ORCID Profile
0000-0003-4776-2849
Current Organisation
Murdoch University
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Publisher: Wiley
Date: 10-2009
DOI: 10.1111/J.1476-4431.2009.00464.X
Abstract: To evaluate the effect of 6% hydroxyethyl starch (HES) solution in vivo, with an average molecular weight of 670 kDa and degree of substitution of 0.75, on canine platelet function. Prospective, controlled-experimental study. University of California, Davis, Veterinary Medical Teaching Hospital. Seven healthy employee-owned dogs. Seven dogs were included in the treatment group. Four of these dogs also served as the control group. Platelet closure time (CT) was measured using a platelet function analyzer and collagen/ADP cartridges. Dogs were given 20 mL/kg of either sodium chloride 0.9% (control group, n=4) or HES (treatment group, n=7) IV over 1 hour. CT was measured before the infusion, and at 1, 3, 5, and 24 hours after the start of the infusion. There was a significant change over time from 0 to 24 hours (P<0.001), a significant difference between groups across time (P<0.001), and a significant group-by-time interaction (P=0.007). At 3 hours, mean CT for the treatment group was 122.3+/-18.1 seconds, which was significantly different (P<0.001) from the control group (71.0+/-3.5 s). At 5 hours, mean CT for the treatment group was 142.7+/-33.9 seconds, which was significantly different (P=0.001) from the control group (75.0+/-8.6 s). Mean CT at 24 hours was within the reference interval for both the control and treatment group (66.0+/-2.9 and 81.8+/-11.9 s, respectively) however, CT in 3 in idual dogs in the treatment group at this time point remained prolonged. A clinically relevant dose of HES 670/0.75 prolongs CT in dogs for up to 24 hours. This may be due to platelet dysfunction in addition to the effects of hemodilution, and therefore, may increase the risk of bleeding.
Publisher: Elsevier BV
Date: 08-2019
Publisher: American Veterinary Medical Association (AVMA)
Date: 08-2013
Abstract: Objective —To determine whether dilution of blood s les from healthy dogs with 2 hydroxyethyl starch (HES) solutions, HES 130/0.4 and HES 200/0.5, would result in platelet dysfunction as measured by closure time (Ct) beyond a dilutional effect. S le —Citrated blood s les from 10 healthy dogs with a Ct within reference limits (52 to 86 seconds). Procedures —Blood s les were diluted 1:9 and 1:3 with 6% HES 130/0.4 and 10% HES 200/0.5 solutions and saline (0.9% NaCl) solution. Dilutions at 1:9 and 1:3 mimicked 10 mL/kg and 30 mL/kg doses, respectively, ignoring in vivo redistribution. Closure time was measured with a platelet function analyzer and compared among dilutions. Results —A dilutional effect on Ct was evident for the 1:3 dilution, compared with the 1:9 dilution, but only HES 200/0.5 increased the Ct beyond the dilutional effect at the 1:3 dilution, to a median Ct of 125 seconds (interquartile range, 117.5 to 139.5 seconds). No effect of HES or dilution on Ct was identified at the 1:9 dilution. Conclusions and Clinical Relevance —1:3 dilution of blood s les from healthy dogs with HES 200/0.5 but not HES 130/0.4 significantly increased Ct beyond the dilutional effect, suggesting that IV administration of HES 200/0.5 in dogs might cause platelet dysfunction.
Publisher: Wiley
Date: 13-08-2020
DOI: 10.1111/AVJ.12992
Publisher: MDPI AG
Date: 06-10-2022
DOI: 10.3390/ANI12192691
Abstract: Synthetic colloid fluids containing hydroxyethyl starch (HES) have been associated with impairment of coagulation in dogs. It is unknown if HES causes coagulation impairment in dogs with naturally occurring critical illness. This study used banked plasma s les from a blinded, randomized clinical trial comparing HES and balanced isotonic crystalloid for bolus fluid therapy in 39 critically ill dogs. Blood was collected prior to fluid administration and 6, 12, and 24 h thereafter. Coagulation biomarkers measured at each time point included prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen concentration, and the activities of coagulation factors V, VII, VIII, IX, and X, von Willebrand factor antigen, antithrombin, and protein C. Given the links between coagulation and inflammation, cytokine concentrations were also measured, including interleukins 6, 8, 10, and 18, keratinocyte-derived chemokine, and monocyte chemoattractant protein-1. Data were analyzed with linear mixed effects models. No significant treatment-by-time interactions were found for any biomarker, indicating that the pattern of change over time was not modified by treatment. Examining the main effect of time showed significant changes in several coagulation biomarkers and keratinocyte-derived chemokines. This study could not detect evidence of coagulation impairment with HES.
Publisher: Wiley
Date: 02-08-2020
DOI: 10.1111/AVJ.12993
Publisher: Wiley
Date: 13-01-2021
DOI: 10.1111/AVJ.13049
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.JCRC.2018.06.015
Abstract: Endocan, a component of the endothelial glycocalyx (EG), has been linked with respiratory failure in sepsis. This study explored the temporal patterns of three EG biomarkers, including endocan, and their relationships with inflammation and respiratory failure. Plasma endocan, syndecan-1, and hyaluronan concentrations were measured in Emergency Department (ED) patients with sepsis due to pneumonia (n = 44) on ED arrival (T0), 1 h (T1), 3 h (T3) and 12-24 h (T24) later, with change over time tested using mixed regression models. Biomarker associations with inflammatory cytokine concentrations and with respiratory failure on days 1, 2 or 3, need for mechanical ventilation and 30-day mortality were also tested. Endocan concentration significantly decreased over time (T0-T24, P = 0.003) whereas both syndecan-1 (T0-T3, P = 0.010 T0-T24, P < 0.001) and hyaluronan (T0-T1, P = 0.010 T0-T3, P < 0.001 T0-T24, P = 0.003) significantly increased over time. Increased syndecan-1 was significantly correlated with neutrophil activation biomarkers and significantly increased the odds of respiratory failure (OR 1.18, 95% CI 1.05-1.33, P = 0.004), need for mechanical ventilation (OR 1.24, 95% CI 1.04-1.48, P = 0.014) and 30-day mortality (OR 1.29, 95% CI 1.07-1.55, P = 0.008). Syndecan-1, but not endocan, was associated with neutrophil activation and was the best EG biomarker predictor of adverse clinical outcomes.
