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1.
Objective: To characterize the clinical findings in dogs and cats that sustained blunt trauma and to compare clinical respiratory examination results with post‐traumatic thoracic radiography findings. Design: Retrospective clinical study. Setting: University small animal teaching hospital. Animals, interventions and measurements: Case records of 63 dogs and 96 cats presenting with a history of blunt trauma and thoracic radiographs between September 2001 and May 2003 were examined. Clinical signs of respiratory distress (respiratory rate (RR), pulmonary auscultation) and outcome were compared with radiographic signs of blunt trauma. Results: Forty‐nine percent of dogs and 63.5% of cats had radiographic signs attributed to thoracic trauma. Twenty‐two percent of dogs and 28% of cats had normal radiographs. Abnormal auscultation results were significantly associated with radiographic signs of thoracic trauma, radiography score and presence and degree of contusions. Seventy‐two percent of animals with no other injuries showed signs of thoracic trauma on chest radiographs. No correlation was found between the radiographic findings and outcome, whereas the trauma score at presentation was significantly associated with outcome and with signs of chest trauma but not with the radiography score. Conclusion: Thoracic trauma is encountered in many blunt trauma patients. The RR of animals with blunt trauma is not useful in predicting thoracic injury, whereas abnormal chest auscultation results are indicative of chest abnormalities. Thorough chest auscultation is, therefore, mandatory in all trauma animals and might help in the assessment of necessity of chest radiographs.  相似文献   

2.
Objective – Evaluate an abdominal fluid scoring (AFS) system using an abdominal focused assessment with sonography for trauma (AFAST) protocol.
Design – Prospective study.
Setting – Private veterinary emergency center.
Animals – One hundred and one client-owned dogs with motor vehicle trauma.
Interventions – AFAST performed on admission and 4 hours post-admission.
Measurements and Main Results – An AFS was assigned to each dog based on the number of AFAST fluid-positive quadrants identified using a 4-point scale: AFS 0 (negative for fluid in all quadrants) to AFS 4 (positive for fluid in all quadrants). Free abdominal fluid was identified in 27 of 101 dogs (27%). Dogs with AFS scores of 3 or 4 (14/27 [52%] AFS-positive dogs) experienced more marked decreases in packed cell volume and total plasma protein, increases in alanine aminotransferase, and needed more blood transfusions than dogs with lower AFS scores and AFS-negative dogs. Serial AFAST was performed in 71% of dogs (71/101); 17% (12/71) of these cases changed AFS score, and 75% (9/12) of the changes were higher (worsened) AFS, correlating with increasing amounts of free abdominal fluid. Ninety-eight percent of the study population was a primary presentation. Overall, median time from trauma to initial AFAST was 60 minutes, and median AFAST examination time was 3 minutes.
Conclusions – Initial and serial AFAST with applied AFS allowed rapid, semiquantitative measure of free abdominal fluid in traumatized patients, was clinically associated with severity of injury, and reliably guided clinical management. Where possible, AFAST and AFS should be applied to the management of blunt trauma cases.  相似文献   

3.
Thoracic injuries caused by blunt trauma are commonly encountered emergencies in veterinary medicine. However, published studies are lacking that compare radiology to CT in blunt trauma caused by motor vehicle accidents in canine patients. The aim of this prospective diagnostic accuracy, methods comparison study were to estimate the sensitivity (Se) and specificity (Sp) of thoracic radiology relative to CT for detecting lung contusions, pneumothorax, pleural effusion, and rib fractures. The study further aimed to develop a severity scoring system for radiology and CT and to compare the findings between the two modalities. The hypothesis was that radiology would be less sensitive than CT at detecting these injuries and that radiology would underestimate the severity of lung contusions. Fifty‐nine patients met the inclusion criteria. Radiology underestimated the presence of lung contusions (Se = 69%, 95% confidence interval) and overestimated the severity of the contusions relative to CT. There was high interobserver variability in evaluating lung contusion severity (coefficient of variation = 91%). Both the three‐view thoracic and horizontal beam radiography had poor sensitivities for the detecting pneumothorax (Se = 19% and 63%, respectively) and pleural effusions (Se = 43% and 71%, respectively). Similarly, the sensitivity (56%) of radiographs for the detection of rib fractures was poor relative to CT. Findings from the current study indicated that thoracic radiography had low sensitivity for detecting lesions related to blunt thoracic trauma caused by motor vehicle accidents and supported the use of CT as an additional diagnostic imaging modality in these patients.  相似文献   

