WikiVet English - User contributions [en]

Kidney Anatomy

2014-01-30T16:12:57Z

Ctrace: Redirected page to Renal Anatomy - Anatomy & Physiology

#REDIRECT[[Renal Anatomy - Anatomy & Physiology]]

User:CR

2013-12-06T11:49:31Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Clare Rusbridge
|Occupation= Veterinary Surgeon 
|School= UK - Glasgow
|Year= 1991
|Email=
|Image=
}}
[[Category:UK - Glasgow Graduates]]

User:Pmorris

2013-11-29T14:40:31Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Penny Morris
|Occupation= Other 
|Place of Work=
|Job Title= Nutrition research manager
|Email=
|Image=
}}

User:Ctrace

2013-11-20T17:39:26Z

Ctrace: /* heading4 */

{{UserPage
|Name=Chris Trace
|Occupation= Veterinary Surgeon
|School= UK - Royal Veterinary College
|Year= 2008
|Email= chris@wikivet.net
|Image= Movember2013.jpg
}}

== My role in WikiVet ==
[[File:Elearning showcase.jpg|thumb|right|200px| [[ELearning_showcase|eLearning showcase]] ]]
=== Newsletter Editor ===
I am currently responsible for putting together the WikiVet newsletter, which is sent out to all WikiVet users who wish to receive it. It is designed to keep you up to date with all the many changes that are going on with WikiVet, and also suggests content we think you may find interesting.

=== eLearning development ===
I'm particularly interested in ways in which useful and engaging [[ELearning_showcase|eLearning activites]] can be incorporated into WikiVet to complement the existing content.

=== Facebook page monitor ===
I'm responsible for monitoring [http://www.facebook.com/WikiVet WikiVet's facebook page] which is a space for users to discuss WikiVet issues and communicate more informally with the WikiVet team.

===WikiVet Media===
I look after [http://media.wikivet.net WikiVet's Media site] too, so if a user posts a video here I'll categorise it.

[[:Category:Chris_Projects|Projects that Chris is working on currently]]

== About me ==
[[Image:CanineRadiograph.jpg|thumb|right|200px| [http://www.rvc.ac.uk/Review/documents/CanineRadiographs.pps Canine Radiographs program] ]]
[[File:ChrisandMarmite.jpg|thumb|Chris and his dog Marmite]]

I graduated from the [[RVC|Royal Veterinary College]] in 2008, since then I've been part of the [http://www.rvc.ac.uk/eMedia/Index.cfm eMedia unit] at the RVC.

Whilst at the RVC I have been involved in developing a range of [http://www.rvc.ac.uk/review e-Learning materials] for students, one of which is the [http://www.rvc.ac.uk/Review/documents/CanineRadiographs.pps Canine Radiographs program]which is now downloadable.

I've become increasingly interested in the use of [http://en.wikipedia.org/wiki/Virtual_patient Virtual Patients] in Veterinary Education. These are computer simulations of patients that you are able to interact with, diagnose and treat. These are used extensively in medical education and are now starting to creep in to Veterinary education.

{| class="wikitable"
|first box here
|second box here
|-
|third box here
|rowspan="2"|image here
|-
|fourth box here
|}

[[File:Chris and Paul.jpg|thumb|Chris and [[User:Kanyari|Prof. Kanyari]] from Nairobi in the eMedia office]]

[[Category:UK - RVC (London) Graduates]]

WikiMarkup

'''bold''' ''italic'' '''''bold and italic'''''
=heading1=
==heading2==
===heading3===
====heading4====
here is a link to a great page on [[Principles of Fluid Therapy|fluid therapy]], and here's a link to [http://www.facebook.com facebook]
[[File:Movember2013.jpg|thumb|left|Add caption here]]
[[File:Human eye cross-sectional view grayscale.png|thumb|Human eye cross-sectional view grayscale]]

Hypomagnesemia

2013-11-20T17:26:11Z

Ctrace: Redirected page to Hypomagnesaemia

#redirect[[Hypomagnesaemia]]

Movember

2013-11-20T17:06:56Z

Ctrace: Created page with "Here is an example page about movember, where Moustachitis takes place. Exhibit A: 400px"

Here is an example page about movember, where [[Moustachitis]] takes place.

Exhibit A:

[[File:Movember2013.jpg|center|400px]]

Systemic Lupus Erythematosus

2013-11-20T16:58:53Z

Ctrace: /* References */

{{OpenPagesTop}}
Also known as: '''''SLE'''''

==Introduction==
Systemic Lupus Erythematous is an immune-mediated disease which can affect '''many different organ systems'''. It is a primary autoimmune disease in which the body loses 'self-tolerance' towards autoantigens and mounts an inappropriate attack on various target tissues of the body. The pathology can be attributed to true autoantibody binding, '''immune complex deposition''' causing a [[Type III Hypersensitivity|type III hypersensitivity reaction]], or cell-mediated autoimmunity.

The most comprehensively studied autoantibodies formed are the '''Anti-Nuclear Antibodies''' (ANA) which are found in up to 100% of cases reported and are important in the diagnosis of the disease. These target a number of nuclear components, including double-stranded DNA, histones and extractable nuclear antigens.

The '''aetiology''' of the disease is multifactorial, involving genetics, immunological disorder, viral infection and hormonal and ultraviolet light modulation.

The condition is uncommon in dogs and rare in cats and horses.

==Clinical Signs==
Clinical signs are varied and changeable. SLE is able to mimic numerous diseases and is sometimes called ''''the great imitator''''.

Dogs: there is no age predilection, but male are more commonly affected.

The most common manifestations are: '''fever''' (constant or cyclic), '''polyarthritis''' (non-erosive, non-deforming), proteinuria and '''skin disease'''.

Skin changes include: periorbital alopecia, seborrhea, oral ulceration, [[Discoid Lupus Erythematosus]], mucocutaneous ulcerations, footpad ulceration, panniculitis and urticaria. Skin changes can be multifocal or generalised, and commonly involve skin poorly covered by hair. Lesions may be exacerbated by exposure to light.

Other common manifestations include: '''[[:Category:Anaemia|anaemia]], leucopaenia, peripheral lymphadenopathy, splenomegaly'''.

Other reported syndromes include: [[pericarditis]], [[thrombocytopaenia]], polymyositis, myocarditis, pneumonitis, pleuritis, neurologic disorders ([[seizures]], meningitis, psychosis) and lymphoedema.

Cats: no age predilection, but Siamese, Himalayan and Persian breeds may be predisposed.

Syndromes reported include: haematological abnormalities, neurological abnormalities, fever, lymphadenopathy, polyarthritis, myopathy, oral ulceration, conjunctivitis, [[:Category:Renal Failure|'''renal failure''']] and subclinical pulmonary disease.

Only 20% of cats will have skin lesions such as seborrhea, erythema, [[alopecia]] and scarring on the face, pinnae and paws.

==Diagnosis==
Diagnosis of SLE is made on a combination of clinical findings, haemotologic, serum biochemistry and immunological testing results. Diagnosis can be '''challenging''' as the condition can mimic a number of other diseases. Ruling out differential diagnoses will help in securing a definitive diagnosis.

The most widely accepted diagnostic criteria for the disease is that an animal should have at least '''2 separate clinically and serologically defined manifestations of autoimmunity in addition to a high serum titre of ANA'''.

'''Haematology and biochemistry''' may reveal: anaemia with or without a positive direct [[Coagulation Tests|Coombs' test result]], thrombocytopaenia, leucopaenia or leucocytosis, proteinuria and hypergammaglobulinaemia.

The '''ANA test''' is considered the most sensitive serological test for SLE. However, it is not the most specific of tests, and can be positive in up to 20% of dogs with infectious diseases, particularly [[leishmaniasis]]. It is important to record the titre and compare it with normal values for the same laboratory.

The Lupus Erythematosus '''(LE) test''' is not as valuable, varies from day to day, and lacks specificity and sensitivity.

'''Pathology''' findings in the skin include: lymphohistiocytic interface dermatitis, thickened basement membrane, vasculitis, subepidermal vesicles, basal cell degeneration.

==Treatment==
Treatment is with '''immunosuppressive drugs'''.

The initial agent of choice is large doses of systemic glucocorticoids such as '''prednisolone'''.

Other drugs may be useful in combination if the response is not satisfactory, and '''azathioprine or cyclophosphamide''' can be used. Typically the dose can be tapered once the condition is under control.

'''Splenectomy''' may be necessary in animals with severe anaemia and thrombocytopaenia. '''Vincristine''' can be useful when thrombocytopaenia is severe.

Animals with SLE are prone to infections and therefore any infections must be identified and dealt with effectively and quickly.

Specific supportive care may be necessary for animals with renal disease, such as dietary manipulation.

'''ANA titres''' can be monitored throughout treatment as levels usually fall with clinical improvement, thought the antibody may persist at lower titres during clinical remission.

==Prognosis==
Prognosis is '''unpredictable''' and depends on the organs involved.

The earlier the diagnosis is made, the better the prognosis.

In general, dogs with muscle, joint and skin disease respond more reliably to medical treatment and remain in remission for longer than animals with severe haemolytic anaemia, thrombocytopaenia or glomerulonephritis.

Over 40% of dogs with SLE are '''dead within 1 year''' after the diagnosis is made, either from disease or from euthanasia.

{{Learning
|flashcards = [[Veterinary Dentistry Q&A 15]]
|literature search = [http://www.cabdirect.org/search.html?q=title%3A%28systemic+lupus+erythematosus%29+OR+title%3A%28multisystemic+immune+mediated+disease%29&fq=sc%3A%22ve%22 Systemic Lupus Erythematosus publications]
}}

==References==
Blood, D.C. and Studdert, V. P. (1999) '''Saunders Comprehensive Veterinary Dictionary (2nd Edition)''' ''Elsevier Science''

Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''

Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''

Muller, G. (2001) '''Small animal dermatology''' ''Elsevier Health Sciences''

Pasquini, C. (1999) '''Tschauner's Guide to Small Animal Clinics''' ''Sudz Publishing''

{{review}}

{{OpenPages}}

[[Category:Expert Review]]

[[Category:Integumentary System - Autoimmune Reactions]]
[[Category:Antibody Mediated Autoimmune Diseases]]
[[Category:Immunological Diseases - Cat]][[Category:Immunological Diseases - Dog]]
[[Category:Immunological Diseases - Horse]]
[[Category:Dermatological Diseases - Dog]]

User:Ctrace

2013-11-20T16:23:51Z

Ctrace:

User:Ctrace

2013-11-20T16:04:04Z

Ctrace: /* heading4 */

{{UserPage
|Name=Chris Trace
|Occupation= Veterinary Surgeon
|School= UK - Royal Veterinary College
|Year= 2008
|Email= chris@wikivet.net
|Image= graduation.jpg
}}

== My role in WikiVet ==
[[File:Elearning showcase.jpg|thumb|right|200px| [[ELearning_showcase|eLearning showcase]] ]]
=== Newsletter Editor ===
I am currently responsible for putting together the WikiVet newsletter, which is sent out to all WikiVet users who wish to receive it. It is designed to keep you up to date with all the many changes that are going on with WikiVet, and also suggests content we think you may find interesting.

=== eLearning development ===
I'm particularly interested in ways in which useful and engaging [[ELearning_showcase|eLearning activites]] can be incorporated into WikiVet to complement the existing content.

=== Facebook page monitor ===
I'm responsible for monitoring [http://www.facebook.com/WikiVet WikiVet's facebook page] which is a space for users to discuss WikiVet issues and communicate more informally with the WikiVet team.