Publisher: Wiley
Date: 14-02-2019
DOI: 10.1111/VEC.12814
Abstract: To investigate the association between synthetic colloids and biomarkers of acute kidney injury (AKI) in dogs with hemorrhagic shock. Experimental interventional study. University. Twenty-four healthy ex-racing Greyhounds. Anesthetized Greyhounds subjected to hemorrhage for 60 min were resuscitated with 20 mL/kg of fresh whole blood (FWB), 6% hydroxyethyl starch (HES) 130/0.4, 4% succinylated gelatin (GELO), or 80 mL/kg of isotonic crystalloid (CRYST) over 20 min (n = 6 per treatment). Concentrations of biomarkers of AKI were measured at baseline, end of hemorrhage, and at 40 (T60), 100 (T120), and 160 (T180) min after fluid bolus. Biomarkers included neutrophil gelatinase-associated lipocalin in urine and serum (uNGAL sNGAL), and urine cystatin C (uCYSC), kidney injury molecule-1 (uKIM), clusterin (uCLUST), osteopontin, gamma-glutamyl transferase, monocyte chemoattractant protein-1 (uMCP), interleukin-6, interleukin-8, protein (uPROT), hyaluronan, and F In dogs treated with GELO, uNGAL fold-change was markedly greater compared with all other groups at T60, T120, and T180 (all P<0.001), and uCYSC was greater at T60 compared with CRYST (P<0.001), and at T120 and T180 compared with all other groups (all P<0.001). Smaller, albeit significant, between-group differences in uKIM, uCLUST, uMCP, and urine protein concentration were observed across the FWB, GELO, and HES groups, compared with CRYST. The GELO group more frequently had marked tubular microvesiculation than the other groups (P = 0.015) although tubular injury scores were comparable. In dogs with hemorrhagic shock, GELO was associated with greater magnitude increases in urine biomarkers of AKI and more frequent marked tubular microvesiculation, compared with FWB, CRYST, and HES.
Publisher: Springer Science and Business Media LLC
Date: 22-09-2021
DOI: 10.1186/S40635-021-00412-9
Abstract: Fluid resuscitation is frequently required for cardiac surgical patients admitted to the intensive care unit. The ideal fluid of choice in regard to efficacy and safety remains uncertain. Compared with crystalloid fluid, colloid fluid may result in less positive fluid balance. However, some synthetic colloids are associated with increased risk of acute kidney injury (AKI). This study compared the effects of succinylated gelatin (4%) (GEL) with compound sodium lactate (CSL) on urinary AKI biomarkers in patients after cardiac surgery. Cardiac surgical patients who required an intravenous fluid bolus of at least 500 mL postoperatively were randomly allocated to receive GEL or CSL as the resuscitation fluid of choice for the subsequent 24 h. Primary outcomes were serial urinary neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C concentrations measured at baseline, 1 h, 5 h and 24 h after enrolment, with higher concentrations indicating greater kidney injury. Secondary biomarker outcomes included urinary clusterin, α1-microglobulin and F 2 -isoprostanes concentrations. Differences in change of biomarker concentration between the two groups over time were compared with mixed-effects regression models. Statistical significance was set at P 0.05. Forty cardiac surgical patients ( n = 20 per group) with similar baseline characteristics were included. There was no significant difference in the median volume of fluid boluses administered over 24 h between the GEL (1250 mL, Q1–Q3 500–1750) and CSL group (1000 mL, Q1–Q3 500–1375) ( P = 0.42). There was a significantly greater increase in urinary cystatin C ( P 0.001), clusterin ( P 0.001), α1-microglobulin ( P 0.001) and F 2 -isoprostanes ( P = 0.020) concentrations over time in the GEL group, compared to the CSL group. Change in urinary NGAL concentration ( P = 0.68) over time was not significantly different between the groups. The results were not modified by adjustment for either urinary osmolality or EuroSCORE II predicted risk of mortality. This preliminary randomised controlled trial showed that use of succinylated gelatin (4%) for fluid resuscitation after cardiac surgery was associated with increased biomarker concentrations of renal tubular injury and dysfunction, compared to crystalloid fluid. These results generate concern that use of intravenous gelatin fluid may contribute to clinically relevant postoperative AKI. Trial registration ANZCTR.org.au, ACTRN12617001461381. Registered on 16th October, 2017, www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373619& isReview=true .
