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Vaccines
Principles of vaccines
- Vaccines are given to Prevent disease by stimulating antiboties to a specifc Antigen (parvovirus)
- Vaccines are not 100% fool proof at preventing disease
- Some do not prevent disease infection, only lesson clinical symptoms.
- Polyvalent vaccines contain many antigens
- DHLLP
- FeRCP
- Monovalent vaccines contain only one antigen
- Rabies
- FELV
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Vaccines
Types
Modified Live (Attenuated)
- Microorganisms are altered so they no longer virulent to cause disease, yet retains their anigenic properties to induce a immune response.
- Produces a stronger and more durable immune response than likked vaccines
- Side effects
- Can induce immunosuppression
- Can cause vaccine induced disease
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Vaccines
Types
Killed (inactivated) Has more than one agent in it
- Cannot replicate, so they are safer
- Requires large anitgenic dose and multiple injections
- Produces weaker immune response with shorter duration
- Subunit Vaccine
- not infectious
- Does not contain complete organism, rather components to produce immune response
- Example: Equine Strangle
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Vaccines
Types
Bacterins- Has to be killed
- Killed bacteria
- less effective than viral vaccines
- Short lived immunity
- Example: Bordatella
Vaccine against viruses work better
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Vaccines
Types
Live Vaccine
- Adjuvant- drug-enhancing agent: a drug or agent added to another drug or agent to enhance its medical effectiveness. Keeps in the system longer
- Live vaccine
- prepared from live organism
- Live vaccines require few doses
- No adjuvents or preservative
- Side effects
- Expensive
- Contamination
- Can give disease to person administering
- Causes disease to animal being vaccinated due to residual virulence
- Ex: Brucella abortus strain 19
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Vaccines
Types
Toxoid- to prevent it
- Vaccine that produces immunity to a toxin rather than to a virus or bacteria
- Proviede protection for 1 year
- Ex. Tetanus toxoid- Clostridium tetani
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Vaccines
Types
Antiserum- Antibodies against infectious agent
- Serum containing specific antibidies from a hyperimmunized animal that has been effected by the specific microorganism
- Produces immediated action to kill live infectious antigens
- Do not vaccinate for at least 21 days after giving antiserum
- Ex. E-Coli in swin or cattle
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Vaccines
Types
Antitoxin- Antibodies against toxin
- Antiserum aimed against specific toxin
- Obtained from hyperimmunized horse which is then extracted from its serum
- Antitoxins neutralize toxin when administered to patients with clinical disease
- Produced immediate passive immunity for 7-14 days
- Side effects
- Allergic reaction
- Ex. Tetanus antitoxin
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Vaccines
Proper Use
- vaccine are made to be given in a specific route, if not followed then they may not produce immunity.
- Lyophilized (powder) should be used immediately after reconstitution
- Improper storage and heat will inactivate vaccine
- especially MLV
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Vaccines
Maternal Antibodies
- Passive immunity from colostrom
- Maternal antibodies cause vaccine failure by inhibiting an immune response.
- For this reason, multiple boosters are needed at a young age
- 1. up to 22 weeks for puppies
- 2. Up to 16 weeks for kittens
- There is a 2-5 week window of vulnerability when an animal can be infected with virus but cannot be successfully immunized.
- Heterotypic immunity- canine
- Immune response to one microorganism by immunizing with a different but antigenically related microorganism
- Measles virus (MV) to protect against cainie distemper
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Vaccines
Vaccinations- age
- Start at 6, 8, 10 weeks of age, then repeat at 2-3 week intervals until 6 months of age. (especially for Rots, pits and doberman)
- Many different protocols
- New theory (vaccine titers)
- Yearly boosters are scientifically invalid
- No tru immunological reason for annual vaccine
- Vaccineate puppies and kittens as before, but then no boosters are needed unless blood titer levels indicated immune toter is to low (vaccone titers)
- Vaccine generally keep immunity for 3 years duration in adult animals
- Take vaccine titers before vaccination.
- Over vaccination causing vaccine induced feline sarcoma (cancers) and immune mediated diseases at ITP and IMHA.
