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1.
The purpose of this retrospective study was to evaluate the use of partial parenteral nutrition (PPN) in dogs and cats. The medical records of all dogs and cats receiving PPN between 1994 and 1999 were reviewed to determine signalment, reasons for use of PPN, duration of PPN administration, duration of hospitalization, complications, and mortality. Complications were classified as metabolic, mechanical, or septic. One hundred twenty-seven animals (80 dogs and 47 cats) were included in the study, accounting for 443 patient days of PPN. The most common underlying diseases were pancreatitis (n = 41), gastrointestinal disease (n = 33), and hepatic disease (n = 23). Median time of hospitalization before initiation of PPN was 2.8 days (range, 0.2-10.7 days). Median duration of PPN administration was 3.0 days (range, 0.3-8.8 days). Median duration of hospitalization was 7 days (range, 2-20 days). In the 127 animals receiving PPN, 72 complications occurred. These included metabolic (n = 43), mechanical (n = 25), and septic (n = 4) complications. The most common metabolic complication was hyperglycemia (n = 19), followed by lipemia (n = 17) and hyperbilirubinemia (n = 6). Most complications were mild and did not require discontinuation of PPN. Ninety-three (73.2%) of the 127 patients were discharged. All 4 animals with septic complications were discharged from the hospital. The presence, type, and number of complications did not impact the duration of hospitalization or outcome. However, animals that received supplemental enteral nutrition survived more often than those receiving PPN exclusively. Although PPN seems to be a relatively safe method of providing nutritional support, future studies are warranted to determine its efficacy.  相似文献   

2.
Feeding commercial enteral diets to critically ill dogs and cats via nasogastric tubes was an appropriate means for providing nutritional support and was associated with few complications. Twenty-six cats and 25 dogs in the intensive care unit of our teaching hospital were evaluated for malnutrition and identified as candidates for nutritional support via nasogastric tube. Four commercial liquid formula diets and one protein supplement designed for use in human beings were fed to the dogs and cats. Outcome variables used to assess efficacy and safety of nutritional support were return to voluntary food intake, maintenance of body weight to within 10% of admission weight, and complications associated with feeding liquid diets. Sixty-three percent of animals experienced no complications with enteral feedings; resumption of food intake began for most animals (52%) while they were still in the hospital. Weight was maintained in 61% of the animals (16 of 26 cats and 15 of 25 dogs). Complications that did occur included vomiting, diarrhea, and inadvertent tube removal. Most problems were resolved by changing the diet or adhering to the recommended feeding protocol. Nutritional support as a component of therapy in small animals often is initiated late in the course of the disease when animals have not recovered as quickly as expected. If begun before the animal becomes nutrient depleted, enteral feeding may better support the animal and avoid serious complications.  相似文献   

3.
Background: The putative role of the gut in amplification of systemic inflammation in acute pancreatitis is gaining credence, and intraluminal nutrition has been shown to decrease inflammation in experimental models of pancreatitis. Prepyloric feeding often is used in people with acute pancreatitis, but has not been evaluated in dogs. Hypothesis: Early intervention with enteral nutrition (EN) delivered proximal to the pylorus will be well tolerated in dogs with acute pancreatitis and provide justification for further larger trials. Animals: Ten dogs with severe acute pancreatitis in an open‐label, prospective pilot study. Methods: Dogs were treated with plasma transfusion and standard care, and then consecutively assigned to receive either EN via esophagostomy tube feeding or parenteral nutrition (PN). Outcome was used to determine optimal study size for future studies, and complications were compared between the 2 groups. Results: A significantly greater number of vomiting or regurgitating episodes occurred in dogs receiving PN. The dogs receiving EN did not demonstrate any noticeable postprandial pain. There were more catheter‐related complications in the PN group. There was no difference in outcome between the 2 treatments, and 43 dogs for each treatment would be required in future studies to determine a difference in outcome. Conclusions and Clinical Relevance: Early EN delivered proximal to the pylorus is well tolerated in dogs with severe pancreatitis and resulted in fewer complications than PN. Prospective trials in a larger cohort are justified to fully establish the potential benefit of early EN, preferably compared with minimal enteral nutrition.  相似文献   

