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The article describes the clinical signs, laboratory findings, including consecutive serum butyryl-cholinesterase (sBuChE) activity measurements, treatment and outcome of a dog diagnosed with intermediate syndrome (IMS) of organophosphate intoxication. A 2-year old neutered female mixed-breed dog was presented with acute cholinergic crisis (ACC) due to anticholinesterase intoxication. sBuChE activity upon admission was markedly low [382 U/L; reference interval, (RI) 2,660-11,00 U/L]. The dog was treated with atropine sulfate, diphenhydramine, 2-pyridine aldoxime-methyl-chloride and supportive care. The muscarinic signs resolved, but 24 hrs post-admission the dog sustained a grand-mal seizure and developed quadriparalysis and severe weakness, including respiratory muscle weakness, necessitating positive pressure mechanical ventilation (PPMV). The dog recovered slowly, presenting signs of ventroflexion, front limb muscle weakness and absent swallow reflex of several days, which gradually improved. During ventilation sBuChE activity was 2735 U/L, and later on during hospitalization, remained mildly less than the RI. The dog was discharged on day 8 of hospitalization. IMS has previously been diagnosed based on the history of a previous case of ACC, with deterioration to classic IMS clinical signs, requiring PPMV. Interestingly, sBuChE was within or mildly below RI during the course of the IMS, which highlighted the possibility of a diagnosis of IMS in face of normal sBuChE activity. The authors conclude that IMS should be suspected in dogs showing cranial nerve, respiratory, neck and proximal limb muscle weakness or paralysis, especially in face of prior ACC, but even in the absence of preceding ACC signs. [ABSTRACT FROM AUTHOR]

Cats exposed to permethrins, which are present in ectoparasite control products intended for dogs, may develop signs of toxicity. This retrospective study describes the clinical course of permethrin toxicosis in cats, and examines if methocarbamol treatment had improved its morbidity and outcome. The study included 61cats diagnosed with permethrin toxicosis presented to the Hebrew University Veterinary Teaching Hospital. In most cases (89%), the owners have inadvertently applied anti-flea spot-on products designated for dogs to their cats, resulting in toxicosis-related clinical signs. These most common signs included tremors and twitching (90%), hypothermia (39%), seizures (30%), tachypnea (25%), abnormal mentation (18%), ataxia (16%), ptyalism (11%) and mydriasis (10%). Treatments included whole body bathing (85%), along with supportive care, sedatives and muscle relaxants. Some cats (5%) required general anesthesia. The median hospitalization period was one day (range, 1-9). The survival rate was 100%. Methocarbamol (50-330 mg/kg, slow IV PRN) was administered to 41 cats (67%), which had a shorter (P=0.032) hospitalization period (median, 1 day) compared to that of cats untreated with methocarbamol (2 days). Cats with seizures treated with methocarbamol had a shorter (P=0.08) hospitalization period compared to that of cats untreated with methocarbamol. In conclusion, permethrin toxicosis occurs in cats, mainly by inadvertent application of canine flea insecticide spot-ons. The overall prognosis of such cases, when treated intensively was excellent. Herein, methocarbamol treatment of cats with this toxicosis, in general, as well as particularly in those presenting seizures, decreased their morbidity, as reflected by a shorter hospitalization period. [ABSTRACT FROM AUTHOR]

This report describes a case of severe lactic acidosis associated with a suspected succinic semialdehyde dehydrogenase (SSADH) deficiency in a 5-month-old Chihuahua. The dog was presented for obtundation and "drunk-like" behavior of 1 month duration. Venous blood gas analysis revealed a severe lactic acidosis (blood pH 6.938; reference interval 7.35-7.45; lactate concentration 18.27 mmol/L; reference interval 0.8-2.0 mmol/L). As other causes of encephalopathy and hyperlactatemia were ruled out, an inborn error of lactate metabolism was suspected. Quantitative organic acid analysis showed marked elevations of urine lactic acid, pyruvic acid and gamma-hydroxybutyric acid (or 4-hydroxybutyric acid) concentrations. Activity level of SSADH, measured in the dog's cultured lymphoblasts, was 30% of that recorded in three healthy dogs, suggesting SSADH deficiency. The dog initially responded to treatment, but eventually deteriorated, and was euthanized. Organic acidurias are being increasingly recognized in veterinary medicine; however SSADH deficiency has never been reported in dogs. Early identification of inherited organic aciduria in domestic animals might facilitate prompt, appropriate treatment, and potentially facilitate modelling of corresponding human pathologies. [ABSTRACT FROM AUTHOR]

