Orogastric
intubation, also known as gastric gavage or stomach tube. This tube enters the
animal’s mouth down through the esophagus and into the stomach. This method is
used to administer medication or food or to remove gas sort toxins from the
stomach of a canine. The equipment needed to perform orogastric intubation
includes the following Adhesive tape or a permanent marking pen n A roll of
adhesive tape or a wooden spacer block n Water-soluble lubricating gel or tap
water. Plastic tubing in several sizes or rubber urinary catheters (22 French,
75 cm long for dogs; 12 French to 16 French, 40 cm long for cats). n A syringe
or funnel There are several steps to follow before placing the orogastric tube.
(Samuelson, K. D.V.M. n.d)

Measure
the tube for appropriate length by extending it alongside the animal’s body the
distance is measured from the animal’s mouth to the thirteenth rib. Also
remember the canine must be in a sternal position. Mark the tube at the
measured length with either adhesive tape or a permanent marking pen. This will
ensure you don’t insert the tube too far. Placed a used roll of adhesive tape
behind the teeth this process will hold the mouth open. Make sure the end of
the stomach tube is lubricated with sterile gel. Gently push the tube into the
pharynx as the animal swallows. The tube is advanced slowly to the level
previously marked by the adhesive tape. Most important thing to remember is if
the animal coughs, remove the stomach tube, as the tube may have been pushed
into the trachea. To ensure proper placement you need to palpate the patients
neck to feel if the tube is in the esophagus. Before you administer medication
or food you must make sure you are in the right place. To do that Sterile water
or saline is injected into the tube. Then attach the syringe or funnel to the
end of the stomach tube. The medication or liquefied food is slowly
administered through the funnel using the syringe or gravity flow. Kink the
stomach tube to prevent liquid contents from being withdrawn and inhaled. And
then remove the tube. (Samuelson, K. D.V.M.n.d) These steps are very vital to
the patients’ health and wellbeing. Not following these steps could cause the
patient to die. According to and news article I read by Justine Lee, DVM, DACVECC, DABT, CEO, VetGirl; “rare
complications of gastric lavage may include risks for sedation, secondary
aspiration pneumonia (once extubated), mechanical injury (to the mouth,
oropharynx, esophagus, stomach), or respiratory effects (e.g., hypoxemia
secondary to aspiration, hypercapnea secondary to sedation).” (Lee,
J. (n.d.).

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Fluid
administration sets are collections of vessels that give a choice of fluid drip
rates. These sets are used to deliver fluids through the various fluid
administration routes. Sterile fluids can be administered via several routes:
Subcutaneous Route (under the skin), Oral Route (by mouth), Intravenous Route
(in the vein), Intraperitoneal Route (abdominal cavity) Intraosseous Route (in
to the bone). (Samuelson, K. D.V.M.n.d.) To assess the patient’s hydration
levels, you will need a complete history, physical examination and laboratory
test. Having history will help establish why the patient needs fluid therapy,
also a patient history is very important to ensure that the veterinary nurses are
aware of past complications. Physical Exam: Include taking temperatures a
normal temp for cats and dogs varies between 101 and 102 degrees, skin and
coats and ears. Which should be performed on patients receiving IV fluids, with
an emphasis on degree of dehydration and perfusion parameters. Physiologic
indicators of poor perfusion to name of few Tachycardia, Increased (>2 sec)
Capillary refill time, light pink to pale mucous membrane. Lastly, Laboratory
Testing: Lab finding should be apart of the patient assessment when evaluating
the fluid therapy plan. Certain tests are used to evaluate, and monitor
hydration status include: Acid Base, PCV/TS, URINE PROUDCUTION (normal
=1-2ml/kg/hr.), USG (dogs, 1.026, cats, 1.035). (Dibartola, S. P.,
& Bateman, S. 2012). Signs of Dehydration Pertaining to Percent
Dehydration (Silverstein, 2015)

5%-6% (Subtle
loss of skin elasticity); 6%-8% (Dry
mucous membranes, decreased skin turgor, slight increase in capillary refill
time); 10%-12% (Dry mucous
membranes, loss of skin turgor, eyes sunken into orbits, possible signs of shock);
12%-15%; (Definite signs of shock).  (Silverstein, 2015)

After
the doctor’s asses the patients there are three different types of fluid
therapy that can be used depending on the patient’s situation Phase 1:
Resuscitation & Emergency Therapy requires immediate resuscitation during
life-threatening fluid deficits, typically requires large fluid volumes at high
rates. Phase
2: Replacement Therapy previous, ongoing, or anticipated losses (vomiting,
diarrhea, diuresis) leading to dehydration must be replaced. Phase 3:
Maintenance Therapy involves maintaining tissue perfusion, electrolyte balance,
and cellular metabolism and function in an ill patient indication for
maintenance fluid therapy include anesthesia, continued fluid losses after
rehydration, and decreased intake. (Silverstein, 2015)

