claus, M
Murdoch University, Perth, Western Australia, Australia
Introduction: Cytokines, interleukin-8 (IL-8), interleukin-1␤ (IL-
1␤) and tumor necrosis factor-␣ (TNF-␣) accumulate in human
packed red blood cells (PRBCs) during storage resulting in recipient
inflammation. Leukoreduction has been shown to prevent cytokine
accumulation. The aim of this study was to measure IL-8, IL-1␤ and
TNF-␣ concentrations in canine stored PRBCs over time and assess
the effect of leukoreduction on these cytokine concentrations.
Methods: Twelve healthy greyhounds were anesthetized and one
unit of blood was collected from each greyhound and processed
into PRBCs. Half of each unit was passed through a leukoreduction
filter to produce a leukoreduced (LR) unit and a non-leukoreduced
(NLR) unit. A complete blood count was performed on day 0 on
all units, which were then stored at 2–6°C. Samples were collected
from the units at days 0, 10, 20, 30 and 37, which were centrifuged
and the supernatant stored at -80°C. Canine TNF-␣ and canine IL-8
were assessed using Luminex xMAP technology and canine IL-1␤
was measured by ELISA.
Results: Leukoreduction resulted in 100% reduction of leukocytes.
Both TNF-␣ and IL-1␤ concentrations were not significantly differ-
ent between LR and NLR units, and did not change significantly
over time. Interleukin-8 concentration was significantly higher in
NLR units compared with LR units at all time points (P = 0.0021).
The IL-8 concentration increased at day 10 and remained increased
at day 37 in NLR units but did not increase during storage in LR
units.
Conclusion: This study showed that leukoreduction of canine
PRBCs prevented accumulation of IL-8 during storage.
THE ASSOCIATION OF LACTATE WITH
PHYSICAL PERFUSION PARAMETERS, BLOOD
PRESSURE, AND OUTCOME IN CATS
PRESENTING TO AN EMERGENCY SERVICE: A
PROSPECTIVE STUDY
Reineke, EL, Rees, C, Drobatz, KJ
University of Pennsylvania School of Veterinary Medicine, Philadelphia,
PA, USA
Introduction: In emergent patients, hyperlactatemia most com-
monly occurs when there is an imbalance between tissue oxygen
delivery and oxygen consumption, which occurs in shock states.
To date, no clinical studies exist evaluating the association of ad-
mission lactate with perfusion parameters and outcome in sick
cats. Our hypothesis was that plasma lactate would be increased
in cats with abnormal physical exam perfusion parameters and
hypotension and admission hyperlactatemia would be associated
with non-survival.
Methods: Cats having a physical examination, systolic blood pres-
sure (SBP), and a plasma lactate measured at emergency service
admission and prior to any interventions were prospectively en-
rolled. Hypotension was defined as a SBP 90 mm Hg. Outcome
was defined as survival to hospital discharge, euthanized, or died.
Results: The median lactate for the 111 study cats was 2.7 mmol/L
(range: 0.5 – 19.3 mmol/L). Physical examination perfusion pa-
rameters significantly associated with an increased median lactate
(2.5 mmol/L) included white mucous membranes, poor femoral
pulses, and absent metatarsal pulses (p 0.01). The median lactate
for hypotensive cats (3.3 mmol/L) was significantly higher than
the median lactate for cats with SBP ࣙ 90 mm Hg (2.35 mmol/L) (P
0.01). The median admission lactate was not significantly differ-
ent between cats that survived to hospital discharge (2.45 mmol/L)
and those that were euthanized (3.2 mmol/L) (P = 0.3858).
Conclusion: Lactate may be a useful biomarker, along with the
physical examination and SBP, in identifying abnormalities in tissue
perfusion and oxygen delivery in cats. However, lactate clearance
in response to therapy is likely more clinically useful than single
lactate measurements in predicting outcome.
COMPARISON OF KAOLIN-ACTIVATED
THROMBOELASTOGRAPHY BETWEEN
HEALTHY AND HOSPITALIZED DOGS
Rubanick, JV, Barr, JW, Bishop, MA, Pashmakova, MB
Texas AM University, College Station, TX, USA
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Abstracts
Introduction: Hospitalized dogs are predisposed to hemostatic al-
terations from a variety of underlying conditions. Thromboelas-
tography (TEG) is one of few available tests of global hemosta-
sis and data comparing tissue factor-activated TEG between
hospitalized and healthy dogs has been published. The pur-
pose of this study was to compare kaolin-activated TEG between
a heterogeneous population of hospitalized dogs and healthy
controls.
Methods: Thirty-four dogs admitted to the teaching hospital be-
tween July 2013–February 2014 with clinical conditions warrant-
ing coagulation testing and 30 control dogs were analyzed with
kaolin-activated thromboelastography. Data was checked for nor-
malityand Mann–Whitneyor unpaired t testswereused to compare
groups. Alpha was set at 0.05.
