Critical Care

93 mg Explanation This question is asking about how many mg he ingested, so his body weight is irrelevant for this particular problem. He consumed 1.55 oz X 60 mg/oz (oz cancel out)= 93 mg ingested The toxic dose of chocolate can vary per patient. At 20mg/kg may be hyperactive, agitated, and have GI symptoms. Around 50mg/kg may start to have cardiac effects such as tachycardia or arrhythmias. Doses above 60 mg/kg may start to cause neurologic symptoms such as tremoring, seizures, etc.; in severe cases death may occur. To see what effects Bernie might have, let's take it one step further: He weighs 15 pounds/2.2 pounds/kg = 6.8 kg 93 mg ingested/6.8kg = 13.6 mg/kg dose ingested (this is well below the 20mg/kg that may cause hyperactivity) Going off the information about side effects above, Bernie is not likely to have any severe effects other than possibly some GI upset. If he just ate the chocolate, the vet may still wish to induce vomiting, or just monitor

"Bernie," a 4-year-old Maltese mix presents to your clinic after having ingested a full milk chocolate bar about 20 minutes prior to his arrival; this means he consumed about 1.55 ounces, according to the package the owner brought. How many milligrams of theobromine would this be? (Hint: Milk chocolate contains about 60mg per ounce of theobromine, the toxin we are concerned about.) Bernie weighs 15 pounds.

magnesium Magnesium deficiency may lead to "grass tetany" in sheep or goats, and sometimes in cows. It occurs when animals graze on pastures that are low in magnesium, or during lactation when demand for magnesium is higher. Treatment is with magnesium and calcium supplementation but can be a very serious and life-threatening condition. Symptoms can include restlessness, staggers, an over-alert appearance, being excitable, falling down, or convulsions and death.

"Grass tetany" may been seen in sheep or goats due to a deficiency in which mineral?

1.86 ml Constant rate infusions are not something that an entry level technician would typically perform. However, the VTNE may have some questions on CRI and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming: 1) Convert pounds to kilograms- 66 pounds/2.2 pounds per kg = 30 kg 2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 Liter, or 1,000 mL) by the rate per hour: 1,000 mL/120mL/hr = 8.3 hours 3) Now take the number of hours (8.3) and multiply by 60 to calculate how many minutes this is: 8.3 X 60 = 498 minutes 4) Now plug into the equation: 5 ug/30kg/498min= 74,700 ug 5) Now convert the ug into mg by dividing by 1,000: 74,700/1,000 = 74.7 mg 6) Calculate the quantity of dopamine to add by now dividing the 74.7 mg by the concentration of the drug (40mg/mL) : 74.7mg/40mg/mL = 1.86 mL To be truly accurate when adding drugs to a bag like this, you should discard 1.86 mL of fluids from the bag prior to adding the 1.86 mL of dopamine.

"Pablo", a 66 pound Labrador mix, is in oliguric renal failure. The veterinarian has asked you to start a constant rate infusion of dopamine at 5 micrograms per kilogram per minute (ug/kg/min) and a fluid rate of 120 mL per hour. Dopamine comes in a concentration of 40 mg/mL. How much dopamine will you add to a liter of 0.9% sodium chloride solution?

his true hemacrit is likely lower than 22% A hematocrit of 22% tells us that the cat is anemic. Dehydration causes a falsely elevated hematocrit or PCV. This means that because this cat is dehydrated, the hematocrit is likely actually lower than 22%. The hematocrit or PCV often goes down when hydration is restored. While chronic renal failure can lead to anemia of chronic disease, this assumption cannot be made based on the information given in the question. Even though the hematocrit is low, this doesn't mean the cat is losing blood. To know whether blood loss or chronic disease is causing the anemia, a reticulocyte count would be needed to see if this cat is regenerating (making new red blood cells). In cases of blood loss or lysis, the anemia is usually regenerative (reticulocytes greater than 60,000). In cases of chronic disease, the anemia is usually non-regenarative (reticulocytes less than 60,000).

A 10-year old domestic short hair presents with a history of vomiting and inappetance and is severely dehydrated. His CBC shows a hematocrit of 22%. What can be said about this cat?

0.18 ml First you have to understand what a 1:1000 concentration means. A 1:1000 solution is the same as saying 1 gram in 1,000 mL. And we know that 1 gram is equal to 1,000 mg. So it would be 1,000 mg: 1000 mL which is the same as 1 mg/mL (when the thousands cancel out). Next you take the patient's weight in kg X the dose: 9 kg/dog X 0.02 mg/kg (the kg cancel out) = 0.18 mg/dog Now divide the dose by the concentration: 0.18 mg/dog x 1mg/mL (mg cancel out) = 0.18 mL/dog

A 10-year-old male neutered Pug presents in respiratory distress and appears to be having an allergic reaction. He has hives and a swollen face. The doctor asks you to get epinephrine ready at a dose of 0.02 mg/kg. He weighs 9 kg. When you get the bottle of epinephrine from the refrigerator it says it is a 1:1000 solution. How many mLs will you draw up for this patient?

220 ml The body weight needs to be converted to kilograms. 12 lb / (2.2 lb/kg) = 5.5 kg 5.5 kg x (40 ml/kg) = 220 ml

A 12-pound cat has presented with diabetic ketoacidosis and is currently in shock. The doctor orders that a 40 ml/kg bolus of 0.9% saline be administered. How many milliliters will this patient receive?

sodium bicarbonate A blood pH of 6.4 is low, or acidic. Sodium bicarbonate can increase the cat's blood pH but ultimately the underlying problem (the diabetes) must be treated. Insulin may be used in both resuscitation efforts and long-term therapy. Darbopoetin causes an increase in red blood cell production and has no effect on blood pH. Potassium gluconate is administered orally to correct hypokalemia. Methylprednisolone can cause an increase in blood glucose levels and is not a drug used to correct pH. Corticosteroids such as this should be avoided in diabetic patients when possible.

A 13-year old diabetic cat arrests during hospitalization during a blood glucose curve. During resuscitation efforts, an emergency blood panel is run which reveals a blood pH of 6.4. What drug may be requested by the veterinarian to help correct this abnormality but would not be used as a long-term therapy?

head trauma Anisocoria is defined as unequal or asymmetrical pupil size and results most often from CNS trauma. Although other systems may have sustained damage, the most likely cause of anisocoria in a patient that was hit by a car is head trauma.

A 2-year old Dalmatian presents after being hit by a car. Anisocoria is noted during the initial physical examination. What type of trauma would be suspected?

brachycephalic syndrome As a young bulldog, this patient would be suspected of having an elongated soft palate, stenotic nares, and (as a result of turbulent airflow), everted laryngeal saccules, or a combination of the three. Laryngeal paralysis is typically seen in large breed, older dogs. Asthma is nonexistent in dogs. A tracheal mass would be uncommon in such a young dog. While a tracheal foreign body is possible, brachycephalic syndrome is a better fit considering the breed and presence of stertor.

