Page 13 - Basic Monitoring in Canine and Feline Emergency Patients

Table 1.2. Normal reference ranges for vital parameters plasma is assessed (see Section 1.3, Interpretation).
in dogs and cats. Next, the PCV is determined utilizing the hematocrit
VetBooks.ir Vital parameter Canine Feline reading card. If there is the presence of a visible buffy
coat, the percentage of the buffy coat is also deter-
reference range
reference range
mined utilizing the hematocrit reading card. In order
Mentation Appropriately Appropriately to measure the TP, the hematocrit tube is carefully
responsive responsive broken at the level of the plasma and cellular sedi-
ment interface. The plasma is then evacuated from the
Temperature 100.0–102.5°F 100.0–102.5°F
(37.38– (37.38– tube onto the refractometer. The reading for the TP is
39.17ºC) 39.17ºC) taken from the scale labeled serum or plasma protein
on the refractometer.
Pulse 60–150 beats 150–220 beats
per minute per minute
Respirations 12–24 breaths 20–40 breaths Blood glucose
per minute per minute The multitude of negative outcomes that can occur
Capillary refill <2 seconds <2 seconds3 as a result of unregulated BG levels warrant diligent
time maintenance and monitoring BG. This monitoring
Mucous Pink Pink can be accomplished by the use of handheld, trans-
membrane portable, point-of-care BG monitors. There are mul-
color tiple commercially available units ranging from
portable strip-based glucometers (Fig. 1.4) to car-
tridge-based systems (Fig. 1.5) and sensor card-based
Point-of-care blood testing technology (Fig. 1.6). When using a cartridge-based
system, the cartridge chosen determines the analytes
Packed cell volume/total protein
measured. While there is a cartridge specifically to
The PCV and TP is measured from a whole blood measure glucose, glucose values are included with
sample placed into a microhematocrit tube. The PCV other cartridges designed to measure parameters like
represents the percent of total blood volume that is electrolytes and blood gases. Table 1.5 provides a list
red blood cells (RBCs) as opposed to plasma. Total of point-of-care BG monitors.
protein is the measurement of the plasma protein The methodology utilized by most handheld units
concentration in serum or plasma, expressed as g/dL (including strip-based and cartridge-based systems)
(grams per deciliter). The protein is a reflection pri- to measure the glucose is based on a glucose oxidase
marily of albumin and globulins. Besides the RBCs reaction between the test strip or cartridge and the
and plasma in the microhematocrit tube, there is also glucose in the blood. Glucose oxidase catalyzes an
the presence of a buffy coat that appears between the oxidation reaction that transforms glucose to glu-
red cells and the plasma after the tubes have been conic acid and hydrogen peroxide. The amount of
spun. The buffy coat contains white blood cells and hydrogen peroxide produced is proportional to the
platelets. The PCV/TP is relatively simple to perform amount of glucose in the blood. The change in the
and requires a minimal amount of fresh or antico- hydrogen peroxide concentration is measured based
agulated whole blood, microhematocrit tubes and on the production of an electrical current that is
clay, a centrifuge capable of spinning microhemato- sensed by an electrode in the glucose meter (this
crit tubes, a hematocrit reading card, and a refrac- methodology is called enzymatic amperometry).
tometer. See Figs 1.2 and 1.3 for the equipment
required to perform a PCV/TP and Table 1.4 for the
normal reference ranges in dogs and cats. Ketone
Once a blood sample is obtained, it can be placed Detection and measurement of ketones in urine or
in heparinized or non-heparinized hematocrit tubes plasma is accomplished by utilizing reagent strips.
and spun at the recommended speed and for the rec- These commercially available strips come in two
ommended duration of time (usually 5 minutes or forms: (i) the multi-stick that contains a test pad for
less) as per the manufacturer’s guidelines for the cen- ketones in addition to test pads for measurement of
trifuge being utilized. Upon completion of spinning, leukocytes, urobilinogen, pH, specific gravity, biliru-
and prior to reading the PCV and TP, the color of the bin, nitrites, protein, blood, and glucose (Fig. 1.7); and

Physical Examination and Point-of-care Testing 5