Lisa Smart

• BVSc (Hons) DACVECC PhD
• Adjunct Associate Professor at Murdoch University

Objective: To evaluate the effect of 6% hydroxyethyl starch (HES) 130/0.4, compared with a Hartmann's solution control (CRYST), on urine biomarkers of acute kidney injury (AKI) in dogs prescribed a fluid bolus. Design: Randomized, controlled, blinded clinical trial January 2018 to February 2019. Setting: University teaching hospital. Animals: Forty...

The goal of resuscitative fluid therapy is to rapidly expand circulating blood volume in order to restore tissue perfusion. Although this therapy often serves to improve macrohemodynamic parameters, it can be associated with adverse effects on the microcirculation and endothelium. The endothelial surface layer (ESL) provides a protective barrier ov...

Abstract Background Fluid resuscitation is frequently required for cardiac surgical patients admitted to the intensive care unit. The ideal fluid of choice in regard to efficacy and safety remains uncertain. Compared with crystalloid fluid, colloid fluid may result in less positive fluid balance. However, some synthetic colloids are associated with...

Objectives To compare concentrations of biomarkers of; allergy [mast cell tryptase (MCT) and histamine], inflammation [interleukin (IL)-6,-10, and−18, CXCL8, CCL2, keratinocyte chemoattractant (KC), C-reactive protein (CRP)], endothelial glycocalyx shedding (hyaluronan), coagulation [prothrombin time, activated partial thromboplastin time, fibrinog...

Endothelial glycocalyx (EG) shedding is associated with septic shock and described following intravenous (IV) fluid administration. To investigate the possible impact of IV fluids on the pathobiology of septic shock we investigated associations between biomarkers of EG shedding and endothelial cell activation, and relationships with IV fluid volume...

Introduction The objective of this study was to describe the clinical features, treatments and outcomes of dogs with iron ethylenediaminetetraacetate (EDTA) molluscicide ingestion. We aimed to identify potential predictors of serum iron concentration >54 μmol/L; a cut‐off recommended for initiating treatment of human iron toxicosis. Methods Medica...

This systematic review identified 20 clinical studies that assessed the relationship between IV fluid administration and indicators of EG shedding in people. Across ten studies involving 1360 patients with sepsis or critical illness, it was found that EG markers were significantly elevated at baseline, but not consistently associated with rate or...

Introduction Alteration in endothelial function during sepsis is thought to play a key role in the progression of organ failure. We herein compared plasma concentrations of endothelial activation biomarkers vascular endothelial growth factor (VEGF), hyaluronan (HA), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF), as well...

Purpose To investigate the effect of IV fluid resuscitation on endothelial glycocalyx (EG) shedding and activation of the vascular endothelium and inflammation. Materials and methods A planned biomarker sub-study of the REFRESH trial in which emergency department (ED) patients) with suspected sepsis and hypotension were randomised to a restricted...

Red blood cell (RBC) transfusion is associated with recipient inflammation and infection, which may be triggered by excessive circulating iron. Iron chelation following transfusion may reduce these risks. The aim of this study was to evaluate the effect of deferoxamine on circulating iron and inflammation biomarkers over time and in vitro growth of...

In veterinary medicine, abdominal auscultation has been described as an adjunctive tool for the diagnosis of abdominal diseases or gastrointestinal dysfunction. There are two basic goals for intubation of the gastrointestinal tract: removing contents or administering food and medications. Nasogastric intubation involves placing a tube through the n...

Simple Summary Critically ill dogs often require intravenous fluid therapy to improve circulation and treat life-threatening shock. Standardly, a balanced electrolyte solution called a crystalloid is prescribed. Some veterinarians also prescribe colloid fluids like hydroxyethyl starch (HES), which are crystalloids that contain large starch molecule...

Background Prestorage leukoreduction of red blood cell (RBC) bags prevents accumulation of pro‐inflammatory mediators and experimentally attenuates post‐transfusion inflammation in healthy dogs. However, the effect of leukoreduction on post‐transfusion inflammation in critically ill dogs is unclear. Hypothesis Dogs transfused with leukoreduced (LR...

INTRODUCTION Intravenous (IV) fluid resuscitation is recommended first line therapy in septic shock, but the effectiveness and safety of this approach has been questioned. To investigate potential mechanisms of harm from IV fluid resuscitation, we measured biomarkers of endothelial glycocalyx (EG) shedding, activation of the vascular endothelium an...