            So, I was given a scenario where my female feline patient
was just examined by the doctor. The doctor determined that the 8lb female
feline is 10% dehydration and has no signs of vomiting or diarrhea. How much
fluid was given to this patient; so, I figured out the fluid rates was using
this formula % of dehydration * body weight in kilograms (BW KG) = fluid
deficit (in liters). Using this formula, the calculation is .10x 3.63kg= 0.363L
is the fluid deficit so the female feline would need 363ml of fluids. Also for
maintenance phase of fluid therapy beings once shock and dehydration has been
corrected. I used the formula (30 * bw kg) + 70=ml/24hr for animals which weigh
between 2kg and 50kg. So, if we were in the maintenance fluid phase for the
female feline patient the calculation would be 30 * 3.63+70=178ml/24hr.

            When patient is receiving IV fluids therapy it always
best to monitor them. The primary goal for IV Fluids is to restore the vascular
volume and tissues perfusion. While monitoring fluid therapy during this phase
is geared toward assessing cardiovascular stability, blood volume and perfusion
include heart rate, pulse quality, capillary refill time (CRT) mucous membrane
color, warmth of distal extremities and mentation. After giving fluids it very
important to access the patient and watch for certain signs of IV fluid overdose.
Signs to look for are serious nasal discharge, tachypnea, new heart mummer,
polyuria if any of these signs appear STOP fluids immediately and alerted the
veterinary. (Gillie, 2004).

            Horses have two sets of teeth; the first set are
deciduous teeth commonly called caps. They erupt around 6-month age of age. Deciduous
teeth are only milk incisors and premolars around two ½ years of age their
permanent teeth begin to replace deciduous teeth. By the age of 5 the permanent
teeth should be complete. According to Penn Foster Study Guide: it varies from
males to female. Most adult males have 44 permanent teeth, while females only
have 36-44 teeth. All horses start with 24 deciduous caps. Wolf teeth are permanent
first premolars generally smaller, cheek teeth are premolars and molars there
are 6 anatomically close together.

            The
average adult dogs have about a 3rd more teeth than humans. Adult
dogs have 42 permanent teeth compared to a human which has 32 teeth. Puppies posses
28 baby teeth, it varies rom breed to breed but at the age of 4 months the 28
puppy teeth are replaced with 42 adult canine teeth 6 incisors on the top and
bottom (smaller front teeth between the large fang like canines. On the other
side of the dogs mouth you have smaller pre-molars used for ripping and
tearing, and rounding out the line-up are the larger molars in the back of the
mouth used for grinding. (Samuelson, K. D.V.M.n.d).

            According
to the definition of a dental prophylaxis; is a cleaning producer performed to
thoroughly clean the teeth. Prophylaxis means it’s an important dental
treatment for halting the progression of periodontal disease and gingivitis.
(Samuelson,
K. D.V.M.n.d). Overview on a canine dental prophylaxis (dental cleaning). A
dental cleaning also sometimes called a prophy or prophylaxis is a cleaning and
polishing of canine’s teeth. Dental check-ups are essential for horses. As
horses become older, the shape and angle of its teeth begin to change, and
problems may occur. Most owners aren’t aware of their horse’s teeth until there
are major concerns like having trouble eating, losing weight, or there horses
just simply have bad teeth. (Samuelson,
K. D.V.M.n.d).

            How a dental prophylaxis is performed on a dog first step
is to do an oral exam while the patient is awake. Second part is a full mouth
exam when the patient in under anesthesia this part is where you will get the
most information about the dog’s teeth like you can check each tooth for
mobility, fractures, malocclusion, and enamel defect. Next step is the gross
part it’s the removal of the plaque and calculus. Also known as supragingival cleaning
this step helps to remove colonies of bacteria that are anchoring to the
calculus. How you preform a dental prophylaxis on a horse is you start with an
exam of the horse’s mouth and general body condition and you also discuss with
the owners if they have any concerns about dental issues or if they are
noticing weight loss or they horse not eating. Second part you need to safely
sedate a horse, so it remains mildly sedated and wait a few minutes for
sedation to kick in. Once the sedation is all kick in you then insert the full
mouth speculum this is to prevent injury to the patient’s gums, and tongue when
floating teeth; and then you used some antiseptic solution to disinfect the
horses mouth. Use a bright light specifically designed for horse dentistry to
see all teeth. Motorized dentistry tools, are used to file multiple teeth down
at once. You flush out the horse’s mouth to remove any tooth fragments. After
comparing the canine process of a dental and a horse’s dental I discovered they
are the same in some ways and different in other ways. What I found to be the
same on canines and horses was they both have incisors, premolars, molar. Dogs
use a mouth speculum and horses use a full mouth speculum. What I found to be
different is that the; dog is laying in a recumbent position where as the horse
is standing. Also, the amount of time is different on both species; one
required full sedation with oxygen and the horse required a mild sedation.

