Incidence of acute haemolysis in cats receiving canine packed red blood cells (xenotransfusions).

OBJECTIVES: The aim of this study was to report the incidence of transfusion reactions in cats, including acute haemolysis (AH), occurring within 24 h of receiving a xenotransfusion. An additional aim was to determine whether cases with AH could be classified as having an acute haemolytic transfusion reaction (AHTR) as per the definition provided by the Association of Veterinary Haematology and Transfusion Medicine's Transfusion Reaction Small Animal Consensus Statement. METHODS: Medical records of cats that received canine packed red blood cells (PRBCs) between July 2018 and September 2020 at a veterinary hospital were reviewed. The incidence of AH, AHTRs, febrile non-haemolytic transfusion reactions (FNHTRs), transfusion-associated circulatory overload and septic transfusion reactions were recorded. RESULTS: The medical records of 53 cats were retrospectively evaluated. Twenty-three (43%) cats had transfusion reactions. Thirteen (25%) cats had AH; however, only four (8%) met the definition of an AHTR. Ten (19%) cats were determined to have FNHTRs. Survival to discharge of cats affected by AH was 50% (25% for cases that met the definition of an AHTR). Survival to discharge of cats not suffering from AHTR was 40%. CONCLUSIONS AND RELEVANCE: This report indicates that a higher proportion of cats undergo AH (25%) when administered canine PRBCs than previously reported, although many could not be classed as having an AHTR due to an apparently adequate packed cell volume rise. Challenges with sourcing feline blood in emergency situations occasionally necessitates the use of xenotransfusion in transfusion medicine. Clinicians should be aware that haemolysis after xenotransfusion can occur within 24 h and that a repeat feline transfusion may be required sooner than anticipated in some cases.

Successful treatment of local anaesthetic toxicity using intralipid 20% emulsion following intrathoracic bupivacaine overdose in a cat.

Case summary: An 8.75-year-old male neutered Burmese cat was referred for treatment of pyothorax. The cat was responsive, cardiovascularly stable and tachypnoeic (40 breaths/min) on arrival. Medical management of pyothorax was initiated, bilateral thoracic drains were placed and thoracic lavage using aliquots of saline 0.9% was performed every 4 h. Regional analgesia was provided using 1 mg/kg of intrapleural bupivacaine divided equally between the left and right hemithoraxes every 6 h. On the second day of hospitalisation, the cat developed hypersalivation, mydriasis and tonic-clonic seizure activity 25 mins after accidental intrapleural administration of a 10 mg/kg bupivacaine overdose. Cardiovascular compromise was also noted; the cat became bradycardic (120 beats/min) and blood pressure decreased to 110 mmHg. Clinical signs resolved after administration of intravenous lipid emulsion (ILE) as an intravenous (IV) bolus (1.5 ml/kg over 5 mins), followed by a continuous rate infusion (0.25 ml/kg/min over 25 mins). Local anaesthetic intrapleural anaesthesia was discontinued. There was recrudescence of clinical signs 10 h post-overdose and repeat ILE 20% infusion was required. The cat was discharged with no ongoing complications. Relevance and novel information: Treatment of IV local anaesthetic systemic toxicity with ILE has been reported in cats. To our knowledge, this is the first reported case of intrapleural bupivacaine overdose with initial response and resolution of clinical signs followed by recrudescence and subsequent successful treatment using ILE.

Rhythm disturbances associated with lidocaine administration in four dogs with supraventricular tachyarrhythmias.

OBJECTIVE: To describe arrhythmias associated with administration of lidocaine in dogs treated for supraventricular tachyarrhythmias. CASE SUMMARIES: Four dogs with recent-onset supraventricular tachyarrhythmias: 3 dogs had atrial fibrillation (AF), and 1 had focal atrial tachycardia (FAT), which was thought to be AF at the time of assessment. The substrate of the supraventricular tachyarrhythmia was considered to be due to primary cardiomyopathy in 1 dog, high vagal tone in 2 dogs, and the change in hemodynamics from heavy sedation in 1 dog. Pharmacological cardioversion using lidocaine was only successful in the 2 dogs with vagally mediated AF. In these 2 cases, lidocaine administration resulted in a paroxysmal atrial flutter that was self-limiting and quickly led to sinus rhythm within 10 seconds in 1 dog but did not change over a 5-minute interval and required additional boluses in another dog. In the latter case, the dog showed severe bradycardia for 17.5 seconds prior to achieving sinus rhythm. The 2 unsuccessful cases both developed ventricular arrhythmias shortly after the lidocaine administration, with 1 case degenerating into ventricular fibrillation and cardiac arrest. NEW OR UNIQUE INFORMATION PROVIDED: Arrhythmias associated with lidocaine should be considered when treating dogs with supraventricular tachyarrhythmia.

Successful management of suspected acorn (Quercus petraea) toxicity in a dog.

A 7-year-old neutered male Labrador retriever dog was referred to a tertiary care veterinary hospital because of gastrointestinal signs and icterus. The dog developed a hepatopathy and acute kidney injury after ingesting acorns (Quercus petraea) 4 days prior to referral. The dog required hospitalization in an intensive care unit but made a full clinical recovery and was discharged after 6 days. This report documents that dogs can be affected by this toxicity and highlights the need for veterinarians to consider acorns as a potential cause of acute hepatotoxicity and renal injury. To the authors' knowledge, this is the first reported case of acorn toxicity in a dog.

Prise en charge réussie d'une toxicité présumée par des glands ( Quercus petraea ) chez un chien. Un chien labrador retriever mâle stérilisé âgé de 7 ans a été référé à un hôpital vétérinaire de soins tertiaires en raison de signes gastro-intestinaux et d'ictère. Le chien a développé une hépatopathie et une lésion rénale aiguë après avoir ingéré des glands (Quercus petraea) 4 jours avant d'être référé. Le chien a dû être hospitalisé dans une unité de soins intensifs mais s'est complètement rétabli et a obtenu son congé après 6 jours. Ce rapport documente que les chiens peuvent être affectés par cette toxicité et souligne la nécessité pour les vétérinaires de considérer les glands comme une cause potentielle d'hépatotoxicité aiguë et de lésions rénales. À la connaissance des auteurs, il s'agit du premier cas signalé de toxicité par des glands chez un chien.(Traduit par Dr Serge Messier).

Waterhouse-Friderichsen syndrome in a cat with Klebsiella spp. infection.

OBJECTIVE: To describe a case of Waterhouse-Friderichsen syndrome of adrenocortical failure in a cat with Klebsiella spp. infection. CASE SUMMARY: A 12-year-old male neutered domestic short-haired cat was referred for respiratory failure requiring mechanical ventilation. The cat remained comatose despite successful weaning from the ventilator and developed a Klebsiella pneumoniae pneumonia. On day 4 of hospitalization, the cat acutely deteriorated with profound hypotension, azotemia, and hyperkalemia, which rapidly progressed to cardiac arrest. Necropsy findings revealed massive adrenal hemorrhage and intralesional bacteria, termed Waterhouse-Friderichsen syndrome. Waterhouse-Friderichsen syndrome was suspected to have been the cause of acquired adrenocortical insufficiency and sudden death of the cat. NEW OR UNIQUE INFORMATION: To the authors' knowledge, this is the first report of sepsis causing Waterhouse-Friderichsen syndrome in a veterinary species.