Page 511 - WSAVA2017
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Neurologic
Seizures/tremors:
Seizures should be initially controlled by IV or per rectal diazepam. If seizures are not controlled with diazepam, propofol should be administered to effect followed by phenobarbitone. If the patient is recumbent with no gag reflex, intubation is required to maintain a patent airway and prevent aspiration pneumonia.
Increased intracranial pressure:
Increased intracranial pressure (ICP) can occur with any intracranial disease, traumatic brain injury, and seizures. Cushing reflex characterised by hypertension and bradycardia, as well as abnormal respiratory patterns can occur. Modified Glascow Coma Score can be used to assess patients with traumatic brain injury, which include assessment of motor activity, brainstem reflexes, and level of consciousness.1 Treatment involves maintaining normal perfusion (blood pressure) and oxygenation, elevating the head 30 degrees being careful not to kink the neck, in addition to reducing intracranial hypertension with mannitol or hypertonic saline:
Spinal injury:
It is important to keep the spine immobilised by securing the animal to a back board.
Other considerations:
Analgesia:
Identifying and providing analgesia to patients is an important part of triage.
Temperature:
Rapid cooling of hyperthermic patients to 39.5C is important. Active cooling should be instituted by running water, fan, bolus of intravenous fluids, flow-by oxygen, enemas, and keeping the animal on a cool surface and not in an enclosed space. Water baths and placing wet towels over animals are not effective methods of cooling.
Hypothermic animals must be warmed slowly by rewarming the trunk of the body by wrapping the body, applying hot packs indirectly, or a rewarming blanket. Rewarming (particularly rewarming of extremities)
can lead to vasodilation and hypotension, therefore intravenous fluids should be administered at the same time.
References are available on request.
An Urban Experience
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