Catheter embolism in a canine patient
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A 6 year old male castrated Rottweiler presented to Cornell University Hospital for Animals (CUHA) for postoperative stabilization after his second gastric dilatation volvulus (GDV) surgery. The Soft Tissue Service provided successful treatment for DIC and peritonitis, including plasma transfusion, anti-coagulation, colloid, gastroprotectant, and antibiotic therapies. A central venous catheter was inadvertently transected during bangage removal and lost into the patient's vasculature. The catheter embolism was ultimately localized to a caudal branch of the left pulmonary artery. Clinical evaluation determined that in this case the risk of surgical retrieval was greater than the risk of retaining the catheter embolism. The patient was observed for another 36 hours without complication before discharge into owner care. The patient was monitored by a local veterinarian for a period of 16 months after the incident occurred, without clinically-evident abnormalities associated with the catheter embolism. A literature review indicates a moderate rate of complication associated with catheter emboli in human medicine, but there is reason to believe that catheter emboli are better-tolerated in veterinary patients. Decision tree analysis indicates complication risk is a critical factor in choosing be between conservative management and retrieval.
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Seminar SF610.1 2006 L49