An atypical presentation of anticoagulant rodenticide toxicosis in a dog.

A 5-month-old intact female Australian shepherd dog was referred to our clinic for neurologic signs including ataxia, a head tilt, and altered mentation following consumption of an unidentified rodenticide several days prior to developing clinical signs. A provisional diagnosis of bromethalin toxicosis had been made, given the neurologic signs seen and the general increased use of bromethalin-containing rodenticide products. However, on physical examination, the dog was noted to have scleral hemorrhage and bleeding at the venipuncture sites, which was inconsistent with bromethalin toxicosis. Coagulation testing was supportive of anticoagulant rodenticide toxicosis and the rodenticide was later identified as the first-generation anticoagulant rodenticide diphacinone. The neurologic signs seen were attributed to a coagulopathy causing multifocal hemorrhage into the central nervous system. Neurologic signs rapidly resolved following treatment with a frozen plasma transfusion and vitamin K1. This atypical presentation of an anticoagulant rodenticide toxicosis highlights the need for accurate product identification, if available, and thorough patient examination and laboratory testing. An atypical presentation of anticoagulant rodenticide toxicosis should be considered when neurologic signs are present with clinical bleeding, especially if the type of rodenticide is unknown, or even if it was not thought to have an anticoagulant as the active ingredient. Key clinical message: Given the change in commercially available rodenticide products, this case highlights the need for accurate product identification in cases of suspected toxicosis, and the variable clinical signs that can be seen following anticoagulant rodenticide toxicosis.

Présentation atypique d'une toxicose aux rodenticides anticoagulants chez un chien. Une chienne berger australien intacte âgée de 5 mois a été référée à notre clinique pour des signes neurologiques, notamment de l'ataxie, une inclinaison de la tête et une altération de l'état mental à la suite de la consommation d'un rodenticide non identifié plusieurs jours avant l'apparition des signes cliniques. Un diagnostic provisoire de toxicose à la brométhaline avait été posé, compte tenu des signes neurologiques observés et d'une utilisation historique accrue de produits rodenticides contenant de la brométhaline. Cependant, lors de l'examen physique, il a été constaté que le chien présentait une hémorragie sclérale et des saignements au niveau des sites de ponction veineuse, ce qui n'était pas cohérent avec une toxicose à la brométhaline. Les tests de coagulation ont confirmé la toxicose au rodenticide anticoagulant et le rodenticide a ensuite été identifié comme étant le rodenticide anticoagulant de première génération diphacinone. Les signes neurologiques observés ont été attribués à une coagulopathie provoquant une hémorragie multifocale du système nerveux central. Les signes neurologiques ont rapidement disparu après un traitement par transfusion de plasma congelé et de vitamine K1. Cette présentation atypique d'une toxicose aux rodenticides anticoagulants met en évidence la nécessité d'une identification précise du produit, si disponible, ainsi que d'un examen approfondi du patient et de tests de laboratoire. Une présentation atypique de toxicose des rodenticides anticoagulants doit être envisagée lorsque des signes neurologiques sont présents avec saignement clinique, en particulier si le type de rodenticide est inconnu, ou même si l'on ne pense pas qu'un anticoagulant soit l'ingrédient actif.Message clinique clé :Compte tenu de l'évolution des produits rodenticides disponibles dans le commerce, ce cas met en évidence la nécessité d'une identification précise du produit en cas de suspicion de toxicose et les signes cliniques variables qui peuvent être observés à la suite d'une toxicose au rodenticide anticoagulant.(Traduit par Dr Serge Messier).

Effect of plasma transfusion on serum amyloid A concentration in healthy neonatal foals and foals with failure of transfer of passive immunity.

