Small Animal Critical Care Medicine
- 3rd Edition - September 3, 2022
- Authors: Deborah Silverstein, Kate Hopper
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 7 6 4 6 9 - 8
The 3rd edition of your #1 go-to resource for veterinary critical care, Small Animal Critical Care Medicine, has been significantly updated to focus specifically on diag… Read more
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Request a sales quoteThe 3rd edition of your #1 go-to resource for veterinary critical care, Small Animal Critical Care Medicine, has been significantly updated to focus specifically on diagnostic and management strategies for the sickest veterinary patients. It covers critical care medical therapy, monitoring, and prognosis — from assessment and stabilization through the entire course of intensive care treatment. To make therapeutic decisions easier, clear and practical guidelines address underlying clinical findings, pathophysiology, outpatient follow-up, and long-term care. Editors Deborah Silverstein and Kate Hopper, along with leading experts from the veterinary emergency and critical care profession, have created this indispensable resource to help you and your team provide the highest standard of care for your critically ill patients.
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Contributors
- Foreword
- Video TOC
- List of Illustrations
- List of Tables
- Part I. Key Critical Care Concepts
- 1. Evaluation and triage of the critically ill patient
- Introduction
- Primary survey
- Supporting diagnostics
- Summary
- Selected references
- References
- 2. Physical examination and daily assessment of the critically ill patient
- Physical examination
- Point-of-care ultrasound
- Monitoring and laboratory data
- Drug dosages and metabolism
- Nutrition
- Nursing care
- References
- 3. Hemostasis
- Overview of platelet structure and function
- Primary hemostasis and the three-stage model of platelet activation
- Secondary hemostasis
- Overview of fibrinolysis
- Immunothrombosis
- Summary
- References
- 4. Cardiopulmonary resuscitation
- Preparedness and prevention
- Basic life support
- Monitoring
- Advanced life support
- Open-chest CPR
- Prognosis
- References
- 5. Postcardiac arrest care
- Propagating sustained ROSC
- Systemic response to ischemia and reperfusion: Sepsis-like syndrome
- Post-cardiac arrest brain injury
- Neurologic assessment and prognostication
- Myocardial dysfunction
- Persistent precipitating pathology
- References
- 6. Classification and initial management of shock states
- Pathophysiology
- Clinical presentation of circulatory shock
- Diagnostics and monitoring
- Treatment
- References
- 7. SIRS, MODS, and sepsis
- Background
- Evolution of definitions
- Assessment of MODS severity
- The apple score
- Assessment of animals with SIRS or MODS
- Summary
- References
- 8. Oxygen toxicity
- Pathophysiology
- Cellular effect of oxidative injury
- Ischemia-reperfusion injury
- Clinical effects of hyperoxia
- Hyperoxia in the critically ill
- Hyperbaric oxygen therapy
- Antioxidants
- Prevention and treatment of oxygen toxicity
- References
- 9. The endothelial surface layer
- Introduction
- The importance of the ESL in critical illness
- Structure and function
- Fluid movement across the endothelium
- Shedding of the ESL
- Methods for detection of ESL shedding
- ESL shedding in dogs and cats
- Protection of the ESL in disease
- Conclusion
- References
- 10. Hyperthermia and fever
- Thermoregulation
- Hyperthermia
- True fever
- Inadequate heat dissipation
- Benefits and detriments of fever
- Clinical approach to the hyperthermic patient
- Nonspecific therapy for febrile patients
- The febrile intensive care patient
- References
- 11. Interstitial edema
- Microvascular filtration
- Lymphatic drainage
- Serosal transudation
- Antiedema mechanisms
- Mechanisms of edema formation
- Chronic edemagenic conditions
- Conclusion
- References
- 12. Patient suffering in the intensive care unit
- Maslow’s hierarchy of needs and primal alert signals
- References
- 13. Predictive scoring systems in veterinary medicine
- Definition
- Outcome probability vs. clinical decision aid tools
- Applications in clinical practice
- Applications in hospital management
- Applications in research
- Demonstration of effective or ineffective randomization in randomized controlled trials
- Reduction of required sample sizes
- Construction of scoring systems
- Critical appraisal
- Conclusion
- References
- Part II. Respiratory Disorders
- 14. Control of breathing
- Central control of breathing
- Descending pathways
- Chemoreceptors and response to blood gases
- Other sensory receptors
- Abnormalities in the control of breathing
- References
- 15. Oxygen therapy
- Arterial oxygen content
- Indications for oxygen therapy
- Methods of oxygen administration
- Complications of oxygen therapy
- References
- 16. Hypoxemia
- Collection of blood samples for in vitro measurement
- Recognition of hypoxemia
- Mechanisms of hypoxemia
- Estimating the magnitude of the venous admixture
- References
- 17. Hypoventilation
- Definitions and measurement
- Mechanisms and etiologies of hypercapnia
- Clinical signs
- Diagnosis
- Treatment
- References
- 18. Upper airway disease
- History and clinical signs
- Patient evaluation
- Stabilization of patients with upper airway obstruction
- Diagnostics
- Diseases of the upper airway
- References
- 19. Tracheal collapse: Management & indications for tracheal stents
- Etiology
- Clinical signs
- Diagnostic evaluation
- Medical management
- Tracheal rings
- Tracheal stenting
- Post-stenting management considerations
- Tracheal stent complications
- Stenting for tracheal neoplasia
- References
- 20. Feline bronchopulmonary disease
- History and physical examination
- Laboratory testing
- Lung function testing
- Airway sampling
- Treatment
- Prognosis
- References
- 21. Lower airway disease in dogs
- Introduction