4.
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5.
BACKGROUND: A syndrome of relative adrenal insufficiency has been identified in septic humans, and is associated with hypotension and death. Relative adrenal insufficiency is generally associated with basal serum cortisol concentration within or above the reference range and a blunted cortisol response to adrenocorticotropic hormone administration. It is unknown whether relative adrenal insufficiency occurs in septic dogs. HYPOTHESIS: That relative adrenal insufficiency occurs in septic dogs, and that relative adrenal insufficiency is associated with hypotension and mortality. ANIMALS: Thirty-three septic dogs admitted to a small animal intensive care unit. METHODS: Dogs were included in the study if they had a known or suspected infectious disease and had systemic inflammatory response syndrome. Dogs were excluded if they had disease or medication history expected to affect the hypothalamic-pituitary-adrenal axis. Serum cortisol and endogenous plasma adrenocorticotropic hormone concentrations were measured before, and serum cortisol concentration measured 1 hour after, intramuscular administration of 250 microg of cosyntropin/dog. The change in cortisol concentration (delta-cortisol) before and after cosyntropin administration was determined in each dog. RESULTS: Hypotension was associated with lower delta-cortisol values (OR 1.3; CI 1.0-1.9; P = .029). delta-Cortisol cutoff of 3.0 microg/dL was most accurate for predicting hypotension, survival to discharge, and 28-day survival. The rate of death in dogs with delta-cortisol < or = 3 microg/dL was 4.1 times that of dogs with delta-cortisol > 3 microg/dL (RR 4.1; CI 1.5-12.3; P = .01). CONCLUSIONS AND CLINICAL RELEVANCE: Delta-cortisol < or = 3 microg/dL after adrenocorticotropic hormone administration is associated with systemic hypotension and decreased survival in septic dogs.  相似文献   

6.
Thoracic CT may be used in the workup of patients with pleural effusion. In humans, certain pleural features on CT aid in diagnosing an underlying cause for pleural effusion, whereas this is not well studied in veterinary medicine. This retrospective cross‐sectional analytical study assessed pleural and other intrathoracic abnormalities on CT in dogs and cats with pleural effusion and explored potential discriminatory features between effusion types. Eighty‐nine dogs and 32 cats with pleural cytology and/or histopathology were categorized into malignant pleural disease (15 dogs and 11 cats), pyothorax (34 dogs and 7 cats), chylothorax (20 dogs and 11 cats), transudative (11 dogs and 2 cats), and hemorrhagic effusion (9 dogs and 1 cat). Multivariable logistic regression analysis comparing malignancy to other effusions found that older patient age (dogs: odds ratio 1.28, P = 0.015; cats: odds ratio 1.53, P = 0.005), nodular diaphragmatic pleural thickening (dogs: odds ratio 7.64, P = 0.021; cats: odds ratio 13.67, P = 0.031), costal pleural masses (dogs: odds ratio 21.50, P = 0.018; cats: odds ratio 32.74, P = 0.019), and pulmonary masses (dogs: odds ratio 44.67, P = 0.002; cats: odds ratio 18.26, P = 0.077) were associated with malignancy. In dogs, any costal pleural abnormality (odds ratio 47.55, P = 0.002) and pulmonary masses (odds ratio 10.05, P = 0.004) were associated with malignancy/pyothorax, whereas any costal pleural abnormality (odds ratio 0.14, P = 0.006) and sternal lymphadenopathy (odds ratio 0.22, P = 0.040) were inversely associated with transudates. There were, however, many overlapping abnormalities between effusion types, so further diagnostic testing remains important for diagnosis.  相似文献   

