Acute overdose of levothyroxine in a dog.

An overdose of up to 850 levothyroxine sodium tablets (0.2 mg) in a healthy 6-year-old 16.8-kg dog induced an episode of vomiting and hippus within 9 hours of ingestion. The dog was treated with activated charcoal and saline (magnesium sulfate) cathartic. Initially the serum concentration of thyroxine (T4) 4,900.9 nmol/L. On the second day, serum concentration of triiodothyronine (T3) was 5.3 nmol/L. Serum T4 concentration decreased slowly and was not determined to be normal until day 36. Serum T3 concentration was found to be normal on day 6. Serum alanine transaminase activity peaked on day 6 at 345 U/L. Significant abnormalities were not found during the following 36 days. Clinical signs of thyroid hormone toxicosis in dogs and cats include hyperactivity, lethargy, tachycardia, tachypnea, dyspnea, abnormal pupillary light reflexes, vomiting, and diarrhea. High overdoses of levothyroxine sodium in dogs should be managed by initial decontamination and administration of activated charcoal with a cathartic followed by supportive care.     

Veterinarians as experts in court

General veterinarians such as veterinary officers act as experts at court. They are in so far part of the evidence. Due to his experience the veterinary expert shall give systematical uniform principles concerning even domains adjacent to the field of animal protection such as protection of animal epidemics and food cases, verifiable by science and university research. Examples for expert's topics as well as the requirements of expert reports are shown. According to paragraph 15 II Tierschutzgesetz (Animal Protection Act), as well as according to paragraph paragraph 63, 76 Ordnungswidrigkeitengesetz the experts participation in the proceeding is necessary. In consideration of paragraph paragraph 74, 22 Strafprozessordnung (Code of Criminal Proceedure) conflicts may arise because the veterinarian officer is self-contained investigator, witness as well as expert in the same proceeding. In general the veterinarian officer, who has been involved in the investigations must be excluded from expert activity in the same case. The veterinarian officers have to solve this problem by seperating tasks and functions within one legal case.     

Perceptions of state public health officers and state veterinarians regarding risks of bioterrorism in the United States

OBJECTIVE:To assess perceptions of state public health officers and state veterinarians in the United States regarding the risks of bioterrorism and determine the degree of support provided for activities related to bioterrorism. DESIGN: Cross-sectional survey. SAMPLE POPULATION: State public health officers and state veterinarians. PROCEDURE: A questionnaire was sent between April and June 2001 to the state public health officer and state veterinarian in each of the 50 states and the District of Columbia. RESULTS: Perceptions of the risk of bioterrorism attacks were similar for state public health officers and state veterinarians. Veterinarians perceived the risks associated with foot-and-mouth disease and Newcastle disease to be higher than did physicians. State veterinarians perceived the risks associated with an anthrax hoax, brucellosis, and ricin toxicosis to be lower than did state public health officers. Risk posed by agents that affected animals exclusively was perceived to be higher than risk posed by agents that affected humans exclusively and zoonotic agents. Number of full-time-equivalent positions devoted to bioterrorism surveillance and percentage of the budget devoted to bioterrorism activities were significantly lower for offices run by state veterinarians than for offices run by state public health officers. State veterinarians were significantly less likely to have knowledge of bioterrorism incidents within their state or district than were state public health officers. CONCLUSIONS AND CLINICAL RELEVANCE: Provision of additional resources to state veterinarians and explicit integration of their expertise and surveillance capabilities may be important to effectively mitigate the risk of bioterrorism.     

Effects of urine alkalization and activated charcoal on the pharmacokinetics of orally administered carprofen in dogs

