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 Sponsored by Zoetis Animal Health
8:00-8:50am (Sullivan) Early Goal Directed Therapy: Updates and Practices
Early goal directed therapy (EGDT) is a concept that has attracted a lot of attention (and recent criticism) within the emergency and ICU setting. Rapid establishment of resuscitation endpoints and the therapeutic interventions used to achieve those targets have been heavily debated and investigated.  Objectives of this lecture include:
• Review initial concepts of EGDT according to the Rivers study and subsequent observational studies.
• Discuss various endpoints used in EGDT and utilize case examples to highlight how those endpoints may vary according to patient population.
• Discuss recent literature that may change future EGDT recommendations and therapeutic interventions.
1 CE Credit

9:10-10:00am (Sullivan) Care Bundles in the ICU Setting
Care bundles, best described as groups of evidence-based practice interventions, help prevent medical care oversights in busy ICUs. These bundles organize multiple treatments into a single protocol. Various protocols have been developed to reduce ICU complications (i.e. those associated with mechanical ventilation, postoperative surgical site healing, and central line placement). Objectives of this lecture include:
• Provide background on the concept of care bundles and elements that should be included when developing a care bundle.
• Incorporation of a checklist-based philosophy when implementing bundle-based care within an ICU.
• Review literature of care bundles used in critically ill people and the effects of their implementation on outcome.
• Foster conversation around feasible care bundles in veterinary medicine and how such bundles could be systemically evaluated.
1 CE Credit

10:30-12:30pm (Barter) Analgesia in the ER..Why and How? Part 1 & 2
This 2-part session will discuss the difficulties of pain assessment in the emergent or ill patient and the challenges faced when trying to provide adequate analgesia. The pharmacology of currently available analgesics, in addition to what evidence we do or don’t have on drug efficacy, side effects and interactions will be covered.  Learning objectives:
• Recognize pain in traumatized or critically ill patients.
• Explain the potential consequences of untreated pain.
• Understand the pharmacology of commonly used analgesic drug groups.
2 CE Credits

12:45-1:45pm  (Sullivan) Monitoring Tissue Perfusion and Oxygenation in Critically Ill Patients
ADDITIONAL fee required - $50 - lunch included.  Resident/specialist level but open to all who sign up!  Oxygen delivery and uptake by cells can be challenging to assess clinically, yet these processes are vital to organ function and overall outcome. Critical illness further complicates the clinical picture through alteration of oxygen uptake and utilization. Objectives of this lecture include:
• Review of the delivery, tissue uptake and cellular utilization of oxygen in health and illness.
• Describe global and regional markers of oxygen delivery that can be used in the clinical setting.
• Discuss technological advances that may help better assess tissue perfusion and oxygenation in critically ill patients.
1 CE Credit

2:00-2:50pm (Sullivan) Fluid Overload in The Critically Ill: Consequences and Strategies
Fluid therapy is essential during both initial stabilization and ongoing hospitalization of critically ill patients. These patients may also present the unique challenge of impaired water excretion and/or inability to maintain water within the intravascular space, leading to fluid overload (FO). Objectives of this lecture include:
• Review the physiology associated with FO .
• Identify expected consequences of FO using a systems-based approach.
• Discuss evidence supporting FO in critically ill people and dogs.
• Include strategies for prevention of FO in the ICU setting.
1 CE Credit

3:00-3:50pm (Sullivan) Massive Transfusion
The clinical management of massive hemorrhage has become a popular topic due to increased awareness of coagulopathy, an expanding array of transfusion products, controversy surrounding the delivery of blood products, complications associated with blood products and the use of cell salvage devices. Objectives of this lecture include:
• Defining massive transfusion in the clinical setting and outlining circumstances when massive transfusion may be required.
• Understanding complications associated with massive transfusion.
• Discussing autologous versus homologous transfusion techniques.
1 CE Credit

4:00-4:50pm (Barter) Epidural Analgesia/Anesthesia
Epidural administration of drugs to produce anesthesia and /or analgesia can provide conditions suitable for invasive procedure and provide pain relief, however, this approach is not without potential side effects. This session will discuss indications and contraindications for epidural anesthesia and analgesia in small animals in addition to reviewing anatomy, procedure and drug selection and dose.  Learning objectives:
• Understand indications, absolute and relative contraindications for epidural or subarachnoid drug administration
• Differentiate epidural anesthesia from analgesia and know which drugs to infuse
• Be able to formulate an appropriate epidural drug protocol for an individual patient.  
1 CE Credit


Sponsored by Caniplas
8:00-8:50am (Barter) Intraoperative Fluid Rates: What’s the Going Rate?
Intraoperative fluids are used to maintain perfusion in anesthetized patients but over-hydration has severe consequences. In human medicine intraoperative fluid therapy has shifted from a generous recipe based approach to a goal directed individualized plan. This session will discuss the consequences of over-hydration, address rational maintenance rates and cover the indices used for goal directed fluid therapy and their use in veterinary patients. Learning objectives:
• Identify consequences of over-hydration in the perioperative patient.
• Understand the most common indices used for goal directed fluid therapy.
• Know how to design an individualized intraoperative fluid plan.
1 CE Credit

