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Fisher CJ, Cavanagh AA, Liss D, Adams T, Marvel SJ, Hall KE. Surgical interventions and outcome in a population of feline trauma patients. J Vet Emerg Crit Care (San Antonio) 2023; 33:337-347. [PMID: 37120709 PMCID: PMC10350302 DOI: 10.1111/vec.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/15/2022] [Accepted: 04/25/2022] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To determine signalment, injury type, trauma severity score, and outcome of feline trauma patients undergoing surgical (emergency room [ER] and operating room [OR]) and nonsurgical treatments in addition to time to surgery, specialty services involved, and cost in the OR surgery population. DESIGN Retrospective evaluation of medical record and hospital trauma registry data on feline trauma cases. SETTING University teaching hospital. ANIMALS Two hundred and fifty-one cats presenting for traumatic injury between May 2017 and July 2020. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Demographics and outcomes were compared for cats undergoing surgical intervention in an OR (12%, 31/251) or an ER (23%, 58/251) setting and feline trauma patients without surgical intervention (65%, 162/251). Between the 2 surgical groups, 99% survived to discharge compared to 73.5% of the nonsurgical group (P < 0.0001). For the OR surgical cohort, electronic medical records were reviewed to determine the specialty surgery service involved, time to and duration of anesthesia and surgery, and visit cost. The most common surgery services involved were orthopedics (41%, 12/29) and dentistry (38%, 11/29), and the most common surgeries performed were mandibular fracture stabilization (8/29) and internal fixation for long bone fractures (8/29). The ER surgical group had a significantly lower Animal Trauma Triage score than the OR group (P < 0.0001), but a significant difference was not found between OR surgical and nonsurgical groups (P = 0.0553). No difference in modified Glasgow Coma Scale score was found between any groups. CONCLUSIONS Surgical intervention in feline trauma patients appears to be associated with higher survival rates, but no difference in mortality was found across surgery services. OR surgical intervention, in particular, orthopedic surgery, was associated with increased length of hospitalization, increased cost, and increased use of blood products.
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Affiliation(s)
- Corey J Fisher
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
| | - Amanda A Cavanagh
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
| | - David Liss
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
| | - Taylor Adams
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah J Marvel
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
| | - Kelly E Hall
- Department of Clinical Sciences, Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA
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Fitzgerald WR, Cave NJ, Yozova ID. Clinical parameters at time of admission as prognostic indicators in cats presented for trauma to an emergency centre in New Zealand: a retrospective analysis. J Feline Med Surg 2022; 24:1294-1300. [PMID: 36018375 PMCID: PMC10812375 DOI: 10.1177/1098612x221115674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aims of this study were to describe the clinical features of cats presented for trauma in a first-opinion and referral teaching hospital in New Zealand, and to determine the relationship between those features and outcome. METHODS The electronic medical records of cats presented for trauma to the Massey University Pet Emergency Centre between September 2013 and January 2019 were examined, from which the signalment, clinical parameters and patient outcomes were extracted. Cases were assigned an Animal Trauma Triage (ATT) score and Modified Glasgow Coma Scale (MGCS) score. Variables were selected for inclusion in a logistic regression model to predict survival, and backward elimination was used to find the minimal significant model. RESULTS In total, 530 cats met the inclusion criteria. The cause of injury was not known in the majority of cases (38.0%). The most common location of injury was the hindlimbs/pelvis/tail (n = 247; 41%), and skin lacerations/abrasions were the most common specific injury. Multivariate analysis revealed altered mentation (odds ratio [OR] 0.31, P = 0.029), hypothermia (rectal temperature <37.8°C [<100.04°F]; OR 0.45, P = 0.015) and an ATT score ⩾5 (OR 0.13, P <0.001) to be statistically significantly associated with mortality. CONCLUSIONS AND RELEVANCE Altered mentation and hypothermia are easily measurable perfusion parameter abnormalities associated with mortality in cats presenting with trauma. The ATT score appears to be an accurate prognostic indicator in cats presenting with trauma in New Zealand. These results highlight the importance of incorporating a hands-on triage examination in each cat that presents as an emergency after trauma.