- ITP- Idiopathic thrombocytopedic purpura
- IMHA- Immune mediated hemolytic anemia
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Vaccines
Core Vaccines (recommended)
- Canine vaccines
- Parvovirus (MLV)
- Canine distemper (MLV)
- Canine adenovirus-2 (MLV)
- Rabies (killed)
- Feline vaccines
- Feline panleukopenia (MLV)
- Feline viral rhinotacheitis- FHV (MLV)
- Feline calicivirus- FCV (MLV)
- Rabies (killed)
- Feline Leukemia virus (killed)
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Vaccines
non core vaccines
Canine Vaccines
- Parainfluenza virus (MLV)
- Bordatella bronchiseptica (killed)
- Lyme(killed)
- Canine coronavirus (MLV)
- Leptospirosis (killed)
- Rattlesnake (toxoid)
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Vaccines
non core vaccines
Feline Vaccines
- Chlamydia psittaci (MLV)
- FIP (MLV)
- Bordatella(MLV)
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vaccine
New Vaccines- Recombinant Vaccines
- Vaccines are created utilizing bacteria or yeast products to form large amounts of a Single viral or bacterial protein antigen.This recombinant protein is made into a vaccine and injected into the patient, and the patients immune system makes antibodies to the specific disease agents protein. (canine distemper)
- Advantages of recombinant vaccines
- No symptoms of the disease vaccinated for since only a single protein of the antigen agent.
- No adjuvant needed- lsee side effect reations
- Produce strong cell mediated and humoral immune response.
- Recombinant vaccines
- Canine distemper
- FELV
- Lyme- Borrelia burgdorferi
- Merial PUREVAC-FELV vaccine
- Recombinant vaccine
- Uses needles injection to prevent feline sarcoma
- Given with VET JET transdermal vaccination system that injects antigen with air force into the dermis
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Vaccines
Canine Vaccines
DHLPP-C
- Distemper
- Hepatitis (CAV1 and CAV2)
- Leptospirosis (L. Canicola and L. icterohemmorrhagica)
- Parainfluenza
- Parvo
- Coronavirus
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Vaccines
Canine Vaccines
Bordetella
- Bordatella bronchiseptica
- Routes are either SQ or intranasal
- Intranasal is passive immunity
- start at 8-12 weeks, of age then yearly booster 4-6 months
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Vaccines
Canine Vaccines
Lyme Disease
- Borrelia burgdorferi
- Start about 9-12 weeks of age, 4 months
- Two vaccine series with shots given 2 weeks apart and booster once annually
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Vaccines
Canine Vaccines
Rabies
- Begin at 4 months of age
- Booster annually
- Booster annually after 1 year of age
- after 1 year age, booster good for 3 years
Rattlesnake (Toxoid)
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Vaccines
Feline Vaccines
FVRC-P
- FVR- Feline Viral Rhinopnuemonitis
- FVC- Feline calicivirus
- FP- Feline Panluekopenia
- P- Pnuemonitis (Chlamydia psittaci)
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Vaccines
Feline Vaccines
FELV
- Start as early as 6 weeks
- 2 vaccine series
- give second injection 2-4 weeks apart, then booster annually
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Vaccines
Feline Vaccines
FIP
- 2 dose series
- second dose given 2-4 weeeks apart,
- Intranasal
- Does not prevent infection, only lessons clinical signs
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Vaccines
Feline Vaccines
Rabies
same as dogs
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Vaccines
Vaccine reactions
- Reactions to any fraction of the vaccine: Rabies, leptospirosis
- Immune respons to antigen vaccine
- Angioedema, hives, vomiting and diarrhea
- Anaphylaxis
- Pain at injection site
- Fibrosarcoma in cats- neoplasia
- Allergic reactions many times caused by adjuvants and preservatives.
- 1. Adjuvant- agent used to carry antigen to enhance the immune response
- Alluminum hydroxide, phosphate and potassium
- 2. Preservatives
- Agents added to prevent growth of microorganisms
- Penicillins, streptomycin and fungistatic agents
- Generally treated as allergic reaction with Diphenhydramine (Benadryl) and corticosteroids. (Dexamethasone)
- 1. Epinephrine and Iv fluid if anaphylaxis
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Equine Vaccine
Core Vaccines
- Tetanus
- Equine encephalitis
- Rhinopneumonitis (EHV) Equine Herpes
- Influenza
- West Nile Virus
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Equine Vaccine
Tetanus (TT)- Core
- Clostrideum tetani
- Infection is characterized by muscle rigidity, which may result in death from respiratory arrest or convulsions.
