DEBATE ON DEX / SOLU-DELTA / CORTICO-STEROIDS

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Originally Posted by Nut

Even though they have short half life dosage. My concern was fluid would withdrawal at a much higher rate as the dosage for anti swelling purposes.

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You have to learn to distinguish between "your concern" (imagination) and reality.

Your concern is legitimate. Definitely.

The reality is, no dog is going to piss-out 1000 ml of fluids faster than you can get it into him with a bolus dose of IV Fluids.

And hell, if the dog does piss out a big amount of fluids, CELEBRATE!, because it means his kidneys are now working :D

And then, guess what? You can run another bag of fluids in him and not give anymore dex/solu ... and keep him hydrated :D

Again, these drugs at that dose are for the VERY short term. ONCE ... maybe TWICE ... but no more :idea:

If they make him have to get up and piss, great! That is progress and a big relief!

You can discontinue (or drastically lower) the cortic-steroid dose, and keep on giving IV fluids.

When he's eating, and drinking, you stop giving those drugs altogether at that point, and continue with fluids and antibiotics.

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Originally Posted by Nut

Thanks for giving a better understanding.

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You're welcome :mrgreen:

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Originally Posted by Nut

Hope this link works: Volvulen It opens in PDF so it probably doens't work on phone.

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Honestly, I haven't used it. The symptoms show an irregular heart beat and I am not sure that is something I would want to do in a life-n-death thing.

But I have no experience, and know of no one who has either, so I can't be of much help here, sorry.

Jack

One more thing to remember is not to go overboard on fluids either :idea:

If you're running IV Fluids, only give what is mentioned in the Article, based on weight.

If you give TOO MUCH fluids, you can actually "drown" your dog, via pulmonary edema (lungs fill with fluid) ... so don't be too gung-ho there either :idea:

Jack

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Originally Posted by CA Jack

The reality is, no dog is going to piss-out 1000 ml of fluids faster than you can get it into him with a bolus dose of IV Fluids.

And hell, if the dog does piss out a big amount of fluids, CELEBRATE!, because it means his kidneys are now working :D

And then, guess what? You can run another bag of fluids in him and not give anymore dex/solu ... and keep him hydrated :D

Again, these drugs at that dose are for the VERY short term. ONCE ... maybe TWICE ... but no more :idea:

If they make him have to get up and piss, great! That is progress and a big relief!

Jack

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This is the simple truth, why one could not grasp this is beyond me. Any why try to complicate things further if you are not as experienced as the ones laying it out for you?

I can see trying to debate this, or using other products if you have the field experience and medical knowledge. But why try to tweak or change what knowledgeable veterinarians, vet techs and dogmen have been doing to save a warrior or any animal experiencing trauma and shock?

It is best to learn these methods first and be great at them before questioning them.

Assumption is the mother of all fucks ups. You're not going to learn any methods before trusting and understanding them. Its better to ask questions when you don't. Nothing can go wrong if you do that. Just slightly if you question it in the wrong manner and piss of Jack. To many people ask to little questions because of their pride or lack of effort to learn something. My apologies to Jack for bringing it up in that manner. But that was in private and i wouldn't have state it like that if I created the tread. Like i said in my first reply I will be happy if correct information is in the article when everything is said and done, even it remains the same. There's a few tweaks, I learned (understand) something new, and I bet some others did too. Cheers.

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Originally Posted by Nut

Do you mean lbs? I said a dog can lose about one kilo over a day. Depending on strength of the drug and size of the dog. I have seen people weighing in a pound under from giving half a cc in the morning.]

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LOL Yes. Everything depends on the strength of the drug, but I've never given 1mL of dex of ANY strength and seen a dog lose that much weight over a 24hour period.

Here's something people are missing. When your dog is dehydrated to that extent, it doesn't have the fluid to give. Most of the fluid, at that time, is being shunted toward the organs, so your urine output is going to be minimal regardless of what the dog is getting. The body is intent on saving those organs, and it's a more mechanical response than anything else. So even with the fluid replacement, your dog isn't going to lose a large portion of fluids simply because of being replaced.

If your organs shut down, your dog is going to die 98% of the time. There is no coming back from multi-organ failure. When the kidneys don't work correctly, it's usually from rhabdomyolysis. Your dog can develop that from work or after a long show, but usually it's going to come into play after the show.

Voluven is a colloid, which is usually one of the things used when shock is encountered. Normal Saline and Lacted Ringers are crystalloids. All of those things are recommended. You just need to be careful of any adverse effects when using colloids as they're not all the same.

The entire thought process of "drying" a dog out was to decrease the amount of bleeding from any damage. It's a tricky process, and I've never seen anyone actually be able to do it as described as it's usually just too much deficit for the dog to overcome. When the dog is dry, nothing works as it should.

The times I heard of people giving Dex before the show is because they noticed they were coming overweight. As a result of this stupidity they came in way under. Others give it right before the show for anti swelling purposes.

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Originally Posted by Nut

Assumption is the mother of all fucks ups.

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Assumption is especially "the mother of all fuck ups" when assuming a man who's been in dogs about as long as you've been alive is "wrong" ... when in fact you're the one who's wrong ;)

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Originally Posted by Nut

You're not going to learn any methods before trusting and understanding them. Its better to ask questions when you don't. Nothing can go wrong if you do that.

