ACVECC-Veterinary Committee on Trauma Registry Report 2013-2017

Surgical interventions and outcome in a population of canine trauma patients

OBJECTIVE

To determine signalment, injury type, trauma severity score, and outcome of canine trauma patients undergoing surgical (emergency room [ER] or operating room [OR]) and nonsurgical treatment 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 canine trauma cases.

SETTING

University teaching hospital.

ANIMALS

One thousand six hundred and thirty dogs presenting for traumatic injury between May 2017 and July 2020.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Demographics and outcome were compared for canine trauma patients undergoing OR surgery (12.8%, 208/1630), ER surgery (39.1%, 637/1630), or no surgical intervention (48.2%, 785/1630). Among the 2 surgical groups, 98.9% (836/845) survived to discharge compared with 92.2% (724/785) of the nonsurgical group (P < 0.0001). The OR surgical group had significantly higher median Animal Trauma Triage scores (2 vs 1, P < 0.0001) and median days in hospital (2 vs < 1, P < 0.0001) compared with the other groups. 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 (45.2%, 94/208) and general surgery (26.9%, 56/208). Neurology and general surgery cases required the longest median length of stay in hospital, and ophthalmology and dentistry cases required the shortest. The median cost of visit was highest in neurology ($10,032) and lowest in ophthalmology ($2305) and dentistry ($2404).

CONCLUSIONS

Surgical intervention in canine trauma patients appears to be associated with higher survival rates, and among the surgery groups, mortality was highest in the ER and general surgery groups. OR surgical intervention, in particular general surgery and neurology, was associated with increased length of hospitalization, increased cost, and higher Animal Trauma Triage scores.

Prospective evaluation of platelet function and fibrinolysis in 20 dogs with trauma

OBJECTIVES

To determine platelet function and assess fibrinolysis in dogs following trauma using multiple electrical impedance aggregometry and a modified thromboelastographic (TEG) technique. To determine if the severity of trauma, as assessed by the Animal Trauma Triage (ATT) score and clinicopathological markers of shock, is associated with a greater degree of platelet dysfunction and fibrinolysis.

SETTING

University teaching hospital.

ANIMALS

Twenty client-owned dogs with trauma (occurring <24 h prior to admission and blood sampling) and ATT score of >4 were prospectively recruited. A control group of 10 healthy dogs was included.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Platelet function was measured using multiple electrode platelet aggregometry (MEPA) utilizing arachidonic acid, ADP, and collagen agonists. Fibrinolysis was assessed in citrated whole blood with the addition of tissue plasminogen activator (tPA; 50 U/mL) using kaolin-activated TEG. Conventional statistical analysis was performed to compare coagulation parameters between the groups and assess linear correlations. Median (interquartile range) ATT score was 5 (5-7), and 65% (n = 13) of dogs suffered polytrauma. Mean (± SD) time from trauma to blood sampling was 9 hours (± 6). Median (interquartile range) shock index and plasma lactate concentration were 1.1 (0.7-2.0, n = 16) and 2.9 mmol/L (0.9-16.0, n = 18), respectively. Four dogs did not survive to discharge (20%). There were no differences between the trauma and control group coagulation variables. A moderate negative correlation between ATT score and area under the curve for ADP was found (P = 0.043, r2  = -0.496).

CONCLUSIONS

Preliminary evaluation of platelet function measured by MEPA, and fibrinolysis measured by tPA-modified TEG, is not significantly different in this population of dogs with traumatic injury compared to healthy dogs.

Retrospective evaluation and review of approaches for nonspecific lameness in dogs presented to an emergency service (2013-2014): 134 cases

OBJECTIVE

This retrospective study aimed to characterize and evaluate the emergency approach, diagnosis, management, treatment, and follow-up of nonspecific canine lameness cases.

DESIGN

Retrospective case series from September 25, 2013 to September 25, 2014.

SETTING

The study was conducted at an urban university teaching hospital.

