Erin L. Patterson, Emily J. Ball, Justin M. Lavallee
Objective
To provide a case description, including perioperative management, of a young cat with feline gastrointestinal eosinophilic sclerosing fibroplasia that presented with septic peritonitis.
Case Summary
A 1.5-year-old male castrated British Shorthair was presented with an acute history of vomiting, inappetence, and periuria. On presentation, the patient was in shock and was apparently painful on abdominal palpation. Abdominal radiographs identified a mass effect within the stomach, pneumoperitoneum, and a mild lack of serosal detail consistent with scant peritoneal effusion. Exploratory laparotomy confirmed a mass affecting the pylorus and proximal duodenum, which was ruptured at the level of the major duodenal papilla. Mass resection with concurrent gastroduodenostomy and cholecystojejunostomy was performed, and feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) was diagnosed histopathologically. The cat was discharged 4 days postoperatively. Two weeks after surgery, treatment with prednisolone was initiated, and a hypoallergenic diet was recommended. Short-term medical management was challenged by poor owner compliance, and the patient was lost to follow-up 7 months after surgery.
New or Unique Information Provided
To the authors’ knowledge, this is the first report of FGESF as a cause of gastrointestinal perforation and septic peritonitis. FGESF should be considered a differential for perforated gastrointestinal masses in cats.
{"title":"Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia and Duodenal Perforation in a 1-Year-Old British Shorthair Cat","authors":"Erin L. Patterson, Emily J. Ball, Justin M. Lavallee","doi":"10.1111/vec.13465","DOIUrl":"10.1111/vec.13465","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide a case description, including perioperative management, of a young cat with feline gastrointestinal eosinophilic sclerosing fibroplasia that presented with septic peritonitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 1.5-year-old male castrated British Shorthair was presented with an acute history of vomiting, inappetence, and periuria. On presentation, the patient was in shock and was apparently painful on abdominal palpation. Abdominal radiographs identified a mass effect within the stomach, pneumoperitoneum, and a mild lack of serosal detail consistent with scant peritoneal effusion. Exploratory laparotomy confirmed a mass affecting the pylorus and proximal duodenum, which was ruptured at the level of the major duodenal papilla. Mass resection with concurrent gastroduodenostomy and cholecystojejunostomy was performed, and feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) was diagnosed histopathologically. The cat was discharged 4 days postoperatively. Two weeks after surgery, treatment with prednisolone was initiated, and a hypoallergenic diet was recommended. Short-term medical management was challenged by poor owner compliance, and the patient was lost to follow-up 7 months after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>To the authors’ knowledge, this is the first report of FGESF as a cause of gastrointestinal perforation and septic peritonitis. FGESF should be considered a differential for perforated gastrointestinal masses in cats.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 3","pages":"279-285"},"PeriodicalIF":1.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daeyun Seo, Seongsoo Lim, Beomkwan Namgoong, Heesung Uhm, Hyeajeong Hong, Nanju Lee, Isong Kim, Seunghun Heo, Ji Hwan Kang, Cheyoun Kim, Hayoung Shin, Jiwoong Her, Min-Su Kim
Objective
To investigate whether point-of-care ultrasound of the external jugular vein (EJV) can predict fluid responsiveness (FR) in healthy, anesthetized, mechanically ventilated dogs.
Design
Prospective, nonrandomized experimental study.
Setting
University-based small animal research facility.
Animals
Six healthy Beagle dogs.
Interventions
Dogs were investigated at six time points (TPs): baseline (TP1); 20 mL/kg of circulating blood was collected over 10 min (TP2); half of the collected blood was autotransfused for 10 min (TP3); remaining collected blood was autotransfused for 10 min (TP4); 0.9% normal saline (10 mL/kg for 10 min) was administered (TP5); and an additional dose of 0.9% normal saline (10 mL/kg for 10 min) was administered (TP6). Hemodynamic variables, Doppler images of the left ventricular outflow tract (LVOT), and M-mode images of the EJV were obtained at each TP. FR was evaluated during TP3–6. FR was defined as an increase of >15% in the LVOT velocity time integral following fluid challenge, while other results were defined as fluid nonresponsiveness (FNR). The external jugular vein distensibility index (EJVDI) was calculated as follows: [(maximal EJV diameter − minimal EJV diameter)/minimal EJV diameter] × 100%. The maximal EJV diameter was measured during inspiration, and the minimal EJV diameter was measured during expiration. In addition, gray zones indicating the range of diagnostic uncertainty were proposed in various indices for predicting FR.
