Why is the severe anaphylaxis patient actually unstable, and how do you treat it?

This was a fascinating discussion with Dr Ryan Smith about his group’s study on dogs with severe anaphylaxis that did not receive early epinephrine as part of their management.

We cover those 49 cases, basic physiology, hepatic rupture and the protocol that Dr Smith and his team use. That protocol is available as supporting information to the study itself here:

Canine Anaphylaxis Patients Receiving Late Epinephrine or No Epinephrine: 49 Cases (2019–2023)

https://onlinelibrary.wiley.com/doi/10.1111/vec.70102

Other articles also mentioned:

Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity

https://onlinelibrary.wiley.com/doi/10.1111/vec.13345

Acute hepatic rupture causing hemoperitoneum in a dog with anaphylaxis

https://onlinelibrary.wiley.com/doi/10.1002/vms3.1391

Clinical characteristics of two-hundred thirty-two dogs (2006-2018) treated for suspected anaphylaxis in Perth, Western Australia

https://onlinelibrary.wiley.com/doi/10.1111/avj.13114