BACKGROUND: Anecdotal evidence suggests plasma transfusions increase serum amyloid A (SAA) concentrations in healthy neonatal foals making this marker of inflammation inappropriate for therapeutic decision making in such animals. HYPOTHESIS/OBJECTIVES: Administration of hyperimmune fresh frozen plasma (FFP) increases SAA concentration in healthy foals and in foals with failure of transfer of passive immunity (FTPI). ANIMALS: Eighty-six healthy foals. METHODS: Prospective cohort study. Foals <24 hours of age receiving plasma transfusion for treatment of FTPI (serum immunoglobulin G [IgG] concentrations <8 g/L; n = 17) or as a preventative measure for Rhodococcus equi infection (IgG >8 g/L; n = 33) were enrolled. A healthy nontransfused group of foals (IgG >8 g/L; n = 21) also was included. Serum amyloid A concentration was determined before (t0h) and after (t24h) administration of FFP. Changes in blood SAA concentration were assessed using linear regression models. RESULTS: No statistical differences were found in SAA concentration at t0h or t24h among the 3 groups (P > .05, for all comparisons). The variation in SAA concentration before (t0h) and after (t24h) plasma transfusion showed that administration of FFP was not associated with the changes in SAA concentration (P > .05). An association between SAA concentration at t0h and at 24 hours (P < .05) was identified, where foals with higher SAA concentration at t0h also had higher SAA concentration at t24h. CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of FFP to newborn foals was not associated with changes in SAA concentration.

Acute kidney injury from presumptive intramural ureteral hemorrhage secondary to diphacinone rodenticide exposure in a dog.

OBJECTIVE: To describe the clinical features and outcome of a dog with anticoagulant rodenticide (diphacinone) exposure, which was subsequently diagnosed with a coagulopathy characterized by hemoperitoneum, and presumptive ureteral wall hemorrhage contributing to acute kidney injury (AKI). CASE SUMMARY: A 4-year-old, female neutered Australian Cattle Dog was evaluated for an acute onset of lethargy, decreased appetite, and a mild right thoracic limb lameness. Radiographs and point of care ultrasound demonstrated retroperitoneal and peritoneal effusion. Diagnostic abdominocentesis confirmed hemorrhagic effusion. Complete blood count, biochemistry, and coagulation profile showed a regenerative anemia (PCV 32%), thrombocytopenia (platelets 96 × 109 /L [96 × 103 /µl]), azotemia (BUN 38.9 mmol/L [109 mg/dl], creatinine 512.8 µmol/L [5.8 mg/dl]), and coagulopathy (prothrombin time >100 s, activated partial thromboplastin time >42.3 s). The client reported access to anticoagulant rodenticide up to 72 hours prior to presentation. Ultrasonographic examination revealed bilateral pyelectasia and hydroureter with thickened distal ureteral walls at the level of the ureteral-vesicular junctions. The ultrasonographic conclusion was presumptive intramural ureteral hemorrhage resulting in ureteral obstruction. The patient was diagnosed with AKI with likely prerenal, renal, and postrenal components. Treatment included vitamin K and frozen plasma transfusion. The patient recovered fully and was discharged 3 days after presentation. Two days after discharge, the patient had improvement in azotemia (BUN 10.7 mmol/L [30 mg/dl], creatinine 176.6 µmol/L [2.0 mg/dl]). Gas chromatography-mass spectrometry confirmed presence of diphacinone in the blood. Repeat ultrasound and biochemistry 60 and 210 days, respectively, after discharge showed resolution of ureteral wall thickening, hydroureter, pyelectasia, and recovery of kidney parameters. NEW OR UNIQUE INFORMATION: Although nephropathies secondary to anticoagulant therapy have been described in people, the authors believe this is the first report of diphacinone anticoagulant rodenticide exposure contributing to an AKI secondary to obstruction from ureteral wall hemorrhage in the veterinary literature.

Stability of coagulation factors in feline fresh frozen plasma intended for transfusion after 1 year of storage.

