Case report: Treatment of cyclobenzaprine ingestion in two dogs with intravenous intralipid therapy.

Introduction: The objective of this case series is to describe the clinical signs and outcome of cyclobenzaprine ingestion in two dogs treated with intralipid emulsion (ILE) and supportive care. Case or series summary: Two dogs presented for evaluation of cyclobenzaprine ingestion. A 4-year-old female spayed Rat Terrier (dog 1) presented within 4 h of ingestion of cyclobenzaprine (between 9.7 and 25.9 mg/kg). The dog experienced abnormal behavior, agitation, tremors, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. The dog was treated with ILE, cyproheptadine, and activated charcoal. All clinical signs resolved after treatment. A 5-month-old female intact mixed-breed dog (dog 2) presented after ingestion of an unknown amount of cyclobenzaprine 2-3 h prior to presentation. The dog experienced dull mentation, tremors, loss of gag reflex, tachycardia, and hypertension. There were no significant clinicopathological abnormalities. Orogastric decontamination was performed via gastric lavage, and activated charcoal was given via orogastric tube, followed by ILE. All clinical signs resolved after therapeutic intervention. Discussion: This is the first report documenting clinical signs of cyclobenzaprine toxicity in two dogs followed by successful treatment with gastric emptying, ILE, and supportive care.

Splenic torsion in a cat with chronic anemia.

Case summary: A 4-year-old female spayed domestic shorthair cat with chronic anemia was evaluated for acute-onset lethargy, vomiting, abdominal distension, and a palpably enlarged and firm spleen. Abdominal ultrasound confirmed marked splenomegaly and concern for a splenic infarct, prompting exploratory abdominal surgery, where splenic torsion was diagnosed. A splenectomy was performed, and the cat recovered uneventfully. Splenitis was diagnosed on histopathology. Anemia improved postoperatively. The role of chronic anemia and other concurrent findings in the development of splenic torsion in this case remains unknown. Relevance and novel information: Splenic torsion has not been previously reported in cats, making this the first case of its kind. In cases of splenomegaly and abnormal splenic blood flow, splenic torsion should be considered a differential diagnosis in cats.

Evaluation of thromboelastography for prediction of clinical bleeding in thrombocytopenic dogs after total body irradiation and hematopoietic cell transplantation.

OBJECTIVE: To determine whether thromboelastography is more accurate than conventional methods of evaluating hemostasis for the prediction of clinical bleeding in thrombocytopenic dogs following total body irradiation (TBI) and bone marrow transplantation (BMT). ANIMALS: 10 client-owned thrombocytopenic dogs with multicentric lymphoma. PROCEDURES: Results of a kaolin-activated thromboelastography assay, platelet count, and buccal mucosal bleeding time were evaluated for correlation to clinical bleeding. RESULTS: Maximum amplitude, derived via thromboelastography, was the only hemostatic variable with significant correlation to clinical bleeding. Buccal mucosal bleeding time had a high sensitivity but poor specificity for identifying dogs with clinical bleeding. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with buccal mucosal bleeding time and platelet count, thromboelastography was more reliable at identifying thrombocytopenic dogs with a low risk of bleeding and could be considered to help guide the use of transfusion products in dogs undergoing TBI and BMT.

Safety of contrast-enhanced ultrasonography in dogs and cats: 488 cases (2002-2011).

OBJECTIVE: To determine the incidence of adverse events within 24 hours after contrast-enhanced ultrasonography (CEUS) in dogs and cats and compare the risk of death within 24 hours after imaging for animals that underwent ultrasonography with and without injection of a contrast agent. DESIGN: Retrospective case-control study. ANIMALS: 750 animals (411 case dogs, 238 control dogs, 77 case cats, and 24 control cats). PROCEDURES: At 11 institutions, medical records were reviewed of dogs and cats that had CEUS performed (cases) as were medical records of dogs and cats with clinical signs similar to those of case animals that had ultrasonography performed without injection of a contrast agent (controls). Information regarding signalment; preexisting disease; type, dose, and administration route of contrast agent used; immediate (within 1 hour after CEUS) and delayed (> 1 and ≤ 24 hours after CEUS) adverse events; and occurrence and cause of death (when available) was extracted from each medical record. Risk of death within 24 hours after ultrasonography was compared between case and control animals. RESULTS: Of the 411 case dogs, 3 had immediate adverse events (vomiting or syncope) and 1 had a delayed adverse event (vomiting). No adverse events were recorded for case cats. Twenty-three of 357 (6.4%) clinically ill case animals and 14 of 262 (5.3%) clinically ill control animals died within 24 hours after ultrasonography; risk of death did not differ between cases and controls. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that CEUS was safe in dogs and cats.