Oncologic emergencies

Cancer can lead to emergencies either due to the primary disease, or as a result of therapy. Appropriate diagnosis and rapid treatment of these conditions can result in survival of the patient. Whether chemotherapy is implemented or not, the clinician may be presented with a patient in need of emergency stabilization. Common occurring emergencies are related to effects of the cancer, ranging from immune dysfunction due to marrow infiltration to brain herniation due to increased intracranial pressure from neoplasia. Often adverse effects secondary to chemotherapy can cause emergency situations such as sepsis. Prompt diagnosis and treatment may result in a favorable outcome. Addressed in this chapter are commonly occurring emergencies and specific stabilizing treatments.     

Ophthalmic emergencies.

Ophthalmic emergencies are common presenting complaints in an emergency room. Most ophthalmic emergencies can be treated and stabilized until an ophthalmologist can be consulted. Most ocular emergencies involve loss of vision, compromised globe integrity, or severe ocular pain. Delay in treating true emergencies may result ina blind eye or loss of an eye. This article discusses the clinical signs,diagnosis, and treatment as well as the prognosis of some of the more common ophthalmic emergencies.     

Management of avian flock emergencies.

Managing avian flock emergencies requires a thorough history, physical examination, and record review before instituting appropriate therapy. Although the general thought processes are similar between approaching a sick individual bird and a "diseased" aviary, the actual steps are different. Infectious diseases are often a component of aviary emergencies but are rarely the primary cause of flock "disease." Managing flock emergencies typically goes beyond addressing individual pathogens. Recognizing, evaluating, and treating flock emergencies are discussed with the intent to provide a better understanding of flock health medicine principles.     

Feline ocular emergencies

Feline ocular emergencies include any ophthalmic condition that has rapidly developed or is the result of trauma to the eye or periocular structures. Common feline emergencies include proptosis, lid lacerations, corneal ulcers, and foreign bodies. Complete ophthalmic examination including procurement of the minimal ophthalmic database (Schirmer tear test, fluorescein stain, and intraocular pressure measurement) should be obtained whenever possible to ensure that the complete and correct diagnosis is made. Concern for the patient's vision and ocular comfort should guide the practioner's diagnostic and therapeutic plan. This article reviews some of the more common feline ocular emergencies, including conditions affecting the orbit and globe, adnexa, conjunctiva, and cornea. Feline uveitis, glaucoma, and lenticular diseases are covered more thoroughly elsewhere in this issue.     

Obstetrical emergencies

This article discusses different techniques that can be used in the diagnosis and treatment of obstetrical emergencies. Female reproductive emergencies commonly encountered by small animal practitioners include pyometra, dystocia, cesarean section, mastitis, eclampsia, uterine torsion, and uterine prolapse. A thorough knowledge of normal and abnormal reproductive behavior will aid the emergency veterinarian in successfully managing such cases. Timely diagnosis and treatment of these emergencies will often give a good outcome.     

Nutritional Problems in Cats: Taurine Deficiency and Vitamin A Excess

Two nutritional problems of the cat are reviewed. One represents a deficiency of taurine, the other vitamin A toxicity. Taurine deficiency in cats is insidious because the progressive retinal degeneration induced may go unnoticed until the damage is advanced and irreversible. Both rods and cones undergo degeneration along with the underlying tapetum lucidum. The hyperreflective focal lesion is easily observed in the area centralis with an ophthalmoscope and has been previously identified as feline central retinal degeneration. This lesion is not reversed by taurine supplementation, even though the remaining retina may be saved from further degeneration. The cat requires dietary taurine, found in meat and fish, because it cannot synthesize enough to meet demands for bile acid conjugation and tissue metabolism, especially those of muscle and central nervous system.

Vitamin A toxicity is not commonly observed in cats but may occur if cats are fed beef liver in which appreciable vitamin A is stored. Cats exhibit muscle soreness and hyperesthesia, especially along the neck and forelimbs where bony exostoses of cervical verterbrae and longbones are common. The diagnosis is readily made from radiographs. The response to removal of vitamin A from the diet is generally rapid and, unless the toxicity has been chronic in young kittens, recovery is generally satisfactory.

     

Assessment of diclofenac LC50 reference values in juvenile and embryonic stages of the zebrafish (Danio rerio)

The aim of the study was to compare the acute toxicity of diclofenac to juvenile and embryonic stages of the zebrafish (Danio rerio). Acute toxicity tests were performed on the aquarium fish Danio rerio, which is one of the model organisms most commonly used in toxicity testing. The tests were performed using a semi-static method according to OECD guideline No. 203 (Fish, acute toxicity test). Embryo toxicity tests were performed in zebrafish embryos (Danio rerio) in compliance with OECD No. 212 methodology (Fish, short-term toxicity test on embryo and sac-fry stages). The results were subjected to a probit analysis using the EKO-TOX 5.2 programme to determine 96hLC50 and 144hLC50 (median lethal concentration, 50% mortality after a 96 h or 144 h interval, respectively) values of diclofenac. The statistical significance of the difference between LC50 values in juvenile and embryonic stages of Danio rerio was tested using the Mann-Whitney non-parametric test implemented in the Unistat 5.1 programme. The LC50 mean value of diclofenac was 166.6 +/- 9.8 mg/L in juvenile Danio rerio, and 6.11 +/- 2.48 mg/L in embryonic stages of Danio rerio. The study demonstrated a statistically higher sensitivity to diclofenac (P < 0.05) in embryonic stages compared to the juvenile fish.     