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Asking questions is a great thing to do.
Coming off like an arrogant prick is not.

The audacity of telling me to take down all my "wrong information," when in fact you have no understanding of the subject, is almost unbelievable.
Telling me to issue "a public retraction" to everyone, because you THINK I'm wrong is much different from "asking a question" :rolleyes:

You need to recognize the difference, and you need to learn how to actually ASK a question, rather than PRESUMING "you must be right" ... "just because you're YOU" :lol:

You might be surprised to learn I have thoroughly researched this subject ... long before you have ever owned a dog ... and the medics that have been involved in helping me were all topnotch.

That said, I WELCOME new information ... I WELCOME updated drug/dosage information ... I WELCOME honest, thoughtful questions :D

But I'll be damned if some relative newcomer is going to "insist" that I issue a public retraction of my WELL RESEARCHED article because HE THINKS my dosages are too high :@:

It might be helpful for you to ASSESS YOUR OWN KNOWLEDGE before you go to questioning mine :-?

I am sure there are things you know, that I do not, but I promise you it's 'not much' on the subject of these dogs :hatsoff:

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Originally Posted by Nut

Just slightly if you question it in the wrong manner and piss of Jack.

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It's not about "pissing me off"; it's about being an unbelievably rude, presumptuous ass to me, when I have done as much (or more) than any other dogman on the planet to provide the best CRITICAL information on these dogs that can be gathered. It would be a very short list of "names" in this game to jot down those who have taken the time to put out as much good information as I have over the years. If you could even write one name.

It would be helpful to keep that in mind while you're asking me your "questions" :-O

There is a difference between asking questions, clarifying points, and just flat calling a whole body of information "wrong," and demanding a retraction, all based on your imagination, without citing an actual fact to stand on.

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Originally Posted by Nut

My apologies to Jack for bringing it up in that manner. But that was in private and i wouldn't have state it like that if I created the tread.

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Apology accepted and, as I said in private, in the end we're on the same side :mrgreen:

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Originally Posted by Nut

Like i said in my first reply I will be happy if correct information is in the article when everything is said and done, even it remains the same. There's a few tweaks, I learned (understand) something new, and I bet some others did too. Cheers.

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The information was already correct, but adding the dosage range was a good result, I agree.

I just wish the whole thing would have been gone about differently.

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Originally Posted by Nut

There's a few tweaks, I learned (understand) something new, and I bet some others did too. Cheers.

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I am sure everybody here learned something new, including me.
(I bet even ol' Frosty is pilfering some Solu-Medrol right now as we speak :lol:)

Let us both, in the future, remember we're on the same side :cheers:

If I have made any mistakes, it is not because I am a dumbass, or didn't research, etc.

It's because, like anyone, I make a certain amount of errors and omissions too ... but try my best not to make too many :mrgreen:

Jack

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Assumption is especially "the mother of all fuck ups" when assuming a man who's been in dogs about as long as you've been alive is "wrong" ... when in fact you're the one who's wrong

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Well Jack, you better assume something is wrong in case it is, than assume its right in case it's not. Gotta give me that. lol.

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You might be surprised to learn I have thoroughly researched this subject

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Fair enough.

Years in dogs are not always relevant. One could be 40 years in sport and not know anything about breeding. On the other hand this greenhorn done more confirmations shows in a short time than others did in 20+ years and I'm not even referring to you. A certain man who has many years in dogs called us pepsi cola generation in a denigrating way, not long after I met him and won the trophy.
There's people with 20+ years in dogs constantly contradicting each other on various subjects, also happened on this board. Who shall I assume is right?

But agreed with with the rest of what you said. and I already apologized for the way I stated the orginal PM.

:cheers:

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Originally Posted by Nut

Well Jack, you better assume something is wrong in case it is, than assume its right in case it's not. Gotta give me that.

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Can't necessarily agree with that, actually.

If I just fell off the turnip truck, then yeah, maybe question what I say.

But when thousands of people all over the world have used my book to their success, and I have actually done the research, then it is foolish to come at me like you did.

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Originally Posted by Nut

You have got allot of experience on allot of things, but I think this info came from someone else.

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Almost all information comes from someone else.

Doc didn't invent dex, he didn't invent solu-medrol, nor did he pioneer any new scientific research of his own.
Neither did the instructors who taught him. Neither did the instructors who taught them.

The idea that, just because I too learned "from someone else" somehow discredits what I say, or somehow means I don't actually know what TH I am talking about, is absolutely asinine.

You didn't invent pit bulls, you didn't invent treadmills, leashes, the Cajun rules ... nor anything else having to do with these dogs ...
But that doesn't mean you can't, through research and trial, become knowledgeable about these matters. Does it?

So why do you think this doesn't apply to me?

I assure you my own brain works just fine .... far better than 99.99999999% of anyone who's ever called himself a "dogman" in fact :lol:

I guess you must think I am some brainless parrot "repeating information" without understanding what I am saying :lol:

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Originally Posted by Nut

Years in dogs are not always relevant. One could be 40 years in sport and not know anything about breeding. On the other hand this greenhorn done more confirmations shows in a short time than others did in 20+ years and I'm not even referring to you.

