Plus-Hex CLINICAL
Additionally , promoting the use of equipment that can help monitor these patients , such as multiparameter monitors , is important , and the use of these monitors should not be restricted to anaesthetised patients . The author has encouraged this in her roles and has successfully acquired the necessary equipment .
Finally , it may be advisable for all veterinary premises to invest in a blood gas analyser . These analysers allow acid – base derangements to be monitored and trends evaluated , and will show a patient ' s response to treatment [ 26 ] . Although this patient did not survive to have multiple blood gas analyses performed , from the author ' s experience in an emergency and critical care setting , similar cases have had serial blood gas analysis dependent on the patient ' s status ; the author has seen multiple ( 4 +) analyses within an hour to evaluate a critical patient ' s response to treatment . The number of analyses that should be performed is dependent on the individual case and analyses should be carried out under the direction of the VS . Costs could be absorbed into the hospitalisation fee for these unstable or critical patients during their care , to facilitate VSs ' preference to monitor trends without the financial burden deterring clients from agreeing to this as part of the treatment plan .
Regular use of multiparameter monitors and blood gas analysers would develop VNs ' knowledge and confidence in their use , and empower VNs in their care of their patients , regardless of the primary nature of their work .
Assessment of learning
4 . Which would be the fluid choice for patients presenting with UO ?
a ) 0.9 % sodium chloride ( saline ) b ) Compound sodium lactate ( Hartmann ' s ) c ) 0.45 % sodium chloride ( half-strength saline ) d ) Hypertonic saline
5 . Which medication could protect the patient from the cardiotoxic effect of hyperkalaemia ?
a ) 50 % dextrose b ) Sodium bicarbonate c ) Meloxicam d ) Calcium gluconate 10 %
1 . c ) Metabolic acidosis 2 . a ) Hyperkalaemia 3 . a ) True 4 . b ) Compound sodium lactate ( Hartmann ' s ) 5 . d ) Calcium gluconate 10 %
Answers
1 . Which acid – base disturbance is most likely to be seen in patients presenting with UO ?
a ) Metabolic alkalosis b ) Respiratory acidosis c ) Metabolic acidosis d ) Respiratory alkalosis
2 . Which primary electrolyte imbalance is commonly seen in patients presenting with UO ?
a ) Hyperkalaemia b ) Hypokalaemia c ) Hypernatraemia d ) Hypophosphataemia
3 . Peaked T-waves on ECG can indicate hyperkalaemia
a ) True b ) False
REFERENCES
1 Beeston D , Humm K , Church DB , Brodbelt D , O ’ Neill DG . Occurrence and clinical management of urethral obstruction in male cats under primary veterinary care in the United Kingdom in 2016 . Journal of Veterinary Internal Medicine . 2022 ; 36 ( 2 ): 599 – 608 . Available from : https :// doi . org / 10.1111 / jvim . 16389 .
2 Sabino CV . Urethral obstruction in cats . Veterinary Team Brief . 2017 ; April : 37 – 41 , Available from : https :// files . brief . vet / migration / article / 37286 / urethral-obstruction-in-cats-37286-article . pdf [ Accessed 21 April 2023 ].
3 Canei DH , Pereira ME , de Freitas MN , Trevisan YPA , Zorzo C , Bortolini J , et al . Biochemical , electrolytic , and cardiovascular evaluations in cats with urethral obstruction . Veterinary World . 2021 ; 14 ( 8 ): 2002 – 2008 . Available from : https :// doi . org / 10.14202 / vetworld . 2021.2002-2008 .
4 Mauro KD , Bradley CW , Drobatz KJ . Postmortem urinary tract changes in cats with urethral obstruction . Journal of Veterinary Emergency and Critical Care . 2020 ; 30 ( 2 ): 187 – 193 . Available from : https :// doi . org / 10.1111 / vec . 12924 .
5 Conway DS , Rozanski EA , Wayne AS . Prazosin administration increases the rate of recurrent urethral obstruction in cats : 388 cases . Journal of the American Veterinary Medical Association . 2022 ; 260 ( S2 ): S7 – S11 . Available from : https :// doi . org / 10.2460 / javma . 21.10.0469 .
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Volume 39 ( 3 ) • June 2024
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