A 2-year old bulldog presents with respiratory distress, specifically on inhalation, and stertor. What, of the following, would be the most common cause of respiratory distress in this patient?

calcium gluconate IV The correct answer is calcium gluconate IV. Puerperal tetany (eclampsia) is often seen in post-partum toy breed dogs. Emergency treatment for these patients is IV calcium in the form of calcium gluconate. Diazepam (either IV or per rectum) can be given to stop the seizures, but does not treat the problem of hypocalcemia. Tetanus intoxication is less likely in this patient.

A 3-year old female Yorkie presents to your hospital as an emergency for seizures and tetany. In the history, you learn that the bitch had a litter of 3 puppies about 2 weeks ago. What is the most likely treatment this dog will need to correct the cause of its problem?

left displaced abomasum Symptoms of left displaced abomasum include decreased appetite, activity, manure production, and milk production. Eliciting a pinging noise while flicking the abdominal area is an indication of a displaced abomasum. Because the pinging was found on the left, it is most likely a left displaced abomasum. Even though you would not be expected to make a diagnosis, knowledge of this common condition is helpful and may show up on the VTNE.

A 3-year old female cow presents with a decreased appetite, decreased manure production, and decreased milk production. She calved three weeks ago and has been less active than normal. You auscultate the GI tract and elicit a pinging noise on the left side of the abdomen. Which of the following emergencies is most likely to be occurring?

90 ml/kg The isotonic crystalloids shock dose in dogs is 90 ml/kg. 1/4 to 1/3 of this volume should be administered initially and the patient reassessed. In cats, the isotonic crystalloids shock dose is 40-60 ml/kg. Synthetic colloids can be administered at a dose of 10-20 ml/kg in dogs and 5-10 ml/kg in cats; hypertonic saline can be administered at a dose of 5 ml/kg.

A 3-year old male neutered Labrador Retriever presents for lethargy and inappetence of a few days in duration. The dog is approximately 7% dehydrated with pale and dry mucous membranes, a capillary refill time > 2 sec, heart rate > 170 bpm and weak femoral pulses. The veterinarian diagnoses the dog with hypovolemic shock and orders isotonic crystalloid fluid therapy. What is the isotonic crystalloid total "shock dose" in dogs?

heart rate Cats with a urethral obstruction can develop hyperkalemia (high potassium) due to decreased glomerular filtration rate (GFR) and the inability of the kidneys to excrete potassium from the body through the urine. Hyperkalemia can slow down the heart rate which can be fatal if it is severe enough, so it is very important to check the heart rate immediately. An ECG can also be of benefit to further assess the heart rhythm. Body temperature can decrease if the patient is in shock and the patient may need to be warmed until the body can maintain a normal temperature on its own. A packed cell volume and blood pressure could be useful in the overall assessment of the patient, but these would not be assessed immediately on presentation.

A 4 year old male neutered domestic shorthair cat presents to your clinic with a history of straining to urinate. The owner is unsure how long it has been since the cat urinated. What is the first thing you should check while waiting for the doctor?

it reduces intracranial pressure Mannitol is an osmotic diuretic and reduces acute increases in intracranial pressure. The veterinarian suspects head trauma has been sustained. Mannitol does not protect the GI tract from damage nor does it provide any pain control. It is not a pressor and therefore does not cause peripheral vasoconstriction.

A 5-year old feline presents after being hit by a car. The veterinarian wants you to administer mannitol intravenously. For what reason was mannitol chosen as a therapy?

permethrin Explanation Permethrin (a synthetic pyrethroid) is very toxic to cats and can be found in some topical flea prevention medications. It can cause neurologic side effects, tremoring, and may even cause seizures. Cats are treated by washing the product off immediately, placing an intravenous catheter, administering IV fluids, and giving muscle relaxants such as valium and/or methocarbamol. Metaldehyde is most commonly found in snail bait and is not part of flea control products. Ethylene glycol is antifreeze and coumadin is Warfarin (an anticoagulant found in some rat poisons); these are not found in flea control products.

A 5-year-old female spayed domestic short hair cat presents on emergency for acute vomiting, weakness, hypersalivation, and tremoring. Her heart rate is 240 bpm and her temperature is elevated at 104.2F. The owner applied an over-the-counter flea control product to her skin earlier in the day. What toxicity is suspected?

2000ml The patient is receiving 500 ml/hr. 50 kg x (10 ml/kg/hr) = 500 ml/hr In four hours, the patient will receive 2000 ml 4 hr x (500 ml/hr) = 2000 ml.

A 50-kg Golden Retriever has presented with extremely pale mucous membranes and is diagnosed with a hemoabdomen. A blood transfusion has been requested, and the doctor would like a 10ml/kg/hr transfusion rate for 4 hours. How many milliliters of blood will you need?

75 ml Constant rate infusions are not something that an entry-level technician would typically perform. However, the VTNE may have some questions on CRI, and it will benefit you to know how to do these calculations. To solve this problem, break down the basic parts to make it less overwhelming. *Note that a 2% solution is the same as 20 mg/mL (add a zero to the % number, so 1% is 10mg/mL, 20% is 200 mg/mL, etc.) 1) Convert pounds to kilograms-55 pounds/2.2 pounds per kg = 25 kg 2) Calculate the number of hours an infusion will last by dividing the volume in the bag (1 liter, or 1,000 ml) by the rate per hour: 1,000 ml/80ml/hr = 12.5 hours 3) Now take the number of hours (12.5) and multiply by 60 to calculate how many minutes this is: 12.5 X 60 = 750 minutes 4) Plug into the equation: 80 ug/25kg/750min= 1,500,000 ug 5) Now convert the ug into mg by dividing by 1,000: 1,500,000/1,000 = 1500 mg 6) Calculate the quantity of lidocaine to add by dividing the 1500 mg by the concentration of the drug (20mg/ml): 1500mg/20mg/ml = 75 ml To be truly accurate when adding drugs to a bag like this, you should discard 75 ml of fluids from the bag prior to adding the 75 ml of lidocaine.

A 55-pound Pit Bull mix "Rocky" was hit by a car and is hospitalized in the emergency ward. The ECG is showing continuous runs of ventricular tachycardia. The veterinarian asks you to start a constant rate infusion of lidocaine to be given at 80 micrograms per kilogram per minute (ug/kg/min). The dog is currently on a fluid rate of 80 mL per hour. Lidocaine is a 2% solution. How much lidocaine will you add to a liter of LRS?

robert jones bandage Definitive stabilization, internal (plates or screws), or external fixation cannot be performed until the patient is stable for anesthesia; these would not be recommended immediately following the accident due to the presence of pulmonary contusions. Temporary stabilization with a Robert-Jones compression bandage would be best. Placing a Robert-Jones bandage on a broken femur is contraindicated as this could act as a fulcrum and cause further displacement of the fragments. Tourniquets for long periods of time can be dangerous.

