Delayed hypersensitivity reactions to sulphonamides: syndromes,pathogenesis and management

Sulphonamide antibiotics are a commonly used, and important, group of antibiotics in veterinary dermatology. However, many of the commonly used sulphonamides such as sulphamethoxazole, sulpha-diazine, or sulphasalazine are associated with idiosyncratic drug reactions in dogs. This paper will review the clinical syndromes, pathogenesis of sulphonamide hypersensitivity reactions and current methods for predicting these occurrences.     

Veterinary pharmacovigilance. Part 6. Predictability of adverse reactions in animals from laboratory toxicology studies

Toxicological studies are conducted on constituents of veterinary medicinal products for a number of reasons. Aside from being a requirement of legislation, they are carried out for predictive purposes in the assessment of user safety or for the determination of consumer safety, for example, in the elaboration of maximum residue limits or tolerances. Alternatively, the results of toxicology studies may be available as they have been generated for registration of the drug for human medicinal purposes. This paper examines if the results of such studies have any predictive value for adverse reactions, which might occur during clinical use in animals. A number of adverse reactions, notably the Type A (toxicology or pharmacology dependent) should be predictable from these laboratory studies. However, as with human pharmaceutical products, they have less utility in predicting Type-B reactions (idiosyncratic in nature).     

Morphea-like lesion following topical endectocide application in a cat

Background – Scleroderma is a rare chronic disease of connective tissues that may affect the skin in humans. Although still unclear, its aetiology may be related to drug reactions. To date, scleroderma has been reported in only a few dogs and one cat. Case report – Localized (morphea‐like) scleroderma was diagnosed in a 3‐year‐old intact male Persian cat that developed a nonpruritic, well‐demarcated alopecic plaque a few days after topical application of a ‘spot‐on’ solution containing praziquantel and emodepside. The lesion occurred at the site of application at the dorsal cervical region, and was characterized histologically by fibrosing dermatitis. There was no response to systemic treatment with pentoxifylline. Following topical therapy with minoxidil 5% for 30 days, hair regrowth occurred, and the lesion had completely disappeared after 60 days. Conclusions and clinical importance – The relationship between the alopecic plaque and the topical application of the spot‐on solution cannot be proved; however, according to the Naranjo scale, which estimates the probability of adverse drug reactions, this case could be classified as a ‘possible’ reaction to one of the components of the product. Sclerodermoid reactions have not been described as a cutaneous drug eruption in veterinary medicine, so this case may possibly represent the first such idiosyncratic reaction to one of the applied substances. Furthermore, to the best of the authors’ knowledge, this is the second report of a morphea‐like lesion in a cat.     

Veterinary pharmacovigilance. Part 4. Adverse reactions in humans to veterinary medicinal products

Although seemingly rare, adverse reactions to veterinary products do occur. These may arise from inadvertent exposure during use or as a result of occupational accidents. They are often mild in nature and include adverse effects such as minor skin reactions. However, more serious reactions may occur, and they are not restricted to the effects of the veterinary medicines themselves. For example, high-pressure injection injuries may occur as a result of accidents occurring during animal vaccination operations. This paper reviews some of these events, mentions where appropriate the regulatory actions taken, and describes some of the measures used to minimise such effects in the future, and serves to bring the issues discussed here to the attention of pharmacologists, pharmacoepidemiologists and others who train those who use veterinary medicinal products.     

Increasing patient safety in veterinary transfusion medicine: an overview of pretransfusion testing

