Glossary of Emergency

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Treatment for aortic thromboembolism
1) analgesia: torbutrol 0.2mg/kg SQ q8h or acepromazine SQ 0.1mg/kg

2) Fluids

3) +/- sodium bacarbonate 1mEq/kg IV over 2-5 minutes

4) Heparin: 200-300IU/kg IV the SQ q8h for 2 days
Give a good sedation protocol for the emergency cardiac patient
Dogs: acepromazine 0.03mg/kg IM, Butorphanol 0.2-0.4mg/kg IM

Cats: acepromazine 0.1mg/kg IM, butorphanol 0.2mg/kg IM
List 4 common causes of metabolic alkalosis.
1) Acute,profuse vomiting
2) Pyloric outflow obstruction
3) Excessive use of diuretics
4) Bicarbonate therapy
What 2 things characterize a peritonitis as septic?
1) Presence of bacteria
2) Degenerate neutrophils
Peritoneal fluid with bewteen 1000-7000 cells/μl and between 2.5-7.5 g/dl protein is called a ...
modified transudate
The term for PaCO2 > 45mmHg is ...
Hypercapnia or respiratory acidosis
How can one diagnose uroabdomen with abdominocentesis and serum?
Creatinine in the abdominal fluid will be greater than serum.

Note that the BUN should be the same in both because BUN reaches equilibrium across the peritoneum
The dose of Benedryl for allergic reactions:
1-2 mg/kg IM
Normal arterial pH:
Characterize an exudate.
>7000 cells/μl
>3.0 g/dl protein
What are the typical characteristics of an FIP effusion?
1) non-septic
2) straw-colored
3) hypocellular
4) foamy (protein rich)
5) macrophages and non-degenerate neutrophils
The term for PaCO2 < 35mmHg:
Hypocapnia or respiratory alkalosis
Name the most common causes of NON-septic peritoneal exudate.
1) bile peritonitis
2) hemoabdomen
3) chylous effusion
4) uroperitoneum
5) neoplasia
Peritoneal fluid with:
>7000 cells/μl
>3.0 g/dl protein is called a ...
Characterize a transudate
<1500 cells/μl
<2.5 g/dl protein
Characterize a modified transudate.
1000-7000 cells/μl
2.5-7.5 g/dl protein
Name some important causes of spetic peritonitis.
1) rupture of GI tract from GDV, obstruction, or surgical breakdown

