Hypoglycemia associated with oleander toxicity in a dog.

Oleander poisoning typically results in cardiac arrhythmias, hyperkalemia, and gastrointestinal irritation, and can be fatal. Oleander extracts have also been studied experimentally as hypoglycemic agents. Here, we describe a dog with confirmed oleander toxicosis presenting with classical symptoms and also hypoglycemia. After excluding other likely causes of hypoglycemia, the finding was attributed to oleander toxicosis, which has not been previously reported in dogs. A 7-year-old female spayed Maltese was presented to the emergency service after ingesting oleander leaves. Toxicosis was confirmed by measurement of digoxin using a competitive binding immunoassay, patient level 0.7 ng/mL (0.9 nmol/L) 24-h post-ingestion. Clinical symptoms included vomiting, cardiac arrhythmia, mild hyperkalemia, and hypoglycemia. Treatment was successful with aggressive supportive care, and the dog was discharged from the hospital after 48 h and made a full recovery. This case reviews the presentation and treatment of oleander toxicity but also highlights possible effects of oleander on blood sugar in dogs. Hypoglycemia in this dog, attributed to oleander poisoning, is interesting as it supports experimental research into hypoglycemic properties of oleander extracts.

Pathophysiologic characteristics of hypovolemic shock.

In the late 1800s, while caring for a trauma victim, Warren characterized shock as "a momentary pause in the act of death." A great deal about shock has been discovered since this first description. Dorland's Medical Dictionary defines shock as a condition of profound hemodynamic and metabolic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs. Shock is now being defined at the cellular level as the inadequate delivery of nutrients to the cells of the body. Because oxygen is the only nutrient that cells cannot store in any appreciable quantity, shock is also equivalent to inadequate oxygen delivery (DO2). Although there are many types of shock, this article concentrates on the pathophysiologic characteristics of hypovolemic shock.

Acute respiratory distress.

The keys to differential diagnoses and anatomical localization for causes of acute respiratory distress are based on history and physical examination findings. The specific factors and therapeutic considerations for conditions associated with acute respiratory distress ranging from laryngeal paralysis to diaphragmatic hernia are examined. Additionally, the general approaches and principles to consider regarding oxygen therapy and ventilatory support are discussed.

Use of synthetic prostaglandin E1 (misoprostol) for prevention of aspirin-induced gastroduodenal ulceration in arthritic dogs.

A randomized, double-blind, controlled study was performed with 18 arthritic dogs administered aspirin (25 mg/kg of body weight, PO, q 8 h) and excipient (control group) or aspirin and misoprostol (100 micrograms, PO, q 8 h). Dogs in the misoprostol (n = 10) and control (n = 8) groups were primarily compared by use of sequential gastroduodenoscopy, changes in PCV, and prevalence of clinical signs of gastrointestinal disturbance over a 14-day treatment period. The misoprostol/aspirin-treated group had significantly (P < 0.05) less gastroduodenal hemorrhage and ulceration and a significantly (P < 0.05) lower prevalence of vomiting than did the control group.

Pulmonary thromboembolism in dogs: 47 cases (1986-1987).

Medical records of 47 dogs with pulmonary thromboembolism were reviewed. Middle-aged to older dogs predominated and dyspnea and arterial hypoxemia were consistent clinical findings. Thoracic radiographic findings were variable. Cardiac disease, neoplasia, hyperadrenocorticism, disseminated intravascular coagulation, and sepsis were identified most frequently. Multiple disease processes were identified in 64% of the dogs.

Antibiotic pressure and nosocomial disease.

Nosocomial infection control programs of various types have been implemented in human hospitals since the staphylococcal pandemic of the 1950s. The prevalence of hospital infections is expected to increase in veterinary medicine with the advent of sophisticated invasive monitoring techniques, lengthier patient hospital stays, and the widespread use of antimicrobial agents. In order to monitor and control nosocomial infection outbreaks, the hospital staff must make strategic measures a priority. We propose the establishment of a nosocomial infection control committee, especially at the larger teaching and referral centers, to oversee such activities as hospital and personnel hygiene protocols, patient handling, antisepsis of surgical and critical care instruments, and surveillance. We have described a hospital pharmacy antibiotic restriction policy similar to those used with success in several human hospitals. It is apparent that the careless use of antibiotics adds significantly to the emergence of resistant hospital microflora and predisposes hospitalized patients to nosocomial infections. Judicious use of antibiotics not only helps to curtail such risks and lower health costs but encourages the clinician to fully evaluate his or her therapeutic rationale. As with any new program, continued staff education is the paramount requirement for its success.

Sensitivity and specificity of canine serum total amylase and isoamylase activity determinations.

Serum isoamylases were determined prospectively in dogs with pancreatic and extrapancreatic diseases. Mean serum isoamylase determinations were significantly different (p less than 0.05) between normal dogs and dogs with pancreatitis and exocrine pancreatic insufficiency. The sensitivity of serum isoamylase determination exceeded that of total amylase activity for the diagnosis of pancreatitis. Serum isoamylase determinations were less influenced by extrapancreatic diseases compared to total amylase activity when used in the diagnosis of pancreatic disease. Neither serum isoamylase determination nor total amylase activity had adequate sensitivity to support their use in the diagnosis of exocrine pancreatic insufficiency. There were significant (p less than 0.05) linear correlations between isoamylase determinations, total amylase activity, and trypsin-like immunoreactivity concentration.