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Affiliation(s)
| | - Nick J Cave
- School of Veterinary Science-Ta¯wharau Ora, Massey University, Palmerston North, Manawatu, New Zealand
| | - Ivayla D Yozova
- School of Veterinary Science-Ta¯wharau Ora, Massey University, Palmerston North, Manawatu, New Zealand
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3
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Lee JA, Huang CM, Hall KE. Epidemiology of severe trauma in cats: An ACVECC VetCOT registry study. J Vet Emerg Crit Care (San Antonio) 2022; 32:705-713. [PMID: 35946950 DOI: 10.1111/vec.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/24/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify demographic information, epidemiological factors, and clinical abnormalities that differentiate cats with severe trauma, defined as an Animal Trauma Triage Score (ATTS) ≥3 from those with mild injury (ATTS 0-2). DESIGN Multicenter observational study utilizing data from the American College of Veterinary Emergency and Critical Care (ACVECC) Veterinary Committee on Trauma (VetCOT) registry. SETTING ACVECC VetCOT Veterinary Trauma Centers. ANIMALS A total of 3859 cats with trauma entered into the ACVECC VetCOT registry between April 1, 2017 and December 31, 2019. INTERVENTIONS None MEASUREMENTS AND MAIN RESULTS: Cats were categorized by ATTS 0-2 (mild, 65.1%) and ≥3 (severe, 34.9%). There was no age difference between categories. Male animals, particularly intact animals, were overrepresented. Blunt trauma was more common than penetrating, with blunt trauma and a combination of blunt and penetrating trauma being more common in the severe trauma group. While 96.6% of cats with ATTS 0-2 survived to discharge, only 58.5% with ATTS ≥3 survived. Only 46.8% of cats with severe trauma had a point-of-care ultrasound performed, of which 8.9% had free abdominal fluid noted. Hospitalization and surgical procedures were more common in the severe trauma group. Transfusions occurred more frequently in the severe trauma group but only in 4.1% of these cats. Other than ionized calcium, all recorded clinicopathological data (plasma lactate, base excess, PCV, total plasma protein, blood glucose) differed between groups. CONCLUSION Feline trauma patients with an ATTS ≥3 commonly present to Veterinary Trauma Centers and have decreased survival to discharge compared to patients with ATTS 0-2. Differences exist between these groups, including an increased frequency of blunt force trauma (particularly vehicular trauma), head and spinal trauma, and certain clinicopathological changes in the ATTS ≥3 population. Relatively low incidences of point-of-care ultrasound evaluation and transfusions merit further investigation.
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Affiliation(s)
- Jack A Lee
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Chien-Min Huang
- Franklin A. Graybill Statistical Laboratory, Colorado State University, Fort Collins, Colorado, USA
| | - Kelly E Hall
- Critical Care Services, Department of Clinical Sciences, Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, USA
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Hickey MC, Napier E, Ong HM. Effect of COVID-19 Lockdown on Small Animal Trauma Patterns in Australia: A Multicentre Study. Front Vet Sci 2022; 9:908679. [PMID: 35720852 PMCID: PMC9199958 DOI: 10.3389/fvets.2022.908679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To determine whether patterns of trauma changed following the start of local lockdowns due to COVID-19. Design Multi-institutional retrospective study assessing patients presenting within 2 years prior to local lockdown due to COVID-19 and 1 year following lockdown inclusive. Setting Two university teaching hospitals and one private referral center in Australia. Animals Dogs and cats with a presenting complaint of known or suspected trauma. Interventions Patient signalment, date of presentation, trauma type, treatment interventions and patient outcome (survival to discharge, cardiopulmonary arrest, or euthanasia) were recorded in a web-based data capture system (REDCap). Measurements and Main Results Three thousand one hundred eighty-nine patients (682 cats and 2,507 dogs) were included in the study. Overall trauma prevalence was 2.9% with pre-lockdown prevalence of 2.8% and post-lockdown prevalence of 3.1% (p < 0.001). Cats had higher rates of blunt trauma while penetrating trauma was more prevalent in dogs (p < 0.001). Juvenile patients were also more likely to have blunt trauma when compared to adult patients (p < 0.001). Patient age and sex characteristics did not differ when comparing the 2 time periods. Compared to pre-lockdown, blunt and penetrating trauma patterns changed post-lockdown in dogs and cats (p < 0.001 for both). Interventions were performed more frequently (p = 0.039) in the post-lockdown with surgical procedures having a significant increase (p = 0.015). Survival rates increased post-lockdown for both species (p < 0.001) with financially driven euthanasia being less common than in pre-lockdown for dogs (p = 0.02). Conclusions Trauma patterns changed for cats and dogs in the post-lockdown period. Compared to pre-lockdown, trauma prevalence was higher with a decrease in mortality rate. No increase in juvenile patients was identified post-lockdown. A decrease in financially driven euthanasia and an increase in interventions suggest no negative financial effect from COVID-19 lockdown on trauma patient care in Australia.