Measurements and Main Results
Among the 24 fluid challenges performed between TP3 and TP6, 11 FR and 13 FNR were identified. The area under the receiver operating characteristic curve for the EJVDI in predicting FR was 0.92, with a cut-ff value of 22.7%, and the gray zone was identified as 22.6%–27.3%.
Conclusions
The EJVDI could be used to predict FR in healthy, anesthetized, mechanically ventilated dogs. Further studies are requ
{"title":"Prediction of Fluid Responsiveness Based on the External Jugular Vein Distensibility Index After Changes in Volume Status in Healthy, Anesthetized, and Mechanically Ventilated Dogs","authors":"Daeyun Seo, Seongsoo Lim, Beomkwan Namgoong, Heesung Uhm, Hyeajeong Hong, Nanju Lee, Isong Kim, Seunghun Heo, Ji Hwan Kang, Cheyoun Kim, Hayoung Shin, Jiwoong Her, Min-Su Kim","doi":"10.1111/vec.13466","DOIUrl":"10.1111/vec.13466","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate whether point-of-care ultrasound of the external jugular vein (EJV) can predict fluid responsiveness (FR) in healthy, anesthetized, mechanically ventilated dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, nonrandomized experimental study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University-based small animal research facility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Six healthy Beagle dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Dogs were investigated at six time points (TPs): baseline (TP<sub>1</sub>); 20 mL/kg of circulating blood was collected over 10 min (TP<sub>2</sub>); half of the collected blood was autotransfused for 10 min (TP<sub>3</sub>); remaining collected blood was autotransfused for 10 min (TP<sub>4</sub>); 0.9% normal saline (10 mL/kg for 10 min) was administered (TP<sub>5</sub>); and an additional dose of 0.9% normal saline (10 mL/kg for 10 min) was administered (TP<sub>6</sub>). Hemodynamic variables, Doppler images of the left ventricular outflow tract (LVOT), and M-mode images of the EJV were obtained at each TP. FR was evaluated during TP<sub>3–6</sub>. FR was defined as an increase of >15% in the LVOT velocity time integral following fluid challenge, while other results were defined as fluid nonresponsiveness (FNR). The external jugular vein distensibility index (EJVDI) was calculated as follows: [(maximal EJV diameter − minimal EJV diameter)/minimal EJV diameter] × 100%. The maximal EJV diameter was measured during inspiration, and the minimal EJV diameter was measured during expiration. In addition, gray zones indicating the range of diagnostic uncertainty were proposed in various indices for predicting FR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Among the 24 fluid challenges performed between TP<sub>3</sub> and TP<sub>6</sub>, 11 FR and 13 FNR were identified. The area under the receiver operating characteristic curve for the EJVDI in predicting FR was 0.92, with a cut-ff value of 22.7%, and the gray zone was identified as 22.6%–27.3%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The EJVDI could be used to predict FR in healthy, anesthetized, mechanically ventilated dogs. Further studies are requ","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 3","pages":"214-224"},"PeriodicalIF":1.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia Lunet Marques, Beatriz Mendoza, Maria Joana Dias, Miguel Carvalho, Stijn M. Niessen, Rodolfo Oliveira Leal
Objective
To describe the medical management of euglycemic diabetic ketoacidosis (EDKA) after two administrations of dapagliflozin in a cat with congenital diabetes mellitus undergoing insulin therapy.
Case Summary
A 2-year-old neutered female domestic shorthair cat with a prior presumptive diagnosis of congenital diabetes mellitus was followed for 20 months. After several adjustments to insulin therapy, the cat was relatively stable on high doses of insulin glargine (8.3 IU/kg, SC, q 12 h) with persistent hyperglycemia. Due to concerns regarding the impact of chronic hyperglycemia in a young cat, treatment was started with dapagliflozin (10 mg/cat, PO, q 24 h). A reduced dose of insulin glargine (1.3 IU/kg, SC, q 12 h) was administered concurrently to minimize the risk of ketoacidosis. Forty-eight hours after the second dapagliflozin administration, the cat was admitted for lethargy, hyporexia, and vomiting. Bloodwork was consistent with ketoacidosis and hypokalemia. During initial treatment for diabetic ketoacidosis, the cat developed hypophosphatemia, hyperbilirubinemia, and increased liver enzyme activities, with normal interstitial glucose values despite cessation of dapagliflozin. Management consisted of 7.5% glucose supplementation, a constant rate infusion of short-acting insulin, and correction of electrolyte and acid–base derangements. Improvement was seen within 12 h of starting this protocol. The cat was discharged after 9 days of hospitalization. Sixteen days after the discontinuation of dapagliflozin, the cat's interstitial glucose concentration, liver enzyme activities, and serum bilirubin concentration returned to pretreatment values.