Publisher: Wiley
Date: 2017
DOI: 10.1111/AVJ.12549
Abstract: We hypothesised that concentrations of interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) would increase during storage in the third sequential unit (U3) of canine packed red blood cells (PRBC) collected from terminal donors in haemorrhagic shock. We further hypothesised that leucoreduction would prevent cytokine accumulation in U3 and that cytokine concentrations in U3 would be higher than in the first units (U1) collected from the same dogs. U1 and U3 were each collected from 12 anaesthetised healthy Greyhounds. Removal of leucocytes from half of each PRBC unit produced one leucoreduced (LR) and one non-leucoreduced (NLR) unit. Canine IL-8, IL-1β and TNF-α concentrations were measured in s les collected from the units during storage on days 0, 10, 20, 30 and 37. The IL-8 concentration in U3 NLR units was significantly higher on days 10, 20, 30 and 37 than on day 0 and was significantly higher than in the LR units at all time points. The IL-1β concentration in U3 did not change over time, or between LR and NLR units. TNF-α was not detected in any unit. There were no significant differences in IL-8 or IL-1β concentrations between U3 and U1 at any time point however, some NLR U3 units had markedly elevated IL-8 concentrations at day 37 (2060-20,682 pg/mL) compared with NLR U1 units (3369-5280 pg/mL). NLR U3 units collected from dogs in haemorrhagic shock showed a significant increase in IL-8 concentrations during storage. Leucoreduction was effective at preventing the accumulation of IL-8. There was no difference detected between U3 and U1.
Publisher: Wiley
Date: 17-08-2018
DOI: 10.1111/VCP.12647
Abstract: High molecular weight (MW) synthetic colloids interfere with refractometry. The effect of low MW synthetic colloids on refractometry is unknown. To investigate the effect of 6% hydroxyethyl starch 130/0.4 (HES) and 4% succinylated gelatin (GELO) on the refractometric measurement of total plasma protein (TPP) and colloid osmotic pressure (COP) in canine plasma. Heparinized plasma from 10 dogs was diluted with 0.9% saline (NaCl), HES, and GELO in ratios of plasma:fluid, 9:1, 8:2, 7:3, 6:4, and 5:5. The biuret TPP (TPPb), refractometric TPP (TPPr), and COP assays were performed for all dilutions. Agreement (bias, 95% limits of agreement (LOA)) was tested between the TPPb (NaCl) and the TPPr of the NaCl, HES, and GELO plasma dilutions, and between the TPPb (NaCl) and the TPPb of the HES and GELO plasma dilutions. A small bias (0.06 g/dL, 95% LOA -0.51 to 0.39 g/dL) existed between TPPb (NaCl) and TPPr (NaCl). A large bias was found between TPPb (NaCl) and TPPr (HES) (1.38 g/dL, 95% LOA 0.30 to 3.10 g/dL), and TPPr (GELO) (1.18 g/dL, 95% LOA 0.53 to 2.88 g/dL). A small bias was found between TPPb (NaCl) and TPPb (HES) (0.08 g/dL, 95% LOA -2.04 to 2.20 g/dL), and a large bias was found between TPPb (NaCl) and TPPb (GELO) (1.00 g/dL, 95% LOA -0.59 to 2.60 g/dL). Increasing overestimation of TPPb (NaCl) by TPPr (HES and GELO) and TPPb (GELO) occurred with increasing colloid volumes. HES and GELO interfered with TPPr, and GELO also interfered with TPPb, in vitro. These variables should be interpreted with caution for dogs that have received these synthetic colloids.
Publisher: Wiley
Date: 18-06-2015
DOI: 10.1111/VEC.12322
Abstract: To assess for any clinical benefit of intravenous lipid emulsion (ILE) for permethrin toxicosis in cats by comparing the progression of clinical signs of cats before and after treatment with ILE to cats treated with a saline control. To accomplish this objective, a clinical staging system for cats with permethrin toxicosis was developed and validated. Prospective, multicenter, randomized, controlled clinical trial. University veterinary teaching hospital and 12 private veterinary emergency hospitals. Thirty-four client-owned cats with permethrin toxicosis. A clinical staging system was designed based on abnormalities found on physical examination of cats with permethrin toxicosis. The clinical staging system had 6 stages, ranging from Stage A for cats with no abnormalities to Stage F for cats with grand mal seizures. The system was validated for intraviewer and interviewer variability. Cats in the clinical trial were randomized to receive 15 mL/kg of either intravenous 0.9% saline (control) or 20% ILE over 60 minutes. For each cat, a clinical stage was recorded at set time points before and after the randomized treatment was administered. The distribution of clinical stage stratified over time was compared across treatment groups. The clinical staging system showed excellent repeatability (P = 1.0) and reliability (P = 1.0). In the clinical trial, there was a significant difference in the distribution of clinical stages over time (P < 0.001) and from presentation stage to Stage B (P = 0.006), with ILE-treated cats (n = 20) having lower clinical stages earlier than control cats (n = 14). There was no significant difference in signalment, body weight, or supportive treatment between the groups. The clinical staging system was repeatable and reliable. Clinical stages of permethrin toxicosis in ILE-treated cats improved earlier compared to control cats, suggesting ILE may be a useful adjunctive therapy in the treatment of permethrin toxicosis in cats.