Natalia Horstmann Risso,1 Cheila Denise Ottonelli Stopiglia,2 Marília Teresa Oliveira,1 Sandra Elisa Haas,2 Tamara Ramos Maciel,2 Natália Reginatto Lazzari,3 Edilson Luis Kelmer,3 Jorge Abrão Pinto Vilela,3 Diego Vilibaldo Beckmann1 1Postgraduate Program in Animal Sciences, Federal University of Pampa (UNIPAMPA), Uruguaiana, Brazil; 2Postgraduate Program in Pharmaceutical Sciences, Federal University of Pampa (UNIPAMPA), Uruguaiana, RS, Brazil; 3Veterinary Medicine Course, Federal University of Pampa (UNIPAMPA), Uruguaiana, BrazilCorrespondence: Diego Vilibaldo BeckmannBR 472 - Km 585, Campus UNIPAMPA-Uruguaiana, Uruguaiana, RS 97501-970, BrazilTel +55 55999725509Fax +55 5539110204Email diegobeckmann@unipampa.edu.brIntroduction: Nanoparticle solutions have been studied to improve antimicrobial effect. The aim of this study was to develop, characterize, and evaluate the in vitro and in vivo antiseptic efficacy of 0.25% aqueous-based chlorhexidine nanoemulsion (NM-Cl 0.25% w/v).Methods: The NM-Cl 0.25% w/v (2.5mg/mL) and free chlorhexidine nanoemulsion (FCN; same composition of NM-Cl without the molecule of chlorhexidine) were synthetized by the spontaneous emulsification method. Characterization analyses of physical and chemical properties were performed. The NM-Cl 0.25% w/v was compared with chlorhexidine 0.5% alcohol base (CS-Cl 0.5%) in vitro studies (microdilution study and kill curve study), and in vivo study (antisepsis of rats dorsum). Kruskal–Wallis test was used between groups and inside the same group, at different sample times and the Mann–Whitney test was performed when difference was detected.Results: The NM-Cl 0.25% w/v presented adequate physicochemical characteristics for a nanoemulsion, revealing a more basic pH than FCN and difference between zeta potential of NM-Cl 0.25% w/v and FCN. The NM-Cl 0.25% w/v and CS-Cl 0.5% solutions were more effective on Gram-positive than on Gram-negative bacteria (p≤ 0.05). NM-Cl 0.25% w/v presented upper antiseptic effect in the microdilution study and residual antiseptic effect was maintained for a longer time when compared to CS-Cl 0.5% (kill curve study). The four-fold (minimal inhibitory concentration) of NM-Cl 0.25% were the formulations with most durable effect within those tested, presenting residual effect until T6 for both bacteria. In the in vivo study, both formulations (NM-Cl 0.25% w/v and CS-Cl 0.5%) had a reduction of the microorganisms in the skin of the rats (p< 0.0001) not revealing any difference between the formulations at different times, showing the antiseptic effect of NM-Cl (p≤ 0.05).Conclusion: Both in vitro and in vivo experiments demonstrated that NM-Cl showed promising future as an antiseptic for cutaneous microbiota.Keywords: antisepsis, cutaneous microbiota, nanoformulation, nanotechnology

Neste artigo apresenta-se um estudo de caso referente à Superintendência Regional de Ensino Diamantina/MG e sua apropriação do Programa de Capacitação a Distância para Gestores Escolares (PROGESTÃO). Foi verificado pela pesquisa com os cursistas, tutores e servidores desta superintendência que, ao terminarem o curso, estes não agregavam o conteúdo ministrado às suas práticas gestoras. A proposta foi criar, ao final do programa, certificação e responsabilização aos cursistas.

The use of antifibrinolytic drugs in human patients with bleeding disorders is common and effective in reducing redundant the number of blood products per patient. The objective of this study was to evaluate the safety of tranexamic acid (TXA) and its efficacy in decreasing blood component requirements in dogs with bleeding disorders. In a retrospective study, dogs with bleeding disorders treated intravenously (IV) with TXA for a median period of 2 days (range 1-21) at a mean (± standard deviation) dose of 8.6 ± 2.3 mg/kg with or without blood products (n=68) were compared with dogs with bleeding disorders that were not treated with TXA but were treated only with blood products (n=62). No TXA-related adverse effects were noted, with the exception of vomiting, documented in 2 dogs (3%) immediately following administration. When the median number of blood products and their dose per dog were compared between the groups, TXA-treated dogs received significantly less units of blood products and a lower blood component dose (P < 0.001). However, when this analysis included only dogs that received blood products in the study group there were no significant differences. It was concluded that intravenous administration of TXA in bleeding dogs at the recommended human dose is safe and that additional studies are warranted to further determine the efficacy of TXA in reducing blood component requirements in bleeding dogs. [ABSTRACT FROM AUTHOR]

Electrocardiographic changes (ECG) are a common complication of acute pancreatitis (AP), although their etiology and pathogenesis remain unclear. Commonly reported electrocardiographic changes in human beings with AP include non-specific changes of the ventricular repolarisation process, and various kinds of conduction and/or rhythm anomalies. The association between AP and ECG abnormalities has not been investigated in the veterinary literature. We report a case of a previously healthy Japanese Chin dog with acute pancreatitis demonstrating severe bradycardia, ST-segment depression, atrial standstill, 2nd and then 3rd degree atrioventricular block, all of which were resolved once the pancreatitis ameliorated. We conclude that due to the transient nature of such ECG findings in patients with AP, as long as haemodynamics remain or can be maintained stable, decisions regarding permanent pacemaker therapy or euthanasia should be made with caution. [ABSTRACT FROM AUTHOR]