- Diagnosis of underlying conditions
- Standard treatment
- Disease exacerbation
- Conclusion
- References
- 22. Pulmonary hypertension
- Definitions and terminology
- Pathophysiology
- Assessment of PH
- Classification of PH
- Clinical findings
- Diagnostic evaluation
- Clinical management
- Prognosis and monitoring
- References
- 23. Pulmonary edema
- Pathophysiology
- Clinical presentation
- Diagnostic tests
- Treatment
- Prognosis
- References
- 24. Pneumonia
- Pathology
- Pathophysiology
- Specific types of pneumonia
- Clinical features
- Diagnostic approach
- Therapeutic approach
- Prevention
- Prognosis and outcome
- References
- 25. Acute respiratory distress syndrome
- Introduction
- Pathophysiology
- Causes/risk factors
- Diagnostic criteria
- Management
- Prognosis
- References
- 26. Pulmonary contusions and hemorrhage
- Pathophysiology and pathology
- Diagnosis
- Management
- Prognosis and outcome
- Atraumatic pulmonary hemorrhage
- Diagnostic evaluation
- Treatment
- Prognosis and outcome
- References
- 27. Pulmonary thromboembolism
- Pathophysiology
- History and clinical signs
- Physical examination
- Diagnostic testing
- Classification of acute pulmonary thromboembolism
- Treatment and prophylaxis
- References
- 28. Chest wall disease
- Chest wall anatomy and function
- Diagnosis of chest wall disease
- Causes of chest wall disease
- Spinal cord and neuromuscular disease
- Obesity
- References
- 29. Pleural space disease
- Pleural space
- Physical examination
- Imaging
- Thoracocentesis
- Pleural effusion
- Pneumothorax
- Diaphragmatic hernia
- Reexpansion pulmonary edema
- Acknowledgment
- References
- 30. Respiratory distress look-alikes
- Introduction
- Control of respiration
- Extrapulmonary causes of decreased oxygen delivery
- Metabolic derangements
- Hyperthermia
- Behavioral
- Brain disease
- Drugs
- Summary
- References
- Part III. Advanced Respiratory Support
- 31. High flow nasal oxygen
- Introduction
- Physiological benefits of high flow nasal oxygen (see Box 31.1)
- High flow nasal oxygen in small animal critical care
- Practical guidance for using high flow nasal oxygen
- References
- 32. Mechanical ventilation—core concepts
- Physiology
- The ventilator breath
- Ventilator settings
- Ventilator alarms
- Indications for mechanical ventilation
- Initiation of mechanical ventilation
- Goals
- Complications
- Troubleshooting
- Prognosis
- References
- 33. Mechanical ventilation—advanced concepts
- Introduction
- Patient–ventilator asynchrony
- Lung protective ventilation
- Refractory hypoxemia
- Pressure modes of advanced mechanical ventilation
- References
- 34. Jet ventilation
- Physics and physiology
- Equipment
- Indications
- Disadvantages
- Monitoring of gas exchange during jet ventilation
- Ventilator settings
- References
- 35. Ventilator waveforms
- Waveform types
- Patient–ventilator dyssynchrony
- Summary
- References
- 36. Anesthesia and monitoring of the ventilator patient
- Injectable anesthetics
- Adjunct agents
- Making an anesthesia plan for the ventilator patient
- Withdrawal of anesthesia for ventilator weaning
- Monitoring of the mechanically ventilated patient
- References
- 37. Nursing care of the ventilator patient
- General monitoring
- Airway management
- Oral care
- Eye care
- Urinary care
- Gastrointestinal tract care
- Recumbent patient care
- Apparatus care
- References
- 38. Discontinuing mechanical ventilation
- When to wean
- Anesthetic considerations
- Approaches to weaning
- Weaning prediction
- Tracheostomy and weaning
- Extubation
- References
- 39. Ventilator-induced lung injury
- Definitions
- Mechanisms of ventilator-induced lung injury
- Histopathology
- Clinical relevance
- Prevention
- References
- 40. Ventilator-associated pneumonia
- Pathogenesis
- Diagnosis
- Prevention
- Treatment
- References
- Part IV. Cardiovascular Disorders
- 41. Mechanisms of heart failure
- Neurohormonal aspects of heart failure
- Myocardial remodeling
- Abnormal calcium ion handling
- Abnormal myocardial energy production
- Global cardiac function
- Clinical staging and assessment of heart failure
- References
- 42. Ventricular failure and myocardial infarction
- Diagnosis
- Treatment
- References
- 43. Feline cardiomyopathy
- Classification and etiology of feline cardiomyopathy
- Pathophysiology
- Clinical presentation and findings
- Diagnostic approach
- Treatment
- References
- 44. Canine cardiomyopathy
- Dilated cardiomyopathy
- Arrhythmogenic right ventricular cardiomyopathy
- Hypertrophic cardiomyopathy
- Atrioventricular myopathy
- References
- 45. Canine myxomatous mitral valve disease
- Introduction
- Pathology and pathophysiology
- Historical and physical examination findings
- Clinicopathologic findings and cardiac biomarkers
- Thoracic radiographic findings
- Cardiac and thoracic ultrasound findings
- Emergency management
- Management of complicating factors
- Monitoring
- Long-term management
- Prognosis
- References
- 46. Blunt cardiac injury
- Definitions and pathogenesis
- Diagnosis and clinical assessment
- Treatment
- Summary
- References
- 47. Pericardial diseases
- Pericardial effusion
- Cardiac tamponade
- Clinical presentation
- Diagnosis
- Management of cardiac tamponade
- Constrictive pericardial disease
- Congenital pericardial disease
- References
- 48. Bradyarrhythmias and conduction disturbances
- Definition
- Differential diagnosis
- Treatment
- References
- 49. Supraventricular tachyarrhythmias
- Introduction
- Electrocardiographic diagnosis
- Treatment
- References
- 50. Ventricular tachyarrhythmias
- Introduction
- Definitions
- Electrocardiographic diagnosis
- Causes of ventricular tachycardia
- Practical approach to ventricular tachycardia treatment
- References
- 51. Myocarditis
- Infectious myocarditis
- Noninfectious myocarditis
- Diagnosis
- Treatment
- References
- 52. Cardiac biomarkers
- Blood-based cardiac biomarkers
- Clinical use of NT-proBNP and BNP testing in the emergency setting