            CPR is an abbreviation for the medical term Cardiopulmonary
Resuscitation it’s a lifesaving procedure for dogs. Cardio means heart,
Pulmonary means lungs to resuscitation; meaning review bring back from the dead.
The main goal of CPR is to provide partial flow of oxygenated blood to the
brain and heart. The objection is to delay tissue death and extend the brief window
for a successful resuscitation without permanent brain damage.

                I
found that CPR on a dog is not that different from a human getting CPR. According
to Penn foster study guide by (Samuelson, K.
D.V.M.n.d).  You must ensure that the
airway is clear of mucous, dirt, vomit, or other foreign material. To clear the
airway, have the owner gently extend the head and neck. If head or neck injuries
are suspected, movements of the head should be kept to a minimum. Pull the
tongue forward and sweep the material out of the mouth with one or two fingers.
Second pull the tongue forward and close the mouth, holding the tongue between
the incisor teeth. Third the rescuer should place his or her mouth over the animal’s
nose. In small dogs and cats, cover both the animal’s mouth and nose. Blow a
steady stream of air into the animal’s nostrils for two to three seconds. Hold
the lips of the animal closed so that the air won’t escape from the sides of
the mouth.  Again, according to Penn
Foster Study Guide by (Samuelson, K. D.V.M.n.d) to perform CPR on a dog who is
not breathing, lay the dog on its side on a flat surface. If no pulse or
heartbeat can be detected, chest compressions should be started in addition to
mouth-to-nose resuscitation. You can feel a beating heart when you place your
hand on the chest wall over the heart. The heart is in the lower part of the
chest cavity just behind the elbow. You can detect the pulse by lightly placing
your index and middle fingers on any part of the body where an artery crosses
bone or firm tissue. Common sites to check pulses on cats and dogs are the same.
Common arteries to check include the femoral, brachial, and dorsal pedal
arteries. The femoral pulse is the easiest pulse for owners to feel.  The recommended rate of chest compressions is
about 120 per minute, or 2 every second. The recommended breathing is every six
seconds. In large dogs, you should instruct the owner to apply compressions
over the widest part of the chest. This position increases the amount of blood
flow created with each compression. Mouth-to-nose breathing, and chest
compressions are minimally effective in resuscitation. They shouldn’t be
considered as at-home treatment, but rather a stopgap measure to be used while
the animal is being transported to the hospital

                What
is a crash cart? According to Merriam Webster dictionary a crash cart is a cart
stocked with emergency medical equipment, supplies, and drugs for use by
medical personnel especially during efforts to resuscitate a patient
experiencing cardiac arrest. The size of the cart depends on the number and
types of emergencies a hospital manages. Multiple-doctor, high-volume hospitals
typically have larger, more complete crash carts than smaller, low-volume
hospitals. Crash carts are commercially available or can be prepared using a
large or a small toolbox (Plummer, P. 2013).  The same equipment is used for canine and
feline emergencies, so the same crash cart can be used for both species. Here
are some items that can be found in a crash cart: Laryngoscope, Endotracheal
tubes (various sizes), Syringes (various sizes) needles (various sizes) Ambu
bag, Monitoring equipment (e.g., electrocardiograph, pulse oximeter,
capnograph, Doppler blood pressure unit), Intravenous fluids, Dextrose 50%, Intravenous
catheters and the supplies for placing them Emergency drug table Emergency
drugs (e.g., epinephrine, atropine, naloxone, calcium gluconate, furosemide,
vasopressin) (Plummer, P. 2013). According to a news
article I read from (Pachtinger, G. VMD, DACVECC. 2015) depending on the arrest
rhythm, drug therapy may include the use of vasopressors, anticholinergics or
anti-arrhythmic, reversal agents, intravenous fluids and alkalinizing drugs.
Thus, placement of a peripheral or central intravenous or intraosseous catheter
is recommended. Some other items that can be used from the crash cart are a
pulse oximetry direct and indirect blood pressure monitor, a continuous Electrocardiography
and end-tidal Carbon dioxide monitoring (ETCO2). These equipment’s are used for
monitoring during CPR.