Manual of Small Animal Emergency and Critical Care Medicine

Douglass K. Macintire was previously Director of Intensive Care, College of Veterinary Medicine, Department of Small Animal Surgery and Medicine, Auburn University and a Diplomate of ACVIM and ACVECC.

Kenneth J. Drobatz is Director, Trauma Emergency Service, and Professor and Chief of Critical Care, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, and a Diplomate of ACVIM and ACVECC.

Steven C. Haskins is Director, Small Animal Intensive Care Unit, Veterinary Medical Teaching Hospital, University of California, Davis and is a Diplomate of ACVA and ACVECC.

William D. Saxon is Telemedicine Consultant, IDEXX and a Diplomate of ACVIM and ACVECC.

CONTRIBUTORS, x

PREFACE TO THE FIRST EDITION, xi

PREFACE TO THE SECOND EDITION, xii

ACKNOWLEDGMENTS, xiii

PART I LIFE SUPPORT AND INITIAL STABILIZATION, MONITORING, AND INTENSIVE CARE OF THE CRITICALLY ILL PATIENT 1

1 APPROACH TO THE EMERGENCY PATIENT, 3
Steve C. Haskins and Douglass K. Macintire

Initial Preparation and Management, 3

The Primary Survey: Initial Examination to Identify Life-Threatening Problems, 4

Brief History, 12

Thorough Secondary Survey, 12

2 EMERGENCY ROOM READINESS, 17
Steve C. Haskins and Douglass K. Macintire

Being Prepared, 17

Equipment Recommendations, 17

Recommended Supplies, 18

Recommended Drugs, 19

3 CARDIOPULMONARY-CEREBRAL RESUSCITATION (CPCR), 21
Steve C. Haskins

Causes, 21

Clinical Signs, 21

The Nature of Cell Injury During Cardiac Arrest, 21

Prognosis/General Recommendations, 22

Treatment, 22

Electrical Activity of the Heart, 27

Postresuscitative Care, 28

4 SHOCK, 30
Steve C. Haskins

Definition, 30

Categories of Shock, 30

Systemic Inflammatory Response, 30

Multiple Organ Dysfunction, 31

Monitoring and Identifying Treatment Opportunities, 31

Treatment of Shock with Special Emphasis on Septic Shock and MODS, 31

Treatment of Anaphylactic Shock, 40

5 ANESTHESIA AND ANALGESIA, 41
Steve C. Haskins

Overview of Anesthesia in Critically Ill Patients, 41

Guidelines for Anesthesia in Critically Ill Patients, 42

Specific Drugs Used for Anesthesia in Critical Patients, 44

Anesthesia Concerns and Protocols for Common Conditions, 54

Overview of Analgesia, 57

Analgesia Drugs and Techniques, 58

6 FLUID THERAPY, 63
Steve C. Haskins and Douglass K. Macintire

Body Fluid Compartments, 63

Crystalloid Solutions, 65

Colloid Solutions, 69

Specific Conditions Requiring Fluid Therapy, 75

7 MONITORING, 85
Steve C. Haskins

Cardiovascular Monitoring, 85

Respiratory Monitoring, 102

Urologic Monitoring, 106

Neurologic Monitoring, 109

8 NUTRITIONAL SUPPORT OF CRITICAL PATIENTS, 116
Steve C. Haskins

Acute Malnutrition, 116

Methods and Procedures of Providing Enteral Nutrition, 117

Methods and Procedures of Providing Parenteral Nutrition, 132

Nutrition as an Aid to Medical Therapy (Pharmaconutrition), 134

PART II SPECIFIC PROTOCOLS AND PROCEDURES FOR EMERGENCY CONDITIONS 137

9 RESPIRATORY EMERGENCIES, 139
Kenneth J. Drobatz and Douglass K. Macintire

General Approach/Methods of Oxygen Delivery, 139

Upper Airway Obstruction (Pharynx, Larynx, Trachea), 142

Pleural Space Disease, 154

Lower Airway Disease, 171

Parenchymal Disease, 179

Cyanosis, 185

Mechanical Ventilation, 185

10 CARDIAC EMERGENCIES, 192
Douglass K. Macintire

Clinical Signs, 192

Diagnosis, 193

Diagnostic and Monitoring Procedures, 193

Management of Specific Conditions, 199