- Clinical use of cardiac troponin in the emergency setting
- Important limitations and considerations involving cardiac biomarker testing
- References
- 53. Systemic hypertension
- Normal determinants of blood pressure
- Pathogenesis of systemic hypertension
- Definitions and causes of systemic hypertension
- Adverse effects associated with systemic hypertension
- Diagnosis of systemic hypertension
- Treatment of systemic hypertension
- References
- 54. Cardiopulmonary bypass
- Introduction
- Fundamentals of cardiopulmonary bypass
- Postoperative management and complications
- Summary
- Acknowledgments
- References
- Part V. Electrolyte and Acid-Base Disturbances
- 55. Sodium disorders
- Distribution of body water
- Osmolality and osmotic pressure
- Regulation of plasma osmolality
- Total body sodium content versus plasma sodium concentration
- Hypernatremia
- Hyponatremia
- Clinical signs of hyponatremia
- A rapid drop in plasma sodium concentration and cerebral edema
- Volume expansion in the hypovolemic patient that is hyponatremic or hypernatremic
- References
- 56. Potassium disorders
- Normal distribution of potassium in the body and its steady state regulation
- Hypokalemia: Definition and causes
- Management of hypokalemia
- Anticipated complications
- Hyperkalemia: Definition and causes
- Pseudohyperkalemia
- Consequences
- Treatment of hyperkalemia
- Acknowledgements
- References
- 57. Calcium disorders
- Calcium homeostasis
- Calcium measurement
- Hypercalcemia
- Hypocalcemia
- References
- 58. Magnesium and phosphate disorders
- Magnesium
- Phosphate
- References
- 59. Traditional acid-base analysis
- Introduction
- Sample collection and handling
- Traditional approach
- Acid-base analysis
- Causes of acid-base abnormalities
- Bicarbonate therapy
- References
- 60. Nontraditional acid-base analysis
- The strong ion difference approach
- Semiquantitative approach
- Conclusion
- Clinical examples
- References
- 61. Hyperlactatemia
- Biochemistry
- Physiology
- Etiology of hyperlactatemia
- d-lactate
- Clinical use
- Prognostic use
- Diagnostic use
- Lactate as a therapeutic endpoint
- References
- 62. Urine osmolality and electrolytes
- Introduction
- Urine osmolality
- Urinary sodium
- Urine potassium
- Urine chloride
- Free water clearance
- References
- Part VI. Fluid Therapy
- 63. Assessment of hydration
- Variability in assessing hydration
- Distribution and control of total body water
- Measuring total body water
- Clinical assessment of hydration status
- Hypotonic fluid loss
- Isotonic fluid loss
- Special challenges
- Conclusion
- References
- 64. Assessment of intravascular volume
- Introduction
- Defining a fluid bolus
- Mini-bolus and passive leg raising
- Conclusions
- References
- 65. Crystalloids and hemoglobin-based oxygen-carrying solutions
- Crystalloids
- Hypotonic fluids
- Hypertonic fluids
- Acid-base effects of crystalloids
- Hemoglobin-based oxygen-carrying solutions
- Conclusion
- Acknowledgement
- References
- 66. Colloid solutions
- Synthetic starch colloids
- Natural colloids
- Conclusion
- References
- 67. Daily intravenous fluid therapy
- Total body water
- Movement of fluids within the body
- Fluid therapy plan
- Fluid type
- Monitoring
- Discontinuation of fluid therapy
- Acknowledgements
- References
- 68. Shock fluids and fluid challenge
- Administration of shock fluids
- Resuscitation endpoints and monitoring
- Shock fluids
- Hypotensive resuscitation
- Fluid challenge
- References
- 69. Transfusion medicine
- Introduction
- Anemia and RBC transfusions
- Platelet transfusions
- Plasma transfusions
- Albumin transfusions
- Blood sources and donor management
- Blood donation
- Blood banking
- References
- 70. Blood types, pretransfusion compatibility, and transfusion reactions
- Blood types
- Precompatibility testing
- Transfusion reactions
- Storage lesion
- Leukoreduction
- Transfusion administration and monitoring
- References
- 71. Hemorrhagic shock
- Assessment of the hemorrhagic shock patient
- Management of controlled hemorrhage
- Management of uncontrolled hemorrhage
- Special considerations
- References
- Part VII. Endocrine Disorders
- 72. The diabetic patient in the ICU
- Insulin
- Nutritional support
- References
- 73. Diabetic ketoacidosis
- Pathophysiology
- Signalment
- History and clinical manifestation
- Diagnosis
- Additional diagnostic evaluation
- Therapy
- Outcome
- References
- 74. Hyperglycemic hyperosmolar syndrome
- Pathogenesis
- History and clinical signs
- Physical examination
- Diagnostic criteria
- Treatment
- Monitoring
- Postcrisis therapy
- Prognosis
- References
- 75. Hypoglycemia
- Normal glucose homeostasis
- Clinical signs and consequences of hypoglycemia
- Diagnosis of hypoglycemia
- Causes of hypoglycemia
- Treatment of hypoglycemic crisis
- References
- 76. Diabetes insipidus
- Osmotic regulation and pathophysiology of diabetes insipidus
- Implications of diabetes insipidus in the critically ill patient
- References
- 77. Syndrome of inappropriate antidiuretic hormone secretion
- Normal physiology
- Syndrome of inappropriate antidiuretic hormone
- Etiology
- Diagnosis
- Management
- References
- 78. Thyroid storm
- Pathogenesis
- Precipitating events
- Clinical signs
- Diagnosis
- Laboratory abnormalities
- Treatment
- Outcome
- References
- 79. Hypothyroid crisis in the dog
- Pathophysiology
- Risk factors
- Clinical signs and physical examination findings
- Clinical pathology
- Differential diagnosis
- Treatment
- Outcome
- References
- 80. Pheochromocytoma
- Clinical signs
- Diagnosis
- Treatment
- Prognosis
- References
- 81. Critical illness-related corticosteroid insufficiency
- Background
- Pathophysiology
- Clinical manifestations
- Diagnosing CIRCI in people
- Diagnosing CIRCI in dogs and cats
- Treating CIRCI in people
- Treating CIRCI in dogs and cats
- Prognosis
- References
- 82. Hypoadrenocorticism
- Who is affected?