===WikiVet Media===
I look after [http://media.wikivet.net WikiVet's Media site] too, so if a user posts a video here I'll categorise it.

[[:Category:Chris_Projects|Projects that Chris is working on currently]]

== About me ==
[[Image:CanineRadiograph.jpg|thumb|right|200px| [http://www.rvc.ac.uk/Review/documents/CanineRadiographs.pps Canine Radiographs program] ]]
[[File:ChrisandMarmite.jpg|thumb|Chris and his dog Marmite]]

I graduated from the [[RVC|Royal Veterinary College]] in 2008, since then I've been part of the [http://www.rvc.ac.uk/eMedia/Index.cfm eMedia unit] at the RVC.

Whilst at the RVC I have been involved in developing a range of [http://www.rvc.ac.uk/review e-Learning materials] for students, one of which is the [http://www.rvc.ac.uk/Review/documents/CanineRadiographs.pps Canine Radiographs program]which is now downloadable.

I've become increasingly interested in the use of [http://en.wikipedia.org/wiki/Virtual_patient Virtual Patients] in Veterinary Education. These are computer simulations of patients that you are able to interact with, diagnose and treat. These are used extensively in medical education and are now starting to creep in to Veterinary education.

{| class="wikitable"
|first box here
|second box here
|-
|third box here
|rowspan="2"|image here
|-
|fourth box here
|}

[[File:Chris and Paul.jpg|thumb|Chris and [[User:Kanyari|Prof. Kanyari]] from Nairobi in the eMedia office]]

[[Category:UK - RVC (London) Graduates]]

WikiMarkup

'''bold''' ''italic'' '''''bold and italic'''''
=heading1=
==heading2==
===heading3===
====heading4====
here is a link to a great page on [[Principles of Fluid Therapy|fluid therapy]], and here's a link to [http://www.facebook.com facebook]

User:Ctrace

2013-11-20T15:57:12Z

Ctrace: /* About me */ added headings

User:Ctrace

2013-11-20T15:51:16Z

Ctrace:

Principles of Fluid Therapy

2013-11-20T10:50:16Z

Ctrace: /* Hepatic Disease */

{{OpenPagesTop}}
==What is Fluid Therapy?==
'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.
[[Image:Body_Compartments.jpg|center|]]

Fluid therapy is indicated either when there is a loss of fluid to any part of these compartments or there is a risk of loss of fluid. The severity of the fluid loss, and the compartment from which it has been lost, influence the choice of fluid and the speed at which it needs to be administered. If fluid therapy is performed as a treatment then it is necessary to diagnose and treat the underlying condition.
===Indications===
*Hypotension
*Hypovolemia
*Electrolyte, metabolic and acid base disorders
*Decreased oxygen delivery
*Geriatric patients at risk of organ failure

==Definitions==
*'''''Osmosis''''' is the ''net movement'' of water across a semi permeable membrane. The movement is caused by a concentration gradient due to different solute concentrations on each side of the membrane.
*'''''Osmotic Pressure''''' is the pressure caused by the solutes within the solution. The solute concentration prevents water movement across the membrane.
*'''''Tonicity''''' is the term used to compare the osmotic pressure of different solutions
**A ''hypotonic'' solution is one that has an osmotic pressure '''lower''' than plasma.
**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.
**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.
*'''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:
** Excessive sweating
** Water deprivation
** [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] and [[Diarrhoea|diarrhoea]]
** [[Haemorrhage|Haemorrhage]]
** Pathological dilatation of capacity of the ciruclatory system, and therefore a relative reduction in circulating blood.
*'''''Hypervolaemia'''''' is an increase in blood volume, which can be caused by congestive heart failure.

==Types of Fluids==
#'''[[Crystalloids]]''' are able to enter all body compartments.
#'''[[Colloids]]''' are restricted to the plasma compartment.

If there is an electrolyte imbalance present then it may be necessary to add the appropriate electrolyte solution.

==Fluid Rate Calculations==
When calculating the fluid requirements of a patient, there are 3 elements to consider -
# Replacement
# Maintainance
# Ongoing Losses
''Replacements'' are calculated based on the level of dehydration. Dehydration is based upon clinical assessment of each individual patient. Most commonly, skin tent is used for assessment. To calculate the amount required for replacement within a 24 hour period, the percentage dehydration is used in the following calculation.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Replacement''' = ''% Dehydration'' x ''Bodyweight (kg)'' x 10
|-
|}
</center>

''Maintainance'' is the basic rate which a patient requires during a 24 hour period. It is commonly calculated as 50ml/kg/24hr, or 2ml/kg/hr.

''Ongoing losses'' are calculated based on a predicted fluid amount lost by a patient within a 24 hour period. Common losses include vomitting and diarrhoea. It is often helpful here if the owners are able to give a detailed history as this makes it easier to predict the pattern of losses. In some patients there may be no ongoing losses and so this step can be skipped. To calculate the fluid requirement, the following calculation is used.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Ongoing losses''' = ''Amount per loss (ml/kg)'' x ''Bodyweight (kg) x ''No. of losses''
|-
|}
</center>

These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.

The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a drip pump is used or fluid rate is adjusted manually as shown below.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!Requirement per hour (ml/hr) = Requirement per day (ml/24hr) ÷ 24

Requirement per minute (ml/min) = Requirement per hour (ml/hr) ÷ 60

Requirement per second (ml/s)= Requirement per minute(ml/min) ÷ 60

Drops per second = Requirement per second (ml/s)x Giving Set Factor
|}
</center>

==Monitoring Fluid Therapy==
Fluid therapy can be monitored by observing urine output, Packed Cell Volume (PVC), Total Protein (TP, or Total Solids, TS), mucous membrane colour, and blood pressure among others. It is important to also observe for signs of oedema, such as pulmonary oedema or ascites. It should not be stopped until hydration of the patient has returned to normal and the patient is able to maintain a normal hydration status independently.

==Special Considerations==
===Shock===
'''[[Shock]]''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -
*Tachycardia
*Pale mucous membranes (May be dark if distributive shock)
*Prolonged/Absent capillary refil time
*Reduced/Absent periperhal pulses
*Hypotension

There are 3 forms of shock:-
*'''Hypovolemic''' is seen when there is reduced circulating blood volume and the most common form of shock.
*'''Cardiogenic''' is seen in any condition when there is a failure for the heart to pump effectively.
*'''Vascular''' can be sub-divided into -
**''Obstructive'' is seen when there is an obstruction to blood flow to a region of tissue.
**''Distributive'' is seen when there is inappropriate vasodilation. This leads to changes in blood flow distribution between tissues.

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.

===Anaesthesia===
====Pre-anaesthetic====
Before an anaesthestic is performed, it is important to stabilise a patient, both fluid deficits and any electrolyte or acid-base inbalances. In many cases, it is ideal to have a minimum blood database. This should include PCV and TP and if possible urea, creatinine, electrolyes and glucose. If there is any evidence of haemoconcentration, azotemia, or electrolyte imbalances then the patient should be given fluids to correct these abnormalities before the anaesthetic. Even if these parameters are normal it is often advisable to place the patient on fluids as most anaesthetic agents will alter fluid homeostasis, even in healthy patients.

When giving fluids ideally they should be warmed to help the patient maintain a normal body temperature.

====Intra-anaesthetic====
During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with [[Diabetes Mellitus|diabetes]], [[:Category:Liver - Pathology|liver disease]] or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

As mentioned previously, it is also ideal to administer warm fluids to a patient to help maintain a normal body temperature during any procedure. This can be done by warming the fluids in a water bath, or wrapping the giving set line around a glove of warm water to help warm the fluids before they reach the patient.

====Post-anaesthetic====
If a patient has been receiving fluids during a procedure, it is often continued after until the patient is either stable and fully recovered from the anaesthetic. The length of time the fluids continue for after the procedure is dependent on the individual patient and the individual case.

===Cardiac Disease===
It is important to avoid fluid overload in cardiac patients who often have reduced cardiac function. This means it is important to closely monitor fluid adminstration in these patients as it may worsen the patient's condition.

===Hepatic Disease===
Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.

If there are any [[:Category:Coagulation Defects|clotting disorders]] then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.

===Central Nervous System Disease===
Patients with head trama or increased intracranial pressure are particularly susceptible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the [[Blood Brain Barrier - Anatomy & Physiology|blood brain barrier]] is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

{{Learning
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439]

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206456.pdf '''Fluid therapy.''' Hackett, T.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 263-265]

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338]
}}

{{OpenPages}}
[[Category:Fluid Therapy|A]]

Principles of Fluid Therapy

2013-11-20T10:48:06Z

Ctrace: /* Central Nervous System Disease */

{{OpenPagesTop}}
==What is Fluid Therapy?==
'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.
[[Image:Body_Compartments.jpg|center|]]

Fluid therapy is indicated either when there is a loss of fluid to any part of these compartments or there is a risk of loss of fluid. The severity of the fluid loss, and the compartment from which it has been lost, influence the choice of fluid and the speed at which it needs to be administered. If fluid therapy is performed as a treatment then it is necessary to diagnose and treat the underlying condition.
===Indications===
*Hypotension
*Hypovolemia
*Electrolyte, metabolic and acid base disorders
*Decreased oxygen delivery
*Geriatric patients at risk of organ failure

==Definitions==
*'''''Osmosis''''' is the ''net movement'' of water across a semi permeable membrane. The movement is caused by a concentration gradient due to different solute concentrations on each side of the membrane.
*'''''Osmotic Pressure''''' is the pressure caused by the solutes within the solution. The solute concentration prevents water movement across the membrane.
*'''''Tonicity''''' is the term used to compare the osmotic pressure of different solutions
**A ''hypotonic'' solution is one that has an osmotic pressure '''lower''' than plasma.
**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.
**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.
*'''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:
** Excessive sweating
** Water deprivation
** [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] and [[Diarrhoea|diarrhoea]]
** [[Haemorrhage|Haemorrhage]]
** Pathological dilatation of capacity of the ciruclatory system, and therefore a relative reduction in circulating blood.
*'''''Hypervolaemia'''''' is an increase in blood volume, which can be caused by congestive heart failure.

==Types of Fluids==
#'''[[Crystalloids]]''' are able to enter all body compartments.
#'''[[Colloids]]''' are restricted to the plasma compartment.

If there is an electrolyte imbalance present then it may be necessary to add the appropriate electrolyte solution.

==Fluid Rate Calculations==
When calculating the fluid requirements of a patient, there are 3 elements to consider -
# Replacement
# Maintainance
# Ongoing Losses
''Replacements'' are calculated based on the level of dehydration. Dehydration is based upon clinical assessment of each individual patient. Most commonly, skin tent is used for assessment. To calculate the amount required for replacement within a 24 hour period, the percentage dehydration is used in the following calculation.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Replacement''' = ''% Dehydration'' x ''Bodyweight (kg)'' x 10
|-
|}
</center>

''Maintainance'' is the basic rate which a patient requires during a 24 hour period. It is commonly calculated as 50ml/kg/24hr, or 2ml/kg/hr.

''Ongoing losses'' are calculated based on a predicted fluid amount lost by a patient within a 24 hour period. Common losses include vomitting and diarrhoea. It is often helpful here if the owners are able to give a detailed history as this makes it easier to predict the pattern of losses. In some patients there may be no ongoing losses and so this step can be skipped. To calculate the fluid requirement, the following calculation is used.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Ongoing losses''' = ''Amount per loss (ml/kg)'' x ''Bodyweight (kg) x ''No. of losses''
|-
|}
</center>

These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.

