Emergency Critical Care

Clinical trials for Emergency Critical Care specialty

  • Description

    The goal of this study is to determine if TK isoenzymes are good biomarkers for the early detection of HSA in dogs and to identify a threshold for detecting HSA from the presence of TK isoenzymes.

    HSA is a malignant and rapidly growing cancer that is difficult to detect. HSA is a tumor derived from blood vessels, and thus the tumor is filled with blood. A frequent cause of death from HSA is the rupturing of the tumor, causing the patient to rapidly hemorrhage to death. HSA is common in dogs, and more so in certain breeds of dogs such as German Shepherds and Golden Retrievers. Dogs with HSA rarely show clinical signs until the tumor has become very large and has metastasized. Typically, clinical signs are due to hypovolemia after the tumor ruptures, causing severe bleeding. Owners of the affected dogs often discover that the dog has HSA only after the animal has collapsed secondary to bleeding. The HSA tumor often appears on the spleen, right side of the heart or liver.

    There are currently no commercially viable screening mechanisms for detecting HSA in dogs. Most dogs present with HSA as emergencies and major decisions about treatment must be made without a definitive diagnosis. A screening test that would allow the detection of HSA would be very valuable in the planning of treatment and earlier detection of the disease. Preliminary data in dogs suggests that TK is significantly increased in dogs with some types of cancer, specifically HSA and thus TK may be useful in detecting, staging and monitoring disease in dogs with HSA.

    Inclusion Criteria

    Any dog (any age, sex or breed) with a hemoabdomen that undergoes exploratory surgery.

    Exclusion Criteria

    Dogs with pre-existing, previously diagnosed neoplastic conditions other than hemangiosarcoma will be excluded.

    Client Benefits

    There are no direct benefits to the client. The indirect benefit is that this research will aid in the development of a point-of-care test for the diagnosis of hemangiosarcoma in dogs which will help owners of dogs with hemoabdomen make decisions regarding the best management for their dogs.

    Contact Information

    Dr. Claire Sharp
    Phone: (508) 839-5302

  • Description

    Pleural effusion (fluid around the lungs) resulting in respiratory distress is a common presenting complaint in veterinary emergency rooms and can be caused by a wide variety of underlying diseases. Malignant (cancerous) effusions are associated with a poor prognosis but differentiation of malignant from benign disease is often difficult on the basis of pleural fluid cytology and routine imaging. Differentiating between normal, reactive and malignant mesothelial cells to refute or establish a diagnosis of malignant mesothelioma is particularly challenging. Currently there are no commercially available tests for diagnosing malignant mesothelioma in dogs, and the gold standard diagnostic tool remains histopathology (evaluating a biopsy of the tissue that lines the inside of the chest wall).

    The objective of this study is to evaluate SMRP as a biomarker for malignant mesothelioma in dogs. We hypothesize that the MesoMARK™ assay, designed to detect SMRPs in human serum, will cross react with canine SMRP and that dogs with malignant mesothelioma will have higher concentrations of SMRPs in both serum and pleural fluid, than dogs with pleural effusion in the absence of malignant mesothelioma.

    Inclusion Criteria

    Any dog (any age, sex or breed) with pleural effusion, of known or unknown etiology, is eligible for study inclusion, with owner consent.

    Exclusion Criteria

    None.

    Client Benefits

    There are no direct benefits to the client. The indirect benefit is that this research will aid in the development of biomarkers for canine malignant mesothelioma, which will help in the earlier diagnosis, and treatment of dogs with this disease in the future.

    Contact Information

    Dr. Claire Sharp
    Phone: (508) 839-5302.

  • Description

    The purpose of this study is to help find ways to accurately predict if/when a dog may develop dehiscence. Dehiscence is the breakdown and leakage of the intestine at the site that has been sutured closed. This is a complication that occurs in about 10-20% of dogs that have had surgery to repair their intestines. We hope to find a way to better predict/diagnose dehiscence in these dogs undergoing intestinal repair.

    Inclusion Criteria

    If your dog is undergoing a surgery due to septic peritonitis and is having (or had) surgery to repair his intestines (either an enterotomy or resection and anastomosis).

    Exclusion Criteria

    None.

