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Textbook of Small Animal Emergency Medicine
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Table of Contents

Contributors xiii Preface xxix About the Companion Website xxx VOLUME 1 Section 1 Emergency Medicine Overview 1 1 Goals in Veterinary Emergency Medicine 3 Dustin Schmid and Bob Murtaugh 2 Triage 6 Nadja Sigrist Section 2 Common Conditions in Emergency Medicine 11 3 Neurological Disorders 13 Daniel J. Fletcher 4 Respiratory Distress 18 Elizabeth Rozanski 5 Ventricular Ectopy 22 Lisa A. Murphy and Reid K. Nakamura 6 Acute Abdomen 26 Amy Koenigshof 7 The Collapsed Patient 31 Anna Gelzer and Marc S. Kraus 8 Global Approach to the Trauma Patient 39 Katie D. Mauro and Kenneth J. Drobatz 9 Reproductive Emergencies 44 Maureen McMichael 10 Anemia 48 Jillian DiFazio and Susan G. Hackner 11 Jaundice 55 Leo Londono and Michael Schaer 12 Ophthalmic Emergencies 60 Steven R. Hollingsworth 13 Vomiting, Regurgitation, and Diarrhea 66 Rebecca Flores and Deborah C. Mandell 14 Dysuria 72 Joseph Bartges 15 Dermatological and Ear Disease 76 Brian K. Roberts 16 Toxin Exposure 92 Tina A. Wismer 17 Epistaxis 97 Meghan E. Vaught and Elizabeth Rozanski 18 Fever 101 Melissa A. Claus Section 3 Emergency Conditions by System 107 A. Neurological Disorders 109 19 Traumatic Brain Injury 111 Jillian DiFazio and Daniel J. Fletcher 20 Altered Mentation 118 Cassie Ostroski and Kenneth J. Drobatz 21 Seizures 124 Leontine Benedicenti and Evelyn M. Galban 22 Intracranial Disease 131 Kendra Mikoloski 23 Vestibular Disease 137 Laura Harvey 24 Spinal Trauma 146 Patrick J. Kenny 25 Intervertebral Disk Disease 154 Evelyn M. Galban and Jonathan H. Wood 26 Diskospondylitis 161 Sheila Carrera-Justiz 27 Lower Motor Neuron Disease 166 Dominic Barfield,Patrick J. Kenny, and Richard Malik B. Respiratory Disease 177 28 Brachycephalic Syndrome 179 Guillaume L. Hoareau 29 Feline Upper Respiratory Complex 186 Alexandra Pfaff 30 Laryngeal Paralysis 193 Margo Mehl 31 Tracheobronchial Injury and Collapse 196 Dana Clarke 32 Acute Airway Obstruction 206 Dana Clarke 33 Exacerbations of Chronic Bronchitis 215 Lynelle R. Johnson 34 Feline Lower Airway Disease 220 Tekla Lee-Fowler 35 Puppy Pneumonia 225 Elizabeth Rozanski and Alex Lynch 36 Coughing and Hemoptysis 229 Geoff Heffner 37 Bronchopneumonia 234 Anthony L. Gonzalez and Lesley G. King 38 Cardiogenic Pulmonary Edema 242 Mark A. Oyama 39 Neurogenic Pulmonary Edema 247 Kenneth J. Drobatz 40 Submersion Injury 253 Nuno Felix and Isabelle Goy-Thollot 41 Pulmonary Hemorrhage 260 Soren Boysen 42 Pulmonary Thromboembolism 266 Ronald Li and Joshua A. Stern 43 Primary and Metastatic Pulmonary Neoplasia 273 Erika L. Krick 44 Pneumothorax 278 Erin Mooney 45 Pleural Effusions 285 Lori Waddell 46 Pyothorax 291 Kate Farrell and Steven Epstein 47 Diaphragmatic Hernia 298 Cara A. Blake 48 Penetrating Thoracic Trauma 304 Ingrid M. Balsa, Guillaume L. Hoareau, and William T.N. Culp 49 Blunt Thoracic Trauma 309 Guillaume L. Hoareau, Ingrid M. Balsa, and William T. N. Culp 50 Look-Alike Causes of Respiratory Distress 316 Angela Borchers and Laura Cagle C. Cardiovascular Disease 319 51 Mechanisms of Heart Failure 321 Mark A. Oyama 52 Congenital Cardiovascular Disease 325 Joshua A. Stern 53 Arrhythmias 329 Meg M. Sleeper 54 Pericardial Effusion 336 Sean B. Majoy 55 Dilated Cardiomyopathy 341 Suzanne M. Cunningham and Kursten V. Pierce 56 Feline Hypertrophic Cardiomyopathy 349 Lance C. Visser 57 Valvular Heart Disease 355 John MacGregor 