Case report: Clinical and pathological findings in a canine patient with intervertebral disk extrusion resembling progressive myelomalacia.

A 4-year-old female spayed dog presented to the emergency department for non-ambulatory tetraparesis, which progressed to tetraplegia. Computed tomography (CT) confirmed cervical intervertebral disk extrusion at C5-6 extending to C6-7, and an emergency ventral slot was performed. After the procedure, the patient was placed on mechanical ventilation due to respiratory failure. Repeat assessment upon weaning her ventilatory support suggested the patient's neurological status had declined. Based on her deterioration and suspicion of progressive myelomalacia on magnetic resonance imaging (MRI), she was euthanized. Post-mortem histopathology of the spinal cord supported the presence of progressive myelomalacia. To the author's knowledge, this is the first case report describing a progressive myelomalacia in a canine patient with cervical intervertebral disk extrusion.

Inadvertent placement of an esophagostomy tube into the mediastinum of a cat.

An 8-year-old neutered male Siberian forest cat was presented for respiratory distress. Endoscopy, exploratory surgery of the neck, and sternotomy confirmed initial placement of the esophagostomy tube (e-tube) into the mediastinum. The patient recovered from surgery, developed laryngeal paralysis, and then arrested and died within 48 h after surgery. Key clinical message: To the authors' knowledge, there are no other case reports documenting inadvertent placement of an e-tube into the mediastinum of a cat. This case report highlights the complications that can be associated with incorrect placement of an e-tube.

Placement par inadvertance d'un tube d'oesophagostomie dans le médiastin d'un chat. Un chat des Forêts sibériennes mâle castré âgé de 8 ans a été présenté pour détresse respiratoire. L'endoscopie, la chirurgie exploratoire du cou et la sternotomie ont confirmé le placement initial du tube d'oesophagostomie (e-tube) dans le médiastin. Le patient s'est remis de la chirurgie, a développé une paralysie laryngée, puis a fait un arrêt cardiaque et est décédé dans les 48 heures suivant la chirurgie.Message clinique clé:À la connaissance des auteurs, il n'y a pas d'autres rapports de cas documentant le placement par inadvertance d'un e-tube dans le médiastin d'un chat. Ce rapport de cas met en évidence les complications qui peuvent être associées au placement incorrect d'un e-tube.(Traduit par Dr Serge Messier).

Septic pericardial disease and mediastinal abscessation in a cat with an intrathoracic needle foreign body.

OBJECTIVE: To describe the successful management of a cat with an intrathoracic sewing needle foreign body and septic pericardial effusion. CASE SUMMARY: A 10-year-old neutered female domestic longhair cat was referred for an intrathoracic metallic foreign body identified via thoracic radiography. Two weeks prior, the cat may have ingested a sewing needle. She was presented hemodynamically unstable; point-of-care thoracic ultrasound identified pericardial effusion with right atrial tamponade. Pericardiocentesis stabilized hemodynamic parameters. The effusion was grossly purulent, and bacterial culture grew an Actinomyces sp. The cat underwent a median sternotomy to remove the foreign body, debride associated mediastinal abscesses, and perform a partial pericardiectomy. Over the next 10 days, the cat was managed in hospital with a left unilateral thoracostomy tube and intermittent lavage of the pleural cavity. The cat was discharged, and follow-up at 7 days showed no evidence of pericardial or pleural effusion. NEW OR UNIQUE INFORMATION PROVIDED: Contrary to previous reports, this case shows that extra-gastrointestinal, specifically intrathoracic, sewing needle foreign bodies can cause significant morbidity in cats. To the authors' knowledge, this report is the first to describe septic pericardial disease resulting from documented foreign body ingestion in the cat. It is also the first case report of successful surgical management of mediastinal abscessation in the cat.

Intravenous lipid emulsion to treat suspected cocaine toxicosis in a dog.