Tropical fish medicine. Bacterial culture and evaluation of diseases of fish

Bacteria are ubiquitous in nature. Fish are constantly exposed to bacteria, and usually only succumb to an infection after having been exposed to prolonged periods of stress. Before making a diagnosis of a bacterial disease, it is necessary to eliminate the possibility of environmental or parasitic problems. Environmental factors may act as stressors and can predispose a fish to bacterial disease while affecting the fish simultaneously. Clinical signs caused by the various bacterial pathogens are very similar. Therefore, to make a definitive bacterial diagnosis, it is necessary to culture and identify the organisms involved.     

Mycobacterium marinum infection in fish and man: epidemiology,pathophysiology and management; a review

Mycobacterium marinum is an opportunistic pathogen inducing infection in fresh and marine water fish. This pathogen causes necrotizing granuloma like tuberculosis, morbidity and mortality in fish. The cell wall-associated lipid phthiocerol dimycocerosates, phenolic glycolipids and ESAT-6 secretion system 1 (ESX-1) are the conserved virulence determinant of the organism. Human infections with Mycobacterium marinum hypothetically are classified into four clinical categories (type I–type IV) and have been associated with the exposure of damaged skin to polluted water from fish pools or contacting objects contaminated with infected fish. Fish mycobacteriosis is clinically manifested and characterized in man by purple painless nodules, liable to develop into superficial crusting ulceration with scar formation. Early laboratory diagnosis of M. marinum including histopathology, culture and PCR is essential and critical as the clinical response to antibiotics requires months to be attained. The pathogenicity and virulence determinants of M. marinum need to be thoroughly and comprehensively investigated and understood. In spite of accumulating information on this pathogen, the different relevant data should be compared, connected and globally compiled. This article is reviewing the epidemiology, virulence factors, diagnosis and disease management in fish while casting light on the potential associated public health hazards.     

Pathogenesis of and strategies for preventing Edwardsiella tarda infection in fish

Edwardsiella tarda is one of the serious fish pathogens, infecting both cultured and wild fish species. Research on edwardsiellosis has revealed that E. tarda has a broad host range and geographic distribution, and contains important virulence factors that enhance bacterial survival and pathogenesis in hosts. Although recent progress in edwardsiellosis research has enabled the development of numerous, highly effective vaccine candidates, these efforts have not been translated into a commercialized vaccine. The present review aims to provide an overview of the identification, pathology, diagnosis and virulence factors of E. tarda in fish, and describe recent strategies for developing vaccines against edwardsiellosis. The hope is that this presentation will be useful not only from the standpoint of understanding the pathogenesis of E. tarda, but also from the perspective of facilitating the development of effective vaccines.     

Purdue University graduate certificate program in Veterinary Homeland Security

Our nation lacks a critical mass of professionals trained to prevent and respond to food- and animal-related emergencies. Training veterinarians provides an immediate means of addressing this shortage of experts. Achievement of critical mass to effectively address animal-related emergencies is expedited by concurrent training of professionals and graduate students in related areas. Purdue University offers a Web-based Graduate Certificate in Veterinary Homeland Security to address this special area of need. The program is a collaborative effort among the Purdue University School of Veterinary Medicine, the Purdue Homeland Security Institute, the Indiana State Board of Animal Health, the Indiana State Police, and others with the overall goal of increasing capacity and preparedness to manage animal-related emergencies. Individuals with expertise in veterinary medicine, public health, animal science, or homeland security are encouraged to participate. The Web-based system allows courses to be delivered efficiently and effectively around the world and allows participants to continue their graduate education while maintaining full-time jobs. Participants enhance their understanding of natural and intentional threats to animal health, strengthen their skills in managing animal-health emergencies, and develop problem-solving expertise to become effective members of animal emergency response teams and of their communities. Students receive graduate credit from Purdue University that can be used toward the certificate and toward an advanced graduate degree. Currently, 70 participants from 28 states; Washington, DC; Singapore; and Bermuda are enrolled.     

Retroviruses of wild and cultured fish

Retroviruses comprise a large group of enveloped RNA viruses which have been found in a wide range of vertebrate species including fish. To date a number of fish retrovirus genomes have been partially or completely sequenced. Phylogenetic analysis and genome organization indicate a high diversity of fish retroviruses as well as some unique structural features that have not been found in any other retroviruses. Piscine retroviruses comprise both exogenous and endogenous viruses; most of them are associated with proliferative diseases. Because several of these proliferative diseases have a seasonal trend, they provide an excellent model for studying tumor development and regression. The aim of this work was to review the best-described fish retroviruses.     

