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Hemoabdomen in the ICU
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Ladan Mohammad-Zadeh, DVM, DACVECC, discusses the medical treatments of a dog that presented to the ER with an acute hemoabdomen. Stabilization prior to surgery, anesthesia, and post-operative stabilization are all covered.
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Ladan Mohammad-Zadeh
DVM DACVECC
Enrolled: 08/2011
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Had to watch this twice, I kept watching the cute old lab in the background, Sooo cute
Hi There!
Can you explain why post-op she had an accelerated atrioventricular rhythm, and how administering additional blood products decreased her heart rate? Thank you in advance!
Hi Jodi, Great question!
Accelerated Idioventricular Rhythms are actually rather common arrhythmias in post splenectomies and GDV surgeries. They are thought to be associated with an increase in vagal tone. They look like ventricular beats but occur at slower heart rates compared to ventricular tachycardia. Accelerated Idioventricular Rhythms tend to be self-limiting- they don't need any specific treatment and will resolve on their own. However, if the rhythm changes to a Ventricular Tachycardia and there is hemodynamic compromise (low blood pressure, dropped pulses) then anti-arrhythmics may be needed.
In this patient we gave blood products to treat the low PCV – 22%. The administration of blood products increases the oxygen carrying capacity of the blood, and reduces hypovolemia. When the hypovolemia is resolved, the heart does not need to work quite as hard, and therefore the tachycardia improves. I hope this answers your question, if not feel free to send me an E-mail and I can give you a little more in depth answer.
What would the reasoning behind the plasma transfusion be? Thank you
Hi Amber,
This patient was experiencing tachycardia and had a low PCV, therfore the blood products were warranted, PCV = 22%. The administration of blood products increases the oxygen carrying capacity of the blood, and reduces hypovolemia. When the hypovolemia is resolved, the heart does not need to work quite as hard, and therefore the tachycardia improves.
what if the PCV was WNL but the patient was tachycardic...would blood products still be warranted?
HI there. That's a great question. We always say "treat the pet, not the number", meaning if the pet seems clinical for the anemia, give blood. If this was a Greyhound whose PCV is normally 60%, a drop to 35% acutely would warrant a blood transfusion. So, in part it depends on how quickly the pet reached that PCV and what their PCV started at. For a pet that is tachycardic but their PCV is normal-ish, I would treat with fluid bolus, pain medications and recheck PCV within an hour. If their tachycardia does not resolve with fluids and pain medications and the PCV declines, then I would reach for blood products. Hope that answers your question!