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Totally agree with you there.

My years in dogs have been spent schooling & breeding dogs, dogs that have won all over the world ... as well as researching the best methods to do things, and classifying it all together.
These methods have likewise worked all over the world, and there aren't many dogmen who can kiss my ass in any of these areas.

You are becoming proficient in matching dogs, and your record is excellent, so props to you in that regard.

But let me gently remind you that, just because you've won a few matches doesn't mean you have the right to talk to me like "I don't know shit" and you do.

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Originally Posted by Nut

Love it when people call me that. A certain man who has many years in dogs called us pepsi cola generation in a denigrating way, not long after we met and i won the trophy.

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I know who you're talking about, and hats off to you on that. But to compare that guy's ape-brain to mine is a pretty far stretch, don't you think :lol:

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Originally Posted by Nut

But agreed with with the rest of what you said. and I already apologized for the way I stated the orginal PM. You are right
:cheers:

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Okay, and for the record I admire your chutzpah :lol:

And you have had a lot of good suggestions here, so we'll just forget about the whole thing and be glad some good eventually came out of a bad start :D

Jack

I pilfered my solu-medrol some time ago, because if nothing else, I will be prepared with SOMETHING, and I have lots of somethings!

My wife and I went round and round about this entire subject yesterday. Neither of us can really wrap our heads around the use of GC's for shock aside from maybe an inability to get other significant drugs like some of the colloids, ie Albumin, Volv like Nut mentioned, Heta-Starch, etc. They would go a lot further in helping dogs in most cases, I believe, than the GC therapy. In human use, you only see GC's given for septic shock, and even then, it's not a regular practice.

That's something I'm trying to really determine. What's the reasoning behind using GC.

Here is an interesting link about colloids, advantages, disadvantages, etc.

Colloids

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Originally Posted by FrostyPaws

I pilfered my solu-medrol some time ago, because if nothing else, I will be prepared with SOMETHING, and I have lots of somethings!

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:lol:

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Originally Posted by FrostyPaws

My wife and I went round and round about this entire subject yesterday. Neither of us can really wrap our heads around the use of GC's for shock aside from maybe an inability to get other significant drugs like some of the colloids, ie Albumin, Volv like Nut mentioned, Heta-Starch, etc.

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What is Heta-Starch?

Another anti-shock I saw Scratch-N-Stitch (another great medic) use was Hypertonic Saline. Have no idea what it does, except that it's for shock are removing excess swelling.

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Originally Posted by FrostyPaws

They would go a lot further in helping dogs in most cases, I believe, than the GC therapy. In human use, you only see GC's given for septic shock, and even then, it's not a regular practice.
That's something I'm trying to really determine. What's the reasoning behind using GC.

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Interesting, why do you think this exactly?

I am not sure comparing human shock to dogs is ideal. Human's don't typically fight till (almost) the death.

I would imagine humans sustain a short, terrible injury.

The anti-inflammatory properties (both internal and external) seem like a good reason to me.

But if you have other ideas, by all means spill the beans.

Have you used these other items on your own dogs? If not, are you going to experiment?

I have never used hypertonic fluids for aftercare, but there is evidence for it's use though it's not significantly greater than the use of Normal Saline. The thought process behind hypertonic fluids is you don't have to administer as much to achieve the same effect as Normal Saline. That's the only significant upside to using hypertonic fluids over saline or LR.

Heta Starch is a colloid. That link I posted goes into a lot more depth about that subject than I could ever be unless dedicating ample time to the subject.

I can't disagree with the difference of how a human or a dog gets to the point of shock, but once there, shock is still the same in human or dog. Not enough blood flow to organs which can result in shutdown. So the treatment is the same even if how they got there is not. I agree about the anti-inflammatory issues, but that's not ultimately what kills dog or person. The inflammatory response is second on the list of things to worry about when it comes to shock. You need to expand volume so blood and oxygen can start to reach through the body. That has to be corrected first before worrying about inflammatory response.

I've never used any of those products as I simply can't find them anywhere short of a hospital setting. One thing I am going to look into is maybe sodium bicarb if I can find it along the way. It will decrease the acidity of the body after such sustained trauma. We've heard a lot of lactic acid buildup during the dog's work out. While most of that has been disproven to have a negative effect, a very real thing is lactic acid from sustaining trauma due to the body releasing lactic acid, and that will kill you regardless of what you do. Anyway, I don't want to get off track with my rambling about cascading issues from the trauma dog's suffer from shows.

I can't really say if dogs live from the fluids they receive, the GC, or a combination of both. I know I've seen dogs saved with just fluids and a combination of GC/fluids. I know they need the fluids moreso than the GC, but I can't say the GCs didn't help at all. The only thing I can say is I can't find any significant science stating the the administration of GC during hypovolemic shock contributes significantly to the survival rate.

Thanks for the info.

I think perhaps the reason these drugs are needed is because of the TRAUMA, not just the state of being hypovolemic.

Here is a brief study showing Solu-Medrol is effective in reversing traumatic/lethal bloodloss shock, in just about exactly the maximum dose indicated in my original article, and the summit dose in the revised article.