OBJECTIVES: The most common use of plasma transfusion is for haemostatic purposes, but coagulation factor activities in stored feline plasma are unknown. The concentration and stability of coagulation factors I (fibrinogen), II, V, VII, VIII, IX, X, XI and XII in feline fresh frozen plasma (fFFP) stored for 1 year were studied. METHODS: Fifty-five units of fFFP were produced from 55 fresh whole-blood donations obtained from indoor healthy blood donor cats. Twenty-one units were stored for <2 weeks (T0) and 34 were stored for 1 year (T1). After the completion of storage, specific coagulation factor activities for factors II, V, VII, VIII, IX, X, XI and XII were tested using modified one-stage activated partial thromboplastin or prothrombin time assays. Fibrinogen was determined using the Clauss method. RESULTS: Significantly decreased activities were observed for factors II (T0: 101.94% ± 19.06%; T1: 73.23% ± 39.06% [P = 0.001]), VII (T0: 102.78% ± 24.69%; T1: 60.08% ± 38.17% [P <0.001]), VIII (T0: 77.52% ± 30.39%; T1: 50.32% ± 23.8% [P = 0.001]), XI (T0: 88.76% ± 22.73%; T1: 66.28% ± 22.2% [P = 0.001]) and XII (T0: 89.50% ± 21.85%; T1: 55.46% ± 23.18% [P <0.001]) when comparing units at time 0 and after 1 year of storage. No significant difference was observed for factors IX (T0: 84.86% ± 29.35%; T1: 71.37% ± 22.23% [P = 0.064]) and X (T0: 96.24% ± 25.1%; T1: 83.91% ± 49.54% [P = 0.236]). Unexpectedly, a significant increase was observed for factor V (T0: 71.94% ± 24.14%; T1: 97.89% ± 62.33%; P = 0.046). Fibrinogen was 2.76 ± 1.09 g/l at T1. Factors VIII, XII and VII had the lowest mean activities after 1 year. CONCLUSIONS AND RELEVANCE: Although a decrease in most coagulation factors activities was noted with storage, 1-year-old fFFP was haemostatically active in vitro. The most suitable factors for quality control assessment of fFFP are factors VII and VIII. Approximately 13-20 ml/kg of fFFP is required to administer a minimum of 10 IU/kg coagulation factor activity.

Serum immunoglobulin G concentration after plasma transfusion in neonatal foals with hypogammaglobulinemia in various health status.

Due to the time-limited intestinal uptake of colostral immunoglobulins, the suggested treatment of hypogammaglobulinemia in new-born foals is usually plasma transfusion. The aims of this study were twofold: firstly, to investigate the course of serum IgG concentration after plasma transfusion in newborn foals; and secondly, to determine the amount of transfusion required for a significant increase in serum IgG concentration. For this purpose, the IgG concentration was measured in 23 foals at three different points in time: before transfusion, 1 hour after transfusion, and 24 hours after transfusion. There was an increase in IgG concentration in the blood of 18 foals (78.3%). In five foals (21.7%), no increase in serum IgG concentration were detected after plasma transfusion. Transfusion of 1 mg IgG caused an average increase in IgG level of 0.03 mg/dl (0.001-0.268 mg/dl) 1 hour after transfusion. After 24 hours, the same amount of IgG caused a larger increase of 0.05 mg/dl (0.002-0.537 mg/dl). None of the foals demonstrated adverse reactions to the plasma transfusion. These values provide a guidance how much IgG is needed to increase serum IgG concentration to a desired level. However, this study has shown that there is a high variability in serum IgG concentration after plasma transfusion. Which highlights the necessity for monitoring IgG concentration following transfusion.

Extracorporeal blood purification in acutely intoxicated veterinary patients: A multicenter retrospective study (2011-2018): 54 cases.