OBJECTIVE: To investigate the effects of oral administration of activated charcoal (AC) and urine alkalinization via oral administration of sodium bicarbonate on the pharmacokinetics of orally administered carprofen in dogs. ANIMALS: 6 neutered male Beagles. PROCEDURES: Each dog underwent 3 experiments (6-week interval between experiments). The dogs received a single dose of carprofen (16 mg/kg) orally at the beginning of each experiment; after 30 minutes, sodium bicarbonate (40 mg/kg, PO), AC solution (2.5 g/kg, PO), or no other treatments were administered. Plasma concentrations of unchanged carprofen were determined via high-performance liquid chromatography at intervals until 48 hours after carprofen administration. Data were analyzed by use of a Student paired t test or Wilcoxon matched-pairs rank test. RESULTS: Compared with the control treatment, administration of AC decreased plasma carprofen concentrations (mean +/- SD maximum concentration was 85.9 +/- 11.9 mg/L and 58.1 +/- 17.6 mg/L, and area under the time-concentration curve was 960 +/- 233 mg/L x h and 373 +/- 133 mg/L x h after control and AC treatment, respectively). The elimination half-life remained constant. Administration of sodium bicarbonate had no effect on plasma drug concentrations. CONCLUSIONS AND CLINICAL RELEVANCE: After oral administration of carprofen in dogs, administration of AC effectively decreased maximum plasma carprofen concentration, compared with the control treatment, probably by decreasing carprofen absorption. Results suggest that AC can be used to reduce systemic carprofen absorption in dogs receiving an overdose of carprofen. Oral administration of 1 dose of sodium bicarbonate had no apparent impact on carprofen kinetics in dogs.     

Deployment morbidity among search-and-rescue dogs used after the September 11, 2001, terrorist attacks

OBJECTIVES: To determine characteristics, variables associated with deployment morbidity, and injuries and illnesses of search-and-rescue dogs associated with the Sept 11, 2001, terrorist attacks. DESIGN: Historical cohort study. ANIMALS: 96 dogs. PROCEDURE: Data collected included previous medical or surgical history, physical attributes of dogs, type and number of years of training, site of deployment, shift and hours worked, and number of days deployed. Combined morbidity was defined as 1 or more abnormalities of body systems, including traumatic injuries. RESULTS: Handlers of 96 of the 212 dogs responded to the surveys. Fifty-nine dogs were deployed by the Federal Emergency Management Agency, 10 by police forces, and 27 as members of other search-and-rescue teams. Sixty-five dogs (incidence rate, 17 events/1,000 dog search hours) had combined morbidity during deployment. System-specific morbidity rates included gastrointestinal tract signs (5 events/1,000 dog search hours), cuts and abrasions mostly on the feet (5 events/1,000 dog search hours), fatigue (6 events/1,000 dog search hours), change in appetite (6 events/1,000 dogs search hours), dehydration (5 events/1,000 dog search hours), respiratory tract problems (2 events/1,000 dog search hours), heat exhaustion (2 events/1,000 dog search hours), and orthopedic or back problems (2 events/1,000 dog search hours). Dogs deployed to the World Trade Center were 6.6 times more likely to have combined morbidity, compared with dogs at the Pentagon. CONCLUSIONS AND CLINICAL RELEVANCE: Injury and illnesses occurred in most dogs and affected several organ systems, but all were minor.     

Verapamil administration for acute termination of supraventricular tachycardia in dogs

Verapamil, a calcium channel-blocking drug, was administered IV at a dosage that ranged from 0.05 to 0.15 mg/kg of body weight to 14 dogs with supraventricular tachycardia. The dosage was titrated, administering 0.05 mg/kg every 5 to 30 minutes following the initial 0.05 mg/kg dose in all but 1 dog. The drug terminated the arrhythmia in 12 dogs and slowed the ventricular rate in 1 dog. One dog was unresponsive to verapamil administration and became transiently hypotensive after the administration of a total dose of 0.15 mg/kg over 5 to 6 minutes. Various arrhythmias occurred after verapamil administration, but none required additional treatment or caused serious sequelae. Verapamil was an effective treatment for acutely converting supraventricular tachycardia to sinus rhythm in these dogs. It appears to be safe when administered in the aforementioned dosage range.     

Administration of charcoal, Yucca schidigera, and zinc acetate to reduce malodorous flatulence in dogs