58 Heartworm Disease 362 Marisa K. Ames 59 Pulmonary Hypertension 372 Rebecca Quinn 60 Bradyarrhythmias and Pacemakers 380 Lance C. Visser 61 Myocarditis 385 Lisa A. Murphy and Reid K. Nakamura 62 Thromboembolic Disease 388 Julien Guillaumin 63 Systemic Arterial Hypertension 397 Amanda E. Coleman D. Hematological and Oncological Disorders 405 64 Leukocytosis and Leukopenia 407 Andrew G. Burton and Karl E. Jandrey 65 Non-Regenerative Anemia 413 Alex Lynch 66 Hemolytic Anemia 419 Megan Morgan and Susan G. Hackner 67 Thrombocytopenia 427 Maureen McMichael 68 Fibrinolysis and Antifibrinolytics 430 Jo-Annie Letendre and Robert Goggs 69 Congenital Coagulopathy 440 Elizabeth Rozanski and Armelle deLaforcade 70 Acquired Coagulopathy 444 Ronald Li 71 Antithrombotics in the Emergency Room 455 Armelle deLaforcade 72 Sick Oncology Patients in the Emergency Room 459 Kim Slensky and Craig A. Clifford 73 Paraneoplastic Syndromes 467 Alycen P. Lundberg and Laura D. Garrett E. Esophageal and Abdominal Disease 473 74 Vomiting and Regurgitation 475 Jayme E. Hoffberg 75 Esophageal Foreign Bodies 481 Mark P. Rondeau 76 Diarrhea 485 Marko Pipan 77 Hematemesis and Gastrointestinal Hemorrhage 490 Kayla Hanson and Elke Rudloff 78 Parvovirus Enteritis 496 Raegan J. Wells and Sullivan Lauren 79 Hemorrhagic Gastroenteritis 501 Erica L. Reineke 80 Protein-Losing Enteropathy 506 Rachel E. Smith and Robert J. Washabau 81 Gastrointestinal Obstruction 511 Chap Pratt 82 Gastric Dilation-Volvulus 520 Elke Rudloff 83 Mesenteric Torsion 524 Fabio Vigano 84 Hemoperitoneum 528 S. Anna Pesillo-Crosby 85 Splenic Disease 535 Alex Lynch and Therese O Toole 86 Pancreatitis 541 Erica Tinson and Elise Boller 87 Peritonitis 550 Medora Pashmakova and James Barr 88 Postoperative Complications Presenting to the Emergency Service 556 Therese O Toole 89 Biliary Disease 561 Amanda K. Boag and Steve J. Mehler 90 Acute Liver Failure 566 Deborah C. Mandell 91 Feeding Tube Complications 578 Daniel L. Chan 92 Anorectal Disease 582 David E. Holt 93 Constipation 587 Mark P. Rondeau VOLUME 2 F. Urogenital Disorders 593 94 Acute Azotemia 595 Carrie Palmr 95.Oliguria 601 J.D. Foster 96 Urinary Tract Infections 606 Reid Groman 97 Urolithiasis 620 Joseph Bartges 98 Feline Ureteral Obstruction: Diagnosis and Management 627 Allyson Berent 99 Feline Lower Urinary Tract Obstruction 634 Edward Cooper 100 Urethral Trauma 641 Elena S. Addison and Donald A. Yool 101 Lyme Nephritis 646 Meryl P. Littman 102 Chronic Kidney Disease 653 Melisa Gunsel Rosenthal and Mary A. LabatoI 103 Uroabdomen 659 Saya Press and Anusha Balakrishnan 104 Urethral Prolapse 665 Jennifer Carr 105 Discolored Urine 667 Julie M. Walker 106 Urinary Diversion in the Emergency Room 673 Cassie Ostroski and Dana Clarke 107 Acid Base Disorders 680 Kate Hopper 108 Sodium and Water Balance 687 Yu Ueda and Kate Hopper 109 Potassium Disorders 697 Sabrina Hoehne and Matthew Mellema 110 Calcium, Magnesium, and Phosphorus Disorders 706 Matthew Mellema 111 Hypoglycemia 716 Anthony L. Gonzalez and Deborah C. Silverstein 112 Hyperglycemia 723 Gideon Daniel and Alex Lynch 113 Complicated Diabetes Mellitus 726 Amie Koenig 114 Adrenal Gland Disorders 733 Jonathan D. Dear and Guillaume L. Hoareau 115 Hypoadrenocorticism 739 Soren Boysen 116 Thyroid Disorders 749 Jonathan D. Dear 117 Diabetes Insipidus 754 Jamie M. Burkitt Creedon G. Reproductive Disorders 759 118 Dystocia 761 Liam Donaldson and Philip Thomas 119 Eclampsia 767 Michelle A. Kutzler 120 Neonatal Resuscitation 771 Carol