- Etiology
- Clinical presentation
- Diagnosis
- Treatment
- Associated disorders
- Prognosis
- References
- Part VIII. Neurologic Disorders
- 83. Neurological evaluation of the ICU patient
- Mentation
- Gait and posture
- Cranial nerves
- Proprioceptive positioning
- Segmental reflexes
- Sensation/nociception
- Neurologically abnormal
- Clinical challenges in the critical patient with neurological disease
- Next steps
- References
- 84. Seizures and status epilepticus
- Definitions
- Classification
- Pathophysiology
- Etiology
- Diagnostic plan
- Treatment plan
- References
- 85. Intracranial hypertension
- Normal physiology of the brain
- Clinical assessment of intracranial hypertension
- Treatment of ICH
- Prognosis
- References
- 86. Tetanus
- Etiology
- Pathogenesis
- Clinical presentation
- Diagnosis
- Treatment
- Prognosis
- References
- 87. Hepatic encephalopathy
- Causes of hepatic encephalopathy
- Diagnosing hepatic encephalopathy
- Managing hepatic encephalopathy
- References
- Part IX. Infectious Disorders
- 88. Hospital-associated infections and zoonoses
- HAI in dogs and cats
- Risk factors
- Antimicrobial-resistant nosocomial pathogens
- Zoonoses, anthropozoonoses and HAI’s in the ICU
- Conclusions
- References
- 89. Febrile neutropenia
- Neutrophil physiology
- Pathophysiology of neutropenia
- Clinical presentation and diagnostic tests
- Treatment and supportive care
- References
- 90. Sepsis and septic shock
- Introduction
- Current sepsis definitions
- Pathobiology of sepsis
- Diagnosis
- Resuscitation and treatment of sepsis and septic shock
- Prognosis
- References
- 91. Bacterial infections
- Introduction
- Bacterial structure and taxonomy
- Diagnosis of bacterial infections
- Gram-positive bacteria of clinical importance
- Gram-negative bacteria of clinical importance
- Mycoplasma and intracellular bacteria of clinical importance
- Treatment and prevention of bacterial infections
- Conclusion
- References
- 92. Fungal infections
- Fungal organisms
- Diagnosis
- Treatment and outcome
- References
- 93. Viral infections
- Canine distemper virus infection
- Influenza virus infections
- Other emerging respiratory viral infections of dogs
- Feline panleukopenia
- Feline respiratory viral disease
- Feline infectious peritonitis
- Severe acute respiratory syndrome coronavirus-2
- References
- 94. Canine parvovirus infection
- Parvoviridae
- Epidemiology
- Risk factors for infection
- Transmission and pathogenesis
- Clinical signs
- Clinical pathology
- Sepsis, systemic inflammatory response syndrome, and coagulation
- Diagnostic investigations
- Diagnostic imaging
- Treatment
- Nutrition
- Antiviral drugs
- Outpatient protocol
- Controversial therapies
- Prevention of transmission
- Prognosis
- References
- 95. Infective endocarditis
- Pathophysiology
- Incidence, signalment, and presenting complaint
- Predisposing factors
- Etiologic agents
- Clinical abnormalities
- Clinicopathologic abnormalities
- Diagnosis
- Treatment
- Prognosis
- References
- 96. Urosepsis
- Introduction
- Pathogenesis
- Causes of urosepsis
- Conclusion
- References
- 97. Necrotizing soft tissue infections
- Diagnosis
- Treatment
- Extracorporeal plasma treatment
- Conclusion
- References
- 98. Catheter-related bloodstream infections
- Pathophysiology
- Definitions
- Risk factors
- Incidence
- Diagnosis
- Treatment
- Prevention
- Acknowledgements
- References
- 99. Multidrug-resistant infections
- Definitions
- Risk factors for multidrug-resistant organisms
- Escalation versus deescalation therapy
- Specific multidrug-resistant organisms
- References
- 100. Infectious disease control in the ICU
- Health care-associated infections and biosafety
- HCAIs in intensive care settings
- HCAI prevention and control
- Surveillance
- Active infection control
- Feedback to stakeholders
- Dedicated biosafety team
- References
- Part X. Hematologic Disorders
- 101. Hypercoagulable states
- Mechanisms of thrombophilia
- Diagnostics
- Common conditions in veterinary medicine
- Management of hypercoagulable conditions
- Conclusion
- References
- 102. Feline aortic thromboembolism
- Introduction
- Pathophysiology
- Clinical presentation
- Diagnosis
- Prognosis
- Thrombolysis in fate
- Antiplatelet therapy in fate
- Anti-coagulant therapy in fate
- Nursing and supportive care in fate
- Prevention of fate
- References
- 103. Platelet disorders
- Acquired thrombocytopenia
- Acquired platelet disorders
- Congenital platelet disorders
- General diagnostic approach to platelet disorders
- Treatment of platelet disorders
- References
- 104. Coagulopathy in the ICU
- Normal hemostasis
- Abnormal bleeding tendency
- Clinical signs associated with hemostatic dysfunction
- Laboratory tests for hemostasis
- Hemostatic disorders in critically ill animals
- Therapeutic management of coagulopathy
- References
- 105. Management of the bleeding patient in the ICU
- Diagnostic approach to a bleeding patient
- Treatment of the bleeding patient
- Suggested reading
- References
- 106. Anemia in the ICU
- Introduction
- Oxygen transport by erythrocytes
- Erythropoiesis
- Physiological adaptation to anemia
- Characterization of anemia
