The use of intralipid emulsion therapy to treat status epilepticus in a guinea pig (Cavia porcellus) secondary to severe ivermectin toxicity.

OBJECTIVE: To describe the successful management of ivermectin-induced status epilepticus in a guinea pig (Cavia porcellus) with intravenous lipid emulsion (ILE) therapy. CASE SUMMARY: A 5-week-old, female intact guinea pig was presented to an emergency hospital for status epilepticus 24 hours after oral administration of ivermectin. Approximately 48 hours after exposure, ILE therapy was administered. Within 12-16 hours after ILE therapy, seizures had stopped and the patient's mentation returned to normal. The definitive diagnosis was based on owner history, clinical presentation, and American Society for the Prevention of Cruelty to Animals poison control guidelines. NEW OR UNIQUE INFORMATION PROVIDED: The use of intralipid therapy has been widely documented as a treatment option for numerous toxicities. Its efficacy in treatment for toxicities in both veterinary and human medicines has been well described in various case reports and studies. However, its use and success in small mammals have yet to be documented. In this case report, intralipid therapy is used to successfully treat a seizuring guinea pig that was administered a severely toxic dose of ivermectin. To the authors' knowledge, this is the first report on the successful use of intralipids in a guinea pig from ivermectin toxicosis.

Acute liver lobe torsion in a kitten.

CASE SUMMARY: A 10-week-old intact male domestic shorthair kitten presented for an acute onset of lethargy, vomiting and anorexia. An abdominal mass effect was palpable on presentation. Blood work, abdominal radiographs and point-of-care abdominal ultrasound showed severe anemia, decreased serosal detail and abdominal effusion, respectively. Based on the concern for an abdominal organ torsion or ruptured mass, an emergency abdominal exploratory surgery was performed. Torsion of the entire caudate liver lobe was discovered with a secondary hemoabdomen, and a liver lobectomy was performed. The kitten was stabilized and discharged 3 days after surgery. At the recheck examination, 15 days postoperatively, the patient was reported to be doing well. RELEVANCE AND NOVEL INFORMATION: Liver lobe torsion is a rare condition previously reported in six other cats; however, this is the first peer-reviewed report in a kitten successfully treated with surgery with no identifiable underlying cause.

Resolution of spontaneous hemoabdomen secondary to peliosis hepatis following surgery and azithromycin treatment in a Bartonella species infected dog.

OBJECTIVE: To describe a case of hemoperitonium in a dog with Bartonellosis and peliosis hepatis (PH) lesions that resolved following antimicrobial therapy. CASE SUMMARY: A 3-year-11-month-old 22.5 kg female spayed mixed breed dog presented for progressive lethargy and vomiting. An abdominal ultrasonographic examination revealed moderate ascites, which when sampled was nonclotting hemorrhagic fluid. An exploratory laparotomy revealed a large volume of nonclotted blood in the dog's abdomen and blood-filled vesicular lesions dispersed diffusely along multiple lobes of the liver. Biopsies revealed lesions indicative of PH. Serology testing for Bartonella species was positive. Treatment with azithromycin resulted in Bartonella serology negative status and no further evidence of hemoperitonium at recheck examination 12 months after initial presentation. NEW OR UNIQUE INFORMATION PROVIDED: This is the first reported case of PH and hemoperitoneum in a Bartonella species serology positive dog wherein treatment with azithromycin resulted in serology negative status. There have been no subsequent episodes of hemoperitoneum in the 12 months since treatment.

Migration of a sewing needle foreign body into the brainstem of a cat.

CASE SUMMARY: A 1-year-old, female spayed domestic shorthair cat with a 6 week history of upper respiratory signs and a progressive reluctance to move, which culminated in a right-sided hemiparesis, was found to have a sewing needle foreign body lodged in the brainstem. Surgical extraction of the needle was successful and the cat's neurological deficits resolved over the days to weeks following its removal. RELEVANCE AND NOVEL INFORMATION: This case report describes, to our knowledge, the first reported incidence and management of an ingested sewing needle migrating into the central nervous system of a cat.

Heatstroke: clinical signs, diagnosis, treatment, and prognosis.

Heatstroke is a complex disease process that, in its most severe form, can result in multiorgan dysfunction and death. Heatstroke stems from the failure of the body's thermoregulatory mechanisms, resulting in cellular damage and death. The organ systems most commonly affected in this disease process include the gastrointestinal tract and the coagulation, renal, cardiac, pulmonary, and central nervous systems. Heatstroke is diagnosed based on the patient history, physical examination, and clinicopathologic findings. Treatment should be instituted immediately to improve patient outcome and includes active cooling, fluid resuscitation, and supportive care. Patients with altered mental status, hypoglycemia, prolonged prothrombin time, and prolonged activated partial thromboplastin time at admission have increased mortality rates. Additional negative prognostic indicators include elevated serum creatinine level, delayed admission to the hospital, seizures, and obesity.

Heatstroke: thermoregulation, pathophysiology, and predisposing factors.

Heatstroke is a common veterinary emergency that, depending on the severity of injury, can progress to a life-threatening condition. Heatstroke can be classic (nonexertional) or exertional. Classic heatstroke develops when the body is exposed to high external temperatures, whereas exertional heatstroke is caused by strenuous exercise. Thermoregulation is the intrinsic ability of the body to maintain core body temperature within normal limits through an intricate balance of heat conservation and heat dissipation. Severe disease ensues when persistent hyperthermia causes injury to the body for which these mechanisms can no longer adequately compensate. The first stages of heatstroke are characterized by initial thermoregulation, acute phase response, and activation of heat shock proteins. The organ systems most commonly affected during heatstroke are the gastrointestinal tract and the coagulation, renal, cardiac, pulmonary, and central nervous systems.

