Companion Animal Advanced Clinical Management WEEK 1

Fluid Therapy

• A water-based solution that contains electrolyte and nonelectrolyte solutes, can enter all body compartments, and is used for rehydration is a balanced crystalloid.
• The shock dose of fluids for cats is 20-30 ml/kg, and for dogs, it is 40-60 ml/kg.

Nutrition

• In a hospitalized dog or cat, the preferred way to deliver nutrition is through enteral nutrition.
• To calculate the dog's RER, use the equation RER = (√(√(BW x BW x BW))) x 70 or RER = (30 x BW) + 70, where BW is body weight in kilograms.

Edema and Third-Spacing

• In a patient with peripheral edema and third-spacing, the interstitial space expands, leading to increased fluid loss.

Opioids and Gastrointestinal Tract

• Opioids have a constipating effect on the gastrointestinal tract.

Hypoalbuminemia

• Patients with hypoalbuminemia experience drug toxicity because many drugs are protein-bound, and decreased albumin levels lead to increased free drug concentrations.

Renal Disease

• The creatinine value in a blood chemistry can be used to reduce the dose or adjust the dosing interval in a patient with renal disease.

Fluid Therapy Contraindications

• IV isotonic crystalloid fluid therapy is contraindicated in hypernatremic dehydration.

Fluid Types

• 7.5% saline is a hypertonic fluid.

Autonomic Receptors

• The autonomic receptor that directly modulates cardiac output through changes in inotropy and chronotropy is the β1 receptor.

Aldosterone Receptor

• Spironolactone directly acts at the aldosterone receptor, resulting in decreased Na+/K+ exchange in the distal tubule and collecting duct of the nephron.

Pulmonary Edema

• Furosemide would likely provide the most immediate benefit to a patient with severe pulmonary edema as a result of left-sided heart failure.

RAAS Inhibiting Drugs

• Azilsartan has greater antihypertensive effectiveness than ACE inhibitors and is FDA-approved for the treatment of systemic hypertension in cats.

Hypokalemia

• Potassium-sparing diuretics are LEAST likely to cause hypokalemia.

Calcium Channel Blockers

• Dihydropyridine calcium channel blockers (e.g., amlodipine) have the greatest effect on vascular muscle.

Pulmonary Arterial Hypertension

• Sildenafil is indicated for the treatment of pulmonary arterial hypertension.

Anti-Thrombotic Drugs

• Clopidogrel is LEAST likely to cause gastric ulcer disease in cats.

Heartworm Adulticides

• Melarsomine dihydrochloride commonly causes injection-site reactions in the epaxial muscles.

Antitussive Drugs

• Codeine has the greatest likelihood of causing constipation as an adverse drug effect.

Osteoarthritis

• NSAIDs are the main drug therapy for osteoarthritis.

Contraindicated Drugs

• Tetracyclines should not be used in cats.

Ear Cleaning

• Ear cleansers should be used with caution in dogs and cats with ruptured tympanic membranes to avoid exacerbating the condition.

Otoscopy

• When the ear canal is too painful and swollen for otoscopic exam and ear flushing, the best treatment approach for a canine patient with otitis is to use oral antibiotics and pain management.

Chemotherapy Agents

• Plerixafor can be administered to increase circulating platelet count.

Immunosuppressive Medications

• It is critical to taper the immunosuppressive medications to the lowest effective dose for long-term management of immune-mediated disease to minimize side effects.

Second-Line Immunosuppressive Medications

• Azathioprine is considered an acceptable second-line immunosuppressive medication.

Dexamethasone

• Dexamethasone is 7-10 times more potent than prednisone.

Cyclosporine

• Cyclosporine is used to treat atopic dermatitis in cats and dogs and perianal fistulas in dogs, as well as other immune-mediated diseases.

Mycophenolate Mofetil

• Mycophenolate mofetil causes gastrointestinal toxicity in up to 67% of patients.