I think if you look up Traumatic Shock, you will find much more research than mere "hypo-volemic" shock :idea:

Here's another

And one more

This second article not only supports your own curiosity, but (ultimately) supports our mutual findings right here, directly stating:

"The data presented herein also clearly demonstrate that in order for one to be able to get the maximum benefit from steroid therapy in shock, steroids must be administered early and in very high dosage. Overall, the data reviewed herein provide a solid scientific basis for the therapeutic use of glucocorticoids (and possibly estrogens) in various forms of cilculatory shock and trauma."

I am sure this is why Doc recommended the high-end of the dosages in the original article.

Jack

The brief study prevented DIC, not fatal shock. I've known about the adrenal insufficiency and addison's crisis aspect of GCs. A lot of what I've read about GC is simply increasing cardiac output and decreasing some vascular resistance.

The first 1/4 or so of this article is interesting as it pertains to dogs specifically.

Shock

In the searching I have done, I agree, for straight blood loss it looks like steroids don't do anything significant.

In tests where they've bled-out puppies, for example, there is no significant benefit to using steroids.

The difference, and relevance, to what we do is the trauma involved with the blood loss ... and there are actually quite a lot of studies that show steroids worked in a variety of ways for trauma shock ... always dosed high.

Jack

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Originally Posted by FrostyPaws

The brief study prevented DIC, not fatal shock. I've known about the adrenal insufficiency and addison's crisis aspect of GCs. A lot of what I've read about GC is simply increasing cardiac output and decreasing some vascular resistance.

The first 1/4 or so of this article is interesting as it pertains to dogs specifically.

Shock

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That is actually a helluvan article in general.

This says the opposite about steroids:
"Steroids. The proposed benefit of steroids include stabilization of lysosomal membranes, prevention of lipid peroxidation, scavenging and stabilization of free radicals, and maintenance of adrenoreceptor function. Disadvantages are many, and include alterations of GI blood flow (especially in an already compromised GI tract), immunosuppression, vasodilation, and impaired wound healing. Multiple studies have failed to show any benefit of high dose steroid administration in any shock state. Low dose steroid administration (at physiologic doses) may be beneficial in anaphylactic or septic shock."

It also answered some questions about Hypertonic Saline:
"7% NaCl (HTS - hypertonic saline) is used for rapid expansion of the intravascular volume. HTS pulls fluid primarily from the interstitial compartment. The advantage is that only small volumes are required to increase intravascular volume quickly. Its use is primarily for treatment of the head trauma patient and in shock resuscitation. Anti-inflammatory effects have also been documented. The volume expansion provided by HTS is short lived, as the sodium redistributes throughout the extracellular compartment quickly. HTS is available as both 7-7.5% and 23% solutions. The 23% solution MUST be diluted prior to administration. HTS should be administered no faster than 1ml/kg/min as vagally mediated bradycardia or arrest could occur."

Part of what I posted came from this article last night.

More Shock Stuff

Yeah! I mean, this whole thing is making me confuzzed. When talking with the wife last night, she says, "How do you know it's not the fluids bringing the dog around instead of the GCs?" And you know? Most of the time she's right. They're always given in conjunction. You have vets around the world advocating the usage of these drugs, but then you have vets, and a lot of science, stating that they don't increase survival rates. I just want to kick my dog at this point. :censored:

LOL

Well, as with anything, there will always be debate I suppose.

I don't know why the second link you posted won't take (one of mine wouldn't either).

In that article you posted previously, the DVN recommends "low dose" cortico steroids for septic shock, and I've read a bunch saying not to use it.

But hey, maybe the fluids/Hypertonic saline is the way to go.

Maybe the Volvulen might prove to be a better solution.

Certainly, fluids alone aren't going to HURT the dogs ... whereas I've read steroids might cause some associated problems.

I would love to get my hands on some of those paid-for articles (that I didn't post) and see what they said.

I agree, it is confusing :-O :-?

Goes back the the old saying, "A man with one watch knows what time it is ... a man with many watches is never sure" ...

I think I may start paying for some of those articles so I can just flat out have them on hand for future reference. Either way, it is something to seriously ponder. Have people been doing it wrong for so long?

I found some studies from the 70s that advocate the use of dex in hemorrhagic shock.

70s Shock
70s Shock x2

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Originally Posted by FrostyPaws

I think I may start paying for some of those articles so I can just flat out have them on hand for future reference. Either way, it is something to seriously ponder. Have people been doing it wrong for so long?

I found some studies from the 70s that advocate the use of dex in hemorrhagic shock.

70s Shock
70s Shock x2

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Interesting, thanks.

Again, the dosages in almost every government/university reference are exactly at the high-end of the dosage range.

(If you decide to buy the paid-for articles, let us know what the finding are.)

Here are some current findings I found for Solu-Medrol:

Solu-Medrol (Pfizer) Package Label.
"Shock: In severe hemorrhagic or traumatic shock, adjunctive use of i.v. methylprednisolone may aid in achieving hemodynamic restoration. [Although there are no well-controlled (double-blind placebo) clinical trials, data from experimental animal models indicate that methylprednisolone may be useful in hemorrhagic and traumatic shock. See also Warnings regarding septic shock.] Corticoid therapy should not replace standard methods of combatting shock, but present evidence indicates that concurrent use of large doses of corticoids with other measures may improve survival rates."