- Clinical approach to anemia in the ICU
- Therapeutic approach to anemia
- References
- 107. Dyshemoglobinemias
- Introduction
- Causes of dyshemoglobinemia
- Diagnosis of dyshemoglobinemias
- References
- 108. Acute hemolytic disorders
- Evaluation of the patient with hemolysis
- Fragmentation hemolysis
- Toxicant-induced hemolysis
- Heritable hemolysis
- Infection-related hemolysis
- Immune-mediated hemolysis
- References
- Part XI. Intraabdominal Disorders
- 109. Acute abdominal pain
- Diagnostic evaluation
- Surgical versus medical management
- References
- 110. Acute pancreatitis
- Pathophysiology
- Clinical presentation
- Diagnosis
- Determining severity
- Treatment
- Outcome
- Conclusion
- References
- 111. Acute cholecystitis
- Clinical findings
- Common causes of cholecystitis in dogs and cats
- Conclusion
- References
- 112. Hepatitis and cholangiohepatitis
- Introduction
- Historical findings
- Physical examination findings
- Causes of hepatitis and cholangiohepatitis in dogs and cats
- References
- 113. Hepatic failure
- Pathophysiology
- Clinical signs
- Diagnosis
- Therapy
- Prognosis
- Future therapies
- References
- 114. Portal hypertension
- Pathogenesis of PH
- Classification of PH
- Diagnosis of PH
- Clinical consequences of PH
- Treatment of PH
- References
- 115. Portosystemic shunt management
- Preoperative stabilization
- Medical management
- Surgical options
- Postoperative monitoring
- Postoperative complications
- Prognosis
- References
- 116. Acute gastroenteritis
- Gastroenteritis
- History and physical examination
- Diagnostic testing
- Therapeutic approach
- Prognosis
- References
- 117. Gastrointestinal hemorrhage
- Etiology
- History and physical examination
- Diagnostic tests
- Treatment
- Prognosis
- References
- 118. Regurgitation and vomiting
- Differentiation of vomiting and regurgitation
- Regurgitation
- Vomiting
- Conclusion
- References
- 119. Diarrhea
- Pathophysiologic mechanisms of diarrhea
- Iatrogenic causes of diarrhea
- Primary gastrointestinal causes of diarrhea
- Extra-gastrointestinal diseases causing diarrhea
- Diagnostic evaluation
- Treatment
- Conclusions
- References
- 120. Peritonitis
- Etiology
- Diagnostics
- Treatment
- Postoperative therapy and monitoring
- Conclusion
- References
- Part XII. Urogenital Disorders
- 121. Acute kidney injury
- Etiology
- Pathophysiology
- Clinical presentation
- Diagnosis
- Treatment
- Prognosis
- References
- 122. Chronic kidney disease
- Etiology
- Pathophysiology
- Clinical presentation
- Diagnosis
- Treatment
- Long-term management
- Advanced therapeutic modalities
- Prognosis
- References
- 123. Kidney transplantation
- Indications
- Case selection
- Donor selection
- Preoperative management
- Anesthetic management
- Surgery
- Postoperative management and perioperative complications
- Long-term management and complications
- Canine transplantation
- Conclusion
- References
- Part XIII. Nutrition
- 124. Nutritional assessment
- Impacts of nutritional support during critical illness
- Screening systems used for nutritional assessments
- Conclusion
- References
- 125. Nutritional modulation of critical illness
- Omega-3 fatty acids
- Antioxidants
- Immune-modulating nutrients
- Nucleotides
- Probiotics
- Conclusion
- References
- 126. Enteral nutrition
- Introduction
- Importance of nutritional support
- Pathophysiology of malnutrition
- Nutritional assessment
- Assessing nutritional needs
- When to initiate feeding
- Choosing the most appropriate feeding tube
- Nutritional plan
- Implementing nutritional plan
- Monitoring and reassessment
- Complications
- Conclusions
- References
- 127. Parenteral nutrition
- Introduction
- Indications for PN support
- Parenteral nutrition
- Components of parenteral nutrition
- Formulation of parenteral nutrition solutions
- Administering parenteral nutrition
- Monitoring
- Complications
- Summary
- References
- Part XIV. Trauma
- 128. Traumatic brain injury
- Incidence and prevalence of head injury
- General approach to the patient with a head injury
- Pathophysiology
- Neurologic assessment
- Diagnostic tests and monitoring
- Treatment
- Prognosis
- References
- 129. Wound management
- Wound healing principles
- Initial patient assessment
- Debridement and lavage
- Dressing and bandaging
- Wound closure
- Additional wound management modalities
- Antimicrobial therapy
- Patient care
- Complications
- Prognosis
- References
- 130. Thermal burn injury
- Definitions
- Patient assessment and medical management
- Burn wound management
- References
- Part XV. Anesthesia and Pain Management
- 131. Pain assessment
- Pain assessment guidelines and tools
- Pain assessment in critically ill patients
- References
- 132. Sedation of the critically ill patient
- Introduction
- Specific drug techniques for sedation
- References
- 133. Anesthesia in the critically ill patient
- Stabilization
- Premedication
- Induction
- Induction agents
- Maintenance anesthesia
- Anesthesia monitoring
- Recovery
- Summary
- References
- 134. Analgesia and constant rate infusions
- Analgesia
- Opioids
- Nonsteroidal antiinflammatory drugs
- α2-adrenergic agonists