Objectives – To review the principles and available technology for pretransfusion testing in veterinary medicine and discuss the indications and importance of test performance before RBC transfusion.
Data Sources – Current human and veterinary medical literature: original research articles and scientific reviews.
Summary – Indications for RBC transfusion in veterinary medicine include severe anemia or tissue hypoxia resulting from blood loss, decreased erythrocyte production, and hemolyzing conditions such as immune-mediated anemia and neonatal isoerythrolysis. Proper blood sample collection, handling, and identification are imperative for high-quality pretransfusion testing. Point-of-care blood typing methods including both typing cards and rapid gel agglutination are readily available for some species. Following blood typing, crossmatching is performed on one or more donor units of appropriate blood type. As an alternative to technically demanding tube crossmatching methods, a point-of-care gel agglutination method has recently become available for use in dogs and cats. Crossmatching reduces the risk of hemolytic transfusion reactions but does not completely eliminate the risk of other types of transfusion reactions in veterinary patients, and for this reason, all transfusion reactions should be appropriately documented and investigated.
Conclusion – The administration of blood products is a resource-intensive function of veterinary medicine and optimizing patient safety in transfusion medicine is multifaceted. Adverse reactions can be life threatening. Appropriate donor screening and collection combined with pretransfusion testing decreases the occurrence of incompatible transfusion reactions.     

我国兽用中化药类产品生产剂型及关键生产、检验设备需求研究

通过对兽药产品批准文号情况进行统计分析,发现粉剂、散剂、最终灭菌注射剂等九大类生产剂型是目前我国最主要的中化药兽药产品生产剂型。为此,选择其中的粉剂、注射剂、中药提取生产剂型并对其所需关键生产、检验设备进行重点分析研究,以帮助企业选择适合的生产与检验设备以满足兽药GMP要求,同时也为兽医行政主管部门检查人员履行属地管理职责提供必要的参考。     

Epilepsy in Cats: Theory and Practice

The veterinary literature on epilepsy in cats is less extensive than that for dogs. The present review summarizes the most important human definitions related to epilepsy and discusses the difficulties in applying them in daily veterinary practice. Epileptic seizures can have a wide range of clinical signs and are not necessarily typical in all cases. Whether a seizure event is epileptic can only be suspected based on clinical, laboratory, and neuroimaging findings as electroencephalography diagnostic techniques have not yet been developed to a sufficiently accurate level in veterinary medicine. In addition, the present review aims to describe other diagnoses and nonepileptic conditions that might be mistaken for epileptic seizures. Seizures associated with hippocampal lesions are described and discussed extensively, as they seem to be a special entity only recognized in the past few years. Furthermore, we focus on clinical work‐up and on treatment that can be recommended based on the literature and summarize the limited data available relating to the outcome. Critical commentary is provided as most studies are based on very weak evidence.     

Anesthetic complications in the horse

The basis for management of all complications is early recognition, preparation, and a problem-solving approach. Some anesthetic complications, such as equipment malfunction and injuries from endotracheal intubation or misplaced drug injections, are common to all animals and can be prevented almost entirely by careful management. Other problems, such as pulmonary dysfunction and cardiovascular depression, seem to occur more often in healthy horses than in healthy members of other domestic species. Postoperative myopathy-neuropathy, sometimes a devastating complication, seems to be peculiar to the horse, and its incidence has been linked to hypotensive inhalant anesthesia. Careful positioning and padding, monitoring of anesthetic depth, and treating of cardiovascular depression may prevent most cases of postanesthetic myopathy. Idiosyncratic drug reactions, such as MH, are entirely unpredictable and can be rapidly fatal unless recognized early and treated vigorously and specifically.     

Canine gastritis.

Gastritis--inflammation of the stomach--is a frequently cited differential yet rarely characterized diagnosis in cases of canine anorexia and vomiting. Although the list of rule-outs for acute or chronic gastritis is extensive, a review of the veterinary literature reveals fewer than 15 articles that have focused on clinical cases of canine gastritis over the last 25 years. The dog frequently appears in the human literature as an experimentally manipulated model for the study of endoscopic techniques or the effect of medications on gastric mucosa. In the veterinary patient, cases of acute gastritis are rarely pursued with the complete diagnostic armamentarium, and cases of chronic gastritis are rarely found to occur as an entity isolated from the rest of the gastrointestinal tract. This article focuses on those findings most clinically relevant to cases of canine gastritis in veterinary medicine.     