OBJECTIVE: To determine whether feeding activated charcoal, Yucca schidigera, and zinc acetate would ameliorate the frequency and odor characteristics of flatulence in dogs. DESIGN: In vitro screening of active agents followed by a randomized controlled trial. ANIMALS: 8 adult dogs. PROCEDURE: A fecal fermentation system was used to assess the effects of activated charcoal, Yucca schidigera, and zinc acetate alone and in combination on total gas production and production of hydrogen sulfide, the primary determinant of flatus malodor in dogs. All 3 agents were subsequently incorporated into edible treats that were fed 30 minutes after the dogs ate their daily rations, and the number, frequency, and odor characteristics of flatulence were measured for 5 hours, using a device that sampled rectal gases and monitored hydrogen sulfide concentrations. RESULT: Total gas production and number and frequency of flatulence episodes were unaffected by any of the agents. Production of hydrogen sulfide in vitro was significantly reduced by charcoal, Yucca schidigera, and zinc acetate by 71, 38, and 58%, respectively, and was reduced by 86% by the combination of the 3 agents. Consumption of the 3 agents was associated with a significant decrease (86%) in the percentage of flatulence episodes with bad or unbearable odor and a proportional increase in the percentage of episodes of no or only slightly noticeable odor. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that activated charcoal, Yucca schidigera, and zinc acetate reduce malodor of flatus in dogs by altering the production or availability of hydrogen sulfide in the large intestine.     

Erythema multiforme associated with zonisamide in a dog

This report describes a dog that developed erythema multiforme in temporal association with administration of the sulphonamide‐based anticonvulsant drug zonisamide. Similar adverse drug reactions have been associated with sulphonamide antimicrobial drugs. Caution should be exercised when prescribing this medication for dogs with known hypersensitivity to sulphonamides.     

Effects of nitrous oxide on mask induction of anesthesia with sevoflurane or isoflurane in dogs.

OBJECTIVE: To determine the effects of nitrous oxide (N2O) on the speed and quality of mask induction with sevoflurane or isoflurane in dogs. ANIMALS: 7 healthy Beagles. PROCEDURE: Anesthesia was induced with sevoflurane or isoflurane delivered in 100% oxygen or in a 2:1 mixture of N2O and oxygen via a face mask. Each dog received all treatments with at least 1 week between treatments. Initial vaporizer settings were 0.8% for sevoflurane and 0.5% for isoflurane (0.4 times the minimum alveolar concentration [MAC]). Vaporizer settings were increased by 0.4 MAC at 15-second intervals until settings were 4.8% for sevoflurane and 3.0% for isoflurane (2.4 MAC). Times to onset and cessation of involuntary movements, loss of the palpebral reflex, negative response to tail-clamp stimulation, and endotracheal intubation were recorded, and cardiopulmonary variables were measured. RESULTS: Administration of sevoflurane resulted in a more rapid induction, compared with isoflurane. However, N2O had no effect on induction time for either agent. Heart rate, mean arterial blood pressure, cardiac output, and respiratory rate significantly increased and tidal volume significantly decreased from baseline values immediately after onset of induction in all groups. Again, concomitant administration of N2O had no effect on cardiopulmonary variables. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of N2O did not improve the rate or quality of mask induction with sevoflurane or isoflurane. The benefits provided by N2O attributable to concentrating and second gas effects appear minimal in healthy dogs when low solubility inhalation agents such as isoflurane and sevoflurane are used for mask induction.     

Treatment rationale for dogs poisoned with aldicarb (carbamate pesticide)

The treatment rationale for dogs poisoned by aldicarb is reviewed from a pharmacological perspective. The illegal use of aldicarb to maliciously poison dogs is a major problem in some parts of the world. In South Africa, it is probably the most common canine poisoning treated by companion animal veterinarians. Aldicarb poisoning is an emergency and veterinarians need to be able to diagnose it and start with effective treatment immediately to ensure a reasonable prognosis. Successful treatment depends on the timely use of an anti-muscarinic drug (e.g. atropine). Additional supportive treatment options, including fluid therapy, diphenhydramine, benzodiazepines and the prevention of further absorption (activated charcoal) should also be considered. Possible complications after treatment are also briefly discussed.     

Advances in Exotic Mammal Clinical Therapeutics

It is imperative that the veterinarian treating exotic companion mammals stay abreast of the latest developments relating to medications and drug delivery approaches for safety and efficacy. Sustained-release formulations of commonly used drugs, as well as newer routes for administration of therapeutic agents, allow the veterinarian treating exotic companion mammals to reduce the stress associated with drug administration. Interactions can occur between vehicle and drugs when formulations are compounded; therefore, research studies are warranted regarding potential problems associated with these formulations. However, newer studies have been published that provide the basis for exploring the use of different vehicles, frequency of dosing, and drug delivery techniques for various classes of drugs in exotic mammals. The goals of this review are to not only evaluate new medications or uses for medications in companion exotic mammal patients but also review new methods of drug delivery that might be useful to the veterinarian who treats these animals.     