A. Margolis and Margret L. Casal 121 Diseases of the Neonate 775 Andrea Hesser and Autumn P. Davidson 122 Metritis and Mastitis 787 Sophie A. Grundy 123 Pyometra 791 Grayson B. Wallace and Margret L. Casal 124 Prostatic Disease 798 Autumn P. Davidson 125 Uterine and Vaginal Prolapse 803 Michelle A. Kutzler 126 Penile, Preputial, and Testicular Disease 808 James Lavely and Autumn P. Davidson H. Common Toxins 815 127 Decontamination and Toxicological Analyses of the Poisoned Patient 817 Justine A. Lee 128 Lipid Rescue Therapy 827 Kathryn Benavides and Jonathan Babyak 129 Blood Purification Techniques for Intoxications 831 Carrie Palm 130 Rodenticide Toxicity 837 Jesse Bullock and Alex Lynch 131 Ethylene Glycol Intoxication 842 Rachel B. Davy and Leo Londono 132 Acetaminophen Intoxication 847 Amanda Thomer and Lesley G. King 133 Non-Steroidal Anti-Inflammatory Drug Intoxications 852 Angela Borchers 134 Grape, Raisin, and Lily Ingestion 858 J.D. Foster 135 Recreational Drug Intoxications 862 Melissa Bucknoff 136 Household Toxins 867 Lindsey Nielsen I. Skin and Soft Tissue Disease 871 137 Life-Threatening Dermatological Emergencies 873 Brian K. Roberts 138 Severe Soft Tissue Infections 888 Melissa Clark and Yekaterina Buriko J. Environmental Emergencies 893 139 Smoke Inhalation Toxicity 895 Erin McGowan and Kenneth J. Drobatz 140 Porcupine Quilling 901 Elizabeth Rozanski 141 Crotalinae Snake Envenomation 904 Raegan J. Wells 142 Elapid Snake Envenomation: American Coral Snakes and Australian Elapids (Tiger Snakes, Brown Snakes, Taipans, Death Adders and Black Snakes) 910 Katrin Swindells and Michael Schaer 143 Spider and Scorpion Envenomation 917 Kate Hopper 144 Bufo Toad Toxicosis 922 Leo Londono and Gareth Buckley 145 Hymenoptera Envenomation 926 Rebecca Flores and Vincent Thawley 146 Hypersensitivity and Anaphylaxis 932 Sabrina Hoehne and Kate Hopper 147 Canine Heat Stroke 938 Yaron Bruchim and Efrat Kelmer 148 Cold Exposure 946 Karol A. Mathews 149 Electrical and Lightning Injuries 952 F.A. (Tony) Mann Section 4 Trauma and Resuscitation 959 A. Cardiopulmonary Resuscitation 961 150 Cardiopulmonary Resuscitation in the Emergency Room 963 Daniel J. Fletcher and Manuel Boller 151 Small Animal Cardiopulmonary Resuscitation Initiatives 970 Manuel Boller and Daniel J. Fletcher B. Circulatory Shock 975 152 Pathophysiology of Shock 977 Edward Cooper 153 Hypovolemic Shock 982 Corrin Boyd and Lisa Smart 154 Cardiogenic Shock 989 Luiz Bolfer and Meg M. Sleeper 155 Additional Mechanisms of Shock 996 Sean Smarick and Iain Keir 156 Lactate Monitoring 1001 Casey Kohen and Kate Hopper 157 Emerging Monitoring Techniques 1007 Rodrigo C. Rabelo 158 Ischemia-Reperfusion Injury 1015 Josh Smith and Robert Goggs 159 Systemic Inflammatory Response Syndrome, Sepsis, and Multiple Organ Dysfunction Syndrome 1026 Claire R. Sharp C. Trauma 1035 160 Trauma Overview 1037 Erica L. Reineke 161 Trauma Center Registry 1048 Kelly Hall 162 High-Rise Syndrome 1050 Yekaterina Buriko 163 Trauma-Associated Coagulopathy 1056 Alex Lynch and Robert Goggs 164 Metabolic Consequences of Trauma 1064 Leo Roa and Elizabeth M. Streeter 165 Traumatic Orthopedic Emergencies 1068 Spencer A. Johnston and Marian E. Benitez 166 Wound Management Principles 1075 F.A. (Tony) Mann Section 5 Fluid and Blood Product Therapy 1085 167 Crystalloid Fluid Therapy 1087 Deborah C. Silverstein and Samantha Hart 168 Colloid Fluid Therapy 1093 Marie K. Holowaychuk 169 Crystalloids versus Colloids 1099 Jennifer Prittie and Dava Cazzolli 170 