New or Unique Information Provided
With the introduction of sodium-glucose linked cotransporter 2 inhibitors, clinicians should be aware of EDKA and its management. This case report describes how the treatment of EDKA in cats, similar to treatment in people, may require proactive, aggressive glucose supplementation, treatment with short-acting soluble insulin, and vigilant electrolyte and acid–base monitoring. It also showcases the possibility of dapagliflozin having effect days beyond drug cessation.
{"title":"Clinical Management of Euglycemic Ketoacidosis in a Cat With Congenital Diabetes Mellitus Treated With Insulin and Dapagliflozin","authors":"Patricia Lunet Marques, Beatriz Mendoza, Maria Joana Dias, Miguel Carvalho, Stijn M. Niessen, Rodolfo Oliveira Leal","doi":"10.1111/vec.13458","DOIUrl":"https://doi.org/10.1111/vec.13458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the medical management of euglycemic diabetic ketoacidosis (EDKA) after two administrations of dapagliflozin in a cat with congenital diabetes mellitus undergoing insulin therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 2-year-old neutered female domestic shorthair cat with a prior presumptive diagnosis of congenital diabetes mellitus was followed for 20 months. After several adjustments to insulin therapy, the cat was relatively stable on high doses of insulin glargine (8.3 IU/kg, SC, q 12 h) with persistent hyperglycemia. Due to concerns regarding the impact of chronic hyperglycemia in a young cat, treatment was started with dapagliflozin (10 mg/cat, PO, q 24 h). A reduced dose of insulin glargine (1.3 IU/kg, SC, q 12 h) was administered concurrently to minimize the risk of ketoacidosis. Forty-eight hours after the second dapagliflozin administration, the cat was admitted for lethargy, hyporexia, and vomiting. Bloodwork was consistent with ketoacidosis and hypokalemia. During initial treatment for diabetic ketoacidosis, the cat developed hypophosphatemia, hyperbilirubinemia, and increased liver enzyme activities, with normal interstitial glucose values despite cessation of dapagliflozin. Management consisted of 7.5% glucose supplementation, a constant rate infusion of short-acting insulin, and correction of electrolyte and acid–base derangements. Improvement was seen within 12 h of starting this protocol. The cat was discharged after 9 days of hospitalization. Sixteen days after the discontinuation of dapagliflozin, the cat's interstitial glucose concentration, liver enzyme activities, and serum bilirubin concentration returned to pretreatment values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information Provided</h3>\u0000 \u0000 <p>With the introduction of sodium-glucose linked cotransporter 2 inhibitors, clinicians should be aware of EDKA and its management. This case report describes how the treatment of EDKA in cats, similar to treatment in people, may require proactive, aggressive glucose supplementation, treatment with short-acting soluble insulin, and vigilant electrolyte and acid–base monitoring. It also showcases the possibility of dapagliflozin having effect days beyond drug cessation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"162-170"},"PeriodicalIF":1.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amelia S. Munsterman, Ana S. Dias Moreira, Jack Kottwitz
Objective
To evaluate the effects of detomidine on equine intestinal slow-wave activity and frequency distribution measured by electrointestinography (EIG).
Design
Prospective, experimental study.
Setting
University teaching hospital.
Animals
A convenience sample of twelve 7- to 21-year-old clinically normal horses.
Interventions
Horses were randomly assigned to saline control (four horses) or detomidine treatment (eight). After obtaining a 30-min baseline EIG, a saline or detomidine bolus was administered, followed by a constant rate infusion, and another EIG was recorded. Ultrasonographic examinations monitored cecal and left ventral colon contractions. Spectral analysis was performed to evaluate changes in dominant frequency, dominant power, total power, percent frequency distribution, and changes in slow-wave rhythmic activity.
