Case report: Treatment of joint supplement toxicity resulting in acidemia, hyperglycemia, electrolyte derangements, and multiple organ dysfunction.

Objective: This case report describes a successful outcome in the treatment of a patient with joint supplement toxicity, which resulted in seizures, severe acidemia, hyperglycemia, hypernatremia, and multiple organ dysfunction. Previous case reports have been published, but this patient presented with different clinical signs and had additional biochemical abnormalities. Treatment modalities varied in this case report, and the patient was discharged sooner than those mentioned in previous reports. Case summary: A 9-year-old spayed female Maltese mix was presented to a specialty hospital for joint supplement toxicity. Presenting clinical signs were vomiting and seizures. Primary biochemical abnormalities consisted of hypernatremia, hyperglycemia, acidemia, azotemia, and elevated liver enzymes. Treatment involved lowering the sodium quickly given the neurologic signs on presentation. Other treatment modalities consisted of sodium bicarbonate, insulin, and liver protectants. The patient responded quickly and was discharged after 3 days in the hospital. New or unique information provided: This case report is different in that the patient was having seizures and was also hyperglycemic, in addition to the expected abnormalities of hypernatremia, acidemia, and multiple organ dysfunction. It also differs from prior reports in that the treatment of hypernatremia was managed as an acute process. This case report describes differing clinical signs, biochemical abnormalities, and treatment modalities that may have led to the discharge from the hospital in a shorter time.

Glucagon therapy in canines with an insulinoma: A retrospective descriptive study of 11 dogs.

Canine insulinomas are uncommon neoplasms, which often result in refractory hypoglycemia. Glucagon is one readily available treatment for insulin-induced hypoglycemia. The primary objective of this study was to evaluate blood glucose trends and outcome (survival to discharge versus death or euthanasia) for dogs with insulinoma that were treated with glucagon. Secondary objectives included the description and influence of other variables such as abnormalities on diagnostic tests, physical examination abnormalities, concurrent administration of dextrose and/or glucocorticoids, and seizures. The median glucagon constant rate infusion dose was significantly higher for the non-survivors than for survivors. No other correlation was found between any of the independent variables evaluated when comparing blood glucose trends, length of hospitalization, and outcome. The main conclusion of the study is that glucagon therapy in insulinomas is an effective treatment to manage hypoglycemia.

Thérapie au glucagon de chiens avec un insulinome: étude rétrospective descriptive de 11 chiens. Les insulinomes canins sont des néoplasmes peu fréquents, qui résultent souvent en hypoglycémie réfractaire. Le glucagon est un traitement facilement disponible pour l'hypoglycémie induite par l'insuline. L'objectif primaire de la présente étude était d'évaluer les tendances du glucose sanguin et l'issu (survie jusqu'au congé versus décès ou euthanasie) de chiens avec insulinome qui furent traités avec du glucagon. Les objectifs secondaires incluaient la description et l'influence d'autres variables telles que des anomalies lors des tests diagnostiques et des examens physiques, l'administration concomitante de dextrose et/ou de glucocorticoïdes, et des convulsions. La dose médiane de perfusion à taux constant de glucagon était significativement plus élevée pour les non-survivants que pour les survivants. Aucune autre corrélation ne fut trouvée entre l'une ou l'autre des variables indépendantes évaluées lors de comparaisons avec les tendances du glucose sanguin, la durée de l'hospitalisation, et l'issu. La principale conclusion de cette étude est que la thérapie au glucagon lors d'insulinomes est un traitement efficace pour gérer l'hypoglycémie.(Traduit par Dr Serge Messier).

Successful use of digoxin-specific immune Fab in the treatment of severe Nerium oleander toxicosis in a dog.

OBJECTIVE: To describe a case in which digoxin-specific immune Fab was used successfully in a dog with severe oleander toxicosis secondary to ingesting plant material. CASE SUMMARY: A 6-year-old intact female Rhodesian Ridgeback mixed breed dog was presented for severe oleander toxicosis and was refractory to all antiarrhythmic therapies and supportive care. Digoxin-specific immune Fab was successful in treating this dog. The dog recovered but suffered ischemic injuries, the long-term effects of which are unknown. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the successful use of digoxin-specific immune Fab in the treatment of oleander toxicosis in a dog, which has not previously been published in veterinary literature. Oleander poisoning can be associated with permanent cardiac arrhythmias due to the ischemic damage.

A case of factor X deficiency in a Chihuahua dog.

A juvenile Chihuahua dog developed hemoperitoneum after routine ovariohysterectomy. She was managed with packed red blood cell and fresh frozen plasma transfusions as well as an exploratory laparotomy to verify ligature sites. No recurrence of hemorrhage occurred. Factor X deficiency was diagnosed and confirmed with repeat analysis including during times of health.

Cas de carence du facteur X chez une chienne Chihuahua. Une jeune chienne Chihuahua a développé un hémopéritoine après une ovariohystérectomie de routine. Elle a été gérée à l'aide de concentrés de globules rouges et de transfusions de plasma frais congelé ainsi que d'une laparotomie exploratoire pour vérifier les sites de ligature. Aucune récurrence d'hémorragie ne s'est produite. La carence du facteur X a été diagnostiquée et confirmée par une analyse répétée durant des périodes de santé.(Traduit par Isabelle Vallières).

Evaluation of fresh frozen plasma administration in dogs with pancreatitis: 77 cases (1995-2005).

OBJECTIVE: Compare outcome of dogs that did and did not receive fresh frozen plasma (FFP) for treatment of pancreatitis. DESIGN: Retrospective case series between 1995 and 2005. SETTING: University referral hospital. ANIMALS: Seventy-four dogs were enrolled with a total of 77 cases as 2 dogs had repeat episodes of pancreatitis. Diagnosis of pancreatitis was based on clinical signs, physical examination, and abdominal ultrasonographic examination. INTERVENTIONS: The medical database was searched for dogs with a diagnosis of pancreatitis. Information collected included signalment, vital signs, CBC, use of FFP, length of stay, use of antimicrobials and supplemental nutrition, surgical intervention, preexisting illness, evidence of a coagulopathy and outcome. Outcome was compared between those patients that did and did not receive FFP. MEASUREMENTS AND MAIN RESULTS: Fifty-nine dogs survived to discharge. Two dogs with repeat pancreatitis survived to discharge after each episode. Thirteen dogs died and 2 were euthanized. FFP was administered to 20 dogs. Two dogs that were hospitalized for repeat pancreatitis did not receive FFP. Seven of 20 (35%) cases that received plasma died or were euthanized compared with 6 of 57 (12%) cases that did not receive plasma. Plasma administration was significantly related to outcome (P<0.001). Severity of illness scores were difficult to assign, however, dogs meeting criteria for systemic inflammatory response syndrome were not more likely to receive FFP. Other therapies included supplemental nutrition, antimicrobials, and surgical intervention, which did not affect outcome. CONCLUSIONS: Mortality rate for those dogs receiving plasma was higher than those that did not. Severity of illness scores were difficult to assign; however, preexisting illness, evidence of systemic inflammatory response syndrome, and presence of a coagulopathy were not significantly different between the groups that did and did not receive FFP. No benefit for administration of FFP was noted. Additional investigation should be performed to confirm this result.