ANIMALS

A consecutive sample of dogs presenting to the emergency service with nonspecific lameness in the designated timeframe was used to identify 134 cases. Owners were contacted to participate in the follow-up survey; dogs that died prior to data collection were excluded from the survey. Medical records were reviewed for lameness localization, etiology of lameness, diagnostics obtained, medications prescribed, and owner recommendations.

INTERVENTIONS

Based on review of the medical records, the lameness localization, presumptive source of lameness (joint, soft tissue, neurological, or bone), diagnostics obtained, medications prescribed, and owner recommendations were recorded. Survey data included duration of lameness, perceived response to treatment, and activity level.

MEASUREMENTS AND MAIN RESULTS

Definitive diagnoses were not assigned in 88.8% of lameness cases. A presumptive diagnosis of soft tissue injury was assigned in 45.3% of cases. Single limb lameness was more prevalent than multiple limb lameness. Owners whose dogs were treated with medication were significantly more likely to report that the lameness resolved (P = 0.049). Dogs with injury localized to ≥1 of the joints were significantly less likely to have resolution of lameness (P = 0.037). Treatment recommendations were predominantly pain control and activity restriction.

CONCLUSIONS

Nonspecific lameness represents approximately 4% of canine urban emergency cases. Highlighting the points of clinical care considerations in understanding the etiology of lameness in dogs represents an opportunity for improved patient care and growth in emergency referral and follow-up.

REDCap and the National Mesothelioma Virtual Bank-a scalable and sustainable model for rare disease biorepositories

OBJECTIVE

Rare disease research requires data sharing networks to power translational studies. We describe novel use of Research Electronic Data Capture (REDCap), a web application for managing clinical data, by the National Mesothelioma Virtual Bank, a federated biospecimen, and data sharing network.

MATERIALS AND METHODS

National Mesothelioma Virtual Bank (NMVB) uses REDCap to integrate honest broker activities, enabling biospecimen and associated clinical data provisioning to investigators. A Web Portal Query tool was developed to source and visualize REDCap data in interactive, faceted search, enabling cohort discovery by public users. An AWS Lambda function behind an API calculates the counts visually presented, while protecting record level data. The user-friendly interface, quick responsiveness, automatic generation from REDCap, and flexibility to new data, was engineered to sustain the NMVB research community.

RESULTS

NMVB implementations enabled a network of 8 research institutions with over 2000 mesothelioma cases, including clinical annotations and biospecimens, and public users' cohort discovery and summary statistics. NMVB usage and impact is demonstrated by high website visits (>150 unique queries per month), resource use requests (>50 letter of interests), and citations (>900) to papers published using NMVB resources.

DISCUSSION

NMVB's REDCap implementation and query tool is a framework for implementing federated and integrated rare disease biobanks and registries. Advantages of this framework include being low-cost, modular, scalable, and efficient. Future advances to NVMB's implementations will include incorporation of -omics data and development of downstream analysis tools to advance mesothelioma and rare disease research.

CONCLUSION

NVMB presents a framework for integrating biobanks and patient registries to enable translational research for rare diseases.

Prognostic indicators for feline craniofacial trauma: a retrospective study of 114 cases

Craniofacial traumatic injuries contribute significantly to the morbidity and mortality of domestic felines. Previous studies focused on feline craniofacial injuries have investigated the origin of injury, injuries sustained, and effectiveness of diagnostic tools. The aim of the study is to identify prognostic indicators for feline craniofacial trauma patients and determine their association with negative and positive outcomes. The Veterinary Committee on Trauma (VetCOT) Trauma Registry and Dentistry and Oral Surgery Case Logs were utilized to identify feline craniofacial trauma cases that were presented to Colorado State University's Veterinary Teaching Hospital between 2014 and 2020. Prognostic indicators evaluated included: etiology of injury, signalment (age and sex), the Modified Glascow Coma Scale (MGCS), Animal Trauma Triage (ATT) scores, craniofacial examination findings, diagnostic imaging technique, and injuries identified via imaging. Outcomes were determined via patient status upon discharge. Outcomes were grouped into the following categories: survival to discharge at initial presentation to CSU Urgent Care (SDIP), survival to discharge after injury treatment/repair by CSU DOSS or another specialty service (SDTX), euthanized due to grave prognosis at initial presentation (EUGP), euthanized due to financial limitations at initial presentation (EUF), and euthanized due to grave prognosis and financial limitations (EUGP + EUF). The continuous data was described using means and standard deviations. To determine the associations of various groupings of clinical signs and imaging findings with outcome a principal component analysis was performed. Patient sex, trauma etiology, cumulative MGCS and ATT scores on initial presentation and clinical signs on initial presentation were identified as prognostic indicators with intact males, vehicular and animal altercations, lower MGCS cumulative scores, higher ATT scores and the presence of altered mentation identified as negative prognostic indicators. Prognostic indicators for feline craniofacial trauma can be associated with outcomes and help guide clinical decision making.