Results: There were statistically significant differences in the me-
dian values of K (1.20 vs 1.85; P = 0.002), alpha-angle (72.93 vs
64.47; P = 0.002), MA (62.25 vs 54.02; P = 0.001), and G (mean; 9.48
vs 6.14; P = 0.001) between the 2 groups; however, there was no
difference in the median R values (3.15 vs 3.50; P = 0.62). Interest-
ingly, 2/3 dogs with ultrasonographically-confirmed thrombi had
a normal TEG tracing.
Conclusion: The results of this study document significant differ-
ences in kaolin-activated TEG in hospitalized dogs compared to
healthy controls. These differences are characteristic of a more hy-
percoagulable state; however, the hypercoagulable median values
of the sick group were within the reference range for the machine.
Future studies correlating clinical findings with TEG parameters in
select patient populations are warranted.
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Abstracts
Posters
EFFECT OF VISCOSITY MANIPULATION WITH
SODIUM CARBOXYMETHYLCELLULOSE ON
CANINE THROMBOELASTOGRAPHIC TRACINGS
Brooks, AC1, Cooper, E1, Guillaumin, J1, Couto, CG2
1The Ohio State University, Columbus, OH, USA
2Metzger Animal Hospital, State College, PA, USA
Introduction: Anemic TEG samples tend to show “hypercoagu-
lable” tracings despite the clinical expectation that anemia often
prolongs bleeding. Hematocrit (HCT) is the main determinant of
whole blood viscosity, and TEG is a viscoelastic assessment of clot-
ting. Therefore, we hypothesize that changes in whole blood vis-
cosity influence TEG measurements.
Methods: Twenty-two blood samples from 11 dogs were manipu-
lated to produce 2 Hct groups (20%, 10%). Each group was divided
into 2 conditions: viscosity normalized by adding carboxymethyl-
cellulose (CMC), or dilution with equal volume of saline (SAL).
Both conditions were analyzed with TEG simultaneously. Viscos-
ity was measured by cone-and-plate viscometer. Additional 10%
Hct samples were assessed by TEG with 0.4M CaCl2 to assess the
impact of CMC binding Ca2+ on TEG tracings.
Results: Viscosity was significantly different (P 0.05) between
CMC and SAL conditions of the same HCT. CMC conditions had in-
creased R and K and decreased angle, MA, and G values compared
to SAL conditions of the same Hct, indicating less “hypercoagula-
ble” CMC tracings. This difference was smaller but still statistically
different for the TEG variables K, MA, and G in the presence of
increased calcium.
Conclusion: Samples with normalized viscosity with CMC had less
“hypercoagulable” TEG tracings compared to SAL samples of the
same HCT, even in the presence of increased Ca2+. TEG tracings are
affected by whole blood viscosity independent of HCT, depending
on the viscosity-modifying agent used.
INFLUENCE OF RED BLOOD CELL
TRANSFUSION ON TEG TRACINGS IN
NATURALLY ANEMIC DOGS
Brooks, AC1, Cooper, E1, Guillaumin, J1, Couto, CG2
1The Ohio State University, Columbus, OH, USA
2Metzger Animal Hospital, State College, PA, USA
Introduction: Anemic blood has “hypercoagulable” thromboelas-
tography (TEG) tracings in vitro compared to non-anemic blood.
However, the impact of hematocrit (Hct) on TEG in naturally ane-
mic dogs is unknown. Therefore, we hypothesized that following
transfusion, TEG values would become less “hypercoagulable,”
despite minimal change in underlying disease status.
Methods: Pre and post packed red blood cell transfusion samples
were taken from 22 dogs and assessed by TEG 30 minutes from
phlebotomy. Signalment, weight, underlying disease process, vol-
ume of transfused blood, and CBC data were also collected. Data
was subdivided into 3 categories of anemia: bleeding (10), IMHA
(6), and non-regenerative (6).
Results: Median Hct pre-transfusion was 11% (6–26%) and median
Hct post-transfusion was 19% (12–31%). A mean of 11(±2) mL/kg
pRBC was transfused, and mean Hct increased by 7% (±3) after
transfusion. Post samples had higher Hct and viscosity, and lower
platelets, white blood cells (WBCs), MA and G than pre samples
(P0.05). Increasing delta MA (pre minus post) was significantly
(r = 0.5, P = 0.03) correlated with increasing Hct (post minus pre).
For every 1% increase in Hct, MA decreased by approximately
0.5mm (±0.2). Disease categories differed in anemia severity, WBC
count, and TEG variables, with IMHA dogs having the highest
WBC counts and lowest pre-transfusion Hct.
