Presumptive vagally-mediated atrial flutter in a dog

An asymptomatic nine-year-old Dobermann Pinscher underwent a screening for dilated cardiomyopathy. Echocardiography revealed left ventricular eccentric hypertrophy and systolic dysfunction; the rest of the echocardiographic parameters were within normal limits. Holter monitoring demonstrated sinus rhythm as the dominant cardiac rhythm during the first hours of the recording. Then, during a period of physiologically enhanced vagal tone (sleep), spontaneous development of atrial flutter (AFL) associated with variable ventricular response was documented. Alternation between AFL and paroxysmal atrial fibrillation was also observed. Subsequently, during a period of physiological increase of sympathetic tone (physical activity/excitement), spontaneous conversion of AFL to sinus rhythm occurred. In light of these findings, a presumptive diagnosis of vagal AFL was made. The images here described allow us to study the onset, behavior and termination of this intriguing electrocardiographic entity.     

Presumptive trimethoprimsulphamethoxazole associated thrombocytopenia and anaemia in a dog

A two-year-old Scottish terrier was referred for investigation of a chronic skin problem. A diagnosis of generalised demodectic mange with a deep pyoderma was made and treatment commenced with trimethoprirn-sulphamethoxazole and amitraz washes. On the sixth week of treatment the owner reported that the dog had developed haematuria. Investigations revealed that the dog was thrombocytopenic and anaemic. Antimicrobial treatment was stopped and the platelet count returned to normal over a three week period. A diagnosis of trimethoprim-sulphamethoxazole associated thrombocytopenia was made.     

Presumptive Nocardia spp. infection in a dog treated with cyclosporin and ketoconazole

Abstract

CASE HISTORY: A dog that had received 8 months of cyclosporin and ketoconazole therapy for treatment of atopic dermatitis subsequently developed severe neurological disease, that failed to respond to treatment with trimethoprim-sulphadiazine and clindamycin.

HISTOPATHOLOGICAL FINDINGS: Histopathological examination of the pulmonary parenchyma and spinal cord revealed loose aggregates of Gram-positive, partially acid-fast, fine, beaded, filamentous bacteria, most consistent with Nocardia spp.

DIAGNOSIS: A presumptive diagnosis was made of disseminated nocardiosis of the spinal cord and lungs.

CLINICAL RELEVANCE: Nocardia spp. is an opportunistic actinomycete that may cause disseminated disease, particularly in immunocompromised animals. Cyclosporin is used in veterinary medicine to control immune-mediated and allergic disorders, with few reported adverse side effects. This case gives further evidence that involvement of the spinal cord in nocardiosis of the central nervous system (CNS) carries a poor prognosis, and opportunistic infection by Nocardia spp. may be a potential complication of immunosuppressive cyclosporin therapy in the dog.     

Presumptive hepatotoxicity and rhabdomyolysis secondary to phenazopyridine toxicity in a dog

Objective – To describe a rare, but potential clinical manifestation of phenazopyridine (PAP) toxicity in a dog. Case Summary – A 6‐year‐old spayed female Chihuahua was evaluated for ataxia and dysphagia after ingestion of 200 mg (66 mg/kg) of PAP hydrochloride. The dog was presented to the hospital with shifting leg lameness involving all 4 limbs, which progressed to reluctance to walk and severe diffuse muscle hyperesthesia. Clinical laboratory abnormalities included marked increases in serum alanine aminotransferase, aspartate aminotransferase, creatine kinase, mild increases in alkaline phosphatase, and increased c‐Tnl‐troponin concentration. Treatment included administration of intravenous fluids, muscle relaxants, pain medications, and hepatoprotectants for 5 days in the hospital, and medical management at home for an additional 5 days. Follow‐up examinations performed 1 and 6 months after initial presentation revealed the dog to be clinically healthy with serum biochemical profiles within reference intervals. New or Unique Information Provided – The purpose of this report is to describe an unusual manifestation of PAP toxicosis in a dog, which has not been previously reported in the literature. A review of the ASPCA Animal Poison Control Center database revealed 347 cases of PAP exposure in dogs during 2000–2009 underscoring the importance of being aware of this toxicity in the dog.     