Esophageal foreign bodies in dogs: 34 cases (2004-2009).

OBJECTIVE: To characterize the clinical and radiographic signs, endoscopic findings, treatment, and outcome for dogs that present with esophageal foreign bodies (EFBs), and to identify factors associated with the severity of secondary esophagitis and length of hospitalization (LOH). DESIGN: Retrospective case series. SETTING: Private referral veterinary center. ANIMALS: Client-owned dogs. INTERVENTIONS: None. MEASUREMENTS: Medical records for 34 client-owned dogs with EFBs that had esophageal radiographs and that had undergone esophagoscopy were evaluated retrospectively. Information regarding clinical history, radiographic signs, findings at esophagoscopy, and outcome were recorded. RESULTS: The most common EFBs were bone (29.7%) and rawhides (29.7%). The median duration of clinical signs prior to initial presentation was 2.75 hours. Radiographically, EFBs were identified definitively in 30 dogs and questionably in 1. The most common location was in the caudal esophagus (59.3%). Esophagitis was not identified in 6 dogs; and was assessed as mild in 14, moderate in 9, and severe in 4. In 1 dog the degree of esophagitis could not be determined due to the presence of contrast agent. Dogs with longer duration of clinical signs and longer anesthesia times were more likely to have moderate or severe esophagitis. Median LOH was 19 hours. Dogs with longer duration of clinical signs, EFBs located in the caudal esophagus, and moderate or severe esophagitis had longer hospital stays. No dogs experienced long-term complications. Complication rate was 82.5% with 8 patients having more than 1 complication. CONCLUSIONS: While long-term prognosis is excellent, early intervention helps reduce short-term esophagitis and LOH.

Determination of strong ion gap in healthy dogs.

OBJECTIVE: To determine and compare reference intervals of the strong ion gap (SIG) in a group of healthy dogs determined with 2 different equations. DESIGN: Prospective observational study. SETTING: Tertiary referral and teaching hospital. ANIMALS: Fifty-four healthy dogs. INTERVENTIONS: None. MEASUREMENTS: Serum biochemistry and blood gas analyses were performed for each dog. From these values, SIG was calculated using 2 different equations: SIG(1) = SID(a) {[Na (+)] + [K(+)] - [Cl(-)]+ [2 × Ca(2+)] + [2 × Mg(2+)] - [L-lactate]}- SID(e) {TCO(2) + A(-)} and SIG(2) = [albumin] × 4.9-anion gap. Reference intervals were established for each SIG equation using the mean ± 1.96 × standard deviation (SD). RESULTS: For SIG(1), the median was 7.13 mEq/L (range, 1.05-11.30 mEq/L) and the derived reference interval was 1.85-10.61 mEq/L. Median SIG(2) was -0.22 mEq/L (range, -5.34-6.61 mEq/L) and the mean SIG(2) was -0.09 mEq/L (95% confidence interval for the mean, -0.82-0.65 mEq/L). The derived reference interval was -5.36-5.18 mEq/L. The results of the SIG calculations were significantly different (P < 0.0001) between the 2 equations used. CONCLUSION: The 2 equations used to calculate SIG yielded significantly different results and cannot be used interchangeably. The authors believe SIG(2) to be a more accurate reflection of acid-base status in healthy dogs, and recommend that this calculation be used for future studies.

Temporary tube cystostomy as a treatment for urinary obstruction secondary to adrenal disease in four ferrets.

Adrenal neoplasia is a common problem in middle-aged to older ferrets. Male ferrets may present for stranguria and dysuria due to prostatic/paraurethral tissue enlargement secondary to elevation in androgens produced by the neoplastic tissue. Progressive urethral compression followed by complete urinary obstruction can result. Urinary obstruction can persist for days following surgery requiring urinary diversion. Four ferrets presenting with signs consistent with urinary obstruction secondary to adrenal disease were immediately treated with urethral catheterization or cystocentesis followed by adrenalectomy and temporary tube cystostomy. The tube cystostomy placement and use were associated with minimal complications and allowed recovery from surgery.

Diagnosis of urinary bladder rupture using ultrasound contrast cystography: in vitro model and two case-history reports.

Because urinary bladder rupture can be life threatening, a simple, safe technique for evaluating patients is desirable. Current diagnostic protocols involve radiographic imaging, but ultrasound-based contrast techniques have not been methodically evaluated in veterinary patients with urologic trauma. Ultrasound contrast cystography (contrast cystosonography) involves infusion of microbubbled saline solution through a urinary catheter. It was performed in an in vitro model and in 2 dogs with naturally occurring urinary bladder rupture. A positive result consisted of visualizing microbubbles sonographically in fluid surrounding the bladder immediately after infusion of contrast into the urinary catheter. A positive result was obtained both in the in vitro model and in the 2 dogs, with radiographic and surgical confirmation of naturally occurring intraperitoneal urinary bladder rupture in the dogs. Based on the results of this study, ultrasound contrast cystography appears to be more sensitive than two-dimensional (2D) abdominal sonography for detecting naturally occurring urinary bladder rupture in dogs.