Shock & Perfusion
Name one potential cause of cardiogenic shock?
Arrythmias
Myocardial disease
A cat presents in severe respiratory distress and is open-mouth breathing.
Oxygen, anxiolytics, minimal handling
Na: 118
K: 7.8
Glucose: 65
What endocrine disease should immediately come to mind?
Hypoadrenocorticism/Addison’s.
Daily double: What other differentials may present this way?
A dog eats a large amount of sugar-free gum.
What toxin should immediately come to mind?
Xylitol
What ER topic/condition do Belt and Danielle compete to host rounds on?
Blocked cats!
A dog has stridor. Where is the problem?
Upper airway (typically trachea)
What is the first line therapy for a ventricular tachyarrythmia?
Daily double!
A blocked cat has:
K: 8.5
HR: 90
Mentation: depressed
What immediately life-threatening complication are you worried about?
Hyperkalemia causing cardiac conduction abnormalities/arrhythmia.
Bonus: What are treatment options
A cat is brought in after its owner used a dog flea product containing permethrin.
The cat is tremoring and hyperexcitable.
What toxin is responsible?
Permethrin/pyrethroid
Treatment?
What is a group of ferrets called?
A business
Where should IVC be placed in a GDV and why?
Forelimbs, obstructive shock results in minimal absorption from the caudal body
A dog suddenly develops a regular narrow-complex tachycardia at 240 bpm.
What rhythm should be high on your differential?
Supraventricular tachycardia (SVT).
Daily double! What do we treat with?
A dog presents after ingesting an unknown amount of anticoagulant rodenticide. Which coagulation parameter is first affected?
PT
Bonus: what is the treatment?
A cat presents with facial swelling and muddy MM. What is an immediate toxicity concern?
Acetaminophen
What was the opening date of NRVS?
June 14, 2022
Name three major categories of shock.
Hypovolemic, distributive, cardiogenic, and/or obstructive
A dyspneic cat has muffled heart sounds and weak pulses.
What bedside imaging modality could rapidly help distinguish pleural effusion from pericardial effusion?
TFAST
PCV: 14%
TS: 8.5
Lactate: 7
What broad clinical picture does this combination suggest?
Severe anemia with poor tissue oxygen delivery/perfusion
A dog has ingested a potentially toxic dose of an NSAID.
Name two major organ systems you are concerned about
Answer: GI tract and kidneys.
Accept: CNS effects/seizures with severe overdose.
Paula Dean
Angie Harmon
A septic dog remains hypotensive despite appropriate fluid resuscitation.
BP: 70/40
MAP: ~50
HR: 160
What is your next major treatment priority?
Time for pressors!
Where is the typical distribution of pulmonary infiltrates in a case of noncardiogenic pulmonary edema?
Caudal-Dorsal
Bonus: What are a few causes of NCPE?
A dog has:
pH 7.20
PaCO₂ 25
HCO₃ 10
What is the primary acid-base disorder?
Answer: Metabolic acidosis with respiratory compensation.
Bonus: Is the compensation appropriate?
Answer: Yes, approximately. Winter’s formula predicts PaCO₂ around 23 ± 2.
A dog ingests a potentially toxic amount of ethylene glycol.
What is the critical early intervention that can prevent metabolism to the more toxic metabolites?
4 MP (fomepizole) or everclear
Name 2 of my 5 cats, nicknames accepted
Olive, Chip, Mary, Dude, and Clint