And another (New Zealand Govt)
"As adjunctive therapy in life threatening conditions (e.g. shock states) the recommended dose of Methylprednisolone is 30 milligrams per kg of methylprednisolone sodium succinate, given IV over a period of at least 30 minutes. This dose may be repeated every 4 to 6 hours for up to 48 hours."

US FDA Statement on Solu-Delta
"There are reports of cardiac arrhythmias and/or cardiac arrest following the rapid administration of large IV doses of SOLU-MEDROL (greater than 0.5 gram administered over a period of less than 10 minutes). Bradycardia has been reported during or after the administration of large doses of methylprednisolone sodium succinate, and may be unrelated to the speed or duration of infusion. When high dose therapy is desired, the recommended dose of SOLU-MEDROL Sterile Powder is 30 mg/kg administered intravenously over at least 30 minutes. This dose may be repeated every 4 to 6 hours for 48 hours."

This is probably why Doc recommended it just be mixed with the bag of fluids, rather than run straight into the vein.

And I also think this almost universal adherence to the high-end of the range, for traumatic shock, is why Doc originally placed the dosages right at that high-end and left out the "ranges" ...

Jack

Here is a great article, that actually rejects cortico-steroids, and yet extolls the use of Hypertonic Saline. It also recommends the Hetastarch you mentioned:

No steroids
"There is no data supporting the use of GC in generalized trauma (i.e. hit by car, dog fights, etc.) or heat stroke. In fact GC may increase morbidity and mortality due to the numerous adverse effects. Supportive care such as crystalloids and colloids, pain management with opioids, and body temperature are the primary recommendations along with stabilization of blood loss and fractures. Antimicrobials may also be indicated."


Advantages of Hypertonic Saline
"Hypertonic saline typically contains either a 5% or 7.2% concentration of sodium chloride. Hypertonic saline is administered relatively quickly, over 5 minutes, and results an increase in plasma osmolality. Advantages of hypertonic saline include the rapid administration of fluid, low volume, low cost, and efficacy. Studies in experimental dogs have indicated hypertonic saline, 4 mL/kg, induces a plasma volume change of 20 mL/kg. Other effects of hypertonic saline include improvements in cardiac output, arterial blood pressure, splachnic blood flow, and acid base status. Hypertonic saline does not appear to cause vasoconstriction or other changes in the mechanical properties of the circulatory system. The primary effects appear to be due to plasma volume expansion.

Administration of 7% hypertonic saline solution (4-5 mL/kg) results in increases in serum osmolality by approximately 28 mOsm/L within 10 minutes. The elevation remains approximately 12 mOsm/L above control values for 4-12 hours. As expected increases in serum sodium and chloride concentrations (~13 mEq/L) occur within 10 minutes of administration. No adverse effects have been noted with these changes in osmolality and sodium concentrations. Serum potassium values decrease following administration in a similar manner to administration of isotonic fluids. Serum potassium concentrations drop by approximate 0.8 mEq/L and no adverse effects have been reported.

Hypertonic saline has been studied in experimental models of hemorrhagic shock, endotoxic shock, and shock due to gastric dilatiation with volvulus. In each case hypertonic saline produced an equal or better effect to traditional resuscitation with isotonic fluids. Resuscitation with isotonic fluids or colloids results in increased intracranial pressure and, worsens cerebral edema. Hypertonic saline does not appear to increase intracranial pressure. Additionally, hypertonic saline does not increase lung water volume during resuscitative administration as compared to isotonic fluid administration. In models of GDV in dogs, hypertonic saline (in combination with dextran-60) 5 mL/kg, resulted in a more effective and sustained resuscitation than did lactated ringers solution, 60 mL/kg. Hypertonic saline treated dogs maintained a better cardiac output for the 3 hour monitoring period and experienced less hemodiltuion. However it is important to remember that experimental models do not always predict naturally occurring conditions.

Hypertonic saline has been assessed in human clinical trials in a variety of conditions resulting in shock. Hypertonic saline (7%) was administered to patients with a variety of conditions resulting in shock which were initially non-responsive to conventional resuscitation. No adverse effects were noted and 9/11 patients which were initially non-responsive, but responded to hypertonic saline. In a controlled study, hypertonic saline in combination with dextran-70 was compared in a blind fashion to isotonic fluid therapy in trauma patients. Patients treated with hypertonic saline had significantly higher mean arterial pressures on arrival to the hospital and a subsequent higher survival rate. Postoperative hypovolemia in surgical patients treated with hypertonic saline maintained increased systemic arterial blood pressures, atrial filling pressures, and cardiac output with less volume administration as compared to isotonic fluids.

Hypertonic saline is not an appropriate choice for resuscitation of a dehydrated animal. Dehydration requires replacement of fluid and electrolyte content of which isotonic solutions are better choices. Hypernatremia is also considered a contraindication to administration of hypertonic saline. Finally, cases of fluid overload (increases in intravascular fluid volume) are also considered a contraindication to hypertonic saline."