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Affiliation(s)
- Mara C. Hickey
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
- *Correspondence: Mara C. Hickey
| | | | - Hui Mei Ong
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC, Australia
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Nascimento DC, Costa Neto JM, Solcà MS, Estrela-Lima A, Barbosa VF. Clinicoepidemiological profile and risk factors associated with mortality in traumatized cats admitted to a veterinary teaching hospital in Brazil. J Feline Med Surg 2022; 24:381-388. [PMID: 34259571 PMCID: PMC10812238 DOI: 10.1177/1098612x211028027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate possible risk factors for death in traumatized cats based on the clinicoepidemiological profile, the Animal Trauma Triage (ATT) scale score and the Modified Glasgow Coma Scale (MGCS) score at the time of presentation to the hospital. METHODS This was a cross-sectional study involving cats admitted to the emergency sector (ES) and the surgical clinic sector (SCS) of a veterinary teaching hospital (VTH) in northeastern Brazil over a 12-month period (2018-2019). Probable risk factors associated with non-survival after trauma were analyzed by calculating the prevalence ratio. The prediction of non-survival was evaluated by analyzing the receiver operating characteristic (ROC) curve employing the ATT scale score, MGCS score and rectal temperature. RESULTS In 1 year, 89 traumatized cats were admitted to the VTH, of which 90% (n = 80) were young, 54% (n = 48) were male, 79% (n = 70) were intact, 59% (n = 53) were indoor cats and 92% (n = 82) were considered as mixed breed. Blunt trauma was the most prevalent cause of injuries, reported in 76% (n = 68) of the cats. Accidents involving falls (30%; n = 27) that affected the pelvic limbs (50.6%) were the most commonly reported. The prevalence of death among cats admitted to the ES was 9.44 times higher than that of animals treated at the SCS. Trauma as result of being run over and chest trauma were associated with a higher probability of death. Most of the animals that died had a lower rectal temperature than those that survived. The ATT scale score, MGCS score and rectal temperature were predictive of mortality. CONCLUSIONS AND RELEVANCE Rectal temperature, ATT scale score and MGCS score were effective predictors of an unfavorable prognosis and point to the need for emergency procedures. Hypothermia, being run over and chest trauma were associated with a higher risk of mortality. Our findings highlight the importance of prompt and effective care for these conditions.
