Here we discuss how best to use fluid therapy in our critical patients – specifically, the concepts of fluid stewardship, hidden fluids, replacement versus maintenance fluids, sodium load and when fluid overload can happen.

Dr Alexandra Pfaff has been building a fluid stewardship team and recently authored a study entitled: Retrospective Evaluation of Risk Factors and Outcome in Dogs With and Without Fluid Overload During Hospitalization in the journal of veterinary internal medicine.

https://onlinelibrary.wiley.com/doi/10.1111/jvim.70132

The International Fluid Academy https://www.fluidacademy.org/

Here we discuss how best to use fluid therapy in our critical patients – specifically, the concept of fluid stewardship, hidden fluids, replacement versus maintenance fluids, sodium load and when fluid overload can happen. All in relation to a recent study entitled: Retrospective Evaluation of Risk Factors and Outcome in Dogs With and Without Fluid Overload During Hospitalization in the journal of veterinary internal medicine.

https://onlinelibrary.wiley.com/doi/10.1111/jvim.70132

The International Fluid Academy https://www.fluidacademy.org/

This study documents a higher frequency of seronegative myasthenia gravis dogs than was previously thought to be the case and discusses a classification approach that is likely to be built on over time. An Vanhaesebrouck as lead author joins Abbe Crawford to discuss - so you’re in excellent hands to learn more about myasthenia gravis.

Case Series of Canine Myasthenia Gravis: A Classification Approach With Consideration of Seronegative Dogs https://onlinelibrary.wiley.com/doi/10.1111/jvim.70113

“Anesthesia safety is less about picking the ‘correct’ drug combination, and more about how you take care of and stabilise the patient…”

Join myself and Dr Lydia Love as we discuss the 2025 Small Animal Anesthesia and Sedation Monitoring Guidelines, specifically thinking how we can improve the care of our ICU and ER patients. We cover all sorts: hypothermia, sedation vs anesthesia, recovery, cases such as urethral obstruction and septic peritonitis, locoregional anaesthesia and plenty more!

For reference

The American College of Veterinary Anesthesia and Analgesia Small Animal Anesthesia and Sedation Monitoring Guidelines 2025

https://www.vaajournal.org/article/S1467-2987(25)00071-6/fulltext

Coccygeal epidural with local anesthetic for catheterization and pain management in the treatment of feline urethral obstruction

https://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2010.00609.x

In this episode we welcome Dr Lauren Minter and Professor Deborah Silverstein to discuss:

-Factors associated with tracheostomy decannulation failure in dogs with BOAS

-When to attempt decannulation of these dogs

-Tracheostomy tube dislodgement

-Complications of suctioning

-Recurrent obstructive fibrinous pseudomembranes. See this report here: https://onlinelibrary.wiley.com/doi/10.1111/jvim.14650

…all in relation to their original study entitled “Factors that may be associated with tracheal decannulation failure in dogs requiring temporary tracheostomy after upper airway surgery for brachycephalic obstructive airway syndrome” https://onlinelibrary.wiley.com/doi/10.1111/vec.13453

Also see a recent related study here:

Retrospective evaluation of the outcomes of advanced airway management in intubated patients with brachycephalic obstructive airway syndrome: 52 cases (2010-2020), https://onlinelibrary.wiley.com/doi/10.1111/jsap.13907 covering specifically those dogs with BOAS that require emergency intubation.

Happy listening and reading!

A chance to cut is a chance to cure?

In this episode we cover:

The principles of cardiopulmonary bypass

Anticoagulation

The mitral valve repair itself

The ideal surgical candidate for mitral valve repair

The outcomes of such a procedure

The original study is below and covers further specifics such as case selection and post-op care plus summaries and discussion of fatalities. An overarching aim was that this should be useful for other centers establishing such a program.

Improvements over time are summarised by improving survival rates: 22/33 in the first quartile, 27/33 in the second quartile, 28/33 in the third quartile, and 30/33 in the final, most recent group. Do have a read.

Improvement in short-term outcome over time, in a single center embarking on a canine mitral valve repair program using a structured multidisciplinary approach

https://onlinelibrary.wiley.com/doi/10.1111/vsu.14229

In this podcast we discuss the actual prevalence of AKI in cats exposed to lilies, how bad the AKI seems to get when it does occur, and the changing management practices over time in toxin exposures, let alone in the management of lily exposure itself.

Happy listening!

Prevalence of acute kidney injury and outcome in cats treated as inpatients versus outpatients following lily exposure

https://avmajournals.avma.org/view/journals/javma/263/1/javma.24.05.0355.xml

Alex Lynch and Rob Goggs discuss the uses of viscoelastic testing, hyperfibrinolysis, when to use antifibrinolytics in dogs, and when to stop them! This is part 2 of 2.

A selection of studies referred to:

CURATIVE guidelines https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801

Characterisation of changes in the haemostasis system in dogs with thrombosis https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037

CRASH 2 Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

CRASH 3 Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext

WOMAN trial Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300

FAT CAT https://www.sciencedirect.com/science/article/pii/S1760273415000958

SUPERCAT https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml

Alex Lynch and Rob Goggs answer questions on indications for thromboprophylaxis, knowledge gaps in the area, if or when we should be more pro-active and ATE in cats. This is part 1 of 2.

A selection of studies referred to:

CURATIVE guidelines

https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.12801

FAT CAT

https://www.sciencedirect.com/science/article/pii/S1760273415000958

SUPERCAT

https://avmajournals.avma.org/view/journals/javma/263/4/javma.24.09.0584.xml

Characterisation of changes in the haemostasis system in dogs with thrombosis

https://onlinelibrary.wiley.com/doi/10.1111/jsap.12037

CRASH 2

Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

CRASH 3

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext

WOMAN trial

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

Rapid resolution of hyperfibrinolysis in dogs with spontaneous hemoperitoneum following surgical control of hemorrhage

https://onlinelibrary.wiley.com/doi/full/10.1111/vec.13300

Do you use rivaroxaban? Do you want to know more about using rivaroxaban? Or even apixaban? In this podcast we discuss both anticoagulant drugs with study authors Alex Lynch and Rob Goggs. I learnt plenty and I hope you will too!

We also recorded a ‘burning questions on thromboprophylaxis’ podcast that will be out very soon, so keep an eye out for that too! You can also find the podcasts on the www.vetlit.org/podcast page itself.

In this episode we cover:

The background to the use of oral anticoagulants

A brief tour of pharmacokinetics and pharmacodynamics.

The biological effect of both drugs, when it happens and the concept of rebound hypercoagulability after drug withdrawal.

The original study is here:

Comparison of the pharmacokinetics and pharmacodynamics of apixaban and rivaroxaban in dogs

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17216