- Transdermal analgesics
- N-methyl-D-aspartate receptor antagonists
- Acepromazine
- Infiltrative and local anesthetics
- Epidural analgesics
- Constant rate infusions
- Morphine-lidocaine-ketamine
- Conclusion
- References
- 135. Physical rehabilitation for the critical care patient
- Introduction
- Pain management
- Passive therapy
- Active therapy
- Pulmonary therapy
- Summary
- References
- 136. Integrative veterinary medicine for the intensive care unit patient
- Acupuncture
- Massage therapy
- Photomedicine (laser therapy and light-emitting diode)
- Pulsed electromagnetic field therapy
- Music therapy
- Botanical medications and challenges for the critically ill patient
- Conclusion
- References
- Part XVI. Environmental Emergencies
- 137. Smoke inhalation
- Introduction and epidemiology
- Pathophysiology
- Physical examination
- Diagnosis and initial assessment
- Treatment
- Prognosis
- References
- 138. Hypothermia
- Classification
- Review of thermoregulation
- Physiologic effects of hypothermia
- Core body temperature measurement
- Rewarming
- Therapy
- Cardiopulmonary resuscitation
- References
- 139. Heat stroke
- Introduction
- Physiology, pathogenesis, and pathophysiology
- Physical examination
- Laboratory evaluation
- Treatment and monitoring
- Prognosis
- References
- 140. Drowning and submersion injury
- Definitions
- Incidence and epidemiology
- Pathophysiology of injury
- Diagnostic tests and monitoring
- Treatment
- Outcome
- References
- Part XVII. Miscellaneous Disorders
- 141. Anaphylaxis
- Mechanisms of anaphylaxis
- Histamine
- Clinical manifestations
- Diagnosis
- Treatment
- References
- 142. Gas embolism
- Gas embolization associated with intravenous access
- Gas embolization during scoping procedures
- Gas embolization during surgery
- Gas embolization during cardiac procedures
- Gas embolization from lung biopsy
- Gas embolization during hyperbaric therapy
- Detection of air emboli
- Management of air embolism
- References
- 143. Subcutaneous emphysema
- Introduction
- Causes
- Pathophysiology
- Clinical presentation
- Diagnostics
- Treatment
- Outcome
- References
- 144. Ocular disease in the intensive care unit
- Warning signs of developing ocular disease
- Ocular diseases most likely to develop in the ICU patient
- References
- 145. Critically ill neonatal and pediatric patients
- Physical examination findings
- Laboratory values
- Imaging: Radiographs
- Intravenous and intraosseous catheterization
- Fluid requirements
- Temperature control
- Nutrition
- Monitoring
- Pharmacology
- Sepsis
- Conclusion
- References
- 146. Critically ill geriatric patients
- Laboratory values
- Imaging
- Fluid therapy
- Nutrition
- Pharmacology
- Neurological function
- Conclusion
- References
- Part XVIII. Pharmacology
- 147. Catecholamines
- Hypotension
- Decreased myocardial contractility
- Catecholamine drugs
- Norepinephrine
- Choosing the right catecholamine
- Combination therapies
- Push-dose vasopressors
- Other effects of catecholamines
- Acknowledgements
- References
- 148. Vasopressin
- Physiology of vasopressin
- Physiologic effects of vasopressin
- Pharmacology
- Clinical uses
- Adverse effects
- Vasopressin antagonists
- References
- 149. Antihypertensives
- Antihypertensive drugs
- Goals of treatment
- References
- 150. Pimobendan
- Mechanisms of action
- Pharmacology
- Clinical uses
- Adverse effects
- Conclusions
- References
- 151. Diuretics
- Physiology of diuresis and antidiuresis
- Pharmacology
- Indications for diuretic therapy
- References
- 152. Appetite stimulants
- Introduction
- Defining abnormal appetite
- Appetite regulation
- Nutritional assessment and patient monitoring
- When to intervene
- Appetite stimulants
- Summary
- References
- 153. Gastrointestinal protectants
- Proton pump inhibitors
- Sucralfate
- Histamine-2 receptor antagonists
- Prostaglandin analogs
- Traditional oral antacids that titrate gastric acid
- Future drug therapy
- Potential complications of increased gastric pH
- References
- 154. Antiemetics and prokinetics
- Antiemetics
- Prokinetic drugs
- References
- 155. Opioid agonists and antagonists
- Terminology and history
- Opioid receptors and mechanism of action
- Physiologic effects of opioids
- Metabolism and excretion
- Potency and effectiveness of opioids
- Epidural opioids
- Characteristics of clinically useful opioids
- Opioid antagonists: Naloxone, nalmefene, and naltrexone
- References
- 156. Benzodiazepines
- Action
- Diazepam versus midazolam
- Benzodiazepine effects
- Benzodiazepines and cats
- Indications
- Hepatic encephalopathy
- References
- 157. α2-agonists and antagonists
- α2 adrenoceptors
- Effects of α2-agonists
- Imidazoline receptors
- Drugs
- Clinical use
- α2-antagonists
- Conclusion
- References
- 158. Nonsteroidal antiinflammatory drugs
- Brief overview of cox enzymes and prostaglandin production
- Potential adverse effects
- Other antiinflammatory drugs
- Selecting candidates for the administration of NSAIDs in critical care
- References
- 159. Gabapentin
- Use of gabapentin for anxiolysis
- Neuropathic pain
- Seizures
- Adverse effects of gabapentin
- Pharmacokinetics and dosing