Publisher: Wiley
Date: 22-03-2016
DOI: 10.1111/VEC.12468
Abstract: To measure platelet closure time (PCT) in dogs during controlled hemorrhagic shock and after fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 or 0.9% sodium chloride. Experimental interventional study. University veterinary teaching hospital. Eleven healthy Greyhounds. Dogs were anesthetized and had 48 mL/kg of blood removed to induce hemorrhagic shock. Dogs received 20 mL/kg of HES 130/0.4 (n = 6) or 80 mL/kg of 0.9% sodium chloride (NaCl n = 5) intravenously over 20 minutes. PCT was measured using the Platelet Function Analyzer-100 with collagen and adenosine-diphosphate cartridges at: T0 = 60 minutes after induction of anesthesia prior to hemorrhage, T1 = during hemorrhagic shock, and T2 = 40 minutes after completion of fluid bolus. Packed cell volume and platelet count were concurrently measured. Hemorrhagic shock did not significantly change PCT, with no difference between T0 and T1. Both the HES 130/0.4 and 0.9% NaCl group had a significantly increased mean PCT at T2 of 91.4 seconds (95% CI 69.3-113.4) and 95.5 seconds (95% CI 78.2-112.8), respectively, compared to T1. The magnitude of change was significantly greater for the 0.9% NaCl group than the HES 130/0.4 group. There was no difference in the magnitude of change in PCV and platelet count between the 2 groups. The PCV and platelet count were >25% and >100,000/μL, respectively, in all dogs, except for dogs in the HES 130/0.4 group at T2 where platelet counts were <100,000/μL. Controlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT. Both HES 130/0.4 and 0.9% NaCl administration after induction of shock increased PCT. These results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution.
Publisher: Wiley
Date: 26-07-2013
DOI: 10.1111/AVJ.12079
Abstract: A dog was presented for acute abdominal distension after inadvertent access to a large amount of dry dog food and possibly horse feed consisting of chaff, pony cubes and vitamin, mineral and yeast supplements. A marked hyperchloraemia and decreased anion gap on blood electrolyte analysis prompted a review of the patient's history for potential ingestion of bromide. It was revealed that the horse feed was supplemented with potassium bromide. The serum bromide level was 23.6 mmol/L. The dog recovered uneventfully. This case report highlights the importance of knowing common interferents of chemical analysis techniques.
Publisher: Springer Science and Business Media LLC
Date: 24-05-2022
DOI: 10.1038/S41598-022-12752-X
Abstract: Endothelial glycocalyx (EG) shedding is associated with septic shock and described following intravenous (IV) fluid administration. To investigate the possible impact of IV fluids on the pathobiology of septic shock we investigated associations between biomarkers of EG shedding and endothelial cell activation, and relationships with IV fluid volume. Serum s les were obtained on admission (T0) and at 24 h (T24) in patients undergoing haemodynamic resuscitation for suspected septic shock in the emergency department. Biomarkers of EG shedding—Syndecan-1 (Syn-1), Syndecan-4 (Syn-4), Hyaluronan, endothelial activation—Endothelin-1 (ET-1), Angiopoeitin-2 (Ang-2), Vascular Endothelial Growth Factor Receptor-1(VEGF-1) and leucocyte activation/inflammation—Resistin, Neutrophil Gelatinase Associated Lipocalin (NGAL) and a marker of cardiac stretch—Pro-Atrial Natriuretic Peptide (Pro-ANP) were compared to the total IV fluid volume administered using Tobit regression. Data on 86 patients (52 male) with a mean age of 60 (SD 18) years were included. The mean fluid volume administered to T24 was 4038 ml (SD 2507 ml). No significant association between fluid volume and Pro-ANP or any of the biomarkers were observed. Syn-1 and Syn-4 were significantly correlated with each other (Spearman Rho 0.43, p 0.001) but not with Hyaluronan. Syn-1 and Syn-4 both correlated with VEGFR-1 (Rho 0.56 and 0.57 respectively, p 0.001) whereas Hyaluronan correlated with ET-1 (Rho 0.43, p 0.001) and Ang-2 (Rho 0.43, p 0.001). There was no correlation between Pro-ANP and any of the EG biomarkers. Distinct patterns of association between biomarkers of EG shedding and endothelial cell activation were observed among patients undergoing resuscitation for sepsis. No relationship between IV fluid volume and Pro-ANP or any of the other biomarkers was observed.
Publisher: Wiley
Date: 06-11-2016
DOI: 10.1111/AVJ.12530
Abstract: To describe the use of sodium carbonate and apomorphine in a historical cohort of dogs, compare the occurrence of emesis and report any adverse effects recorded. This historical, observational study included information from medical records of dogs that received an emetic agent. The occurrence of emesis with apomorphine or sodium carbonate was calculated and the association between emesis and agent was explored, with the odds ratio and 95% confidence interval (CI) reported. A non-inferiority analysis of the occurrence of emesis for sodium carbonate was performed against an equivalence range of ±7% of the estimated occurrence of emesis with apomorphine. Owners were emailed a short survey about their dog's health after their visit to the hospital for induced emesis. Records for 787 dogs seen from January 2007 to December 2013 were included. For apomorphine, 382/392 dogs showed emesis (97%, 95% CI 95-100%). For sodium carbonate, 320/395 dogs showed emesis (81%, 95% CI 77-85%), which fell below the equivalence range for apomorphine (97 ± 7%, 90-100%) and was considered inferior. The odds ratio of emesis with apomorphine to sodium carbonate was 9.0 (95% CI 4.6-17.6). Of 18 responses to the survey, 5 reported abnormalities after emesis (3 with sodium carbonate, 2 with apomorphine). The occurrence of emesis with sodium carbonate was high but inferior to apomorphine. However, the advantages of sodium carbonate, including less expense and ease of accession compared with apomorphine, make it a viable choice in emergency medicine.
