Medical management of pneumoperitoneum, gastric pneumatosis, and hepatic venous gas secondary to 3% hydrogen peroxide toxicity in a dog.

OBJECTIVE: To describe the medical management and outcome of a dog suffering severe hydrogen peroxide toxicity. CASE SUMMARY: A 3-year-old neutered female Bichon Frise was presented to an emergency and referral practice after ingestion of 10-20 mL/kg 3% hydrogen peroxide. On presentation, the dog was obtunded, was tachypneic, and had severe gastric tympany. Abdominal radiographs revealed pneumoperitoneum, gastric pneumatosis, and hepatic venous gas. The dog was managed conservatively with supportive care and oxygen therapy. Repeat radiographs 6 hours later showed complete resolution of all gas inclusions. While hospitalized, the dog developed severe hematemesis, and abdominal ultrasound revealed severe gastric wall thickening. Subsequent endoscopy confirmed severe gastric mucosal necrosis without evidence of deeper ulceration and relatively mild petechiation of the esophagus. The dog was ultimately discharged after 5 days of hospitalization and continued to do well at home. Recheck ultrasound 5 weeks postdischarge showed normal gastric wall appearance. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first reported case of pneumoperitoneum secondary to hydrogen peroxide toxicity and the first description of the clinical course of severe toxicity in dogs.

Repeatability of Three-Dimensional Computed Tomographic Volumetric Measurement of Lumbosacral Intervertebral Foramina in German Shepherd Dogs.

OBJECTIVES: This article determines the repeatability of a recently reported method of volumetric measurement of the lateral intervertebral neurovascular foramina at the lumbosacral junction in German shepherd dogs. MATERIALS AND METHODS: Batch files including the intervertebral neurovascular foramina were derived from previously obtained computed tomography studies of the extended lumbosacral junction of 20 German shepherd dogs and converted into volume datasets. Three observers independently performed five measurements of the left and right lumbosacral intervertebral neurovascular foramina in each dog, using an Extended Brilliance Workstation (Phillips, The Netherlands) to generate a volume of the lumbosacral intervertebral foramina in cubic millimetres, as described by Worth and colleagues in 2017. The inter-observer repeatability of the mean of the five-volume measurements (40 foramina) was assessed using the Bland-Altman limits of agreement method. One observer, blinded to the previous measurements, repeated the volumetric analysis on 20 lumbosacral intervertebral foramina for an assessment of intra-observer repeatability using the same statistical methods. RESULTS: This method of volumetric analysis showed good intra- and inter-observer repeatability with 95% of paired comparisons falling within two standard deviations of the mean difference between them. CLINICAL SIGNIFICANCE: This method of measuring the volume of the lumbosacral intervertebral neurovascular foramina is repeatedly reliable and may be a useful tool when testing the effects of motion and disease on the lumbosacral junction, and could help guide surgical intervention when foraminal narrowing is implicated in the clinical signs.