- Summary
- References
- 160. Tramadol
- Mechanisms of action
- Pharmacology
- Clinical uses
- Adverse effects
- Conclusions
- References
- 161. Trazodone
- Mechanism of action
- Adverse effects
- Medication interactions
- Serotonin syndrome
- References
- 162. Cannabinoid medicine in intensive care unit patients
- Regulatory hurdles
- Veterinary research
- Cannabis basics for critical care providers
- Visions for veterinary cannabinoid medicine
- References
- 163. Anticonvulsants
- Introduction
- Phenobarbital
- Bromide
- Zonisamide
- Levetiracetam
- Benzodiazepines (see also Chapter 156)
- Imepitoin
- Cannabinoids (see also Chapter 162)
- References
- 164. Antiplatelet drugs
- Platelet physiology
- Antiplatelet drugs
- References
- 165. Anticoagulants
- Pathogenesis
- Indications for anticoagulant use
- Anticoagulants
- Conclusion
- References
- 166. Thrombolytic agents
- Pathophysiology of thrombolysis
- Streptokinase
- Urokinase
- Tissue plasminogen activator
- Other thrombolytic agents
- Indications for thrombolysis
- References
- 167. Hemostatic drugs
- Systemic hemostasis
- Local hemostasis
- Dressings
- References
- 168. Antiarrhythmic agents
- Classification schemes
- Class I antiarrhythmic agents
- Class III antiarrhythmic agents
- Class IV antiarrhythmic agents
- Other antiarrhythmic agents
- Antiarrhythmic devices and procedures
- References
- 169. Inhaled medications
- Introduction
- Principles of aerosol deposition in the lungs
- Delivery systems
- Clinical applications
- Conclusion
- References
- 170. Complications of chemotherapy agents
- Principles of chemotherapy
- Testing for chemotherapy drug sensitivity
- Toxicities and treatment of chemotherapy-related emergencies
- References
- 171. Antitoxins and antivenoms
- Tetanus antitoxin
- Tick antitoxin
- Botulism antitoxin
- Black widow spider antivenom
- Scorpion antivenom
- Snake antivenom
- References
- Part XIX. Antimicrobial Therapy
- 172. Antimicrobial use in the critical care patient
- Principles of antimicrobial prescriptions
- Antimicrobial stewardship and deescalation
- Conclusion
- References
- 173. β-lactam antimicrobials
- Mechanism of action
- Resistance to β-lactams
- Pharmacokinetics
- Specific antimicrobials
- Dosing
- Adverse effects
- References
- 174. Aminoglycosides
- Introduction
- Spectrum
- Mechanism of action
- Pharmacology
- Nonparenteral use of aminoglycoside
- References
- 175. Fluoroquinolones
- Introduction
- Mechanism of action
- Spectrum of activity
- Pharmacology
- Resistance
- Clinical use
- Dosing and administration
- Adverse effects
- Selected fluoroquinolones
- Acknowledgements
- References
- 176. Antifungal therapy
- Classes of antifungal drugs
- Recommendations for specific fungal infections
- References
- 177. Miscellaneous antibiotics
- Introduction
- Metronidazole
- Chloramphenicol
- Clindamycin
- Tetracycline
- Sulfonamides and trimethoprim
- Antimicrobials used specifically to treat multidrug-resistant pathogens
- Acknowledgements
- References
- Part XX. Extracorporeal Therapy
- 178. Renal replacement therapies
- Principles of dialysis
- Indications
- Contraindications
- Components of dialysis
- Dialysis prescription
- Complications and other considerations
- Outcome and prognosis
- Summary
- References
- 179. Apheresis
- Equipment
- Principles of apheresis
- Indications
- Future applications
- References
- 180. Extracorporeal therapies for blood purification
- Introduction
- Medical management of intoxications
- Basic pharmacokinetics
- Considerations for blood purification with ECT
- Treatment modalities
- Treatment guidelines
- Conclusions
- References
- Part XXI. Monitoring
- 181. Hemodynamic monitoring
- Continuous electrocardiogram monitoring
- Blood pressure monitoring
- Central venous pressure monitoring
- Pulmonary artery pressure monitoring
- Mixed venous and central venous oxygen saturation
- Sonographic assessment of caudal vena cava collapsibility
- References
- 182. Cardiac output monitoring
- Normal determinants of cardiac output
- Indications for monitoring cardiac output
- Measurement of cardiac output
- Conclusions
- References
- 183. Electrocardiogram evaluation
- Indications
- Electrocardiographic principles
- Technique and placement of the ECG
- Electrocardiogram waveforms
- Electrocardiogram interpretation
- Effects of disease states on the electrocardiogram
- References
- 184. Oximetry monitoring
- Oxygen transport
- Technology of oximetry
- Co-oximetry
- Pulse oximetry
- References
- 185. Colloid osmotic pressure and osmolality
- Colloid osmotic pressure
- Osmolality
- References
- 186. Coagulation and platelet monitoring
- Assessment of primary hemostasis
- Assessment of secondary hemostasis
- Assessment of fibrinolysis
- Global assessment of coagulation – viscoelastic testing (see also Chapter 187, viscoelastic monitoring)
- Monitoring anticoagulation – anti-Xa activity assay
- References
- 187. Viscoelastic monitoring
- Introduction
- Instrumentation
- Provets recommendations
- Tracing, parameters, and global coagulation indices
- Viscoelastic assays
- VCM-Vet
- Clinical applications
- Limitations
- Acknowledgements
- References