Publisher: Wiley
Date: 11-2017
DOI: 10.1136/VR.104353
Abstract: The clinical features and management of food engorgement (FE) in dogs have not been previously described. This retrospective observational study describes characteristics and outcome of 35 dogs with FE, and compares features on presentation to 36 dogs with gastric dilation and volvulus (GDV). Cases were retrospectively reviewed for history, clinical findings and outcome. Gastric distension was measured by caudal gastric margin (CGM), level with lumbar vertebrae, on a lateral abdominal radiograph. Frequent characteristics of dogs with FE included tachycardia, tachypnoea, hyperproteinaemia, increased base excess (BE), mild hypernatraemia and hyperlactataemia. There was overlap in CGM between dogs with GDV (CGM range L3 to >L6) and dogs with FE (CGM range <L2 to L5-L6). In contrast to dogs with GDV, lactate concentration in dogs with FE was not associated with CGM or BE. Dogs with FE mostly received medical intervention consisting of fluid therapy and analgesia, and all dogs survived to discharge. In conclusion, dogs with FE frequently presented with acid-base and electrolyte derangements, including hyperlactataemia. While dogs with FE can have gastric distension as severe as that seen with GDV, outcome with supportive care only is excellent.
Publisher: Frontiers Media SA
Date: 13-11-2018
Publisher: Wiley
Date: 12-03-2021
DOI: 10.1111/VEC.13056
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JCRC.2017.07.001
Abstract: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics. This prospective observational study included 23 patients with simple infection, 86 with sepsis and 29 healthy controls. Serum EG biomarkers included syndecan-1, syndecan-4 and hyaluronan. S les were taken on enrolment in the ED (T0), 1 hour (T1), 3 hours (T3) and 12 to 24 hours (T24) later. Syndecan-1 concentration increased incrementally over time (T0-T24, both patient groups, P < .001) whereas hyaluronan concentration peaked at T3 (T0-T3, sepsis group, P < .001). Hyaluronan was positively associated with cumulative fluid volumes (P < .001) at T0, T1, and T3, independent of illness severity. Both syndecan-1 (OR 1.04, 95% CI 1.01-1.07, P = .017) and hyaluronan (OR 1.83, 95% CI 1.46-2.30, P < .001) were associated with organ failure, independent of age and comorbidity. Syndecan-4 concentration was not different between groups or over time. In contrast to previous ICU studies, EG biomarkers increased during the first 24 hours of sepsis treatment and were associated with fluid volumes and organ failure. Further investigation is required to determine if interventions delivered in the ED contribute to EG shedding.
Publisher: Frontiers Media SA
Date: 07-05-2021
DOI: 10.3389/FVETS.2021.661660
Abstract: The goal of resuscitative fluid therapy is to rapidly expand circulating blood volume in order to restore tissue perfusion. Although this therapy often serves to improve macrohemodynamic parameters, it can be associated with adverse effects on the microcirculation and endothelium. The endothelial surface layer (ESL) provides a protective barrier over the endothelium and is important for regulating transvascular fluid movement, vasomotor tone, coagulation, and inflammation. Shedding or thinning of the ESL can promote interstitial edema and inflammation and may cause microcirculatory dysfunction. The pathophysiologic perturbations of critical illness and rapid, large-volume fluid therapy both cause shedding or thinning of the ESL. Research suggests that restricting the volume of crystalloid, or “clear” fluid, may preserve some ESL integrity and improve outcome based on animal experimental models and preliminary clinical trials in people. This narrative review critically evaluates the evidence for the detrimental effects of resuscitative fluid therapy on the ESL and provides suggestions for future research directions in this field.
Publisher: Wiley
Date: 03-2009
DOI: 10.1111/J.1939-1676.2008.0252.X
Abstract: Urine specific gravity (USG) is used clinically to estimate urine osmolality (UOsm). Although USG has been shown to have a linear correlation with UOsm in dogs, the relationship is altered when there are significant numbers of high molecular weight (MW) molecules in the urine. USG would no longer predict UOsm in dogs given intravenous hetastarch (670/0.75)(HES). Eight healthy employee-owned adult dogs. Prospective, controlled experimental study. USG and UOsm were measured every 30 minutes from t=0 minutes to t=360 minutes. Dogs were administered 20 mL/kg of either NaCl 0.9% (control group, n=4) or HES (treatment group, n=8) IV over 1 hour starting at t=90 minutes. There was a decrease in UOsm in both groups starting at t=120 minutes and continuing for the study duration, and there was no significant difference in UOsm between treatment and control groups across all time points. There was an appropriate decrease in USG from t=120 minutes for the control group. In the treatment group, USG increased significantly at t=120 minutes (P= .0006), t=150 minutes (P= .0002), and t=180 minutes (P= .0044). The largest increase in USG occurred at t=150 minutes with a mean USG of 1.070 +/- 0.021 (range 1.038-1.104). Urine specific gravity should not be used to estimate urine solute concentration in dogs following the administration of 20 mL/kg of HES. In a clinical setting, the evaluation of USG following this dose of HES may lead to an overestimation of urine concentration.