A ten year old castrated male domestic short haired cat was presented to the Veterinary teaching hospital of the Koret School of Veterinary Medicine with a history of relapsing icterus, anemia, and lethargy. A diagnosis of disseminated toxoplasmosis (Toxoplasma gondii) was made on histopathological examination and confirmed by immunohistochemical studies. The immune status of this cat was unknown and therefore it could not be concluded that the disseminated infection was due to immunodeficiency. The presence of a cholangioma in the liver of this cat was regarded as an incidental finding. [ABSTRACT FROM AUTHOR]

An adult spayed female Boxer was presented with complaints of collapse, disorientation, and hyperthermia (rectal temperature 41 °C) following a prolonged exposure to an environmental heat stress. Clinicopathological abnormalities at presentation included increased creatine kinase activity, hypoglycemia (57.9 mg/dL, reference interval [RI] 64-123 mg/dL), mild prolongation of coagulation times, and rubricytosis. The dog was diagnosed with heatstroke, complicated by presence of hypoglycemia. The dog was hospitalized, treated, and improved over the following 48 hours, however the severe hypoglycemia persisted (34-51 mg/ dL) despite therapy. Thoracic radiographs and abdominal ultrasound were unremarkable. Serum insulin concentration was high (31 μIU/mL, RI 5-20 μIU/mL), in the face of hypoglycemia (43 mg/dL). The dog was therefore tentatively diagnosed with an insulin-secreting tumor, which caused hypoglycemia. It was considered that this might have precipitated the heatstroke, possibly due to the persistent hypoglycemia, possible seizures, as a result of the heat stress. Alternatively, environmental heatstroke, known to induce hypoglycemia, may have aggravated the dog's insulinoma-induced hypoglycemia. The presence of heatstroke in this case is supported by the history of prolonged exposure to heat stress, presence of hyperthermia, prolonged coagulation times and peripheral rubricytosis. Insulinoma should be included as a differential diagnosis in dogs presenting with heatstroke and persistent, unresponsive hypoglycemia. [ABSTRACT FROM AUTHOR]

The objective of this study was to characterize the clinical, laboratory and echocardiographic findings of dogs with cardiac tamponade and their prognostic value. Medical records of 108 dogs undergoing pericardiocentesis were reviewed. The median survival time was 44 days (range 0.5 - 1455). Males were over-represented (P = 0.03). Mixed-breed dogs were under-represented (P = 0.003), while Golden retrievers were over-represented (P = 0.01). The latter were significantly (P = 0.004) more likely to have "echo-negative" cardiac tamponade. Factors significantly (P = 0.02) and positively associated with 30 day survival included an ability to ambulate or ascites at presentation, presentation to and pericardiocentesis performed by the Cardiology Service, normal femoral pulse intensity, longer inter-pericardiocentesis intervals and undergoing pericardectomy. Thirty-day survival and complication rates were not associated with the pericardiocentesis approach (i.e., choosing the right vs. the left hemithorax, P = 0.17). The pericardial fluid volume drained correlated positively and significantly (r = 0.77; P < 0.0001) with the echocardiographically measured apexto- pericardial distance: on average, for every 1 cm measured, 125 mL of pericardial fluid was drained. Dogs presenting with cardiac tamponade had a poor long-term prognosis; however, Golden retrievers, non-pale, ambulatory and ascetic dogs, dogs selected for pericardectomy and those with longer inter-centesis intervals had a longer median survival time. The hemithorax from which pericardiocentesis was performed did not affect survival or complication rates. [ABSTRACT FROM AUTHOR]

This report describes a case of a 7-year spayed female Vizsla dog, presented to the The Hebrew University Koret School of Veterinary Medicine (HUVTH) and diagnosed with infectious endocarditis due to Erysipelothrix rhusiopathiae infection based on echocardiology, blood culture and putative secondary immune mediated hemolytic anemia and thrombocytopenia (Evans syndrome), and secondary left iliac artery thromboembolism. The putative exposure route to the bacterium, the prognosis and secondary complications are discussed, in light of a literature review. [ABSTRACT FROM AUTHOR]

Horses are highly sensitive to endotoxemia and its complications. During systemic inflammatory response syndromes such as seen in colic, acute phase proteins and cytokines enter into the circulation. In this study, gene expression of tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6) and interleukin 8 (IL-8) were quantified using real-time PCR (RT-PCR) in 15 adult horses undergoing colic surgery at different points of time (0, 6, 12, 24, 48 hours), before and after surgical intervention. Gene expression of TNF-α was down-regulated while gene expression of IL-1β, IL-6 and IL-8 were up-regulated in the first 12 hours. This study shows that RT-PCR is reliable and sensitive method for detection of the changes in cytokines serum levels in horses with colic. This study demonstrated the presence of inflammatory processes mediated by cytokines upon admission of horses for medical treatment before surgical intervention. [ABSTRACT FROM AUTHOR]