Surgical interventions and outcome in a population of feline trauma patients

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.

Ballistic trauma to the axial skeleton in 13 animals

OBJECTIVE

To describe the clinical presentation and outcome of small animals that sustained ballistic trauma to the axial skeleton.

DESIGN

Retrospective, multicenter observational study.

SETTING

Two university teaching hospitals.

ANIMALS

Twelve client-owned dogs and 1 client-owned cat sustaining ballistic trauma to the axial skeleton.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Thirteen animals sustaining ballistic trauma to the axial skeleton with complete medical records were included in this study. Twelve of 13 animals survived to discharge; 1 animal was euthanized shortly after presentation. Two animals had ophthalmic abnormalities, 9 animals had neurologic lesions, and 2 animals had no significant ophthalmic or neurologic deficits. Neurolocalization of injury included peripheral vestibular (n = 1), multifocal brain (n = 1), brainstem (n = 1), C1-C5 (n = 1), C6-T2 (n = 1), T3-L3 (n = 3), and L4-S3 (n = 1). Seven dogs underwent surgical intervention: 5 neurosurgical, 1 enucleation, and 1 laparotomy. Median hospitalization time was 6 days with a range from 1 to 31 days.

CONCLUSIONS

Overall prognosis and outcome are variable and dependent on specific injury location and degree of injury.

Evaluation of outcome associated with feline trauma: A Veterinary Committee on Trauma registry study

OBJECTIVE

To evaluate outcome (survival to discharge) among trauma types (blunt, penetrating, both) in cats. Secondary objectives were to evaluate for associations between trauma type, injury severity, and the diagnostics and interventions selected by primary clinicians.

DESIGN

Retrospective evaluation of veterinary trauma registry data.

SETTING

Veterinary Committee on Trauma (VetCOT) veterinary trauma centers (VTCs).

ANIMALS

A total of 3895 feline trauma patients entered in the VetCOT trauma registry from April 1, 2017 to December 31, 2019.

INTERVENTIONS

Data collected included patient demographics, trauma type, Abdominal Fluid Score (AFS), Animal Trauma Triage (ATT) score, surgical intervention, glide sign on Thoracic Focused Assessment with Sonography for Trauma, Triage, and Tracking (TFAST), pleural effusion on TFAST, modified Glasgow Coma Scale (mGCS), and outcome (survival to discharge).

MEASUREMENTS AND MAIN RESULTS

Data from 3895 cats were collected over a 30-month period. Incidence of trauma types was as follows: blunt, 58% (95% confidence interval [CI]: 56%-59%); penetrating, 35% (95% CI: 34%-37%); and combination, 7.4% (95% CI: 6.7%-8.3%). Differences in survival incidence among the trauma types were identified: blunt, 80% (95% CI: 78%-81%); penetrating, 90% (95% CI: 89%-92%); and combined, 68% (95% CI: 63%-74%) (P < 0.01). Cats in the penetrating trauma group had the lowest proportion of severe injuries (6%) and highest proportion of mGCS of 18 (89%); cats with combined trauma had the highest proportion of severe injuries (26%) and lowest proportion of mGCS of 18 (63%). Point-of-care ultrasound and surgery were not performed in the majority of cases. When surgery was performed, the majority of blunt cases' procedures occurred in the operating room (79%), and the majority of penetrating cases' procedures were performed in the emergency room (81%).

