Misc.

Question 1

What is heatstroke in dogs?

Answer 1

A nonpyrogenic increased body temperature above 104°F (40°C) with systemic signs.

Heatstroke is life-threatening and can affect dogs of any age, breed, or gender.

Question 2

What is the role of the thermoregulatory center in dogs?

Answer 2

Maintains body temperature within a narrow range or set point.

Located in the anterior hypothalamus.

Question 3

What differentiates pyrogenic from nonpyrogenic hyperthermia?

Answer 3

Pyrogenic hyperthermia involves an increase in the hypothalamic set point; nonpyrogenic does not.

Active cooling is safe in nonpyrogenic hyperthermia.

Question 4

What are the methods of cooling for dogs?

Answer 4

• Evaporation
• Conduction
• Convection
• Radiation

Question 5

How does evaporation help in thermoregulation in dogs?

Answer 5

Occurs through panting, dispelling heat via evaporation of water from the tongue.

Most effective when ambient temperature is below 89.6°F (32°C).

Question 6

What is the definition of heat stress in veterinary patients?

Answer 6

Includes discomfort and physiologic strain with normal core body temperature.

It is rarely recognized in veterinary patients.

Question 7

What are the main clinical signs of heatstroke in dogs?

Answer 7

• Collapse
• Tachypnea
• Shock
• Inappropriate mentation
• Signs of coagulopathy

Question 8

What is exertional heatstroke?

Answer 8

Occurs during exercise, more common in dogs not acclimated to their environment.

Acclimation can take up to 60 days.

Question 9

What is nonexertional heatstroke?

Answer 9

Results from exposure to increased environmental temperatures without adequate cooling.

Examples include being left in a parked car.

Question 10

What is the acute-phase response?

Answer 10

A coordinated cellular response during inflammatory events to protect tissues from excessive heat.

Stimulated during nonpyrogenic hyperthermia.

Question 11

What are negative acute-phase proteins?

Answer 11

Proteins that decrease by 25% during an acute-phase response, such as albumin.

Levels can decrease due to GI or renal loss or decreased production.

Question 12

What are positive acute-phase proteins?

Answer 12

• C-reactive protein
• Serum amyloid A

Question 13

What is the effect of heatstroke on the central nervous system?

Answer 13

Increased susceptibility to cytotoxicity, resulting in injury and death of neurons, cerebral edema, and hemorrhage.

Severity depends on temperature and duration.

Question 14

What cardiovascular changes occur during heatstroke?

Answer 14

Initially increased cardiac output, peripheral vasodilation, and central vasoconstriction, followed by hypotension and shock.

Blood circulation is compromised.

Question 15

What are the common diagnostic findings in heatstroke patients?

Answer 15

• Increased creatinine
• Increased lactate
• Decreased platelets
• Increased hemoglobin concentration

Question 16

What is the most important aspect of treatment for heatstroke?

Answer 16

Active cooling.

Early cooling efforts significantly improve prognosis.

Question 17

True or False: Dogs may present normothermic or hypothermic with heatstroke due to prior cooling efforts.

Answer 17

True

Question 18

Fill in the blank: Heatstroke in dogs can be classified as _______ or nonexertional (classical).

Answer 18

exertional

Question 19

What is the most important aspect of treatment for heatstroke?

Answer 19

Active cooling

Active cooling may not prevent all deleterious effects of heatstroke but is crucial for treatment.

Question 20

What is the mortality rate for dogs that are actively cooled before reaching the hospital compared to those that are not?

Answer 20

19% for cooled dogs vs. 49% for non-cooled dogs

Question 21

What should be avoided during the treatment of heatstroke?

Answer 21

• Use of ice
• Gastric lavage
• Cold water enemas
• Shivering

Using ice causes peripheral vasoconstriction, gastric lavage poses aspiration risks, and cold water enemas may damage the GI tract.

Question 22

What is an effective cooling method for dogs experiencing heatstroke?

Answer 22

Directing a fan toward the dog and applying cool or tepid water to the skin

Question 23

At what body temperature should active cooling be discontinued to avoid rebound hypothermia?