OBJECTIVE: To investigate the clinical outcome and complications associated with extracorporeal blood purification (EBP) using either hemodialysis (HD), hemodialysis and hemoperfusion (HD + HP), or therapeutic plasma exchange (TPE) for the management of acute toxin ingestion in small animals. DESIGN: Retrospective, multicenter study from January 2011 to July 2018. SETTING: One university teaching hospital and one private specialty hospital. ANIMALS: Fifty-one dogs and 3 cats with a history of acute toxin exposure that could lead to severe morbidity and mortality, managed with different EBP techniques. MAIN RESULTS: Nonsteroidal anti-inflammatory drugs (38/54, 52%), baclofen (8/54, 15%), and ethylene glycol (7/54, 13%) were the most common toxicities treated with EBP. Membrane-based TPE was used most commonly (22/54, 40.7%), followed by HD (17/54, 31.5%) and then HD + HP (15/54, 27.8%). There was an 83.3% (45/54) overall survival, with 88.9% (8/9) of nonsurvivors having clinical signs prior to therapy. One third (18/54) of the patients never developed clinical signs of toxicity. Treatment complications occurred in 44.4% (24/54) of the animals, although only 18.5% (10/54) of these complications, such as mild hypotension, thrombocytopenia secondary to the HP cartridge, facial swelling after plasma transfusion for TPE, bleeding from catheter size secondary to heparinization, or clotting of the system, could be attributed to the EBP treatment. None of the nonsurvivors died because of EBP complications. CONCLUSIONS: Early initiation of EBP therapy might be considered as an alternative route of decontamination in severe acute toxicities with high potential for significant morbidity and mortality. The survival rate in small animals undergoing EBP is high despite exposure to potential lethal doses of toxins, and survival appears to be more likely if clinical signs of toxicity are not present at the time of EBP. Continued research is warranted with randomized controlled clinical trials to further evaluate the clinical efficacy and benefit of EBP.

Assessment of the impact of age and of blood-derived inflammatory markers in horses with colitis.

OBJECTIVES: To determine the impact of age on survival in horses with colitis and to elucidate whether a lower type-1/type-2 cytokine ratio or an exaggerated inflammatory state contribute to reduced survival in aged horses. DESIGN: Part 1: Retrospective cohort analysis. Part 2: Analytic observational study. ANIMALS: Part 1: One hundred twenty-four adult horses with colitis. Part 2: Twenty-nine adult horses with new diarrhea onset while hospitalized. MEASUREMENTS AND MAIN RESULTS: Part 1: Patient signalment, select clinicopathological data, diagnoses, treatment, hospitalization length, and invoice were compared between survivors (n = 101) and nonsurvivors (n = 23). Only age and plasma transfusion retained statistical significance in the final multivariate outcome model, with 8.5 times lower odds of survival in transfused horses (95% confidence interval [CI], 2.6-27.2%). Additionally, the likelihood of nonsurvival increased by 11.8% (95% CI, 4-20.2%) for every year the horse aged (P = 0.002). Similarly, geriatric horses (≥20 years) were 15.2 times more likely to die than young-adults (2-12 years, P = 0.03), independent of financial investment, documented comorbidities, and duration of hospitalization. Part 2: Select cytokine analyses were performed on serum collected from hospitalized horses within 1 hour of diarrhea onset (T0) and 6 hours later. At T0, all recorded clinicopathological variables were comparable between geriatric and young-adult horses, suggesting a similar degree of systemic illness. The median concentration of type-2 cytokines interleukin-4 and interleukin-10, and type-1 cytokine interferon-γ did not differ between age groups. Inflammatory cytokines interleukin-6 and tumor necrosis factor-α were significantly higher in geriatric compared to young-adult horses at both sampling time points. CONCLUSIONS: Outcome of colitis was less favorable in aging horses and patients receiving a plasma transfusion. Although an exaggerated inflammatory state, based on increased interleukin-6 and tumor necrosis factor-α concentrations, in geriatric horses may contribute to reduced survival, a lower type-1/type-2 cytokines ratio was not identified in our geriatric population.

Intravenous vitamin K1 normalises prothrombin time in 1 hour in dogs with anticoagulant rodenticide toxicosis.

