PH-Induced Coagulopathy?

A 12-year-old female spayed Chihuahua was presented to the emergency service for evaluation of respiratory distress that had started acutely several hours prior to presentation. The dog began coughing at 10 am the morning of presentation, and was unobserved during the day while the owner was at work. At 6 pm the cough was worse, and the dog became dyspneic. The patient has had a chronic cough for a couple years but typically only has one coughing episode per day. The cough was a hacking cough that lasted about 10-15 seconds, and the dog has never been dyspneic before.

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VetEmCRIT Rounds: A Chat about Fibrinolysis

During these rounds, two Diplomates of American College of Veterinary Emergency and Critical Care (Laura Cole and Rachael Birkbeck) are discussing a post-operative bleeding in a dog that underwent an anal sacculectomy and sublumbar lymph node removal. Drs. Cole and Birkbeck talk about physiology and pathophysiology of fibrinolysis as well as DIC, viscoelastic testing and the reasons why hemorrhagic cavitary effusions do not clot.

Dr. Birkbeck’s review paper on hyperfibrinolysis in dogs and cats can be found here.

Understanding Stats When Reading a Scientific Paper

In this post, I want to underscore the importance of understanding a statistical analysis section when reading any scientific paper, especially in veterinary medicine where the peer-review process of statistical analysis is not always as strict as in human medicine.

Obviously, it is impossible to cover the entire statistical analysis course in this post, and I am by no means a statistician. However, I will give you an example of choosing a wrong statistical test leading to a completely wrong interpretation of the results of a clinical study. My goal is to ignite your interest and curiosity with respect to statistical analysis, and I plan to continue posting similar articles in the future.

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Approach to Hyponatremia in Dogs and Cats

This post presents diagnostic and therapeutic approaches to canine and feline patients with hyponatremia. As we all remember, the plasma sodium concentration represents a ratio of plasma sodium content to the water content. As a result, the plasma sodium concentration depends heavily on water balance. Therefore, hyponatremia may develop secondary to either excess of free water in the body or lack of sodium ions relatively to the free water. Also, it is helpful to remember that plasma sodium concentration is the key determinant of plasma osmolality, and the majority of hyponatremic patients will have low plasma osmolality. However, this is not always the case. For example, patients with hyperglycemia or those who received mannitol may develop hyponatremia in conjunction with high plasma osmolality caused by excessive glucose concentration or the presence of other osmotically active substances (e.g. mannitol). Hyponatremic patients with normal plasma osmolality typically have spurious hyponatremia (aka pseudohyponatremia).

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