TOXICOLOGY
What 3 organ systems can be impacted with chocolate toxicity and at what doses?
GI, Nervous, and Cardiac systems
GI: 20 mg/kg
Cardiac: 40 mg/kg
Nervous: 60 mg/kg
What is the most common arrest rhythm seen during a code?
Asystole (accounts for 70% of cases)
Explain the acronym for remembering the 5 main organ echogenicity's
"My cat loves sunny places"
hypoechoic -> hyperechoic
Medulla, Cortex, Liver, Spleen, Prostate
This drug group is typically used in emergency situations for seizure management
Benzodiazepines!
What radiographic view is considered diagnostic for GDV?
Right lateral view
-pylorus will be cranial to the body of the stomach
-double bubble
What urine crystals can be seen with ethylene glycol toxicity that can obstruct the renal tubules and lead to acute renal injury?
Calcium oxalate monohydrate (can be seen 3-6 hours post-ingestion)
What ECG rhythms are shockable during a code?
Ventricular fibrillation and pulseless ventricular tachycardia
A 14MHz probe has ____ resolution and ____ depth penetration compared to a 8MHz probe
high resolution and poor depth penetration
What are our realistic goals for long-term seizure control in vet med?
Minimize seizures while also minimizing adverse effects of medications (patient's health and quality of life)
What direction do the pylorus and duodenum move with GDV?
Pylorus and duodenum move VENTRALLY and to the LEFT of midline (clockwise)
Albuterol inhalation can cause profound _____ upon chemistry panel evaluation
hypokalemia! due to it activating the Na/K ATPase on cell membranes
Higher doses of atropine (0.4 mg/kg) are associated with _____ ROSC.
decreased
What does a positive glide sign tell us?
Tells us that the lung is contacting the pleural surface of the chest wall
-used to rule out pneumothorax
What are the 3 broad causes of seizure activity?
-Idiopathic epilepsy (diagnosis of exclusion)
-Structural epilepsy (neoplasia, inflammation, degenerative, vascular, trauma)
-Reactive seizures (E-lyte imbalances of Ca and Na, hypoglycemia, endogenous neurotoxins, exogenous neurotoxins)
What is the first thing you should do when a patient comes in presumptively suffering from GDV?
Begin to stabilize!!
-IV fluids: large bore catheters in both cephalic veins or jugular vein (shock dose of fluids)
Then we can perform vitals and bloodwork while fluids are going (PE, TPR, BP, ECG, Blood gas, Coag panel)
Your patient is presenting for a bloodwork recheck after being discharged from the hospital following anticoagulant rodenticide ingestion. Upon rechecking the patient's coagulation panel, you find their PT is still prolonged. How long will you continue treatment?
2 weeks and then check again or reconsider diagnosis
What medications can be administered through the endotracheal tube if no IV is placed (and at what volume)?
N-Naloxone
A- Atropine
V- Vasopressin
L- Lidocaine
E- Epinephrine
**Double the volume!
Name the 5 layers of the intestines in order and their echogenicity
Serosa- hyperechoic
Muscularis- hypoechoic thin outer layer
Submucosa- hyperechoic thick inner layer
Mucosa- hypoechoic thick inner layer
Mucosal surface- hyperechoic thin inner most layer
What is status epilepticus?
-status epilepticus: >5 minutes of continuous epileptic seizure activity or >1 seizure without recovery between
What are cons to percutaneous gastric decompression?
-less complete decompression, especially if large amounts of food or thick froth present
-may lacerate spleen
What clinical features can be present with Acetaminophen toxicity in cats?
-Methemoglobinemia (muddy MMs, respiratory distress, heinz body hemolytic anemia)
-tachycardia, tachypnea
-depression, coma
-edema of the face and paws
What should the defibrillator be charged to during a code and what how should it change if it is not effective initially?
2-4 J/kg
**Increase by 50% if not effective
You see an intussusception on your ultrasound screen. What are 3 potential underlying causes of this condition?
Bonus: What are the names of the outer and inner portions?
-Parasitism
-Foreign body
-Masses/nodules
**Outer= intussuscipiens
**Inner= intussusceptum
What are the 3 seizure phases? How long can the last phase last?
1. Preictal (prodrome)- abnormal behavior
2. Ictus- seizure itself
3. Postictal- disorientation, blindness, ataxia; lasts minutes to days (usually 20-30 minutes)
Even if the patient is unstable, what must be done prior to closing the patient after performing a GDV repair?
Gastropexy!!
-80% recurrence rate without it
What side?