Conclusion: Increasing Hct correlates with decreasing MA and G
TEG variables in anemic dogs. Within the range of anemia and dis-
eases studied, these changes are small and unlikely to significantly
impact clinical decision making, but do suggest an impact of red
cell mass on measurement with TEG.
EVALUATION OF PaO2/FIO2 AND SaO2/FIO2
RATIOS IN POSTOPERATIVE DOGS
RECOVERING ON ROOM AIR VERSUS NASAL
OXYGEN INSUFFLATION
Carver, A1, Sullivan, L2
1Michigan State University, East Lansing, MI, USA
2Colorado State University, Fort Collins, CO, USA
Introduction: Very limited data exists regarding PaO2/FIO2 (P/F)
and SaO2/FIO2 (S/F) ratios in dogs. The goal of this study was to
evaluate P/F and S/F ratios, and the correlation between P/F and
S/F in dogs recovering postoperatively on nasal oxygen supple-
mentation versus room air.
Methods: Records were retrospectively evaluated from a study in
which healthy dogs were randomized to receive 100 mL/kg/min
nasal oxygen (estimated 37% FIO2, n = 9) or room air (estimated
21% FIO2, n = 10) for 2 hours postoperatively. Baseline information
was obtained one hour intraoperatively (estimated 100% FIO2), fol-
lowed by 3 postoperative time points (10, 60 and 120 minutes). Data
recorded included FIO2, PaO2, SaO2, P/F ratio, S/F ratio, PaCO2,
rectal temperature, and arterial blood pH. Using the baseline value
as a covariate, results were analyzed with ANOVA. Correlations
between P/F and S/F were determined with Pearson correlation
coefficients.
Results: The P/F ratio in dogs receiving oxygen was significantly
higher (516 ± 28 versus 359 ±10, P .0001). Conversely, the S/F
ratio in dogs on oxygen was significantly lower (268 ± 0.5 versus
448 ± 1.4, P .0001). The P/F and S/F ratios demonstrated excellent
correlation for both groups at all times. The P/F and S/F correlation
at each time point for dogs on oxygen were 0.94, 0.93, and 0.90
(P .001) and 0.90, 0.95 and 0.93 (P .001) for dogs on room air.
Conclusion: This study provides expected P/F and S/F ratios over
a two hour postoperative period, and also indicates an excellent
correlation between P/F and S/F in this population.
SPLENECTOMY AS ADJUNCTIVE THERAPY FOR
REFRACTORY CANINE IMMUNE-MEDIATED
HEMOLYTIC ANEMIA: 8 CASES (2008–2012)
Carver, A, Jutkowitz, LA, Koenigshof, AM
Introduction: The objective of this study was to describe the use of
splenectomy in a series of dogs with severe or refractory immune-
mediated hemolytic anemia (IMHA).
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Abstracts
Methods: This was a retrospective analysis of data gathered
prospectively between 2008–2012. Dogs with a diagnosis of id-
iopathic IMHA were eligible for study inclusion if they required
daily transfusions for 3 consecutive days, or were still transfusion
dependent after 7 days of treatment. Following owner consent, el-
igible dogs received a minimally invasive splenectomy. If a rise in
hematocrit was documented within 1 day of splenectomy, the cor-
ticosteroid dose was immediately reduced by 50%. Data recorded
included PCV (at admission, pre-, 1 day post-, and 3 days post-
splenectomy), median number of blood transfusions pre- and post-
splenectomy, drug doses, length of surgery, surgical complications,
survival, and relapse rates.
Results: Eight cases were included and all survived to discharge.
In 6/8 dogs, hematocrit increased within 24 hours of splenec-
tomy and the corticosteroid dose was immediately reduced from
2 mg/kg/day to 1mg/kg/day. Median PCV was 23 (15–37) just
prior to splenectomy, 25 (15–34) 1 day post-splenectomy, and 27
(13–35) 3 days post-splenectomy. Median number of transfusions
prior to the splenectomy was 4 (1–7) and 0 (0–1) post- splenectomy.
The median length of surgery was 17.5 minutes and there were no
surgical complications. Only one dog relapsed at 15 months after
splenectomy.
Conclusion: Splenectomy is a safe and effective adjunctive therapy
in dogs with refractory IMHA and may allow more rapid tapering
of immunosuppressive therapies.
PRESENTING CLINICAL PARAMETERS AND
PREDICTORS OF OUTCOME IN PRIMARY
IMMUNE MEDIATED THROMBOCYTOPENIA
Darling, ME, Koenigshof, AM, Jutkowitz, LA
Introduction: Immune Mediated Thrombocytopenia (IMT) is rela-
tively common in dogs, but few studies have identified associations
between findings at presentation and outcome. The goal of this
study was to identify whether presenting clinical parameters pre-
dict survival, number of blood transfusions, or length of hospital
stay in dogs with IMT.