Measurements and Main Results
Median (interquartile range [IQR]) dominant frequency in cycles per minute (cpm) was similar for the cecum (2.4 cpm; IQR: 0.51 cpm) and left ventral colon (2.13 cpm; IQR: 0.16 cpm) and unchanged by either treatment (P > 0.074). Compared with saline, which was unchanged, detomidine reduced dominant power ratios for both cecum (0.45; IQR: 0.18) and left ventral colon (0.63; IQR: 0.35; P = 0.002). Detomidine decreased total power for the cecum in the 2–4 cpm frequency range from 55.0% (IQR: 4.4%) to 43.1% (IQR: 6.7%) and for the left ventral colon from 54.4% (IQR: 5.5%) to 27.3% (IQR: 9.3%; P < 0.087). Total power for the cecum was increased in the 8–12 cpm frequency range from 9.6% (IQR: 1.9%) to 18.5% (IQR: 6.6%; P = 0.0044) with detomidine. No change in frequency distribution was noted in controls (P > 0.08). Dominant power correlated with the rate of contractions measured ultrasonographically (P < 0.001).
Conclusions
Detomidine decreased dominant power ratios for both the cecum and left ventral colon and produced tachyarrhythmias in cecal slow-wave activity. The correlation of dominant
{"title":"Evaluation of the Effects of Detomidine on Equine Myoelectrical Activity Using Electrointestinography","authors":"Amelia S. Munsterman, Ana S. Dias Moreira, Jack Kottwitz","doi":"10.1111/vec.13464","DOIUrl":"https://doi.org/10.1111/vec.13464","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effects of detomidine on equine intestinal slow-wave activity and frequency distribution measured by electrointestinography (EIG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, experimental study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>A convenience sample of twelve 7- to 21-year-old clinically normal horses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Horses were randomly assigned to saline control (four horses) or detomidine treatment (eight). After obtaining a 30-min baseline EIG, a saline or detomidine bolus was administered, followed by a constant rate infusion, and another EIG was recorded. Ultrasonographic examinations monitored cecal and left ventral colon contractions. Spectral analysis was performed to evaluate changes in dominant frequency, dominant power, total power, percent frequency distribution, and changes in slow-wave rhythmic activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Median (interquartile range [IQR]) dominant frequency in cycles per minute (cpm) was similar for the cecum (2.4 cpm; IQR: 0.51 cpm) and left ventral colon (2.13 cpm; IQR: 0.16 cpm) and unchanged by either treatment (<i>P</i> > 0.074). Compared with saline, which was unchanged, detomidine reduced dominant power ratios for both cecum (0.45; IQR: 0.18) and left ventral colon (0.63; IQR: 0.35; <i>P</i> = 0.002). Detomidine decreased total power for the cecum in the 2–4 cpm frequency range from 55.0% (IQR: 4.4%) to 43.1% (IQR: 6.7%) and for the left ventral colon from 54.4% (IQR: 5.5%) to 27.3% (IQR: 9.3%; <i>P</i> < 0.087). Total power for the cecum was increased in the 8–12 cpm frequency range from 9.6% (IQR: 1.9%) to 18.5% (IQR: 6.6%; <i>P</i> = 0.0044) with detomidine. No change in frequency distribution was noted in controls (<i>P</i> > 0.08). Dominant power correlated with the rate of contractions measured ultrasonographically (<i>P</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Detomidine decreased dominant power ratios for both the cecum and left ventral colon and produced tachyarrhythmias in cecal slow-wave activity. The correlation of dominant","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"120-130"},"PeriodicalIF":1.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reviewer list for 2024","authors":"","doi":"10.1111/vec.13423","DOIUrl":"https://doi.org/10.1111/vec.13423","url":null,"abstract":"","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"181-182"},"PeriodicalIF":1.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Lister, Jessica Kielb Basile, Colette Wegenast
Background
Since the release of chewable flavored oclacitinib, household pets are ingesting larger quantities and are experiencing signs of toxicosis that have not been noted previously.
Key Findings
Reports of intoxication have included gastrointestinal signs (vomiting, diarrhea, abdominal pain), cardiovascular signs (rhythm disturbances, hypotension, new onset heart murmur), CNS signs (lethargy, dull mentation, elevated nictitans), acute kidney injury in both dogs and cats, hepatotoxicity, and death.