Presumptive subcutaneous surgical transplantation of a urinary bladder transitional cell carcinoma in a dog

A urinary bladder mass in a 12-year-old spayed female West Highland White Terrier was diagnosed after exploratory surgery and biopsy as a transitional cell carcinoma. Four months later the dog presented with an ulcerated plaque-like cutaneous lesion at the previous surgical incision site; concurrent inguinal lymphadenopathy and recurrence of the urinary bladder mass were identified. Transitional cell carcinoma was diagnosed at all 3 sites. Although a definitive relationship cannot be established between the initial surgery for urinary bladder mass and the resultant subcutaneous lesion, surgical implantation should be considered as a source for the neoplastic cells.     

Presumptive caudal cerebellar artery infarct in a dog: clinical and MRI findings

Clinical signs and magnetic resonance imaging findings of a caudal cerebellar artery infarct are reported for the first time in a dog. Clinical signs were characterised by a peracute, non-progressive, right-sided central vestibular syndrome with paradoxical right-sided head tilt. Magnetic resonance images were consistent with a territorial, non-haemorrhagic, ischaemic lesion affecting the caudo-ventral part of the right cerebellar hemisphere, mainly involving the right paramedian lobe, the ansiform lobe and the caudal cerebellar peduncle. Bloodwork results were suggestive of an underlying hypercoagulable state, although the concomitant presence of a histologically confirmed mammary gland adenocarcinoma could have also been related to the cerebellar vascular obstruction through metastatic emboli formation. Posterior-inferior cerebellar artery infarction is the human equivalent of caudal cerebellar artery infarct in dogs.     

Presumptive tremorgenic mycotoxicosis in a dog in New Zealand, after eating mouldy walnuts

CASE HISTORY: A 1-year-old, intact male Labrador-cross dog vomited after eating walnuts that had been on the ground for 5 months. The dog then developed tremors, ataxia, increased salivation, and hyperaesthesia. CLINICAL FINDINGS: The dog had marked generalised tremors, ataxia and a temperature of 39.9 degrees C. Both pupils were of normal size and normally responsive to light. Vomiting was induced, and walnut shell was visible in the vomitus. DIAGNOSIS: Due to the sudden onset of tremors, lack of exposure to other convulsive toxins, and the evidence of ingestion of walnuts, the provisional diagnosis was tremorgenic mycotoxicosis. The dog was treated symptomatically, and made a full recovery over 18 hours. Tremorgenic mycotoxins were detected within walnuts collected from the dog's environment. CLINICAL RELEVANCE: Fungi that produce tremorgenic mycotoxins are present in New Zealand. Intoxication should be suspected in dogs that suddenly develop muscle tremors, especially if there is a history of ingestion of mouldy food 2-3 hours prior to the development of tremors.     

Presumptive iatrogenic hypoadrenocorticism induced by high‐dose ketoconazole administration in a dog

A 11‐year‐old male neutered Shih Tzu was referred to a tertiary facility with a history of weight loss, decreased appetite, polydipsia, and lethargy. The dog had a 10‐year history of nonspecific allergic dermatitis and was being treated with 16 mg/kg of ketoconazole q12h for Malassezia dermatitis. Vague gastrointestinal signs, hypocholesterolemia, and lack of a stress leukogram increased suspicion for hypoadrenocorticism (HA). An adrenocorticotropic hormone (ACTH) stimulation test identified hypocortisolemia on pre‐ and post‐ACTH samples and ketoconazole was discontinued. After a short course of corticosteroid treatment, an ACTH stimulation test was repeated and pre‐ACTH cortisol concentration was within the reference range, and the post‐ACTH cortisol concentration was mildly increased. The temporal association between return of adequate adrenocortical cortisol production and discontinuation of ketoconazole led to the conclusion that the dog had developed iatrogenic HA secondary to ketoconazole treatment.     