The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a drip pump is used or fluid rate is adjusted manually as shown below.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!Requirement per hour (ml/hr) = Requirement per day (ml/24hr) ÷ 24

Requirement per minute (ml/min) = Requirement per hour (ml/hr) ÷ 60

Requirement per second (ml/s)= Requirement per minute(ml/min) ÷ 60

Drops per second = Requirement per second (ml/s)x Giving Set Factor
|}
</center>

==Monitoring Fluid Therapy==
Fluid therapy can be monitored by observing urine output, Packed Cell Volume (PVC), Total Protein (TP, or Total Solids, TS), mucous membrane colour, and blood pressure among others. It is important to also observe for signs of oedema, such as pulmonary oedema or ascites. It should not be stopped until hydration of the patient has returned to normal and the patient is able to maintain a normal hydration status independently.

==Special Considerations==
===Shock===
'''[[Shock]]''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -
*Tachycardia
*Pale mucous membranes (May be dark if distributive shock)
*Prolonged/Absent capillary refil time
*Reduced/Absent periperhal pulses
*Hypotension

There are 3 forms of shock:-
*'''Hypovolemic''' is seen when there is reduced circulating blood volume and the most common form of shock.
*'''Cardiogenic''' is seen in any condition when there is a failure for the heart to pump effectively.
*'''Vascular''' can be sub-divided into -
**''Obstructive'' is seen when there is an obstruction to blood flow to a region of tissue.
**''Distributive'' is seen when there is inappropriate vasodilation. This leads to changes in blood flow distribution between tissues.

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.

===Anaesthesia===
====Pre-anaesthetic====
Before an anaesthestic is performed, it is important to stabilise a patient, both fluid deficits and any electrolyte or acid-base inbalances. In many cases, it is ideal to have a minimum blood database. This should include PCV and TP and if possible urea, creatinine, electrolyes and glucose. If there is any evidence of haemoconcentration, azotemia, or electrolyte imbalances then the patient should be given fluids to correct these abnormalities before the anaesthetic. Even if these parameters are normal it is often advisable to place the patient on fluids as most anaesthetic agents will alter fluid homeostasis, even in healthy patients.

When giving fluids ideally they should be warmed to help the patient maintain a normal body temperature.

====Intra-anaesthetic====
During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with [[Diabetes Mellitus|diabetes]], [[:Category:Liver - Pathology|liver disease]] or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

As mentioned previously, it is also ideal to administer warm fluids to a patient to help maintain a normal body temperature during any procedure. This can be done by warming the fluids in a water bath, or wrapping the giving set line around a glove of warm water to help warm the fluids before they reach the patient.

====Post-anaesthetic====
If a patient has been receiving fluids during a procedure, it is often continued after until the patient is either stable and fully recovered from the anaesthetic. The length of time the fluids continue for after the procedure is dependent on the individual patient and the individual case.

===Cardiac Disease===
It is important to avoid fluid overload in cardiac patients who often have reduced cardiac function. This means it is important to closely monitor fluid adminstration in these patients as it may worsen the patient's condition.

===Hepatic Disease===
Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.

If there are any clotting disorders then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.

===Central Nervous System Disease===
Patients with head trama or increased intracranial pressure are particularly susceptible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the [[Blood Brain Barrier - Anatomy & Physiology|blood brain barrier]] is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

{{Learning
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439]

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206456.pdf '''Fluid therapy.''' Hackett, T.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 263-265]

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338]
}}

{{OpenPages}}
[[Category:Fluid Therapy|A]]

Principles of Fluid Therapy

2013-11-20T10:38:16Z

Ctrace: /* Intra-anaesthetic */

{{OpenPagesTop}}
==What is Fluid Therapy?==
'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.
[[Image:Body_Compartments.jpg|center|]]

Fluid therapy is indicated either when there is a loss of fluid to any part of these compartments or there is a risk of loss of fluid. The severity of the fluid loss, and the compartment from which it has been lost, influence the choice of fluid and the speed at which it needs to be administered. If fluid therapy is performed as a treatment then it is necessary to diagnose and treat the underlying condition.
===Indications===
*Hypotension
*Hypovolemia
*Electrolyte, metabolic and acid base disorders
*Decreased oxygen delivery
*Geriatric patients at risk of organ failure

==Definitions==
*'''''Osmosis''''' is the ''net movement'' of water across a semi permeable membrane. The movement is caused by a concentration gradient due to different solute concentrations on each side of the membrane.
*'''''Osmotic Pressure''''' is the pressure caused by the solutes within the solution. The solute concentration prevents water movement across the membrane.
*'''''Tonicity''''' is the term used to compare the osmotic pressure of different solutions
**A ''hypotonic'' solution is one that has an osmotic pressure '''lower''' than plasma.
**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.
**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.
*'''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:
** Excessive sweating
** Water deprivation
** [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] and [[Diarrhoea|diarrhoea]]
** [[Haemorrhage|Haemorrhage]]
** Pathological dilatation of capacity of the ciruclatory system, and therefore a relative reduction in circulating blood.
*'''''Hypervolaemia'''''' is an increase in blood volume, which can be caused by congestive heart failure.

==Types of Fluids==
#'''[[Crystalloids]]''' are able to enter all body compartments.
#'''[[Colloids]]''' are restricted to the plasma compartment.

If there is an electrolyte imbalance present then it may be necessary to add the appropriate electrolyte solution.

==Fluid Rate Calculations==
When calculating the fluid requirements of a patient, there are 3 elements to consider -
# Replacement
# Maintainance
# Ongoing Losses
''Replacements'' are calculated based on the level of dehydration. Dehydration is based upon clinical assessment of each individual patient. Most commonly, skin tent is used for assessment. To calculate the amount required for replacement within a 24 hour period, the percentage dehydration is used in the following calculation.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Replacement''' = ''% Dehydration'' x ''Bodyweight (kg)'' x 10
|-
|}
</center>

''Maintainance'' is the basic rate which a patient requires during a 24 hour period. It is commonly calculated as 50ml/kg/24hr, or 2ml/kg/hr.

''Ongoing losses'' are calculated based on a predicted fluid amount lost by a patient within a 24 hour period. Common losses include vomitting and diarrhoea. It is often helpful here if the owners are able to give a detailed history as this makes it easier to predict the pattern of losses. In some patients there may be no ongoing losses and so this step can be skipped. To calculate the fluid requirement, the following calculation is used.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Ongoing losses''' = ''Amount per loss (ml/kg)'' x ''Bodyweight (kg) x ''No. of losses''
|-
|}
</center>

These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.

The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a drip pump is used or fluid rate is adjusted manually as shown below.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!Requirement per hour (ml/hr) = Requirement per day (ml/24hr) ÷ 24

Requirement per minute (ml/min) = Requirement per hour (ml/hr) ÷ 60

Requirement per second (ml/s)= Requirement per minute(ml/min) ÷ 60

Drops per second = Requirement per second (ml/s)x Giving Set Factor
|}
</center>

==Monitoring Fluid Therapy==
Fluid therapy can be monitored by observing urine output, Packed Cell Volume (PVC), Total Protein (TP, or Total Solids, TS), mucous membrane colour, and blood pressure among others. It is important to also observe for signs of oedema, such as pulmonary oedema or ascites. It should not be stopped until hydration of the patient has returned to normal and the patient is able to maintain a normal hydration status independently.

==Special Considerations==
===Shock===
'''[[Shock]]''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -
*Tachycardia
*Pale mucous membranes (May be dark if distributive shock)
*Prolonged/Absent capillary refil time
*Reduced/Absent periperhal pulses
*Hypotension

There are 3 forms of shock:-
*'''Hypovolemic''' is seen when there is reduced circulating blood volume and the most common form of shock.
*'''Cardiogenic''' is seen in any condition when there is a failure for the heart to pump effectively.
*'''Vascular''' can be sub-divided into -
**''Obstructive'' is seen when there is an obstruction to blood flow to a region of tissue.
**''Distributive'' is seen when there is inappropriate vasodilation. This leads to changes in blood flow distribution between tissues.

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.

===Anaesthesia===
====Pre-anaesthetic====
Before an anaesthestic is performed, it is important to stabilise a patient, both fluid deficits and any electrolyte or acid-base inbalances. In many cases, it is ideal to have a minimum blood database. This should include PCV and TP and if possible urea, creatinine, electrolyes and glucose. If there is any evidence of haemoconcentration, azotemia, or electrolyte imbalances then the patient should be given fluids to correct these abnormalities before the anaesthetic. Even if these parameters are normal it is often advisable to place the patient on fluids as most anaesthetic agents will alter fluid homeostasis, even in healthy patients.

When giving fluids ideally they should be warmed to help the patient maintain a normal body temperature.

====Intra-anaesthetic====
During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with [[Diabetes Mellitus|diabetes]], [[:Category:Liver - Pathology|liver disease]] or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

As mentioned previously, it is also ideal to administer warm fluids to a patient to help maintain a normal body temperature during any procedure. This can be done by warming the fluids in a water bath, or wrapping the giving set line around a glove of warm water to help warm the fluids before they reach the patient.

====Post-anaesthetic====
If a patient has been receiving fluids during a procedure, it is often continued after until the patient is either stable and fully recovered from the anaesthetic. The length of time the fluids continue for after the procedure is dependent on the individual patient and the individual case.

===Cardiac Disease===
It is important to avoid fluid overload in cardiac patients who often have reduced cardiac function. This means it is important to closely monitor fluid adminstration in these patients as it may worsen the patient's condition.

===Hepatic Disease===
Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.

If there are any clotting disorders then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.

===Central Nervous System Disease===
Patients with head trama or increased intracranial pressure are particularly susceptible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the blood brain barrier is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

{{Learning
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439]

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206456.pdf '''Fluid therapy.''' Hackett, T.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 263-265]

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338]
}}

{{OpenPages}}
[[Category:Fluid Therapy|A]]

Principles of Fluid Therapy

2013-11-20T10:35:57Z

Ctrace: /* Intra-anaesthetic */

{{OpenPagesTop}}
==What is Fluid Therapy?==
'''Fluid Therapy''' is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water. This can further be divided into intracellular or extracellular as shown below.
[[Image:Body_Compartments.jpg|center|]]

Fluid therapy is indicated either when there is a loss of fluid to any part of these compartments or there is a risk of loss of fluid. The severity of the fluid loss, and the compartment from which it has been lost, influence the choice of fluid and the speed at which it needs to be administered. If fluid therapy is performed as a treatment then it is necessary to diagnose and treat the underlying condition.
===Indications===
*Hypotension
*Hypovolemia
*Electrolyte, metabolic and acid base disorders
*Decreased oxygen delivery
*Geriatric patients at risk of organ failure

==Definitions==
*'''''Osmosis''''' is the ''net movement'' of water across a semi permeable membrane. The movement is caused by a concentration gradient due to different solute concentrations on each side of the membrane.
*'''''Osmotic Pressure''''' is the pressure caused by the solutes within the solution. The solute concentration prevents water movement across the membrane.
*'''''Tonicity''''' is the term used to compare the osmotic pressure of different solutions
**A ''hypotonic'' solution is one that has an osmotic pressure '''lower''' than plasma.
**A ''isotonic'' solution is one that has an osmotic pressure '''the same''' as plasma.
**A ''hypertonic'' solution is one that has an osmotic pressure '''higher''' than plasma.
*'''''Hypovolaemia''''' is a reduction in normal blood volume which can be caused by:
** Excessive sweating
** Water deprivation
** [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] and [[Diarrhoea|diarrhoea]]
** [[Haemorrhage|Haemorrhage]]
** Pathological dilatation of capacity of the ciruclatory system, and therefore a relative reduction in circulating blood.
*'''''Hypervolaemia'''''' is an increase in blood volume, which can be caused by congestive heart failure.