Significance
When overdoses occur with meaningful clinical signs, clinicians are urged to provide proactive monitoring and treatment. Consultation with a poison control center and adverse event reporting to the manufacturer and the Food and Drug Administration are recommended.
{"title":"Oclacitinib Intoxication","authors":"Sara Lister, Jessica Kielb Basile, Colette Wegenast","doi":"10.1111/vec.13459","DOIUrl":"https://doi.org/10.1111/vec.13459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since the release of chewable flavored oclacitinib, household pets are ingesting larger quantities and are experiencing signs of toxicosis that have not been noted previously.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>Reports of intoxication have included gastrointestinal signs (vomiting, diarrhea, abdominal pain), cardiovascular signs (rhythm disturbances, hypotension, new onset heart murmur), CNS signs (lethargy, dull mentation, elevated nictitans), acute kidney injury in both dogs and cats, hepatotoxicity, and death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>When overdoses occur with meaningful clinical signs, clinicians are urged to provide proactive monitoring and treatment. Consultation with a poison control center and adverse event reporting to the manufacturer and the Food and Drug Administration are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"176-177"},"PeriodicalIF":1.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan R. Reeves, Brandi L. Mattison, Deborah A. Keys, Tereza Stastny
Objective
To compare the efficacy of ropinirole (ROP) eye drops and IV apomorphine (APO) for inducing emesis in dogs in an emergency setting and to compare the adverse effects of these two drugs.
Design
Prospective, randomized, clinical trial between October 2021 and March 2023.
Setting
Two private specialty referral centers.
Animals
One hundred thirty-two client-owned dogs with known or suspected foreign material ingestion.
Interventions
Dogs were randomly assigned to receive ROP (n = 63) or APO (n = 69) to induce emesis. If emesis did not occur within 20 min, subjects were re-dosed with the same medication and dosage. The reason for emesis, success, time to first emesis, number of emetic events, and need for rescue antiemetic were evaluated. Heart rate, respiratory rate, and temperature were tracked at time 0 and at 20 and 40 min. Adverse events were categorized into major events (e.g., tachycardia, hyperthermia, tachypnea), minor events (e.g., sedation, ocular irritation), and protracted vomiting (vomiting past 30 min).
Measurements and Main Results
ROP's first-dose success was 81% (51/63) compared with APO's 99% success (68/69) (p < 0.001). The median time to the first emetic event was 8.6 min in the ROP group and 1.6 min in the APO group (P < 0.001). Antiemetic rescue was required in 37% (23/63) of dogs receiving ROP and 0% (0/69) of dogs receiving APO (P < 0.001). The major adverse event frequency between groups was not different (P = 0.604); however, the minor adverse event frequency was statistically significant (P = 0.011).
Conclusions
ROP had a lower first-dose emetic success rate, a longer median time to the first emetic event, an increased occurrence of minor adverse events, and a higher frequency of protracted vomiting necessitating rescue therapy. These findings suggest APO is a clinically superior emetic agent for dogs presenting to the emergency department requiring rapid decontamination.
{"title":"Evaluation of Ropinirole versus Apomorphine for Emesis Induction in Dogs","authors":"Ryan R. Reeves, Brandi L. Mattison, Deborah A. Keys, Tereza Stastny","doi":"10.1111/vec.13456","DOIUrl":"https://doi.org/10.1111/vec.13456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the efficacy of ropinirole (ROP) eye drops and IV apomorphine (APO) for inducing emesis in dogs in an emergency setting and to compare the adverse effects of these two drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective, randomized, clinical trial between October 2021 and March 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Two private specialty referral centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>One hundred thirty-two client-owned dogs with known or suspected foreign material ingestion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions</h3>\u0000 \u0000 <p>Dogs were randomly assigned to receive ROP (<i>n</i> = 63) or APO (<i>n</i> = 69) to induce emesis. If emesis did not occur within 20 min, subjects were re-dosed with the same medication and dosage. The reason for emesis, success, time to first emesis, number of emetic events, and need for rescue antiemetic were evaluated. Heart rate, respiratory rate, and temperature were tracked at time 0 and at 20 and 40 min. Adverse events were categorized into major events (e.g., tachycardia, hyperthermia, tachypnea), minor events (e.g., sedation, ocular irritation), and protracted vomiting (vomiting past 30 min).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>ROP's first-dose success was 81% (51/63) compared with APO's 99% success (68/69) (<i>p</i> < 0.001). The median time to the first emetic event was 8.6 min in the ROP group and 1.6 min in the APO group (<i>P</i> < 0.001). Antiemetic rescue was required in 37% (23/63) of dogs receiving ROP and 0% (0/69) of dogs receiving APO (<i>P</i> < 0.001). The major adverse event frequency between groups was not different (<i>P</i> = 0.604); however, the minor adverse event frequency was statistically significant (<i>P</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ROP had a lower first-dose emetic success rate, a longer median time to the first emetic event, an increased occurrence of minor adverse events, and a higher frequency of protracted vomiting necessitating rescue therapy. These findings suggest APO is a clinically superior emetic agent for dogs presenting to the emergency department requiring rapid decontamination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"105-111"},"PeriodicalIF":1.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Torrente, Patricia Bou, Marta Riba, Dania Fernández, Luis Bosch
Objective
To describe type 4 renal tubular acidosis (RTA) and acquired pseudohypoaldosteronism in a cat with acute kidney injury (AKI) presumably associated with lipid infusion therapy for permethrin toxicosis.