Feline genetics: clinical applications and genetic testing

DNA testing for domestic cat diseases and appearance traits is a rapidly growing asset for veterinary medicine. Approximately 33 genes contain 50 mutations that cause feline health problems or alterations in the cat's appearance. A variety of commercial laboratories can now perform cat genetic diagnostics, allowing both the veterinary clinician and the private owner to obtain DNA test results. DNA is easily obtained from a cat via a buccal swab with a standard cotton bud or cytological brush, allowing DNA samples to be easily sent to any laboratory in the world. The DNA test results identify carriers of the traits, predict the incidence of traits from breeding programs, and influence medical prognoses and treatments. An overall goal of identifying these genetic mutations is the correction of the defect via gene therapies and designer drug therapies. Thus, genetic testing is an effective preventative medicine and a potential ultimate cure. However, genetic diagnostic tests may still be novel for many veterinary practitioners and their application in the clinical setting needs to have the same scrutiny as any other diagnostic procedure. This article will review the genetic tests for the domestic cat, potential sources of error for genetic testing, and the pros and cons of DNA results in veterinary medicine. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's internal genome.     

Pharmaco-epidemiology and -economics should be developed more extensively in veterinary medicine

Pharmaco-epidemiology, which has emerged within the last 20 years as a new discipline in human medicine, deals with the quantities of drugs consumed and their effects on populations in terms of epidemiological concepts and tools. To a lesser extent, it is also practised in veterinary medicine. The applications presented in this review are illustrative of pharmaco-epidemiological and -economical concepts. Assessment of drug consumption, the study of adverse drug effects, and the economic implications of drug use are the three main fields considered. Developments can be expected in veterinary medicine within the next few years relative to novel areas of interest such as antimicrobial resistance and new therapeutic class uses. These applications will require methodological progress and the elimination of current gaps. Pharmaco-epidemiological methods need to be developed, which implies close co-operation between statisticians, pharmacologists, veterinary practitioners and epidemiologists. A greater use of the term 'pharmaco-epidemiology' as a keyword in literature would facilitate recognition of this domain which associates closely epidemiology and pharmacology.     

Cutaneous paraneoplastic syndromes in dogs and cats: a review of the literature

Cutaneous paraneoplastic syndromes are a group of noncancerous dermatoses associated with internal malignancy. Their recognition can facilitate detection and timely treatment of underlying cancer. More than 30 such disorders have been identified in the human scientific literature, whereas only a few are described in veterinary medicine. This may reflect a lower incidence in animals than in people or may be the result of failure to recognize an association between certain skin lesions and neoplasia. Establishing a relationship between a cutaneous disorder and neoplasia can be difficult unless the skin lesions are rare and almost always associated with a particular tumour type, as is the case for most recognized veterinary paraneoplastic dermatoses. Among these are feline paraneoplastic alopecia, feline thymoma-associated exfoliative dermatitis, nodular dermatofibrosis, feminization syndrome associated with testicular tumours, superficial necrolytic dermatitis and paraneoplastic pemphigus. The aetiology of most cutaneous paraneoplastic syndromes has remained elusive in both people and animals.     

Markers of Osteoarthritis: A Review of the Literature

There may be a great potential in the use of diagnostic "markers" of osteoarthritis in synovial fluid to diagnose the disease in an earlier stage and perhaps assess the severity of the disease and monitor the effect of a treatment. In the present study, potential markers are characterized, discussed, and grouped according to the latest knowledge on the etiology, pathogenesis, and pathology of osteoarthritis. They are grouped according to their origin as either cartilage degradation products, or related to the mechanisms of cartilage degradation, or related to chron-drocytic anabolic activity during disease, or related to genetic disorders. Also potential markers that have not yet been studied clinically or experimentally are discussed. Examples of the progress that has been made in human medicine approaching reliable diagnostic markers that should also be tried in veterinary medicine are described.     

Physical examination and preventive care of rabbits.

As rabbits gain increasing popularity as house pets, more rabbit owners are seeking basic preventive veterinary care. Although a knowledge of the unique anatomic and physiologic characteristics of pet rabbits is essential, annual examination and review of diet and husbandry are as important as with any other species. Many disease states can be detected or prevented with routine veterinary care. Despite all the advances in diagnostic testing in veterinary medicine, there will never be a substitute for a complete physical examination.     