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Affiliation(s)
- Débora C Nascimento
- School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Bahia, Brazil
| | - João M Costa Neto
- Department of Anatomy, Pathology and Veterinary Clinics, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Manuela S Solcà
- Department of Preventive Veterinary Medicine and Animal Production, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Alessandra Estrela-Lima
- Department of Anatomy, Pathology and Veterinary Clinics, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Vivian F Barbosa
- Department of Anatomy, Pathology and Veterinary Clinics, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Bahia, Brazil
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Klainbart S, Shipov A, Madhala O, Oron LD, Weingram T, Segev G, Kelmer E. Dog bite wounds in cats: a retrospective study of 72 cases. J Feline Med Surg 2022; 24:107-115. [PMID: 33980052 PMCID: PMC10812173 DOI: 10.1177/1098612x211010735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Bite wounds are a common cause of trauma in cats; nevertheless, large-scale studies of this trauma in cats are lacking. The aims of the present study were to characterise the clinical and clinicopathological findings in these cats, to assess the association of these variables and therapeutic measures with survival, and to assess the association between the animal trauma triage (ATT) score and severity of injuries score (SS) at presentation with survival. METHODS The medical records of cats presented to a veterinary teaching hospital and two large referral clinics were reviewed retrospectively. RESULTS The study included 72 cats diagnosed with canine bite wounds (with the dog attacks having been witnessed). Seventy-one percent of cats suffered multiple injuries, and there was a significant association between the number of injured body areas and survival, and between severity of injury and survival (P = 0.02 and P = 0.012, respectively). The median ATT scores and SSs for non-survivors were significantly higher compared with survivors (P <0.0001). There was a strong and significant correlation between ATT scores and SSs (r = 0.704, P <0.0001). Total protein and albumin were significantly lower and alanine aminotransferase significantly higher in non-survivors compared with survivors (P ⩽0.032). Fifty percent of cats were treated conservatively, 32% by local surgical debridement and 18% of cats required an exploratory procedure. Cats undergoing more aggressive treatments were significantly less likely to survive (P = 0.029). Fifty-seven cats (79%) survived to discharge. CONCLUSIONS AND RELEVANCE Cats sustaining canine bite wounds have a good overall prognosis for survival to discharge. High ATT score, high SS, multiple body area injuries, penetrating injuries, radiographic evidence of vertebral body fractures and body wall abnormalities, as well as hypoproteinaemia and elevated alanine aminotransferase, are negative predictors of survival.
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Affiliation(s)
- Sigal Klainbart
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Anna Shipov
- Small Animal Surgery, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ori Madhala
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Liron D Oron
- Knowledge Farm Specialty Referral Center, Beit Berl, Israel
| | - Tomer Weingram
- Herzliya Veterinary Hospital, Ben Gurion 26 Herzliya, Israel
| | - Gilad Segev
- Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Hickey MC, Gray R, van Galen G, Ward MP. Distribution of mortality patterns in cats with naturally occurring trauma: A Veterinary Committee on Trauma registry study. Vet J 2021; 278:105765. [PMID: 34715365 DOI: 10.1016/j.tvjl.2021.105765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 10/20/2022]
Abstract
A greater understanding of the prognostic variables that affect the timing of death for cats with trauma may help clinicians select treatments and monitoring plans. This study investigated the mortality rate and its distribution pattern in a large population of cats to identify variables associated with the timing of trauma-related deaths. Clinical data was retrieved from the Veterinary Committee on Trauma database to determine mortality rates and timing of deaths, defined as early death (ED; <1 day post-presentation) or delayed death (DD; ≥1 day post-presentation). Multivariable logistic regression analyses were performed to identify characteristics and interventions that best predicted timing of death. Overall mortality rate for 6703 feline trauma patients with complete records was 17.2%, with 7.6% due to natural death and 92.3% due to euthanasia. Among the subset of 543 cats with trauma that died after presentation or required euthanasia due to a grave prognosis (representing an 8.1% mortality rate), EDs were more common (71.7%) than DD and the cause of death was not significantly associated with the timing of death. Clinical pathology parameters were unable to identify animals more likely to die or to require euthanasia due to a poor prognosis during hospitalisation. Factors that were significantly different for cats with ED vs. DD included the median cumulative results for the Modified Glasgow Coma Scale (MGCS) score and the Animal Trauma Triage (ATT) score, the presence of spinal trauma, administration of blood products and undertaking surgical procedures. An increased likelihood of DD rather than ED was associated with the administration of blood products (odds ratio [OR], 3.959; P = 0.019) vs. not, performing a surgical procedure (OR, 6.055; P < 0.001) vs. not, and a cumulative MGCS of 15-17 or 18 (OR, 1.947 and 3.115; P = 0.031 and P = 0.01, respectively) vs. a cumulative MGCS ≤ 11.