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Equine Vaccine
Equine encephalitis vaccines (EEE, WEE, VEE)
- Eastern, western and Venezuelan strains
- Combination trivalent vaccine for all three
- Infection is characterized by a viral nuerological disease that can be minor as pyrexia and anorexia to convulsions and death
- Transmitted by biting insects
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Equine Vaccine
Equine Influenza (A1, A2)
- Primarily infected by strains A1 and A2
- Infection is characterized by fever, depression, anorexia, coughing and muscle pain
- Transmitted by contact from horse to horse
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Equine Vaccine
Equine Strangle
- Streptococcus equi
- Highly contagious respiratory disease characterized by fever and upper respiratory pus nasal discharge, followed by abscess formation of the submandibular, submaxillary and retropharyngeal lymph nodes
- Subunit vaccine
- May cause injection site abscess
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Equine Vaccine
Equine Viral Arteritis (EVA)
- RNA Virus
- Infection is characterized by fever, depression, nasal discharge, caughing and limb swelling.
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Equine vaccines
- Potomic horse fever
- Rabies
- Anthrax
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Sites of vaccine administration
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Dog
- Giardia- left shoulder
- DHPPC- right shoulder
- microchip- back
- Rabies- back
- Lyme disease- back left leg
- Rattlesnake- right rear leg
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Sites of vaccination Administration
Cat
- Giardia- front left shoulder
- Microchip- same as dog
- FVRCPP- front right shoulder
- FeLV- left rear leg
- Rabies- right rear leg
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Fluids for Therapy
Animals water Weight On average 55-67% of weight
How to access dehydration
History of animal
- Vomiting
- Diarrhea
- not drinking or eating
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Fluids for Therapy
Animals water Weight On average 55-67% of weight
How to assess dehydration
- Skin fold 4,6,8
- 4% dehydration- not evident clinically
- Not eating or drinking for 1-3 days
- Vomiting and diarrhea- fluid loss
- 6% dehydration- moderate
- Skin sluggish to return to position
- Eyes are dull and dry
- 8% dehydration- severe
- Skin stays in tented position
- Eyes are sunken
- 12-15% dehydration- extremeel sever
- Death is soon
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Fluids for Therapy
Animals water Weight On average 55-67% of weight
How to assess dehydration
- PCV+ TP = dehydration
- Fluid loss will increase Pack Cell Volume + Total protein
- Increased BUN Blood urea Nitrogen
- Increased urine specific gravity >1.040
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Fluids for Therapy
Hydration
Fluid rate guidlines and calculations
- Administration of lfuids depends on the condition of the animal.
- No more than 1/4 total volume is given in the first hour
- Daily maintenance calculation
- 45mls * body weight
- Fluid loss calculation
- Body weight kg and % dehydration
- 1 liter (1000 mls per L) = total ml
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Fluids for Therapy
Hydration
Fluid rate guidelines and calculations
- Drip rate calculation
- 15 drops/ml= macro (white)
- 60 drops/ml = micro (green)
- Drops/min= type of drip set (drops/ml) * volume hour
- Example :
- Drops/min= 15 drops/ml * 250 ml=3750 drops/ml Or 3750 drops/ml x1 hr/60min= 60-65 drops/min or 1 drop/sec
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Fluids for Therapy
Hydration
Methods of Rehydration
- Oral
- Subcutaneous Fluids (SQ) fluids
- Intravenous (IV) fluids
- fluids with addisitve of Potassium Chloride (K+) and calcium (Ca) are given slowly.
- Intraperitoneal (IP) fluids in the abdomen
- Intraosseous (IO) fluids usually reptile
- Parental nutrition- feeding tubes PEG tube
Jejunostomy tube, naso-gastro tube (NG)
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Fluids for Therapy
Hydration
Fluid Types
Introduction
- Most fluid is lost through the extracellular fluid
- Normal plasma osmolarity is 300 MOsm
- Blood Ph=7.4
- Urine output 20-45 ml/kg/day
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Fluids for Therapy
Hydration
Types of fluids
Crystalloids
Introduction
- Balanced electrolyte fluids with water
- Sodium based electrolyte solutions that are commonly used replace fluids loss.
