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Emergency case admissions at a large animal tertiary university referral hospital during a 12-month period

Authors

  • Brett A. Dolente VMD, DACVIM,

    1. Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA
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  • Susan Lindborg BS,

    1. Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA
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  • Gail Russell BS,

    1. Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA
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  • Louise L. Southwood BVSc, PhD, DACVS, DACVECC

    1. Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA
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Address correspondence and reprint requests to:
Dr. Louise L. Southwood, Department of Clinical Studies, New Bolton Center, 382 West Street Rd., Kennett Square, PA 19348.
E-mail: southwoo@vet.upenn.edu

Abstract

Objective: To collate and describe emergency admissions to a large animal tertiary university referral hospital during a 12-month period.

Design: Prospective clinical study.

Setting: Large animal tertiary university referral hospital.

Animals: Large animal emergency patient admissions.

Interventions: None.

Measurements and main results: Information obtained from the medical record included the presenting complaint, clinical problem, admission time, duration of clinical signs before presentation, diagnostic procedures performed, therapies administered, and therapeutic procedures performed during the first 24 hours following admission, and survival to discharge. The most common category listed for the presenting complaint and clinical problem categories was gastrointestinal. Most emergency cases were admitted during the evening and in late spring, summer, and early fall. Most cases had a duration of clinical signs before presentation of >2 hours and ≤8 hours (27%) or >8 hours and ≤24 hours (29%). The most common diagnostic procedures performed during the first 24 hours were palpation per rectum, ultrasonographic examination, radiographs, and abdominocentesis. Antimicrobials, fluids, and nonsteroidal anti-inflammatory drugs were the most common therapies administered. Approximately 25% of cases required surgery. An exploratory celiotomy was performed in approximately 15% of cases. Enterotomy, intestinal resection and anastomosis, cesarean section, or joint or sheath lavage was each performed in <5% of cases. Overall survival to discharge was 74%.

Conclusions: Large animal emergency clinicians are required to have knowledge on a wide range of diseases and should be proficient at performing numerous procedures on an emergency basis. Gastrointestinal disease is the most common type of emergency and the diagnostic and therapeutic procedures performed during the first 24 hours following admission are a reflection of this type of case. Only 25% of cases required surgery. Additional research in the form of a multicenter study and surveying both private and university practitioners needs to be performed to further define the necessary skills for an ‘ideal’ large animal emergency clinician.

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