Effects of small and large face masks and translaryngeal and tracheostomy intubation on ventilation, upper-airway dead space, and arterial blood gases

Pulmonary function was examined in pentobarbital-anesthetized dogs that were spontaneously breathing through a large poorly fitted face mask, a small snug-fitted face mask, an endotracheal tube, and a tracheostomy tube. Increasing upper-airway dead space volumes were associated with higher minute ventilation and faster breathing rates. Minute and tidal alveolar ventilation, calculated ideal alveolar oxygen, alveolar-arterial oxygen gradient, venous admixture, arterial pH and blood gases, cardiac output, and systemic and pulmonary arterial blood pressure were not changed. The functional dead space of each mask was considerably less than that measured by water displacement. The small mask only slightly increased, and the endotracheal tube slightly decreased, the dead space estimated for a nasally breathing healthy dog.     

Acute thallium toxicosis in a dog.

A Doberman Pinscher was evaluated for acute onset of gastroenteritis, characterized by anorexia, hematemesis, and hematochezia. The dog had ingested mole bait containing thallium 2 days prior to admission. Thallium toxicosis was confirmed by detection of thallium in the urine, using colorimetric analysis. The dog responded well to administration of antibiotics, fluids administered IV, warm-water enemas, and oral administration of activated charcoal slurries.     

Exaggerated breed characteristics in dogs

Dutch dog owners seem to be aware of bad dog breeding practices with regard to exaggerated breed characteristics that are detrimental to the dog's welfare. Yet they do not always look for these features when buying a dog. Most dog owners think that veterinarians could have an important role in preventing these exaggerated physical traits, by providing information about these traits and taking action in their capacity as veterinarian. Articles 36 and 55 of the Dutch GWWD (animal health and welfare law) provide opportunities to act against the breeding of dogs with exaggerated genetic traits.     

Milbemycinoxime intoxication in a Miniature Australian Shepherd dog

A 3-year-old female intact Miniature Australian Shepherd presented with convulsive status epilepticus after milbemycinoxime administration in the recommended dosage. In addition to continuous intravenous antiepileptic therapy the dog had to be ventilated for 36 hours due to aspiration pneumonia. After extubation control of intermittent tonic-clonic seizures required a constant-rate-infusion of propofol for another 96 hours, before it could be discontinued on day 5. The patient had fully recovered by day 10. The dog was known to be homozygous for the MDR1-gene mutation. So far milbemycinoxime was regarded a save drug in MDR1-deficient dogs. However, the present case suggests using the lowest possible dosage in MDR1-deficient dogs and pet owners should be advised of potential complications.     

The safety-net story about macrocyclic lactone heartworm preventives: a review, an update, and recommendations

A number of safe, effective, and convenient heartworm preventatives are currently available for virtually all canine and feline pets. Yet, a 2001 survey of over 18,000 veterinary clinics in the United States identified more than 240,000 dogs and 3000 cats infected with Dirofilaria immitis. This high level of owner compliance failure is alarming. Prolonged administration of some of the macrocyclic lactone (ML) preventatives kills young larvae, older larvae, "immatures," young adults, and/or old adults. Efficacy of 95% or more requires dosing for 9-30 months, with older worms being more difficult to kill. Of the various MLs, ivermectin (IVM) has the most potent safety-net and adulticidal activity, milbemycin oxime has the least, and selamectin and moxidectin injectable lie somewhere in between. The unique effects of IVM are related to the age of the heartworms at initiation of treatment. The earlier treatment is started, the more stunted and smaller the worms and the shorter their survival time. Conversely, the later treatment is started, the longer the worms live, and the more likely the dog will be antigen- and microfilariae-positive. Drug effects do not appear to be enhanced by increasing the dosage or administering at shorter intervals, and it appears that continuous monthly treatment is needed to produce the full effects of the drug. The American Heartworm Society (AHS) recognizes the safety-net (or reach-back effect) and adulticidal properties of some MLs, particularly IVM. The AHS 2003 (American Heartworm Society, 2004. 2003 Updated guidelines for the diagnosis, prevention, and management of heartworm (Dirofilaria immitis) infection in dogs. In: McCall, et al., (Eds.), Proceedings of the Symposium Session on Recent Advances in Heartworm Disease, The 19th International Conference of the World Association for the Advancement of Veterinary Parasitology, New Orleans, LA, 10-14 August, 2003. Vet. Parasitol. 125, 105-130) canine guidelines state that it is beneficial to administer prophylactic doses of IVM before treatment with melarsomine. Results of laboratory studies suggest that less active dogs are at low risk of severe thromboembolism and death. However, heartworm-positive working dogs might be more at risk. Worsened radiographic and echocardiographic images in a client-owned dog given IVM monthly for 2 years with greatly restricted exercise suggests that such treatment of dogs with clinical, radiographic, and/or echocardiographic evidence of heartworm disease as well as for asymptomatic working dogs is contraindicated. Furthermore, until further data are available, such treatment of even the less active asymptomatic dog should be administered only with much caution and with examination by a veterinarian at least once every 4-6 months. IVM clearly provides potent "safety-net" activity against older larvae, immatures, and young adults in cases of owner compliance failure, even when the owner and veterinarian are not aware that the animal is infected, and offers much promise as a unique "soft-kill" treatment for young, and possibly older adult heartworms, with reduced risks.     