7.
Objectives – To describe changes in fresh frozen plasma (FFP) utilization over a 10‐year period at a veterinary teaching hospital. To evaluate the effect of FFP administration on specific laboratory parameters. Design – Retrospective observational study. Setting – University teaching hospital. Animals– Two hundred and eighty‐three dogs and 25 cats. Interventions – A hospital database search was performed for all animals receiving FFP during the study periods. Measurements and Main Results – Medical records of patients receiving plasma transfusions from 2006 to 2008 and from 1996 to 1998 were reviewed. Data collected included indications for transfusion, transfused volume, concurrent therapies, clinicopathologic data pre‐ and post‐transfusion, transfusion reactions, days of hospitalization, and outcome. FFP was administered to 112 dogs and 23 cats from 2006 to 2008 and to 171 dogs and 2 cats from 1996 to 1998. Significantly fewer patients received FFP for the treatment of hypoalbuminemia (2006–2008: 15% versus 1996–1998: 53%; P<0.001) or pancreatitis (2006–2008: 2% versus 1996–1998: 13%; P=0.001) and significantly more patients received FFP for coagulopathy (2006–2008: 80% versus 1996–1998: 31%; P<0.001) in the 2006–2008 group compared with the 1996–1998 group. For all patients receiving FFP, there was no difference in mean serum albumin concentration pre‐ and post‐transfusion. Median prothrombin time and activated partial thromboplastin time were significantly decreased post FFP administration. No association was found between the volume of plasma administered and outcome. Conclusions – FFP utilization has changed significantly over a 10‐year period. FFP was used most commonly in 2006–2008 for the correction of coagulopathy. FFP administration was associated with significant reduction in prothrombin time and activated partial thromboplastin time but did not significantly alter albumin concentration when administered at median doses of 15–18 mL/kg.  相似文献   

8.
Background: Feline systemic arterial hypertension (SHT) is associated with a wide spectrum of left ventricular (LV) geometric patterns as well as diastolic, and to a lesser extent, systolic myocardial dysfunction. However, little is known about SHT‐related cardiac changes in dogs. Hypothesis: SHT in dogs is responsible for morphological and functional cardiac alterations. Animals: Thirty dogs with spontaneous untreated SHT and 28 age‐ and body weight‐matched healthy dogs as controls. Methods: Prospective observational study. Conventional echocardiography and 2‐dimensional color tissue Doppler imaging were performed in SHT dogs by trained observers and compared with controls. Results: Forty‐seven percent of SHT dogs (14/30) had diffuse concentric hypertrophy. None had left atrial dilatation and 10/30 (33%) had aortic insufficiency (AoI) associated with proximal aortic dilatation. Longitudinal diastolic left ventricular free wall (LVFW) motion was altered in all SHT dogs at the base (early to late diastolic wave ratio, E/A = 0.5 ± 0.1 versus 1.3 ± 0.3 for controls, P < .0001) and the apex (E/A = 1.6 ± 1.7 versus 3.9 ± 3.1, P < .05). Longitudinal motion of the interventricular septum at the base (E/A = 0.7 ± 0.4 versus 1.1 ± 0.1, P < .01) and radial LVFW motion in the subendocardium (E/A = 0.9 ± 0.5 versus 1.6 ± 0.3, P < .01) were also altered in dogs with SHT. Longitudinal LVFW systolic velocities and gradients were also significantly decreased (P < .05) in SHT dogs. Conclusion and Clinical Importance: As in SHT in cats, SHT in dogs is associated with myocardial dysfunction independently of the presence of myocardial hypertrophy. However, unlike feline SHT, it results in a homogeneous LV geometric pattern with a relatively high prevalence of AoI.  相似文献   

9.
REASONS FOR PERFORMING STUDY: Adequate nutritional support of sick foals in critical care is an important aspect of treatment. When enteral feeding is contraindicated, parenteral nutrition (PN) provides a source of energy and protein. However, no study has critically assessed the use of PN in a large group of foals. OBJECTIVE: The administration of PN to clinically ill foals was examined retrospectively to determine the effects of PN formulation and variables on the incidence of PN-associated complications and outcome. HYPOTHESES: There was no effect of PN formula on 1) the occurrence or type of complications; 2) of PN formula on outcome; 3) of disease severity on the occurrence or type of complications; and 4) of disease severity on outcome. METHODS: Medical records of 45 foals, presented to the Marion duPont Scott Equine Medical Center, which received PN, were reviewed for the years 2000-2004. RESULTS: The indications for PN were recumbency, depression or gastrointestinal conditions. Formulation of PN was not associated with the development of complications, and there was no association of PN formula with patient survival. Disease severity was positively associated with the development of PN complications and the occurrence of PN complications was associated with an increased risk of nonsurvival. CONCLUSION AND POTENTIAL RELEVANCE: The use of lipid-containing PN solutions facilitates the delivery of energy to the critically-ill foal without increasing the risk of deleterious side effects. Severely ill foals are more prone to develop complications associated with PN and to have a poor outcome.  相似文献   

