DOI : https :// doi . org / 10.56496 / OJAD7944

Emma Foley , FdSc , BSc ( Hons ), CertVNECC , RVN

Blaise Veterinary Referral Hospital , Birmingham

ENVELOPE efoley7 @ rvc . ac . uk

Emma is an emergency and critical care ( ECC ) RVN with a particular interest in ECC and feline nursing . She has worked in veterinary practice since 2013 , and obtained an FdSc ( Distinction ) and a first-class BSc ( Hons ) in veterinary nursing from the Royal Veterinary College , in 2020 and 2021 , respectively . More recently , she also obtained a distinction in the Certificate in Veterinary Nursing in ECC ( CertVNECC ).

ABSTRACT A 4-year-old French bulldog presented with status epilepticus . Blood tests revealed hyperlactataemia , hyperglycaemia and respiratory alkalosis . The dog later developed aspiration pneumonia . Risk factors for aspiration pneumonia in veterinary patients include decreased mentation , neurological diseases and brachycephaly .

Oxygen therapy is imperative , with oxygen cages being most effective . An oxygen hood would be unsuitable for this patient due to the risk of hyperthermia . Nasal prongs would also be unsuitable due to the risk of increased intracranial pressure and the difficulty of placing them in brachycephalic breeds . Oxygenation should be monitored , as dogs with aspiration pneumonia can decompensate quickly ; if unresponsive to oxygen supplementation , more intensive support should be considered . Humidification is required for long-term oxygen therapy , which can be provided through nebulisation .

Veterinary nurses ( VNs ) can use the modified Glasgow Coma Scale to monitor the patient ' s neurological status . The patient ' s blood abnormalities may be caused by seizure activity ; these parameters should be rechecked to ensure improvement . Cooling measures may be required to treat the hyperthermia . The obtunded patient requires additional nursing interventions , such as padded bedding , position changes , urinary catheterisation or bladder expression , and eye lubrication .

Treatment for aspiration pneumonia includes intravenous fluid therapy . VNs can calculate and provide fluids , monitor the patient ' s hydration and perfusion status and adjust the fluid rate as necessary . Urine output can aid this assessment . Blood pressure may be raised as a consequence of status epilepticus , which can increase intracranial pressure . If this occurs , immediate action must be taken to reduce intracranial pressure , which may include the administration of hyperosmolar agents and nursing interventions such as elevating the head and minimising stimulation .

The VN plays a significant role in in-patient care , which can be intensive for the emergency patient . The dedicated VN can contribute significantly to patient wellbeing and recovery .

Keywords seizure , aspiration pneumonia , oxygen , mentation , fluid therapy , brachycephalic

32 Veterinary Nursing Journal