Methods: Medical records of dogs with a clinical diagnosis of IMT
from January 2008 through June 2013 were reviewed. Dogs with
a platelet count of 30,000/uL and no other underlying diseases
associated with thrombocytopenia were eligible for inclusion. Data
collected included presenting clinical signs, laboratory data, length
of stay, survival, and number of transfusion events. The data was
analyzed using non-parametric statistics, where P 0.05 was con-
sidered significant.
Results: Ninety-six cases of IMT were identified, and 58 met the in-
clusion criteria. Fifty-three (90%) survived to discharge. A present-
ing complaint of hematuria was associated with a longer length of
hospitalization (P = 0.0029). Gastrointestinal bleeding (P = 0.0176)
and ocular hemorrhage (P = 0.0274) were associated with an in-
creased number of transfusion events. Peak band neutrophil count
during hospitalization was positively correlated with length of hos-
pital stay (P 0.001) and transfusion events (P 0.001), while band
neutrophil count on admission correlated with transfusion events
only (P 0.001). Albumin (P 0.001), total protein (P 0.001),
platelet count (P = 0.0397) and hematocrit (P 0.001) on presenta-
tion were negatively correlated with transfusion events.
Conclusion: Although no clinical parameter predicted survival in
dogs with IMT, band neutrophil count and gastrointestinal, ocular,
or urinary hemorrhage were associated with an increased number
of transfusions and a longer hospital stay.
COMPARISON OF DEA1 EXPRESSION ON DOG
ERYTHROCYTES ANALYZED BY FLOW
CYTOMETRIC TECHNIQUE AND A
POINT-OF-CARE IMMUNOCHROMATOGRAPHIC
STRIP IN A POPULATION OF HEALTHY DONORS
AND SICK ANEMIC RECIPIENT DOGS IN AN
INTENSIVE CARE UNIT
Canard, B1, Barthelémy, A2, Boisvineau, C2, Pin, A2, Pouzot-
Névoret, C2, Goy-Thollot, I2
1Dianov, Limonest, France
2SIAMU, VetAgro Sup, Marcy l’Étoile, France
Introduction: The aim of this study was to investigate the accuracy
of a point-of-care immunochromatographic strip (CHROM; Alve-
dia) in evaluating DEA1 expression when used in an intensive care
unit (ICU) in both healthy and anemic dogs.
Methods: Samples from 85 blood donors and 38 recipients were
analyzed. ICU technicians visually assessed the band strength on
CHROM on a scale from 0 (no band) to weak, normal and strong.
Flow cytometry (FC) analysis of mean fluorescence intensity (MFI)
was used as the reference method. DEA1 antigen expression was
described as negative (MFI 10), weak (11 ࣘ MFI ࣘ 100), normal
(101MFIࣘ350), and strong (MFI351). Sensitivity, specificity, pos-
itive predictive values (PPV) and negative predictive values (NPV)
were calculated to investigate the relationship between CHROM
and FC.
Results: FC technique identified 42 DEA1- and 81 DEA1+ (16
weak, 38 normal, 27 strong). CHROM identified 42 DEA1- and
79 DEA1+ (26 weak, 30 normal, 23 strong). Two recipients with
severe immune mediated hemolytic anemia (IMHA) could not be
typed by CHROM. The sensitivity, specificity, PPV and NPV of
CHROM to type were 100% in the remaining 121 dogs. Among
the 81 DEA1+ dogs, DEA1 antigen expressions were the same
between CHROM and FC in 58 dogs.
Conclusion: The CHROM technique appears to be accurate for
blood typing dogs in an ICU setting. Among DEA1+ dogs, dis-
crepancies in DEA1 expression between CHROM and FC could be
due to the subjectivity of the visual evaluation and the absence of
PCV-adjustment. In two cases, the auto-agglutination due to severe
IMHA prevented result interpretation.
PREVALENCE OF THROMBOEMBOLIC EVENTS
IN DOGS WITH PRECURSOR-TARGETED
IMMUNE-MEDIATED ANEMIA
Gravelyn, TD, Koenigshof, A, Jutkowitz, AL, Scott, M
Introduction: A prothrombotic state is well-established in dogs
with immune-mediated hemolytic anemia (IMHA) but has not
yet been investigated in dogs with precursor-targeted immune-
mediated anemia (PIMA). The objective of this study was to deter-
mine the prevalence of thromboembolic events (TE) in dogs with
PIMA.