Objective The primary objective of this study was to document coagulation factor activity in canine “NEVER‐FROZEN” and “THAWED” refrigerated plasma for the purposes of defining recommended expiration dates. We hypothesized that NEVER‐FROZEN and THAWED refrigerated plasma would maintain >50% activity of coagulation factors V (FV), VII (FVII), VIII (...

Background There is no consensus on obtaining blood cultures routinely in companion animals with suspected sepsis, and there is a paucity of evidence concerning their utility. The objectives of this retrospective study were to determine the yield of positive blood cultures from hospitalized dogs, the prevalence of resistant bacteria, and the freque...

Objective To describe the clinical features of dogs treated for suspected anaphylaxis in Perth, Western Australia. Design Single-centre observational case series with retrospective and prospective phases. Methods This was a two-phase study of dogs with clinical suspicion of anaphylaxis presenting to the emergency service of a university teaching...

Intravenous fluid administration in veterinary patients can alter coagulation function by several mechanisms. Both crystalloid and colloid fluids cause hemodilution, reducing platelet count and plasma coagulation protein concentrations. Hemodilution is associated with a hypercoagulable effect at low dilutions and a hypocoagulable effect at higher d...

Electrical impedance tomography (EIT) is used in lung physiology monitoring. There is evidence that EIT is linearly associated with global tidal volume (VT) in clinically healthy patients where no positive end-expiratory pressure (PEEP) is applied. This linearity has not been challenged by altering lung conditions. The aim of this study was to dete...

Objective To describe small animal transfusion practices in Australia, including access to blood products and frequency of pre‐transfusion compatibility testing and medication administration. Methods An online survey was disseminated to target Australian veterinarians treating dogs and cats. Information collected included demographics, sources of...

[This corrects the article DOI: 10.3389/fvets.2018.00279.].

Introduction: An understanding of the inflammatory and coagulation profile of dogs with anaphylactic reactions may provide insight into the pathophysiology of anaphylaxis. The objective of this study was to compare plasma cytokine and chemokine concentrations and coagulation assays between dogs with evidence of an anaphylactic reaction (ANAPHYLAXIS...

Introduction: Hydroxyethyl starch (HES) administration has been associated with hypocoagulability in dogs. There is a lack of evidence relating HES administration causing sustained hypocoagulability in dogs with naturally occurring critical illness. We used banked samples to compare plasma coagulation assays in dogs randomized to receiveHES or Hart...

SnakeMap is a national cloud‐based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary communi...

Background Obstructive shock can be caused by any lesion leading to extraluminal compression or intraluminal occlusion of the cardiac chambers or major vessels. Case Report A 12‐year‐old, male castrated, Border Collie cross dog presented to a veterinary teaching hospital for collapse. A physical examination revealed severe vasoconstrictive shock...

Blood vessels are lined with endothelial cells that have a protective layer of proteoglycans and glycosaminoglycans on their apical surface. This superficial layer of the endothelium is called the glycocalyx. Widespread inflammation resulting from conditions such as sepsis or severe traumatic injury can lead to shedding of the endothelial glycocaly...

Hepcidins are an evolutionarily conserved class of liver-expressed peptide, from which the twenty-five amino acid hormone, hepcidin-25 (herein hepcidin), has gained significant notoriety as the master regulator of iron homeostasis in mammals. Hepcidin maintains iron homeostasis by controlling the dietary absorption of iron and the mechanisms of rec...

Introduction: Patients admitted to the intensive care unit (ICU) after cardiac surgery frequently require intravenous fluid resuscitation and are at risk of developing postoperative acute kidney injury (AKI). Colloids, including 4% succinylated gelatine (GEL), are used commonly but their safety is uncertain. Objectives/Aims: To provide preliminar...

Introduction: The effect of leukoreduction on inflammation in canine transfusion recipients has only been explored in healthy dogs, and results are conflicting. The aim of this multicenter, randomized, blinded, phase II clinical trial was to assess the effect of leukoreduction on post-transfusion inflammation in critically ill dogs by comparing leu...