10.
OBJECTIVE: To estimate the prevalence and characteristics of pain in dogs and cats examined by an emergency service at a veterinary teaching hospital and evaluate the response of dogs and cats with signs of pain to analgesic treatment. DESIGN: Cross-sectional study. ANIMALS: 317 dogs and 112 cats. PROCEDURE: A questionnaire was used to categorize the characteristics of pain. The location, cause, and signs of pain were determined by obtaining a thorough history and conducting a physical examination. Pain was categorized by type (superficial somatic, deep somatic, or visceral), mechanism (inflammatory, neuropathic, or both), severity (mild, moderate, or severe), and duration. Evidence for primary or secondary hypersensitivity and hyposensitivity to manipulation was determined. The response to single or multiple analgesic drug administration was assessed. RESULTS: 179 (56%) dogs and 60 (54%) cats had signs of pain. In most of these dogs and cats, pain was classified as acute (< 24 hours' duration) and of moderate severity and was associated with primary hypersensitivity. Most dogs had deep somatic pain; most cats had visceral pain. Inflammation was the most common mechanism. One hundred nineteen (66%) dogs and 41 (68%) cats were treated with analgesic drugs. Analgesic treatment was considered effective in 73 (61%) dogs and 31 (76%) cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that moderate to severe acute somatic pain caused by inflammation is common in dogs and cats examined by an emergency service and that a combination of multiple analgesic drugs is more effective than any single analgesic drug in the treatment of pain in these dogs and cats.  相似文献   

11.
Background: Clinical remission is frequent in cats with well‐controlled diabetes mellitus, but few studies explored predictors of this phenomenon. Hypothesis: Data retrieved from medical records at admission might be valuable to identify likelihood of remission and its duration in diabetic cats. Animals: Ninety cats with newly diagnosed diabetes, followed‐up until death or remission. Methods: Retrospective cohort study. Data were collected from records at admission, including history, signalment, physical examination, haematology, and biochemical profile, and the occurrence and duration of remission, defined as normoglycemia without insulin for ≥4 weeks. Predictors of remission were studied with univariate and multivariate logistic regression. Factors associated with remission duration were analyzed with Kaplan‐Meier and Cox proportional hazard models. Results: Forty‐five (50%) cats achieved remission, after a median time of 48 days (range: 8–216). By study end, median remission duration was 114 days (range: 30–3,370) in cats that died and 151 days (range: 28–1,180) in alive cats. Remission was more likely with higher age (OR: 1.23, 95% CI: 1.04–1.46; P= .01) and less likely with increased serum cholesterol (OR: 0.36, 95% CI: 0.11–0.87; P= .04). Remission was longer with higher body weight (HR: 0.65, 95% CI: 0.42–0.99; P= .04) and shorter with higher blood glucose (HR: 1.01, 95% CI: 1.00–1.02; P= .02). Conclusions and Clinical Importance: Age, body weight, cholesterol, and glucose levels are suggested for prediction of remission or its duration in diabetic cats. Older cats developing diabetes may have a better outcome, possibly suggesting a slower disease progression.  相似文献   

12.
OBJECTIVE: To determine frequency and types of complications, prognostic factors, and primary diseases affecting clinical outcome associated with administration of total parenteral nutrition (TPN) in cats. DESIGN: Retrospective study. ANIMALS: 75 cats that received TPN for > or = 12 hours. PROCEDURE: Medical records were reviewed, and information was obtained on signalment, history, problems at initial evaluation, physical examination findings, weight and changes in weight while receiving TPN, duration in the hospital before initiation of TPN, the type of TPN catheter used, duration of TPN administration, and final diagnosis. Laboratory results obtained immediately prior to TPN and at 24 and 96 hours following initiation of TPN administration were compared. RESULTS: Reports of weight loss at initial evaluation, hyperglycemia at 24 hours, or diagnosis of chronic renal failure were significantly associated with increased mortality rate. Greater serum albumin concentrations prior to and at 96 hours following TPN administration were significantly associated with decreased mortality rate. Mechanical and septic complications were infrequent and not associated with increased mortality rate. Most cats had multiple diseases. The overall mortality rate was 52%; among 75 cats, 36 recovered, 23 were euthanatized, and 16 died as a result of their primary illness or complications associated with their illness. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated high mortality rate in cats maintained onTPN that had multiple concurrent diseases associated with a poor prognosis. Indicators of poor prognosis included a history of weight loss, hyperglycemia at 24 hours following TPN administration, hypoalbuminemia, and chronic renal failure.  相似文献   

