scott@vtx-cpd.com

Great Question!

Tayer also asked a similar question from lesson one which I will pop here:

“One question I have from the first lesson on Haemoabdomen – you mentioned stabilising the hypovolemia and hypotension but didn’t mention fresh frozen plasma. If you were able to maintain PCV and stop active bleeding but low TP would use it then or do you tend to just stick with colloids and wait for body to reproduce? If so when do you reach for the plasma and why…”

Scott 🙂

Replying to Katherine Howie 26/05/2024 - 21:00

Hi Kath,

Thanks for elaborating on this. It’s a great reminder that even without all the advanced monitors, we can still gather crucial information through thorough physical exams and assessing perfusion parameters. Your point about hypotension only appearing after a significant drop in cardiac output is really important—it’s good to remember that a patient can be hypoperfused even with normal blood pressure.

I completely agree that hands-on assessments and repeated serial physical exams are invaluable. It’s reassuring to know that these fundamental skills can provide us with so much insight into a patient’s cardiovascular status.

Thanks again for sharing your expertise!

Best regards,

Scott

Replying to Raquel M. 25/05/2024 - 15:34

Hi there,

Thanks for your question! Urine dipstick strips that differentiate between RBCs, hemoglobin, and myoglobin based on the pattern of the color change can be quite useful in a clinical setting. These strips can provide a quick and easy way to get a preliminary assessment of hematuria versus hemoglobinuria or myoglobinuria.

However, there are a few points to keep in mind:

Accuracy: While dipstick tests can be helpful, they are not always 100% accurate. False positives and false negatives can occur, so it’s important to confirm any suspicious results with more definitive testing, such as microscopic examination of the urine sediment or additional blood tests.

Interference: Various substances in the urine, such as certain medications, foods, or contamination, can sometimes interfere with the results of the dipstick test.

Clinical Context: Always interpret dipstick results within the broader clinical context. For example, the presence of RBCs in the urine should be correlated with clinical signs and other diagnostic findings to determine the underlying cause.

Follow-Up: If the dipstick test indicates the presence of hemoglobin or myoglobin, further testing may be needed to determine the source. Conditions like hemolysis or muscle damage can cause these substances to appear in the urine, and additional diagnostics will be necessary to address the underlying issue.

In summary, urine dipstick strips can be a valuable tool for initial screening, but they should be used alongside other diagnostic methods to ensure accurate and comprehensive assessment.

Hope this helps, and feel free to ask if you have any more questions!

Best regards,

Scott 🙂

Replying to Katherine Howie 12/05/2024 - 21:19

Hi Kath,

I completely agree with you.

Recognizing patients at risk for SIRS or sepsis is crucial. Your red flag system sounds very effective—persistent tachycardia and other unresponsive parameters are definitely key indicators to watch for.

Cats are definitely more challenging compared to dogs. Their clinical signs can be so subtle and different, making it harder to detect early signs of deterioration. Continuous monitoring and being vigilant about any changes in their behavior or vitals are essential.

I’m curious about the red flag system you use—is this a defined system with set parameters, or is it more of an intuitive approach based on experience?

Best regards,

Scott