Introduction: Hydroxyethyl starch (HES) has been associated with acute kidney injury (AKI) in people, but there is limited evidence in dogs. We performed a randomized, blinded, phase II clinical trial to compare urine biomarkers of AKI in dogs randomized to receive HES or Hartmann’s solution (CRYST). Methods: Dogs (n=40) treated by the emergency a...

Objective To determine if low molecular weight synthetic colloid fluids administered to dogs interfere with refractometric estimates of total plasma protein (TPPr) and urine osmolality (UOsm). Study design Experimental study Animals Eighteen healthy greyhound dogs Methods Anaesthetized greyhounds subjected to haemorrhage for 60 minutes were give...

The aim of this study was to determine the influence of positive end-expiratory pressure (PEEP) on Tidal Volume (V T) estimation using electrical impedance tomography (EIT) technology, and spirometry (L/breath). Anaesthesia was induced in ten steers, volume controlled ventilation was initiated. An EIT belt was applied around the thorax. PEEP levels...

Objective and design Hypertonic saline administered during fluid resuscitation may mitigate endothelial glycocalyx (EG) shedding and inflammation. The objective of this pilot randomised controlled trial was to measure the effect of hypertonic saline, compared to isotonic saline, on biomarkers of EG shedding and inflammation in emergency department...

Objective: To investigate the association between synthetic colloids and biomarkers of acute kidney injury (AKI) in dogs with hemorrhagic shock. Design: Experimental interventional study. Setting: University. Animals: Twenty‐four healthy ex‐racing Greyhounds. Interventions: Anesthetized Greyhounds subjected to hemorrhage for 60 min were resuscitate...

Background: Hemorrhagic shock and volume replacement can alter coagulation. Synthetic colloids, hydroxyethyl starch (HES), and gelatin, may enhance hypocoagulability. Our primary objective was to describe the effect of four fluid products on coagulation in canine hemorrhagic shock. Our secondary objective was to compare measurements of coagulation...

Hypovolemic shock is a common problem in small animal emergency medicine. It occurs when a decrease in circulating blood volume decreases cardiac output and impairs oxygen delivery to the tissues. Hypovolemic shock is immediately life‐threatening if untreated. Furthermore, delayed or inadequate treatment can lead to subsequent complications. The em...

This study was funded by the Veterinary Emergency and Critical Care Foundation Research Grant. Introduction: Hydroxyethyl starch (HES) has been associated with acute kidney injury (AKI) in humans, but there is limited evidence in dogs. We present the protocol and feasibility analysis of an ongoing prospective randomized blinded phase II clinical t...

Introduction: Endothelial dysfunction plays an important role in the pathophysiology of sepsis and may emerge as a novel therapeutic target. Studies in dogs investigating biomarkers of endothelial activation in naturally occurring sepsis are lacking. Herein, we investigated changes in markers of endothelial activation in dogs with severe sepsis com...

Shedding of the endothelial glycocalyx precedes leukocyte activation and adherence in acute inflammation. Rapid administration of crystalloid or colloid fluids for treating hemorrhagic shock may cause endothelial glycocalyx shedding, thereby increasing inflammation. This study aimed to compare the effect of different fluid treatments in a canine sh...

Background High molecular weight (MW) synthetic colloids interfere with refractometry. The effect of low MW synthetic colloids on refractometry is unknown. Objectives To investigate the effect of 6% hydroxyethyl starch 130/0.4 (HES) and 4% succinylated gelatin (GELO) on the refractometric measurement of total plasma protein (TPP) and colloid osmot...

Purpose: Endocan, a component of the endothelial glycocalyx (EG), has been linked with respiratory failure in sepsis. This study explored the temporal patterns of three EG biomarkers, including endocan, and their relationships with inflammation and respiratory failure. Materials and methods: Plasma endocan, syndecan-1, and hyaluronan concentration...

Introduction: Rapid administration of crystalloid or colloid fluids may cause endothelial glycocalyx shedding, thereby increasing inflammation. Methods: Greyhounds under general anesthesia subject to hemorrhage for 60 minutes were given 20 mL kg-1 of either fresh whole blood (FWB), hydroxyethyl starch (HES) 130/0.4, 4% succinylated gelatin (GELO),...

Introduction: Hypertonic saline for fluid resuscitation may reduce glycocalyx shedding, endothelial activation and inflammation in patients with infection, and reduce the volume of fluid subsequently administered. Methods: This randomised controlled open-label pilot study included 65 patients presenting to an emergency department with suspected inf...