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Affiliation(s)
- M C Hickey
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia.
| | - R Gray
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
| | - G van Galen
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
| | - M P Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camperdown 2006, Australia
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Hall K, Drobatz K. Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications. Front Vet Sci 2021; 8:638104. [PMID: 34395568 PMCID: PMC8357988 DOI: 10.3389/fvets.2021.638104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
Acute hemorrhage in small animals results from traumatic and non-traumatic causes. This review seeks to describe current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient through evaluation of pre-clinical canine models of hemorrhage and resuscitation, clinical research in dogs and cats, and selected extrapolation from human medicine. The physiologic dose and response to whole blood loss in the canine patient is repeatable both in anesthetized and awake animals and is primarily characterized clinically by increased heart rate, decreased systolic blood pressure, and increased shock index and biochemically by increased lactate and lower base excess. Previously, initial resuscitation in these patients included immediate volume support with crystalloid and/or colloid, regardless of total volume, with a target to replace lost vascular volume and bring blood pressure back to normal. Newer research now supports prioritizing hemorrhage control in conjunction with judicious crystalloid administration followed by early consideration for administration of platelets, plasma and red blood during the resuscitation phase. This approach minimizes blood loss, ameliorates coagulopathy, restores oxygen delivery and correct changes in the glycocalyx. There are many hurdles in the application of this approach in clinical veterinary medicine including the speed with which the bleeding source is controlled and the rapid availability of blood component therapy. Recommendations regarding the clinical approach to volume resuscitation in the acutely hemorrhaging veterinary patient are made based on the canine pre-clinical, veterinary clinical and human literature reviewed.
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Affiliation(s)
- Kelly Hall
- Department of Clinical Sciences, Critical Care Services, Colorado State University, Fort Collins, CO, United States
| | - Kenneth Drobatz
- Section of Critical Care, Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA, United States
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Lyons BM, Ateca LB, Otto CM. Clinicopathological abnormalities associated with increased animal triage trauma score in cats presenting for vehicular trauma: 75 cases (1998-2009). J Vet Emerg Crit Care (San Antonio) 2020; 30:693-697. [PMID: 32918338 DOI: 10.1111/vec.13005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/06/2019] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To document the clinical and clinicopathological changes in cats presenting with vehicular trauma (VT) and to determine whether the calculated animal trauma triage (ATT) score was associated with any clinicopathological abnormalities. DESIGN Retrospective descriptive study conducted between 1998 and 2009. SETTING University veterinary teaching hospital. ANIMALS Seventy-five client-owned cats that presented for VT to an urban veterinary hospital. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Pertinent history, physical examination findings, results of biochemical testing, and outcome were extracted from medical records. ATT score was calculated based on physical examination. Patients were classified as having either a low (<5) ATT (n = 30) or a high (≥5) ATT (n = 45) score. Male cats were overrepresented (60.0%), and a majority of cats had outdoor access (65.3%). Low PCV (P = 0.024), low total plasma protein concentration (P = 0.032), low venous blood pH (P = 0.047), high plasma lactate concentration (P = 0.047), low plasma bicarbonate concentration (P = 0.047), low base excess (P = 0.047), and high plasma glucose concentration (P = 0.047) were associated with higher ATT scores. In addition, low noninvasive blood pressure measurements (P = 0.008) were associated with higher ATT scores. CONCLUSIONS There was a significant association between lower PCV, lower total plasma protein concentration, lower venous blood pH, higher plasma lactate concentration, lower plasma bicarbonate concentration, lower base excess, higher whole blood glucose concentration, and lower noninvasive blood pressure and higher ATT scores at presentation in feline patients suffering from VT. Prospective evaluation of these values may prove useful in furthering understanding of the pathophysiology of trauma in cats.
