Citrate Toxicity Calculator for Dogs

Those of you who have ever participated in canine blood donation might have encountered a situation when the blood flow through a sampling line has significantly slowed down or even completely stopped, and despite your best efforts, you had to abort the mission. As a result, the blood bag may end up being half full and contain only 200-250 ml of blood. Since the majority of commercially available donor bags contain 63-70 ml of citrate-based anticoagulant, they are designed to be filled up with 400-450 ml of donor blood to maintain a 1:7 – 1:9 citrate-to-blood ratio. If not, the citrate-to-blood ratio goes up, which creates a risk for citrate toxicity during a blood transfusion. In this situation, a clinician or technician may elect to waste this blood product and send this donor home since collecting another full bag of blood will not be safe for the donor animal. On the other hand, there is an extreme shortage of blood products in veterinary medicine, and, if possible, any waste should be avoided.  In this blog post, I will give you a tool that may help you decide on whether a blood product with a high citrate-to-blood ratio should be discarded or safely given to a prospective recipient. 

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Mechanical GI Obstruction: Fake News?

A 2-year-old spayed female standard poodle was referred to a specialty private practice for evaluation of a suspected small intestinal mechanical obstruction. Two weeks prior, the dog started vomiting and stopped eating. The initial diagnostic work-up performed by her primary veterinarian showed normal bloodwork, and the dog received regular supportive care on an outpatient basis. Due to the presence of persistent vomiting and inappetence, the abdominal survey radiographs were performed, and they were consistent with the gastrointestinal obstruction as it was interpreted by a board-certified radiologist.

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Do All Cats with “HCM” have HCM?

A 7-month-old female spayed domestic shorthair was presented to an emergency service (ER) for increased respiratory rate and effort. The cat got spayed at her primary veterinarian 6 days prior to this episode, and had been doing well otherwise up until the evening of presentation. The owner reported no previous medical conditions. 

The initial triage examination showed tachypnea and moderately increased respiratory effort with increased bronchovesicular sounds in dorsal lung fields. No heart murmur or other abnormal physical examination findings were noted at that time. An emergency clinician performed thoracic radiographs (Figure 1 and 2) and point-of-care blood work that was within normal limits.  

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Radiographic confirmation of NG/NE tube placement in dogs and cats: Is it truly foolproof?

Nasogastric and nasoesophageal tubes are commonly used in small animal practice for short-term enteral nutrition. They are easy to place without general anesthesia, inexpensive and can be used for gastric decompression and drug administration.

Unfortunately, feeding tube misplacement happens much more frequently than the number of cases described in the literature. Although rare, misplacement may occur in advanced tertiary veterinary hospitals despite a strict adherence to the institutional policies and radiographic confirmation by board-certified veterinary radiologists (Rodriguez-Diaz JAAHA 2021).

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Fetal Heart Rate in M-mode

In this video, I will teach you how to obtain an accurate fetal heart rate by using the M-mode (point-of-care ultrasound).

NOTE*** This was a GE Logiq e machine that I used to record this video. If you are using a different ultrasound machine, your abdominal preset may be set up differently or you may not have an HR (Heart rate) option. In this case, just measure duration of one cardiac cycle (from mid-systole to mid-systole or mid-diastole to mid-diastole) and divide 60 by the duration of the cycle and you will get the heart rate. The majority of ultrasound machines will use miliseconds (ms) to measure the duration of the cycle in the M mode. You will need to convert ms to seconds to calculate the heart rate. To do that, divide ms by 1000 = sec. 

For example, in the video below the duration of the cardiac cycle in the first example was 214 ms = 0.214 sec. If you divide 60 by 0.214, the HR will be equal to 280 beats per minute, which is exactly the same HR as the calculated HR by the machine.