    Client Benefits

    This study will cover the cost of lactate measurements, glucose measurements, abdominal fluid analysis, aerobic and anaerobic cultures after and during surgery. A variety of intestinal biomarker tests will also be run at a later date on saved samples of blood (IL-1B, IL-6, IL-10 and TNF-alpha). With your pets participation in this study we hope to gain information that will help in the diagnosis, management and treatment of other dogs with this condition.

    Contact Information

    Dr. Yuki Tse
    Phone: (508) 839-5395; ext. 8-4745

  • Description

    Urethral obstruction (UO) is a common reason for the emergency evaluation of male cats and may be life-threatening. Some clinicians advocate bladder flushing at the time of urinary catheter placement, while others do not. The purpose of this prospective randomized study is to evaluate the effect of bladder flushing on short-term outcome including duration of catheterization, length of hospitalization and recurrence of UO.

    Inclusion Criteria

    Cat presenting to the ER with evidence of UO on physical examination requiring placement of a urinary catheter.

    Exclusion Criteria

    None.

    Client Benefits

    There is no direct benefit to the client. We hope that this will give a better understanding of how to treat cats presenting to the ER with a UO.

    Contact Information

    Dr. Meghan Respess, DVM (ECC resident)
    Phone: (508) 839-5395

  • Description

    Anxiety in hospitalized dog can contribute to patient morbidity and affect the caregivers’ ability to provide adequate nursing care. Additionally, anxiety experienced by one dog, and associated vocalization, often stimulates anxiety in other dogs in the hospital.

    This study will involve the measurement of anxiety with the use of an anxiety scoring system in dogs hospitalized in the ICU. Following enrollment, dogs will be videotaped and scored (by the primary investigator) for 20 minutes as a baseline evaluation. The Thundershirt (a jacket placed around the dog’s torso which provides reassuring pressure) will be applied and the dog will be videotaped for an additional 10-20 minutes and scored again. After the period of videotaping the dog’s primary clinician will decide whether to keep the Thundershirt on the patient. More information about the Thundershirt can be found at http://www.thundershirt.com

    We hypothesize that application of the Thundershirt will reduce anxiety in hospitalized canine patients as assessed by the anxiety score.

    Inclusion Criteria

    Dogs exhibiting anxiety, as subjectively assessed by ICU personnel, will be enrolled following client consent.

    Exclusion Criteria

    Physical factors that prevent the application of the Thundershirt, such as chest tubes.

    Client Benefits

    The direct benefit is the potential that the Thundershirt will reduce anxiety levels of their dog, preventing the need for giving sedative or anxiolytic drugs.

    Contact Information

    Dr. Claire Sharp: Claire.Sharp@tufts.edu
    Michelle Damon: Michelle.Damon@tufts.edu

  • Description

    This study is designed to evaluate whether instilling some of a patient’s own blood (termed a “blood patch”) in the chest cavity will hasten healing of small tears in the lung that result from vehicular trauma. These tears can cause air to leak into the chest cavity, causing pneumothorax, a potentially life-threatening condition.

    Inclusion Criteria

    Pneumothorax from trauma severe enough to require a chest tube.

    Exclusion Criteria

    Dogs managed with surgery.

    Client Benefits

    Free blood patch and monitoring.

    Contact Information

    Dr. Elizabeth Rozanski
    Phone: (508)839-5395, ext. 8-4745

  • Description
    Many dogs presenting with a splenic mass are at risk of significant bleeding, which may necessitate emergency stabilisation and surgery. However a smaller population of dogs are also known to be at risk of developing post-operative thromboembolic complications. The aim of this study is to assess the pre-operative coagulations status in hemodynamically stable dogs with splenic mass that undergo splenectomy. Pre-operative blood tests will be performed to assess for any potential clues that these dogs may be at increased risk of thromboembolic disease.
    Inclusion Criteria
    Dogs that are hemodynamically stable (HR <140, lactate <3 mmol/L and PCV ≥35%) with splenic mass that are undergoing pre-operative ultrasound examination and undergoing splenectomy.
    Exclusion Criteria
    Dogs not fulfilling above criteria.
    Client Benefits
    Lactate level, platelet count and thromboelastography will be paid for by the study.
    Contact Information