A 6-year-old male neutered cat was referred with a 3-month history of lethargy, chronic constipation, intermittent vomiting, inappetence, progressive weight loss, dysphagia and polyuria. Previous treatment with intravenous fluids, antimicrobials, glucocorticoids, laxatives and appetite stimulants [megestrol-acetate (MgAc)] resulted in partial response. During the treatment course, the cat developed diabetes mellitus (DM). Physical examination revealed obtundation, cachexia, dehydration, pale mucosal membranes, generalised muscle atrophy, sialoadenomegaly and thoracolumbar pain as well as pain upon opening the mouth. Serum electrolyte analysis showed severe hypochloridaemia, hyperkalaemia and hyponatraemia, with a sodium to potassium (Na:K) ratio of 19.6. As the cat had been chronically treated with prednisolone at presentation cortisol concentration could not be reliably interpreted. Therefore, ACTH-stimulation was performed and pre- and post-ACTH aldosterone concentrations were measured, and were consistent with hypoadrenocorticism. Fludrocortisone treatment was initiated, and the clinical signs and electrolyte imbalances resolved; however DM persisted. Feline hypoadrenocorticism is rare, and unlike dogs, cats with this disease may present with dysphagia as a major clinical sign. Although MgAc may induce glucocorticoid deficiency and DM in cats, it has not been reported to induce mineralocorticoid deficiency with subsequent electrolyte imbalance, and its role in the pathogenesis of hypoadrenocorticism in this cat is questionable. [ABSTRACT FROM AUTHOR]

The article describes the case of the 13-year-old mixed breed dog found to have an acute dyspnea disease when presented at the Koret School of Veterinary Medicine, University Teaching Hospital. In the physical examination it was found that the disease was associated with cyanotic and orthopneic with a respiratory rate of 24 breaths per minute. Initial stabilization was supervised and radiographic findings reflect that a bony foreign body located in the pharynx is causing respiratory obstruction.

Background: Thromboelastometry (TEM) provides a comprehensive overview of the entire coagulation process and has not been evaluated in heatstroke-induced coagulopathies in dogs., Objectives: To determine the diagnostic and prognostic utility of TEM in dogs with heatstroke., Animals: Forty-two client-owned dogs with heatstroke., Methods: Prospective observational study. Blood samples for intrinsic and extrinsic TEM (INTEM and EXTEM, respectively) were collected at presentation and every 12 to 24 hours for 48 hours. Coagulation phenotype (hypo-, normo-, or hypercoagulable) was defined based on TEM area under the 1st derivative curve (AUC)., Results: Case fatality rate was 31%. Median TEM variables associated with death (P < .05 for all) included longer INTEM clotting time, lower AUC at presentation and at 12 to 24 hours postpresentation (PP), lower INTEM alpha angle, maximum clot firmness, and maximum lysis (ML) at 12 to 24 hours PP, and lower EXTEM ML at 12 to 24 hours PP. Most dogs were normo-coagulable on presentation (66% and 63% on EXTEM and INTEM, respectively), but hypo-coagulable 12 to 24 PP (63% for both EXTEM and INTEM). A hypo-coagulable INTEM phenotype was more frequent at presentation and 12 to 24 PP among nonsurvivors compared to survivors (55% vs 15% and 100% vs 50%, P = .045 and .026, respectively). AKI was more frequent (P = .015) in dogs with hypo-coagulable INTEM tracings at 12 to 24 hours. Disseminated intravascular coagulation was more frequent (P < .05) in dogs with a hypo-coagulable INTEM phenotype and in nonsurvivors at all timepoints., Conclusions and Clinical Relevance: Hypocoagulability, based on INTEM AUC, is predictive of worse prognosis and occurrence of secondary complications., (© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Objective: To describe the incidence, etiology, clinical signs, diagnostics, treatments, and outcome of noniatrogenic traumatic pneumomediastinum (TPM) in dogs and cats., Design: Retrospective study of cases (2005-2022)., Setting: University veterinary teaching hospital., Animals: Fifty-two patients (29 dogs, 23 cats)., Measurements and Main Results: Data collected from the medical records included signalment, physical examination findings, animal trauma triage (ATT) score, clinicopathological data, imaging data, surgical intervention, length of hospitalization, supportive care, complications, and outcome. Most dogs presented with tachycardia and tachypnea, while cats presented with hypothermia and tachypnea. Subcutaneous emphysema, pneumothorax, and dyspnea were the most common clinical signs for both species. The median calculated ATT score was 3.5 in dogs and 4 in cats. The most common radiographic abnormalities other than pneumomediastinum were pneumothorax and lung contusions. The overall mortality rate was 18%, with a significantly higher survival rate in dogs (26/28 dogs [93%], 15/22 cats (68%); P = 0.03). Outcome was unknown in 1 dog and 1 cat. The only significant difference in treatment between survivors and nonsurvivors was the requirement in dogs for positive pressure ventilation. The median hospitalization period was 2 days for both species, with a shorter hospitalization in the nonsurvivors (0.6 vs 2 days, respectively; P = 0.006)., Conclusions: TPM is an infrequent pathology in veterinary medicine and may be seen without an externally obvious injury. The most common causes for TPM in dogs were vehicular trauma and bite wounds, while high-rise syndrome was the most common cause in cats. Most of the cases have concurrent pneumothorax and require thoracocentesis; however, direct intervention to treat TPM is not usually required. The vast majority of cases did not undergo surgery to treat TPM. The prognosis for dogs with TPM was good but was guarded for cats., (© Veterinary Emergency and Critical Care Society 2024.)