Hetastarch
"Hetastarch is a commonly used colloid solution in veterinary medicine due to its ease of use and storage, and its relatively low cost. Hetastarch has a mean molecular weight of 70,000 (albumin is approximately 69,000 MW) with a colloid oncotic pressure of 30 mm Hg (albumin is approximately 18-20 mm Hg). Hetastarch ranges in size from 10,000 MW to 1,000,000 MW with sizes less than 50,000 MW eliminated by the kidneys, whereas large sized molecules are primarily cleared by the liver and spleen. Hetastarch is an effective volume expander with each mL capable of retaining approximately 30 mL of water. This property results in a volume expansion greater than the volume administered and may persist for up to 24 hours. Up to 50% of the administered hetastarch volume is retained in the vasculature for 48 hours. Hetastarch may increase the bleeding tendency due to a dilutional effect of clotting factors (fibrinogen and antithrombin III). A single case report in humans detailed a subclinical von Willebrand's patient that experienced increased bleeding following administration. Overall the adverse effect rate of hetastarch in humans is low, 0.085%.

Colloids are often used for shock resuscitation. Colloids provide rapid volume expansion with a low volume administration, which persists for long time periods. Hetastarch is often administered in conjunction with cystalloids to prolong the volume expansion provided by the crystalloids. A common dosing strategy for resuscitation is to administer 5 mL/kg of hypertonic saline (7.2%) followed by 5 mL/kg of hetastarch. As previously mentioned, colloids can increase intracranial pressure and cerebral edema, therefore should be used cautiously in patients with head trauma. Colloids can also be administered to hypoproteinemic animals to increase oncotic pressure and maintain proper fluid balance. A response to colloid administration is often noted within 12 hours including decreases in peripheral edema, increased urine production, and decreased lung volume. However it is important to note that hetastarch should not be used to treat cardiogenic pulmonary edema as it may worsen the condition due to increased pulmonary arterial pressures."


It remains someone confusing on the steroid issue ... but it seems universal that fluids, and hypertonic Saline, are good for after-battle shock treatment.

Time for bed now ... got a bunch of stuff to do tomorrow ... but this is getting more and more interesting.

Jack

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Originally Posted by FrostyPaws

Yeah! I mean, this whole thing is making me confuzzed. When talking with the wife last night, she says, "How do you know it's not the fluids bringing the dog around instead of the GCs?" And you know? Most of the time she's right. They're always given in conjunction. You have vets around the world advocating the usage of these drugs, but then you have vets, and a lot of science, stating that they don't increase survival rates. I just want to kick my dog at this point. :censored:

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correct, that's what I understood as well

I meant to post a link to that article Jack, but I just forgot to do so last night. Good job on bringing that one on board also.

One of the problems, I think, in accurately quantifying these 'studies' is the lack of controllable uniformity in what can be called "Traumatic Shock" :idea:

If we pull out the ol' microscope, and examine this term itself, we soon realize there is NO WAY to get a uniform sampling for error-free, controlled study.
There are simply too many variables, and I think this is why there have NOT been such controlled studies: there is no way TO control the damages.
It is one thing to purposely let 40% of the blood volume out of 2 groups of dogs, and get uniform, controlled studies like that, because of the ease in achieving uniformity of the challenge.
It is quite another to call all dog fights "the same," as they can involve an almost endless array of potential injuries/trauma ...

That last link that I posted has "hit by car, dog fights," etc. ... AS IF all dog fights are "the same" ... but ARE THEY?

I might have a dog that went 1.5 hours, and is "shocky," but he might have been on the ear the whole time, almost never got bit, but became "shocky" just from a combination of fatigue, coming in dry, and having a bleeder hit at the :20 mark. When correctly assessed, he really isn't "injured" at all, but has merely bled out and become too exhausted/dehydrated, to the point of shock.

On the other hand, I might have a second dog who was in a brutal, non-stop WAR with another dog, been bit in the guts, deep in the throat, become truly traumatized ... and is SWELLING BADLY in these deadly areas ...

Now then, both of these dogs were in "dog fights," per se, but yet each of them has had drastically-different injury levels :idea:

The first dog, because he's dehydrated, we would not use the Hypertonic Saline approach (as it's contra-indicated for dehydration), but we absolutely would want to give him ringers to restore lost fluids (a blood transfusion would be even better). Ideally, the first dog may well be able to be stabilized just fine without the use of steroids at all, just ringers, or a transfusion, and maybe some antibiotics.

However, the second dog, with all that FLESH TRAUMA + SWELLING in his throat/windpipe/guts, you bet your ass I'd be running a massive dose of Solu-Medrol (or even dexamethosone sodium phosphate) into that dog, so he doesn't blow-up like a bullfrog in his throat. Therefore, here again, it becomes a judgment call on the part of the owner ... and having somewhat of an understanding of WHAT THESE DRUGS DO ... and analyzing EXACTLY WHAT'S WRONG WITH THE DOG ... become the keys to making the right choices.

As with tailoring a conditioning regimen around the dog's strengths/weaknesses, so too must the medic tailor his aftercare choices around what has actually happened to his dog. To write a tiny paragraph about "trauma" and to lump all "dog fights" into one heading is shallow, at best. The truth is, it is absolutely MULTI-DIMENSIONAL what happens to any dog in a fight ... and each dog needs to be assessed individually as to what procedures should be followed, based on what has actually happened to that dog.