- Their composition is similar to plasma
- Crystalloids are classified into categories by their tonocoty as isotonic, hypotonic, hypertonic
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Fluids for Therapy
Hydration
Types of fluids
Crystalloids
Isotonic fluids
- Electrolyte balance is similar to plasma
- Lactated ringers solution (LRS), 0.9% sodium chloride (Nacl), 0.45% Nacl + 2.5% dextrose, Plamalyte, Normosol
- Can be given at any rate
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Fluids for Therapy
Hydration
Types of fluids
Crystalloids
Hypertonic Fluids- Head Trauma
- More electrolytes than plasm
- 50% dextrose, 9% NACL (Hypertonic saline)
- Cannot be given SQ
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Fluids for Therapy
Hydration
Types of fluids
Crystalloids
Hypotonic Fluids
- Less electrolytes than plasma
- Sterile water, 5% Dextrose and water (D5W)Not used except to constitute drugs
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Fluids for Therapy
Hydration
Types of fluids
Colloids
- Large macromolecules restricted to plasma compartment that enhances the oncotic force of blood causing fluid to move into the vascular space.
- Colloids are used to treat shock and hypoproteinemia
- Natural colloids
- Plasma and Fresh whole blood
- Synthetic colloids
- Hetastarch and Dextran 70
- Oxyhemoglobin (synthetic blood transfusion)
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Fluids for Therapy
Hydration
Types of fluids
Blood Products
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Blood Transfusions
Transfusion Therapy
- Transfusions are given not only for red blood cells, but also for other blood components as plasma and coagulation factors
- Fresh whole blood can be separated into four components
- Red cells
- Platelet rich plasma
- Fresh frozen plasma
- Cryoprecipitate- factor VIII, Von Willondbrands
- Transfusions may be indicated for the flollowing
- Anemia
- Coagulopathy
- Thrombocytopenia- give plasma
- Hypoproteinemic- give plasma
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Blood Transfusions
Blood Types
- Blood types are genetic markers on the red cell that are antigenic and specific for each species.
- These alloantibodies are the cause of transfusion reactions and neonatal isoerythrolysis.
- Canine blood types
- Dogs system known as DEA (Dog Erythrocyte Antigen)
- Blood types can be positive and negative
- Ideal Blood donor- DEA 1.1 negative (greyhounds)
- Types
- DEA 1
- DEA 1.1 (A1)
- DEA 1.2 (A2)
- DEA 3B
- DEA 4 C
- DEA 5D
- DEA 7tr
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Blood Transfusions
Feline Blood Types
- Cats have three blood types: A, B, AB
- Type A is the most dominant, while AB is rare
- A/A or A/B are both type A
- Only B/B is type B
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Blood Transfusions
Crossmatching
- Blood crossmatching test the serological incompatibility and compatibility between the donor and recipient.
- Crossmatching test for alloantibodies, but does not determine blood type.
- Dogs have naturally occuring alloantibodies, thus crossmatch should show compatibility
- Cats have naturally occuring alloantibodies
- Incompatibility of crossmatch show hemolysis or agglutination.
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Blood Transfusions
Blood Sources
Blood donors
- donor criteria
- PCV>40% in dog
- PCV>35% in cats
- Disease free and current vaccines
- Weight at least 25kg. Dogs and 4kg for cats
- Should not donate blood sooner than 4 weeks after blood donation
- Maximal volume to be donated
- Dog 20ml/kg or 450mls
- Cat 10ml/kg or 50mls
- Anticoagulent used Citrate-phosphate-dextrose-adenine (CPD-A)
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Blood Transfusions
Blood Sources
Storage
- Whole blood- 4 degree C for 1 month
- Packed red blood cells- 4 degree C 1 month
- Platelet rich plasma - 24 hours
- Fresh frozen plasma- <20 degree C up to 1 year
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Blood Transfusions
Blood Sources
Before Administering Blood
- Warm to room temperature
- At 50 degree C fibrinogen precipitates
- At 45 degree C RBC will agglutinate
- Filter needed when administering cell products to prevent thrombosis.