Answer 23

103.5°F to 104°F (39.7°C–40°C)

Question 24

What is the cornerstone of heatstroke treatment?

Answer 24

Intravenous fluids

Question 25

What type of fluids should be administered upon arrival of a heatstroke patient?

Answer 25

Room temperature crystalloids

Question 26

When should colloids be considered in heatstroke treatment?

Answer 26

If crystalloids do not adequately maintain intravascular volume or if the patient is hypoalbuminemic

Question 27

What are some recommended antibiotics for heatstroke patients?

Answer 27

* Ampicillin * Cefazolin * Enrofloxacin * Metronidazole ## Footnote These antibiotics help prevent bacterial translocation due to GI damage.

Question 28

What medications are beneficial for GI tract support in heatstroke patients?

Answer 28

* Antiemetics (metoclopramide, dolasetron, maropitant) * Proton pump inhibitors (omeprazole, pantoprazole) * H2 receptor antagonists (famotidine, ranitidine) * Sucralfate ## Footnote These medications help manage nausea and prevent gastric ulceration.

Question 29

What is mannitol used for in heatstroke treatment?

Answer 29

To decrease intracranial pressure and improve cerebral microcirculation

Question 30

What is the prognosis for heatstroke patients primarily dependent on?

Answer 30

Length of time the patient was hyperthermic and the highest body temperature experienced

Question 31

True or False: The development of ventricular arrhythmias is a negative prognostic indicator in heatstroke patients.

Answer 31

True

Question 32

What are some prevention strategies for heatstroke in dogs?

Answer 32

* Ensure availability of shade and drinking water * Exercise dogs during cooler periods * Never leave dogs alone in closed vehicles * Acclimate dogs to warm temperatures * Surgically address upper airway obstructions ## Footnote Owner education is crucial for preventing heatstroke.

Question 33

What should be monitored during the hospitalization of a heatstroke patient?

Answer 33

* Neurologic status * Heart rate and pulse quality * Respiratory rate and effort * Blood pressure * ECG * PT and aPTT * Packed cell volume and total protein * Blood glucose and electrolytes * Lactate and acid–base balance * Urine output ## Footnote Serial monitoring can help assess response to therapy, particularly lactate clearance.

Question 34

What is the normal urine output for a dog on IV fluids?

Answer 34

At least 1 to 2 mL/kg/hour

Question 35

What is a positive prognostic indicator for dogs that have suffered heatstroke?

Answer 35

Return of normal CNS function

Question 37

What is heatstroke in dogs?

Answer 37

An acute, life-threatening emergency characterized by nonpyrogenic elevation in body temperature resulting in direct thermal injury to body tissues

Question 38

What are the key clinical features of heatstroke?

Answer 38

* Metabolic acidosis * Oliguric renal failure * Coagulation abnormalities * Neurologic disturbances

Question 39

What are common clinical signs observed in dogs with heatstroke?

Answer 39

* Excessive panting * Hyperemia * Hypersalivation * Tachycardia * Various neurologic signs

Question 40

What laboratory changes are associated with heatstroke?

Answer 40

* Hemoconcentration * Elevated liver enzymes * Electrolyte changes * Prolonged clotting times * Azotemia * Hypoglycemia

Question 41

What is the primary goal in managing heatstroke?

Answer 41

To rapidly cool the core body temperature while preventing further damage to vital organs

Question 42

What temperature is considered indicative of heatstroke in dogs?

Answer 42

A core body temperature higher than 106˚F (41.1˚C)

Question 43

What are some risk factors for heatstroke in dogs?

Answer 43

* Exercise * Poor ventilation in enclosed areas * Hot weather conditions

Question 44

True or False: Systemic infections with fever usually cause panting and hypersalivation.

Answer 44

False

Question 45

What should owners do if they suspect their dog is experiencing heatstroke?

Answer 45

Institute cooling measures immediately before transporting to a veterinarian

Question 46

What are some clinical signs that may indicate severe neurologic involvement in heatstroke?