Trends in veterinary cancer imaging

With the recent advances in diagnostic imaging technology, cancer imaging in veterinary medicine has become more specific for disease diagnosis, more accurate for determining tumour margins and more sensitive for detecting metastatic disease. Ultrasound provides highly detailed images of parenchymal masses and infiltrative lesions while providing a means for aspiration or biopsy using real‐time image guidance. Computed tomography and magnetic resonance‐imaging techniques provide exquisite anatomical resolution that improves diagnostic accuracy, provides an accurate means of radiation or surgical treatment planning and a quantitative means for monitoring response to therapy. In addition to traditional anatomic imaging, new techniques are being developed for estimating functional parameters such as tumour perfusion, cell metabolism and gene expression. While conventional planar scintigraphy has been available for some time, newer nuclear imaging modalities such as positron emission tomography promise to further improve the accuracy of initial tumour diagnosis and staging and determination of response to therapy. Although many of these functional techniques are not yet clinically available, it is highly likely that some will be integrated into routine clinical practice in the near future.     

A literature review of reports of the stability and storage of common injectable chemotherapy agents used in veterinary patients

Many chemotherapy drugs used in human patients are discarded after single use or within 24 h of reconstitution, as per the manufacturer's product label recommendations. This can be wasteful and costly to veterinary clients. This report reviews the published stability and storage data for 19 injectable chemotherapy drugs commonly used in veterinary medicine. Based on these data, storage procedures are presented, assuming aseptic technique and a closed system drug transfer device (CSDTD) are used for drug preparation and handling. Further studies on the risk of microbiological contamination of chemotherapeutics using a CSDTD, and validated high quality drug assays such as stability‐indicating high‐performance liquid chromatography, are required. The authors' intent is not to supersede product label recommendations, but to suggest that longer storage without significant loss of drug efficacy may be possible, thus reducing the costs of chemotherapeutics to some veterinary clients.     

A model for teaching raptor medicine in the veterinary curriculum

Injured or sick wild avian species, especially raptors (birds of prey, including hawks, owls, falcons, and eagles), can present different challenges to veterinary students and veterinarians who are trained in companion avian medicine (e.g., parrot medicine). Proper capture and restraint, feeding, housing, and certain diagnostic and treatment techniques involving raptors require different skills, knowledge, and resources than working with parrots. We developed an innovative raptor medicine program that enables students to acquire proficiency in safe capture, restraint, and examination techniques and in common diagnostic and treatment procedures. A self-assessment survey was developed to determine students' confidence and proficiency in 10 procedures taught in the lab. Groups were compared by class status (Year 1 vs. Year 2 and 3) and level of prior raptor experience (non-experienced or experienced). In surveys conducted before and after teaching two sets of raptor training labs, students rated themselves significantly more proficient in all 10 diagnostic and treatment procedures after completing the two raptor laboratories. The greatest improvements were observed in technical skill procedures such as fluid administration, intramuscular injections, cloacal swabs, venipuncture, and bandaging. Our approach to incorporating elective wildlife learning experiences into the veterinary curriculum may be replicable in other veterinary schools, with or without a wildlife rehabilitation program.     

Surgery in hematopoietic tumors

The role of surgery in the diagnosis of hematopoietic malignancies is undisputed. Many techniques to procure and examine representative tissue samples are recognized in identifying dogs and cats with these diseases. More sophisticated cytologic techniques not yet readily available would be helpful in implementing appropriate diagnostic, prognostic, and therapeutic approaches. Surgery has a limited role in the management of primary disease. The greatest limitation to surgical intervention is the systemic nature of most hematopoietic malignancies. Other limitations that can more realistically be overcome include early recognition of patients with extranodal lymphomas in Stage I disease, the increased use of surgery and radiation as adjunctive therapies for patients with regional disease, a more aggressive approach to the treatment of disease complications, and the implementation of promising experimental therapies in clinical patients of the future. The surgeon treating dogs and cats with hematopoietic malignancies must, as always, practice accepted principles of bacteriologic and oncologic asepsis and await further advances in veterinary medicine to integrate this discipline more completely with other modalities of therapy.