This week we discussed the practical use of traditional HH acid base, the SID method, and the semi-quantitative approach. The SID and semi-quantitative approaches may identify more acid base abnormalities than the traditional HH approach – the clinical significance of those abnormalities is not clear from the literature. We felt like the most applicable use of them is when an acid-base disturbance cannot be explained by the history, exam, and diagnostics; or when an acid-base disturbance is not changing as expected with therapy.
Then we worked through a case scenario involving a patient with anticoagulant rodenticide toxicity who developed an anaphylactic reaction during transfusion. The notes from this discussion are available here: Download
Questions to look up before next week:
- Describe the various blood products, indications, limitations, etc (Frozen plasma, FFP, fresh whole blood vs whole blood, pRBC, etc).
- What are the common anticoagulants used in donor blood products & what is the storage life associated with each?
A few good references for these questions are: (textbooks are in the DVM office)
The Association of Veterinary Hematology and Transfusion Medicine’s website (avhtm.org)
Animal Blood Resources International’s FAQ page
Manual of Veterinary Transfusion Medicine and Blood Banking
Practical Transfusion Medicine for the Small Animal Practitioner (MADE EASY SERIES)
Next week we will discuss the pathophysiology and treatment for diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome, diabetes insipidus, and the syndrome of inappropriate ADH secretion.
Good textbook references for this discussion include: (textbooks in DVM office)
Canine and Feline Endocrinology (Feldman & Nelson)
Small Animal Critical Care Medicine (Silverstein & Hopper)
Review articles from The Veterinary Clinics of North America:
Guillaumin J, DiBartola SP. Disorders of Sodium and Water Homeostasis. Vet Clin North Am Small Anim Pract. 2017 Mar;47(2):293-312. doi:10.1016/j.cvsm.2016.10.015. Epub 2016 Dec 23. Review. PubMed PMID: 28017410.
Rand JS. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in cats. Vet Clin North Am Small Anim Pract. 2013 Mar;43(2):367-79. doi:10.1016/j.cvsm.2013.01.004. Review. PubMed PMID: 23522177.
The 2015 NEJM review series titled “Disorders of fluids and electrolytes”
A few other articles:
Trotman TK, Drobatz KJ, Hess RS. Retrospective evaluation of hyperosmolar hyperglycemia in 66 dogs (1993-2008). J Vet Emerg Crit Care (San Antonio). 2013 Sep-Oct;23(5):557-64. doi: 10.1111/vec.12100. Epub 2013 Sep 19. PubMed PMID: 24102960.
Moens NM, Remedios AM. Hyperosmolar hyperglycaemic syndrome in a dog resulting from parenteral nutrition overload. J Small Anim Pract. 1997 Sep;38(9):417-20. PubMed PMID: 9322182.
