Pre-anaesthetic blood testing is pretty much a part of practice now. It is critical that veterinarians have a “game plan” for addressing the potential issues being presented by the identification of abnormal blood tests. During this session we will be discussing when and how I go about investigating abnormal hepatic enzyme parameters on Pre-anaesthetic blood testing. Both history taking and a thorough physical examination should be standard in every patient. Depending on the clinical and historical findings, and abnormalities identified on the Pre-anaesthetic blood testing, different pathways may be indicated in further investigation. This may be simply “monitoring” both the patient and biochemistry, or it may involve a LDDST or ACTH Stimulation Test, or pre and postprandial bile acid testing, abdominal ultrasound or tissue sampling by cytology or the collection of biopsies.
Traumatic shock presumes hypovolaemia, the most common form of shock seen in veterinary patients. The early restoration of tissue perfusion and maintenance of tissue oxygenation is essential in achieving a positive outcome. The ABCDE of trauma medicine pneumonic applies for immediate action in the trauma patient. Blood volume reestablishment is the mainstay of traumatic shock therapy. Ensuring the patient’s airway, establishing adequate oxygenation & ventilation, restoring blood volume take preference over the next most important categories, the central nervous system and the abdomen. This concept is the crux of this session. Targeted end-point resuscitation parameters in the trauma patient will highlight the discussion, along with bedside diagnostic tests to aid in diagnosis, monitoring, and assessing response to treatment – some examples include the haematocrit, blood lactate levels, the use of radiology and/or ultrasonography and techniques such as abdominocentesis & thoracocentesis. Concepts of Shock Index and Animal Trauma Triage Score seen in emergency papers will be introduced and the lecture will finish with a suggested practical protocol for resuscitation of the trauma patient that can be followed by every veterinary practice.