Daboia ( Vipera ) palaestinae ( Dp ), accounts for most envenomations in humans and dogs in Israel. In humans envenomed by Dp , serum cholesterol concentration (sChol) is inversely correlated with envenomation severity. This study examined the utility of sChol upon admission in dogs envenomed by Dp as an envenomation severity and outcome marker. Data upon admission, including sChol, were retrospectively collected from the medical records of dogs with proven Dp envenomation. The study included 415 dogs. The mortality rate was 11%. The heart rate upon admission was higher in non-survivors than in survivors. Signs of bleeding or hematoma and circulatory shock signs were more frequent among non-survivors compared to survivors. sChol, the platelet count, and serum albumin concentration (sAlb) were lower, while serum creatinine concentration was higher among non-survivors. sChol and sAlb were moderately, positively, and significantly correlated. sChol was significantly, negatively, albeit weakly, correlated with the length of hospitalization and the heart rate. sChol was lower in dogs admitted >12 h post-envenomation than in those admitted later. In dogs, sChol upon admission is a potential marker of severity and outcome of Dp envenomation. The platelet count, sAlb, and sCreat might also be potential markers.

Objectives: Xenotransfusion is the transfusion of blood from one species to another. With varying availability of allogenic feline blood (AFB) and in emergency conditions, circumstances occur when canine blood is transfused to cats. This study aimed to characterise the indications, effectiveness, limitations, and acute and late transfusion-related adverse effects of canine blood xenotransfusion compared with matched AFB to anaemic cats, and their survival and longer-term outcome., Methods: This retrospective study (2013-2020) examined cats receiving canine blood xenotransfusions or AFB., Results: The study included 311 cats (xenotransfusion [X-group], n = 105; allotransfusion [A-group], n = 206). Xenotransfusion was more frequent among cats sustaining haemorrhage than in those with haemolysis ( P <0.01) or hypoproliferative anaemia ( P <0.001). Financial constraints were the most common reason to elect xenotransfusion (49%). The post-transfusion mean packed cell volume was higher ( P <0.001) in the X-group (22%) compared with the A-group (18%), and also higher ( P <0.001) at 48-96 h post-transfusion (23% vs 18%, respectively). Transfusion-related adverse effects (TRAEs) were more frequent ( P  = 0.001) in the X-group (37.1%) compared with the A-group (19.4%), as were delayed haemolytic transfusion reactions (85% vs 42.5%, respectively; P <0.001). Acute transfusion reactions (ATRs) were more frequent ( P <0.001) in the A-group (60%) compared with the X-group (20%). TRAEs were unassociated with survival to discharge. The survival to discharge rate of the X-group (55%) was lower ( P  = 0.007) than in the A-group (73%), while post-discharge survival rates to 30 days of cats surviving to discharge were 90% and 88%, respectively ( P  = 0.85)., Conclusions and Relevance: Canine blood xenotransfusions to cats might save lives in emergency conditions when AFB is unavailable or blood typing is infeasible. The survival to discharge rate of the X-group was lower than that of the A-group. The longer-term survival rate of cats administered xenotransfusions and surviving to discharge from the hospital was good.

Objective: To compare the short- and long-term outcomes of dogs and cats with left-sided congestive heart failure (L-CHF) undergoing positive pressure ventilation (PPV) to patients undergoing PPV for other causes and to determine risk factors associated with outcomes in this population., Design: This retrospective study included dogs and cats that underwent PPV during 2018-2020. The study group included patients diagnosed with L-CHF. The control group included patients who were ventilated for reasons other than L-CHF. The risk factors evaluated included vital signs on presentation, ventilator settings, development of azotemia during hospitalization, cardiopulmonary resuscitation (CPR), complications, and medications used., Setting: University Teaching Hospital., Animals: Fifty (32 dogs, 18 cats) study group animals and 51 (39 dogs, 12 cats) control group animals were included in the L-CHF and control groups, respectively., Measurements and Main Results: Sixty-six percent (33/50) of L-CHF patients, compared with 35% (18/51) of the control patients, were weaned off PPV (P = 0.002). Fifty-four percent (27/50) of the L-CHF patients survived to discharge, compared with 26% (13/51) of the control group patients (P = 0.003). However, only 54% (12/22) of the discharged L-CHF patients survived for >2 months compared to 100% of the control patients. The median survival time for dogs and cats with L-CHF surviving to discharge was 240 days (range: 1-730 days). In dogs, factors negatively associated with survival included CPR in both groups and the development of azotemia in the L-CHF group. Anemia on presentation was negatively associated with survival for both cats and dogs in the control group., Conclusions: Dogs and cats undergoing PPV due to L-CHF were more commonly weaned off the ventilator and survived to discharge compared to other causes necessitating PPV. However, these patients suffer from severe heart disease, and therefore, their long-term survival is guarded., (© Veterinary Emergency and Critical Care Society 2022.)

