Re: Severe haemoptysis associated with seizures in a dog

Extract

In the paper by FE James, VS Johnson, ZM Lenard and CS Mansfield published in the New Zealand Veterinary Journal 56, 85–88, 2008, entitled, “Severe haemoptysis associated with seizures in a dog”, the authors reported a case of repeated haemoptysis and radiographically visible severe bilateral alveolar lung pattern in a 7-year-old German Shepherd dog suffering from generalised tonic-clonic seizures. On the basis of several other examination methods, they concluded that “The cause of the haemoptysis could not be defined in this dog, but was considered likely to be due to either severe neurogenic pulmonary oedema or rupture of the pulmonary capillaries secondary to seizures.” Further in the text they stated that “Haemoptysis associated with severe neurogenic pulmonary oedema, rather than traumatic rupture of the pulmon ary capillaries may have occurred in this dog.” I agree with these statements.     

Refractory seizures associated with an organic aciduria in a dog

A 6-month-old, female Cavalier King Charles spaniel exhibited seizures that were difficult to control with standard anticonvulsants over a 12-month period. The diagnosis of an organic aciduria with excessive excretion of hexanoylglycine was determined when the dog was 20 months old. Recurrent and cluster seizures were eventually controlled with the addition of levetiracetam to potassium bromide and phenobarbital.     

Severe seizures associated with traumatic brain injury managed by controlled hypothermia,pharmacologic coma,and mechanical ventilation in a dog

Objective – To describe the management and outcome of a dog presenting with intractable seizures associated with traumatic brain injury. Case Summary – A spayed female Wheaten Terrier was presented to an emergency clinic with neurologic deficits (modified Glasgow coma scale of 10) shortly after a road traffic accident. Seizures were uncontrolled despite aggressive pharmacologic intervention. Controlled hypothermia to achieve a rectal temperature of 33–35°C (91.4–95°F) was initiated as a protective measure to reduce intracranial pressure and cerebral metabolic rate, and to assist with seizure control. Intubation and mechanical ventilation were required to protect the airway and manage hypercapnia associated with hypoventilation. The patient went on to make a full recovery, although behavioral changes were noted by the owners for an 8‐week period following injury. New or Unique Information Provided – To the author's knowledge, this is the first instance of therapeutic hypothermia reported in the veterinary literature. A short review of this treatment modality is provided.     

Isoniazid-induced seizures with secondary rhabdomyolysis and associated acute renal failure in a dog

Isoniazid-induced seizures resulted in rhabdomyolysis and associated acute renal tubular necrosis in a dog. Rhabdomyolysis and myoglobinuric renal failure, although recognised in the dog, are reported infrequently as a consequence of seizures. The clinical presentation of isoniazid toxicity in a dog is described.     

Severe calcinosis cutis associated with treatment of hypoparathyroidism in a dog.

A 6-month-old, female border collie was referred for evaluation of hypocalcemia, hyperphosphatemia, fever, and painful ventral abdominal skin. She had recently been treated intravenously and subcutaneously (SC) with a diluted 10% calcium gluconate solution. The medical evaluation supported the diagnosis of primary hypoparathyroidism, but the subsequent hospital course was complicated by severe calcinosis cutis, which caused extensive skin necrosis and marked debilitation. This patient illustrates that administration of a calcium gluconate solution SC can be associated with extensive morbidity when administered to hyperphosphatemic patients.     

Salicylate-induced seizures in a dog

A 10-year-old, mixed-breed, castrated male dog was examined because of acute onset of vomiting followed by severe generalized seizures. The dog had been on a treatment regimen that included a salicylate-containing drug, and the owners unknowingly supplemented aspirin. Supportive treatment utilizing sodium bicarbonate resulted in return to normal within 24 hours. Blood salicylate concentrations were determined to be in the range toxic to human beings.     

Neurogenesis in a young dog with epileptic seizures

Epileptic seizures can lead to various reactions in the brain, ranging from neuronal necrosis and glial cell activation to focal structural disorganization. Furthermore, increased hippocampal neurogenesis has been documented in rodent models of acute convulsions. This is a report of hippocampal neurogenesis in a dog with spontaneous epileptic seizures. A 16-week-old epileptic German Shepherd Dog had marked neuronal cell proliferation (up to 5 mitotic figures per high-power field and increased immunohistochemical expression of proliferative cell nuclear antigen) in the dentate gyrus accompanied by microglial and astroglial activation. Some granule cells expressed doublecortin, a marker of immature neurons; mitotically active cells expressed neuronal nuclear antigen. No mitotic figures were found in the brain of age-matched control dogs. Whether increased neurogenesis represents a general reaction pattern of young epileptic dogs should be investigated.     

Ethmoidal encephalocoele associated with seizures in a puppy

A six-month-old puppy was presented for investigation of a seizure disorder. Neurological examination indicated persistent cerebral dysfunction in the absence of any identifiable metabolic disorder and magnetic resonance imaging revealed extension of the rostral lobes of the cerebrum into the nasal cavity. Despite symptomatic treatment, the puppy continued to exhibit seizures and appeared distressed and so was euthanased. Postmortem examination confirmed the abnormal anatomy of the rostral part of the brain and absence of a cribriform plate. There was extensive grey and white matter degeneration plus intraparenchymal haemorrhage in the abnormal brain tissue. The findings are consistent with a diagnosis of ethmoldal encephalocoele--a condition that has not previously been reported in the dog.     