A 6-month-old puppy was treated for suspected cocaine toxicosis. Supportive care was initiated but clinical signs worsened and treatment with intravenous lipid emulsion (ILE) was instituted. Clinical signs rapidly resolved in response to treatment with ILE.

Émulsion lipidique intraveineuse pour traiter une suspicion de toxicose à la cocaïne chez un chien. Un chiot âgé de 6 mois fut traité pour une suspicion de toxicose à la cocaïne. Un traitement de support fut initié mais les signes cliniques se sont aggravés et un traitement avec une émulsion lipidique intraveineuse (ILE) fut mis en place. Les signes cliniques se sont rapidement résolus en réponse au traitement avec ILE.(Traduit par Dr Serge Messier).

PLASMA COLLOID OSMOTIC PRESSURE IN CHRONICALLY DEBILITATED LOGGERHEAD SEA TURTLES (CARETTA CARETTA).

Colloid osmotic pressure (COP) is an important component of the forces that manage capillary filtration and is determined by circulating plasma proteins. Patients affected by conditions resulting in hypoproteinemia often suffer severe hemodynamic derangements, including decreased COP. Because chronically debilitated sea turtles (CDT) present with severe hypoproteinemia, the objectives of this study were to 1) determine differences in plasma COP and blood analyte data (packed cell volume [PCV], sodium, chloride, plasma protein fractions) in CDT at admission compared with data from apparently healthy rehabilitated turtles at time of release (HRT) admitted from various stranding causes, and 2) to investigate correlations of COP with these selected blood analytes. COP, PCV, and most plasma protein fractions (excluding pre-albumin and γ-globulins) were significantly lower in CDT upon admission as compared with HRT. Sodium and chloride did not significantly differ between CDT and HRT. A significant increase was observed with PCV and all plasma protein fractions as COP increased. Of all protein fractions tested, albumin contributed the most toward COP (r2 = 0.88, P < 0.001). The results of this study suggest that COP is significantly lower in CDT as compared with HRT, providing insight into the complexity of this critical clinical condition and a small step in advancing the understanding of associated hemodynamic imbalances. Although COP analysis is not readily available as a diagnostic test, this preliminary baseline data suggests that additional research studies are warranted, given the potential for optimization of fluid therapy during rehabilitation of CDT.

Oncotic pressure and the effects of water deprivation in healthy captive Asian elephants.

We evaluated the oncotic pressure (plasma colloid osmotic pressure, πc) in a group of healthy, captive Asian elephants (Elephas maximus; n = 21) with a colloid osmometer with a membrane cutoff of >20,000 daltons. The median πc for these elephants was 26.3 mm Hg with an interquartile interval of 25.5-26.8 mm Hg. The mean πc value was 26.0 mm Hg ± SD 1.1. We found moderate correlation between albumin measured by electrophoresis and πc (r = 0.622; p = 0.003). After a 16-h water deprivation test in a subset of elephants (n = 16), a difference in πc was not detected, despite a significant increase in serum total proteins, urea, and osmolality. These results indicate that πc is not a sensitive indicator of hydration status in elephants after a short period of water deprivation. Use of oncotic pressure as a diagnostic tool in diseased Asian elephants warrants further investigation.

Treatment of acute kidney injury secondary to oak intoxication with hemodialysis in a miniature zebu.

OBJECTIVE: To describe the successful management of acute kidney injury (AKI) secondary to oak intoxication using hemodialysis in a miniature zebu. CASE SUMMARY: A 1-year-old male intact miniature zebu was presented for evaluation of a 2-day history of lethargy, anorexia, decreased urine production, and dry, firm stool. Initial diagnostics revealed severe azotemia and the bull was presumptively diagnosed with AKI secondary to oak intoxication due to free access to oak trees in the pasture. Despite conventional management with IV fluids and supportive therapy, the degree of azotemia progressively worsened, and the bull became oliguric and fluid overloaded. Two treatments with hemodialysis resulted in reduction of azotemia and ketonemia, and resolution of fluid overload and oliguria. The zebu was discharged from the hospital after 10 days of hospitalization. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first reported case using hemodialysis for AKI in a bovid. Treatment with hemodialysis was effective in this case resulting in rapid resolution of azotemia, fluid overload, and oliguria. Hemodialysis may hasten the recovery and decrease morbidity and mortality in bovids with AKI.