Publisher: Wiley
Date: 20-06-2013
DOI: 10.1111/AVJ.12074
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.VAA.2016.05.015
Abstract: To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock. Prospective, experimental, complete randomized block design. Twelve healthy adult greyhounds. After 60 minutes of isoflurane anaesthesia, 48 mL kg O and clinical relevance The effect of 20 mL kg
Publisher: Wiley
Date: 12-11-2022
DOI: 10.1111/VEC.13152
Abstract: The primary objective of this study was to document coagulation factor activity in canine “NEVER‐FROZEN” and “THAWED” refrigerated plasma for the purposes of defining recommended expiration dates. We hypothesized that NEVER‐FROZEN and THAWED refrigerated plasma would maintain % activity of coagulation factors V (FV), VII (FVII), VIII (FVIII), IX (FIX), X (FX), and von Willebrand factor antigen (vWF) and a concentration of fibrinogen above the lower bound of the reference interval ( .982 g/L) for greater than 14 days but less than 42 days. Prospective laboratory‐based study. University teaching hospital blood bank. Ten canine plasma units derived from healthy client‐owned blood donors. Serial s ling (days 0, 1, 3, 5, 7, 10, 14, 17, 21, 24, 28, 32, 35, 39, 42) from NEVER‐FROZEN and THAWED refrigerated canine plasma units was conducted for measurement of activities of FV, FVII, FVIII, FIX, FX, vWF, and fibrinogen concentrations using the ACL TOP 300. Plasma was defined as “suitable for transfusion” at a given time point if the entire 95% confidence interval for each factor was above 50% activity and above a fibrinogen concentration of 0.982 g/L. The lower bounds of the FVIII and vWF confidence intervals were above 50% up to and including day 32 for NEVER‐FROZEN refrigerated plasma and day 28 for THAWED refrigerated plasma. Confidence intervals for FV, FVII, FIX, and FX remained above 50% activity at all time points. The lower bound of the fibrinogen concentration was .982 g/L on day 39 for NEVER‐FROZEN refrigerated plasma and on day 35 for THAWED refrigerated plasma. Refrigerated canine plasma from these 10 dogs retained coagulation factor activity above the limit that we defined as suitable for transfusion for up to 32 days when NEVER‐FROZEN and 28 days when THAWED. Further studies should evaluate the clinical outcomes and effects on coagulation factor activity of dogs receiving refrigerated plasma transfusions.
Publisher: Wiley
Date: 05-2008
Publisher: Springer Science and Business Media LLC
Date: 12-12-2022
DOI: 10.1038/S41467-022-35225-1
Abstract: Although ocular manifestations are reported in patients with COVID-19, consensus on ocular tropism of SARS-CoV-2 is lacking. Here, we infect K18-hACE2 transgenic mice with SARS-CoV-2 using various routes. We observe ocular manifestation and retinal inflammation with production of pro-inflammatory cytokines in the eyes of intranasally (IN)-infected mice. Intratracheal (IT) infection results in dissemination of the virus from the lungs to the brain and eyes via trigeminal and optic nerves. Ocular and neuronal invasions are confirmed using intracerebral (IC) infection. Notably, the eye-dropped (ED) virus does not cause lung infection and becomes undetectable with time. Ocular and neurotropic distribution of the virus in vivo is evident in fluorescence imaging with an infectious clone of SARS-CoV-2-mCherry. The ocular tropic and neuroinvasive characteristics of SARS-CoV-2 are confirmed in wild-type Syrian hamsters. Our data can improve the understanding regarding viral transmission and clinical characteristics of SARS-CoV-2 and help in improving COVID-19 control procedures.
Publisher: Springer Science and Business Media LLC
Date: 19-04-2017
DOI: 10.1007/S00011-017-1043-5
Abstract: Resistin and neutrophil gelatinase-associated lipocalin (NGAL) are upregulated in circulating leucocytes in sepsis, but the significance of this is uncertain. We evaluated associations between Resistin and NGAL with endothelial cell activation and clinical outcomes in a prospective observational study in the Emergency Department (ED). Serum levels of Resistin, NGAL, inflammatory cytokines (IL-6, IL-10) and soluble endothelial adhesion molecules (VCAM-1, ICAM-1) were measured at defined time points up to 24 h. Patterns and relationships between markers were investigated using linear mixed regression models. Predictive values for clinical outcomes for markers at enrollment were assessed by logistic regression and receiver operator characteristic (ROC) curves. 186 participants (89 septic-shock, 69 sepsis, 28 uncomplicated infection) were compared with 29 healthy controls. Median Resistin and NGAL were higher in uncomplicated infection compared to controls, and in septic shock compared to non-shock sepsis. Resistin and NGAL correlated with IL-6 and IL-10, with VCAM-1 and ICAM-1, and with organ failure. Resistin and NGAL were associated with septic shock but had limited predictive utility for mortality. Resistin and NGAL correlate with expression of endothelial cell adhesion molecules in sepsis. Further evaluation of the role of Resistin and NGAL in sepsis pathogenesis is warranted.
Publisher: Wiley
Date: 08-2008
Publisher: Wiley
Date: 19-09-2021
DOI: 10.1111/AVJ.13114
Abstract: To describe the clinical features of dogs treated for suspected anaphylaxis in Perth, Western Australia. Single‐centre observational case series with retrospective and prospective phases. This was a two‐phase study of dogs with clinical suspicion of anaphylaxis presenting to the emergency service of a university teaching hospital. Dogs required evidence of, and appropriate treatment of, a type 1 hypersensitivity reaction as well as two or more organs affected (or cardiovascular signs alone) to be included. Phase 1 includes retrospective case series of 186 dogs (March 2006–December 2018). Phase 2 includes prospective descriptive case series of 46 dogs (October 2017–July 2018) focused on clinical signs. In phase 1, 88 (47%) dogs had evidence of insect exposure prior to the acute event. One hundred forty (75%) dogs had dermatological signs, 141 (76%) had gastrointestinal signs and 129 (69%) had cardiovascular signs. Ninety‐two (49%) dogs had vasoconstrictive shock (5 with bradycardia), 24 (13%) had vasodilatory shock, 8 (4%) had mixed vasodilatory and vasoconstrictive shock and 5 (3%) had unclassifiable shock. On focused abdominal ultrasound, 42 of 71 (59%) dogs had gallbladder wall oedema and 3 of 71 (4%) dogs had peritoneal free fluid. In phase 2, the distributions of insect exposure, organ dysfunction and sonographic abnormalities were similar to phase 1. Dogs presenting with suspected anaphylaxis showed a broad range of presentations. Dermatological signs were absent in a proportion of dogs, vasoconstrictive shock was more frequent than vasodilatory and unique features of shock were identified. This study highlights the challenges of diagnosis based on presenting features alone.
