• DVM360_Conference_Charlotte,NC_banner
  • ACVCACVC
  • DVM 360
  • Fetch DVM 360Fetch DVM 360
DVM 360
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
By Role
AssociatesOwnersPractice ManagerStudentsTechnicians
Subscriptions
dvm360 Newsletterdvm360 Magazine
News
All News
Association
Breaking News
Conference Coverage
Education
Equine
FDA
Law & Ethics
Market Trends
Medical
Politics
Products
Recalls
Regulatory
Digital Media
dvm360 LIVE!™
Expert Interviews
The Vet Blast Podcast
Medical World News
Pet Connections
The Dilemma Live
Vet Perspectives™
Weekly Newscast
dvm360 Insights™
Publications
All Publications
dvm360
Firstline
Supplements
Vetted
Clinical
All Clinical
Anesthesia
Animal Welfare
Behavior
Cardiology
CBD in Pets
Dentistry
Dermatology
Diabetes
Emergency & Critical Care
Endocrinology
Equine Medicine
Exotic Animal Medicine
Feline Medicine
Gastroenterology
Imaging
Infectious Diseases
Integrative Medicine
Nutrition
Oncology
Ophthalmology
Orthopedics
Pain Management
Parasitology
Pharmacy
Surgery
Toxicology
Urology & Nephrology
Virtual Care
Business
All Business
Business & Personal Finance
Hospital Design
Personnel Management
Practice Finances
Practice Operations
Wellbeing & Lifestyle
Continuing Education
Conferences
Conference Listing
Conference Proceedings
Resources
CBD in Pets
CE Requirements by State
Contests
Veterinary Heroes
Partners
Spotlight Series
Team Meeting in a Box
Toolkit
Top Recommended Veterinary Products
Vet to Vet
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us

© 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Advertisement
By Role
  • Associates
  • Owners
  • Practice Manager
  • Students
  • Technicians
Subscriptions
  • dvm360 Newsletter
  • dvm360 Magazine
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us
  • MJHLS Brand Logo

© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

CVC Highlight: Evil foreign bodies and more cautionary tales

December 1, 2011
Scott P. Shaw, DVM, DACVECC

This critical care specialist shares 13 lessons he learned the hard way while practicing emergency medicine.

For many diseases in veterinary patients, the diagnosis is straightforward once you have the clues to add the possibilities to your rule-out list. Here are a few of my hard-learned lessons that I hope will help you when you see patients on emergency.

1. Migrating foreign bodies are evil, particularly porcupine quills. A single quill left behind may end up in the brain, lung, or pericardium-several days to months after the porcupine encounter. So do your best to find and remove them all.

2. Only serious problems cause pleural effusion. Pyothorax, heart failure, and cancer are common causes of pleural effusion, but you can help patients in distress with thoracocentesis. If you're not afraid to perform cystocentesis, don't fear thoracocentesis; it can be lifesaving.

3. Pericardial effusion is more common than you think. It's an often missed diagnosis by referring veterinarians. Clinical clues may include a patient with collapse, jugular venous distention, vomiting (perhaps within the week preceding presentation), hyponatremia, ascites (especially in animals with chronic pericardial effusion), and a large vena cava seen radiographically (conversely, in animals with hypovolemic shock, the vena cava looks small on radiographs). In a crisis, pericardiocentesis can be lifesaving.

4. A drop in a patient's total solids indicates bleeding. Remember that because of splenic contraction, the hematocrit doesn't decrease right away with hemorrhage.

5. The type of fluid you choose in an emergency seldom matters, except in animals with heart failure or severe hypochloremia.

6. Wounds aren't always what they seem, especially in patients with impalement injuries. Be aggressive in exploring stick wounds whenever you can; sticks leave a long track of debris that can quickly lead to sepsis.

7. Dog breeders may know more than you do about some reproductive issues, so listen to their concerns and treat accordingly.

8. A fever doesn't always indicate an infection-so if a febrile patient doesn’t improve within 24 to 72 hours of treatment with a reasonably chosen antibiotic and supportive care, stop and reevaluate.

9. Your diagnosis is probably wrong if a patient isn't responding to antibiotics.

Advertisement

10. Cats that are in heart failure are hypothermic. So if you see a dyspneic cat with a temperature > 100 F, think respiratory disease. If its temperature is < 100 F, think heart failure.

11. Animals with head trauma can make amazing recoveries. So give them at least 24 hours to show improvement with treatment.

12. Age is not a disease. While age-related diseases exist, an ill older animal may live quite awhile if the disease is managed appropriately.

13. If you can't have fun doing it, it's not worth doing!

Scott P. Shaw, DVM, DACVECC

Department of Clinical Sciences

Cummings School of Veterinary Medicine

Tufts University

North Grafton, MA 01536

Related Content:

Clinical
An update on copper concerns in pet foods
An update on copper concerns in pet foods
Evaluating liver enzyme elevation
Evaluating liver enzyme elevation
Chronic feline pain from all perspectives
Chronic feline pain from all perspectives

Advertisement

Latest News

An update on copper concerns in pet foods

Dental hacks to make every case more manageable

Q&A with a keynote: Walter Brown, RVTg, VTS, ECC

News wrap-up: This week’s headlines, plus dvm360® launches its first CE podcast

View More Latest News
Advertisement