The clinical features and management of food engorgement (FE) in dogs have not been previously described. This retrospective observational study describes characteristics and outcome of 35 dogs with FE, and compares features on presentation to 36 dogs with gastric dilation and volvulus (GDV). Cases were retrospectively reviewed for history, clinica...

Introduction: This study investigated the effect of low molecular weight (MW) hydroxyethyl starch (HES) (130/0.4) and 4% succinylated gelatine (GELO) on refractometric measurement of total plasma protein (TPP) and urine specific gravity (USG), compared to a crystalloid control (Plasmalyte-148 [P148]). Methods: Blood was removed from anesthetized g...

Background Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack of evidence from clinical trials to support this. Accumulating observational data suggest harm associated with the injudicious use of fluids in sepsis. There is currently equipoi...

Objective and designResistin and neutrophil gelatinase-associated lipocalin (NGAL) are upregulated in circulating leucocytes in sepsis, but the significance of this is uncertain. We evaluated associations between Resistin and NGAL with endothelial cell activation and clinical outcomes in a prospective observational study in the Emergency Department...

Purpose: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics. Materials and Methods: This prospective observational study included 23 patients with simple infection, 86 with sepsis and...

Objective To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock. Study design Prospective, experimental, complete randomized block design. Animals Twelve healthy adult greyhounds. Methods After 60 minutes o...

Case report Two dogs with an oesophageal foreign body (FB) were diagnosed with secondary pyothorax at the time of presentation. One dog was managed with surgical FB removal, pleural lavage and thoracostomy tube placement. Following surgery, it was admitted to the intensive care unit for oxygen therapy, antimicrobial and analgesic administration, fl...

Background We hypothesised that concentrations of interleukin-8 (IL-8), interleukin-1β (IL-1β) and tumour necrosis factor-α (TNF-α) would increase during storage in the third sequential unit (U3) of canine packed red blood cells (PRBC) collected from terminal donors in haemorrhagic shock. We further hypothesised that leucoreduction would prevent cy...

Objective To describe the use of sodium carbonate and apomorphine in a historical cohort of dogs, compare the occurrence of emesis and report any adverse effects recorded. Methods This historical, observational study included information from medical records of dogs that received an emetic agent. The occurrence of emesis with apomorphine or sodi...

Objectives: 1) To explore three biomarkers of EGD in ED patients with infection over the first 24 hours, 2) to compare these results to a trauma group, and 3) to explore associations with illness severity, comorbidities and clinical outcomes in patients with infection. Methods: Banked serum samples were used from patients with simple infection (n =...

Background: Ongoing work by our group found differences in endothelial glycocalyx damage (EGD) biomarker expression over time in Emergency Department (ED) patients with infection and trauma. This may be explained by varying levels of inflammation or endothelial activation. Objectives: To explore associations of three EGD biomarkers with inflammator...

Background: Our group previously used a canine haemorrhagic shock model that removed a set volume of blood over a short period of time before comparing resuscitation interventions. We found wide variability in the degree of shock achieved. Removal of blood guided by blood pressure may be more synergistic with the individual’s ability to compensate...

Introduction: Artificial colloids may contribute to kidney injury. This study compared kidney injury after administering two different artificial colloids to dogs in shock, using whole blood and a crystalloid fluid as controls. Methods: Blood was removed from anesthetized Greyhounds to maintain a mean arterial pressure <60 mmHg for 60 minutes, foll...

Introduction: It is unknown whether coagulation deficits occur in dogs that receive balanced HES 130/0.4 or gelatine colloids for shock. This study assessed platelet function and viscoelastic tests in dogs with hemorrhagic shock treated with balanced HES 130/0.4,4%succinylated gelatine (GELO), fresh whole blood (FWB) or Plasmalyte-148 (P148). Metho...

Objective: To measure platelet closure time (PCT) in dogs during controlled hemorrhagic shock and after fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 or 0.9% sodium chloride. Design: Experimental interventional study. Setting: University veterinary teaching hospital. Animals: Eleven healthy Greyhounds. Interventions: Dogs were...

