Page 973 - Cote clinical veterinary advisor dogs and cats 4th

Home-Prepared Diets 479

• Fluid therapy for hypovolemia • Antimicrobials as needed if wounds or open • Autotransfusion can be considered if there
fractures, after bacteriologic culture.
○ Isotonic crystalloid bolus of 20 mL/kg • Surgical procedures should occur after the is significant hemorrhage into a body cavity
VetBooks.ir ○ Repeat as necessary up to 60-90 mL/kg Chronic Treatment must be filtered, and hemorrhage must be Diseases and Disorders
IV over 15-20 minutes, then reassess
and blood products are not available. Blood
perfusion parameters.
patient has stabilized.
acute.
in a dog and 40-60 mL/kg in a cat.
ing is vital because biliary tract rupture may
○ If patient is hypovolemic but hydrated, • When neurologic or musculoskeletal injuries • Client education regarding at-home monitor-
a 7% hypertonic saline (HTS) bolus are sustained, physical therapy may be take days to weeks to manifest.
(3-5 mL/kg IV over 15 minutes) rapidly indicated for weeks to months. • Tracheal rupture in cats may not manifest
expands intravascular volume. • Limit exercise for a month if suspected or significant clinical signs until days after injury.
HTS also decreases intracranial pressure. confirmed pulmonary or pleural space disease.
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Caution in patients with cardiac disease. Prevention
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Monitor serum sodium concentration Nutrition/Diet The best way to prevent animals from vehicular
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HTS should be followed with IV No special recommendations unless maxil- trauma is to keep dogs on leash and cats indoors.
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isotonic crystalloid. lofacial trauma necessitates tube feeding.
• Treat hemorrhagic shock with transfusion Technician Tips
of packed red blood cells (pRBCs) or fresh Behavior/Exercise • Large-gauge, short, intravenous catheters
whole blood. Exercise should be limited for 1 month; dogs should be chosen.
○ Approximately 1 mL/kg of pRBCs or that freely roam should be leash walked. • Signs of worsening condition include
2 mL/kg of fresh whole blood will raise increased respiratory rate and effort,
the PCV ≈1% (p. 1169). PROGNOSIS & OUTCOME shallow breathing, persistent or worsening
• Oncotic support can be provided with tachycardia, bradycardia, development of
colloids or albumin (canine or human). • Patients that survive the initial event have arrhythmias, rapid or prolonged CRT, pale
• Analgesics are indicated in almost all cases; an excellent prognosis for survival. Mortality or cyanotic mucous membranes, poor pulse
a pure mu opioid agonist is the drug of rates are 10%-12%. quality, depressed mentation, vomiting, and
choice. • Factors that negatively affect survival include progressive pain or paresis. Veterinary techni-
○ Methadone 0.1-0.3 mg/kg IM, IV q 4-6h head trauma, fractures of the cranium, cians are often the first to notice these signs
○ Hydromorphone recumbency at admission, hematochezia, due to close and frequent contact with the
Dogs: 0.05-0.1 mg/kg IV, 0.05-0.2 mg/ suspicion of acute respiratory distress trauma patient.
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kg IM, SQ q 2-4h syndrome, DIC, multiorgan dysfunction • Recumbent patients should be propped in
Cats: 0.03-0.05 mg/kg IV, 0.05-0.1 mg/ syndrome, development of pneumonia, sternal recumbency or rotated every 4 hours
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kg IM, SQ q 3-4h requirement for positive-pressure ventilation, to avoid atelectasis and pressure sores. Passive
○ Oxymorphone use of vasopressors, cardiopulmonary arrest, range-of-motion exercises may be indicated,
Dogs: 0.03-0.1 mg/kg IM, IV q 2-4h hyperlactatemia (≥ 4 mmol/L), modified and patients must be kept clean and dry.
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Cats: 0.01-0.05 mg/kg IM, IV q 2-4h Glasgow coma scale ≤ 17 (p. 404), and • Observation of adequate urine production
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○ Fentanyl animal trauma triage score ≥ 5. helps assess for possible urinary tract injury.
Dogs: loading dose of 2-3 mcg/kg IV
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followed by infusion of 2-5 mcg/kg/h PEARLS & CONSIDERATIONS SUGGESTED READING
Cats: loading dose of 1-3 mcg/kg IV
■ Simpson SA, et al: Severe blunt trauma in dogs:
followed by an infusion of 1-4 mcg/ Comments 235 cases (1997-2003). J Vet Emerg Crit Care
kg/h • Frequent reassessment and close monitoring 19(6):588-602, 2009.
• Thoracocentesis for pneumothorax or is essential. AUTHORS: Sage M. De Rosa, DVM; Kenneth J.
hemothorax (p. 1164) • Radiographic evidence of pulmonary contu- Drobatz, DVM, MSCE, DACVIM, DACVECC
• Sterile lubricant should be placed in wounds, sions may lag 12-24 hours behind clinical EDITOR: Benjamin M. Brainard, VMD, DACVAA,
the area clipped and cleaned and then flushed signs and may progress over 48 hours (p. DACVECC
copiously, followed by sterile bandaging. 835).

Home-Prepared Diets

BASIC INFORMATION RISK FACTORS (particular concern for diets containing raw
Animals with demanding requirements, such as animal products).
Definition those during growth or reproduction or those
Home-prepared diets are an alternative to with underlying disease, are at higher risk for ASSOCIATED DISORDERS
commercially available options. adverse effects of unbalanced or otherwise inad- Some owners chose home-prepared diets to
equate home-prepared diets. Most recipes found address poor pet acceptance of commercially
Synonyms in books or on the Internet are unbalanced, available options. Poor acceptance of commercial
Homemade diet, home-cooked diet imprecise, and lack appropriate strategies for diets may be due to behavioral issues (learned
supporting health or managing disease. pickiness; fixed food preferences, especially in
Epidemiology cats), but it also commonly occurs secondary to
SPECIES, AGE, SEX CONTAGION AND ZOONOSIS underlying illness that can predispose to food
Any dog or cat Food-borne pathogens may affect pets or aversion (e.g., gastrointestinal disease, chronic
people in contact with the pet or the diet kidney disease [CKD]).

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