CONCLUSIONS

Cats suffering from penetrating trauma had the best outcome (survival), lower ATT scores, and higher mGCS overall. Cats that sustained a component of blunt trauma had a lower survival rate, higher ATT scores, and the highest proportion of mGCS <18.

Comparison of clinical outcomes in cases of blunt, penetrating, and combination trauma in dogs: A VetCOT registry study

OBJECTIVE

To evaluate outcome (survival to discharge) among trauma types (blunt, penetrating, both) in dogs. The secondary objective was to evaluate if other trauma registry parameters differ between trauma types and influence survival.

DESIGN

Retrospective evaluation of veterinary trauma registry data.

SETTING

Veterinary Committee on Trauma (VetCOT) identified Veterinary Trauma Centers (VTCs).

ANIMALS

A total of 20,289 canine trauma patients with data entered in the VetCOT trauma registry from April 1, 2017 to December 31, 2019 INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS

Data were obtained from the VetCOT database and included patient demographics, trauma type (blunt, penetrating, both), Animal Trauma Triage (ATT) score, modified Glasgow Coma Scale (mGCS), abdominal fluid score (AFS), loss of glide sign on thoracic focused assessment with sonography for trauma (TFAST), pleural effusion on TFAST, surgical procedure performed and in what location (emergency room vs operating room), and outcome. Data from 20,289 dogs were collected over a 30-month period. The most common type of trauma was penetrating (10,816, 53.3%), followed by blunt (8360, 41.2%) and then combined blunt and penetrating trauma (1113, 5.5%). Dogs suffering only penetrating trauma had a 96.5% survival rate, blunt trauma had an 89.5% survival rate, and combined trauma had an 86.3% survival rate. Dogs suffering from both types of trauma had higher ATT scores, lower mGCS scores, and were more likely to be admitted to the ICU. Trauma type, mGCS, and ATT score were found to be associated with survival.

CONCLUSIONS

The present study highlights that dogs suffering from a combination of blunt and penetrating trauma are more likely to suffer moderate to severe injuries, have lower survival rates, and are more likely to be admitted to the ICU compared to dogs suffering from only blunt or penetrating trauma. Trauma type, mGCS, and ATT scores were found to be associated with survival in all groups.

Epidemiology of severe trauma in cats: An ACVECC VetCOT registry study

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.

Expanding Our Reach: Development of a Civilian Helicopter Air Ambulance K9 Response Program

This short communication highlights the development and implementation of the first civilian helicopter air ambulance canine response program in the United States.

Effect of COVID-19 Lockdown on Small Animal Trauma Patterns in Australia: A Multicentre Study

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.

Prospective evaluation of the Animal Trauma Triage Score and Modified Glasgow Coma Scale in 25 cats with high-rise syndrome

OBJECTIVES

The purpose of this study was to prospectively evaluate the prognostic utility of the Animal Trauma Triage Score (ATTS) and Modified Glasgow Coma Scale (MGCS) in cats with high-rise syndrome.

METHODS

ATTS and MGCS were obtained upon arrival from 25 client-owned cats presented for high-rise syndrome. Cases were followed during hospitalisation and several variables, including outcome, were recorded.

RESULTS

The mortality rate in this cohort of cats with high-rise syndrome was 16%. Univariate statistical analysis showed that lactate (P = 0.022), creatinine (P = 0.01), body weight (P = 0.036) and ATTS (P = 0.02) were higher and MGCS (P = 0.011) lower among non-survivors. Multivariable statistical analysis showed that ATTS was the only factor significantly associated with mortality (odds ratio 2.41, 95% confidence interval [CI] 1.02-5.71; P = 0.046). A receiver operating characteristics curve showed that ATTS was an excellent predictor of mortality (area under the curve 0.917, 95% CI 0.8-1.0; P = 0.009). An ATTS cut-off of 6.0 had a 75% sensitivity and 90% specificity for non-survival and a cut-off of 10 had a 25% sensitivity and 100% specificity for non-survival.