==Types of Fluids==
#'''[[Crystalloids]]''' are able to enter all body compartments.
#'''[[Colloids]]''' are restricted to the plasma compartment.

If there is an electrolyte imbalance present then it may be necessary to add the appropriate electrolyte solution.

==Fluid Rate Calculations==
When calculating the fluid requirements of a patient, there are 3 elements to consider -
# Replacement
# Maintainance
# Ongoing Losses
''Replacements'' are calculated based on the level of dehydration. Dehydration is based upon clinical assessment of each individual patient. Most commonly, skin tent is used for assessment. To calculate the amount required for replacement within a 24 hour period, the percentage dehydration is used in the following calculation.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Replacement''' = ''% Dehydration'' x ''Bodyweight (kg)'' x 10
|-
|}
</center>

''Maintainance'' is the basic rate which a patient requires during a 24 hour period. It is commonly calculated as 50ml/kg/24hr, or 2ml/kg/hr.

''Ongoing losses'' are calculated based on a predicted fluid amount lost by a patient within a 24 hour period. Common losses include vomitting and diarrhoea. It is often helpful here if the owners are able to give a detailed history as this makes it easier to predict the pattern of losses. In some patients there may be no ongoing losses and so this step can be skipped. To calculate the fluid requirement, the following calculation is used.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!'''Ongoing losses''' = ''Amount per loss (ml/kg)'' x ''Bodyweight (kg) x ''No. of losses''
|-
|}
</center>

These calculations are then added together to allow for the total fluid requirement in a 24 hour period. It is important to assess these requirements on a daily basis as losses may be increased/reduceed for example.

The calculated fluid requirement is multiplied by the bodyweight of the individual patient to give the total amount of fluid required for that patient as ml/24hr period. This is then further calculated depending on whether a drip pump is used or fluid rate is adjusted manually as shown below.
<center>
{| border="1" cellpadding="1"
|-style="background:#B0E0E6; color:black"
!Requirement per hour (ml/hr) = Requirement per day (ml/24hr) ÷ 24

Requirement per minute (ml/min) = Requirement per hour (ml/hr) ÷ 60

Requirement per second (ml/s)= Requirement per minute(ml/min) ÷ 60

Drops per second = Requirement per second (ml/s)x Giving Set Factor
|}
</center>

==Monitoring Fluid Therapy==
Fluid therapy can be monitored by observing urine output, Packed Cell Volume (PVC), Total Protein (TP, or Total Solids, TS), mucous membrane colour, and blood pressure among others. It is important to also observe for signs of oedema, such as pulmonary oedema or ascites. It should not be stopped until hydration of the patient has returned to normal and the patient is able to maintain a normal hydration status independently.

==Special Considerations==
===Shock===
'''[[Shock]]''' is defined as decreased oxygen delivery or utilisation by tissues that may lead to irreversible cellular damage if prolonged. Patients who present in a state of shock require immediate fluid therapy. To assess whether a patient is in shock the following signs may be seen -
*Tachycardia
*Pale mucous membranes (May be dark if distributive shock)
*Prolonged/Absent capillary refil time
*Reduced/Absent periperhal pulses
*Hypotension

There are 3 forms of shock:-
*'''Hypovolemic''' is seen when there is reduced circulating blood volume and the most common form of shock.
*'''Cardiogenic''' is seen in any condition when there is a failure for the heart to pump effectively.
*'''Vascular''' can be sub-divided into -
**''Obstructive'' is seen when there is an obstruction to blood flow to a region of tissue.
**''Distributive'' is seen when there is inappropriate vasodilation. This leads to changes in blood flow distribution between tissues.

The first choice fluid in hypovolemic shock cases are ''isotonic crystalloid'' fluids and are given at a high flow rate. They are often administered as a rapid bolus followed by the high flow rate. In cardiogenic shock cases, often the patient is already in volume overload and so often treated with a diuretic. Obstructive shock is often treated by removal of the obstruction.

===Anaesthesia===
====Pre-anaesthetic====
Before an anaesthestic is performed, it is important to stabilise a patient, both fluid deficits and any electrolyte or acid-base inbalances. In many cases, it is ideal to have a minimum blood database. This should include PCV and TP and if possible urea, creatinine, electrolyes and glucose. If there is any evidence of haemoconcentration, azotemia, or electrolyte imbalances then the patient should be given fluids to correct these abnormalities before the anaesthetic. Even if these parameters are normal it is often advisable to place the patient on fluids as most anaesthetic agents will alter fluid homeostasis, even in healthy patients.

When giving fluids ideally they should be warmed to help the patient maintain a normal body temperature.

====Intra-anaesthetic====
During an anaesthetic, normal homeostatic functions of the patient are altered and so fluid therapy should be initiated to any patient undergoing an anaesthetic to allow for maintained fluid balance. During any procedure, glucose levels should be closely monitored, especially patients with [[Diabetes Mellitus|diabetes]], liver disease or paediatric patients. If necessary it is then possible to add glucose or dextrose to the fluid the patient is receiving.

Some patients may develop an anaesthetic-induced hypotension from the side-effects of the agents used to induce and maintain anaesthesia. Fluids are therefore often given as a preventative measure. If there is significant blood loss during a procedure, it is necessary to replace these losses, either using blood products or an appropriate fluid.

As mentioned previously, it is also ideal to administer warm fluids to a patient to help maintain a normal body temperature during any procedure. This can be done by warming the fluids in a water bath, or wrapping the giving set line around a glove of warm water to help warm the fluids before they reach the patient.

====Post-anaesthetic====
If a patient has been receiving fluids during a procedure, it is often continued after until the patient is either stable and fully recovered from the anaesthetic. The length of time the fluids continue for after the procedure is dependent on the individual patient and the individual case.

===Cardiac Disease===
It is important to avoid fluid overload in cardiac patients who often have reduced cardiac function. This means it is important to closely monitor fluid adminstration in these patients as it may worsen the patient's condition.

===Hepatic Disease===
Patients with hepatic diease often have alterations in protein levels due to reduced production, as well as changes in clotting factors. Hypoproteinemia will affect patients undergoing anaesthetics as many agents are protein bound so the reduction in protein means that more of the agent may be available. However, the hypoproteinemia may also be affected by the adminstration of certain fluid types so it is important to have a baseline so that the most appropriate fluid can be selected.

If there are any clotting disorders then it may be necessary to give blood products so that the missing clotting factors are available to the patient, while the underlying cause is diagnosed and treated.

===Central Nervous System Disease===
Patients with head trama or increased intracranial pressure are particularly susceptible to insufficient or excessive fluid loading. It is therefore with care that fluids are administered and monitored. The choice of fluid is dependent on the other clinical signs of the patient such as haemodynamics. The status of the blood brain barrier is an important consideration in any patient and in the selection of fluid. However, fluids containing glucose should be avoided in these patients.

{{Learning
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017987.pdf ''' Why did fluid therapy kill my patient?''' Schaer, M.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 437-439]

[http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206456.pdf '''Fluid therapy.''' Hackett, T.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 263-265]

[http://www.cabi.org/cabdirect/FullTextPDF/2006/20063240205.pdf '''Fluid therapy - when enough is enough.''' Cooke, K.; The North American Veterinary Conference, Gainesville, USA, The North American Veterinary Conference 2003, Small Animal and Exotics. Orlando, Florida, USA, 18-22 January, 2003, 2003, pp 338]
}}

{{OpenPages}}
[[Category:Fluid Therapy|A]]

User talk:Ctrace

2013-11-12T16:35:15Z

Ctrace: Created page with "Write me a message in here if you want to talk!"

Write me a message in here if you want to talk!

User:S1369844

2013-11-07T16:52:56Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Bailey Teitge
|Occupation= Veterinary Student 
|School= UK - Edinburgh
|Year= 2018
|Email=
|Image=
}}

User:JaniceCampbell

2013-11-07T16:43:02Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Janice Campbell
|Occupation= Veterinary Student 
|School= UK - Glasgow
|Year= 2018
|Email=
|Image=
}}
[[Category:UK - Glasgow Graduates]]

User:Jaimberlyn

2013-11-07T16:22:17Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Jaimberlyn
|Occupation=
|School=
|Place of Training=
|Job Title=
|Year=
|Email=
|Image=
}}

Category:OpenPages

2013-11-06T18:45:43Z

Ctrace: Created page with "This category contains all of the pages that are currently open to the public within WikiVet."

This category contains all of the pages that are currently open to the public within WikiVet.

Template:OpenPagesTop

2013-11-06T18:43:19Z

Ctrace: added category to template

{| align="center" width="100%" cellpadding="0" style="background-color:#f5faff; border:1px solid #0B3861;"
|-
| align="center" | '''''Created by the veterinary profession for you''''' - [[WikiVet Introduction|find out more about WikiVet]]
Did you know you can [http://commons.wikivet.net/images/b/b8/Editing_a_WikiVet_Page.pdf edit] or [[Helping WikiVet|help WikiVetTM]] in other ways?
|-
|}
 
[[Category:OpenPages]]

WikiVet Edit-A-Thon

2013-10-29T13:06:32Z

Ctrace: /* Latest News */ added workshop image

== Latest News ==

=== WIKIVET/ WIKIMEDIA VETERINARY SCIENCE EDIT-A-THON ===
[[File:Workshop.png|right]]

Want to share your veterinary knowledge and expertise with colleagues and students in the profession, then why not join us on the 20th November in London for a WikiVet and WikiMedia [http://outreach.wikimedia.org/wiki/Edit-a-thon Edit-a-Thon]? This is part of a series of national events jointly organised by [http://www.jisc.ac.uk Jisc] and [https://wiki.wikimedia.org.uk Wikimedia UK] to encourage more users to author wiki content.

This first ever veterinary edit-a-thon will feature introductions to both WikiVet and Wikipedia and include training for anyone new to wiki editing. Content development will focus on common diseases that vets see in everyday practice, but contributions with a wider veterinary relevance are also welcome.

The event is designed for vets, students and those with an interest in publishing veterinary content on the internet. Wikipedians will be on hand to help so no previous experience of wikis or web editing is required! By the end of the day, all participants will have had the chance to create and publish some new content on Wikipedia or WikiVet.

The edit-a-thon will take place at the '''[[UK - Royal Veterinary College, London|Royal Veterinary College’s Camden Campus]]''' on the afternoon of '''20th November from 14.00 – 18.00'''. This is a '''free event''' but '''advance registration is required''' using our '''[http://wikivet.eventbrite.co.uk/ Online Booking]''' system.

More details about the event can be found on the '''[https://wiki.wikimedia.org.uk/wiki/Veterinary_Science_editathon Wikimedia UK blog]'''.

'''For more information please contact:'''
<table>
<tr><th colspan="2"></th></tr>
<tr><td>
:'''Wikimeda UK'''
:Martin Poulter
:E: [mailto:martin.poulter@wikimedia.org.uk martin.poulter@wikimedia.org.uk]
</td>
<td>
:'''WikiVet'''
:Chris Trace
:E: [mailto:chris@wikivet.net chris@wikivet.net]
</td>
</table>

[[Category:News]]

Test Home Page

2013-10-29T13:02:31Z

Ctrace: added system button

{| class="wikitable"
|[[File:Discipline.png]]
|learning resources image will go here
|-
|[[File:System.png]]
|rowspan="2"|image or news would go in here
|-
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This site has been developed for veterinary graduates, students and nurses. It provides a comprehensive virtual curriculum containing a wealth of veterinary information and learning resources. Use the navigation buttons above to jump to the relevant section of the site or [[:Special:Search|search]] for a particular topic.