A 6-year old collie presents after falling out of a moving vehicle. The dog has an open tibial fracture and pulmonary contusions. What would be the best way to immediately stabilize the fracture?

a diuretic Hypertrophic cardiomyopathy is a condition whereby the myocardium becomes thickened and diastolic function becomes impaired, often resulting in congestive heart failure. The diuretic is given to decrease blood volume and therefore reduce the strain on the heart. Intravenous fluids should not be given as they would increase plasma volume. A sedative might be advantageous to calm the patient but should be given after treatment has begun. An antibiotic will not treat HCM. Corticosteroids are contraindicated in cases of heart failure.

A 6-year old male domestic short hair presents dyspneic with fluid dripping from both nares. The veterinarian suspects heart failure due to hypertrophic cardiomyopathy. What type of injection would most likely immediately be given?

1500 ml Formula- kg X % dehydration = volume (memorize this) For Marley: 65 pounds/ 2.2 pound/kg (pounds cancel out) = 30 kg 30 kg X 0.05 (which is 5%) = 1.5 L volume deficit Since 1.5 L is not an answer choice, continue converting into mL: There are 1000 mL in 1 liter: 1.5 L X 1000mL/liter (liters cancel out)= 1500 mL total volume deficit

A 65-pound Golden Retriever "Marley" presents with a history of gastroenteritis over the past 48 hours. He is approximately 5% dehydrated and the attending veterinarian would like to hospitalize him on IV fluids for the day. Calculate the volume deficit in this patient.

urine ketones A patient with ketones in the urine is likely to be in a diabetic ketoacidotic state. An elevated BUN would be an indication of renal disease. A low hematocrit level would cause a patient to be dull, but this value does not relate directly to diabetes. Blood lactate levels directly correspond to shock. A total protein level would help in determining the patient's hydration and protein status.

A 7-year old female spayed domestic short hair previously diagnosed with diabetes mellitus presents to your clinic dull and unresponsive. In addition to obtaining a blood glucose, what other laboratory test would be important for determining the cat's diabetic status?

perform a blood smear and look for echinocytes Echinocytes are often seen in rattlesnake envenomation. While rattlesnake bites may cause coagulopathies, an increased bleeding time would not be diagnostic for rattlesnake bite or support the suspicion as strongly the as presence of echinocytes. Spherocytes are most often seen in cases of autoimmune hemolytic anemia. Aspirating the swelling would not be helpful, as the swelling is most often occurring due to edema (swelling within the cells) and not free fluid.

A 7-year-old Lab mix presents to your hospital with a very swollen muzzle. The vet suspects the swelling is from a rattlesnake bite. How could you support this suspicion?

hypoglycemia When a young puppy or kitten presents lethargic and minimally responsive, or has symptoms of weakness or pale gums, hypoglycemia should be at the top of your list of suspected afflictions. You should draw a blood sample to check the glucose level, and be ready to administer dextrose when the veterinarian gives the order. Parvovirus and intestinal parasites can also cause hypoglycemia (what he is acutely presenting for), so additional diagnostics will be necessary to determine the underlying cause of this puppy's problem.

A Boston terrier puppy presents lethargic and minimally responsive at your clinic. The owner says he hasn't been eating very well; his gums are a little pale, temperature is 99.1F. What is the likely cause of his acute symptoms?

hypocalcemia Eclampsia, also known as "milk fever" is caused by a low calcium level. It most often occurs around 3 weeks after whelping due to losing calcium in the milk and the inability of the body to keep up with demand. It is most common in small-breed dogs with larger litters. It is treated with calcium gluconate IV in an acute crisis and oral supplementation is then required. Milk fever is also seen more commonly in dairy cows that are close to calving. It typically causes a LOW temperature and often causes staggering and recumbency. It can also cause tremors and dilated pupils. It is also treated with injectable calcium. When cows are dry (not lactating), they should be kept on a LOW calcium diet so that calcium can be mobilized more rapidly from the bone when it is needed during calving and lactation.

A Yorkshire Terrier who has given birth 2 weeks ago presents with a history of tremoring. She is febrile and not eating well. On her electrolyte panel which of the following would you expect to see?

heart disease Aortic thromboembolism, or saddle thrombus, is a complication associated with heart disease in the cat. A thrombus is a blood clot. An embolism is when a clot lodges inside a blood vessel. In cats, a saddle thrombus develops due to underlying cardiomyopathy. A clot forms in the heart, then breaks free and travels in the blood vessels until it becomes lodged. The most common site for the clot to lodge is in the bifurcation of the aorta, in the area where blood supply branches off to supply the rear legs. The thrombus cuts off the circulation to the legs and is very painful.

A cat presents with a history of having difficulty walking and is dragging one of his back legs. The limb is cool to the touch. The veterinarian diagnoses a saddle thrombus. Which of the following underlying diseases is most likely present in this cat?

only A blood A cat with type A blood can only receive type A blood. Type B cats can only receive type B blood, while AB cats are able to receive type A or type B blood.

A cat with type A blood is in need of a transfusion, what type of blood is it able to receive?

inflammation of the internal abdominal lining The peritoneum is a membrane that lines the abdominal cavity. It also covers most of the abdominal organs. The peritoneum helps support the organs and helps to facilitate blood and lymph flow to these organs. Peritonitis is inflammation ("itis") of the peritoneum. The most common causes of peritonitis include infection (such as a leak in the GI tract or a ruptured gall bladder). In cats, FIP causes a viral peritonitis. Fluid in the pericardial sac is termed pericardial effusion. The pleura is the tissue that protects the lungs.

A dog has a high fever, is lethargic, and is diagnosed with peritonitis. What does this dog have?

congestive heart failure The chordae tendinae are cord-like tendons that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart. If this structure ruptures, the valves can no longer function properly, and this can lead to congestive heart failure.

A dog has ruptured a chordae tendinae. What condition can this lead to?

103F

A dog has snail bait poisoning (metaldehyde) and presents with seizures. His temperature is 109F, and you begin cooling techniques while the veterinarian treats the seizures. At what temperature should you stop trying to cool him?

propofol Explanation Status epilepticus is the state of continuous seizuring. Propofol and valium are the most common drugs used for this condition. Rectal valium may be given initially until a vein can be accessed. Ketamine would be contraindicated, as this drug causes muscle rigidity.

A dog presents to the emergency hospital in status epilepticus. Which of the following drugs may be given for this condition?

trocharize the stomach on the right side Decompression should be performed; the best place for the trocharization is on the right side. Trocharization involves passing a large sterile needle or catheter through the abdominal wall into the stomach to relieve the gas within the stomach. This is necessary in order to make the patient more stable prior to surgery.