4.
The purpose of this study was to evaluate if pre-anaesthetic thoracic radiographs contribute to the anaesthetic management of trauma patients by comparing American Society of Anesthesiologists Physical Status Classification (ASA grade) with and without information from thoracic radiography findings. Case records of 157 dogs and cats being anaesthetized with or without post-traumatic, pre-anaesthetic chest radiographs were retrospectively evaluated for clinical parameters, radiographic abnormalities and anaesthetic protocol. Animals were retrospectively assigned an ASA grade. ASA grades, clinical signs of respiratory abnormalities and anaesthesia protocols were compared between animals with and without chest radiographs. The group of animals without pre-anaesthetic radiographs was anaesthetized earlier after trauma and showed less respiratory abnormalities at presentation. The retrospectively evaluated ASA grade significantly increased with the information from thoracic radiography. Animals with a higher ASA grade were less frequently mechanically ventilated. Pre-anaesthetic radiographs may provide important information to assess the ASA grade in traumatized patients and may therefore influence the anesthesia protocol.  相似文献   

5.
One hundred dogs with skeletal injury were evaluated for co-existing thoracic abnormalities. Parameters used to assess thoracic trauma were physical examination, thoracic radiographs, electrocardiograms and arterial blood gas PaO2. Thoracic abnormalities were found in 57 per cent of the dogs. Within this group, 77 per cent had abnormal thoracic radiographs, 44 per cent had abnormal low PaO2, and 30 per cent had cardiac arrhythmias. No clinical signs suggestive of thoracic injury were found on physical examination in 79 per cent of the dogs with thoracic lesions.  相似文献   

6.

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.  相似文献   

7.
The records of 267 dogs seen at the University of Minnesota Veterinary Teaching Hospital for fractures resulting from motor vehicle accidents were examined to determine the prevalence and types of thoracic wall and pulmonary trauma associated with such cases. Results were analyzed for type and prevalence of thoracic wall and pulmonary injury, and for the prevalence of such injury in dogs with and without extrathoracic injury, in dogs with fractures of single vs multiple bones, in dogs with single fractures of specific bones, in dogs with fractures in the cranial vs the caudal one half of the body, and in dogs with fractures ipsilateral vs contralateral to thoracic injury. The overall prevalence of thoracic wall and pulmonary trauma was 38.9%; pulmonary contusions, pneumothorax, and fractured ribs were the most common injuries. More than 1 type of thoracic wall or pulmonary injury was diagnosed in 57.7% of the cases. Of the dogs with thoracic injury, 24% also had extrathoracic injuries; 16.5% of dogs without thoracic injury had extrathoracic injuries, not including fractures. Of the dogs with fractures of 1 bone, 36.3% had thoracic injuries. Of the dogs with fractures of more than 1 bone, 42.3% had thoracic injuries. The prevalence of thoracic wall and pulmonary trauma was significantly associated with the site of the fracture (cranial vs caudal and ipsilateral vs contralateral); significant association with the specific bone fractured was also seen for some fractures.  相似文献   