Case Summary
A 1-year-old neutered male cat presented with acute weakness, ataxia, fasciculations, tremors, hyperthermia, and seizures resulting from permethrin toxicosis. Upon admission, IV diazepam and 20% IV lipid emulsion were administered. Forty-eight hours after discharge, the patient was readmitted for lethargy, anorexia, polyuria, and vomiting. Upon admission, the patient exhibited signs of depression, dehydration, and moderate hypoperfusion. Initial assessments included CBC, serum biochemistry profile, and urinalysis. Further diagnostic workup and abdominal point-of-care ultrasound revealed clinical findings compatible with AKI. Laboratory analysis confirmed severe hyperkalemia, hyperchloremic normal anion gap metabolic acidosis, decreased fractional excretion of potassium, and decreased transtubular potassium gradient in the urine, all consistent with a diagnosis of secondary or acquired pseudohypoaldosteronism and type 4 RTA. Emergency medical treatment for hyperkalemia was initiated, but control of serum potassium concentration was unsuccessful. Peritoneal dialysis (PD) and general supportive care were initiated 24 h after admission. Mineralocorticoid support (continuous rate infusion of hydrocortisone) was initiated 4 days after admission due to suspected deficiency/resistance to aldosterone at the distal nephron. Unfortunately, despite PD, refractory hyperkalemia persisted, and the cat died 16 days after admission. Histopathological examination confirmed an acute and severe renal papillary necrosis.
New or Unique Information
To the authors’ knowledge, this is the first description of type 4 RTA in a cat. Furthermore, we hypothesize that, according to the histopathological findings, this presentation of AKI may be secondary to the use of IV lipid emulsion for permethrin toxicosis, a complication not previously reported in the veterinary literature.
{"title":"Refractory Hyperkalemia With Type 4 Renal Tubular Acidosis Associated With Tubulointerstitial Nephritis and Renal Papillary Necrosis Following Intravenous Lipid Emulsion Therapy in a Cat","authors":"Carlos Torrente, Patricia Bou, Marta Riba, Dania Fernández, Luis Bosch","doi":"10.1111/vec.13462","DOIUrl":"10.1111/vec.13462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe type 4 renal tubular acidosis (RTA) and acquired pseudohypoaldosteronism in a cat with acute kidney injury (AKI) presumably associated with lipid infusion therapy for permethrin toxicosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 1-year-old neutered male cat presented with acute weakness, ataxia, fasciculations, tremors, hyperthermia, and seizures resulting from permethrin toxicosis. Upon admission, IV diazepam and 20% IV lipid emulsion were administered. Forty-eight hours after discharge, the patient was readmitted for lethargy, anorexia, polyuria, and vomiting. Upon admission, the patient exhibited signs of depression, dehydration, and moderate hypoperfusion. Initial assessments included CBC, serum biochemistry profile, and urinalysis. Further diagnostic workup and abdominal point-of-care ultrasound revealed clinical findings compatible with AKI. Laboratory analysis confirmed severe hyperkalemia, hyperchloremic normal anion gap metabolic acidosis, decreased fractional excretion of potassium, and decreased transtubular potassium gradient in the urine, all consistent with a diagnosis of secondary