The Veterinary clinics of North America. Small animal practice
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Establishing and maintaining vascular access is often vital to the preoperative, intraoperative, and postoperative management of the small animal emergency surgical patient. Vascular access may be used for the delivery of crystalloids, colloids, blood components, medications, and anesthetic or sedative agents. ⋯ The small animal emergency and critical care veterinarian should have a thorough knowledge of vascular access techniques, including peripheral and central venous catheterization, intraosseous, and arterial access. Competence in percutaneous, percutaneous facilitative, and surgical cutdown approaches should ensure that vascular access can always be established in the critically ill patient.
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The goal of any method of fracture repair should be the early return of total limb function and the prevention of fracture disease. This can be accomplished through adhering to the basic principles of good patient and fracture assessment, choosing the correct method of fracture repair, and appropriate patient care. The complications of external coaptation can be minimized by appropriate patient and fracture assessment as well as correct cast and splint application. Choosing external coaptation as a method of fracture repair can be rewarding as long as the appropriate steps are taken to ensure success.
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Vet. Clin. North Am. Small Anim. Pract. · Sep 1999
ReviewExternal skeletal fixation. Linear fixators.
Linear external skeletal fixators offer some unique advantages over other fixation systems; they are biomechanically versatile, minimize surgical trauma to the fracture environment, and allow for simple staged disassembly to help promote bone healing. Historically, the use of linear external skeletal fixators has been reported to result in numerous complications, primarily related to the pin-bone interface. ⋯ Increased knowledge of proper pin insertion techniques and advancements in pin design have greatly enhanced the longevity of the pin-bone interface, resulting in fewer complications. This article reviews some of the potential advantages of linear external skeletal fixators and principles of application to help strengthen the pin-bone interface and minimize complications.
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The alpha 2 agonists can produce reliable dose-dependent sedation and analgesia in most species. Nevertheless, they can also produce significant physiological adverse side effects depending on dose, rate, route of administration, and the concurrent use of other CNS depressants. For this reason, it may be best to use a low dose of an alpha 2 agonist as a preanesthetic agent. ⋯ The combining of low doses of alpha 2, opioid, and benzodiazepine agonists results in a synergistic CNS depressant response while minimizing the undesirable side effects of these three classes of drugs. Each group of drugs has specific antagonists available for their reversal, thus allowing veterinarians to reverse one or more of the agonists depending on the desired response. This may represent a significant advantage to the use of low-dose alpha 2 agonists in combination with opioids and benzodiazepines.
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There has been a substantial increase in the use of analgesics for pain management in the last 10 years. Traditionally, veterinarians have not been trained in the identification of or monitoring of patients that are in pain, even though an evaluation of pain is inherent in assessing improvement in many medical and surgical diseases. Until recently, the physiology and pharmacology of opioids, NSAIDs, local anesthetics, and alpha 2 agonists were taught, but the therapeutic role of these drugs was generally believed to be related to restraint, anesthesia, or control of inflammation rather than to pain management.