Use of charcoal hemoperfusion and hemodialysis in the treatment of methotrexate toxicosis in a dog.

OBJECTIVE: To describe the successful use of charcoal hemoperfusion (HP) and hemodialysis (HD) in a dog in the treatment of methotrexate (MTX) toxicosis. CASE SUMMARY: An American Pit Bull Terrier accidentally ingested 56.8 mg/m2 of MTX. The patient's initial serum MTX concentration was 0.11 µmol/L. At this dosage, myelosuppression and gastrointestinal epithelial necrosis have been reported. Charcoal HP and HD in series were used to enhance elimination of MTX. Serial serum samples were obtained during the session at 0, 30, 60, 90, 120, 150, and 180 minutes and 12 hours after the session. These were later analyzed for MTX concentrations. Clearance of MTX was 73% and extraction ratio was 63% within the first 30 minutes of HP/HD. A 3-hour session eliminated all detectable traces of MTX. The dog tolerated the session well and did not develop any clinical signs of MTX toxicosis. NEW OR UNIQUE INFORMATION PROVIDED: HP and HD together were highly effective in enhancing elimination of MTX from this patient. The prompt use of extracorporeal techniques decreased toxic concentrations of MTX to safer values, which prevented myelosuppression and gastrointestinal injury. HP and HD in conjunction or in place of traditional therapy may be a viable option for the treatment of acute toxic exposures to MTX.

Kidney injury in a dog following bee sting-associated anaphylaxis.

This report describes a case of honeybee envenomation in a dog that developed anaphylaxis after being stung by approximately 10 bees. The dog subsequently developed acute kidney injury. The dog had a previous mild increase in blood urea nitrogen with normal creatinine, possibly indicating an insidious chronic renal degenerative process that went into acute decompensation at the time of bee envenomation.

Lésion rénale chez un chien après l'anaphylaxie associée à une piqûre d'abeille. Ce rapport décrit un cas d'envenimement d'un chien qui a été piqué par environ 10 abeilles et a développé l'anaphylaxie puis une lésion rénale aiguë. Le chien avait eu une légère hausse antérieure de l'azote uréique du sang avec une créatinine normale, ce qui indique éventuellement un processus dégénératif rénal chronique insidieux qui s'est développé en une décompensation aiguë au moment de l'envenimement par les abeilles.(Traduit par Isabelle Vallières).

Clearance of plasma ivermectin with single pass lipid dialysis in 2 dogs.

OBJECTIVE: To describe the use of single pass lipid dialysis (SPLD) for treatment of ivermectin toxicosis in 2 Australian Shepherd dogs with the ABCB1-1Δ gene mutation. CASE SERIES SUMMARY: Two Australian Shepherd dogs were presented for treatment of ivermectin toxicosis. Dogs were initially treated with intravenous lipid emulsion and supportive care, without improvement of clinical signs. They both developed respiratory paralysis and required mechanical ventilation. In order to increase the clearance of circulating ivermectin, SPLD was performed using dialysate containing 5% lipid. Blood samples were obtained immediately before and after dialysis and analyzed for serum ivermectin concentration. Ivermectin reduction ratio was calculated at 29% and 39% for each dog, respectively. When compared to intrinsic total body ivermectin clearance, only the second dog had a relative improvement of plasma clearance following SPLD. Both dogs were confirmed to be homozygous for ABCB1-1Δ gene mutations. Both dogs remained ventilator dependent for several days and ultimately made a full recovery. NEW OR UNIQUE INFORMATION PROVIDED: SPLD may be an adjunctive detoxification strategy for highly lipophilic toxins such as ivermectin.