Publisher: Springer Science and Business Media LLC
Date: 25-01-2021
Publisher: Springer Science and Business Media LLC
Date: 18-12-2019
DOI: 10.1038/S41598-019-55009-W
Abstract: Hepcidins are an evolutionarily conserved class of liver-expressed peptide, from which the twenty-five amino acid hormone, hepcidin-25 (herein hepcidin), has gained significant notoriety as the master regulator of iron homeostasis in mammals. Hepcidin maintains iron homeostasis by controlling the dietary absorption of iron and the mechanisms of recycling cellular iron stores. With the physiological significance of this hormone well established, it has emerged as an informative biomarker. In a comparison of the genome, transcriptome and peptidome of Canis lupis familiaris , we reveal the size of the hepcidin peptide in the canine, previous reports of which were contradictory to the evolutionary conservation predicted by genome annotation. Here, measurement of the peptide by mass spectrometry, following isolation from greyhound blood serum, revealed an amino acid sequence and peptide mass, differing from all accounts to date, yet demonstrating perfect sequence identity to that of the greater Canidae lineage of the Carnivora. Importantly, in the greyhound, the measured hepcidin peptide showed a similar temporal pattern to total serum iron, consistent with our understanding of hepcidin regulating iron homeostasis, in agreement with human diagnostics, and providing added translational evidence of the measured peptide being the iron regulatory hormone of the Canidae.
Publisher: Springer Science and Business Media LLC
Date: 04-05-2018
DOI: 10.1007/S10753-018-0797-4
Abstract: Shedding of the endothelial glycocalyx precedes leukocyte activation and adherence in acute inflammation. Rapid administration of crystalloid or colloid fluids for treating hemorrhagic shock may cause endothelial glycocalyx shedding, thereby increasing inflammation. This study aimed to compare the effect of different fluid treatments in a canine shock model on glycocalyx biomarker, hyaluronan, and inflammatory biomarkers. Greyhound dogs under general anesthesia subject to hemorrhage for 60 min were given 20 mL kg
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
Publisher: Elsevier
Date: 2014
Publisher: Wiley
Date: 2017
DOI: 10.1111/AVJ.12548
Abstract: Two dogs with an oesophageal foreign body (FB) were diagnosed with secondary pyothorax at the time of presentation. One dog was managed with surgical FB removal, pleural lavage and thoracostomy tube placement. Following surgery, it was admitted to the intensive care unit for oxygen therapy, antimicrobial and analgesic administration, fluid therapy, thoracic drainage and enteral nutrition. The other dog was managed with endoscopic FB removal, thoracostomy tube placement with continuous suction, and similar aftercare in the intensive care unit. Both survived to discharge from hospital. This report details the treatment and survival of two dogs with secondary pyothorax associated with oesophageal FB, with successful management through supportive care, oesophageal rest and treatment of infection.
Publisher: Frontiers Media SA
Date: 15-04-2021
DOI: 10.3389/FVETS.2021.662504
Abstract: Intravenous fluid administration in veterinary patients can alter coagulation function by several mechanisms. Both crystalloid and colloid fluids cause hemodilution, reducing platelet count and plasma coagulation protein concentrations. Hemodilution is associated with a hypercoagulable effect at low dilutions and a hypocoagulable effect at higher dilutions. Composition of crystalloid fluids likely has a minor effect, primarily dependent on fluid ion composition. Hypertonic crystalloids may also cause hypocoagulability. Colloids, both synthetic and natural, can cause hypocoagulability by several mechanisms beyond the effects of hemodilution. These include impaired platelet function, decreased plasma coagulation factor activity, impaired fibrin formation and crosslinking, and accelerated fibrinolysis. The vast majority of the veterinary literature investigates the hypocoagulable effects of hydroxyethyl starch–containing fluids using in vitro , experimental, and clinical studies. However, results are inconsistent, likely due to the varying doses and physicochemical properties of the specific fluid products across studies. In addition, some evidence exists for hypocoagulable effects of gelatin and albumin solutions. There is also evidence that these colloids increase the risk of clinical bleeding in people. Limitations of the veterinary evidence for the hypocoagulable effects of colloid fluids include a predominance of in vitro studies and in vivo studies using healthy subjects, which exclude the interaction of the effects of illness. Therefore, clinical relevance of these effects, especially for low-molecular-weight hydroxyethyl starch, is unknown. Firm recommendations about the most appropriate fluid to use in clinical scenarios cannot be made, although it is prudent to limit the dose of synthetic colloid in at-risk patients. Clinicians should closely monitor relevant coagulation assays and for evidence of hemorrhage in at-risk patients receiving any type of fluid therapy, especially in large volumes.