Zoonotic dermatoses of dogs and cats

Zoonotic dermatoses in dogs and cats are an important cause of skin disease in human beings. In addition, human dermatoses may occasionally be transmitted to dogs and cats. The veterinarian and the physician form a critical "health care team" in the proper management of these disorders.     

Alterations in activated T‐cell cytokine expression in healthy dogs over the initial 7 days of twice daily dosing with oral cyclosporine

Cyclosporine is a powerful T‐cell inhibitor used in the treatment of immune‐mediated and inflammatory diseases in the dog. There is limited information on how to best monitor patients on cyclosporine therapy. Currently, pharmacokinetic and pharmacodynamic assays are available. Pharmacokinetic assays that measure the concentration of cyclosporine in the blood are used to assess if an appropriate drug concentration has been achieved; however, target blood drug concentrations have not been shown to reliably correlate with suppression of T‐cell function in the dog. In human transplant recipients, therapeutic drug monitoring has shifted to include pharmacodynamic‐based monitoring. Our laboratory has validated a RT‐qPCR assay to measure the pharmacodynamic effects of cyclosporine in the dog. In this study, activated T‐cell expression of IL‐2 and IFN‐γ was measured using RT‐qPCR daily for 7 consecutive days in 8 healthy Walker hounds receiving oral cyclosporine at a dosage of 10 mg/kg every 12 hr. Cytokine production was found to be markedly decreased within 24 hr after the initiation of cyclosporine and remained significantly decreased for the duration of the project. Based on these results, cyclosporine causes a rapid drop in T‐cell cytokine production that is sustained with continued dosing in healthy dogs. Although performed in healthy dogs, this study demonstrated a marked decrease in cytokine suppression within 24 hr of drug administration, suggesting that pharmacodynamic monitoring of cyclosporine's effects on T cells could be considered within several days of commencing therapy in dogs suffering from life‐threatening immune‐mediated disorders.     

Anesthesia of the sighthound

The sighthounds are an ancient group of dog breeds that have been selectively bred for high-speed pursuit of prey by sight. Probably as a consequence of this selection process, these dogs have a number of idiosyncrasies that can potentially adversely affect their anesthetic management. These include (1) nervous demeanor which can lead to stress-induced clinical complications, such as hyperthermia; (2) lean body conformation with high surface-area-to-volume ratio, which predisposes these dogs to hypothermia during anesthesia; (3) hematological differences such as a higher packed cell volume and lower serum protein compared with other dog breeds which may complicate interpretation of preanesthetic blood work; (4) Impaired biotransformation of drugs by the liver resulting in prolonged recovery from certain intravenous anesthetics, especially thiopental; and increased risks of drug interactions. Safe anesthetic management of sighthounds should include sedative premedication and appropriate use of analgesic drugs to minimize perioperative stress. Thiopental, or any other thiobarbiturate, should not be used in these dogs. Propofol, ketamine/diazepam combination, and methohexital are recommended alternative intravenous anesthetics. Avoid coadministration of agents that inhibit drug biotransformation, such as chloramphenicol. Inhalation anesthesia using isoflurane is the preferred anesthetic maintenance technique. Core body temperature should be monitored closely and techniques to minimize hypothermia should be employed both during anesthesia and into the recovery period.