11 GASTROINTESTINAL EMERGENCIES, 226
Douglass K. Macintire

Clinical Signs, Diagnosis, 226

Diagnostic and Monitoring Procedures, 226

Management of Specific Conditions, 231

12 UROLOGIC EMERGENCIES, 269
Kenneth J. Drobatz and William D. Saxon

Clinical Signs, Diagnosis, 269

Diagnostic and Monitoring Procedures, 270

Management of Specific Conditions, 279

13 NEUROLOGIC EMERGENCIES, 297
Michelle B. Carnes, Douglass K. Macintire, and William D. Saxon

Clinical Signs, Diagnosis, 297

Diagnostic and Monitoring Procedures, 297

Management of Specific Conditions, 298

14 HEMATOLOGIC EMERGENCIES, 333
Douglass K. Macintire

Clinical Signs, Diagnosis, 333

Diagnostic and Monitoring Procedures, 335

Management of Specific Conditions, 342

15 ENDOCRINE AND METABOLIC EMERGENCIES, 355
William D. Saxon, Kenneth J. Drobatz, and Douglass K. Macintire

Clinical Signs, Diagnosis, 355

Diagnostic and Monitoring Procedures, 355

Management of Specific Conditions, 359

16 REPRODUCTIVE EMERGENCIES, 397
Douglass K. Macintire and William D. Saxon

Clinical Signs, Diagnosis, 397

Diagnostic and Monitoring Procedures, 398

Management of Specific Conditions, 399

17 PEDIATRIC EMERGENCIES, 405
Douglass K. Macintire and William D. Saxon

Resuscitation of Neonates (Birth to 2 weeks), 405

Diseases of Infant Animals (2–6 weeks), 410

Diseases of Juvenile Animals (6–12 weeks), 413

18 OCULAR EMERGENCIES, 418
William D. Saxon and Deborah Mandell

Clinical Signs, Diagnosis, 418

Diagnostic and Monitoring Procedures, 419

Management of Specific Conditions, 421

19 DERMATOLOGIC EMERGENCIES, 441
Robert Kennis and Douglass K. Macintire

Clinical Signs and Diagnosis, 441

Diagnostic Procedures, 442

Management of Specific Conditions, 443

20 TOXICOLOGICAL EMERGENCIES, 453
Kenneth J. Drobatz

Diagnosis, Clinical Signs, 453

Initial Approach to the Poisoned Patient, 454

Management of Specific Toxicities, 457

21 MISCELLANEOUS EMERGENCIES, 479
William D. Saxon, Kenneth J. Drobatz, and Douglass K. Macintire

Heat Illness, 479

Hypothermia, 481

Frostbite, 484

Near Drowning (Submersion Injury), 485

Insect and Spider Bites, 487

Snakebites, 490

Electrocution, 493

Fever of Unknown Origin, 495

APPENDICES, 499

A. Calibration Tables for the Schiötz Tonometer, 499

B. Normal Values for the Canine and Feline Electrocardiogram, 501

C. CPCR Guidelines, 502

D. Common Equations, 505

E. Constant Rate Infusions, 506

F. Conversion Tables, 511

G. Normal Values for Oxygen and Hemodynamic Parameters, 514

H. Toxicology, 517

I. Transfusion Guide, 522

J. Drug Formulary, 524

K. Guidelines for Anesthesia in Animals with Critical Problems, 652

INDEX, 657

"This is an informative quick reference for emergency cases, with useful tools for management. A revised and updated edition was necessary to reflect new medications and treatments." (Doody's, 19 October 2012)

"The second updated edition of Manual of Small Animal Emergency and Critical Care Medicine provides key details on common emergencies in small animals and offers a new edition with completely new chapter on orthopedic injuries, wound management, and expanded toxicology information and treatment protocols. Chapters are packed with indexing and cross-references, offer a fine outline format for emergency reference, and includes tables, drug dosages, formulas and illustrations throughout. The result is a fine pick for any veterinary or animal medical reference library." (Midwest Book Reviews, 1 October 2012)