A dog presents with Gastric Dilatation and Volvulus (GDV), and you have tried multiple times to pass an orogastric tube to no avail. If this is not working what else can be done?

electrocardiogram Electrocardiogram (ECG) monitoring must be performed during calcium gluconate administration, and the administration should be slowed or discontinued if bradycardia or arrhythmias occur. Respiration should be monitored but might not change until the heart rate has already significantly slowed. The same is true of blood pressure. Central venous pressures or CVPs would not provide information on the electrical activity of the heart. ETCO2 would also not provide any information pertinent to the infusion.

A dog presents with excitability, muscle tremors, and hyperthermia. A blood panel shows hypocalcemia, and the patient is prescribed an intravenous dose of calcium gluconate. What monitoring must be performed during calcium gluconate administration?

respiratory acidosis Respiratory obstruction leads to accumulation of carbon dioxide. Increased PCO2 results in lower blood pH. This is respiratory acidosis.

A dog tries to swallow his ball and it gets stuck in the back of his throat. He is breathing very slowly and is not ventilating properly. He is alert but the obstructive breathing is a concern. Which of the following abnormalities would you expect?

anemia The hematocrit and packed cell volume (PCV) are red blood cell counts. A hematocrit or a PCV of 23% would be considered low, otherwise known as anemia. Thrombocytopenia is a low platelet count. An animal with dehydration would have hemoconcentration and typically, an elevated hematocrit, unless the animal has both anemia and dehydration concurrently.

A dog with a hematocrit of 23% has which of the following?

thrombocytopenia Thrombocytopenia is the term for decreased platelets. Dogs that have low platelets have problems clotting and could potentially have a serious bleed from the site of venipuncture.

A dog with which condition should not have blood drawn from the jugular vein?

5% dextrose in 0.9% sodium chloride 5% dextrose in 0.9% NaCl is a hypertonic solution and can not be given subcutaneously because it can cause sloughing of the skin and increases risk for bacterial infections at the injection site. The other solutions are safe to be given subcutaneously.

A ferret presents to your hospital in lateral recumbency. A blood glucose test confirms hypoglycemia, and dehydration is making venous access very difficult. The veterinarian directs you to administer subcutaneous fluids. Which of the following fluids can not be given via this method?

sepsis Depression, cold limbs, aural petechiations, injected tongue and mucous membranes, hypoglycemia, increased respiration, decreased suckling of the mare, hypothermia, and recumbency are all symptoms of sepsis in the foal. Failure of passive transfer predisposes the foal to sepsis.

A foal has petechial hemorrhages on its pinna, injected sclera, and brick red mucous membranes. These are signs of which of the following?

lungs In addition to causing painful burns in the mouth, most pets will develop non-cardiogenic pulmonary edema when electrocuted. The fluid in the lungs can be life threatening and most of these pets will need extended hospitalization with oxygen and careful monitoring.

A kitten presents to the emergency service for burns in the mouth after biting into an electrical cord. Aside from the oral burns, what organ system would you most be concerned about?

pressure from laying in one position for too long A decubital ulcer is the proper term for a pressure sore. This is more common in patients that are not ambulatory and lay in the same position for too long; this is why patients must be turned and moved regularly.

A large canine patient that has been in the hospital developed a decubital ulcer. What is likely causing this?

iron deficiency A low packed cell volume indicates anemia. Iron deficiency is also known as hypochromic microcytic anemia. It is most often suspected in patients with chronic blood loss but could also result from poor nutrition.

A low packed cell volume could occur due to which of the following?

third thoracic vertebrae Central venous pressure, or CVP, monitoring must be performed according to specific guidelines to reduce the possibility of inappropriate readings. The third thoracic vertebra is the anatomical landmark that the normal values are based on.

A multi-lumen jugular catheter must be placed in a canine with renal disease for CVP monitoring. To what anatomical landmark should the catheter be inserted to?

3.75 ml First calculate the amount of milligrams to be given. 30 kg x (0.5 mg/kg) = 15 mg Next calculate the amount of milliliters to be administered. 15 mg / (4 mg/ml) = 3.75 ml

A patient has come into the hospital after being stung by a bee. The patient's muzzle is severely swollen, and the doctor has ordered a dose of dexamethasone sodium phosphate to be given intravenously. The patient weight is 30 kg, and the dose is 0.5 mg/kg. The concentration of the dexamethasone is 4 mg/ml. How many milliliters is this patient to receive?

fresh frozen plasma Rodenticide toxicity causes hemorrhage by inhibiting vitamin K1 clotting factors. Fresh frozen plasma provides coagulation factors. Fresh whole blood could be used as well because it also contains coagulation factors; however, this was not an option in this question. Packed red blood cells don't have any coagulation factors since the plasma has been removed. Stored plasma has plasma proteins only. Platelets or coagulation factors are no longer present at significant levels.

A patient presents with rodenticide toxicity and is hemorrhaging. The doctor decides the animal needs a transfusion. What blood product is most likely to help stop the patient's bleeding?

take an endotracheal tube with a similar outside diameter, line up the measurement numbers on the proximal end of the tube and then lay it against the outside of the patient approximately following the route of the trachea The endotracheal tube's distal end should not extend past the point of the shoulder, and its proximal end should not extend past the incisor teeth. Proper placement insures that the animal is not endobronchially intubated which can cause hypoxemia and one-sided lung collapse. Lining up the connectors on the proximal end of the endotracheal tube may give you a false measurement because endotracheal tubes can be cut shorter to lessen the dead space on smaller patients. Pulling the endotracheal tube cranially without measuring could cause the patient to become extubated, making matters worse. If the endotracheal tube connector is past the incisors, it doesn't necessarily mean that it in too far. The tube might have been cut shorter for a previous patient to lessen dead space and may not be long enough for another patient. The distal end might be perfectly placed.

A patient under general anesthesia has become hypoxic. You suspect that the endotracheal tube might be in too far. How can you be sure?

wound stabilization Just as in other species, assessment of 'ABC's, control of hemorrhage, treatment of hypothermia, diagnosis of ruptured organs, and fluid or air accumulations are part of initial triage. Stabilization of the most critical conditions are performed first and then wound and supportive care is addressed.

A pet Guinea Pig is presented to your hospital for emergency treatment after sustaining a crushing injury. Which of the following is not considered part of the initial emergency assessment of the patient?

cyanide toxicity The correct answer is cyanide toxicity. The bright red-colored blood and mucous membranes with signs of respiratory distress are typical findings for cyanide toxicity. There are many plants that can accumulate cyanide to levels that are toxic to horses. They include Sudan and Johnson grasses, cherries (chokecherries), and Sorghum. Treatment is with sodium nitrate or sodium thiosulfate IV. Use of black walnut shavings in horse bedding can cause laminitis. Choke is an obstruction in the esophagus. It may cause coughing or distress, but not bright red blood. COPD, also called heaves due to heavy expiration, can be caused by dusty or moldy hay, dust and molds in bedding, or pollens, dust and other irritants in the environment. Horses housed with these symptoms should be led out to pasture to remove them from the irritating environment.