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Blood Transfusions
Transfusion Administration
- Warm to room temperature before administration
- Rate depends on disease and patients status
- Always start blood transfusion slowly initially and give over 4 hours
- Rate guide lines
- 10 ml/kg hr to 22ml/kg/hr
- 1 lm/lb of weight increase PCV by 1%
- Calculations
- Volume to be given = PCV desired- PCV recipient
- 2.2 * recipients Weight (kg) * (30 dog or 40 cat) x PCV of donor in anticoagulent
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Transfusion Reactions
- Most common is fever, followed by vomiting and diarrhea.
- Monitor temperature every 5 minutes- first symptom of transfusion reaction will be an increase in body temperature, then panting.
- Phase 1 (anaphylaxis)
- Hypotension and bradycardia
- Vomiting and diarrhea
- Lethargy, seizure and nystagmus
- Phase 2 (Hemolytic)
- Hemolysis, hemoglobinemia, bilirubinuria
- Tachycardia, DIC, Death
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Dexamethasone
corticosteroid, is similar to a natural hormone produced by your adrenal glands. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Dexamethasone is also used to treat certain types of cancer.
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Blood Transfusions
- Only NaCL .9% can be used when flushing lines before and after a blood product transfusion. Calcium will precipitate if you use LRS
- Lactated Ringer's solution) is a liquid solution of electrolytes in water.
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Blood Sources
- Blood banks offer different types of blood products. Usually relieable)
- Autotransfusion from clean traumatic hemorrhage in body cavities
- Blood donors- Donor criteria
- PCV >40% dog > 35% cat
- Disease free and current on vaccines
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Electrocardiogram
Basic Principles of Cardiac Vectors
- Forces moving towards a positive electrode cause upward deflection on the dog.
- forces moving away from a positive electrode cause a downward deflection on the ECG
- ECG records the difference in electrical activity between the two electrodes
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Electrocardiogram
Leads and lead colors
- Leads detect electreical activity in different planes through the body are called I,II, III, Avr, Avl, and Avf
- Black lead- Front left leg
- White lead- Front right leg
- Green lead- right rear leg
- Red lead- left rear leg
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Electrocardiogram
Lead System
Bipolar standard Leads
- Lead I: right arm (-) and left arm (+)
- Lead II: right arm (-) and left leg (+)
- Lead III: left arm (-) and left leg (+)
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Electrocardiogram
Augmented unipolar limb leads
- Uses same electrodes as standard leads, but now connects them in different combinations.
- Allow heart to be studies from three new angles.
- Lead Avr: Right arm (+) compared with left arm and left leg (-)
- Lead Avl: Left are (+) compared with right are and left leg (-)
- Lead Avf: Left leg (+) compared with right and left arms (-)
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Performing an EKG
- Animal in right lateral recumbency on non- metallic surface
- Forelimbs- black on white like a newspaper
- Hindlegs- Red over green like a stoplight
- 6 lead axis strips at 25 mm/sec
- Lead I
- Lead II
- Lead III
- Lead Avr
- Lead Avl
- Lead Avf
- Lead II rythm strip at 50mm/sec for about 15-30 sec
- Record the standard, usually 1cm = 1mv, write the strip speed, identify patient
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Indications for ECG
- ECG may detect enlargement for cardiac chambers
- ECG is used to diagnose cardia arrythmias
- It detects electrolyte imbalances
- It monitors response to therapy
- Digitals for CHF- Atrial arrythmias
- Antiarrythmic therapy
- It is useful in the diagnosis of nonspecific diseases.
- Myocarditis
- Endocarditis
- Neoplasia
- It helps to establish prognosis
- Changes or improvements
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EKG complexes
- Definition: Depolarization- contraction (systole)
- Repolarization- filling (diastole)
- "P" wave
- Depoloarization of the atria
- Impulse from SA node to AV node
- "P-R" interval
- Impulse from SA node to ventricles
- QRS complex
- Depolarization of ventricles
- "T" wave
- repolarization of ventricles
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EKG in cardiac disease
- Left cardiac enlargement
- Left axis deviation
- QRS complexes wide
- Tall "R" wave
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EKG in cardiac disease
Right ventricular enlargement
- Right ventricular Enlargement
- Right axis deviation
- Large "S" wave
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EKG measurements
- Normal Speed is 25 mm/sec
- 50mm/sec at the end of the strip
- Calculation of heart rate from ECG
- Measures R to R interval in 3 seconds and multiply by 20 at speed 50mm/sec
- Measure R to R interval in 3 seconds and multiply by 10 speed 25mm/sec
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