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Abstracts
Methods: Medical records (2004–2013) for dogs with a clinical
diagnosis of PIMA were reviewed. Dogs were eligible for inclu-
sion if they had a persistent nonregenerative anemia (reticulocytes
76,000/␮L and PCV31%), bone marrow findings consistent with
PIMA, and absence of underlying disease. Diagnosis of TE was
based on clinical findings, supportive labwork (arterial blood gas,
abdominocentesis) and diagnostic imaging (thoracic radiographs,
abdominal ultrasound or CT angiography).
Results: Sixty-five dogs met the inclusion criteria for PIMA, and
8/65 had one or more reported TE. All TEs occurred in dogs with
confirmed rubriphagocytosis on bone marrow aspirate or core
biopsy. There were 2 splenic vein thrombi (SVT), 2 portal vein
thrombi (PVT) and 4 pulmonary thromboemboli (PTE). One ad-
ditional dog was suspected to have PVT on the basis of acute onset
ascites but imaging was not definitive. One dog had both PTE and
PVT on presentation. The median time from presentation for PIMA,
either initial onset or from relapse, to development of TE was 33.5
days (range 0–72). Mortality rate from TE was 50% (4/8).
Conclusion: TE was a complication of PIMA and contributed to
mortality. PIMA dogs with rubriphagocytosis may be predisposed
to TE. Prospective studies on the mechanism for prothrombosis
and strategies for thrombophylaxis in these patients should be
pursued.
SHORT- AND LONG-TERM OUTCOME OF
TRAUMATIC BRAIN INJURY IN DOGS AND CATS:
278 CASES (2006–2012)
Hart, SK, Drobatz, KJ
Introduction: Traumatic brain injury (TBI) is an important cause
of morbidity and mortality. There is limited information on short-
and long-term outcome in dogs and cats with TBI. The objectives of
this study were to evaluate the effect of patient demographics and
clinicopathologic data on short-term outcome, and obtain long-
term (6 month) follow-up to determine neurologic function in
patients that survived to hospital discharge.
Methods: Medical records (2006–2012) of dogs and cats with TBI
were reviewed. Cases were excluded if they were not hospitalized
for at least 24 hours or if they were euthanized for financial reasons.
Results: 172 dogs and 106 cats were included in the study. Over-
all, 148/172 dogs and 91/106 cats survived to discharge. Base-
line data was not significantly different between survivors and
non-survivors. Factors significantly associated with survival in
dogs included body temperature, modified Glasgow Coma Scale
(mGCS) consciousness score, total mGCS, non-invasive blood pres-
sure, packed cell volume, and anion gap at admission. Factors
significantly associated with survival in cats included body tem-
perature, heart rate, mGCS motor and consciousness scores, total
mGCS, non-invasive blood pressure, and packed cell volume. Hy-
perglycemia and hyperlactatemia at presentation were not associ-
ated with short-term outcome. Neurologic deficits (primarily mild)
were still present in 48/148 dogs, and 32/91 cats at discharge. Long-
term follow-up was obtained. Thirty three out of sixty nine dogs
and 24/43 cats were reportedly neurologically normal at long-term
follow-up.
Conclusion: Overall prognosis for TBI in dogs and cats is good. In-
jury severity appears to be related to survival. Long-term outcome
is favorable.
VARIABILITY IN COMPOSITION OF COMMONLY
USED ISOTONIC CRYSTALLOID FLUIDS
Hoehne, SN, Epstein, SE, Hopper, K
University of California, Davis, Davis, CA, USA
Introduction: To investigate variability in electrolyte composition
of isotonic crystalloid fluids and determine the accuracy of potas-
sium (K+) supplementation in fluid therapy.
Methods: Volume, pH, electrolyte and L-lactate concentrations
were measured in 20 bags each of Lactated Ringer’s, Plasma-Lyte
148, and 0.9% NaCl. [K+] was subsequently measured in these
bags after supplementation to 20 mmol/L of K+ and mixed
well. In another 12 bags of stock fluids, K+ supplementation was
performed without mixing the bag and [K+] of the delivered fluid
was measured at regular time points during infusion. The [K+] of
210 samples from intravenous fluid bags with K+ supplementation
in use for clinical patient care was measured and compared to the
intended [K+] of the bag.
Results: The sodium concentration and volume within the bag is
variable for each commercially available crystalloid fluid. With ad-
equate mixing, K+ supplementation of fluids can be accurate with
the mean difference (95% CI) between measured and intended [K+]
of 0.7 (-0.32 to 1.7) mmol/L when supplementing stock fluid bags.
When not mixed, K+ supplementation can lead to very high [K+] of
delivered fluid (up to 1410 mmol/L). In clinical samples measured,
[K+] was significantly higher from intended [K+] (P0.001). In 27%
of clinical samples, the measured [K+] was 5 mmol/L different
than the intended concentration.
Conclusion: There is variability in electrolyte concentration of iso-
tonic crystalloid fluids that may have clinical significance in specific
case scenarios. Inadequate mixing following K+ supplementation
of IV fluid bags can lead to very high infused [K+].