13.
Feline anesthetic deaths in veterinary practice   总被引：1，自引：0，他引：1  
Anesthetic complications appear relatively rare, though recent work suggests they are more common in cats than dogs. Current estimates indicate that approximately 0.11% (1 in 895 anesthetics) of healthy cats die of an anesthetic-related death, which is more than twice as frequent as has been recently reported in dogs (0.05% or 1 in 1849). Most of these deaths occurred in the postoperative period. A number of risk factors have been associated with death, including patient health status, age, weight, and procedure type and urgency. Endotracheal intubation and fluid therapy have been reported to be associated with increased odds of anesthetic death in cats and may reflect higher risk techniques in cats compared with dogs. Monitoring patient pulse and the use of a pulse oximeter were also recently reported to be associated with reduced risk of anesthetic death. These data can help veterinarians care for their patient under anesthesia and address greater attention to patient assessment and management before anesthesia, as well as more careful fluid administration and patient monitoring during and after anesthesia, which could reduce perioperative complications in cats.  相似文献   

14.
OBJECTIVE: To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy. STUDY DESIGN: Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999. SAMPLE POPULATION: Thirty-six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid. METHODS: Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed. Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal. Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined. RESULTS: There was no significant difference in survival between animals in the OPD versus PC groups (P =.26) with an overall survival rate of 71%. White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P >.05). A significantly greater number of animals in the OPD group received plasma (P =.009), blood (P =.037), and a jejunostomy tube (P =.02) than animals in the PC group. There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 +/- 4.1 days for the OPD group and 3.5 +/- 2.3 days for the PC group (P =.02). CONCLUSIONS: Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC.  相似文献   

15.
Objective: To define the peri‐anesthetic risk factors that are associated with the development of postoperative pulmonary complications (PPCs) in dogs following laparotomy. Study design: Retrospective study. Animals: One hundred and sixty‐two dogs that underwent laparotomy at a veterinary teaching hospital. Methods: Cases were evaluated for factors including signalment, American Society of Anesthesiologists (ASA) physical status (PS) score, duration of fast, duration of anesthesia, anesthetic and analgesic protocols, fluid and blood product therapy, animal positioning, and postoperative temperature. Results: Statistically significant differences between dogs that developed PPCs and those that did not (nPPCs) were identified in the following categories: ASA PS score≥III (P=0.041), emergent surgery (P=0.038), longer duration of anesthesia (P=0.0462), and use of butorphanol or oxymorphone instead of hydromorphone for postoperative medication (P=0.04 and 0.015, respectively). Dogs that received transfusions of stored blood products (fresh frozen plasma or packed red blood cells) during their hospital stay were also more likely to develop PPCs (P=0.035 and 0.005, respectively). Dogs that developed PPCs were also more likely to have received antagonists for potent opiates or benzodiazepines postoperatively and to have recovered in the intensive care unit (ICU) (P=0.03 and 0.009, respectively). Conclusions: Dogs with ASA PS scores≥III, or those requiring longer or emergency anesthesia are at a higher risk of developing PPCs. Additionally, dogs receiving stored blood products in the perioperative period may be at risk for pulmonary complications. Dogs fitting criteria for the above risk factors should be monitored closely postoperatively for development of pulmonary complications.  相似文献   

