Association between cardiac troponin I concentrations and electrocardiographic abnormalities in dogs with blunt trauma.

OBJECTIVE: To determine whether a normal cardiac troponin I (cTnI) concentration and normal ECG on entry rule out the development of a clinically significant cardiac arrhythmia (CSCA, defined as an arrhythmia requiring anti-arrhythmic treatment) in dogs that have sustained blunt trauma. DESIGN: Prospective, observational study. Client-owned dogs were enrolled between January 2015 and November 2016. SETTING: University teaching hospital. ANIMALS: Forty-seven client-owned dogs with a history of witnessed or suspected blunt trauma within 24 hours prior to presentation to the hospital. INTERVENTIONS: On admission to the emergency service, dogs had a standard 3-lead ECG and cTnI concentration (using a veterinary point-of-care device* ) performed. Animal Trauma Triage (ATT) scores, Modified Glasgow Coma Scale (MGCS), and the details regarding the nature and timing of the injury were recorded. The patients were monitored in the ICU for a minimum of 24 hours on continuous ECG telemetry. Cardiac rhythm was monitored every hour, and any abnormalities were noted. The need for anti-arrhythmic therapy was recorded. There were no treatment interventions. MEASUREMENTS AND MAIN RESULTS: Five of 47 dogs (10.6%) developed a CSCA during hospitalization after sustaining blunt trauma. A normal entry ECG and normal cardiac troponin concentration on entry had a 100% negative predictive value (NPV) for ruling out the development of a CSCA, although a normal cardiac troponin concentration alone also had an NPV of 100%. A normal entry ECG had an NPV of 95.3%. The prognosis for survival to discharge was 89.4% in this study population (42/47 dogs). CONCLUSIONS: In dogs with blunt trauma, an entry cTnI concentration or a combination of cTnI and ECG on entry may be useful in determining which patients are at a higher risk for the development of CSCA during the first 12 to 24 hours after the trauma.

Emphysematous gastritis in a cat.

OBJECTIVE: To describe the presentation, diagnosis, treatment, and outcome of a case of emphysematous gastritis (EG) in a cat. CASE SERIES SUMMARY: A 15-year-old female neutered domestic short-hair cat presented for a 4-month history of weight loss and intermittent vomiting. Clinicopathologic and imaging findings suggested an underlying primary gastrointestinal (GI) disease, as well as possible hepatobiliary disease. Two days following exploratory laparotomy to obtain GI and liver biopsies, the patient became septic and intracellular bacteria were present on cytology of peritoneal effusion. On radiographs, the stomach was markedly distended with fluid and contained a thin gas opacity surrounding the stomach wall. The patient was taken back to surgery to identify a source of sepsis. At surgery, the patient's stomach was firm and emphysematous on palpation but grossly appeared normal. There were no signs of dehiscence of the previous biopsy sites. Stomach biopsy confirmed the presence of intralesional Gram-positive rods, consistent with microbial EG, and a light growth of a Clostridium sp. was cultured from abdominal fluid, consistent with clostridial peritonitis. During a third surgery for suspected septic peritonitis, a jejunostomy tube was placed for postgastric enteral feeding. The patient ultimately survived to discharge and is clinically stable 10 months later. NEW/UNIQUE INFORMATION PROVIDED: EG is a rare but potentially fatal clinical entity in the human and veterinary literature with only 1 other case reported in cats. Though clostridial organisms have been reported in EG in people, this is the first implication of EG secondary to a Clostridium sp. in the cat. This is also the first report to document the use of a jejunostomy tube for postgastric enteral nutrition to treat EG in the veterinary literature.

A serious adverse event secondary to rapid intravenous levetiracetam injection in a dog.

OBJECTIVE: To describe a serious adverse event as a result of rapid intravenous injection of undiluted levetiracetam in a dog. CASE SUMMARY: An 8-year-old female spayed Chihuahua was evaluated for cluster seizures and tachypnea. The patient was administered an intravenous dose of undiluted levetiracetam (60 mg/kg) and immediately developed tachycardia, hyperglycemia, hypotension, and a dull mentation. The patient's blood pressure and mentation did not respond to intravenous fluid boluses but improved immediately after administration of epinephrine intravenously. The patient subsequently developed respiratory failure necessitating mechanical ventilation, prior to cardiac arrest. Necropsy examination noted a pulmonary inflammatory cell infiltrate, pulmonary edema, and interstitial pneumonia. NEW OR UNIQUE INFORMATION PROVIDED: This report documents a serious adverse event associated with intravenous levetiracetam administration to a dog.