Answer 46

* Ataxia * Loss of consciousness * Seizures * Coma

Question 47

Fill in the blank: The most common clinical sign in patients with heatstroke is _______.

Answer 47

excessive panting

Question 48

What are the common clinicopathologic findings in heatstroke?

Answer 48

* Hemoconcentration * Low blood glucose * Elevated BUN and creatinine levels * Electrolyte abnormalities

Question 49

What kind of abnormalities may be present in coagulation due to heatstroke?

Answer 49

* Thrombocytopenia * Coagulation factor disruption * Disseminated intravascular coagulation (DIC)

Question 50

What electrolyte imbalance is frequently present in canine heatstroke?

Answer 50

Hypernatremia due to pure water loss

Question 51

What should be avoided when cooling a dog with heatstroke?

Answer 51

Ice water baths

Question 52

What is a recommended initial fluid therapy for dogs with heatstroke?

Answer 52

Crystalloid fluids, such as balanced electrolyte solutions

Question 53

What is the significance of monitoring blood gases in heatstroke patients?

Answer 53

To assess for respiratory alkalosis or metabolic acidosis

Question 54

What are some potential causes of hyperthermia that can be confused with heatstroke?

Answer 54

* Eclampsia * Tremorgenic toxins * Malignant hyperthermia

Question 55

What is the recommended temperature to stop aggressive cooling efforts in heatstroke patients?

Answer 55

103˚F (39.4˚C)

Question 56

What clinical findings may indicate disseminated intravascular coagulation (DIC) in dogs with heatstroke?

Answer 56

* Petechial hemorrhages * Ecchymosis * Tachycardia with thready pulses

Question 57

True or False: Owners should wait to cool their dog until reaching the veterinary clinic.

Answer 57

False

Question 58

What are common signs of renal impairment in dogs with heatstroke?

Answer 58

* Elevated BUN and creatinine levels * Myoglobinuria

Question 59

What is the initial type of fluid therapy recommended for cardiovascular shock?

Answer 59

Crystalloid fluids (e.g., balanced electrolyte solutions) ## Footnote These fluids are preferred to rehydrate the interstitium.

Question 60

When are colloids typically used during heatstroke treatment?

Answer 60

During the initial resuscitation period, but must be followed by crystalloid therapy ## Footnote Examples of colloids include hetastarch, dextran, and plasma.

Question 61

What is the recommended dose reduction when using both crystalloids and colloids together?

Answer 61

Reduce the dose of crystalloids by 40% to 60%.

Question 62

What condition may benefit from the use of colloids in heatstroke treatment?

Answer 62

Hypoalbuminemia and decreased colloid osmotic pressure.

Question 63

What type of blood product may be necessary to treat anemia after initial resuscitation?

Answer 63

Whole blood or packed red blood cell transfusions.

Question 64

What factors should be monitored to evaluate fluid therapy effectiveness?

Answer 64

Heart rate, pulse quality, mucous membranes, capillary refill time, arterial blood pressure.

Question 65

True or False: Prophylactic antibiotic therapy is universally recommended in heatstroke cases.

Answer 65

False ## Footnote It is controversial due to potential resistance and worsening endotoxemia.

Question 66

What should be supplemented in IV fluids if hypoglycemia is present?

Answer 66

Dextrose.

Question 67

Which drug is recommended for gastrointestinal protection in heatstroke treatment?

Answer 67

Cimetidine or ranitidine.

Question 68

What is the recommended treatment for Disseminated Intravascular Coagulation (DIC) in dogs?

Answer 68

Fresh-frozen plasma and possibly heparin.

Question 69

How should metabolic acidosis be corrected in heatstroke patients?

Answer 69

Sodium bicarbonate can be given if acidemia persists after adequate resuscitation.

Question 70

What is the recommended treatment for hypokalemia?

Answer 70

Potassium chloride, no more than 0.5 mEq/kg/hr IV.

Question 71

What should be monitored to prevent acute renal failure during heatstroke treatment?

Answer 71

Urine output.