OBJECTIVE To measure changes in interleukin-8 (IL-8), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) concentrations in stored canine packed RBCs (PRBCs) over time and assess the effect of leukoreduction on these cytokine concentrations. ANIMALS 12 anesthetized healthy Greyhounds. PROCEDURES 1 unit of whole blood from each dog was proce...

To assess for any clinical benefit of intravenous lipid emulsion (ILE) for permethrin toxicosis in cats by comparing the progression of clinical signs of cats before and after treatment with ILE to cats treated with a saline control. To accomplish this objective, a clinical staging system for cats with permethrin toxicosis was developed and validat...

Introduction: Food engorgement in dogs has not been well described in the literature and diagnosis may be confused with gastric dilation and volvulus (GDV). This study characterizes the clinical findings of dogs with engorgement and compares these with the findings of dogs with GDV. Methods: Cases were retrospectively reviewed for data related to h...

The two basic goals for intubation of the gastrointestinal tract are removing the contents or administering medications. Gastrointestinal decontamination (GID) for ingested toxins includes emesis, gastric lavage, whole bowel irrigation (WBI), enema, and activated charcoal administration. Veterinary poisoning cases differ from human cases in that th...

Objective To compare adequacy of oxygen delivery and severity of shock during maintenance of anaesthesia with isoflurane or alfaxalone infusion in greyhounds experiencing blood loss.Study designProspective, randomised study.AnimalsTwenty-four greyhounds (ASA I).Methods All greyhounds were premedicated with methadone (0.2 mg kg−1) intramuscularly. A...

Objective: To determine whether dilution of blood samples from healthy dogs with 2 hydroxyethyl starch (HES) solutions, HES 130/0.4 and HES 200/0.5, would result in platelet dysfunction as measured by closure time (Ct) beyond a dilutional effect. Sample: Citrated blood samples from 10 healthy dogs with a Ct within reference limits (52 to 86 seco...

A dog was presented for acute abdominal distension after inadvertent access to a large amount of dry dog food and possibly horse feed consisting of chaff, pony cubes and vitamin, mineral and yeast supplements. A marked hyperchloraemia and decreased anion gap on blood electrolyte analysis prompted a review of the patient's history for potential inge...

This study aimed to: (1) confirm a temporal association between exposure to the sea hare Aplysia gigantea and the development of a neurotoxicosis in dogs and (2) further characterise the clinical signs, treatment and outcomes in dogs with this suspected toxicosis. The medical records from four veterinary practices within the Geraldton region of Wes...

To describe the use of intravenous lipid emulsion (IVLE) as an adjunctive therapy in 3 cats with permethrin toxicosis. Three cats with permethrin toxicosis were treated with IVLE in addition to the current accepted treatment regime. All 3 cats demonstrated a subjective rapid clinical improvement after the administration of IVLE, with no adverse rea...

To evaluate the effect of 6% hydroxyethyl starch (HES) solution in vivo, with an average molecular weight of 670 kDa and degree of substitution of 0.75, on canine platelet function. Prospective, controlled-experimental study. University of California, Davis, Veterinary Medical Teaching Hospital. Seven healthy employee-owned dogs. Seven dogs were in...

Urine specific gravity (USG) is used clinically to estimate urine osmolality (UOsm). Although USG has been shown to have a linear correlation with UOsm in dogs, the relationship is altered when there are significant numbers of high molecular weight (MW) molecules in the urine. USG would no longer predict UOsm in dogs given intravenous hetastarch (6...

Objective: To describe the case management for a dog diagnosed with a nasopharyngeal polyp. Case summary: A 9-week-old Shar-Pei puppy presented for progressive dyspnea and collapse. Clinical signs were consistent with an upper airway obstruction (UAO) and a temporary tracheostomy was performed. The puppy was at first diagnosed with and treated for...

The objective of this review is to summarise current research in the use of three different vasopressors for cardiopulmonary arrest. Both experimental and clinical studies from human and veterinary literature are employed to assess the efficacy of these vasopressors and to recognise potential for current use of the drugs in veterinary emergency med...

To evaluate cardiac electrical function in the Spectacled Flying Fox (bat) infested with Ixodes holocyclus. Prospective clinical investigation of bats treated for naturally occurring tick toxicity. ECGs were performed on bats with tick toxicity (n = 33), bats that recovered slowly (n = 5) and normally (n = 5) following treatment for tick toxicity,...