EVALUATION OF THE EFFICACY OF
SIMULTANEOUS ACID SUPPRESSION IN DOGS
Howell, RS, Tolbert, K, Odunayo, A
University of Tennessee, Knoxville, TN, USA
Introduction: Critically ill dogs with gastrointestinal bleeding are
often treated with rapidly acting famotidine in combination with
slower acting but more effective pantoprazole. The study aim was
to determine if combination therapy with pantoprazole and famo-
tidine is superior to monotherapy with pantoprazole.
Methods: In a randomized, crossover pilot study, a continuous,
intragastric pH monitoring device was endoscopically placed in
the gastric fundus of two healthy dogs. 24hr baseline intragastric
pH was recorded on day 0. Dog A was given pantoprazole, while
dog B received pantoprazole and famotidine. Study drugs were
intravenously administered at 1 mg/kg q12hr for 72hrs. Mean per-
centage time (MPT) that intragastric pH was 3 was compared
between dogs.
Results: The MPT intragastric pH was ࣙ3.0 for dogs A and B was
80.5 ± 21.7% and 70.1 ± 12.9%, respectively, when the entire study
period was evaluated. When the first two days of treatment were
evaluated, the MPT intragastric pH was ࣙ3.0 for dog A and B was
72.4 ± 11.5% and 76.9% ± 9.6%, respectively. No differences were
observed in baseline pH between dogs.
Conclusion: This pilot study of two dogs demonstrates that both
treatments maintained an intragastric pH ࣙ3.0 for 70% of the
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Abstracts
time. Pantoprazole given 1mg/kg every 12 hours appears to be
as effective as combination therapy with famotidine. A crossover
study of 10 dogs is ongoing and will provide further evidence to
support appropriate acid suppressant therapy in dogs.
DELAYED ADMINISTRATION OF ETHYL
PYRUVATE PREVENTS ORGAN DAMAGE
IN A CANINE ENDOTOXEMIA MODEL
Kim, H1, Park, J2, Yu, D1
1College of Veterinary Medicine, Chonnam National University,
Gwangju, Republic of Korea
2College of Veterinary Medicine, Chonbuk National University, Jeonju,
Jeonbuk, Republic of Korea
Introduction: Ethyl pyruvate (EP), a stable lipophilic pyruvate
derivative, is an effective reactive oxygen species (ROS) scavenger,
and it has been shown to prevent lethality, systemic inflammation
and organ damage in murine models of sepsis. In this study, we
report that ethyl pyruvate has an anti-inflammatory effect in a ca-
nine endotoxemia model. We instituted a delayed REPS (Ringer’s
ethyl pyruvate solution) protocol to a canine endotoxemia model,
and evaluated the effects of EP on cytokine production, neutrophil
activation and organ damage.
Methods: Fifteen healthy adult Beagles were used. Low dose
lipopolysaccharide (LPS, 10␮g/kg/h) was continuously adminis-
tered to all dogs to induce endotoxemia with fluid support. After
6 hours of LPS infusion, the animals were randomized to receive
REPS (n = 6) or lactated Ringer’s solution (LRS, n = 4), or normal
saline (NS, n = 5). Plasma IL-6, IL-10 and oxidative burst was mea-
sured. Plasma biochemistry analysis was also done to assess organ
damage.
Results: IL-10 at 24 hours in the REPS group was significantly
increased, and ROS in the REPS group was significantly decreased.
LDH and CPK changes (࢞enzymes: values between 24 h and 6 h)
were significantly different among groups.
Conclusion: EP was effective at attenuating the LPS-induced in-
crease in cytokines and ROS production. REPS may prevent the
development of MODS in sepsis by a anti-inflammatory effect.
RISK FACTORS AND RADIOGRAPHIC FINDINGS
IN CATS WITH ASPIRATION PNEUMONIA: 28
CASES (2001–2013)
Levy, N, Ballegeer, E, Koenigshof, A
Introduction: The clinical syndrome of aspiration pneumonia has
not been previously described in cats. The goals of this study were
to identify the occurrence of aspiration pneumonia in cats and de-
scribe the clinical syndrome.
Methods: A medical records search for cats with a clinical diagno-
sis of “aspiration pneumonia” or “bronchopneumonia” was per-
formed. Cases were included if they had a complete medical record
and description of radiographic evidence of pulmonary infiltrates
with no other cause of pneumonia or cardiopulmonary disease.