A rancher pulls into the clinic you are working at and rushes in to say his horse is having difficulty breathing. You assist the vet in examining the horse and note that the horse is in respiratory distress. He has dilated pupils and bright red mucous membranes. You are asked to pull blood for testing which you note is also bright red in color. Which of the following may cause this in the horse?

lungs In the cat, the shock organ is the lungs. In the dog, it is the liver. Both species often also have gastrointestinal involvement (vomiting, diarrhea).

A shock organ is the organ or tissue that exhibits the most marked response to an allergic reaction. What is the shock organ in the cat?

intraosseus Intraosseus fluid administration is delivery of fluid directly into the bone/bone marrow. It can be very beneficial and life saving in a tiny animal with poor peripheral veins when a catheter cannot be placed. Intraperitoneal means inside the abdominal cavity; this route has very slow absorption. Oral/orogastric absorption is very slow, especially in an animal that is obtunded; this may put the patient at an increased risk for aspiration. Subcutaneous fluid administration could be used but may be poorly absorbed in a patient this dehydrated and is not the most efficient.

A very tiny kitten presents with severe dehydration and is hardly responsive to handling. You are unable to place a peripheral IV catheter. Which of the following routes could be used as a fast or most efficient way of administering fluids and medications to such a small animal?

103 A patient will continue to cool despite cessation of active cooling, so a patient should not be cooled past the high end of the normal temperature range. Normal temperature range is 101-102.5F in dogs and cats.

An 11-year old intact male Golden Retriever presents with respiratory distress and a temperature of 106.7 F. The attending veterinarian has gone to talk to the client and has requested that the patient be cooled. To what temperature should the dog be cooled?

hydrocephalus Hydrocephalus is a build-up of cerebrospinal fluid inside the skull, leading to brain swelling. Hydrocephalus means "water on the brain".

An 8-month old Siamese kitten presents for ataxia, and the veterinarian suspects the kitten has "water on the brain" due to her enlarged head size. What is the term for this?

80-120 beats per min Any faster or slower than 80-120 bpm and one runs the risk of the circulation becoming impaired. This will then result in organs and muscles not getting the oxygen that they need.

An adult canine patient is in cardiac arrest and it is your job to administer thoracic compressions. How fast should you give compressions?

administer supplemental oxygen All animals in respiratory distress can benefit from supplemental oxygen. If the patient is stressed, then blow-by oxygen can be used if a mask isn't tolerated. The technician should never attempt to do other treatments such as starting fluids, performing radiographs, etc. without instruction from the veterinarian.

An animal presents with difficulty breathing. You take the animal to the treatment area. The doctor is on the way. What do you do first?

thoracocentesis Explanation A large amount of fluid in the pleural space (around the outside of the lungs) will prevent the lungs from fully expanding. A chest tap (thoracocentesis) will allow the fluid to be drained from the pleural space and allow the patient to expand the lungs and breath easier. While radiographs may be needed, an unstable patient in respiratory distress should not have radiographs. The chest tap should occur first to stabilize the patient.

An animal with pleural effusion may require which procedure for stabilization?

brain stem The brain stem consists of the midbrain, pons, and medulla oblongata. The pons contains important respiratory centers. The medulla also influences the respiratory rate as well as heart rate. The cerebellum is responsible for coordination and balance. The diencephalon contains the thalamus and hypothalamus. The thalamus behaves as a relay station for sensory input. The hypothalamus is involved in helping regulate many endocrine functions of the body. Motor control and interpretation of sensory impulses occurs at the cerebrum.

An injury to what region of the brain is most likely to result in respiratory arrest?

ancylostoma The most significant risk to an animal with hookworms is anemia. Hookworms live in the small intestine and ingest blood. Ancylostoma and Uncinaria are the two hookworms in dogs and cats (hookworm eggs are shown in this photo). Cystoisospora (coccidia) can cause a significant bloody diarrhea in some cases, which could lead to anemia, but this is not as likely as with hookworms. Toxocara (roundworm) and Dipylidium (tapeworm) are not as likely to cause a severe anemia.

Anemia would likely result from a heavy infection with which parasite?

blood perfusion and oxygen delivery to tissues Blood lactate is a marker of perfusion and oxygen delivery to the tissues. When there is adequate oxygen present in the patient, aerobic metabolism (oxidative phosphorylation) occurs, producing energy. When there is lack of oxygen delivery to the body or a specific tissue/organ, anaerobic metabolism occurs and produces lactate as a by-product. Instances in which lactate may be elevated include sepsis, GDV in dogs, and strangulating intestinal lesions in horses.

Blood lactate is a marker of what?

stroke volume x heart rate The correct formula for cardiac output (the amount of blood pumped by the heart per minute) is Stroke volume x Heart rate.

Cardiac Output (CO) is determined by what variables?

intratracheally Drugs are rapidly absorbed via the intratracheal route. Establishing an airway is the second step (see below) in CPCR, so a polypropylene urinary catheter or red rubber feeding tube can be placed inside the endotracheal tube; the drug can then be injected through the tube followed with several mLs of sterile saline to help with distribution. The other methods listed are not appropriate for administration of emergency drugs as they would be absorbed at a very slow rate and absorbed very poorly due to poor circulation during cardiac arrest. *Establishing an airway was previously the first step in CPCR. However, the current guidlines put "Circulation" above "Airway", so that chest compressions are to be started immediately even prior to placing the endotracheal tube. (Obviously the endotracheal tube needs to also be placed ASAP)

During an emergency you are assisting with CPCR. What is the best way listed to administer the drugs (atropine, epinephrine, and lidocaine)? You are unable to place an IV catheter despite multiple attempts.

hypoxia in the calf Hypoxia is inadequate tissue oxygenation. The umbilical cord supplies oxygen from the mother's blood to the calf, therefore, if the umbilical cord ruptures, the calf will not receive oxygen and it is a life threatening emergency. Hyperemia is the increase of blood flow to different tissues in the body. Sepsis is caused by infection and does not result from a ruptured umbilical cord.