16.
Background: Parenteral nutrition is an important method of nutritional support in hospitalized animals, but minimal information has been published on its use in camelids. Hypothesis/Objectives: The purpose of this study was to characterize the use of total parenteral nutrition (TPN) in alpacas, evaluate the formulations used, and determine potential complications. Animals: Twenty‐two alpacas hospitalized at the Tufts Cummings School for Veterinary Medicine (site 1: n = 8) and the Ohio State University Veterinary Teaching Hospital (site 2: n = 14). Methods: A retrospective analysis of all alpacas that received TPN between 2002 and 2008 was performed to assess clinical indications, clinical and clinicopathologic data, and outcome. Results: The most common underlying diseases in animals receiving TPN were gastrointestinal dysfunction (n = 16), hepatic disease (n = 2), and neoplasia (n = 2). Several metabolic abnormalities were identified in animals (n = 20/22) before TPN was initiated, including lipemia (n = 12/22), hyperglycemia (11/22), and hypokalemia (n = 11/22). Median age was significantly lower for site 1 cases (0.1 years; range, 0.01–11.0) compared with those from site 2 (4.9 years; range, 0.1–13.7; P= .03). Animals at site 2 also had a longer duration of hospitalization (P= .01) and TPN administration (P= .004), as well as higher survival rate (P < .02). Twenty‐one of 22 alpacas developed at least 1 complication during TPN administration. Metabolic complications were most prevalent (n = 21/22) and included hyperglycemia (n = 8/21), lipemia (n = 7/21), hypokalemia (n = 3/21), and refeeding syndrome (n = 3/21). Conclusions and Clinical Importance: TPN is a feasible method of nutritional support for alpacas when enteral feeding is not possible. Prospective studies are warranted to determine optimal TPN formulations for alpacas.  相似文献   

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18.
OBJECTIVE: To identify factors associated with leakage following intestinal anastomosis in dogs and cats. DESIGN: Retrospective study. ANIMALS: 90 dogs and 25 cats. PROCEDURE: Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. RESULTS: Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL. The model accurately predicted whether leakage would develop in 67 of 80 (84%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.  相似文献   

19.
The records of all dogs and cats receiving total parenteral nutrition (TPN) over a 43-month period were examined retrospectively. Dextrose, amino acids, lipids, electrolytes, and vitamins were administered by central venous catheter according to published nutrient recommendations; 72 dogs and 12 cats were studied, accounting for 380 patient days of TPN. Duration of TPN administration was 1–14 days with a mean of 4.5 days. Most animals required TPN because of gastrointestinal dysfunction, and more than half of them gained weight during TPN administration. Mechanical complications were frequent. Metabolic complications, especially lipid and glucose intolerance, were also commonly seen. Septic complications were the least frequently encountered, but resulted in patient morbidity and may have contributed to mortality. Most animals receiving TPN were returned to enteral nutrition and discharged. For critically ill animals unable to tolerate enteral alimentation, TPN can be supportive therapy in the treatment of the primary disease.  相似文献   

20.
Objective: To describe the indications, clinical features, outcomes and complications associated with use of continuous renal replacement therapy (CRRT) in 17 client-owned dogs and 16 client-owned cats with acute or acute-on-chronic renal failure refractory to aggressive medical management.
Series summary: Twenty-nine percent of dogs and 44% of cats had evidence of pre-existing chronic kidney disease (CKD). Median duration of CRRT was 16.3 hours (range 0.3–83.0 hours) in dogs and 11.5 hours (range 1.0–35.5 hours) in cats. Median canine blood urea nitrogen (BUN) improved from 41.0 mmol/L (115.0 mg/dL) to 11.8 mmol/L (33.0 mg/dL) and creatinine from 636.5 mmol/L (7.2 mg/dL) to 274 mmol/L (3.1 mg/dL). Median feline BUN improved from 46.4 mmol/L (130 mg/dL) to 13.9 mmol/L (39.0 mg/dL) and creatinine from 1069.6 mmol/L (12.1 mg/dL) to 291.7 mmol/L (3.3 mg/dL). Metabolic acidosis resolved in 80% of affected dogs and 71% of affected cats. Hyperkalemia resolved in 100% of affected dogs and 88% of affected cats. Complications noted with CRRT included iatrogenic hypokalemia, iatrogenic metabolic alkalosis, clinical hypocalcemia, total hypercalcemia, filter clotting, anemia, hypothermia, and neurologic complications. Forty-one percent of dogs and 44% of cats survived to discharge. No dogs and only 1 cat developed newly diagnosed CKD.
New or unique information provided: CRRT can be a viable option for the management of acute or acute-on-chronic renal failure in dogs and cats that are refractory to aggressive medical management. The frequency of complications associated with CRRT in this study warrants further experience with this modality before its widespread use can be recommended.  相似文献   

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