Message for '''all new veterinary students''' starting in 2013, '''[[New Students|take a look at these pages]]''' which explain how you can get the most out of WikiVet during your studies.

There are currently '''[[Special:Statistics|{{NUMBEROFARTICLES}}]]''' articles on WikiVet and '''[[Special:Statistics|{{NUMBEROFUSERS}}]]''' registered users of the site.
|}
|}

[[es:Página Principal]]
[[fr:Accueil]]

Test Home Page

2013-10-29T12:58:36Z

Ctrace: added discipline button

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This site has been developed for veterinary graduates, students and nurses. It provides a comprehensive virtual curriculum containing a wealth of veterinary information and learning resources. Use the navigation buttons above to jump to the relevant section of the site or [[:Special:Search|search]] for a particular topic.

Message for '''all new veterinary students''' starting in 2013, '''[[New Students|take a look at these pages]]''' which explain how you can get the most out of WikiVet during your studies.

There are currently '''[[Special:Statistics|{{NUMBEROFARTICLES}}]]''' articles on WikiVet and '''[[Special:Statistics|{{NUMBEROFUSERS}}]]''' registered users of the site.
|}
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[[fr:Accueil]]

Test Home Page

2013-10-29T12:54:50Z

Ctrace:

{| class="wikitable"
|discipline image will go here
|learning resources image will go here
|-
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<div id="mf-body" title="Welcome to WikiVet">
{{#widget:Button|name=Login|page=Login}}{{#widget:Button|name=About|page=WikiVet_Introduction}}{{#widget:Button|name=Help|page=/Frequently_Asked_Questions}}
{{mobilemainpage}}
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{{#tag:imagemap|File:Front-Page-1.png{{!}}center{{!}}800px
rect 0 0 420 150 [[Discipline]]
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rect 0 425 420 560 [[Species]]
rect 500 200 1000 570 [http://media.wikivet.net/media/the-online-veterinary-anatomy-museum Online Veterinary Anatomy Museum Introduction]
desc none}}
 
This site has been developed for veterinary graduates, students and nurses. It provides a comprehensive virtual curriculum containing a wealth of veterinary information and learning resources. Use the navigation buttons above to jump to the relevant section of the site or [[:Special:Search|search]] for a particular topic.

Message for '''all new veterinary students''' starting in 2013, '''[[New Students|take a look at these pages]]''' which explain how you can get the most out of WikiVet during your studies.

There are currently '''[[Special:Statistics|{{NUMBEROFARTICLES}}]]''' articles on WikiVet and '''[[Special:Statistics|{{NUMBEROFUSERS}}]]''' registered users of the site.
|}
|}

[[es:Página Principal]]
[[fr:Accueil]]

Degenerative Mitral Valve Disease

2013-10-22T09:37:00Z

Ctrace: /* Prognosis */ add link to cardio academy

{{OpenPagesTop}}
Also known as: '''''MVD — Mitral Valve Disease — Mitral Insufficiency — Mitral Endocardiosis — Myxomatous Mitral Valve Disease (MMVD) — Endocardiosis — Mitral Regurgitation — Chronic Valvular Disease'''''

== Introduction ==
[[Image:AV valve dysplasia cat.jpg|right|thumb|200px|<center>'''Mitral dyplasia'''. Courtesy of A. Jefferies</center>]]
Endocardiosis is a valvular insufficiency. The most commonly affected site is the mitral valve. The condition results in slowly developing [[:Category:Heart Failure|heart failure]] as the valves become swollen and shortened/misshapen, so the heart cannot pump blood effectively from the left ventricle to the circulation.

Blood passes back into the left atrium, compromising the filling from the pulmonary vein, which leads to back pressure on the pulmonary capillaries. Resultant [[Oedema|oedema]] forms in the lungs, and can be heard as moist sounds on auscultation. This reduces the oxygenation of blood leading to exercise intolerance. Failure of the left side eventually compromises the function of the right side. In [[Heart Failure, Right-Sided|right sided heart failure]] there is a pooling of blood in the venous system i.e. in the [[Liver - Anatomy & Physiology|liver]]. In some cases a jet lesion can occur, where a small stream of blood passes back into the left atrium and contacts the atrial wall.

Mitral valve dysplasia is a congenital malformation or degeneration of the mitral valve leaflets and its supporting structures (''chordae tendinae'', papillary muscles, valvular leaflets, annulus) resulting in valvular regurgitation (insufficiency). It is common in dogs and cats and rare in other species.

Chronic mitral regurgitation leads to volume overload of the left heart, which results in dilatation (eccentric hypertrophy) of the left ventricle and atrium. When mitral regurgitation is severe, cardiac output decreases, which results in signs of [[Heart Failure, Left-Sided|left sided cardiac failure]] (LCHF) and pulmonary venous congestion. Dilatation of the left-sided chambers predisposes affected animals to [[:Category:Arrhythmia|arrhythmias]]. In some cases, malformation of the mitral valve complex causes a degree of valvular stenosis as well as insufficiency.

In advanced cases, signs of right sided congestive heart failure may follow due to an increased pressure load on the right ventricle as a result of long standing pulmonary congestion.

==Signalment==

Endocardiosis tends to affect middle-aged and older dogs, with males being predisposed. Breeds with particular predisposition to the disease include smaller breeds
such as Chihuahuas, Boston Terriers, Poodles, Pomeranians, Bull Terriers, Cavalier King Charles Spaniels and larger breeds such as the German Shepherd and Great Danes. It is the most common heart condition in dogs. In dogs over 9 years old 97% show lesions, of which approximately 40% are clinically significant. The condition is often found at post mortem as an incidental age related change. The disease is rare in cats.

===History===
Animals may remain asymptomatic for years. Typical reported signs include exercise intolerance and dyspnoea as a result of reduced cardiac output and a ventilation perfusion mismatch due to pulmonary oedema. A progressive cough often during rest or recumbency is frequently seen and needs to be distinguished from primary respiratory disease. Sudden death is possible due to a left atrial tear or advanced pulmonary oedema.

== Clinical Signs ==

Signs depend on stage of disease, but may include coughing, syncope, weight loss, pale or cyanotic mucus membranes and prolonged capillary refill time. If left sided heart failure is present then signs will also include exercise intolerance, weakness, dyspnoea, inappetance and lethargy. If right sided heart failure is present then signs including hepatomegaly, jugular pulses & distension, pleural effusion, ascites and peripheral oedema (pulmonary crackles) will occur.

There may be resting tachycardia, pale mucous membranes, prolonged capillary refill time (CRT) and jugular filling time, cool extremities, loss of sinus arrhythmia and new cardiac arrhythmias e.g. [[Atrial Fibrillation|atrial fibrillation]] or [[Supraventricular Premature Complexes|atrial premature complexes]].

== Diagnosis ==

Clinical signs plus signalment of the dog are indicative of the disease. Upon physical examination a '''systolic murmur over the left heart apex''' may be heard. Snaps, crackles, pops will also be heard if pulmonary edema is present. Muffled heart sounds in the presence of pleural/pericardial fluid will be auscultated.

===Diagnostic Imaging===
====Radiography====
Left lateral, right lateral and ventrodorsal views of the thorax are needed. The key radiographic signs associated with mitral valve dysplasia and resulting left sided congestive heart failure are cardiomegaly leading to possible dorsal displacement of trachea. There will possibly be none, some or all of the following radiographic signs - left atrial enlargement (DV view appears at 2-3 o'clock position), left ventricular enlargement, bronchial compression, pulmonary venous
congestion (enlarged pulmonary arteries and veins) and/or pulmonary oedema.

Evidence of right sided congestive heart failure maybe present in severe cases e.g. distended caudal vena cava, hepatomegaly, ascites, pleural effusions.

====Echocardiography====
Evidence of left atrial and left ventricular enlargement is visible on echocardiography. The 'fractional shortening' on M wave echography is also increased which is measured as the percentage change in the left ventricular diameter during systole and is used as a measure of systolic function. It is also possible to see structural changes in the valve leaflets in some cases. It may detail irregularities of the valves affected (e.g. thickening, shortening, and/or prolapse of the valve leaflets), abnormal valve movements & valve regurgitation, left atrial enlargement (wide P wave) and left ventricular dilation (tall R wave, wide QRS complex). The regurgitant jet of blood can be detected using colour doppler and evidence of turbulent flow.

===Electrocardiogram (ECG)===
A resting ECG trace may show evidence of an enlarge left atrium (wide P wave), an enlarged left ventricle (tall R wave, wide QRS complex, shift of mean electrical axis to the left) and rhythm disturbances such as sinus tachycardia, [[Atrial Fibrillation|atrial fibrillation]], [[Supraventricular Premature Complexes|atrial premature complexes]] and atrial tachycardia.

===Laboratory Tests===
Pro-brain natriuretic peptide (N-BNP) is a newly described cardiac hormone considered to be an effective marker of severity and prognosis of acute coronary syndromes and congestive heart failure. Circulating levels of the hormone increase in peripheral blood with increased myocardial stress. Commercial assays are not currently available.

== Treatment ==

If animal is presented in left or right sided heart failure treatment is given at the onset of clinical signs. Such treatments include ACE inhibitors and diuretics.

If the disease is detected but the animal is not yet in heart failure then no treatment is required. Exercise must also be restricted and special formulated sodium reduced cardiac diets recommended.

Symptomatic treatments are also given if clinical signs persist while the animal is on heart failure medications.

No treatment is recommended prior to the onset of heart failure. Once there is evidence of congestive heart failure, treatment is aimed at its management through a combination of drugs.

The aims of treatment are to:

1. '''Reduce Preload'''
::Diuretics to reduce circulating fluid volume (Frusemide, Benzofluazide, Spironolactone, Amiloride)
::Vasodilators to reduce venous return (Nitrates, ACE inhibitors, Alpha antagonists)
2. '''Reduce Afterload
::Vasodilators to decrease systemic vascular resistance
:::ACE inhibitors e.g. Enalapril, Benzapril, Imidopril
:::Pimobendan
:::Calcium channel blockers e.g. Amlodipine
:::Nitrates e.g. Nitroprusside
3. '''Enhance Systolic function
::Positive inotropes to increase cardiac contractility and increase cardiac output (Pimobendan, Digoxin, Dobutamine, Xanthines)
4. '''Improve Diastolic function
::Negative chronotropes to increase the length of diastole (Digoxin, Atenolol)
::Calcium channel blockers to improve relaxation (Amlodipine)
5. '''Control cardiac arrhythmias using anti-arrhythmic drugs

== Prognosis ==

Asymptomatic patients may live for many years. Once heart failure occurs, life expectancy is usually around one year although some patients remain stable for years on heart failure medications.

Mitral Valve Dysplasia can remain asymptomatic for many years (average 4 years). Once congestive heart failure has developed, the progression of the diseae can be monitored by the severity of the clinical signs (cough, exercise intolerance) and radiographically looking at cardiac size, the degree of pulmonary oedema and the size of the left atrium. Cardiac size can be measured objectively using the Vertebral Heart Score method.
Mean survival is 200-300 days once in overt cardiac failure with standard treatment protocols.

