Keeping animals in overnight

RE: Keeping animals in overnight

Gillian Mostyn — Thu, 13 Sep 2018 07:30:26 GMT

Fair enough. Never seen or heard of it personally but...wow.

RE: Keeping animals in overnight

Alex Gough — Wed, 12 Sep 2018 09:08:52 GMT

[quote user="Gillian Mostyn"]

Yes. The 'is it dead' test with a stethoscope. Usually pretty reliable.

Can't think of any others.

[/quote]

This one is definitely not 100% sensitive. As above, not stories for sharing on the internet.

RE: Keeping animals in overnight

Michael Woodhouse — Tue, 11 Sep 2018 20:33:43 GMT

[quote user="Gillian Mostyn"]Yes. The 'is it dead' test with a stethoscope. Usually pretty reliable. [/quote]

I have at least 2 tales that go against this that are not for sharing on the internet.

RE: Keeping animals in overnight

Martin Atkinson — Tue, 11 Sep 2018 10:37:36 GMT

[quote user="Sammy82"]

I was told by a farmer that a bullock my Boss once put to sleep was walking around eating the next morning, after it had spent the night lying at the roadside waiting for collection. Pretty sure I got told the story everytime I was there. Really hard to think of any test that has no false negatives.

[/quote]I have had an owner phone back hours later after they'd taken the dog home after euthanasia to say it was still breathing - it was and not just Cheyne-Stoking. I can't imagine I didn't listen to the heart and look for dilated pupils but its possible I just made an assumption the dose of pentobarb was lethal. I suspect your bullock case was the same.

I have nightmares about euthanased animals getting out of the freezer - a variation on Zombie dreams I suppose!!

RE: Keeping animals in overnight

Sammy82 — Tue, 11 Sep 2018 07:29:09 GMT

RE: Keeping animals in overnight

Clare Tapsfield-Wright — Mon, 10 Sep 2018 21:29:52 GMT

Many years ago the pets crematorium man AKA the “dead dog man “ brought us back a live hamster ......

RE: Keeping animals in overnight

Gillian Mostyn — Mon, 10 Sep 2018 21:10:59 GMT

[quote user="Tricia Goulden"]Reptiles are an exception to the stethoscope test [/quote]

ok. Fair enough.

Make that a Doppler.....

RE: Keeping animals in overnight

Tricia Goulden — Mon, 10 Sep 2018 20:32:32 GMT

Reptiles are an exception to the stethoscope test

RE: Keeping animals in overnight

Anthony Dennison — Mon, 10 Sep 2018 19:36:19 GMT

[quote user="Gillian Mostyn"]

Yes. The 'is it dead' test with a stethoscope. Usually pretty reliable.

Can't think of any others.

[/quote]

Depends on how long you listen for... people have faked their own deaths with drugs to induce extreme bradycardia...

RE: Keeping animals in overnight

Gillian Mostyn — Mon, 10 Sep 2018 19:20:54 GMT

Yes. The 'is it dead' test with a stethoscope. Usually pretty reliable.

Can't think of any others.

RE: Keeping animals in overnight

Alex Gough — Mon, 10 Sep 2018 18:48:36 GMT

I have tried in the past to think of a single veterinary test that is 100% specific and sensitive in all circumstances, and have failed. Can anyone think of one?

Alex

RE: Keeping animals in overnight

Francisco Gomez — Sun, 09 Sep 2018 18:30:51 GMT

[quote user="Michael Woodhouse"]

[quote user="Francisco Gomez"]But can you name a test that isn't dangerous if it isn't paired with your physical examination and your knowledge?[/quote]

You know you can buy pregnancy tests in Poundland? Lots of tests are pretty black and white when it comes to their interpretation. I think the issue here is a poor accuracy test used in isolation to categorise animals as something clinically wrong, when it may be a normal response.

[/quote]

I agree but it's never black and white. Your Poundland test can be falsely negative or positive. Would you make your next life decisions about your not yet born baby based on just that?

RE: Keeping animals in overnight

Michael Woodhouse — Sun, 09 Sep 2018 17:56:31 GMT

[quote user="Francisco Gomez"]But can you name a test that isn't dangerous if it isn't paired with your physical examination and your knowledge?[/quote]

RE: Keeping animals in overnight

Francisco Gomez — Sun, 09 Sep 2018 16:54:54 GMT

[quote user="David Mills"]

Fundamentally, they are either useless, or worse, dangerous.

[/quote]

Not a fan of those things.

But can you name a test that isn't dangerous if it isn't paired with your physical examination and your knowledge?

RE: Keeping animals in overnight

Alex Gough — Sun, 09 Sep 2018 15:44:55 GMT

[quote user="Anthony Todd"]There's not much skin to scruff and watch in children, so I'd expect it to be much more difficult to estimate, why doesn't someone do it in cats or dogs and let us know?[/quote]

Maybe with human's increased skin elasticity it would be easier to assess skin tenting than in say a Shar Pei? ;)

RE: Keeping animals in overnight

rhmrcvs — Sat, 08 Sep 2018 21:21:09 GMT

[quote user="An On MRCVS"]

Having worked in a place where we keep animals in overnight ( we don’t do on call but inpatients are checked 1+ times as deemed necessary) I wondered what people’s thoughts were on the pros and cons of this.