During calving, the rupture of the umbilical cord before birth causes which of the following?

ventricular fibrillation Ventricular fibrillation usually occurs just prior to asystole, when there is uncoordinated contraction of the ventricular muscles (uncontrolled quivering of the muscle fibers). It is during the ventricular fibrillation that a defibrillator is most often used to try to induce a normal rhythm to the heart. Defibrillation delivers a dose of electrical energy to the heart. This depolarizes the heart muscle, stops the arrhythmia, and allows normal sinus rhythm to be reestablished in the sinoatrial node (the "pacemaker" of the heart). The heart will generally not respond to defibrillation in asystole because it is already depolarized. Defibrillation only works if electrical activity is occurring. If a pulse is present, defibrillation for ventricular tachycardia is not indicated. Normal sinus arrhythmia is a normal rhythm in which there is mild acceleration and slowing of the heart rate that occurs during inhalation and exhalation; many normal pets have this rhythm.

During which cardiac status would a defibrillator most likely be used and effective?

gasoline The correct answer is gasoline. Emesis, if you can initiate it soon after exposure to a toxin, is a very effective means of decontamination. The times that emesis is not appropriate is for caustic (acid or alkali) substances and substances that are volatile and may be inhaled, causing pulmonary toxicity or aspiration pneumonia. The other contraindication to inducing emesis is when the patient is not awake enough to protect their airway and prevent aspiration.

Emesis should not be induced in dogs that have ingested which toxin?

b, a, c, d A patient with an airway obstruction is in immediate danger of respiratory arrest and therefore takes priority over all other patients. A cat with urethral obstruction would be the next priority due to the possibility of a bladder rupture. A laceration needs care within a few hours. Elongated or overgrown teeth in a hamster, while needing treatment, would have the lowest priority in this group of emergency patients.

Four patients present to your emergency clinic at the same time: a) 2-year old male domestic short hair with a urethral obstruction b) 5-year old female Labrador with a tracheal foreign body and cyanosis c) 10-year old male standard poodle with a laceration on its forelimb d) 4-year old male hamster with elongated teeth In what order should these patients be triaged?

yellow discoloration of the skin, eyes, and mucous membranes Icterus, or jaundice, means yellow discoloration of the skin and sclera. It is most often associated with liver disease from a poor flow of bile or biliary obstruction in the liver. It can also be caused by hepatitis or from red blood cell destruction. Small hemorrhages on the mucus membranes are petechiae. Straining to urinate is termed stranguria. Blood in the stool is hematochezia (bright red blood suggests large intestine bleeding) or melena (black/digested blood suggests small intestine bleeding) This is a photo of a foal with neonatal isoerythrolysis, which causes icterus. Note the yellow appearance of the mucous membranes and sclera.

Icterus is a term that means which of the following?

obturator Obturator nerve paralysis (ONP) is most common. This nerve is responsible for adducting the hind limbs and runs from the spinal cord into the birth canal before it innervates the inner thighs. During birthing, this nerve can become crushed and lead to this problem.

In a cow that is having difficulty calving and seems to have her legs splaying out from underneath her, you are most concerned about damage to which nerve?

failure of passive transfer Newborns require essential maternal antibody absorption from the colostrum to help protect against infectious diseases. If they do not get these precious immunoglobulins, they can suffer from increased morbidity and mortality from infections. There are now field test kits that can detect blood levels of IgG in calves and foals to help determine if failure of passive transfer has occurred.

In neonatal calves and foals, what is the most common reason that these animals succumb to disease and death?

bradycardia Excessive vagal tone can cause a slower heart rate (bradycardia). Vomiting can sometimes stimulate the vagus nerve but vagal nerve stimulation should not cause vomiting. The vagus nerve carries parasympathetic fibers.

Increased input from the vagus nerve can result in which of the following responses?

status epilepticus, dyspnea, fracture, stranguria, cervical pain, abscess In a perfect situation both the seizuring pet and the pet with difficulty breathing would be treated immediately. Sometimes this may not be possible and triage is necessary. Status epilepticus is a state of seizuring that is continuous. This is life-threatening, and the seizures must be stopped immediately or permanent brain and organ damage can occur. Dyspnea or difficulty breathing is always a top priority emergency. The dyspneic animal should be assessed and placed on oxygen while the seizuring dog is being treated. Fractures, while painful, are not immediately life-threatening as long as there is no bleeding vessel that needs to be controlled, which is sometimes the case with an open fracture. Straining to urinate is not usually life-threatening unless it is a "blocked cat", or urethral obstruction. If this were a blocked cat, it should be seen before the fracture. Neck pain and abscesses are not life-threatening and should be seen last if the patients are stable.

It is a very busy day at the clinic. Multiple emergencies walk in all at the same time. Choose the order in which the following cases should be seen.

withdrawing fluid from the abdomen "Centesis" is the act of puncturing a body cavity or hollow organ in order to remove fluid; therefore, abdominocentesis implies the removal of fluid from the abdominal cavity. Similarly thoracocentesis would be removal of fluid from the chest cavity. A cystocentesis describes the removal of fluid from the urinary bladder. Terms that involve the removal of an organ usually end with "-ectomy". Examples of terms would include splenectomy, nephrectomy, and lung lobectomy.

Performing an abdominocentesis involves which of the following?

dehydration Explanation Dehydration is the most common cause of pre-renal azotemia. Azotemia is the term for elevated renal values (BUN and creatinine). When a patient is dehydrated, renal values may be elevated. When re-hydration occurs, renal values should return to normal. Renal failure (acute or chronic) causes primary renal azotemia. Post-renal azotemia is most often caused by obstruction either in the bladder or urethra, which prevents urine from being voided.

Pre-renal azotemia is most commonly caused by which of the following?

Disseminated intravascular coagulation DIC, or Disseminated intravascular coagulation is the condition in which coagulation factors are excessively consumed. This prevents additional clots from being formed and also impairs the breakdown of existing clots. Patients in DIC are both pro-thrombic (producing micro-clots that get trapped in the capillaries) and anti-thrombic (unable to create new clots). These patients have severe bleeding tendencies. DIC most often follows severe trauma, inflammatory conditions, or sepsis.

The acronym DIC stands for which of the following?

have the owner bring the pet in immediately Rat bait can cause prolonged clotting times or cerebral edema, and the dog should be seen immediately. It may not be advisable to induce vomiting without a veterinarian examination. Signs such as poor mucus membrane color only develop after a coagulopathy has developed, and by that time, intervention will be much less effective. The veterinarian won't be able to provide any treatment for rat bait ingestion over the phone. Rat bait is never pet-friendly.