Results: 28 cases met the inclusion criteria. 71.4% (20/28) were do-
mestic shorthair cats with a median age of 1.6 years). 43% (12/28)
had a history of vomiting, and 39% (11/28) had a history of recent
anesthesia. 18% (5/28) received enteral nutrition and 14.3% (4/28)
had pre-existing esophageal disease. Pre-existing neurologic or la-
ryngeal disease was noted in 7% (2/28) and 3.5% (1/28) of cases,
respectively. 89% (25/28) of cats survived to discharge, with a me-
dian length of hospitalization of 3 days. Length of hospitalization
was correlated with serum albumin (R = -0.58, P = 0.005), PCV (R
= -0.6991, P = 0.001) and age (R = 0.4987, P = 0.0069).
Three-view thoracic radiography was performed on all 28 cats. An
alveolar pattern was present in 71% (20/28) of cases, an interstitial
pattern in 21% (6/28), and a mixed alveolar-interstitial pattern in
10% (3/28). Multiple lung lobes were affected in 57% (16/28), with
43% (12/28) having only single lobe involvement.
Conclusion: Common concurrent conditions affecting cats with as-
piration pneumonia include vomiting, anesthesia, and receiving
enteral nutrition. 89% of cats survived to discharge following treat-
ment with antibiotics and supportive care.
SHOCK INDEX IN IDENTIFYING ACUTE BLOOD
LOSS IN HEALTHY BLOOD DONOR DOGS
McGowan, E, Marryott, K, Drobatz, KJ, Reineke, E
Introduction: Shock index (SI) has been shown in dogs to be both
specific and sensitive for detection of moderate to severe shock. The
goal of our study was to determine whether SI would be accurate in
detecting acute blood loss in blood donor dogs. Our hypothesis was
that SI would increase following a blood donation and it would be
more sensitive for detecting blood loss compared to measurements
of heart rate, blood pressure, or lactate individually.
Methods: Healthy blood donor dogs were enrolled. Heart rate and
systolic blood pressure (SBP) were performed prior to (t = pre),
immediately following (t = 0), and 10 minutes post blood donation
(t = 10). SI was calculated at each time point. PCV, TS, and lactate
were evaluated prior to and 10 minutes post donation.
Results: The median SBP immediately post blood donation was
significantly decreased (SBPpre = 159 versus SBP0 = 125, P = 0.01)
but was not significantly different at 10 minutes post donation
(SBP10 = 144; P = 0.21). The median heart rate was not significantly
different immediately post donation (HRpre = 132/min versus
HR0 = 142/min, P = 0.17) but it was increased at 10 minutes post
donation (HR10 = 154/min; P = 0.025). Pre-donation median SI was
0.85 (range: 0.65–1.1). The median SI was significantly increased
immediately post donation (SIo: 1.24, P = 0.01) and at 10 minutes
after donation (SI10: 1.11, P = 0.031). PCV, TS and lactate remained
normal.
Conclusion: In blood donors, both SI and HR significantly in-
creased after donation. Although SBP did decrease, it was still
within the reference range. SI may be useful in identifying occult
shock as compared to SBP, PCV, TS, and lactate.
INCIDENCE OF COAGULOPATHY IN CRITICALLY
ILL CATS: 59 CASES (2008–2012)
McGowan, E, Drobatz, KJ, King, L, Santoro-Beer, K
Introduction: Coagulopathies often affect our critically ill feline
patients. The frequencies, characteristics of coagulopathy, and as-
sociated diseases have not been previously well described. We
hypothesized that coagulopathies are associated with disease type
and severity, clinical bleeding and outcome.
C

Abstracts
Methods: Medical records (2008–2012) were searched for cats in the
ICU with a coagulation panel. Cats with primary coagulopathies
and those that received plasma products or vitamin K1 prior to
coagulation screening were excluded. Data collected included sig-
nalment, systemic inflammatory response syndrome (SIRS) criteria,
parameters for acute patient physiologic and laboratory evaluation
(APPLE) scoring, underlying and type of disease, evidence of clin-
ical bleeding, treatment with fresh frozen plasma, and survival.
Results: Of the 59 cats evaluated, coagulopathy (prolonged pro-
thrombin time (PT), activated partial thromboplastin time (aPTT)
or both) was present in 48/59(81%) patients. Prolongations of
PT/aPTT were most common in cats with GI tract/pancreas (16/17)
diseases. Most (37/59) patients had infectious/inflammatory dis-
eases, with 31/39(80%) having a coagulopathy. Of the 15/59(25%)
cats that met SIRS criteria, 12/15(80%) had a coagulopathy. Clin-
ical bleeding was seen most in patients with both PT and aPTT
prolonged (5/19, 26%). Of the 11/59(19%) cats with normal co-
agulation panels, 4/11(36%) had evidence of bleeding. There was
no significance found between having a coagulopathy and type of
disease, severity of disease, clinical bleeding or outcome.
Conclusion: Coagulopathy was seen in 81% of evaluated cats.