2) rupture of hepatic, pancreatic, or prostatic abscess

3) contamination from pyometra

4) puncture or bite wound
How many platelets per high-powered field would indicate a thrombocytopenia in danger of bleeding?
0-3/hpf in the monolayer
The emergency CPR dose of epinephrine is ...
0.2mg/kg IV
0.4mg/kg IT
Name the components of the cardiac conduction system in order.
1) SA node
2) internodal tracts
3) AV node
4) bundle of His
5) right and left bundle branches
6) purkinje fibers
What does a PvCO2 of 53mmHG indicate?
note: this is VENOUS
Hypercapnia or respiratory acidosis
Can venous blood be used to assess acid-base balance?
However, PvCO2 is 3-6 mmHG higher than PaCO2 so ..
Normal PvCO2=38-51mmHG
At what PaO2 do we begin treatment for hypoxemia?
What is considered hypertensive in dogs and cats?
systolic >180mmHg
diastolic >120mmHg
The term for PaO2<80mmHg?
What is the normal PaO2 on room air at sea level?
80 to 110 mmHg
What is the normal range for base excess?
-4 to +4 mEq/L
What is the normal range for HCO3?
18-24 mmol/L
What 2 values can be used to assess the metabolic component of acid-base balance?
or base excess
What value is used to assess the respiratory component on acid-base balance?
What causes hypercapnia or respiratory acidosis?
alveolar hypoventilation
The ECG complex abnormality associated with left atrial enlargment:
widened P wave
dog: >0.04sec
cat: >0.04sec
Hypocapnia in the dog starts at:
PaCO2 <35mmHg
Peritoneal fluid with:
<1500 cells/μl
<2.5 g/dl protein is called a...
The term for arterial pH<7.35 is ...
acidemia, part of the overall process called acidosis
Name the 6 steps to ECG analysis.
1) calculate heart rate
2) interpret rhythm
3) measure durations and amplitudes
4) identify effects of electrolytes
5) establish mean electrical axis
6) identify effects of atrial and ventricular enlargement
The term for arterial pH > 7.45 is ...
Alkalemia, part of the overall process called alkalosis
What is represented by the PR interval?
impulse travel time from the SA node through the AV node to the ventricles.
(The ventricles fill during this time)
What lactate value is correlated with the need for gastric resection in GDV?
Why can't you use hypertonic saline is a dehydrated animal to rapidly incrase vascular tone?
The extracellular (extravascular) volume is already contracted.
How does the kidney maintain electroneutrality during excessive loss of chloride?
By reabsorbing bicarbonate
Which electrolyte is most commonly affected by changes in acid-base balance?
Severe metabolic acidosis increases K+
Severe metabolic alkalosis decrease K+
What is the maximum dose of bicarb not to be exceeded?
0.25 mEq/kg
Normal PaCO2?
List 5 common causes of respiratory acidosis.
1) anesthesia
2) respiratory depressant drugs
3) obesity
4) chronic obstructive pulmonary disease
5) brain injuries
list 6 common causes of metabolic acidosis.
1) renal failure
2) diarrha
3) chronic vomiting
4) severe shock
5) diabetes mellitus
6) hypoadrenocorticism
What liver enzyme metabolizes ethylene glycol?
alcohol dehydrogenase
What does a PvCO2 of 47mmHg indicate?
note: this is VENOUS
While outside the range of PaCO2, it is less than 3 mmHG higher that 45 mmHg so still within the normal range of PvCO2
2 drugs for ethylene glycol toxicity:
1) grain alcohol
2) 4MP (fomepizole)
3 categories of crystaloids and an example of each
1) hypotonic: D5W, 0.45% NaCl
2) Isotonic: LRS, Norm-R, 0.9% NaCl
3) Hypertonic: hypertonic saline ~7% NaCl
Approximate doseof hypertonic saline to raoidly increase blood volume:
3-5 ml/kg
What about ethylene glycol is damaging to the kidney?
Ocalate and maybe other metabolites from hepatic metabolism of EG.
What is the biggest problem we worry about with hyperkalemia?
cardiac arrhythmias (bradycardia)
List 4 common causes of respiratory alkalosis
1) Fever
2) Left to right shunts
3) Shock
4) Hypoxemia
The dose of calcium gluconate for hyperkalemia?
50-150 mg/kg slow IV
What is represented by the width of the P wave?
The time of impulse travel from the SA node to the AV node.
Give the steps to pass a stomach tube in a GDV dog.
1)+/- sedation (hydro-val)
2) roll of tape in mouth
3) Measure tube length to last rib
4) pass tube with care
5) feel for tube in esophagus
6) lavage
The ECG complex abnormality associated with right atrial enlargment?
TALL P waves
dog: >0.4mV
cat: >0.2mV
How do you treat sustained or significant ventricular tachycardia in the dog?
lidocaine 2mg/kg/min bolus
repeat up to 8mg/kg total over 10 minutes. If successful start CRI @ 50 to 70μg/kg/min.

Under what conditions do you treat ventricular tachycardia?
1) Very rapid (>200/min)
2) Causing hypotension (<90mmHg systolic)
3) Animal is symptomatic
4) Suspect degeneration to V. fib
Secondary treatment for dogs with DCM?
Dobutamine CRI @ 2.5 to 10 μg/kg/min
Secondary treatment for mitral regurgitation after stabilization with lasix and nitroglycerine?
Oral hydralazine 0.5mg/kg PO q12h
increase to 3.0mg/kg over several days
Initial treatment of cardiogenic pulmonary edema regardless of cause?
1) Furosemide 2-6mg/kg IV hourly until responsive
3) Nitroglycerine 1/2cm to 4cm percutaneously q8h

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