{{Learning
|videos = [http://www.cardioacademy.cevalearn.com/en/Programme/Sessions/1-Pathophysiology-of-Mitral-Valve-Disease video on mitral valve disease from Cardio Academy]
|flashcards = [[Endocardial Pathology Flashcards]]
|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Mitral+Valve+Dysplasia%22&occuring1=title&rowId=2&options2=OR&q2=%22Mitral+Valve+Disease%22&occuring2=title&rowId=3&options3=OR&q3=%22Mitral+insufficiency%22&occuring3=title&rowId=4&options4=OR&q4=%22endocardiosis%22&occuring4=title&x=36&y=9&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Mitral Valve Dysplasia publications]

[http://www.cabdirect.org/search.html?it=any&q2=%22Mitral+Valve+Disease%22&q1=%22Mitral+Valve+Dysplasia%22&calendarInput=yyyy-mm-dd&q4=%22endocardiosis%22&q3=%22Mitral+insufficiency%22&occuring1=title&show=all&rowId=1&rowId=2&rowId=3&rowId=4&options1=AND&options2=OR&occuring4=title&options3=OR&options4=OR&occuring3=title&occuring2=title&publishedend=yyyy&la=any&publishedstart=yyyy&fq=sc:(ft+OR+fr+OR+fa+OR+fv+OR+fw+OR+fx+OR+gf+OR+ga+OR+b1+OR+b2+OR+b3+OR+b4+OR+b5+OR+b6)&y=9&x=36 Other MDV Full Text Articles]
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2010/20103219945.pdf ''' Myxomatous degenerative mitral valve disease: an update.''' Disatian, S.; Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand, Thai Journal of Veterinary Medicine, 2010, 40, 2, pp 151-157, many ref.]

[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093114836.pdf ''' Latest information about canine mitral valve disease: results of the QUEST trial.''' Häggström, J.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 188-191, 10 ref. - '''Full Text Article''']

[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017845.pdf ''' Treatment of mitral valve disease in dogs.''' French, A.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 107-108]

[http://www.cabi.org/cabdirect/FullTextPDF/2009/20093017847.pdf ''' Prognostic variables in canine mitral valve disease.''' Häggstrom, J.; Gething, M.; Jones, B.; Australian Small Animal Veterinary Association, Bondi, Australia, 33rd World Small Animal Veterinary Association Congress, Dublin, Ireland, 20-24 August 2008, 2008, pp 112-113, 7 ref.]
}}

==References==
* Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition), W.B. Saunders Company
* Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2), W.B. Saunders Company
* Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition), Mosby Elsevier * Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
* Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
* Tilley, L.P. and Smith, F.W.K.(2004) '''The 5-minute Veterinary Consult (Third edition)''' ''Lippincott, Williams & Wilkins''.
* Tilley,L.P., Smith, F.W.K, Oyama, M., Sleeper, M. (2007) '''Manual of Canine and Feline Cardiology''' ''Saunders''.

{{review}}

{{OpenPages}}

[[Category:Cardiovascular_System_-_Degenerative_Pathology]] [[Category:Endocardial_Pathology]] [[Category:Expert_Review]] [[Category:Cardiac_Diseases_-_Cat]] [[Category:Cardiac_Diseases_-_Dog]]
[[Category:Cardiac_Diseases_-_Horse]]
[[Category:Cardiovascular_System_-_Developmental_Pathology]]
[[Category:Cardiology Section]]

Test Home Page

2013-10-16T14:46:48Z

Ctrace:

{| class="wikitable"
|-
|Pie
|rowspan="2"|text
|-
|Cheese
|}

{| class="wikitable"
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<div id="mf-body" title="Welcome to WikiVet">
{{#widget:Button|name=Login|page=Login}}{{#widget:Button|name=About|page=WikiVet_Introduction}}{{#widget:Button|name=Help|page=/Frequently_Asked_Questions}}
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{|width="100%" cellpadding="2" cellspacing="5" style="vertical-align:top; background:#f5faff;"
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{{Strapline}}
 
{{#tag:imagemap|File:Front-Page-1.png{{!}}center{{!}}800px
rect 0 0 420 150 [[Discipline]]
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rect 0 425 420 560 [[Species]]
rect 500 200 1000 570 [http://media.wikivet.net/media/the-online-veterinary-anatomy-museum Online Veterinary Anatomy Museum Introduction]
desc none}}
 
This site has been developed for veterinary graduates, students and nurses. It provides a comprehensive virtual curriculum containing a wealth of veterinary information and learning resources. Use the navigation buttons above to jump to the relevant section of the site or [[:Special:Search|search]] for a particular topic.

Message for '''all new veterinary students''' starting in 2013, '''[[New Students|take a look at these pages]]''' which explain how you can get the most out of WikiVet during your studies.

There are currently '''[[Special:Statistics|{{NUMBEROFARTICLES}}]]''' articles on WikiVet and '''[[Special:Statistics|{{NUMBEROFUSERS}}]]''' registered users of the site.
|}
|}

[[es:Página Principal]]
[[fr:Accueil]]

User:Ctrace

2013-10-16T14:45:50Z

Ctrace: /* About me */

Test Home Page

2013-10-16T14:41:08Z

Ctrace:

Aneurysm

2013-10-15T10:32:51Z

Ctrace: /* Test yourself with the Vascular Pathology Flashcards */

[[Image:Dissecting aneurysm 2.jpg|left|thumb|125px|<center>'''Dissecting aneurysm'''. Courtesy of A. Jefferies</center>]]
Aneurysm is a local abnormal dilation of a vessel due to weakening of loss of elasticity of the vessel wall.
[[Image:Dissecting aneurysm 3.jpg|right|thumb|125px|<center>'''Dissecting aneurysm'''. Courtesy of A. Jefferies</center>]]
Seen proximal to a stenotic lesion. If the wall partially ruptues blood can track within the wall producing a dissecting aneurysm.
'''Verminous anurysm''' occurs in horses with [[Strongylus vulgaris]] infestation.

{{Learning
|flashcards=[[Vascular Pathology Flashcards|Vascular Pathology]]
}}

[[Category:Arterial_Pathology]][[Category:Cardiovascular_System_-_Vascular_Pathology]][[Category:To_Do_-_Cardiovascular]][[Category:Cardiology Section]]

Amyloidosis

2013-10-15T10:30:40Z

Ctrace: /* Test yourself with the Vascular Pathology Flashcards */

==Introduction==
Amyloid infiltration occurs in all species - amyloid is an inert substance that becomes deposited under the endothelium and basement membranes of a variety of tissues, notably the renal glomeruli,
[[Pancreas - Anatomy & Physiology#Endocrine|Islets of Langerhans]] in the [[Pancreas - Anatomy & Physiology|pancreas]] and the [[Liver - Anatomy & Physiology|liver]] (between the sinusoidal reticulum and the hepatic cords).

==Causes==
May be a primary condition or appear secondary to some chronic tissue destructive process such as:
*an infectious process elsewhere in the body
*sustained antigenic stimulation, eg repeated injections with an antigenic substance or production of excessive antibody by leukocytes

==Gross Pathology==
Affected organs will apear:
*pale (greyish waxy appearance)
*enlarged with rounded edges
*firm
*very prone to rupture

====Microscopically====
*deposition of amyloid in the space of Disse (or perisinusoidal space) which is in the liver between the hepatocytes and a sinusoid.
*shows 'apple-green' fluorescence under polarised light after staining with Congo Red

==Arterial Dissemination==
Amyloid is an eosinophilic, homogenous, hyaline material. Due to its beta-pleated-sheet structure it is almost insoluble. Amyloid may be present in one of two forms:
*'''AA''': Serum amyloid A, alpha-2 globulin.
*'''AL''': Derived from immunoglobulin light chains.

Disease may be truly idiopathic (dogs and cats) or may be secondary to another disease process, often chronic inflammation or neoplasia. Chronic antigenic stimulation induces the overproduction of AA protein which may become deposited throughout the body.

Deposits can be found in:
*Renal vessels and glomeruli.
*Splenic white pulp.
*Space of Disse.
*Coronary arteries.
*Meningeal arteries.

Affected organs are non-functional and appear waxy and pale.

*Amyloid is an insoluble protein that can accumulate in the kidney and compress the glomerulus, interfering with its normal function.
*Hypoproteinaemia and nephrotic syndrome can result due to substantial protein loss in the urine.
*Causes can be idiopathic or associated with underlying chronic inflammatory conditions.
'''Gross pathology'''
*Kidneys are firm, enlarged, and pale. Affected glomeruli may be seen as yellowish spots in the cortex.
*Amyloid can be visualised by treating the freshly cut surface of the kidneys with iodine.

'''Histopathology'''
*Amyloid stains pink with congo red.
*Presence of a pink, homogenous material replacing the epithelium and endothelium of the glomerulus.
<center><gallery>
Image:Congo red.jpg|'''Amyloidosis Stained with Congo Red''' Susan Rhind, University of Edinburgh
Image:Amyloidosis_histology.jpg|'''Amyloidosis Histology''' Susan Rhind University of Edinburgh

</gallery></center>

{{Learning
|flashcards=[[Vascular Pathology Flashcards|Vascular Pathology]]
}}

[[Category:Liver_-_Storage_Diseases]]

[[Category:Cardiovascular_System_-_Degenerative_Pathology]][[Category:Cardiovascular_System_-_Vascular_Pathology]][[Category:Arterial_Pathology]]
[[Category:Glomerular Disease]]
[[Category:To Do - Urinary]][[Category:Cardiology Section]]

Category:Cardiology Section

2013-10-15T10:27:59Z

Ctrace: Created page with "This section contains pages that could be linked in to an integrated cardiology section"

This section contains pages that could be linked in to an integrated cardiology section

Amyloidosis

2013-10-15T10:27:31Z

Ctrace: /* Test yourself with the Vascular Pathology Flashcards */

==Introduction==
Amyloid infiltration occurs in all species - amyloid is an inert substance that becomes deposited under the endothelium and basement membranes of a variety of tissues, notably the renal glomeruli,
[[Pancreas - Anatomy & Physiology#Endocrine|Islets of Langerhans]] in the [[Pancreas - Anatomy & Physiology|pancreas]] and the [[Liver - Anatomy & Physiology|liver]] (between the sinusoidal reticulum and the hepatic cords).

==Causes==
May be a primary condition or appear secondary to some chronic tissue destructive process such as:
*an infectious process elsewhere in the body
*sustained antigenic stimulation, eg repeated injections with an antigenic substance or production of excessive antibody by leukocytes

==Gross Pathology==
Affected organs will apear:
*pale (greyish waxy appearance)
*enlarged with rounded edges
*firm
*very prone to rupture

====Microscopically====
*deposition of amyloid in the space of Disse (or perisinusoidal space) which is in the liver between the hepatocytes and a sinusoid.
*shows 'apple-green' fluorescence under polarised light after staining with Congo Red

==Arterial Dissemination==
Amyloid is an eosinophilic, homogenous, hyaline material. Due to its beta-pleated-sheet structure it is almost insoluble. Amyloid may be present in one of two forms:
*'''AA''': Serum amyloid A, alpha-2 globulin.
*'''AL''': Derived from immunoglobulin light chains.

Disease may be truly idiopathic (dogs and cats) or may be secondary to another disease process, often chronic inflammation or neoplasia. Chronic antigenic stimulation induces the overproduction of AA protein which may become deposited throughout the body.

Deposits can be found in:
*Renal vessels and glomeruli.
*Splenic white pulp.
*Space of Disse.
*Coronary arteries.
*Meningeal arteries.

Affected organs are non-functional and appear waxy and pale.