Anon because I’m now looking at different jobs but most places don’t seem to keep animals in.

Ours on fluids get a minimum of a check at midnight and other checks ( by vet or nurse) if needed for monitoring, pain relief etc. usuallly the person checking is off the next day or starts at 11.00 ( but not always).

If you don’t keep inpatients in what happens to the pancreatitis cases or acute/ chronic renal disease cats that need a few days of fluids?

Pre or post op cases that would benefit from fluids ( eg obstructing/ suspect foreign bodies, pyometras etc).

Acute vomiting cases that are dehydrated or haemorrhagic gastroenteritis cases - do they get managed as outpatients? Is that ideal?

Do all these get referred on to an OOH Centre and if so doesn’t that remove a large portion of interesting cases from the caseload?

[/quote]As things have gone off at a bit of a tangent, sadly it appears to me that increasingly our profession is only interested in treating and caring for sick animals during " office hours". This is then " justified with every excuse known to man. Downward spiral to the level of the medics.

RE: Keeping animals in overnight

Anthony Todd — Sat, 08 Sep 2018 17:49:03 GMT

[quote user="Alex Gough"]There is positive but weak correlation between residents' estimation and PLBW in patients with dehydration.[/quote]

There's not much skin to scruff and watch in children, so I'd expect it to be much more difficult to estimate, why doesn't someone do it in cats or dogs and let us know?

RE: Keeping animals in overnight

Anthony Todd — Sat, 08 Sep 2018 16:54:41 GMT

[quote user="David Mills"]Urea strips should be outlawed.[/quote]

I assume it's because they are inaccurate??

[sorry just catching up...]

Don't you just need ball-park figures ie OK, low, normalish, high, sheeet!?

So the skin fold of the cervical spine isn't enough for "dehydration"? Bit of fluid, if in doubt will do nothing but good in most cases, won't it?

Happy to discuss blocked cats 'til the cows, or your 15yo daughter, comes home......

Start with the obligatory blood [K++]...... it'll be off the scale!

RE: Keeping animals in overnight

Alex Gough — Sat, 08 Sep 2018 14:16:25 GMT

Electron Physician. 2018 Apr 25;10(4):6707-6711. doi: 10.19082/6707. eCollection 2018 Apr.
Accuracy of pediatric residents in determination of dehydration in children with gastroenteritis.
Khodashenas E1, Azarfar A2, Bakhtiari E3, Eslami ARD4, Roodi MS5, Ravanshad Y6,7.
Author information
Abstract
OBJECTIVE:
The aim of the present study was to determine the accuracy of pediatric residents in diagnosis of dehydration in children with gastroenteritis.

METHODS:
This was a cross-sectional study in Dr. Sheikh Hospital, affiliated with Mashhad University of Medical Sciences (Mashhad, Iran), in 2016. One hundred fifteen children aged 1 month to 14 years with gastroenteritis were included according to easy sampling. All patients were weighed. Dehydration was scored as mild, moderate and severe by pediatric residents according to Nelson standard table including pulse rate, blood pressure, blood skin supplement, skin turgor, fontanel, mucus membrane, tear respiration and urine output criteria. Patients were rehydrated and reweighed consequently. Percent loss of body weight (PLBW) was calculated and compared with dehydration score. Statistical analysis was performed using SPSS windows program version 19 (SPSS Institute, Inc., Chicago, IL, USA).

RESULTS:
Of the115 children, 65 patients were male (56.5%) with the median age of 14.5 months. The Kendall's tau-b and Spearman correlation coefficient for residents' estimation and PLBW were 0.18 and 0.23 respectively (p=0.01 and 0.12 respectively). The ICC between estimated dehydration and PLBW was 0.47. According to residents' estimation and gold standard, PLBW was 6.76% and 1.33%, respectively. The serum level of sodium, potassium, urea and creatinine were 141.8 mEq/L, 4.6 mEq/L, 34.45 mg/dL and 0.6 mg/dL, respectively.

CONCLUSION:
There is positive but weak correlation between residents' estimation and PLBW in patients with dehydration. It is necessary to enhance the educational level of pediatric residents to increase the accuracy of physical examination and decrease medical errors.

RE: Keeping animals in overnight

David Mills — Sat, 08 Sep 2018 12:10:33 GMT

If you read my abstract from BSAVA this year then you will see how well they perform in field conditions. It certainly isn't anywhere near the study quoted, which uses a somewhat unusual banding to assess accuracy.

My issues with them are manifold. That they are not accurate, being non specific for renal function. That they are misused and misinterpreted - I have seen animals condemned to being "kidney disease" based on a raised urea, or denied NSAIDs. That they have become more commonplace as some element of a "minimum databases" (great marketing shtick), chargeable of course.