8.
OBJECTIVES: Canine bite wounds may cause severe underlying tissue trauma even with no clinically evident puncture wounds. In order to assess the ability of pre-operative diagnostic parameters to predict the extent of internal damage inflicted by a thoracic bite wound, the clinical, radiological and surgical data of 45 dogs that sustained thoracic bite trauma were recorded. METHODS: Clinical, radiographic and surgical parameters from 45 dogs of various breeds with thoracic bite trauma, were analysed (P<0.05). All dogs were treated according to a previously described protocol and had exploratory surgery including a thoracotomy. RESULTS: Mainly small-breed dogs were traumatised. Clinical and radiological data were suggestive of internal trauma but not reliable as accurate indicators for internal lesions. Only radiological evidence of lung contusion was significantly associated with the presence of surgically confirmed lung contusion (P=0.006). Dogs with postoperative wound complications had a significantly higher risk of dying than those without complications (P=0.04). CLINICAL SIGNIFICANCE: This study concludes that according to protocol an optimal management of thoracic bite wounds in small dogs includes surgical exploration of the wound and the thoracic cavity in the presence of flail or pseudo-flail chest, fractured ribs, radiological evidence of lung contusion, pneumothorax or any combination of these.  相似文献   

9.
Comparison of test characteristics allows a clinician to choose the optimal diagnostic test method for an individual patient. This study assessed the comparative test characteristics of noninvasive (NI) blood pressure measurement methods (oscillometric and Doppler) and used this information to develop optimal cutoff values for diagnosis of systolic hypertension in dogs by these NI methods. Simultaneous NI (oscillometric or Doppler methods) and invasive (arterial puncture [AP]) systolic blood pressure (SBP) measurements were obtained prospectively from normal dogs and dogs suspected of having systemic hypertension based on clinical signs. Oscillometric SBP readings were obtained from the distal hind limb (Osc-L, n = 54) or the proximal tail (T. n = 27). Doppler BP measurements were obtained using a forelimb cuff (n = 57). AP-SBP was categorized as hypertensive if > or = 160 mmHg, and sensitivity (Se). specificity (Sp), and likelihood ratios (LR) were calculated for diagnostic cutoff values ranging from 130 to 220 mmHg. Receiver operator characteristic (ROC) curves were analyzed to determine optimal cutoff values for diagnosis of AP-SBP > or = 160 mmHg. Optimal NI SBP cutoff values considered to reflect AP values > or = 160 mmHg were: Osc-L = 160 mmHg (Se: 65%, Sp: 85%. LR = 4.33: 1), Osc-T = 150 mmHg (Se: 84%, Sp: 75%, LR = 3.36: 1), and Doppler = 160 mmHg (Se: 71%,  相似文献   

10.
A 2-year-old female African pygmy hedgehog (Atelerix albiventris) presented to emergency for anorexia, lethargy and vulvar discharge. Tranquilization with midazolam, administration of oxygen therapy and facemask anesthesia with isoflurane were used for radiography study which showed increased radio-opacity and silhouette sign in the thoracic cavity. The patient underwent cardio-respiratory arrest during the performance of TFAST echocardiography. TFAST confirmed pleural effusion, a nodule in the chamber of the right atrium. Abdominal ultrasound revealed two fluid filled structures compatible with left ovarian cysts. Necropsy confirmed dilated cardiomyopathy, bilateral atrial thrombi, endometrial hyperplasia and two left ovarian cysts.  相似文献   

11.
OBJECTIVE: To document pulmonary function, ventilator management, and outcome of dogs with thoracic trauma that required mechanical ventilation because of severe pulmonary contusions. DESIGN: Retrospective study. ANIMALS: 10 dogs that required mechanical ventilation because of severe pulmonary contusions caused by blunt thoracic trauma. PROCEDURE: Signalment, historical data, arterial blood gas values, oxygen tension-based indices, ventilator settings, peak inspiratory pressure, positive end-expiratory pressure, tidal volume, and minute ventilation values were retrieved from medical records. RESULTS: All 10 dogs required positive-pressure ventilation because of dyspnea following trauma and had severely abnormal pulmonary function. Survival rate to discharge was 30%. Dogs were categorized into 2 groups; group A included 5 dogs in which pulmonary function improved during ventilation, whereas group B included 5 dogs that were euthanatized because of progressive lung dysfunction (n = 4) or cardiac arrest (1). Mean +/- SD body weight of group-A dogs (30.9 +/- 15.9 kg [68 +/- 35 lb]) was significantly greater than that of group-B dogs (7.6 +/- 1.8 kg [16.7 +/- 4 lb]). Dogs with improved lung function had peak inspiratory pressure that decreased progressively, whereas lung compliance deteriorated in dogs in group B. CONCLUSIONS AND CLINICAL RELEVANCE: Dyspneic dogs with severe pulmonary contusions may require and benefit from positive-pressure ventilation Prognosis is better for dogs that weigh > 25 kg (55 lb).  相似文献   