Objective: To describe the management of dogs with acute kidney injury (AKI) by continuous renal replacement therapy (CRRT), and to investigate the relationship between a prescribed CRRT dose, the hourly urea reduction ratio (URR), and the overall efficacy., Animals: 45 client-owned dogs diagnosed with severe AKI, receiving 48 CRRT treatments at a veterinary teaching hospital., Procedures: Retrospective study. Search of medical records of dogs with AKI managed by CRRT., Results: Median serum urea and creatinine at CRRT initiation were 252 mg/dL [Inter quartile range (IQR), 148 mg/dL; range, 64 to 603 mg/dL] and 9.0 mg/dL (IQR, 7 mg/dL; range, 4.3 to 42.2 mg/dL), respectively. Median treatment duration was 21 hours (IQR, 8.8 hours; range, 3 to 32 hours). Systemic heparinization and regional citrate anticoagulation were used in 24 treatments each (50%). The prescribed median CRRT dose for the entire treatment was 1 mL/kg/min (IQR, 0.4 mL/kg/min; range, 0.3 to 2.5 mL/kg/min). The median hourly URR was 4% (IQR, 1%; range, 2% to 12%), overall URR was 76% (IQR, 30%; range, 11% to 92%) and median Kt/V was 2.34 (IQR, 1.9; range, 0.24 to 7.02). The CRRT dose was increased gradually from 0.9 mL/kg/min to 1.4 mL/kg/min (P < .001) and the hourly URR decreased from 6.5% to 5.5% (P = .05). The main complication was clotting of the extra-corporeal circuit, occurring in 6/48 treatments (13%). Twenty-four dogs (53%) survived to discharge., Clinical Relevance: CRRT is safe when the prescription is based on the current veterinary guidelines for gradual urea reduction. Treatment efficacy can be maximized by gradually increasing the dose according to the actual URR.

Objective: To describe the successful treatment of a life-threatening type III hypersensitivity reaction suspected to have been related to human serum albumin (HSA) administration in a dog with therapeutic plasma exchange (TPE)., Case Summary: A 3-year-old neutered male mixed breed dog was suspected to have developed immune-mediated vasculitis 2 weeks after the administration of HSA (740 mg/kg) for the management of hypoalbuminemia resulting from septic peritonitis. The dog was presented with fever, edema, hypoalbuminemia (26 g/L [2.6 g/dL]; reference interval, 30-44 g/L [3.0-4.4 g/dL]), and coagulopathy. The dog was treated with fresh frozen plasma (FFP) and glucocorticoids but remained hypoalbuminemic (18 g/L [1.8 g/dL]) and developed acute kidney injury (AKI). Over 4 days, 3 TPE treatments were performed, with a total of 2.7 plasma volumes exchanged. Replacement fluids consisted of a combination of FFP, hydroxyethyl starch 6%, and 0.9% saline solution. Following TPE treatments, serum albumin concentration increased (from 18 g/L [1.8 g/dL] to 25 g/L [2.5 g/dL]), serum creatinine concentration decreased (from 340 μmol/L [3.9 mg/dL] to 87 μmol/L [0.98 mg/dL]), and clotting times normalized (activated partial thromboplastin time decreased from 33 seconds to 14.5 seconds). There was a gradual but consistent clinical improvement of the edema and overall demeanor of the dog. No significant adverse effects were noted during the TPE treatments, and the dog was discharged after 8 days of hospitalization. Following discharge, the dog had complete clinical resolution of edema and AKI. NEW/UNIQUE INFORMATION: This is the first report describing successful use of TPE for the management of an immune-mediated reaction (type III hypersensitivity) following HSA administration., (© Veterinary Emergency and Critical Care Society 2022.)

Background: Organophosphates and carbamates are important sources of intoxication for humans and animals. However, large-scale studies of these intoxications in cats are unavailable., Methods: The medical records of 39 cats presented to a veterinary teaching hospital with acute organophosphate or carbamate intoxication were reviewed retrospectively., Results: Mortality in intoxicated cats was 15%. Low respiratory rate and low rectal temperature at presentation were associated with death. Other common clinical signs included weakness, ataxia, apathy, recumbency, anorexia and bradycardia, but these were unassociated with the outcome. The common biochemical abnormalities included decreased serum butyryl-choline esterase activity, acidaemia, hypercarbaemia and total hypocalcaemia, and increased creatine kinase activity and total plasma protein concentration. There were no significant differences in haematological, biochemical and blood gas analytes between survivors and non-survivors. Common medications and treatments included 2-pyridine aldoxime methyl-chloride-pralidoxime (2-PAM) (74%), metoclopramide (64%), antibiotics (64%), diphenhydramine (59%) and atropine sulphate (54%). There were no significant drug and treatment differences between survivors and non-survivors. The secondary complications of the intoxication included pneumonia (10%), acute kidney injury (10%) and pancreatitis (8%)., Conclusions: Acute cholinergic crisis due to organophosphate or carbamate intoxication has a fair prognosis in cats. Low respiratory rate and low rectal temperature at presentation were associated with death. The most commonly used specific medications in this study included 2-PAM, diphenhydramine and atropine sulphate., (© 2022 British Veterinary Association.)