Four dogs with anticoagulant rodenticide toxicosis were treated with intravenous vitamin K1 in lieu of plasma transfusion due to client cost constraints. Two dogs experienced a suspected anaphylactoid reaction, necessitating cessation of the treatment in one dog. Prothrombin time was rechecked 1 h after treatment in the remaining three dogs and all results were within the normal reference range. All four dogs were discharged from hospital within 48 h of presentation. Intravenous vitamin K1 rapidly reverses the coagulopathic state in dogs with anticoagulant rodenticide toxicosis. It is a viable alternative therapy to plasma transfusion if circumstances preclude its use; however, patients must be monitored for anaphylactoid reactions.

Effect of leukocyte-reduced platelet-rich plasma on osteoarthritis caused by cranial cruciate ligament rupture: A canine gait analysis model.

The goal of this study was to objectively assess the effect of a platelet-rich plasma (PRP) derivate in English bulldogs with stifle degenerative joint disease secondary to cranial cruciate ligament rupture (CCLR). We used a force platform and affixed electrogoniometers to measure peak vertical force (PVF), vertical impulse (VI), stance time (ST), and angular range of motion (AROM), from 12 lame client-owned English bulldogs with post-CCLR stifle joint abnormalities. The 12 affected subjects were treated with 4 intra-articular injections of PRP, at 30-day intervals. Ten untreated, sound English bulldogs were used as a reference group. Clinical outcomes were evaluated using a linear mixed effects model. Mean values of PVF, VI, ST, and AROM were improved within the first 3 months post-treatment in the CCLR group, with mean measured changes increasing to maximum 4.56% body weight gain, 1.5% body weight/second, 0.07 seconds, and 6.18 degrees, respectively. The effects declined progressively after the treatment interval, ending at nearly initial levels after 6 months. This study demonstrates that dogs with CCLR treated with intra-articular PRP had improved PVF, VI, ST, and AROM over time; the duration of effect was waning by the end of the post-treatment period.

Fluid therapy for the emergent small animal patient: crystalloids, colloids, and albumin products.

Fluid therapy is essential in the treatment of emergent veterinary patients. Many different types of intravenous fluids are available, including crystalloids, artificial colloids, and natural colloids. The type, dose, and administration rate can determine the outcome in a critically ill patient. This article discusses the various types of fluids and their indication for use.

Treatment of afibrinogenemia in a chihuahua.

This report discusses the diagnosis and treatment of afibrinogenemia in a Chihuahua. Prolongations of prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin clotting time (TCT) together with fibrinogen assay results of either no or trace amounts of fibrinogen support a diagnosis of afibrinogenemia. Differential diagnoses include common coagulopathies, liver failure, and disseminated intravascular coagulation (DIC). Either aggressive cryoprecipitate or plasma transfusions are required to treat afibrinogenemia. The current guidelines for treatment of coagulopathies include plasma transfusions (either 15-30 mL/kg or until both PT and aPTT are normalized). This report describes a case in which bleeding persisted 2 days after standard plasma transfusion levels were administered and PT and aPTT levels had normalized. In this case, the bleeding was stabilized for up to 2 mo after administering > 54 mL/kg plasma. In human medicine, either cryoprecipitate or fibrinogen concentrate is used to increase blood fibrinogen levels to 100 mg/dL for minor bleeding and 200 mg/dL for major bleeding. Further studies are needed; however, the author of this report suggests that aggressive transfusions and monitoring are needed in veterinary afibrinogenemia cases.

All clinically-relevant blood components transmit prion disease following a single blood transfusion: a sheep model of vCJD.

Variant CJD (vCJD) is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents). Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion.

[Severe gastrointestinal bleeding secondary to lornoxicam in the dog]. / Lornoxicam-assoziierte schwere gastrointestinale Blutungen beim Hund.