9:00-9:20am (Sullivan) VetTalks - Vascular Access: Optimizing Success
Administration of fluids and drugs using venous access is a cornerstone of emergency and critical care medicine. Patient populations within these disciplines can make vascular access challenging for numerous reasons, including patient size and cardiovascular/respiratory stability. Objectives of this lecture include:
• Describe anatomic locations for vascular access and pros/cons of each location.
• Demonstrate the use of ultrasound to quickly identify vessels for venous access.
• Review the vascular cut-down procedure and use of an intraosseous drill, via technique description and videography.
.5 CE Credit

9:30-9:50am (Epstein) VetTalks - Management of Emergent Cardiac Arrhythmias.
This lecture will cover the classification of anti-arrhythmic medication and their application to dogs and cats in the emergency room. A step-wise approach to the management of refractory arrhythmias will be presented providing a practical application of these anti-arrhythmic medications. Objectives of this lecture include:
• Review therapeutic drug options for management of arrhythmias in the ER
• Be comfortable with emergency management of drug resistant ventricular tachycardia
.5 CE Credit

10:20-10:40am (O’Kelley) VetTalks - Managing The Post-Cardiac Arrest Syndrome: What to do Following Successful ROSC
The 72-hour period following a successful ROSC is a critical and challenging time. The “post-cardiac arrest syndrome” seen during this time is characterized by brain injury and systemic ischemia-reperfusion injury. Adrenal insufficiency and/or myocardial dysfunction may develop. Multi-organ dysfunction and death is common. While much remains to be learned about the management of post-cardiac arrest syndrome in veterinary patients, current recommendations include aggressive monitoring, goal-directed hemodynamic resuscitation, avoidance of hypoxemia and hyperoxemia, and mechanical ventilation if hypoventilation develops. Clinicians must consider myocardial dysfunction and adrenal insufficiency if shock persists despite standard resuscitation measures. Objectives:
• Briefly review the pathophysiology of the “post-cardiac arrest syndrome”
• Review current recommendations in the management of patients following ROSC
• Discuss future directions in improving outcomes following ROSC
.5 CE Credit

10:40-11:00 (Giuliano) VetTalks - Practical Tips for Enucleation
Many practitioners, particularly new graduates, often do not feel comfortable removing a blind, painful eye that warrants enucleation, evisceration and prosthesis, or exenteration.  This will provide an overview of an enucleation for the small animal practitioner and provide some useful tips to making this procedure a more comfortable experience for both patient and veterinarian alike. Objectives of this lecture include:
• To review the subconjunctival approach to enucleation in small animals
• To review the benefits and techniques of regional anesthesia in an enucleation procedure
• To answer questions from the small animal emergency practitioner regarding his/her experiences and frustrations when enucleating a patient
.5 CE Credit

11:30am-12:20pm  (Sullivan) Canine Parvovirus
Canine parvovirus (CPV) is a serious etiology of gastrointestinal signs and sepsis in unvaccinated puppies. Although identification and treatment of CPV may be viewed as simplistic, overall outcome is influenced through complex pathophysiological processes and various treatment options. Objectives of this lecture include:
• Review more advanced pathophysiology associated with CPV and its effect on various organ systems.
• Highlight therapeutic interventions that may enhance the recovery of dogs with CPV.
• Discuss an evidence-based outpatient treatment protocol and its use in circumstances of financial constraints.
1 CE Credit

12:45-1:45pm (Barter) Gas Exchange in the Awake and Anesthetized Patient
ADDITIONAL fee required - $50 - lunch included.  Resident/specialist level but open to all who sign up!  This session will briefly discuss gas exchange in the awake patient and then attach them to an anesthetic machine, track the gas from the gas source to the tissues and re-evaluate gas exchange.  Learning objective:
• Understand the principles of gas exchange.
• Describe the second gas effect.
• Describe the factors influencing rate of rise of alveolar anesthetic concentration.
Describe the effects of anesthesia on pulmonary gas exchange.
1 CE Credit


8-8:50am (Kerl) Journal Club
1 CE Credit

9:10-10:00am  (Barter) Top 10 Misconceptions in Anesthesia
Myths and misconceptions are common in veterinary anesthesia. Some stem from misapplied truths or outdated information, whilst others are convenient, or inconvenient, excuses. This session will discuss some of these misconceptions and present what is currently know about the topic.  Learning outcomes:
• Be able to discuss the truth behind common misconceptions in veterinary anesthesia to colleagues and clients.
1 CE Credit

10:30am-12:30pm (Barter, et al) Case based panel discussion and other sundry topics
2 CE Credits

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