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JOURNAL CLUB |
GASTROENTEROLOGY
Identification of Risk Factors for Septic Peritonitis and Failure to Survive Following Gastrointestinal Surgery in Dogs Grimes JA, Schmiedt CW, Cornell KK, Radlinksy MG. Journal of the American Veterinary Medical Association 2011;
CRITICAL POINTS GSPN 5FBDIJOH )PTQJUBM UIBU VOEFSXFOU
This retrospective cohort study reviewed medical records EPHT BENJUUFE UP UIF 6OJWFSTJUZ PG (FPSHJB 7FUFSJOBSZ FYQMPSBUPSZ DFMJPUPNJFT
History, clinicopathologic findings, surgery characteristics, BOE PVUDPNF XFSF SFDPSEFE 0G UIF TVSHFSJFT involved dogs with pre-operative septic peritonitis, of which EFWFMPQFE QPTUPQFSBUJWF TFQUJD QFSJUPOJUJT BOE EJFE 0G UIF EPHT XJUIPVU QSF PQFSBUJWF TFQUJD EFWFMPQFE QPTUPQFSBUJWF TFQUJD QFSJUPOJUJT
QFSJUPOJUJT
PG XIJDI EJFE .BKPS SJTL GBDUPST JEFOUJGJFE GPS EFWFMPQNFOU of postoperative septic peritonitis included: r 1SF PQFSBUJWF TFQUJD QFSJUPOJUJT r -PX QSF PQFSBUJWF TFSVN BMCVNJO BOE QMBTNB QSPUFJO concentration
r *OUSB PQFSBUJWF IZQPUFOTJPO The presence of a gastrointestinal foreign body was statistically
associated with a lower risk of postoperative septic peritonitis. Anusha Balakrishnan, BVSc, University of Pennsylvania
r 5IJT TUVEZ TVHHFTUFE UIBU QSF PQFSBUJWF BMCVNJO and plasma protein concentrations were signifi- cant predictors of anastomotic complications. This is likely due to their important role in wound healing, and because they are markers of sys- temic disease and nutritional status.
r *OUSB PQFSBUJWF IZQPUFOTJPO XBT GPVOE UP CF B significant predictor of postoperative peritonitis for 1 of 2 reasons: (1) its role as a marker for systemic disease or (2) direct impairment of healing secondary to poor tissue perfusion and oxygenation.
r 1SF PQFSBUJWF TFQUJD QFSJUPOJUJT JT B NBKPS SJTL factor for postoperative septic peritonitis. Administration of antimicrobials during surgery decreased this risk while postoperative admin- istration of corticosteroids increased the risk.
r 5IFSBQFVUJD FGGPSUT TIPVME CF GPDVTFE PO improving pre-operative albumin and protein concentrations as well as aggressive efforts to maintain normotension intra-operatively.
ANALGESIA & UROLOGY
Coccygeal Epidural with Local Anesthetic for Catheterization and Pain Management in the Treatment of Feline Urethral Obstruction O'Hearn AK, Wright BD. Journal of Veterinary Emergency and Critical Care
Male cats with urethral obstruction are common emergencies, requiring sedation or general
anesthesia to facilitate urethral unblocking and urinary catheter placement. The presence of hyperkalemia and/or metabolic acidosis secondary to urethral obstruction often increases
the anesthetic or sedation-associated risks in affected cats. In this report, the technique for a coccygeal epidural CMPDL JT EFTDSJCFE BT B NFUIPE UP QSPWJEF MPDBM BOFTUIFTJB JO DPOKVODUJPO XJUI MJHIU TFEBUJPO JO PSEFS UP BDIJFWF urethral catheterization. After light sedation (eg, an opioid and benzodiazepine), the cat is placed in sternal recumbency. Either the
sacrococcygeal space or the space between the first and second coccygeal vertebrae is identified as the needle entry site, over XIJDI UIF TLJO JT BTFQUJDBMMZ QSFQBSFE " HBVHF JODI OFFEMF JT BEWBODFE JOUP UIF FQJEVSBM TQBDF BU B BOHMF 5IFO UP N- LH PG
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the epidural space. When performed correctly, the anesthetic effect to the caudal
urogenital tract, colon, anus, perineum, and tail occurs within NJOVUFT PG BENJOJTUSBUJPO BOE NBZ MBTU VQ UP IPVS .PTU
important, the motor function of the hindlimbs is preserved. The authors suggest that coccygeal epidural block may be a useful and safe local anesthetic technique for the management of feline urethral obstruction.
Debra Liu, DVM, University of Pennsylvania January/February 2012 Today's Veterinary Practice 75 CRITICAL POINTS
r " DPDDZHFBM FQJEVSBM CMPDL JT B QSBDUJDBM MPDBM anesthetic technique to be considered as part of the sedation/anesthesia protocol for unblocking male cats with urethral obstruction.
r " DPDDZHFBM FQJEVSBM CMPDL QSPWJEFT BOFTUIFTJB to the caudal urogenital tract, colon, anus, perineum, and the tail, while preserving the motor function of the rear limbs.
r 8IFO QFSGPSNFE DPSSFDUMZ UIF BOFTUIFUJD FGGFDU PDDVST XJUIJO NJOVUFT PG BENJOJTUSBUJPO BOE may last up to 1 hour.
Collection of Commentaries on Veterinary, Medical, & Related Literature