Six dogs with lornoxicam induced severe gastrointestinal bleeding are described. The ingested dose ranged between 0.5 - 5.1 mg/kg BW (median 0.63 mg/kg BW). The severity of the bloodloss anemia was moderate to severe with PCV values ranging between 12 - 27 % (median 16 %) and serum albumin concentrations between 12 - 22 g/l (median 16 g/l). One dog had evidence of chronic thrombocytopathia over 13 days and clinicopathologic findings of gastrointestinal bleeding over 55 days. None of the dogs developed kidney injuries. The clinical condition required transfusion of blood products in 5 of 6 cases. One dog with a perforated duodenal ulcer and septic peritonitis survived until discharge but had to be euthanized later on due to recrudescent clinical signs (hematemesis, melena). The median length of hospitalisation was 12 days (5 - 14). No correlation was seen between the ingested dose and severity of clinical signs. Lornoxicam ingestion leads to severe and longlasting gastrointestinal bleeding in the dog and requires immediate intensive therapy.

Incidence of transfusion reactions to commercial equine plasma.

OBJECTIVE: To report on the incidence of transfusion reactions to commercial equine plasma in a hospital-based population of horses, to characterize these reactions and report on outcome. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: Client-owned horses referred to the University of Wisconsin. INTERVENTIONS: Intravenous administration of 2 commercial equine plasma products when clinically indicated. MEASUREMENTS AND MAIN RESULTS: Medical records of 107 horses that received plasma transfusions between 2003 and 2008 were evaluated. Transfusion reactions were recorded in 6 of 107 transfusions. All individuals were administered plasma from 1 commercial source. Foals <30 days of age received a hypergammaglobulinemic product and all adults received a lower IgG concentration product. No reactions were recorded in adults. In foals (<30 d) reactions were recorded in 6 of 69 cases (8.7%), all of which occurred in neonates <7 days of age (6/62; [9.7%]). The most frequent reactions were fever (4/6), tachycardia (2/6), tachypnea (2/6), and colic (2/6). All affected foals survived the reaction. There were no statistically significant differences (P<0.05) in any of the variables examined between those foals that did and those that did not experience transfusion reactions. CONCLUSION: The incidence of transfusion reactions was 8.7% in foals and 0% in adult horses in our referral population. Five of 6 foals responded to medical therapy and eventually received the clinically indicated transfusion. No transfusion related mortality occurred.

Trends in plasma transfusion at a veterinary teaching hospital: 308 patients (1996-1998 and 2006-2008).

OBJECTIVES: To describe changes in fresh frozen plasma (FFP) utilization over a 10-year period at a veterinary teaching hospital. To evaluate the effect of FFP administration on specific laboratory parameters. DESIGN: Retrospective observational study. SETTING: University teaching hospital. ANIMALS: Two hundred and eighty-three dogs and 25 cats. INTERVENTIONS: A hospital database search was performed for all animals receiving FFP during the study periods. MEASUREMENTS AND MAIN RESULTS: Medical records of patients receiving plasma transfusions from 2006 to 2008 and from 1996 to 1998 were reviewed. Data collected included indications for transfusion, transfused volume, concurrent therapies, clinicopathologic data pre- and post-transfusion, transfusion reactions, days of hospitalization, and outcome. FFP was administered to 112 dogs and 23 cats from 2006 to 2008 and to 171 dogs and 2 cats from 1996 to 1998. Significantly fewer patients received FFP for the treatment of hypoalbuminemia (2006-2008: 15% versus 1996-1998: 53%; P<0.001) or pancreatitis (2006-2008: 2% versus 1996-1998: 13%; P=0.001) and significantly more patients received FFP for coagulopathy (2006-2008: 80% versus 1996-1998: 31%; P<0.001) in the 2006-2008 group compared with the 1996-1998 group. For all patients receiving FFP, there was no difference in mean serum albumin concentration pre- and post-transfusion. Median prothrombin time and activated partial thromboplastin time were significantly decreased post FFP administration. No association was found between the volume of plasma administered and outcome. CONCLUSIONS: FFP utilization has changed significantly over a 10-year period. FFP was used most commonly in 2006-2008 for the correction of coagulopathy. FFP administration was associated with significant reduction in prothrombin time and activated partial thromboplastin time but did not significantly alter albumin concentration when administered at median doses of 15-18 mL/kg.