Jack

Quote:

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Originally Posted by CA Jack

One of the problems, I think, in accurately quantifying these 'studies' is the lack of controllable uniformity in what can be called "Traumatic Shock" :idea:

If we pull out the ol' microscope, and examine this term itself, we soon realize there is NO WAY to get a uniform sampling for error-free, controlled study.
There are simply too many variables, and I think this is why there have NOT been such controlled studies: there is no way TO control the damages.
It is one thing to purposely let 40% of the blood volume out of 2 groups of dogs, and get uniform, controlled studies like that, because of the ease in achieving uniformity of the challenge.
It is quite another to call all dog fights "the same," as they can involve an almost endless array of potential injuries/trauma ...

That last link that I posted has "hit by car, dog fights," etc. ... AS IF all dog fights are "the same" ... but ARE THEY?

I might have a dog that went 1.5 hours, and is "shocky," but he might have been on the ear the whole time, almost never got bit, but became "shocky" just from a combination of fatigue, coming in dry, and having a bleeder hit at the :20 mark. When correctly assessed, he really isn't "injured" at all, but has merely bled out and become too exhausted/dehydrated, to the point of shock.

On the other hand, I might have a second dog who was in a brutal, non-stop WAR with another dog, been bit in the guts, deep in the throat, become truly traumatized ... and is SWELLING BADLY in these deadly areas ...

Now then, both of these dogs were in "dog fights," per se, but yet each of them has had drastically-different injury levels :idea:

The first dog, because he's dehydrated, we would not use the Hypertonic Saline approach (as it's contra-indicated for dehydration), but we absolutely would want to give him ringers to restore lost fluids (a blood transfusion would be even better). Ideally, the first dog may well be able to be stabilized just fine without the use of steroids at all, just ringers, or a transfusion, and maybe some antibiotics.

However, the second dog, with all that FLESH TRAUMA + SWELLING in his throat/windpipe/guts, you bet your ass I'd be running a massive dose of Solu-Medrol (or even dexamethosone sodium phosphate) into that dog, so he doesn't blow-up like a bullfrog in his throat. Therefore, here again, it becomes a judgment call on the part of the owner ... and having somewhat of an understanding of WHAT THESE DRUGS DO ... and analyzing EXACTLY WHAT'S WRONG WITH THE DOG ... become the keys to making the right choices.

As with tailoring a conditioning regimen around the dog's strengths/weaknesses, so too must the medic tailor his aftercare choices around what has actually happened to his dog. To write a tiny paragraph about "trauma" and to lump all "dog fights" into one heading is shallow, at best. The truth is, it is absolutely MULTI-DIMENSIONAL what happens to any dog in a fight ... and each dog needs to be assessed individually as to what procedures should be followed, based on what has actually happened to that dog.

Jack

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I don't think all fights are exactly the same, no. I do think a great majority of them are the same in regards to actual damage and exhaustion instead of any type of shock. When I sit here and think about everything I've seen in relation to these dogs, I think I've seen no more than 10 dogs that I believe were actually in shock and not just at a point of exhaustion. Do I think there are times to use some of those drugs? Yes I do, but I don't believe it's after every long, hard show a dog may have as I've seen too many dogs handle those shows with just fluids, and some of those dogs were hanging around death's door.

I don't think many people are able to make a distinction between sheer exhaustion and shock, and that included me at one point in time. I think for 98% of the shows out there, dex or any anti-inflammatory isn't a MUST have drug. It's not a bad idea to have them on hand if the dog is actually IN shock, and at this point, I think people should learn what shock actually is and what the signs/symptoms of such a process are. If not, they could be causing more overall harm than good to their dogs.

Quote:

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Originally Posted by FrostyPaws

I don't think all fights are exactly the same, no. I do think a great majority of them are the same in regards to actual damage and exhaustion instead of any type of shock. When I sit here and think about everything I've seen in relation to these dogs, I think I've seen no more than 10 dogs that I believe were actually in shock and not just at a point of exhaustion.

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Hmmm, I can think of several dogs I have seen with unresponsive pupils dilated, etc. Some that would hardly blink when their eyes were touched, etc.

Quote:

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Originally Posted by FrostyPaws

Do I think there are times to use some of those drugs? Yes I do, but I don't believe it's after every long, hard show a dog may have as I've seen too many dogs handle those shows with just fluids, and some of those dogs were hanging around death's door.

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Clearly, fluids and antibiotics are numero uno.

I agree that not every dog that goes the long haul is in shock, sure.

Yet, I believe every one of them could still benefit from the anti-inflammatory properties of something like dex. Not at the shock doses, but general doses given to reduce swelling, pain, and discomfort.

Again, all based on individual assessment.

Quote:

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Originally Posted by FrostyPaws

I don't think many people are able to make a distinction between sheer exhaustion and shock, and that included me at one point in time.

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I am sure this is true.

Quote:

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Originally Posted by FrostyPaws

I think for 98% of the shows out there, dex or any anti-inflammatory isn't a MUST have drug.

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I would have to disagree.

Some, yes.
98%, no.

