Recognition, treatment, and monitoring of canine hypovolaemic shock

Access the article

Llewellyn, E., Lourenço, M. and Ambury, A. (2020) Recognition, treatment, and monitoring of canine hypovolemic shock in first opinion practice in the United Kingdom, Topics in Companion Animal Medicine, Volume 39, Article 100427. https://doi.org/10.1016/j.tcam.2020.100427

[Access for RCVS Knowledge Library members]

Summary

This paper published in the June 2020 edition of Topics of Companion Animal Medicine reports on a study carried out by researchers at the University of Edinburgh into the detection, treatment, and monitoring of hypovolaemic shock (HVS) in dogs. The research collected data from 177 general practitioners in the United Kingdom using an online survey.

The authors stress the importance of recognising hypovolaemic shock in order to enable appropriate fluid therapy. They make the distinction between hypovolaemic shock, which is due to an intravascular volume deficit and requires rapid restoration of vascular volume, and dehydration, which refers to fluid loss from the interstitial and intracellular compartments, and is corrected more slowly.

The research highlights variabilities in the initial approach, fluid management strategies and monitoring used by UK general practitioners when faced with canine patients in hypovolaemic shock. The authors suggest this indicates that there may be a discrepancy from the optimal diagnostic and treatment plan for canine patients with hypovolaemic shock.

Practices may find it helpful to use this paper as part of a discussion or journal club, in order to review and improve their management of these cases.

Support with assessing the relevance of this paper

We have produced a guide that you can use to work through this paper as a practice.  For those less confident in assessing published papers there is a partially completed guide.

For those new to journal clubs, we have a step-by-step guide you might find useful: Setting up and running a journal club.

Next steps

One of the reasons for the variation found may be that there is currently limited evidence relating to standard treatment practices for hypovolaemic veterinary patients. However, if you wish to review your practice management of these cases you may find the following additional references useful.

Further Reading

Davis, H., et al. (2013) 2013 AAHA/AAFP Fluid Therapy Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association: 49(3) pp. 149-159. Available at: https://www.aaha.org/globalassets/02-guidelines/fluid-therapy/fluid_therapy_guidelines.pdf

These guidelines are supplemented by an AAHA implementation toolkit to help you apply the information in the published guidelines to your own practice.

Peterson, K.L., Hardy, B.T. and Hall, K. (2013) Assessment of shock index in healthy dogs and dogs in hemorrhagic shock. Journal of Veterinary Emergency and Critical Care, 23(5), pp.545-550. https://doi.org/10.1111/vec.12090

Cazzolli, D. and Prittie, J. (2015) The crystalloid‐colloid debate: Consequences of resuscitation fluid selection in veterinary critical care.  Journal of Veterinary Emergency and Critical Care, 25(1), pp.6-19. https://doi.org/10.1111/vec.12281

Hayes, G., Benedicenti, L. and Mathews, K. (2016) Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007–2010). Journal of Veterinary Emergency and Critical Care, 26(1), pp.35-40 https://doi.org/10.1111/vec.12412

Rosenstein, P.G., Tennent‐Brown, B.S. and Hughes, D. (2018) Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia. Journal of Veterinary Emergency and Critical Care, 28 (2) pp 106-121 https://doi.org/10.1111/vec.12706

Silverstein, D.C. and Santoro Beer, K.A. (2015) Controversies regarding choice of vasopressor therapy for management of septic shock in animals. Journal of Veterinary Emergency and Critical Care, 25 (1) 48-54. https://doi.org/10.1111/vec.12282