*Amyloid is an insoluble protein that can accumulate in the kidney and compress the glomerulus, interfering with its normal function.
*Hypoproteinaemia and nephrotic syndrome can result due to substantial protein loss in the urine.
*Causes can be idiopathic or associated with underlying chronic inflammatory conditions.
'''Gross pathology'''
*Kidneys are firm, enlarged, and pale. Affected glomeruli may be seen as yellowish spots in the cortex.
*Amyloid can be visualised by treating the freshly cut surface of the kidneys with iodine.

'''Histopathology'''
*Amyloid stains pink with congo red.
*Presence of a pink, homogenous material replacing the epithelium and endothelium of the glomerulus.
<center><gallery>
Image:Congo red.jpg|'''Amyloidosis Stained with Congo Red''' Susan Rhind, University of Edinburgh
Image:Amyloidosis_histology.jpg|'''Amyloidosis Histology''' Susan Rhind University of Edinburgh

</gallery></center>

==Test yourself with the Vascular Pathology Flashcards==

[[Vascular Pathology Flashcards]]

[[Category:Liver_-_Storage_Diseases]]

[[Category:Cardiovascular_System_-_Degenerative_Pathology]][[Category:Cardiovascular_System_-_Vascular_Pathology]][[Category:Arterial_Pathology]]
[[Category:Glomerular Disease]]
[[Category:To Do - Urinary]][[Category:Cardiology Section]]

Actinobacillosis - Pig

2013-10-15T10:22:45Z

Ctrace: /* References */

{{OpenPagesTop}}
Also known as: '''''Actinobacillosis — Actinobacillus suis septicaemia in pigs — A. equuli in swine — Otitis media, externa, interna, middle and inner ear infections'''''

==Introduction==
Actinobacillosis is caused by the '''bacterium''' [[Actinobacillus suis|'''''Actinobacillus suis''''']]. The disease affects suckling, weanling and fattening pigs, and adult pigs and it is thought that it colonises piglets within the first three weeks of life.

In '''piglets''' aged 1 to 8 weeks old the organism causes acute and rapidly '''fatal septicaemia''', and '''localized infections''' such as endocarditis, polyarthritis, and '''respiratory distress''' may also been seen with additional '''neurological signs'''.

'''Adult''' pigs can suffer '''pneumonia-like symptoms''', see [[Actinobacillus suis#Clinical Signs| clinical signs]] for more details. It is not considered a zoonosis but there has been a report of human infection after a pig bite <ref>Escande, F., Bailly, A., Bone, S., Lemozy, J. (1996) '''''Actinobacillus suis'' infection after a pig bite'''. ''Lancet'' (British edition), 348(9031):888; 5 ref</ref>.

==Signalment==
'''High health status herds''' with lower immune challenges are '''more at risk''' then conventional herds. Piglets from high health status herds can suddenly die without any premonitory signs. Disease progression can be '''exacerbated by excessive temperature fluctuation, high humidity, mixing of pigs of different ages and overcrowding'''. '''Genetic make up''' and '''immune status''' can also influence infectivity rate and clinical signs.

==Clinical Signs==
Clinical signs vary from fever, lethargy, depression, [[Erysipelas - Pig#Clinical Signs|'''erysipelas-like lesions''']], abscesses, haemorrhage, vomiting/regurgitation and '''lameness''' and '''multiple joint swelling'''. More serious cases progress to '''pneumonia''' (clinical signs similar to [[Actinobacillus pleuropneumoniae#Clinical Signs| ''A. pleuropneumoniae'']]) and '''sudden death'''.

'''Cardiorespiratory signs''' include tachycardia, heart murmurs, purulent or serous occulonasal discharges, sneezing, coughing, abnormal lung sounds, dyspnoea, '''cyanosis''' changes in heart rate and open-mouthed breathing.

'''Aural purulent mucoid discharge''' and increased amounts of wax are present along with a '''foul odour'''. Pigs can become '''deaf''' and are often found rubbing and scratching their ears.

Affected animals are in a lot of pain and discomfort and suffer from dysphagia, lymphadenopathy, '''anorexia''', and unthriftiness. In '''sows''' it can cause '''agalactia, mastitis, abortions, still births''' or '''weak piglets'''.

Neurological signs include head tilt, circling, '''tremors''', nystagmus, strabismus, decreased or absent menace response, ptosis, miosis or meiosis, photophobia, headshaking, opisthotonus, facial paralysis, '''paraparesis''' and '''ataxia'''. Further occular signs associated with this disease is '''corneal oedema''' and '''ulceration'''.

==Diagnosis==
[[File:Actinobacillus suis.jpg|thumb|200px|right|''Actinobacillus suis'' Gram stain]]
Diagnosis can be difficult as its clinical signs are similar to other pathogens, such as ''[[Streptococcus suis]]'' and ''[[Haemophilus parasuis]]'', which also cause septicaemic infection and sudden death. Infection can be confirmed by the isolation of ''A. suis'', from '''culturing infected tissue'''.

On post-mortem serous or '''fibrinous exudates''' can be found in the thorax and pericardium and '''ecchymotic haemorrhages''' can be seen in kidneys, lungs, liver, spleen and other organs.

'''Differential diagnoses''': [[Actinobacillus pleuropneumoniae|''A. pleuropneumoniae'']], [[Erysipelas - Pig|Erysipelas]], [[Glasser's Disease|Glasser’s disease]], [[Streptococcus suis|''Streptococcus suis'']], and [[Mulberry Heart Disease|Mulberry heart disease]].

==Treatment==
''A.suis'' has '''good sensitivity''' to '''ceftioufur, gentamicin''' and '''trimethoprim/sulfadiazine''', and moderate sensitivity to ampicillin, neomycin, sulfadimethoxine and tiamulin. Culture and sensitivity is recommended.

==Control==
'''Routine biosecurity''' and '''disinfection''' should be followed and maintained. At present there is no commercial vaccine for ''A. suis'' <ref>Radostitis, O.M., Gay, C.C., Hinchcliff, K.W., and Constable, P.D. (2007) '''Veterinary Medicine: A textbook of the diseases of cattle, horses, sheep, pigs and goats (10th Edition)'''. ''Saunders'', 1052-1053</ref> but there is evidence that autogenous vaccines in a herd could help stabilise antibody levels in the whole population <ref>Lapointe, L., D'Allaire, S., Lacouture, S., Gottschalk, M. (2001) '''Serologic profile of a cohort of pigs and antibody response to an autogenous vaccine for ''Actinobacillus suis'''''. ''Veterinary Research'', 32(2):175-183; 18 ref</ref>.

{{Learning
|flashcards = [[Actinobacillosis - Pig Flashcards|Actinobacillosis - Pig Flashcards]]
}}

==References==
<references/>

{{CABI source
|datasheet = [http://www.cabi.org/ahpc/?compid=3&dsid=95736&loadmodule=datasheet&page=2144&site=160 Actinobacillus suis infection]
|date = August 08, 2011
}}
 

{{Andrew Rycroft
|date = December 22, 2011}}

{{OpenPages}}

[[Category:Neurological Diseases - Pig]]
[[Category:Cardiovascular Diseases - Pig]]
[[Category:Dermatological Diseases - Pig]]
[[Category:Respiratory Diseases - Pig]]
[[Category:Musculoskeletal Diseases - Pig]]
[[Category:CABI Expert Review Completed]][[Category:CABI AHPC Pages]]
[[Category:Cardiology Section]]

Test Home Page

2013-10-14T14:21:47Z

Ctrace: Created page with "<div id="mf-body" title="Welcome to WikiVet"> {{#widget:Button|name=Login|page=Login}}{{#widget:Button|name=About|page=WikiVet_Introduction}}{{#widget:Button|name=Help|page=/F..."

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This site has been developed for veterinary graduates, students and nurses. It provides a comprehensive virtual curriculum containing a wealth of veterinary information and learning resources. Use the navigation buttons above to jump to the relevant section of the site or [[:Special:Search|search]] for a particular topic.

Message for '''all new veterinary students''' starting in 2013, '''[[New Students|take a look at these pages]]''' which explain how you can get the most out of WikiVet during your studies.

There are currently '''[[Special:Statistics|{{NUMBEROFARTICLES}}]]''' articles on WikiVet and '''[[Special:Statistics|{{NUMBEROFUSERS}}]]''' registered users of the site.
|}
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<!--------------------------- Teaser------
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{|id="mp-right" width="100%" cellpadding="2" cellspacing="5" style="vertical-align:top; background:#f5faff;"
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|-
|style="color:#000;"|

<center>'''What is your diagnosis?'''</center>
 
This 12-year-old, neutered female cat presented with a plantigrade posture and a prolonged history of polyuria/polydipsia.
 
<center>
<gallery widths=150px caption="[[Small Animal Abdominal and Metabolic Disorders Q&A 06]]">
Image:SmAn Ab and Met 06.jpg
</gallery>
</center>
<center>Test yourself [[Small Animal Abdominal and Metabolic Disorders Q&A 06|here]].</center>
 
'''[http://twitter.com/#!/WikiVet Follow us on Twitter]''' to get notified whenever a new page is released and to receive teaser questions! You can also find them on our [http://www.facebook.com/pages/WikiVet/188576847835536?v=wall Facebook page].

If you have some teaching resources like these that you would like to make available via WikiVet, why not contact the WikiVet team? If you have any comments or suggestions, please feel free to email the [mailto:wikimaster@wikivet.net WikiVet team] or you can post a comment on our [http://www.facebook.com/pages/WikiVet/188576847835536?v=wall Facebook page]!
|}

[[es:Página Principal]]
[[fr:Accueil]]

User:Plectrude13

2013-09-20T15:50:44Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Franzi Sebastian
|Occupation= Veterinary Surgeon 
|School= Germany - Universitât Leipzig Veterinârmedizinische Fakultât
|Year= 2013
|Email=
|Image=
}}

User:Meltholth

2013-09-11T12:24:06Z

Ctrace: Creating user page with biography of new user.

{{UserPage
|Name=Mahmoud Eltholth
|Occupation= Veterinary Surgeon 
|School= Egypt - Kafr El-Sheikh University Faculty of Veterinary Medicine
|Year= 1998
|Email=
|Image=
}}
[[Category:Egypt - Kafr El-Sheikh University Faculty of Veterinary Medicine Graduates]]

Category:RVC Clinical Podcasts

2013-08-30T10:30:44Z

Ctrace:

This category contains [[Podcasts|podcasts]] created by Shailen Jasani that cover a range of clinical topics.

 
[[Category:Podcasts]]

Category:Podcasts

2013-08-30T10:29:37Z

Ctrace:

This category contains all podcasts that are linked to from WikiVet

[[Category:Multimedia Resource]]

Category:Podcasts

2013-08-30T10:28:30Z

Ctrace: Created page with "This category contains all podcasts that are linked to from WikiVet"

This category contains all podcasts that are linked to from WikiVet

Category:RVC Clinical Podcasts

2013-08-30T10:27:49Z

Ctrace: Created page with "This category contains podcasts created by Shailen Jasani that cover a range of clinical topics. Category:Podcasts"

This category contains podcasts created by Shailen Jasani that cover a range of clinical topics.