Objectives: Bite wounds are a common cause of trauma in cats; nevertheless, large-scale studies of this trauma in cats are lacking. The aims of the present study were to characterise the clinical and clinicopathological findings in these cats, to assess the association of these variables and therapeutic measures with survival, and to assess the association between the animal trauma triage (ATT) score and severity of injuries score (SS) at presentation with survival., Methods: The medical records of cats presented to a veterinary teaching hospital and two large referral clinics were reviewed retrospectively., Results: The study included 72 cats diagnosed with canine bite wounds (with the dog attacks having been witnessed). Seventy-one percent of cats suffered multiple injuries, and there was a significant association between the number of injured body areas and survival, and between severity of injury and survival ( P  = 0.02 and P  = 0.012, respectively). The median ATT scores and SSs for non-survivors were significantly higher compared with survivors ( P <0.0001). There was a strong and significant correlation between ATT scores and SSs ( r  = 0.704, P  <0.0001). Total protein and albumin were significantly lower and alanine aminotransferase significantly higher in non-survivors compared with survivors ( P  ⩽0.032). Fifty percent of cats were treated conservatively, 32% by local surgical debridement and 18% of cats required an exploratory procedure. Cats undergoing more aggressive treatments were significantly less likely to survive ( P  = 0.029). Fifty-seven cats (79%) survived to discharge., Conclusions and Relevance: Cats sustaining canine bite wounds have a good overall prognosis for survival to discharge. High ATT score, high SS, multiple body area injuries, penetrating injuries, radiographic evidence of vertebral body fractures and body wall abnormalities, as well as hypoproteinaemia and elevated alanine aminotransferase, are negative predictors of survival.

Objectives: The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI)., Methods: The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed., Results: Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term ( P  = 0.005) and long-term ( P  = 0.023) survival. KCTS was significantly associated with short-term survival ( P  = 0.002) and long-term survival ( P  = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival., Conclusions and Relevance: KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.

Context: Echis coloratus is endemic to the Middle East. Clinical reports describing E. coloratus envenomation in humans are scarce, while natural envenomations of animals were not reported. Such envenomations may induce systemic coagulopathy. This report describes a confirmed E. coloratus envenomation in a dog, with assessment of the global hemostasis by thromboelastometry., Case Details: A 6-year old Belgian Shepherd dog was presented in shock, mucosal bleeding and swelling due to snakebite. Laboratory tests showed prolonged prothrombin and activated partial thromboplastin times. Because Daboia palaestinae is the most common venomous snake in Israel, immunoglobulin-G monovalent D. palaestinae antivenom was administered, with supportive care. The dog improved clinically, was discharged, and was readmitted, with active bleeding from the bite site. The dead snake was only then identified as E. coloratus . Thromboelastometry demonstrated severe hypocoagulability. The dog was treated with polyvalent antivenom directed against venoms of several Middle Eastern snakes, fresh-frozen plasma and packed red blood cells. Bleeding completely ceased, and thromboelastometry results improved. The dog was discharged. 3 days later, all hemostatic test results had normalized., Discussion: Thromboelastometry is useful for assessing the hemostatic status in E. coloratus envenomation, and for monitoring and managing the venom-induced coagulopathy, and guide plasma and polyvalent antivenom treatment.

Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) gut shedding in human medicine is considered as a major reservoir for ESBL-associated infections in high risk patients. In veterinary medicine, data regarding ESBL-PE gut shedding on admission to emergency and critical care department is scarce. We aimed to determine ESBL-PE shedding rates by dogs and cats in this setting and to determine the risk factors for shedding, at two separate periods, three-years apart. Rectal swabs were collected from animals, on admission and 72 h post admission, enriched and plated on Chromagar ESBL plates, followed by bacterial identification. ESBL phenotype was confirmed and antibiotic susceptibility profiles were determined (Vitek 2). Medical records were reviewed for risk factor analysis (SPSS). Overall, 248 animals were sampled, including 108 animals on period I (2015-2016) and 140 animals on period II (2019). In both periods combined, 21.4% of animals shed ESBL-PE on admission, and shedding rates increased significantly during hospitalization (53.7%, p -value < 0.001). The main ESBL-PE species were Escherichia coli and Klebsiella pneumoniae , accounting for more than 85% of the isolates. In a multivariable analysis, previous hospitalization was a risk factor for ESBL-PE gut shedding ( p -value = 0.01, Odds ratio = 3.05, 95% Confidence interval 1.28-7.27). Our findings demonstrate significant ESBL-PE gut shedding among small animals in the emergency and critical care department, posing the necessity to design and implement control measures to prevent transmission and optimize antibiotic therapy in this setting.

Objective: To describe the successful management of ventricular fibrillation (VF) and ventricular tachycardia (VT) using cardiopulmonary resuscitation, including defibrillation, followed by continuous rate infusion of IV amiodarone, in a cat with cardiac arrest secondary to tachyarrhythmia., Case Summary: A 12-year-old previously healthy neutered male Scottish Fold cat presented following an acute episode of collapse. Initial physical examination revealed severe tachycardia and cardiovascular collapse. Within a few minutes after arrival, the cat experienced cardiopulmonary arrest. Electrocardiographic assessment was suggestive of VF, and CPR was initiated, including 2 rounds of defibrillation (2 joule/kg each), resulting in return of spontaneous circulation with sustained VT. After procainamide and lidocaine failed to result in conversion to normal sinus rhythm (NSR), continuous IV amiodarone therapy was initiated, and NSR was achieved. Echocardiography demonstrated severe systolic dysfunction, and tachycardia-induced cardiomyopathy (TICM) secondary to chronic VT was suspected; however, dilated cardiomyopathy (DCM) or end-stage hypertrophic cardiomyopathy could not be ruled out. The patient was discharged the following day with oral amiodarone and pimobendan. During a recheck examination performed 7 months later the cat was in NSR, with no direct evidence of long-term amiodarone adverse effects. The cat died acutely at home 8 months after discharge., New or Unique Information Provided: This report is the first to describe the successful use of IV amiodarone in a cat to manage sustained VT following CPR., (© Veterinary Emergency and Critical Care Society 2020.)