Management of Hemorrhagic Shock 1111 Andrew Linklater 171 Management of Dehydration 1122 Ashley E. Allen-Durrance and Samantha Campos 172 Maintenance Fluid Therapy 1128 Travis Lanaux 173 Potassium Supplementation 1132 Jillian DiFazio 174 Administration of Sodium Bicarbonate 1136 Jennifer E. Waldrop 175 Continuous-Rate Infusion 1143 Andrea M. Steele and Karol A. Mathews 176 Transfusion of Red Blood Cells and Plasma 1147 Raegan J. Wells and Brandi L. Mattison 177 Massive Transfusion 1152 Kari Santoro Beer and Amanda Thomer Section 6 Emergency Room Procedures 1157 178 Vascular Access 1159 Matthew W. Beal 179 Intraosseous Catheters 1165 Alison Allukian and Amanda Abelson 180 Airway Management 1169 Elizabeth Rozanski 181 Oxygen Therapy 1173 Christine L. Guenther 182 Sonography in the Emergency Room 1179 Gregory R. Lisciandro 183 Thoracocentesis 1191 Melissa Bucknoff and Meghan Respess 184 Thoracostomy Tube Placement 1195 Samantha Campos and Alex Lynch 185 Pericardiocentesis 1198 Kursten Roderick and John E. Rush 186 Abdominocentesis 1202 Karl E. Jandrey 187 Urethral Catheterization (Including Urohydropulsion) 1206 Sean Smarick 188 Mechanical Ventilation in the Emergency Room 1212 Lisa L. Powell 189 Damage Control Surgery 1215 Steve J. Mehler Section 7 Anesthesia and Analgesia for the Emergency Room Patient 1219 190 Anesthesia and Analgesia in the Emergency Room: An Overview 1221 Lisa J. Bazzle and Benjamin M. Brainard 191 Anesthetic Concerns and Protocols for Common Conditions 1227 Becca Reader and Amanda Abelson 192 Sedation for the Emergency Room Patient 1235 Stephanie R. Krein 193 Pain Management in Critical Patients 1241 Alicia Z. Karas 194 Opioids 1246 Lois A. Wetmore 195 Alpha-2 Adrenergic Agonists 1251 Katherine A. Cummings 196 Non-Steroidal Anti-Inflammatory Drugs 1254 Christopher L. Norkus 197 Regional Anesthesia Techniques 1259 Marlis L. de Rezende 198 Go Home Analgesics 1265 Ashley Wiese 199 Approach to the Aggressive or Fearful Emergency Room Patient 1272 Selena L. Lane and Benjamin M. Brainard Section 8 Unique Emergency Medicine Topics 1279 200 Antimicrobial Therapy in the Emergency Patient 1281 Steven Epstein 201 Disaster Medicine 1288 Lee Palmer 202 Working Dogs in the Emergency Room 1294 Cynthia M. Otto 203 Approach to Unowned and Shelter/Rescue Animals in the Emergency Room 1299 April Paul 204 Euthanasia Considerations 1302 Katherine J. Goldberg 205 Emergency Room Design and Staffing Models 1309 Jan P. Kovacic 206 Conflict in the Emergency Room 1318 Jim Wohl 207 Maximizing Communication 1323 Laura D. Garrett 208 Basics of Clinical Study Design 1327 Kenneth J. Drobatz 209 Designing and Participating in Clinical Trials 1331 Dorothy Cimino Brown

About the Author

The Editors Kenneth J. Drobatz, DVM, MSCE, Diplomate ACVIM, Diplomate ACVECC, is Professor of Critical Care and Director of Emergency Services at the University of Pennsylvania School of Veterinary Medicine in Philadelphia, Pennsylvania, USA. Kate Hopper, BVSc, PhD, Diplomate ACVECC, is Associate Professor at the University of California Davis School of Veterinary Medicine in Davis, California, USA. Elizabeth Rozanski, DVM, Diplomate ACVIM, Diplomate ACVECC, is Associate Professor at Tufts University Cummings School of Veterinary Medicine in North Grafton, Massachusetts, USA. Deborah C. Silverstein, DVM, Diplomate ACVECC, is Professor of Critical Care at the University of Pennsylvania School of Veterinary Medicine in Philadelphia, Pennsylvania, USA.

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