or acquired pseudohypoaldosteronism and type 4 RTA. Emergency medical treatment for hyperkalemia was initiated, but control of serum potassium concentration was unsuccessful. Peritoneal dialysis (PD) and general supportive care were initiated 24 h after admission. Mineralocorticoid support (continuous rate infusion of hydrocortisone) was initiated 4 days after admission due to suspected deficiency/resistance to aldosterone at the distal nephron. Unfortunately, despite PD, refractory hyperkalemia persisted, and the cat died 16 days after admission. Histopathological examination confirmed an acute and severe renal papillary necrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> New or Unique Information</h3>\u0000 \u0000 <p>To the authors’ knowledge, this is the first description of type 4 RTA in a cat. Furthermore, we hypothesize that, according to the histopathological findings, this presentation of AKI may be secondary to the use of IV lipid emulsion for permethrin toxicosis, a complication not previously reported in the veterinary literature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 3","pages":"286-294"},"PeriodicalIF":1.2,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabrina N. Hoehne, Vishal D. Murthy, Steven E. Epstein, Kate Hopper, Linda G. Martin, Marta E. Kantyka
Objective
To describe the in-hospital postcardiac arrest (PCA) care and short- and long-term functional outcomes of dogs and cats surviving to hospital discharge after naturally occurring cardiopulmonary arrest (CPA) and CPR.
Design
Multicenter retrospective observational study.
Setting
Three veterinary teaching hospitals.
Animals
Client-owned dogs (n = 25) and cats (n = 15).
Measurements and Main Results
Medical records of animals that underwent CPR and survived to discharge were retrospectively reviewed, and information was recorded regarding CPR event, PCA hospitalization, and short- and long-term outcomes. Ninety-two percent of CPA events occurred in hospital and were witnessed, and 8% occurred out of hospital. Eighty-five percent of events occurred during general anesthesia or sedation. CPR efforts ranged from <1 to 18 min, and animals remained hospitalized between 0.5 and 15.5 days after return of spontaneous circulation. Seventy-three percent of animals required supplemental oxygen, 13% required mechanical ventilation, and 20% required vasopressor, positive inotropic, or glucocorticoid therapy. Hyperosmolar therapies were administered to 38% of animals, anticonvulsants were given to 18%, and 8% of animals developed new-onset PCA seizures. The median (range) modified Glasgow Coma Scale score before CPA was 18 (11–18), 12 h PCA was 16 (6–18), and 72 h PCA was 17.5 (14–18). Median survival time was 455 days (range: 11–2650 days). Twenty-five percent of owners perceived a persistent disability in their pets, from behavioral changes to required nutritional and recumbent care. Nonetheless, all owners reported their pet's PCA quality of life to be good.
Conclusions
Good short- and long-term functional outcomes post-CPA can be achieved in dogs and cats. Functional survival remains possible in some cases of out-of-hospital CPA and after prolonged CPR, suggesting a benefit of high-quality CPR in all scenarios. Patient stabilization and neurological improvement may take 48–72 h, and early discouraging findings should not prevent continuation of PCA care.