Question 72

What is the first step in treating hypotension after fluid resuscitation?

Answer 72

Consider dopamine or dobutamine hydrochloride.

Question 73

What are the potential complications associated with corticosteroid use in heatstroke treatment?

Answer 73

Gastric ulceration, immunosuppression, exacerbation of renal damage.

Question 74

Why are NSAIDs contraindicated in heatstroke treatment?

Answer 74

They can cause severe hypothermia, gastrointestinal ulceration, prolonged bleeding times, and bone marrow suppression.

Question 75

What is the survival rate reported for dogs with heatstroke in some cases?

Answer 75

As high as 64%.

Question 76

List at least three unfavorable prognostic criteria for heatstroke in dogs.

Answer 76

* Coma or progressive neurologic deterioration * Persistent hypoglycemia * Worsening azotemia despite adequate fluid therapy.

Question 77

What is the key to successful treatment and recovery from heatstroke?

Answer 77

Early recognition and treatment.

Question 78

Fill in the blank: To prevent exertional heatstroke, outdoor duties should be scheduled during the _______ parts of the day.

Answer 78

[cooler]

Question 79

What is crucial for monitoring during the first 24 to 48 hours after heatstroke treatment?

Answer 79

Continuous critical monitoring of acid–base status, packed cell volume, white blood cell count, total solids, BUN, and platelet count.

Question 80

What should owners be educated about to prevent heatstroke in their dogs?

Answer 80

The risks of confining or exercising dogs in hot environments.

Question 81

What is the primary goal of treatment for patients with heatstroke?

Answer 81

Lower the core body temperature as quickly as possible.

Question 82

Which of the following is not a clinical pathologic finding in canine heatstroke?

Answer 82

Decreased alkaline phosphatase

Question 83

DIC is suspected if there is _______.

Answer 83

Thrombocytopenia, prolonged prothrombin time, and elevated activated partial thromboplastin time.

Question 84

True or False: Immersing the body totally in ice cold water is an accepted method of cooling during heatstroke.

Answer 84

False

Question 85

What are common electrolyte changes that occur during heatstroke?

Answer 85

Hypernatremia and hyperchloremia

Question 86

Unfavorable criteria associated with poorer outcomes of dogs with heatstroke include all of the following except _______.

Answer 86

Persistently elevated alanine transaminase

Question 87

Heatstroke in dogs can be prevented primarily by _______.

Answer 87

Educating owners concerning the risks of confining animals outdoors

Question 88

How long may it take for some dogs to fully acclimate to a hot environment?

Answer 88

28 days

Question 89

Which of the following physical examination findings is commonly seen in dogs with heatstroke?

Answer 89

Excessive panting

Question 90

Fill in the blank: Patients with oliguric or anuric renal failure are best treated with _______.

Answer 90

Dopamine and furosemide

Question 91

What are the common clinical signs of heatstroke in dogs?

Answer 91

* Excessive panting * Hypersalivation * Hyperemic mucous membranes * Tachycardia

Question 92

True or False: Providing adequate ventilation and shade and allowing free access to cool drinking water is a method to prevent heatstroke.

Answer 92

True

Question 93

What is the effect of glucocorticoids in rat heatstroke as mentioned in the text?

Answer 93

Reduce interleukin-1 concentration and result in neuroprotective effects

Question 94

What is the role of colloids in maintaining fluid balance according to the text?

Answer 94

Critical need for colloids: Maintaining fluid balance

Question 95

What are the acute effects of massive transfusion of a bovine hemoglobin blood substitute in a canine model of hemorrhagic shock?

Answer 95

Effects described in the study by Harringer et al.

Question 96

What is a common consequence of heatstroke related to coagulation as mentioned in the text?

Answer 96

Disseminated intravascular coagulation (DIC)

Question 97

Fill in the blank: Malignant hyperthermia in dogs is discussed in the work of _______.

Answer 97

Nelson TE

Question 98

What is the significance of the study by Lee-Chiong Jr TL regarding temperature regulation disorders?

Answer 98

Disorders of temperature regulation