CONCLUSIONS AND RELEVANCE

ATTS is predictive of severity and outcome in cats with high-rise syndrome and can help facilitate decision-making by owners and veterinarians.

High-rise syndrome in cats and dogs

OBJECTIVE

To review the current literature pertaining to the pathophysiology, diagnosis, and treatment of injuries sustained from high-rise syndrome in cats and dogs.

ETIOLOGY

High-rise syndrome is defined as a fall from a height of 2 or more stories that results in a constellation of injuries, including thoracic, abdominal, orthopedic, and orofacial trauma. Animals often fall after slipping from windowsills, engaging in mating behavior, or chasing prey. Cats suffer less severe injuries than dogs due to their "righting reflex" and smaller body mass. Affected animals are younger, and the frequency of falls is higher in warmer months.

DIAGNOSIS

Physical examination coupled with radiographs, ultrasound, and computed tomography can diagnose a myriad of injuries that include pneumothorax, pleural or abdominal effusion, orthopedic fractures, and orofacial injuries. Bloodwork may identify anemia, thrombocytopenia, or increases in hepatic, renal, or pancreatic values consistent with trauma to these organs. Serial venous or arterial blood gas can help determine the severity of respiratory compromise and influence resuscitative efforts. Traditional coagulation tests and thromboelastography can assess trauma-induced coagulopathy and guide transfusion therapy.

THERAPY

Animals presenting in shock require hemodynamic stabilization. Initial resuscitation may incorporate crystalloids, colloids, blood products, and analgesics. Thoracic injuries may require oxygen, thoracocentesis, chest tube placement, and mechanical ventilation. Fractures and wounds are decontaminated and splinted/bandaged, with definitive fixation pursued after stabilization. Abdominal injuries are managed medically unless there is severe ongoing bleeding, sepsis, or injury to the urinary tract.

PROGNOSIS

In feline high-rise syndrome, the prognosis is generally excellent following treatment, with survival exceeding 90%. Canine literature is sparse. The largest retrospective study reported a >90% survival to discharge and a greater need for surgical stabilization in this species. There are no prognostic factors identified that are associated with survival for either species.

Clinicoepidemiological profile and risk factors associated with mortality in traumatized cats admitted to a veterinary teaching hospital in Brazil

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.

Distribution of mortality patterns in cats with naturally occurring trauma: A Veterinary Committee on Trauma registry study

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.

The prognostic value of admission point-of-care testing and modified Glasgow Coma Scale score in dogs and cats with traumatic brain injuries (2007-2010): 212 cases

OBJECTIVE

To investigate the association between admission point-of-care parameters and survival to discharge in dogs and cats with traumatic brain injury (TBI).

DESIGN

Retrospective study 2007-2010.

SETTING

A rural university teaching hospital and an urban private practice teaching hospital.

ANIMALS

One hundred thirty-one dogs and 81 cats admitted to the emergency service with evidence of head injury based on history from the owner or physical exam.

MEASUREMENTS AND MAIN RESULTS

In dogs, nonsurvivors had significantly higher glucose concentrations at admission than survivors (median = 8.49 mmol/L [153 mg/dl] vs 6.83 mmol/L [123 mg/dl], p = 0.039). In cats, there was no significant difference in admission glucose between survivors and nonsurvivors (median = 10.21 mmol/L [184 mg/dl] vs 10.93 mmol/L [197 mg/dl], p = 0.17). Modified Glasgow Coma Scale (MGCS) score was available for 105 of the 131 dogs (80%) and was significantly higher in survivors than in nonsurvivors (median = 16 vs 11, p < 0.0001). MGCS was available for 45 of the 81 cats (56%) and was significantly higher in survivors than in nonsurvivors (median = 17 vs 14, p = 0.0005). The relative prognostic value of the admission point-of-care testing parameters and MGCS were assessed using a stepwise linear regression model, which included admission glucose, pH, base excess, sodium, and MGCS. In dogs, only admission glucose was an independent predictor of survival (odds ratio = 1.027, 95% confidence interval, 1.0042-1.05, p = 0.019).

