Oxidative red blood cell damage associated with propofol and intravenous lipid emulsion therapy in a dog treated for 5-fluorouracil toxicosis.

OBJECTIVE: To describe the first documented case of oxidant-induced anemia in a dog associated with propofol and IV lipid emulsion (IVLE) treatment for 5-fluorouracil (5-FU) toxicosis. CASE SUMMARY: A 2-year-old male intact mixed breed dog was presented for evaluation after ingestion of 5% 5-FU cream. Refractory reactive seizures rapidly developed, and treatment with benzodiazepines, propofol, levetiracetam, and IVLE was initiated. The dog was euthanized due to development of marked oxidant-induced anemia. NEW INFORMATION PROVIDED: This report documents the first instance of oxidant-induced anemia in the dog, associated with propofol and IVLE infusion therapy prescribed for treatment of 5-FU toxicosis.

Neuromuscular signs associated with acute hypophosphatemia in a dog.

The purpose of this report was to describe the successful recognition and management of neuromuscular dysfunction secondary to severe, acute hypophosphatemia in an adult dog with a 2 day history of vomiting, anorexia, and abdominal pain. Radiographs were suggestive of a foreign body obstruction, and surgery was recommended. Resection and anastomosis of the distal duodenum and proximal jejunum was performed. The dog recovered uneventfully, but approximately 36 hr postoperatively, he was found to have significant weakness and muscle tremors that were accompanied by hyperthermia. The only significant abnormality on a serum biochemical profile was a phosphorous level of 0.26 mmol/L. Within 6 hr of initiating phosphorous supplementation, the patient fully recovered and had no residual signs of neuromuscular dysfunction. Signs of neurologic dysfunction secondary to hypophosphatemia are commonly recognized in human patients. Reports of patients with severe muscle weakness, some of which necessitate ventilation due to weakening of muscles of respiration, are common throughout the literature. Less commonly, tremors are noted. This is the first known report of neuromuscular signs recognized and rapidly corrected in a dog. Although it is likely to be uncommon, hypophosphatemia should be recognized as a differential diagnosis in patients with tremors and/or muscle weakness.

Thrombotic complications associated with atrial fibrillation in three dogs.

Atrial fibrillation (AF) is the most common chronic pathologic arrhythmia in dogs, and whereas thromboembolism is a common complication of AF in humans, this complication has not been previously reported in dogs. This report describes thrombotic complications associated with AF in three dogs. A spherical left atrial mass consistent with a thrombus was identified in two dogs during echocardiographic examination. A third dog experienced arterial thromboembolism confirmed with ultrasound and postmortem examination. These cases provide a unique antemortem description of intra-atrial thrombus formation and cardioembolic disease associated with AF in dogs, and raise awareness of the importance of thorough echocardiographic evaluation of the atria for thrombus prior to pharmacologic cardioversion or direct current cardioversion.

Effects of morphine and fentanyl constant rate infusion on urine output in healthy and traumatized dogs.

OBJECTIVE: To determine whether healthy and traumatized dogs receiving a constant rate infusion (CRI) of either morphine or fentanyl have decreased urine production. STUDY DESIGN: Prospective randomized controlled study. ANIMAL POPULATION: Eighteen privately owned previously healthy dogs that had undergone trauma were included. Twenty-three privately owned healthy dogs were used as the controls. METHODS: Traumatized dogs were randomized into one of two groups. Group Tmorphine received a CRI of morphine (0.12 mg kg(-1) hour(-1)) and group Tfentanyl received a CRI of fentanyl (3 microg kg(-1) hour(-1)) both administered in lactated Ringer's solution (LRS) at a rate of 60 mL kg(-1) day(-1). Control healthy dogs were randomized into one of three groups. The LRS control group (CLRS) (n = 8) received LRS at a rate of 60 mL kg(-1) day(-1). Group Cmorphine (n = 8) and group Cfentanyl (n = 7) received the same infusions as Tmorphine and Tfentanyl, respectively. Collected data were identical for all groups and consisted of measuring total fluid administered, urine output, and urine specific gravity (USG) for a 24-hour period. An analysis of variance (ANOVA) was used for statistical analysis and a p < 0.05 was considered statistically significant. RESULTS: Urine output was significantly decreased (p < 0.05) in all groups compared with the LRS control group. The end mean USG was significantly lower (p = 0.003) in the LRS control group compared with all other groups. CONCLUSIONS: There was a decrease in urine output with a CRI of morphine or fentanyl in both healthy and traumatized dogs. CLINICAL RELEVANCE: Decreased urine output caused by an opioid effect might lead to improper assessments of renal function and urine production.

Blood gas analysis.

Evaluation of both arterial and central venous blood can be valuable in monitoring the critically ill veterinary patient. The traditional approach, which concentrates on arterial blood analysis only, may miss important aspects of oxygen delivery to tissues, especially in patients with poor perfusion. The advances that have resulted in affordable bedside blood gas analyzers have created a clinical situation in which blood gas analysis should be an integral part of critical care monitoring. Following basic principles of interpretation, blood gas analysis, which has traditionally been viewed as a complex method of monitoring, should become more useful. Assessing both the arterial and central venous samples should result in more efficient and higher quality care for veterinary patients.