Publisher: Elsevier
Date: 2015
Publisher: Wiley
Date: 09-2018
DOI: 10.1111/VEC.12758
Publisher: Wiley
Date: 04-10-2022
DOI: 10.1111/VEC.13144
Abstract: There is no consensus on obtaining blood cultures routinely in companion animals with suspected sepsis, and there is a paucity of evidence concerning their utility. The objectives of this retrospective study were to determine the yield of positive blood cultures from hospitalized dogs, the prevalence of resistant bacteria, and the frequency and nature of changes to antimicrobial therapy once the culture result became available. Forty‐five dogs had a blood culture submitted over a 10‐year period, of which 9(20%) yielded positive growth and 36 (80%) yielded no bacterial growth. The most frequent reasons for submission of blood culture were pyrexia of unknown origin ( n = 14), suspected soft tissue infection (7), and suspected discospondylitis (7). The most frequent final diagnoses were soft tissue infection ( n = 11), discospondylitis (7), and unknown (6). No significant difference was found between the culture‐positive versus culture‐negative groups with regard to the most frequent reasons for blood culture ( P = 0.55), final diagnoses ( P = 0.80), survival until the blood culture result ( P = 0.37), or whether the infection was hospital‐ or community‐acquired ( P = 0.99). There were significantly more immunosuppressed dogs in the culture‐positive group ( P = 0.02). Resistance to one or more antimicrobials was documented in all dogs with susceptibility reported. In the culture‐positive dogs, 63% had antimicrobial de‐escalation and none had escalation, whereas 19% of the culture‐negative dogs had de‐escalation and 7% had escalation. Blood cultures were submitted infrequently, but the proportion of resistance was higher than expected and supports the use of blood cultures in cases of suspected infection resulting in bacteremia.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.VAA.2019.05.007
Abstract: To determine if low molecular weight synthetic colloid fluids administered to dogs interfere with refractometric estimates of total plasma protein (TPPr) and urine osmolality (UOsm). Experimental study. Eighteen healthy Greyhound dogs. Anaesthetized Greyhounds subjected to haemorrhage for 60 minutes were given 80 mL kg For dogs given CRYST and GELO, median TPPr and TPPb decreased in parallel, with a small consistent TPP bias (CRYST range of bias, 0.38-0.67 g dL Administration of HES and GELO to dogs with haemorrhagic shock interferes with refractometric measurements for at least 3 hours after administration.
Publisher: Frontiers Media SA
Date: 08-09-2020
Publisher: Wiley
Date: 06-2003
DOI: 10.1111/J.1751-0813.2003.TB11505.X
Abstract: To evaluate cardiac electrical function in the Spectacled Flying Fox (bat) infested with Ixodes holocyclus. Prospective clinical investigation of bats treated for naturally occurring tick toxicity. ECGs were performed on bats with tick toxicity (n = 33), bats that recovered slowly (n = 5) and normally (n = 5) following treatment for tick toxicity, and on normal bats with no history of tick toxicity (n = 9). Bats with tick toxicity had significantly prolonged corrected QT intervals, bradycardia and rhythm disturbances which included sinus bradydysrhythmia, atrial standstill, ventricular premature complexes, and idioventricular bradydysrhythmia. The QT prolongation observed on ECG traces of bats with tick toxicity reflected delayed ventricular repolarisation and predisposed to polymorphic ventricular tachycardia and sudden cardiac death in response to sympathetic stimulation. The inability to document ventricular tachycardia in bats shortly before death from tick toxicity may be explained by a lack of sympathetic responsiveness attributable to the unique parasympathetic innervation of the bat heart, or hypothermia-induced catecholamine receptor down-regulation. Bradycardia and rhythm disturbances may be attributable to hypothermia.
Publisher: Springer Science and Business Media LLC
Date: 29-08-2017
Publisher: American Veterinary Medical Association (AVMA)
Date: 11-2015
Abstract: OBJECTIVE To measure changes in interleukin-8 (IL-8), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) concentrations in stored canine packed RBCs (PRBCs) over time and assess the effect of leukoreduction on these cytokine concentrations. ANIMALS 12 anesthetized healthy Greyhounds. PROCEDURES 1 unit of whole blood from each dog was processed into PRBCs. Half of each PRBCs unit was passed through a leukoreduction filter to produce a leukoreduced unit, and the remaining blood was kept as a nonleukoreduced unit. All units had a CBC performed on day 0 (day of collection) and were stored at 2° to 6°C. S les were collected from leukoreduced and nonleukoreduced units on days 0, 10, 20, 30, and 37 and centrifuged the supernatant was stored at −80°C until analysis. Canine TNF-α and IL-8 concentrations were assessed with a multiplexed genomic and proteomic biomarker analyzer, and canine IL-1β concentration was measured by ELISA. RESULTS Leukocyte counts were decreased by ≥ 99.9% in all leukoreduced units. Median TNF-α and IL-1β concentrations were not significantly different between leukoreduced and nonleukoreduced units and did not change significantly during storage median IL-8 concentration was significantly higher in nonleukoreduced versus leukoreduced units on all days, and was greater at all time points after ≥ 10 days of storage than on day 0. Median IL-8 concentration in leukoreduced units did not increase during storage. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that leukoreduction was effective for the removal of leukocytes from canine PRBCs and prevented significant increases in IL-8 concentration during storage. Further studies are needed to evaluate whether leukoreduction reduces cytokine-associated complications of transfusion.
Publisher: Wiley
Date: 30-10-2012
DOI: 10.1111/J.1476-4431.2012.00804.X
Abstract: To describe the use of intravenous lipid emulsion (IVLE) as an adjunctive therapy in 3 cats with permethrin toxicosis. Three cats with permethrin toxicosis were treated with IVLE in addition to the current accepted treatment regime. All 3 cats demonstrated a subjective rapid clinical improvement after the administration of IVLE, with no adverse reactions observed. This is the first reported use of IVLE for feline permethrin toxicosis, with encouraging results. A possible reduction in costs associated with treatment may contribute to a reduction in euthanasia. Further investigation of the use of IVLEs in permethrin toxicosis is warranted.
No related grants have been discovered for Lisa Smart.