{"title":"Post-Cardiopulmonary Arrest Care and Functional Outcomes in Dogs and Cats Surviving to Hospital Discharge Since Publication of the RECOVER Guidelines: 2012–2022","authors":"Sabrina N. Hoehne, Vishal D. Murthy, Steven E. Epstein, Kate Hopper, Linda G. Martin, Marta E. Kantyka","doi":"10.1111/vec.13457","DOIUrl":"https://doi.org/10.1111/vec.13457","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the in-hospital postcardiac arrest (PCA) care and short- and long-term functional outcomes of dogs and cats surviving to hospital discharge after naturally occurring cardiopulmonary arrest (CPA) and CPR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Multicenter retrospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Three veterinary teaching hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Client-owned dogs (<i>n</i> = 25) and cats (<i>n</i> = 15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements and Main Results</h3>\u0000 \u0000 <p>Medical records of animals that underwent CPR and survived to discharge were retrospectively reviewed, and information was recorded regarding CPR event, PCA hospitalization, and short- and long-term outcomes. Ninety-two percent of CPA events occurred in hospital and were witnessed, and 8% occurred out of hospital. Eighty-five percent of events occurred during general anesthesia or sedation. CPR efforts ranged from <1 to 18 min, and animals remained hospitalized between 0.5 and 15.5 days after return of spontaneous circulation. Seventy-three percent of animals required supplemental oxygen, 13% required mechanical ventilation, and 20% required vasopressor, positive inotropic, or glucocorticoid therapy. Hyperosmolar therapies were administered to 38% of animals, anticonvulsants were given to 18%, and 8% of animals developed new-onset PCA seizures. The median (range) modified Glasgow Coma Scale score before CPA was 18 (11–18), 12 h PCA was 16 (6–18), and 72 h PCA was 17.5 (14–18). Median survival time was 455 days (range: 11–2650 days). Twenty-five percent of owners perceived a persistent disability in their pets, from behavioral changes to required nutritional and recumbent care. Nonetheless, all owners reported their pet's PCA quality of life to be good.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Good short- and long-term functional outcomes post-CPA can be achieved in dogs and cats. Functional survival remains possible in some cases of out-of-hospital CPA and after prolonged CPR, suggesting a benefit of high-quality CPR in all scenarios. Patient stabilization and neurological improvement may take 48–72 h, and early discouraging findings should not prevent continuation of PCA care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 2","pages":"142-155"},"PeriodicalIF":1.1,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In veterinary medicine, high-flow nasal cannula oxygen therapy (HFNT) has gained popularity in managing hypoxemic respiratory failure, bridging the gap between conventional oxygen therapy and mechanical ventilation. The SpO2:FiO2 (SF) ratio could be useful in assessing oxygenation impairment in dogs undergoing HFNT. The current study aimed to determine whether the SF ratio correlates with the PaO2:FiO2 (PF) ratio in dogs undergoing HFNT.
Key Findings
A total of 30 data pairs with concurrent SpO2 and PaO2 measurements were identified from 19 dogs treated with HFNT from two university veterinary teaching hospitals. PF and SF ratios were measured when PaO2 fell between 74 and 129 mm Hg. The median SF and PF ratios were 186 (interquartile range: 97–243) and 168 (interquartile range: 108–297), respectively. SF ratios were strongly correlated with PF ratios (rho = 0.86 [95% confidence interval: 0.73–0.93], p < 0.001, weighted r = 0.89 [95% confidence interval: 0.74–0.96]).
Significance
Preliminary results suggest a statistically significant positive correlation between SF and PF ratios in dogs treated with HFNT. This study provides data that can be used to calculate appropriate sample sizes for subsequent studies investigating the specific SF ratios corresponding with the PF ratios as the criteria for assessing hypoxemia.
{"title":"Retrospective Evaluation of the Correlation Between PaO2:FiO2 and SpO2:FiO2 Ratios in Dogs Undergoing High-Flow Nasal Cannula Oxygen Therapy","authors":"Jiwoong Her, Emily Lu, Kendon Kuo","doi":"10.1111/vec.13463","DOIUrl":"10.1111/vec.13463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In veterinary medicine, high-flow nasal cannula oxygen therapy (HFNT) has gained popularity in managing hypoxemic respiratory failure, bridging the gap between conventional oxygen therapy and mechanical ventilation. The SpO<sub>2</sub>:FiO<sub>2</sub> (SF) ratio could be useful in assessing oxygenation impairment in dogs undergoing HFNT. The current study aimed to determine whether the SF ratio correlates with the PaO<sub>2</sub>:FiO<sub>2</sub> (PF) ratio in dogs undergoing HFNT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>A total of 30 data pairs with concurrent SpO<sub>2</sub> and PaO<sub>2</sub> measurements were identified from 19 dogs treated with HFNT from two university veterinary teaching hospitals. PF and SF ratios were measured when PaO<sub>2</sub> fell between 74 and 129 mm Hg. The median SF and PF ratios were 186 (interquartile range: 97–243) and 168 (interquartile range: 108–297), respectively. SF ratios were strongly correlated with PF ratios (rho = 0.86 [95% confidence interval: 0.73–0.93], <i>p</i> < 0.001, weighted <i>r</i> = 0.89 [95% confidence interval: 0.74–0.96]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>Preliminary results suggest a statistically significant positive correlation between SF and PF ratios in dogs treated with HFNT. This study provides data that can be used to calculate appropriate sample sizes for subsequent studies investigating the specific SF ratios corresponding with the PF ratios as the criteria for assessing hypoxemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 3","pages":"314-317"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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