Transfusion medicine in small animal practice.

Red blood cell transfusions in veterinary medicine have become increasingly more common and are an integral part of lifesaving and advanced treatment of the critically ill. Common situations involving transfusions are life-threatening anemia from acute hemorrhage or surgical blood loss, hemolysis from drugs or toxins, immune-mediated diseases, severe nonregenerative conditions, and neonatal isoerythrolysis. Although transfusions can be lifesaving, they are also associated with adverse events that can be life threatening. This article reviews the principles for pretransfusion blood typing and compatibility testing and the types of transfusion reactions that exist despite test performance.

Autologous conditioned plasma as therapy of tendon and ligament lesions in seven horses.

This case report describes the intralesional application of autologous conditioned plasma (ACP) in seven horses as treatment of severe tendinitis of the superficial digital flexor tendon, deep digital flexor tendon, or desmitis of the inferior check ligament. Follow-up data of the horses revealed a positive outcome in 10 to 13 months post injury. All horses treated with ACP were either performing in their previous work-load or were back in full training. Further studies with long-term follow-up will have to be performed to support these clinical intermediate-term observations.

Autologous conditioned plasma as therapy of tendon and ligament lesions in seven horses

This case report describes the intralesional application of autologous conditioned plasma (ACP) in seven horses as treatment of severe tendinitis of the superficial digital flexor tendon, deep digital flexor tendon, or desmitis of the inferior check ligament. Follow-up data of the horses revealed a positive outcome in 10 to 13 months post injury. All horses treated with ACP were either performing in their previous work-load or were back in full training. Further studies with long-term follow-up will have to be performed to support these clinical intermediate-term observations.

Evaluation of fresh frozen plasma administration in dogs with pancreatitis: 77 cases (1995-2005).

OBJECTIVE: Compare outcome of dogs that did and did not receive fresh frozen plasma (FFP) for treatment of pancreatitis. DESIGN: Retrospective case series between 1995 and 2005. SETTING: University referral hospital. ANIMALS: Seventy-four dogs were enrolled with a total of 77 cases as 2 dogs had repeat episodes of pancreatitis. Diagnosis of pancreatitis was based on clinical signs, physical examination, and abdominal ultrasonographic examination. INTERVENTIONS: The medical database was searched for dogs with a diagnosis of pancreatitis. Information collected included signalment, vital signs, CBC, use of FFP, length of stay, use of antimicrobials and supplemental nutrition, surgical intervention, preexisting illness, evidence of a coagulopathy and outcome. Outcome was compared between those patients that did and did not receive FFP. MEASUREMENTS AND MAIN RESULTS: Fifty-nine dogs survived to discharge. Two dogs with repeat pancreatitis survived to discharge after each episode. Thirteen dogs died and 2 were euthanized. FFP was administered to 20 dogs. Two dogs that were hospitalized for repeat pancreatitis did not receive FFP. Seven of 20 (35%) cases that received plasma died or were euthanized compared with 6 of 57 (12%) cases that did not receive plasma. Plasma administration was significantly related to outcome (P<0.001). Severity of illness scores were difficult to assign, however, dogs meeting criteria for systemic inflammatory response syndrome were not more likely to receive FFP. Other therapies included supplemental nutrition, antimicrobials, and surgical intervention, which did not affect outcome. CONCLUSIONS: Mortality rate for those dogs receiving plasma was higher than those that did not. Severity of illness scores were difficult to assign; however, preexisting illness, evidence of systemic inflammatory response syndrome, and presence of a coagulopathy were not significantly different between the groups that did and did not receive FFP. No benefit for administration of FFP was noted. Additional investigation should be performed to confirm this result.