The owner of an 8-year old German Shepherd dog calls to report that the dog may have ingested an unknown quantity of rat bait 12 hours ago. What would be the best course of action to advise over the phone?

icterus Icterus, or jaundice, is the yellowing of the mucous membranes, skin, or sclera. It is often seen in patients with liver dysfunction or immune mediated hemolytic anemia. Cyanosis is the blue, purple, or grey tinge seen in the mucous membranes of patients with low oxygen levels. Hemoptysis is the coughing up of blood or blood tinged fluid. Hyperemic mucous membranes are bright or brick red and are usually caused by sepsis, allergic reactions, or shock

Upon examining this 7 year old female spayed Dachshund, you notice her mucous membrane color is abnormal. What term would your write in the medical record to describe your findings?

gently blow air into the tube and listen for gurgling A nasogastric (nose to stomach) tube should go down the esophagus (not the trachea). First measure the length of the tube needed to reach the pharynx and the length to reach the stomach. Lubricate the tube before insertion. Enter the ventral nasal meatus and gently push forward; do not force the tube. Once it reaches where the pharynx would be, flex the neck of the horse which helps to get it into the esophagus and not the trachea. The tube should pass when the horse starts to swallow. If the tube goes into the trachea, the horse does not always cough. You should not feel the horse breathing through the tube; this would indicate that the tube has entered the trachea. You do not want to put water in the tube until correct esophageal placement is confirmed. Often times when the tube is passed into the stomach, there may be a sweet or fetid odor. If you gently blow air into the tube it will cause bubbling in the stomach, and you can hear it by ausculting on the left side between the 8th and 14th ribs. Fluid does not automatically come out of the tube.

What is one way to help determine if a nasogastric tube was properly placed in a horse?

2-4 mls/kg/hr

What is the minimum volume of water required by mammals to sustain life?

rat only The rat is the only species that can donate blood to be given to another rat.

When administering a blood transfusion to a rat which species is able to donate?

cardiac compressions and establishing an airway Establishing an airway and adequate cardiac compression rate first contribute to positive outcomes when performing CPR in the neonatal calf.

When performing CPR in the neonatal calf which are the two most critical procedures to begin?

listeria Encephalitis is the most readily recognized form of Listeriosis in ruminants and a droopy face or head tilt are frequently observed symptoms. If encephalitis is severe enough, death will typically occur. Encephalitis is treated with high doses of antibiotics. Listeria monocytogenes is a small motile coccobacillus (bacteria) causing neurologic symptoms due to localized lesions in the brainstem. Grazing animals ingest the organism and continue to further contaminate the soil through their feces.

Which bacteria are known for causing a head tilt and neurologic symptoms in ruminants?

it is a protrusion of the chorioallantois and is an emergency Red bag is a protrusion of the chorioallantois and indicates premature placental separation. It is an emergency situation in which the chorioallantois needs to be broken down manually to assist in delivery of the foal, or death of the foal can occur.

Which is true of "red bag" during birth in the mare?

it is a sympathomimetic A sympathomimetic mimics the sympathetic nervous system. Epinephrine is also "adrenaline"; this stimulates the fight-or-flight response. When adrenaline spikes, heart rate increases, blood pressure jumps, etc. It may cause an increase in the blood sugar (hyperglycemia).

Which is true regarding epinephrine?

tachycardia The toxic principles of chocolate are methylxanthines (specifically theobromine and caffeine). Methylxanthines can cause CNS excitation tachycardia, and vasoconstriction. Signs include vomiting, diarrhea, hyperactivity, polyuria, polydipsia, lethargy, tachycardia, cardiac arrhythmias, seizures, and death.

Which of the following is a clinical sign you would see in a dog with chocolate toxicosis?

increased heart rate Typical signs of shock in general are pale gums, increased heart rate, and low blood pressure. Frequently, body temperature is low; however in septic shock, the temperature can be high and the gums brick red in color.

Which of the following is characteristic of an animal in shock?

urethral obstruction Post-renal azotemia is an elevation in BUN and creatinine due to pathology located after the kidney (in the ureters, bladder, or urethra). A urethral obstruction means that the outflow from the bladder is obstructed. This could be from severe inflammation, uroliths, or neoplasia. This puts ascending pressure on the kidneys because the urine has no way of being voided. This may cause an elevation of renal values (BUN and creatinine) and is referred to as azotemia. Treatment of post-renal azotemia depends on relieving the obstruction and subsequent IV fluid diuresis. Pre-renal causes of azotemia include dehydration and lack of perfusion (as could occur in shock from hypotension). Renal azotemia is caused by a primary problem with the kidneys (acute or chronic renal failure).

Which of the following may be a cause of post-renal azotemia?

hang the calf off the ground by its back legs and shake or swing it to stimulate breathing Recent data suggests that hanging calves to clear the airway is unnecessary. Placing a finger or piece of straw in the nose will elicit a gasping reflex and help aerate the lungs. Pouring cold water over the head will stimulate a hypothermal respiratory response. A pharmacological initiation of respiration can be achieved with medications like doxapram (Dopram). Acupuncture points on the muzzle are also useful for stimulation of respirations.

Which of the following techniques should NOT be performed when trying to stimulate breathing in a newborn calf?

septic shock Explanation Septic shock, sometimes called distributive shock, may cause brick-red or injected mucous membrane color and bounding pulses. This is because in cases of sepsis, the bacteria in the bloodstream cause severe vasodilation, which leads to hyperemic gums and low blood pressure. Septic shock may be caused by infectious diseases or by secondary infections. Cardiogenic shock is caused by decreased cardiac output. It may occur from primary heart diseases like cardiomyopathy, arrhythmia, or valvular disease. Obstructive shock is a type of cardiogenic shock, caused by an obstruction of blood flow. Examples of this include heartworm, pulmonary thromboemolism (PTE), or pericardial disease. Hypovolemic shock is caused by decreased perfusion, especially from blood loss or dehydration. Hypovolemic shock is the most common cause of shock in small animals.

Which of the following types of shock may cause brick-red mucous membrane color?

great dane The correct answer is Great Dane. Large and giant breed pure-bred dogs, particularly with deep chests, are very predisposed to developing GDV. Great Danes are a classic example; other common breeds include Weimaraner, Saint Bernard, and Irish Setters. Note the boxing glove appearance of the stomach in this x-ray of a dog with a GDV.

Which of these dog breeds is most predisposed to development of gastric dilatation and volvulus?

cerebellum The cerebellum has a major role in motor control. It helps to coordinate voluntary movement and is located just above the brainstem. Hypermetria is an exaggerated gait in which the movements extend beyond what is intended.

Which part of the brain coordinates motor activity? Disease of this part of the brain can cause a hypermetric gait.

the tube should be held lower than the patient to aid in removal of gastric contents The patient does not always have to be anesthetized for placement of the tube, however, many patients require some sedation. The tube is measured prior to placement (to just the last rib) and when inserted into the esophagus and into the stomach, the other end is held downward (lower than the patient) so that gravity will help to allow removal of stomach contents. If the tube cannot be placed, the stomach may be trocharized to relieve pressure.

You are assisting the emergency veterinarian with a dog who has a GDV. The doctor is ready to place an orogastric tube and the patient is awake on the exam table. Which of the following is true regarding this procedure?

