Intralipid Emulsion Therapy for the Treatment of Suspected Toxicity in 2 Avian Species.

Intravenous lipid emulsion (ILE) therapy has shown promise as a treatment option for a variety of lipophilic toxins. Two birds presented for suspected ingestion of a toxic substance. A blue-and-gold macaw (Ara ararauna) presented after chewing a block of bromethalin rodenticide without overt clinical signs at the time of presentation. Additionally, a free-ranging bald eagle (Haliaeetus leucocephalus) was found weak and depressed near a municipal landfill after presumptive ingestion of pentobarbital. Both birds were treated with ILE therapy for potential intoxication without any adverse events. The macaw was clinically normal after 3 days of hospitalization and at a 1-week reevaluation. The eagle was transferred to a rehabilitation center after markedly improved mentation and strength and was released 7 days later. Clinicians should consider ILE therapy for the treatment of lipophilic toxicities; however, monitoring is recommended for persistent lipemia and other adverse effects that have been reported in the veterinary literature.

Retrospective evaluation of transportation and outcome of dogs on a mechanical ventilator: 9 cases.

OBJECTIVE: To describe the transportation and clinical outcome of 9 dogs transported to a referral hospital on mechanical ventilation (MV). DESIGN: Retrospective case series (2015-2020). SETTING: University teaching hospital. ANIMALS: Nine dogs transported to a referral center on MV. INTERVENTIONS: All dogs underwent MV during vehicular transport. MEASUREMENT AND MAIN RESULTS: The medical records of 9 dogs transported on a MV to a university teaching hospital were reviewed. Data collected included signalment, reason for MV, ventilator settings, sedation protocol, monitoring in transit, distance traveled, complications, clinical outcome, and cost. All dogs transported survived transport to the referral hospital and 8 of 9 were successfully weaned from the ventilator and discharged home. CONCLUSIONS: MV during transport in this setting was practical and safe. Dogs in this study had a high survival rate compared to previous studies of dogs undergoing MV, likely due to selection of cases assessed to have a correctable underlying disease.

Familial nephropathy in Bracchi Italiani: 8 cases (2012-2019).

OBJECTIVE: To characterize the signalment, clinical signs, clinical pathological and histologic findings, and outcome in 8 related Bracchi Italiani with proteinuric kidney disease. ANIMALS: 8 client-owned Bracchi Italiani. PROCEDURES: Health records submitted to the Bracco Italiano Health Foundation and the Bracco Italiano Club of America between 2012 and 2019 were reviewed for dogs with evidence of nephropathy for which histologic diagnoses were obtained. Pedigree, signalment, clinical signs, diagnostic test results (including microscopic examination of kidney tissue samples collected ante- or postmortem), and outcome were acquired. Results were presented as descriptive statistics. RESULTS: The most common clinical sign in affected dogs was inappetence. All dogs were proteinuric, and 4 dogs were azotemic. Seven dogs developed clinical signs of kidney disease and were euthanized a median of 75 days postdiagnosis. Six dogs had glomerular amyloidosis, and 1 dog each had nephrosclerosis and nonamyloidotic fibrillar glomerulopathy. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the clinical presentation may vary in affected dogs, and proteinuria in young or middle-aged Bracchi Italiani should raise the concern for hereditary nephropathy. Prognosis is likely poor once clinical signs are noted.

Pit viper envenomation in pediatric dogs: 5 cases.

Treatment of pit viper envenomated puppies (≤6  months old) with antivenom was well tolerated, similar to adult dogs. However, therapeutic guidelines should be established to direct use and prove efficacy in this population.

Retrospective evaluation of Micrurus fulvius (Eastern coral snake) envenomation and the use of mechanical ventilation in dogs and a cat (2011-2016): 8 cases.

OBJECTIVE: To describe the use of mechanical ventilation (MV) in the management of Eastern coral snake envenomation in 7 dogs and a cat. DESIGN: Retrospective study (2011-2016). SETTING: University teaching hospital. ANIMALS: Seven dogs and 1 cat receiving MV for ventilatory failure secondary to Eastern coral snake envenomation. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: The medical records of 8 animals that received MV following Eastern coral snake envenomation were reviewed. Data collected included signalment, time to veterinary assessment, physical and laboratory characteristics at arrival, clinical course during hospitalization, management including antivenom administration, MV settings, duration of ventilation, length of hospitalization, cost of care, and survival to discharge. The mean ± SD age was 4 ± 3.2 years. Median (range) time to onset of clinical signs was 30 (5-240) minutes. Coral snake antivenom was administered to 7 of the 8 animals following arrival at a median (range) of 30 (5-90) minutes. All animals had progressive hypoventilation and received MV, specifically volume controlled, synchronized intermittent mandatory ventilation with pressure support. The median (range) duration of MV was 58 (25-84) hours and the median (range) duration of hospitalization was 8.2 (6-11) days. Ventilator associated complications occurred in all animals, but overall outcome was excellent with 7 of 8 surviving to discharge. No dog, but the 1 cat, had an adverse reaction to antivenom. CONCLUSIONS: Ventilatory failure secondary to Eastern coral snake envenomation necessitating MV carries an excellent prognosis and is better than reported for other causes of lower motor neuron disease. Successful response to ventilation was achieved even with associated complications being common in this cohort of animals.

A Quick Reference on Phosphorus.

Phosphorus, or phosphate, is the body's major intracellular anion involved in numerous biological processes. Most phosphate is intracellular, with the remaining amount contained within soft tissues and the extracellular space. Parathyroid hormone, calcitriol, calcitonin, and phosphatonins regulate normal phosphate homeostasis by adjusting renal and/or gastrointestinal absorption and/or excretion. Hypophosphatemia occurs secondary to decreased gastrointestinal absorption, transcellular shifts, increased renal excretion, or some combination of these general mechanisms. Hyperphosphatemia results from decreased renal excretion, increased intake or iatrogenic administration, transcellular shifts, or some combination of these.