 
[[Category:Podcasts]]

Seizures podcast

2013-08-30T10:27:01Z

Ctrace:

{{Podcast
|Name = RVC Clinical Podcasts - Seizures
|Link = http://www.rvc.ac.uk/small-animal-referrals/news-events/clinical-podcasts
|Description = blah blah blah
|Duration = 45m 43s
|Date =19th April 2013
|Author = [http://shailenjasani.com/about-me/ Shailen Jasani]
|Image =WVpodcasts.png}}

 
[[category:RVC Clinical Podcasts]]

Podcasts

2013-08-30T10:22:48Z

Ctrace:

__NOTOC__
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|-
|-
|colspan="4"|
{|width="740px" align="center" style="clear:both; background-color:#fcfcfc;"
|<center>This section contains links to podcasts on a wide range of veterinary topics at all levels of the veterinary course.</center>
|}
|-
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|}

[[Category:Multimedia Resource]]

Podcasts

2013-08-30T10:20:49Z

Ctrace: Changed page in to a more generic podcasts page so can group together other podcasts from various locations

__NOTOC__
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|-
|-
|colspan="4"|
{|width="740px" align="center" style="clear:both; background-color:#fcfcfc;"
|<center>This section contains links to podcasts on a wide range of veterinary topics at all levels of the veterinary course.</center>
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|-
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[[Category:Multimedia Resource]]

Seizures

2013-08-30T10:15:19Z

Ctrace: /* Investigation of Seizures */

==Introduction==

* '''Seizures''' are paroxysmal changes in cerebral cortex electrical activity that start abruptly, end suddenly and have a tendency to recur.
* '''Epilepsy''' is the occurence of recurrent seizures.

==Pathophysiology==

* Seizures occur when there is imbalance between exitatory and inhibitory processes. This may be due to :
** Inadequate neuronal inhibition.
*** Major inhibitory neurotransmitters include GABA and glycine.
** Excessive neuronal excitation.
*** Major excitatory neurotransmitters include aspartate and glutamate.

===Proposed Mechanisms===

* Defective feed-forward inhibition or feed-back initiation of inhibitory neurons in cortical circuits.
** Recurrent excitatory collaterals may be formed.
* Changes in membrane properties of neurons.
** These may include changes at:
*** Potassium, sodium, chloride and calcium ion channels
*** GABA receptors
*** Nicotinic acetyl choline receptors
*** NMDA receptors
**** Activation.
* Changes in the ionic microenvironment.

===Seizure Development===

# At the onset of a seizure, abnormal neurons undergo prolonged depolarisations.
#* These depolarisations are associated with the rapid firing of repeated action potentials.
# Depolarisation of abnormal neurons recruits adjacent neurons with which they are connected.
# The electrical discharges of the large number of neurons involved become linked together.
# A storm of electrical activity results, causing a clinical seizure.
# Seizures may then spread:
#* To adjacent areas of the brain.
#* Through established anatomic pathways to other distant areas.

==Nomenclature==

* '''Status epilepticus''' is the term used to describe
** A seizure lasting longer than 5 minutes, or
** A collection of discrete seizures without full recovery of consciousness.
* '''Cluster seizures''' occur when 2 or more seizures are experienced in a brief periods, but the patient regains consciousness between them.
* Three classes of seizures are recognised:
*# Generalised seizures
*# Focal seizures
*# Focal generalising seizures

===Generalised Seizures===

* Generalised seizures may be:
** Idiopathic
** Symptomatic
*** Due to intracranial disease e.g. neoplasia, storage diseases etc.
** Cryptogenic
*** There is probably an underlying cause but it cannot be identified by the diagnostic tests available.
** Reactive
*** Due to some extracranial disorder, for example a toxin or metabolic disorder.

====Clinical Signs====

* Initial clinical signs show involvement of both cerebral hemispheres.
* Generalised seizures result in:
** Change in consciousness
** Motor activity
*** Tonic-clonic seizures are most common in dogs and cats.
** Autonomic signs
* The body's energy utilisation can increase to around 250% of the normal value during a generalised seizure.

====Stages====

# Prodromal Phase
#* The animal experiences an indication of a forthcoming seizure.
#* This occurs hours to days before the event itself.
# Aural Phase
#* This is the very start of the seizure.
#* Behaviour changes may be apparent.
# Ictal Phase
#* The seizure "proper".
# Postictal phase
#* Consists of transient neurological and behavious changes, which can last from hours to days.

====[[Idiopathic Epilepsy]]====

====Acquired Generalisd Seizures====

* Other general seizures may be acquired.
* Seizures can occur at any age, but generally occur in animals younger than 2 years and older than 5 years.
* Causes may include:
** Intracranial disease
*** Neoplasia
*** Trauma
*** Infection
*** Inflammation
** Extracranial disease (also known as "reactive epilpsy").
*** Electolyte disorders
*** Metabolic disorders
*** Toxicity

===Focal Seizures===

* Almost always an acquired disease.
* Active diseases often progress to become more general.
** Cause generalised seizures.

===Simple Focal Seizures===

* Onset occurs in a limited area of one cerebral hemisphere.
* No impairment of consciousness.

=== Complex Focal Seizures===

* Arise in a single brain region, but cause impaired consciousness.

==Causes of Acquired Seizures==

{| border="3" cellpadding="8"
!width="150"|'''Cause'''
!width="400"|'''Examples'''

|-
|Neoplasia
|Primary or metastatic
|-
|Inflammatory
|Distemper, FIP, FeLV/FIV, rabies, cryptococcosis (cats), toxoplasmosis
|-
|Traumatic
|Immediate or delayed
|-
|Vascular
|Feline ischaemic encephalopathy, thromboembolism, hypertenstion
|-
|Anomalous
|Hydrocephalus
|-
|Metabolic
|Hepatic encephalopathy, uraemia, hyperparathyroidism, hypolycaemia, hyperkalaemia, hypocalcaemia, hypoxia, acid-base disorders, hyperthermia
|-
|Toxic
|Lead, organophosphates, metaldehyde, strychnine
|}

==Investigation of Seizures==

* It must first be determined whether seizure activity is in fact a seizure, rather than a non-epileptic paroxysmal event, for example:
** Syncope
** Exercise-induced weakness
** Obsessive-compulsive behaviour
** Narcolepsy
* Idiopathic epilepsy may be differentiated from secondary or reactive seizures by considering:
** Age of onset
** Breed disposition
** Partial seizures or asymmetrical post-ictal signs
*** These suggest a discrete lesion.
** Older animals (>5 years) may be more likely to have an acquired aetiology.
** Younger animals (<6 months) may be more likely to have toxic or metabolic causes.
* Useful tests include:
** Metabolic screening
** Haematology
** Serum biochemistry
** Urinalysis
** Serology.
** Bile acid stimulation test
** Serum lead
** MRI and CT scanning, and CSF analysis, help rule out cancer.
 

{{Template:Learning
|podcasts = [[Seizures podcast|RVC clinical podcast about seizures]] 
}}

[[Category:Central Nervous System - Pathology]]

Template:Learning

2013-08-30T10:14:25Z

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{{!}}[[Ocular Reflexes resource|Why not try to diagnose what is wrong with the Ocular Reflexes virtual patient?]]
{{!}}-
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|}

Template:Learning

2013-08-30T10:03:30Z

Ctrace: added in podcasts

{| class="toccolours vevent" align=center style="width:{{{box_width|80em}}}; font-size:90%; text-align:left;"
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rect 0 0 360 350 [[Veterinary Education Online]]
desc none}}<big>Pages </big> Recommended pages
{{!}} <big>{{{pages}}}</big>
{{!}}-
}}
{{#if: {{{dragster<includeonly>|</includeonly>}}} |
! width="385" {{!}} {{#tag:imagemap|Image:Dragster logo.png{{!}}left{{!}}80px
rect 0 0 360 350 [[Dragster]]
desc none}}<big>Drag and Drop (Dragster) </big> Test your knowledge using drag and drop boxes
{{!}} <big>{{{dragster}}}</big>
{{!}}-
}}
{{#if: {{{quiz<includeonly>|</includeonly>}}} |
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desc none}}<big>WikiQuiz </big> Multiple choice quizzes
{{!}} <big>{{{quiz}}}</big>
{{!}}-
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{{!}} <big>{{{flashcards}}}</big>
{{!}}-
}}
{{#if: {{{videos<includeonly>|</includeonly>}}} |
! width="385" {{!}} {{#tag:imagemap|Image:WikiVideo.png{{!}}left{{!}}80px
rect 0 0 360 350 [[Video]]
desc none}}<big>Videos </big> Selection of relevant videos
{{!}} <big>{{{videos}}}</big>
{{!}}-
}}
{{#if: {{{videos<includeonly>|</includeonly>}}} |
! width="385" {{!}} {{#tag:imagemap|Image:WVpodcasts.png{{!}}left{{!}}80px
rect 0 0 360 350 [[Podcasts]]
desc none}}<big>Podcasts </big> Selection of relevant podcasts
{{!}} <big>{{{podcasts}}}</big>
{{!}}-
}}
{{#if: {{{powerpoints<includeonly>|</includeonly>}}} |
! width="385" {{!}} {{#tag:imagemap|Image:PowerPoint.png{{!}}left{{!}}80px
rect 0 0 360 350 [[:Category:Histology PowerPoints]]
desc none}}<big>PowerPoint </big> Selection of relevant PowerPoint tutorials
{{!}} <big>{{{powerpoints}}}</big>
{{!}}-
}}
{{#if: {{{CAL<includeonly>|</includeonly>}}} |
! width="385" {{!}} {{#tag:imagemap|Image:CanineRadiograph.jpg{{!}}left{{!}}80px
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{{!}} <big>{{{CAL}}}</big>
{{!}}-
}}
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{{!}}<big>{{{literature search}}}</big>
{{!}}-
}}
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{{!}}{{{full text}}}
{{!}}-
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{{!}}[[Ocular Reflexes resource|Why not try to diagnose what is wrong with the Ocular Reflexes virtual patient?]]
{{!}}-
}}

|}

Seizures podcast

2013-08-30T09:57:07Z

Ctrace:

{{Podcast
|Name = RVC Clinical Podcasts - Seizures
|Link = http://www.rvc.ac.uk/small-animal-referrals/news-events/clinical-podcasts
|Description = blah blah blah
|Duration = 45m 43s
|Date =19th April 2013
|Author = [http://shailenjasani.com/about-me/ Shailen Jasani]
|Image =Podcast.jpg}}

Seizures podcast

2013-08-30T09:54:15Z

Ctrace: Created page with "{{Podcast |Name = RVC Clinical Podcasts - Seizures |Link = http://www.rvc.ac.uk/small-animal-referrals/news-events/clinical-podcasts |Description = blah blah blah |Duration = ..."

Template:Podcast

2013-08-30T09:54:08Z

Ctrace: Created page with "<includeonly>{|cellspacing="0" cellpadding="0" width="800px" style="clear:both; background-color:#fcfcfc; border:3px solid #50A6C2;" align="center" |- |colspan="4" style="back..."

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|-
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{|width="740px" align="center" style="clear:both; background-color:#fcfcfc;"
|<center><big>[{{{Link}}} Click here to access the resource.]</big></center>
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|-
|style="color:#000;" align="left"|

{| summary="Wm-license-information-table-summary" class="toccolours vevent" style="width: 100%;" cellpadding="2"
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! 
|-
|align="center"|{{#tag:imagemap|Image:{{#if:{{{Image|}}}|{{{Image|}}}|}}{{!}}center{{!}}300px
rect 0 0 1000 1000 [{{{Link}}} link to resource]
desc none}}
|}
|}
|-
| 
|}
</includeonly>

<noinclude>

To use this template insert the following information. (case sensitive)
<big>
<pre>
{{Resource
|Name =
|Link = (for exapmle: www.rvc.ac.uk)
|Description = '''Type''' e.g. video What is the resource about duration if applicable
|Source =
|Date =
|Author =
|Licensing =
|Image =
}}
</pre>
</big>
</noinclude>