Hemophilia A in a female dog.

Hemophilia A was diagnosed in a mixed-breed female dog with an acute bleeding disorder. Coagulation factor analysis was used to determine low factor VII-coagulant activity in the dog. Hemophilia A is an X chromosome-linked recessive trait that has not been reported as a cause of disease in female dogs.

Platelet function in experimentally induced pancreatitis in the dog.

Evidence suggests that changes in prostaglandins and disseminated intravascular coagulation accompany pancreatitis. Both may induce changes in platelet function. We wished to determine if experimentally induced pancreatitis in the dog was associated with altered platelet number and function, and whether there were concomitant changes in prostaglandins. Evidence for disseminated intravascular coagulation in the dogs with pancreatitis were red blood cell fragmentation, increased platelet turnover indicated by macro-platelets and the transient presence of fibrin degradation products in urine. There were no significant changes in platelet count. The platelets from dogs with pancreatitis showed a functional defect characterized by significantly decreased aggregation in response to adenosine diphosphate, arachidonic acid, and collagen. Release of adenosine triphosphate from platelets was reduced in collagen-stimulated aggregation. There were no changes in the plasma concentrations of thromboxane B2, 6-Keto-PGF1a, and PGE2. This defect may have been due to the generation of fibrin degradation products and platelet "exhaustion".

Squamous cell carcinoma of the esophagus in an Amazon parrot.

Squamous cell carcinoma of the distal portion of the esophagus was diagnosed, through use of contrast radiography and necropsy, in a 30-year-old Amazon parrot. The clinical signs were collapse, opisthotonos, and torticollis following feeding.

Effects of xylazine administration on serum amylase, pancreas-specific isoamylase and pancreatic polypeptide in normal dogs.

Changes in serum total amylase, pancreas-specific isoamylase and pancreatic polypeptide activities were measured in six dogs following multiple intramuscular injections of xylazine at 0.5 mg/kg of body weight. The activities of those analytes did not change over 24 hours of study.

Focal granulomatous meningoencephalomyelitis in a pup.

Granulomatous meningoencephalomyelitis (GME) was diagnosed in an 8-month-old Maltese with signs of CNS disease. Serum immunoglobulin (Ig) G concentration was decreased, and CSF analysis revealed high concentrations of mononuclear WBC and IgG. Initial improvement of the pup's signs in association with prednisolone treatment and postmortem examination of CNS tissues confirmed GME. Granulomatous meningoencephalomyelitis occurs rarely in young dogs and the abnormal Ig concentrations in this pup's serum and CSF suggest that immune responses may have a role in the cause and/or pathogenesis of GME.

Suspected immune-mediated megakaryocytic hypoplasia or aplasia in a dog.

Megakaryocytic hypoplasia or aplasia causing thrombocytopenia was diagnosed in a 3-year-old Miniature Poodle with scleral hemorrhage, melena, ecchymoses, and blood-loss anemia. Immunosuppressive, cytotoxic, and lithium carbonate therapy resulted in successful correction of the dog's disease. It is important to recognize megakaryocytic hypoplasia or aplasia as the cause of thrombocytopenia, since the response to therapy will be slower when there is stem cell injury.

Serum pancreatic polypeptide and amylase concentrations in dogs with experimentally induced acute pancreatitis.

Serum concentrations of immunoreactive pancreatic polypeptide (IPP) were measured serially for 7 days after experimental induction of acute hemorrhagic pancreatitis in dogs by infusion of oleic acid into the pancreatic duct. The mean serum IPP concentrations in dogs with pancreatitis were increased significantly (P = 0.013) for 96 hours after induction of pancreatitis. Providing food at 108 hours resulted in significant increases (P = 0.032) in mean serum IPP concentrations in sham-operated control dogs compared with dogs with induced pancreatitis. This was attributed to cephalic-phase release of IPP due to a conditioned response that resulted from feeding immediately after each blood sampling. Mean serum IPP concentrations returned to base line more quickly than did mean serum amylase concentrations in dogs with pancreatitis.

Serum amylase and isoamylases and their origins in healthy dogs and dogs with experimentally induced acute pancreatitis.

Agarose-gel electrophoresis was used to study isoamylases in tissues and sera of healthy dogs and the sera of dogs with experimentally induced acute pancreatitis. Three or 4 isoamylases were found in the serum of healthy dogs; they were numbered 1 to 4 with respect to their degree of anodal migration. Peak 4 isoamylase, the slowest migrating (most cathodal), was the major isoamylase fraction in sera and tissues of healthy dogs. Peak 3 was identified as a pancreas-specific isoamylase. Absolute total serum amylase and total isoamylase concentrations increased significantly in dogs with pancreatitis compared with values for control dogs (sham-operated). The relative increase in peak 3 isoamylase was greater than that seen with total amylase or the other isoamylases. The decrease in total serum amylase and isoamylase concentrations paralleled each other; however, peak 3 remained proportionally high longer than did total amylase and the other isoamylase fractions. These findings indicate that measurement of peak 3 isoamylase concentrations may be of diagnostic value in dogs with suspected pancreatitis with normoamylasemia and in dogs with extrapancreatic hyperamylasemia.