Presumptive increase in protein‐bound serum calcium in a dog with multiple myeloma

Abstract: An 11‐year‐old male castrated Australian Shepherd was presented with a history of lethargy, panting, and weight loss for 1 month. Physical examination revealed a moderately enlarged spleen. Laboratory abnormalities included thrombocytopenia and marked hypercalcemia, with hyperglobulinemia, hypoalbuminemia, and a monoclonal spike in the β‐globulin region on serum protein electrophoresis. Serum total calcium concentration was markedly increased (16.5 mg/dL, reference interval 8.9–11.4 mg/dL) but ionized calcium concentration (1.39 mmol/L) was within the reference interval (1.25–1.45 mmol/L). Isosthenuria was noted, but the dog was not polyuric or polydipsic. Serum parathyroid hormone concentration was within reference limits and parathyroid hormone‐related peptide concentration was 0 pmol/L. Radiographic findings were largely unremarkable. Results of cytologic evaluation of a fine‐needle aspirate specimen from the spleen indicated plasma cell neoplasia. Based on the results of the electrophoresis, splenic aspirates, radiographs, and hypercalcemia, a diagnosis of splenic multiple myeloma was made. The marked hypercalcemia, normal ionized calcium and parathyroid hormone concentrations, and lack of osteolytic lesions indicated a presumptive increase in protein‐bound serum calcium, likely due to binding to molecules of the paraprotein (M protein). Protein binding of calcium in dogs with multiple myeloma should be considered as a potential mechanism of elevated total serum calcium concentration.     

Dimethylnitrosamine-induced hepatotoxicosis in dogs as a model of progressive canine hepatic disease.

A model of toxin-induced progressive hepatitis is described in Beagles. The toxin, dimethylnitrosamine, was administered orally to 18 Beagles; 6 dogs comprised a control group. Clinical signs and laboratory test results were monitored as disease progressed and were used to determine the end point of disease. Following euthanasia, histologic lesions were scored and used to derive a total severity score for each dog. Severity scores were then used to allot the 18 dogs to 3 groups of hepatic disease, defined as mild, moderate, or severe. Changes in clinical laboratory test results, including tests of hepatic function, and clinical signs indicative of liver disease were described chronologically for all dogs. Group means of clinical laboratory test results and quantifiable clinical signs (eg, weight loss and ascitic fluid accumulation) were compared. This model offers several advantages, compared with other experimental models of canine hepatic disease. These include hepatospecificity, similarity to natural disease (eg, the development of multiple extrahepatic portosystemic shunts), and the ability to titrate the disease to a desired end point. The major disadvantages of this model were the toxic nature of the drug to human beings and the variation in individual animal response to the toxin, which precludes preassignment of animals into groups.     

Presumptive sialadenosis in a cat

A cat was presented with signs associated with enlargement of the mandibular salivary glands. Histological findings were normal, consistent with a diagnosis of sialadenosis, and the cat responded to symptomatic treatment with oral phenobarbitone.     

Presumptive Baclofen Intoxication in a Dog

A five year old mixed breed dog weighing 30 kg., presumptively ingested six to twelve 20 mg baclofen tablets four to six hours prior to admission. The dog had been ataxic and vocalizing at home but was stuporous on presentation. Toxic effects noted were hypothermia, hypertension and sedation, followed by prolonged agitation. Treatment consisted of administration of activated charcoal, fluid diuresis, sodium nitroprusside, and diazepam. Baclofen overdose has been reported frequently in humans, but this is the first report of it in a dog. (Vet Emerg & Crit Care, 1998; 8: 49–54)     

Presumptive herpesvirus-associated erythema multiforme in a cat

Erythema multiforme (EM), an uncommon immune-mediated skin disorder of cats, conceivably could be triggered by feline herpesvirus type-1 (FHV-1) infection, in a manner analogous to human herpesvirus-associated EM (HAEM). This report describes a 10-year-old Persian-mixed cat with a presumptive diagnosis of HAEM.     

Presumptive Toxoplasma gondii abortion in a sheep

A primiparous ewe aborted in mid-gestation. Toxoplasma gondii was suspected as the cause of abortion and a presumptive diagnosis of T. gondii abortion was based on histological lesions of the placenta.