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Affiliation(s)
- Bridget M Lyons
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura B Ateca
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cynthia M Otto
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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10
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Hornsey SJ, Halfacree Z, Kulendra E, Parker S, Kulendra N. Factors affecting survival to discharge in 53 cats diagnosed with uroabdomen: a single-centre retrospective analysis. J Feline Med Surg 2020; 23:115-120. [PMID: 32573338 DOI: 10.1177/1098612x20932267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to assess outcomes in cats diagnosed with uroabdomen at a single referral centre. METHODS Fifty-three cats diagnosed with uroabdomen at a veterinary teaching hospital were identified between June 2003 and September 2016. Data collected included signalment, presenting signs, aetiology, location of rupture, presence of concurrent injury, outcome of urine culture, presence of uroliths and packed cell volume (PCV)/creatinine/potassium levels at presentation. Cats managed medically and surgically were included, and the use of urinary catheters, cystotomy tubes and abdominal drains were recorded. It was determined if patients survived to discharge or if they were euthanased or died. RESULTS Seventy-four percent (n = 39) of cats survived to discharge. Elevations in creatinine (P = 0.03) were shown to be significantly correlated with survival to discharge. Sex, age, location of rupture, presence of uroliths, outcome of urine culture, presence of concurrent injury, potassium at presentation and PCV at presentation were not associated with survival to discharge. There was no difference in survival between cats that were medically or surgically managed. CONCLUSIONS AND RELEVANCE Cats that develop uroabdomen have a good chance of survival. Electrolyte and biochemistry values should be assessed at the time of presentation, in addition to the presence of concurrent injury.
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Affiliation(s)
- Samuel J Hornsey
- Department of Clinical Sciences, The Royal Veterinary College, North Mimms, Hatfield, UK
| | - Zoe Halfacree
- Department of Clinical Sciences, The Royal Veterinary College, North Mimms, Hatfield, UK
| | | | - Sarah Parker
- Centre for Applied Epidemiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Murgia E, Troia R, Bulgarelli C, Pelizzola M, Foglia A, Dondi F, Giunti M. Prognostic Significance of Organ Dysfunction in Cats With Polytrauma. Front Vet Sci 2019; 6:189. [PMID: 31294034 PMCID: PMC6598119 DOI: 10.3389/fvets.2019.00189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 05/28/2019] [Indexed: 11/13/2022] Open
Abstract
Polytrauma is a common emergency condition in small animals and is frequently associated with higher morbidity and mortality rates compared to minor trauma. Multiple Organ Dysfunction Syndrome (MODS) is a major complication of extensive traumatic injury, carrying a high risk of death despite intensive care treatment. Little is known about the prevalence and the prognostic impact of MODS in feline polytrauma. The current study aimed to prospectively evaluate the occurrence and the prognostic significance of organ dysfunction at admission in a population of polytraumatized cats. Cats with polytrauma requiring intensive care unit hospitalization were included and categorized according to outcome (survivors/non-survivors). Clinical and clinicopathological data, including scores of disease severity [Animal Trauma Triage Score (ATTS), APPLEfast, and APPLEfull], selected organ dysfunction and presence of MODS were evaluated upon admission, and analyzed with respect to mortality. Non-parametric statistics was performed and P < 0.05 was considered significant. Thirty-eight cats met the inclusion criteria: 8/38 (21%) had penetrating trauma, while 30/38 (79%) had blunt trauma. The overall in-hospital mortality was 37% (14/38). Cats with evidence of MODS upon admission had significantly higher frequency of death compared to cats without MODS (9/14 vs. 2/24 P = 0.0004). Hemostatic dysfunction, respiratory dysfunction, and MODS upon admission were significantly associated with mortality in the univariate logistic regression analysis (P = 0.005, P = 0.001, P = 0.001, respectively). The values of APPLEfast, APPLEfull, and ATTS were independently associated with a higher risk of death and positively correlated with the number of dysfunctional organs (P = 0.025, P = 0.004, P = 0.003, r = 0.57, P = 0.0002; r = 0.59, P = 0.0001; r = 0.55, P = 0.0003, respectively). Multiple Organ Dysfunction Syndrome is a common complication of feline polytrauma and its development is associated with increased disease severity and worse outcomes. The presence of hemostatic dysfunction and respiratory dysfunction upon admission is associated with a higher risk of death. The ATTS and the APPLE scores are useful prognostic tools for the assessment of cats with polytrauma.
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Affiliation(s)
- Elsa Murgia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Roberta Troia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Cecilia Bulgarelli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Marco Pelizzola
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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