Conservative management of metallic sharp-pointed straight gastric and intestinal foreign bodies in dogs and cats: 17 cases (2003-2021).

OBJECTIVE: To describe the conservative management and outcome of gastrointestinal metallic sharp-pointed straight foreign bodies in dogs and cats. MATERIALS AND METHODS: Clinical records of dogs and cats presented to a university teaching hospital between 2003 and 2021 with gastrointestinal metallic sharp-pointed straight foreign bodies (e.g. needles, pins, nails) were reviewed. Conservative management was defined as leaving the foreign body in situ. Cases were excluded if the foreign body was identified outside of the gastrointestinal tract (including oropharynx and oesophagus) or if it was removed by endoscopy or surgery as the first treatment choice. Patient signalment, presenting complaint, foreign body location, treatment, complications, gastrointestinal transit time, length of hospitalisation and outcome were recorded. RESULTS: A total of 17 cases (13 dogs and four cats) were included in the study, being treated with primary conservative therapeutic approach (11) or following failure of endoscopy (two), surgery (three) or both (one). Clinical signs associated with the foreign body were reported in three (17.6%) cases. Conservative management was successful in 15 (88.2%) cases, with no complications reported. Patients were clinically and radiographically monitored with variable supportive care. In two (11.8%) cases, surgery was subsequently performed as the foreign body failed to progress on repeated radiographs after 24 hours. Mean foreign body gastrointestinal transit time for patients treated conservatively was 59.2 (±31.4) hours. All patients survived to discharge. CLINICAL SIGNIFICANCE: Conservative management is a treatment option for clinically stable cats and dogs with metallic sharp-pointed straight gastrointestinal foreign bodies in the absence of perforation.

Successful management of fipronil toxicosis in two pet rabbits.

Background: Antiparasitic drug toxicosis is commonly described in dogs and cats, but reports on the management of antiparasitic drug toxicities in pet rabbits are scarce. Here, we describe the successful clinical management of two pet rabbits with fipronil toxicosis. Cases Description: The first case was a 5-month-old, intact female, rabbit that presented with the acute onset of seizures, obtunded mentation, and in lateral recumbency, while the second rabbit was a 1-year-old, intact male, rabbit that presented with anorexia and lethargy. In both cases, the owners reported to have administered a 0.5 ml fipronil vial topically on the skin as an antiparasitic drug between 4 and 6 hours prior to presentation. Complete blood count and serum biochemistry were unremarkable and both rabbits tested negative on Encephalitozoon cuniculi serology. Both animals were decontaminated by bathing with tepid water and dishwashing soap. The rabbit with seizures received on admission intravenous midazolam. In both cases, overnight hospitalization, intravenous isotonic crystalloid fluids, and assisted-feeding by oral syringe were provided until voluntary feeding was resumed. Both rabbits rapidly improved approximately 12 hours of initiating supportive care. Complete resolution of clinical signs and return of normal appetite and defecation occurred within 24 hours of hospitalization in both animals. No recurrence of neurological signs was reported in the rabbit presenting with seizures on a follow-up period of 1 month. Conclusion: The outcome of these cases suggests that supportive treatment of fipronil toxicity in pet rabbits can be successful if administered promptly.

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003-2019).

OBJECTIVES: Hypertensive emergency is well recognised in human medicine, yet there is limited veterinary evidence. This study aimed to determine the presentation, treatment and outcome in dogs and cats with hypertensive emergency. MATERIALS AND METHODS: A retrospective case series of dogs and cats with hypertensive emergency identified as follows: acute history with non-invasive Doppler systolic blood pressure greater than 180 mmHg and target organ damage including acute onset seizures, altered mentation with or without lateral recumbency or blindness. Data collected included signalment, history, physical examination and clinicopathological findings, systolic blood pressure, antihypertensive treatment and outcome. RESULTS: Seven dogs and eight cats were included presenting with seizures (n=9), blindness (n=4), altered mentation with (n=2) or without (n=2) lateral recumbency. Median age was 9 years (range 1 to 15) and duration of clinical signs before presentation was 1.5 days (range 1 to 15). Median systolic blood pressure on presentation was 230 mmHg (range 190 to 300). Amlodipine was the most common first-line agent (n=10), followed by hydralazine (n=4) and hypertonic saline (n=1). Aetiology of hypertensive emergency was acute kidney injury (n=9), idiopathic hypertension (n=3), hyperthyroidism (n=1), lymphoma (n=1) and suspected cutaneous and renal glomerular vasculopathy (n=1). Five cats and three dogs survived to discharge with an overall survival of 53.3%. CLINICAL SIGNIFICANCE: Hypertensive emergencies had various presenting signs in this series. AKI was considered to be the cause of hypertension in the majority of patients. Further evaluation of treatment for hypertensive emergencies is warranted, considering almost half of the cases did not survive to discharge.