Fundamentally, they are either useless, or worse, dangerous. Why not just run a urine sample and interpret in light of the animal's hydration status, or as Atko says, run a full profile, rather than sitting around for half an hour waiting for a bun strip?

Re other points, hydration status has not to my knowledge been reliably related to total solids or pcv. It is a clinical estimation based on that old art, examination.

RE: Keeping animals in overnight

Jo Dyer — Sat, 08 Sep 2018 10:11:29 GMT

[quote user="villagevet"]Mostly because a lone BUN number/range does not give any indication as to clinical relevance? BUN without creatinine and usg (preferably PCV and TS also) does not given you much information on azotaemia (there are plenty of factors which influence BUN!!!)?[/quote]

Yes I am aware of that, thank you

I haven't used them since the 80's, but it appears they do exactly what they say on the tin, so if people want to use them as a cheap and quick screening test, should we be quite so scornful?

RE: Keeping animals in overnight

Alex Gough — Sat, 08 Sep 2018 09:55:40 GMT

[quote user="villagevet"]Mostly because a lone BUN number/range does not give any indication as to clinical relevance?[/quote]

It's a screening test. A negative would suggest a lack of azotaemia, a positive would suggest further investigation was needed ie creatinine, usg, PCV etc. Disclaimer, I haven't used a BUN test strip since I was a student at the PDSA, just thought it would be interesting to see what the evidence said.

RE: Keeping animals in overnight

Lindsey Edwards — Fri, 07 Sep 2018 19:57:36 GMT

[quote user="Jo Dyer"]

[quote user="Alex Gough"]Sensitivity and specificity were 95% (20/21) and 99% (94/95), respectively, for dogs and 87% (13/15) and 100% (43/43), respectively, for cats.[/quote]

[quote user="Alex Gough"]Results suggest that reagent test strips are a reliable method for rapidly estimating BUN concentrations in dogs and cats.[/quote]

Impressive results! I remember using them in my first practice, over 30 years ago, before in-house analysers were around. I wonder why they have such a bad name?

[/quote]

Mostly because a lone BUN number/range does not give any indication as to clinical relevance? BUN without creatinine and usg (preferably PCV and TS also) does not given you much information on azotaemia (there are plenty of factors which influence BUN!!!)?

RE: Keeping animals in overnight

Jo Dyer — Fri, 07 Sep 2018 18:58:59 GMT

[quote user="Alex Gough"]Sensitivity and specificity were 95% (20/21) and 99% (94/95), respectively, for dogs and 87% (13/15) and 100% (43/43), respectively, for cats.[/quote]

[quote user="Alex Gough"]Results suggest that reagent test strips are a reliable method for rapidly estimating BUN concentrations in dogs and cats.[/quote]

Impressive results! I remember using them in my first practice, over 30 years ago, before in-house analysers were around. I wonder why they have such a bad name?

RE: Keeping animals in overnight

Alex Gough — Fri, 07 Sep 2018 17:43:37 GMT

A little evidence to inform one of the points in this discussion (below). As for whether everything that is on a minimum database can be detected in a physical examination, that sounds like a simple study to run. I couldn't find any evidence either way on this one. Personally I'd be surprised if even the most experienced of vets can reliably predict the level of dehydration of an animal better than a total solids and PCV, but maybe a yet to be done study will tell me different.

Urea test strips:

OBJECTIVE: To evaluate the clinical accuracy of reagent test strips used to estimate BUN concentration in dogs and cats.

DESIGN: Prospective study.

ANIMALS: 116 dogs and 58 cats.

PROCEDURE: Blood samples were collected at the time of admission to the hospital. Estimates of BUN concentration obtained with reagent test strips (category 1 [5 to 15 mg/dL], 2 (15 to 26 mg/dL], 3 [30 to 40 mg/dL], or 4 [50 to 80 mg/dL]) were compared with SUN concentrations measured with an automated analyzer. For dogs, category 1 and 2 test strip results were considered a negative result (nonazotemic) and category 3 and 4 test strip results were considered a positive result (azotemic). For cats, category 1, 2, and 3 test strip results were considered a negative result (nonazotemic) and category 4 test strip results were considered a positive result (azotemic).

RESULTS: On the basis of SUN concentration, 40 of the 174 (23%) animals (20 dogs and 20 cats) were classified as azotemic. One dog and 2 cats had false-negative test strip results, and 1 dog had a false-positive result. Sensitivity and specificity were 95% (20/21) and 99% (94/95), respectively, for dogs and 87% (13/15) and 100% (43/43), respectively, for cats.

CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that reagent test strips are a reliable method for rapidly estimating BUN concentrations in dogs and cats. Because test strip results are only semiquantitative and there remains a potential for misclassification, especially in cats, urea nitrogen concentration should ultimately be verified by means of standard chemistry techniques.