I hear what you're saying (most dogs quit before they're in shock), so the winner will be able to survive just fine on fluids/antibiotics, I get that.

But to say the winner doen't really need anti-inflammatory? I can't agree with that.

Anti-inflammatories may not be critical for their survival, but they absolutely WILL reduce swelling and not make them have to go through painful, swollen hell.

Again, you may not always have to give the shock dose, but SOME anti-inflammatory will make their recovery easier, I absolutely know this to be true.

Quote:

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Originally Posted by FrostyPaws

It's not a bad idea to have them on hand if the dog is actually IN shock, and at this point, I think people should learn what shock actually is and what the signs/symptoms of such a process are. If not, they could be causing more overall harm than good to their dogs.

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I agree with this: I think the SHOCK DOSE of these drugs should be used judiciously. But I think the use of the swelling dose should be given after every single match, because that dog has HOLES and SWELLING ... and will be swollen/stiff as hell without them.

We do agree that the SHOCK doses of these drugs should hardly ever be given ...

Thanks,

Jack

I know anti-inflammatories will decrease the swelling. I'm not saying it won't do that. I simply don't think it's needed near as much as people give it.

I can't remember the last time I gave dex, or another type drug, after a show. Again, I think it's simply a reaction to pull it out and give it most of the time. Are there times where it's used? Certainly, but most of the times I've seen it used, I didn't think it warranted. Some swelling isn't necessarily a bad thing. While swelling is unsightly, and at times painful, it also serves another purpose in which to keep a possible infection within a certain area of the body. That's one of the reasons I like to use Rimadyl, or something of the like, afterwards. It doesn't so much effect any type of swelling, but it does wonders for pain and discomfort.

I have these articles I have referred to in the pass. They have helped me. Maybe they'll help someone else.

http://issuu.com/equestrian/docs/dru...delines2013/13


https://www.fairfieldequine.com/site...es/dex_rdm.pdf

Frosty I too keep rimadyl. I had a buddy have a terrible accident with a dog when it was young. A buddy of mine an older dogman told me if I could get rimadyl it would do him a lot of good. I had a buddy overnight some. In no time this dog who months had passed with this injury which had him walking on 3 legs was flirt poling and running up trees on all 4. The muscles in that leg were tore up so I know rimadyl works.

I even give some dex at 0,15 mg/kg after roles with head damages. And Metamizole for pain. Even a dog who won't stand up cause chest damages will walk and piss.

I understood mixing painkiller with dex is not the way to go

guys rimadyl or carboprofen (not sure on the last name) its great
I give it after rolls . they love it

unlike some I feel like rolls should be fun and the dog should have a good feeling about it

I use Deramaxx over Rimadyl it is easier on the stomach.

Quote:

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Originally Posted by bulldoghistorian

I understood mixing painkiller with dex is not the way to go

guys rimadyl or carboprofen (not sure on the last name) its great
I give it after rolls . they love it

unlike some I feel like rolls should be fun and the dog should have a good feeling about it

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Agreed. And even if it doesnt have the mental effect ur about, at least they dont have to feel shit.

I never had a problem giving low dose of dex and metamizole. Not mixing it together, to be clear. Would like to hear if this is in fact not smart.

Really good thread and many thanks to everyone shared their knowledge.

It's good to see folks work together and put aside their differences… As was said, the bottom line is that we are all on the same side.

Some very useful info here and I will have to read it again a few times to make sure I have a better understanding.

A comment about Rimadyl, it can have some bad side effects and can do damage to the liver. Some dogs cannot tolerate it at all.

A quick question… from one of Frosty's posts --

Quote:

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Originally Posted by FrostyPaws

You need to expand volume so blood and oxygen can start to reach through the body.

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How would TFX's info on Organic Germanium (Ge 132) fit in with all this? From what I understand, GE 32 increases the oxygen in the blood and promotes healing.

http://www.thepitbullbible.com/forum...m-%28Ge-132%29

Seems like the Ge 132 would be worth administering to promote healing once the dog is stable.

I have it as injectable

Quote:

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Originally Posted by Nut

Agreed. And even if it doesnt have the mental effect ur about, at least they dont have to feel shit.

I never had a problem giving low dose of dex and metamizole. Not mixing it together, to be clear. Would like to hear if this is in fact not smart.

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"Metamizole is marketed under various trade names, including Algozone, Algocalmin, Algopyrin, Analgin, Dipirona, Novalgin, Neo-Melubrina and Optalgin. Metamizole has been used for decades in many European (excluding the UK, but including most of continental Europe, including Germany, Italy, Russia and Spain), Asian (China, India, Indonesia and Thailand included), African (including South Africa) and South American (including Argentina and Brazil) countries, despite this, it has been found to have a potentially fatal side effect of agranulocytosis (a dangerously compromised immune system; its rate varies significantly country-to-country), aplastic anaemia and hypersensitivity reactions (like allergic reactions such as anaphylaxis). It was once widely combined with various other active ingredients, but since concerns over its safety have been raised in the late 1960s and 1970s its use in combination products has been in decline and in some countries, banned."


We don't use this drug in the US, and (based on some internet research) it sounds like an archaic, forgotten remedy and not very smart to use 1) in combo with dex and 2) on a wounded animal susceptible to infection...

.

???