CONCLUSIONS

These results suggest that, as in people with TBI, increased blood glucose concentrations may have prognostic significance in dogs with TBI but not in cats. In addition, MGCS score may be predictive of survival in both dogs and cats with TBI.

Comparison of trauma sustained by civilian dogs and deployed military working dogs

OBJECTIVE

To compare the prevalence of types of trauma, mechanisms of injury, and outcomes among military working dogs (MWDs), operational canines (OpK9s), and civilian dogs (CDs) that sustained traumatic injury.

DESIGN

Retrospective descriptive analysis.

ANIMALS

One hundred and ninety-three cases of MWD trauma, 26,099 cases of CD trauma, 35 cases of OpK9 trauma.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Medical records of MWDs that incurred trauma while deployed to the Middle East were identified, and information was extracted from these records. The resultant database was compared to CD and OpK9s in the American College of Veterinary Emergency and Critical Care (ACVECC) Veterinary Committee on Trauma registry. All 3 groups showed similar trends with regard to type of trauma: penetrating injuries occurred most frequently, followed by blunt injuries for CDs and OpK9s. An equal proportion of blunt and blunt and penetrating traumas were observed in MWDs. Only MWDs sustained trauma from explosions, which accounted for 22.3% of injuries in this group. Animal bite/scratch/quilling and motor vehicle accidents (MVAs) were significantly more prevalent among CDs than MWDs (P < 0.01), whereas injuries from gunshot wounds (GSW) or a knife/sharp object were more common among MWDs compared to CDs (P < 0.01). No statistical differences in survival were observed between CDs and MWDs after excluding civilian dogs euthanized due to financial limitations.

CONCLUSIONS

MWDs, OpK9s, and CDs experience differences in injury type, mechanism, and outcome. Regardless, MWDs and CDs have good prognosis for survival to discharge after trauma.

SnakeMap: four years of experience with a national small animal snake envenomation registry

SnakeMap is a national cloud-based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary community-based online database allowing case entry from veterinary hospitals across Australia. Registry data comprise hospital characteristics, patient characteristics, envenoming snake type, treatment and outcome variables, including time and geolocation of the snake bite. We present summative information on select key variables from the SnakeMap registry (1 July 2015 to 30 June 2019). Twenty-eight hospitals from 6 states/territories entered 624 cases into the registry, including 419 dogs (67%) and 205 cats (33%). Bite time was available in 216 animals of which 90 (42%) were reported to be bitten in the 3 hours between 03:00 pm and 05:59 pm; median bite to presentation interval was 60 (interquartile range [IQR] 30, 211) minutes in dogs and 95 (IQR 41, 238) minutes in cats. Bites occurred in the owner's yard in 356 dogs (85%) and 53 cats (26%). A snake venom detection kit was used in 172 cases (28%) and antivenom was administered in 523 cases (85%). Most animals (n = 534, 88%) survived to discharge (median hospitalisation of 25 [IQR 16, 62] hours). SnakeMap effectively collects relevant clinical data from dogs and cats with presumed snake bite and provides locally specific information on the epidemiology of snake envenomation in small animals.

VetCOT: The Veterinary Trauma Registry

The goals of the Veterinary Committee on Trauma (VetCOT) trauma registry are to (1) inform improvement of veterinary and human trauma patient care and (2) design clinical and preclinical trials that could inform go/no go decisions for interventional strategies and tools. The VetCOT registry was established in 2013, and includes all trauma cases that present to Veterinary Trauma Centers. Veterinary Trauma Centers are well-resourced veterinary hospitals that are initially identified, then subsequently verified, by the American College of Veterinary and Emergency Critical Care VetCOT (http://vetcot.org/index.php/home/identification-and-verification-process/). As of June 2019, there are > 40,000 dog and cat cases in the registry, 3 publications and 9 ongoing projects utilizing data from the registry. Application materials to utilize VetCOT registry data is available on the VetCOT website (http://vetcot.org/index.php/home/registry-use-materials/).