The most common disease states associated with coagulopathy
were GI tract/pancreas diseases and infectious/inflammatory
disease states. Clinically significant bleeding was apparent in
both patients with and without a coagulopathy. Thus far, no
statistical significance between disease state, disease severity,
clinical bleeding, or outcome has been found.
STABILITY OF CANINE HEMOSTATIC PROTEINS
IN FRESH FROZEN PLASMA FOLLOWING RAPID
MICROWAVE THAW PROCESS
Pashmakova, MB1, Pashmakov, BI2, Barr, JW1, Bishop, MA1
1Texas AM University, College Station, TX, USA
2Ovshinsky Innovation, LLC, Pontiac, MI, USA
Introduction: Dogs with coagulopathies often require rapid admin-
istration of plasma products. Warm water bath (WWB) is the most
common method of thawing plasma in veterinary medicine; how-
ever, plasma-thawing microwaves are used in human medicine.
The goal of this study was to compare the stability of hemostatic
proteins of canine fresh frozen plasma (FFP) thawed by a modi-
fied commercial microwave (MCM), a 37C WWB, and at 20C room
temperature (control).
Methods: A commercial microwave was modified for this study.
Eight canine donor plasma samples were split into 2 @ 60 mL bags
and 1@ 6 mL aliquot. The microwave and WWB were used to thaw
the two 60 mL bags to 20–30C. The 6-mL aliquots equilibrated
to room temperature without a heat source. Hemostatic protein
activities, albumin, D-dimers, prothrombin time (PT) and partial
thromboplastin time (PTT) were obtained. A repeated measures
ANOVA and a Tukey’s multiple comparison post test were used to
compare groups. Alpha was set at 0.05.
Results: Significant decreases in factors II, IX, X, XI, fibrinogen, von
Willebrand factor, antithrombin, protein C activities, albumin con-
centration, and increases in PT and PTT were detected in plasma
thawed by MCM compared to WWB (P 0.05). D-dimers concen-
tration, factors VII, VIII, and XII activities were not significantly
different. No statistically significant difference existed for any ana-
lyte between WWB and room-thawed control.
Conclusion: Significant differences in hemostatic protein concen-
trations and coagulation times were observed in plasma thawed by
our MCM, but not between the WWB and the controls. The clinical
significance of these changes needs to be investigated.
ESTABLISHMENT OF REFERENCE INTERVALS
FOR KAOLIN-ACTIVATED
THROMBOELASTOGRAPHY IN HEALTHY
GREYHOUNDS
Pfaff, A, de Laforcade, AM, O’Toole, TE
Grafton, MA, USA
Introduction: Greyhounds have higher packed cell volumes, lower
platelet counts, and a tendency to bleed despite normal stan-
dard coagulation testing. A study comparing tissue factor (TF)-
activated Thromboelastography (TEG) in Greyhounds to those of
non-Greyhound breeds documented differences in all TEG vari-
ables. Kaolin is a commonly used activator but it is unclear if results
of TF- and kaolin-activated TEGs are comparable. The aims of this
study were to establish reference intervals and assess intra-assay
repeatability for kaolin- activated TEG in Greyhounds.
Methods: Twenty-five healthy Greyhounds were included based
on normal physical examination and hematological testing. Refer-
ence intervals were defined using the robust method with a 95%
interval and compared to previously established reference ranges
in non-Greyhounds. When robust ranges were not available, a non-
parametric range was calculated.
Results: Reference intervals were as follows:
Greyhounds Non-Greyhounds P Value
Reaction-time (R) 2.72 – 6.6 min 1.8 – 6.99 min 0.6980
Clot formation
time (K)
1.84 – 8.32 min 1.33 – 3.05 min 0.0001
Angle (␣) 30.99 – 59.23 44.83 – 74.42 0.0001
Maximum-
Amplitude
(MA)
34.13 – 64.08 mm 43.85 – 64.08 mm 0.0001
Clot strength (G) 2.43 – 6.32 dyn/cm2
3.83 – 8.7 dyn/cm2
0.0001
% Lysis at 30
minutes (LY30)
0.01 – 20.73% 0.00 – 2.6% 0.1181
% Lysis at 60
minutes (LY60)
0.08 – 43.61% − 4.00 – 7.6% 0.0057

Non-parametric ranges
Conclusion: TEGs in Greyhounds indicate slower clot formation,
weaker clot strength and increased fibrinolysis compared to non-
Greyhounds. This study provides reference intervals for kaolin-
activated TEG in Greyhounds.
CORRELATION BETWEEN
THROMBOELASTOGRAPHY AND TRADITIONAL
COAGULATION TEST PARAMETERS IN
HOSPITALIZED DOGS
Rubanick, JV, Pashmakova, MB, Bishop, MA, Barr, JW
Texas AM University, College Station, TX, USA
S18 C

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