A review of hyperfibrinolysis in cats and dogs.

The fibrinolytic system is activated concurrently with coagulation; it regulates haemostasis and prevents thrombosis by restricting clot formation to the area of vascular injury and dismantling the clot as healing occurs. Dysregulation of the fibrinolytic system, which results in hyperfibrinolysis, may manifest as clinically important haemorrhage. Hyperfibrinolysis occurs in cats and dogs secondary to a variety of congenital and acquired disorders. Acquired disorders associated with hyperfibrinolysis, such as trauma, cavitary effusions, liver disease and Angiostrongylus vasorum infection, are commonly encountered in primary care practice. In addition, delayed haemorrhage reported in greyhounds following trauma and routine surgical procedures has been attributed to a hyperfibrinolytic disorder, although this has yet to be characterised. The diagnosis of hyperfibrinolysis is challenging and, until recently, has relied on techniques that are not readily available outside referral hospitals. With the recent development of point-of-care viscoelastic techniques, assessment of fibrinolysis is now possible in referral practice. This will provide the opportunity to target haemorrhage due to hyperfibrinolysis with antifibrinolytic drugs and thereby reduce associated morbidity and mortality. The fibrinolytic system and the conditions associated with increased fibrinolytic activity in cats and dogs are the focus of this review article. In addition, laboratory and point-of-care techniques for assessing hyperfibrinolysis and antifibrinolytic treatment for patients with haemorrhage are reviewed.

Neutrophil Gelatinase-Associated Lipocalin in Dogs With Sepsis Undergoing Emergency Laparotomy: A Prospective Case-Control Study.

BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is an early indicator of acute kidney injury (AKI) in dogs and its use has not been evaluated in dogs with sepsis. ANIMALS: Fifteen dogs with sepsis requiring laparotomy (study dogs) and 10 dogs undergoing surgery for intervertebral disc disease (control dogs). OBJECTIVE: To determine whether NGAL increases in dogs with sepsis undergoing emergency laparotomy and whether it is correlated with development of AKI and survival. METHODS: Longitudinal study conducted at a referral teaching hospital. Serum neutrophil gelatinase-associated lipocalin (sNGAL), urinary NGAL normalized to urinary creatinine concentration (UNCR), and serum creatinine concentration were measured at 4 time points (admission, after anesthesia, and 24 and 48 hours postsurgery). Development of AKI (increase in serum creatinine concentration of 0.3 mg/dL) and in-hospital mortality were recorded. Linear mixed-model analysis was employed to assess differences between groups over time. Mann-Whitney U-test was performed for comparison of continuous variables between groups and Chi square or Fisher's exact tests were used to assess correlation between discrete data. RESULTS: Serum NGAL and UNCR were significantly higher in study dogs across all time points (P = .007 and P < .001, respectively) compared with controls. Urinary NGAL normalized to creatinine in the study group was not significantly different between survivors (n = 12) and nonsurvivors (n = 3). Dogs that received hydroxyethyl starch had significantly higher UNCR across all time points (P = .04) than those that did not. DISCUSSION-CONCLUSION: Serum neutrophil gelatinase-associated lipocalin and UNCR are increased in dogs with sepsis requiring emergency laparotomy. Additional studies are needed to evaluate its role as a marker of AKI in this population.