- 188. Intraabdominal pressure monitoring
- Definitions and incidence
- Risk factors
- Pathophysiology
- Methods of intraabdominal pressure measurement
- Physiologic effects of intraabdominal hypertension
- General considerations
- Acknowledgments
- References
- 189. Point-of-care ultrasound in the ICU
- Equipment
- Binary or closed questions
- Abdominal pocus
- Pleural and lung ultrasound
- Cardiac pocus
- Ultrasound-guided vascular access
- References
- 190. Capnography
- Nondiverting and diverting monitors
- Technology
- Physiology
- Capnogram interpretation
- References
- 191. Intracranial pressure monitoring
- Intracranial pressure
- Intracranial pressure monitoring systems
- ICP monitoring in small animals
- References
- 192. Urine output
- Measurement of urine output
- Determinants of urine output
- Normal urine output
- Abnormal urine output
- Fluid balance
- References
- Part XXII. Procedures
- 193. Peripheral venous catheterization
- Catheter types
- Catheter insertion site
- Percutaneous insertion technique
- Challenging vascular access
- Intraosseous cannulation
- Complications associated with catheterization
- Catheter maintenance
- References
- 194. Intraosseous catheterization
- Introduction
- Physiology
- Indications
- Contraindications
- Methods
- Complications
- References
- 195. Central venous catheterization
- General concepts
- Catheter types
- Catheter insertion site
- Catheter insertion
- Ultrasound guided central venous catheter insertion
- Complications and catheter maintenance
- Central venous catheter removal
- Summary
- References
- 196. Blood film evaluation
- Blood film preparation
- Blood film evaluation
- White blood cell responses1,2
- Red blood cell responses
- Platelet responses
- Leukemia (myeloid and lymphoid)
- References
- 197. Endotracheal intubation and tracheostomy
- Introduction
- Endotracheal intubation
- Tracheostomy
- Summary
- References
- 198. Thoracocentesis
- Indications
- Materials
- Techniques
- Diagnostic evaluation of the aspirate
- Postprocedure care
- Complications
- References
- 199. Thoracostomy tube placement and drainage
- Introduction
- Indications
- Materials
- Techniques
- Drainage
- Maintenance and care
- Removal
- Complications
- References
- 200. Abdominocentesis
- Indications
- Technique
- Abdominal fluid analysis
- Conclusion
- References
- 201. Arterial catheterization
- Patient preparation
- Percutaneous arterial catheter placement
- Ultrasound-guided arterial catheterization
- Surgical cutdown for arterial catheter placement
- Maintenance of the arterial catheter
- Complications of arterial catheterization
- Three-syringe technique
- References
- 202. Blood gas sampling
- Introduction
- Sampling basics
- Temperature correction
- Preanalytical error
- Analytical errors
- Summary
- References
- 203. Temporary cardiac pacing
- Indications for temporary cardiac pacing
- Description of the temporary pacemaker systems
- Troubleshooting
- Complications
- References
- 204. Cardioversion
- Definitions
- Mechanism of cardioversion
- Cardioverter-defibrillator
- Approach to synchronized cardioversion
- References
- 205. Defibrillation
- Introduction
- Mechanism of action
- Equipment
- Technique and timing
- Precautions
- Monitoring and post resuscitation care
- References
- 206. Cerebrospinal fluid sampling and interpretation
- CSF formation and functions
- Indications for CSF collection and analysis
- Contraindications and risks of CSF tap
- CSF collection techniques
- Analysis of CSF
- Interpretation of common CSF findings
- References
- 207. Urinary catheterization
- Indications
- Risk and complications
- Catheter types
- Placement technique
- Securing the catheter
- Closed collection system
- Care of an indwelling urinary catheter
- References
- 208. Urinary diversion techniques
- Upper urinary tract
- Lower urinary tract
- Conclusions
- References
- Part XXIII. Intensive Care Unit Design and Management
- 209. Intensive care unit facility design
- The design process
- Location in the hospital
- Arrangement and size
- Unit configuration
- Utilities
- Environmental aspects
- Details and common design elements
- References
- 210. Management of the intensive care unit
- Staffing
- Veterinarians
- Nursing staff
- Scheduling
- Staff/patient ratio
- Communication
- Handling stress and burnout
- References
- 211. Client communication, grief, and veterinary wellness
- Other client considerations
- Understanding grief and loss
- Veterinary wellness and well-being
- Partnering with mental health professionals
- References
- 212. Prevention of compassion fatigue and burnout
- Introduction
- Compassion fatigue
- Burnout
- Helpful resources
- References
- Appendices
- Index
- No. of pages: 1280
- Language: English
- Edition: 3
- Published: September 3, 2022
- Imprint: Saunders
- Hardback ISBN: 9780323764698
DS
Deborah Silverstein
Affiliations and expertise
Assistant Professor (Critical Care), Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, PA, USAKH
Kate Hopper
Affiliations and expertise
Assistant Professor, Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CARead Small Animal Critical Care Medicine on ScienceDirect