12.
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13.
One hundred acutely traumatized dogs were evaluated for the presence of cardiopulmonary abnormalities with thoracic radiographs, electrocardiography and arterial blood gas analysis. Fifty-seven dogs were found to have concurrent appendicular fracture(s) and thoracic injury as defined by an abnormality in one or more of the variables evaluated. Thoracic radiographs were abnormal in 44 dogs. Ventricular arrhythmias were identified in 17 dogs. Hypoxemia (PaO2 < 80 mmHg) was detected in 25 dogs. Hypoxemia was noted with increased frequency in dogs with abnormal thoracic radiographs. Ventricular arrhythmias occurred more frequently in the hypoxemic group of dogs.
Although a relationship was noted between the presence of hypoxemia, radiographic changes of the thorax and ECG abnormalities, all three examinations provided important information for assessing the cardiopulmonary status of each patient.  相似文献   

14.
Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B‐lines, representing interstitial edema) versus dry lung (A‐lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A‐lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B‐lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8‐view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left‐sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6–19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74–100%) in those with left‐sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions.  相似文献   

15.
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16.
BACKGROUND: Left atrial (LA) enlargement (LAE) is a morphologic expression of the severity and chronicity of left ventricular (LV) diastolic dysfunction, volume overload, and increased atrial pressure and has diagnostic, therapeutic, and prognostic importance in cats. The noninvasive gold standard for assessing LA size is 2-dimensional echocardiography (2DE). HYPOTHESIS: ECG and thoracic radiography may be used to predict LAE in cats. ANIMALS: Twenty-one healthy control cats and 31 cats with cardiomyopathy were prospectively studied. METHODS: 2DE studies, including determination of the maximum LA dimension (LAD) and area (LAA), were performed prospectively in all cats and compared to the assessment of LA size based on thoracic radiography and indices obtained from a 6-lead ECG. Results obtained from healthy cats were used to generate discrimination limits suggestive of LAE as defined by LAD > 1.57 cm and LAA > 2.75 cm2. RESULTS: In cats with LAE, P wave duration and PR interval were prolonged and radiographic LA vertebral heart size (LA-VHS) was increased (P < .05). P wave-related indices had low sensitivity (Se; range, 0.12 to 0.60) but high specificity (Sp; range, 0.81 to 1.00) for the prediction of LAE. Radiographic indices had low Se (range, 0.28 to 0.72) and high Sp (range, 0.74 to 0.95) for the prediction of LAE. Correlation analyses identified correlations between LAA and P wave duration (r = 0.47, P = .003) and LAD and LA-VHS (r = 0.70, P < .001). CONCLUSION AND CLINICAL IMPORTANCE: ECG and thoracic radiography are reasonably specific but less sensitive predictors of LAE in cats.  相似文献   

17.
Background – This study was performed to document the frequency and severity of limb injuries that occur when dogs come in contact with metal landscape edging. A retrospective study from 1997 to 2007 was performed at Colorado State University veterinary teaching hospital. Sixty dogs were admitted to hospital for traumatic limb injuries resulting from metal landscape edging identified by a computerized medical records search. Key Findings – Most dogs were young, large breed dogs. All 60 dogs suffered traumatic pedal lacerations when contacting metal landscape edging, the majority of which occurred on the forelimbs. Eighty‐five percent required surgical repair. All 60 dogs were discharged from the hospital and 30 were available for long‐term follow‐up. While most dogs healed with a perfect cosmetic outcome, 3 dogs with tendon involvement developed residual digital deformities. Significance – Dogs are at risk of injury when exposed to metal landscape edging. Severity of pedal injury determines treatment protocol and prognosis for recovery.  相似文献   