Objective: To report the use of gas chromatography-mass spectrometry to confirm a diagnosis of synthetic cannabis toxicosis in a dog and to describe the clinical course of the intoxication., Case Summary: An 11-year-old neutered female Boxer dog was referred due to acute onset of vomiting, ataxia, dull mentation, and delirium that progressed to generalized seizures, unresponsive to diazepam. Prior to presentation, the dog was found lying down, minimally responsive with vomitus around it. A chewed bag containing dried plant material was found next to the dog. The dog was anesthetized and ventilated with positive pressure for 16 hours, and eventually made a full recovery. Gas chromatography-mass spectrometry analysis of the plant material and a plasma sample from the dog revealed presence of the synthetic cannabinoid N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide, also known as AB-CHMINACA, a relatively new illegal synthetic cannabinoid, known by the local forensic police department as a drug of recreational abuse., New or Unique Information Provided: Reports of synthetic cannabinoid toxicosis in dogs are scarce and are based on urine test kits for tetrahydrocannabinol that have not been validated in the veterinary literature. This is the first report to describe utilization of gas chromatography-mass spectrometry on canine plasma to reach a definitive diagnosis., (© Veterinary Emergency and Critical Care Society 2019.)

Coagulopathies in horses are common and potentially life-threatening. In equine field medicine, a portable point-of-care (POC) prothrombin time (PT) testing device could be useful to identify early changes in extrinsic clotting. The CoaguChek-XS (Roche Diagnostics) is a small, portable POC PT analyzer used in human medicine. Our preliminary study assessed the suitability of CoaguChek-XS for testing PT in horses and established the PT reference interval (PT RI) in healthy horses using this instrument. Blood samples collected from 102 healthy and ill horses were analyzed with the CoaguChek-XS and compared to a semi-automated coagulometric analyzer (SACA) as the gold standard. There was a significant positive correlation between the 2 measurement methods ( r = 0.765, p < 0.01), and very good agreement, with 97% of the samples falling within limits of agreement. The mean CoaguChek-XS PT coefficient of variation was 0.8%, indicating high precision. With high precision and good agreement with the coagulometric PT, the CoaguChek-XS should be further validated for PT measurement in horses.

Gastric dilatation and volvulus (GDV) is a life-threatening condition, suspected to result in differential tissue perfusion in different regions of the body. Lactate is a biomarker of hypoperfusion that correlates with treatment outcomes in dogs with GDV. This prospective observational study aimed to compare lactate between saphenous and cephalic venous samples in 45 client-owned dogs with GDV, to evaluate their association with treatment outcomes (survival, surgical complications, and duration of hospitalization) and to assess the correlation between lactate and other biochemical parameters. Both saphenous and cephalic lactate concentrations were significantly higher in non-survivors ( P = 0.01). No statistical difference was found between lactate concentrations in saphenous versus cephalic venous samples ( P = 0.480). For each dog, the difference in lactate between saphenous and cephalic veins was calculated (Δlactate = saphenous - cephalic); it was not associated with survival ( P = 0.198), surgical complications ( P = 0.346), or duration of hospitalization ( P = 0.803). Higher lactate and lower glucose (saphenous vein) were associated with lower PCV and higher creatinine, on presentation. The results of this study failed to show an association between Δlactate concentrations and treatment outcomes in dogs with GDV; however, in agreement with previous studies, lower lactate was associated with a decreased mortality rate.

This study has retrospectively reviewed the medical records of 140 dogs sustaining road traffic accident (RTA), and has examined the population characteristics, medical history, injury type, physical examination, emergency laboratory tests and radiography findings, the animal trauma triage (ATT) score, the length of hospitalisation, the complications and the outcome. The survival rate was 83.2 per cent. Younger dogs sustained more frequently lung contusions and limb fractures, while larger dogs more frequently suffered limb fractures, and smaller dogs and older ones sustained more frequently pelvic fractures and sacroiliac luxation (P<0.05 for all). Dogs sustaining orthopaedic injuries required longer hospitalisation (P<0.001). The survival rates of non-ambulatory dogs (P<0.001) and those with neurological abnormalities (P<0.001), abnormal body temperature (P=0.001), hyperglycaemia (P=0.026) or hypoproteinaemia (P=0.04) at presentation were lower compared with those in which these were absent. The number of injured body systems was significantly (P<0.001) and positively associated with death. Dogs surviving RTA to presentation to the hospital have a good prognosis for survival to discharge. Older age, and high ATT score, abnormal body temperature, neurological deficits, hyperglycaemia and hypoproteinaemia at presentation, and occurrence of multiorgan trauma are negative prognostic indicators in such dogs., Competing Interests: Competing interests: None declared., (© British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.