Emergency medicine: it's a different way of thinking/practicing

In this post I wanted to touch on some of the things that make emergency medicine a bit different from routine/elective/non-emergency (!) medicine.

Canine parvovirus infection - role for interferons?

We are all familiar with the potential for canine parvovirus (CPV) to cause severe morbidity and mortality. Treatment is symptomatic and supportive and antibiotics are used in many/all cases (there is more to say about this but that is for another blog some other time!). The ability to provide good intensive care can significantly impact on outcome but nevertheless some dogs will die. None of the medical therapies currently used are expected to have any effect on modulating or dampening down the actual pathology of the disease (although early enteral nutrition likely helps to ameliorate intestinal changes to some degree). A treatment that could reduce disease severity and even lower mortality is therefore something that is undoubtedly very desirable but does such an option exist?

Heartbroken: traumatic myocarditis/myocardial contusions

Traumatic cardiac injury is probably not something that many people give much consideration to. When we see dogs and cats that have suffered blunt thoracic trauma we think a lot about the thoracic injuries that can compromise respiration such as pneumothorax or pulmonary contusions. But how often do we wonder how the heart is?

Out-of-date adder antivenom: to use or not to use?

I am not going to go into any detail here suffice to say that when it comes to treating envenomation by the common adder (common European adder, Vipera berus), antivenom is the only therapy shown to have a beneficial impact on progression and outcome. It is true that mortality in dogs and cats from bites by this snake is (very) low but antivenom use can significantly reduce severity and duration of morbidity which attenuates suffering and saves pet carers money too! As I say, I am not going to get into any more about the treatment here – except to say NO STEROIDS and NO EMPIRICAL ANTIBIOTICS!

Inducing emesis in cats: what's to be done?

Cats do not tend to ingest poisons as often as dogs do, this we know, and therefore the scenario in which one may be considering inducing emesis in a cat is encountered less often. That said, the Veterinary Poisons Information Service (VPIS), based in the UK, gets more or less one telephone enquiry a day about a cat that has ingested a toxin (personal communication, 2014) so it is not totally unheard of! I am going to skip some of the other talking points about gastrointestinal decontamination, especially in cats, here and just consider the circumstance in which it has been decided to induce emesis in a cat. What are the options?