18.
Objective: To explore the potential value of transesophageally‐determined descending thoracic aortic blood flow parameters in critically ill dogs undergoing surgery. Design: Observational case series. Setting: Private small animal referral hospital. Animals: Ten anesthetized critically ill dogs that underwent emergent surgery. Interventions: Placement of the ultrasonic transesophageal probe. Measurements and main results: Transesophageally‐determined descending thoracic aortic blood flow, stroke volume, blood velocity, blood acceleration, left ventricular ejection time interval, and heart rate parameters were recorded every minute. Systolic and mean arterial blood pressures were non‐invasively determined and recorded at 1–5 minute intervals. The anesthetist and surgeon were blinded to the descending thoracic aortic blood flow parameters. All dogs received fluid challenges as part of their management, and 2 dogs received dopamine. The variability of the descending thoracic aortic blood flow parameters within each dog was greater than has been reported in non‐critically ill anesthetized dogs. Consistent trends in descending thoracic aortic blood flow parameters after fluid challenges were not found. An escalating dopamine infusion was, however, accompanied by increasing aortic blood flow, stroke volume, acceleration, and peak velocity. Conclusions: Descending thoracic aortic blood flow parameters may eventually be useful for evaluating the responses to and suggesting the need for cardiovascular interventions during emergent surgeries in anesthetized critically ill canine patients. For this to occur, more experience with this technology will be required.  相似文献   

19.
Apparent restihg energy expenditure (AREE) and respiratory quotient (RQ) were determined by open flow indirect calorimetry in a group of 104 apparently resting, critically ill, postoperative and severely traumatized dogs. The evaluations were conducted in a calm, temperature-controlled environment after at least a 12-hour fast. Subjects were allowed to acclimilate to the monitoring equipment prior to beginning the study. The clinical patients were compared to a group of 20 clinically normal, apparently resting, client owned dogs (NC). The data was also compared to published normals (NP) for energy expenditure of apparently resting dogs. Measurements were indexed to actual body weight in kilograms (BW) as well as to metabolic body size(BW0.75). Measurements of VO2 (VO2/kg and VO2/kg0.75) and VCO2 (VCO2/kg and VCO2/kg0.75) were used to calculate the RQ and the AREE. Critically ill, postperative and severely lower RQ values AREE/kg or AREE/kg0.75 (p=0.39). The PO&T dogs did exhibit significantly lower RQ values (p<0.0001) than either the (NC) or (NP) groups. Measured AREE of the PO&T dogs was significantly less than a calcualted value using the illness/injury/infection energy requirement (IER), (p<0.0001). Energy expenditure in typical trauma and postoperative patients may commonly be overstimated by the IER method. Conclusion: The AREE of critically ill, postoperative and severly trumatized dogs was not higher than healthy dogs as has been previously suggested in the literature.  相似文献   

20.
Because urinary bladder rupture can be life threatening, a simple, safe technique for evaluating patients is desirable. Current diagnostic protocols involve radiographic imaging, but ultrasound-based contrast techniques have not been methodically evaluated in veterinary patients with urologic trauma. Ultrasound contrast cystography (contrast cystosonography) involves infusion of microbubbled saline solution through a urinary catheter. It was performed in an in vitro model and in 2 dogs with naturally occurring urinary bladder rupture. A positive result consisted of visualizing microbubbles sonographically in fluid surrounding the bladder immediately after infusion of contrast into the urinary catheter. A positive result was obtained both in the in vitro model and in the 2 dogs, with radiographic and surgical confirmation of naturally occurring intraperitoneal urinary bladder rupture in the dogs. Based on the results of this study, ultrasound contrast cystography appears to be more sensitive than two-dimensional (2D) abdominal sonography for detecting naturally occurring urinary bladder rupture in dogs.  相似文献   

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