Erysipelas rhusiopathiae Erysipelas may cause diamond shaped purple skin lesions in pigs. This bacterium is commonly found in the tonsils of pigs, but may cause disease and death if the pigs experience stress, poor sanitation or feed, causing the bacteria to invade the bloodstream and cause sepsis. Staphylococcus hyicus causes greasy pig disease (exudative epidermitis). Haemophilus parasuis causes Glasser's disease (polyserositis/arthritis/cyanotic ears and skin). Streptococcus suis is more common in weaning pigs (may cause meningitis, and also has similar symptoms to Glasser's disease).

You are called to a pig operation where some of the adult pigs are experiencing sudden death. The vet points out purple skin lesions that look like a "diamonds." What organism causes "Diamond Skin Disease" in pigs?

hives

You are checking the fax machine and get a report from the local emergency clinic that a patient from the hospital where you work presented overnight for severe urticaria. What did this patient have?

3.4 mEq/hr; no The correct answer is 3.4 mEq/hr, which is only about 1/3 of his maximum potassium dose per hour, so it is not too high. Let's do the math on this problem: First, calculate how many mEq/hr he will be receiving with this dose and rate: (There are 1,000 mL in 1 Liter) 40 mEq/1000 mL = 0.04 mEq/mL Next multiply by his fluid rate: 0.04 mEq/mL X 85 mL/hr (mL cancel out) = 3.4 mEq/hr he is receiving currently Now calculate his maximum dose: Convert his body weight to kg: 50 pounds/2.2 pounds/kg = 22.7kg 0.5 mEq X 22.7 kg = 11.3 maximum mEq/hr he can have He is getting 3.4 and his max is 11.3, so he is only getting about 1/3 of his maximum.

You are instructed to add 40 mEq of potassium chloride (KCl) to a 1 Liter bag of 0.9% sodium chloride for a patient. The patient to receive fluids weighs 50 pounds and will be on a rate of 85 mL/hr. You know that the maximum potassium a patient should receive is 0.5 mEq/kg/hr. What is his potassium intake, and is it too high?

500 ml/hr

You are instructed to administer 12 liters of sterile isotonic IV fluids via a fluid pump over the next 24 hours. What is the appropriate fluid rate to administer this volume of IV fluids?

thoracocentesis this is commonly used for removing fluid from the pleural space (pleural effusion)

You are new on the ICU floor and are taking time to look through the crash cart so you will be prepared when emergency arises. You find a 60 cc syringe attached to a 3-way stopcock and extension set with a 22-gauge needle attached. What might this setup be used for?

neonatal isoerythrolysis This foal is hemolyzing its own red blood cells as a result of antibody it acquired in colostrum which is directed at the red cells. This is the best answer choice to explain the low hematocrit and signs of icterus. Only vigorous and effective treatments can save foals which are severely affected.

You are riding along on an emergency call to assist the vet with a sick foal who was born two days ago. The foal appeared normal at birth, but is now lethargic and icteric. It has a fever of 102 F. The packed cell volume is down to 15%. Which of the following diseases leads to jaundice and anemia in young foals?

copper The correct answer is copper. Sheep are highly susceptible to copper toxicity. Because this causes an acute hemolytic crisis, the most common signs are acute death, icterus, depression, hemoglobinuria, increased respiratory rate, and weakness. Pathology often shows dark, hemoglobin filled kidneys ("gun metal blue"). Goats and cattle are less susceptible to copper toxicity. While you will not be responsible for diagnosing animals, you should know that copper toxicity causes icterus in sheep . Salt toxicity in livestock often causes neurologic symptoms. Selenium and potassium toxicities are not common. Selenium deficiency (along with Vitamin E deficiency) may cause poor wool production, decreased fertility, and is the cause of white muscle disease.

You are riding along with the veterinarian to a small sheep operation. The operation has had two sheep die in the last 24 hours. Upon arrival, icterus, depression, and weakness are noted in several sheep in the herd. One sheep urinates and the urine is very dark. Toxicity from which mineral can cause icterus and hemoglobinuria (red urine) in sheep?

flush the urinary catheter with sterile saline First, flush the catheter and make sure the line didn't get kinked, etc. If the urine production had been good and suddenly urine production slowed dramatically, it is likely a result of some mechanical issue. If the catheter flushes normally and all appears OK, call the veterinarian immediately.

You are working in the ICU; a dog on a high rate of fluids has a very sudden drop in urine production in his urine collection bag. What do you do first?

plasma, red blood cells, white blood cells, and platelets The correct answer is plasma, red blood cells, white blood cells, and platelets (everything that is found in whole blood).

You are working in the emergency clinic and are assisting with treating a dog that has been hit by a car. You are asked to set up for a blood transfusion, and the doctor would like you to give whole blood. A whole blood transfusion would include which of the following components?

30 L You can estimate the fluid deficit by the following formula: Body weight in kg X % dehydration = Liters needed to re-establish hydration So for this horse: 950 pounds/2.2 pounds per kilogram (pounds cancel out) = 431.8 kg (will round up to 432kg) Now, multiply by percent dehydrated: 432 kg X 0.07 (which is 7%) = 30 Liters

You are working in the large animal ward at the hospital. You are receiving a horse that needs immediate treatment for dehydration. The vet asks you to calculate the fluid deficit for this horse. He is a 950-pound horse that is about 7% dehydrated. What is his fluid deficit?

400 ml/hr First convert the liters (L) into milliliters (mL): (there are 1000 mL in 1 L) 2 L X 1000mL/L (liters cancel out)= 2000 mL You need to give this over 5 hours: 2000 mL/ 5 hours (mL cancel out)= 400 mL/hr

You calculate the volume deficit for a patient which is approximately 2 liters. You are instructed to give this volume over the next 5 hours. What should the fluid rate be?

40 ml 800 mL X 0.025 = 20 mL. If this were 100% dextrose, adding 20 mL to the bag would create the 2.5% concentration. Since it is 50% dextrose, this number must be doubled: So, 20 mL X 2 = 40 mL Draw out 40 mL from the bag (now there are 760 mL left in the bag). Add in 40 mL of 50% Dextrose. Now, 2.5% of the total 800 mL is Dextrose. Double check the math: 40 mL/ 800mL = 0.05 (i.e. 5%) divided by 2 {because it was 50% dextrose that was added) = 0.025 = 2.5%.

You have a bottle of 50% Dextrose. You are asked to add it to a bag of LRS for a pet in diabetic ketoacidosis to create a 2.5% solution. The pet has 800 mL left in his bag. How much will you add to his bag?

45 ml/kg The full shock dose of fluids for cats is 45 mL/kg of crystalloids. When giving shock doses of fluids, they are often given in 1/4 increments. The shock dose of fluids for dogs is 90 mL/kg.

what is the shock dose of fluids for a cat?