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Schedule
April 3-6, 2025
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Monte Carlo, Monaco
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18 CE Hours
Predicting bleeding is challenging. This session will evaluate laboratory tests that can be used to assess hemostasis in dogs prior to invasive procedures.
Thrombocytopenia is commonly encountered in dogs and cats. An approach to the diagnostic work up of these cases will be discussed, along with a review of therapeutic intervention options.
Haemorrhagic shock is a common clinical presentation in veterinary patients that can rapidly lead to organ dysfunction and death. We will review the pathophysiology and the progression of the body’s response to haemorrhage, its correlation to clinical signs, and how haemorrhagic shock compares with other types of shock. We will discuss diagnostic approaches and different causes (Traumatic VS spontaneous), along with the role of coagulopathies. Resuscitation strategies will be covered with a case-based approach, including controversies and advanced topics such as management of massive transfusions, autotransfusion, and role of vasopressors. Finally, we will review the veterinary pre-clinical and human literature to see what the future might hold for the understanding and the management of this condition.
Thanks to the advancements of veterinary transfusion medicine and blood banking, the availability and safe administration of blood products to veterinary patients has become common practice. Although units of whole blood can be transfused without further processing, the technologies to separate and store blood components have become more widely available and therefore the use of component therapy, especially in dogs, has increased substantially in recent years.
In this lecture, we will review how the most frequently administered blood components are produced, what is their content, their indications for use, and the respective advantages and disadvantages. We will discuss how to pick the optimal blood product in a variety of clinical scenarios and what safe alternatives we have if that product is not available.
This session will explore the cell-based model of coagulation, focusing on the roles of platelets and endothelial cells in hemostasis. Participants will learn to apply this model in diagnosing and managing coagulation disorders in
veterinary patients.
The administration of intravenous fluids is probably the most ubiquitous therapeutic intervention in veterinary emergency and critical care. Despite this, intravenous fluids are not benign, and significant risks are associated with both under- and over-administration. Moreover, veterinary fluid administration strategies are not supported by robust evidence, and side effects are often overlooked in day-to-day clinical practice.
In this lecture, we will review recent advances in our understanding of fluid physiology and discuss what really happens to our patients when we give intravenous fluids. We will focus primarily on crystalloids and approach these fluids as drugs, with their unique mechanisms of action, indications, doses, duration of treatment, and side effects (e.g., volume overload, electrolyte abnormalities).
We will discuss how to dynamically assess and adjust volume status in critical patients to maximise benefits and minimise risks, while taking into account patient-specific factors. The role of ‘hidden fluids’ and whether maintenance fluids are always needed will also be covered.
An ‘holistic’ approach to fluid balance management will be proposed and concepts borrowed from the human literature such as fluid stewardship and the ROSE approach (Resuscitation, Optimisation, Stabilisation, and Evacuation or de-resuscitation) will be discussed.
Sepsis is a life-threatening host response to an infection that is overwhelming in its severity or widespread in its extent and is associated with high morbidity and mortality. In human medicine, sepsis remains a major global health burden, and despite decades of clinical research, specific therapeutic interventions able to improve outcomes are still lacking. In veterinary medicine, mortality remains high and optimal treatment strategies are unknown.
The human definition of sepsis has evolved in parallel with an improved understanding of its pathophysiology. However, in veterinary medicine, there is no consensus on how sepsis is defined and how best to identify it clinically.
In this lecture we will cover the knowns and unknowns of sepsis pathophysiology in dogs and cats to help understand the rationale for therapeutic interventions. We will draw from the most recent human and research literature to describe the potential processes involved in the development and progression of sepsis and how infections can lead to distant organ dysfunction. We will then cover diagnostic options to identify sepsis quickly in clinical practice. Finally, we will discuss the current efforts to establish a veterinary consensus definition of sepsis.
Maximizing oxygen delivery in sepsis can be challenging. This session will review an approach to the resuscitation of these cases, taking into account the unique characteristics of sepsis.
Traumatic chest injuries are commonly encountered in dogs and cats. The diagnostic and therapeutic approach to these cases will be reviewed using a case-based approach.
Albumin is one of the most essential proteins in the body, and becomes deficient in a broad variety of critical illnesses. For this reason, albumin supplementation is frequently an important part of therapy.
This lecture will discuss the important functions of albumin in health and consequences of hypoalbuminemia during acute and chronic illnesses in veterinary patients and review the literature surrounding albumin supplementation in human and veterinary critical illness. Indications, contraindications, benefits and potential risks of albumin replacement therapy will be discussed. Case examples will be utilized to demonstrate dosing recommendations using the variety of albumin sources available for use in the critically ill small animal patient.
Systemic corticosteroids are commonly prescribed in veterinary medicine and are an essential part of therapy in a variety of conditions such immune-mediated diseases. However, their use in critically ill veterinary patients has been heavily influenced by trends in human critical care and emergency medicine, with a lack of species-specific clinical evidence.
In this lecture, we will review the physiology of the hypothalamus-pituitary-adrenal axis, the mechanisms of action of endogenous steroids, and the pharmacology of the synthetic formulations available for clinical use. We will then discuss clinical steroid use (including timing, type, and dose) in several critical conditions including sepsis, refractory hypotension, pneumonia, acute respiratory distress syndrome, and trauma. We will cover the evidence for potential benefits in both veterinary and human patients, and balance that with the known risks and complications. Attendees will leave equipped with the evidence-based knowledge needed to decide if the use of steroids in their next critically ill patient is justified.
How should scoring systems be used in veterinary ICU populations? This session will review principles of scoring system design and interpretation, with examples of published scoring systems in dogs and cats.
Complex cases in ICU are often prescribed several drugs concurrently. Keeping on top of potential interactions is challenging. This session will review pharmacokinetic and pharmacodynamic issues that might arise during polypharmacy, as well as discuss specific drug combinations that could cause issues.
Mitochondria are the ‘power plant’ of the cell, providing the vast majority of energy required by the cell metabolism and function. In addition, they play a key role in numerous other aspects of cellular homeostasis, including regulation of redox status, cell growth and signaling, and apoptosis. Therefore, it is not surprising that, in humans, mitochondria are implicated in the pathogenesis of numerous diseases including cancer, diabetes, neurodegenerative and cardiovascular disorders. However, we know little about their role in the pathogenesis of acute diseases in veterinary species.
In this lecture we will review basics principles of mitochondrial physiology and the multiple roles that mitochondria play in maintaining cellular homeostasis. We will then discuss mechanisms of mitochondrial damage and dysfunction and the veterinary critical care diseases whose progression might be affected by mitochondrial disturbances, with a particular focus on ischemia-reperfusion and sepsis. Finally, we will mention emerging therapies for mitochondrial dysfunction.
This course will review the how to perform CPR in cats and dogs according to the current RECOVER guidelines.
This session will review pertinent topics published in the last year with a focus on critical evaluation of this literature.
During this lively discussion, a panel of experts will present case examples of diagnostic and therapeutic challenges with significant respiratory and cardiovascular compromise. Audience participation with questions and experiences will be encouraged.