Chylothorax associated with blastomycosis in a dog

Respiratory distress caused by pleural effusion resulted from chylothorax. Thoracic drainage and lowfat dietary therapy was effective in removing and preventing significant recurrence of the chylothorax; however, the patient died unexpectedly. At necropsy a blastomycotic granuloma found at the precava was considered the cause of the chylothorax. There had been no recognizable antemortem signs of blastomycosis. Blastomycosis can be considered as a rare cause of chylothorax.     

Placentitis associated with leishmaniasis in a dog

A 1.5-year-old Coonhound from Maryland aborted 7 fetuses. Placenta and internal tissues of 1 fetus were examined histologically. The predominant lesion was placentitis characterized by necrosis and infiltration of mixed leukocytes. Numerous Leishmania spp amastigotes were identified in placental trophoblasts, and the diagnosis was confirmed by use of immunohistochemical staining with Leishmania-specific antibodies. Protozoa were not found in the fetal tissues. An indirect fluorescent antibody test yielded a serum titer of 1:100, and a recombinant K39 immunoassay of serum yielded positive results for the K39 Leishmania antigen.     

Severe hypercalcemia in a dog with a retained fetus and endometritis

A 10-month-old sexually intact female German Shorthaired Pointer examined because of lethargy, episodes of fever, inappetence, and vomiting was found to have severe hypercalcemia. Results of laboratory testing, radiography, and ultrasonography excluded previously recognized causes of hypercalcemia in dogs. Instead, the dog was found to have purulent endometritis and an incompletely resorbed fetus. Treatment with fluids i.v., diuretics, and calcitonin failed to adequately reduce serum calcium concentration, but serum calcium concentration was normal within 4 days after the dog underwent an ovariohysterectomy. Retention of one or more fetuses and endometritis should be included in the differential diagnosis for dogs with hypercalcemia.     

Pneumopericardium associated with a pulmonary-pericardial communication in a dog

A 6-year-old 18-kg (39-lb) spayed female Standard Poodle was referred for treatment of pneumopericardium. The dog did not have severe clinical signs relating to the pneumopericardium, and the diagnosis was made incidentally while investigating the cause of a cough. Computed tomography revealed an air-filled structure consistent with a bulla to the right of the heart base that appeared to communicate with the pericardial cavity Because spontaneous resolution of the pneumopericardium seemed unlikely and cardiac tamponade was a possibility, exploratory thoracotomy was performed. A lobulated bulla was found at the hilus of the right middle lung lobe adhered to the underlying pericardial sac, and a 4-cm-diameter communication from the pericardium to the pulmonary bulla was found. Right middle lung lobectomy was performed, and the pericardiotomy and pericardial opening were sutured. The dog recovered without complications. In previously reported cases of pneumopericardium involving a cat and a dog, the condition resolved spontaneously. In this dog, in contrast, surgical resection of the affected lung lobe with pericardial reconstruction was required for resolution of the pneumopericardium.     

Hyperthyroidism associated with a thyroid adenoma in a dog

Hyperthyroidism associated with thyroid adenoma was diagnosed in a dog. Typical clinical signs of hyperthyroidism were resolved with surgical excision of the adenoma. Hyperthyroidism in dogs usually is associated with thyroid carcinoma, which has a poor prognosis. This case emphasizes the importance of obtaining a histologic diagnosis of thyroid tumors in hyperthyroid dogs before giving a prognosis.     

Thrombocytosis associated with a myeloproliferative disorder in a dog

A dog with a myeloproliferative disorder and thrombocytosis had clinical signs that were consistent with a diagnosis of essential thrombocythemia. The dog was treated with aspirin, radioactive phosphorus, and melphalan. Eighteen months after referral, the disorder progressed to chronic granulocytic leukemia, and treatment was switched to hydroxyurea. Fourteen months later, the dog was euthanatized because of uncontrollable atrial fibrillation.     

Pancreatitis associated with clomipramine administration in a dog

A three-year-old, male, entire, Yorkshire terrier was presented with peracute onset of abdominal pain and vomitus. Clinicopathological abnormalities included severely increased serum lipase activity, immeasurably high serum trypsin-like immunoreactivity and mild hypocalcaemia. Canine pancreatic lipase immunoreactivity (cPLI) was intended to be measured, however, the sample got lost. Ultrasonography revealed a hypoechoic pancreas with small amounts of peripancreatic fluid and hyperechogenic mesentery. Acute pancreatitis (AP) was diagnosed and the dog recovered with appropriate therapy within 48 hours. Clomipramine, a selective serotonin reuptake inhibitor (SSRI) for alleviating signs of separation anxiety had been given for seven weeks. Two similar, albeit less severe, episodes associated with previous courses of clomipramine had occurred eight months earlier that responded to discontinuing clomipramine and supportive care. As SSRIs are associated with AP in human beings and no other trigger could be identified, we conclude that clomipramine should be considered as a potential cause when investigating causes for AP in susceptible breeds or other dogs presenting with compatible clinical signs.     

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.     

Hyperammonemia associated with urethral obstruction in a dog

Hyperammonemia was documented in a 10-week-old male Lhasa Apso referred for urethral obstruction and rupture. Results of liver function tests were normal. Staphylococcus sp was isolated from urine. Anomalies of the portal vascular system and hepatic insufficiency are the most common causes of hyperammonemia in the dog. Hyperammonemia, however, in the absence of recognizable concurrent hepatic disease, also may result from urinary stasis and infection with urea-splitting organisms.