Efficacy of doramectin against natural and experimental infections of Lernaea cyprinacea in carps

Efficacy of doramectin administered via oral and parenteral routes against experimentally induced and natural infections of the copepod parasite Lernaea cyprinacea in carps was studied. Administration of doramectin incorporated in feed at 1mg/kg b.wt. of fish for 10 days effectively controlled experimentally induced Lernaea infection in Labeo fimbriatus fingerlings within an average of 19 days of post-treatment as compared to the normal course of 41 days. Similarly, doramectin given through feed at 1mg/kgb.wt. of fish for 10 days was equally effective in controlling natural infection of this parasite in the underyearlings of Catla catla and L. fimbriatus. Intramuscular administration of doramectin at 200mug/kgb.wt. of fish effectively removed adult Lernaea infection in L. fimbriatus as early as 18 days of treatment as compared to the time period of 43 days taken by the untreated fish to get rid of the infection. Single intramuscular administration of the drug was more effective against the parasite than its administration in multiple divided doses. In all cases, doramectin did not cause any noticeable adverse reactions or toxicity to the fish host. In view of the handling associated stress and other operational difficulties involved, a single intramuscular administration of the drug at 200mug/kgb.wt. is suggested for treatment of heavily infected adults and brood stock of carps. Doramectin incorporated in feed at 1mg/kgb.wt. of fish is best suited for treatment of Lernaea infection in young fish including fingerlings. However, detailed studies on the toxicity and pharmacokinetics of doramectin upon its administration to aquatic organisms and the environmental impact of its usage are required to be undertaken before finally recommending the safe use of this drug for control of parasitic infections of aquatic organisms.     

Amphibian emergency and critical care.

Amphibians present unique challenges for the clinician in the diagnosis and treatment of life-threatening conditions. Their adaptability to both aquatic and terrestrial lifestyles leaves them vulnerable to dehydration and fluid overload, either of which may accompany serious disease. This article presents the most common emergency conditions in amphibians, the physiologic basis of disease, and a guide to the diagnosis and treatment of amphibian emergencies.     

Three-dimensional study on the effect of organophosphate pesticide 'monocrotophos' on lens of fish and its recovery

The present studies are based on the feedback provided by fish farmers practicing composite fish culture of carps. According to them, fish habitats are affected by pesticides draining from agricultural fields into their catchments, especially during the rainy season. The lenses of most of the cultured fish became opaque, resulting in poor overall growth. In the literature, there was mounting evidence of pesticide toxicity involving multiple tissues. However, the fish visual system has never been investigated particularly from the toxicological perspective. In this regard, we carried out comparative toxicological studies on the lens of Cyprinus carpio communis using three different sublethal concentrations (0.038, 0.062 and 0.126 p.p.m.) of monocrotophos along with untreated controls for 30 days. Lenses from all the groups were extracted and preserved in gluteraldehyde and osmium tetraoxide and dehydrated in increasing grades of acetone. After dehydration, tissues were conducted with gold to observe under SEM. The fish exposed to monocrotophos developed cataract. Furthermore, when fish from the monocrotophos-treated tanks were transferred to normal environmental conditions for the next 60 days, progressive lens degeneration was noted. To conclude, monocrotophos induces irreversible cataractous changes in the lens of C. carpio communis . The fish visual system has many similarities to mammals and may serve as a good model for comparative toxicologic and ophthalmologic studies.     

Toxicology of aquarium fish.

Most aquarium fish live in a closed system, so the effects of toxins can be cumulative and devastating. Most cases of toxicity are due to deficiencies in husbandry and tank maintenance. Poor water quality kills more fish than infectious agents, making client education a very important preventive tool for aquatic practitioners. This article includes a discussion of toxicities related to water quality, chemotherapeutics, pesticides, and household substances.     

Use of praziquantel to control platyhelminth parasites of fish

Fish are common definitive and intermediate hosts for a variety of parasitic flatworms. In unstressed wild populations, parasitic infections often go unnoticed and are perceived to represent a lesser threat to fish health. In contrast, platyhelminth parasitism of captive fish often results in decreased weight gain and increased mortality which often necessitates chemotherapeutic treatment. The presence of platyhelminth parasites in fish tissues is not only unappealing but in some cases also represents a threat to human health. In veterinary medicine, one of the most commonly used agents with anti‐flatworm activity is praziquantel; yet, no praziquantel products are labeled for use in fish in the United States. Veterinarians may use praziquantel preparations approved for other vertebrate species under the Animal Medicinal Drug Use Clarification Act (AMDUCA). However, such extra‐label use should be informed by scientific evidence including efficacy and tissue residue studies. Herein, we review studies testing the efficacy of praziquantel for treatment of platyhelminthes along with an assessment of routes of administration, pharmacokinetics, and toxicity information.     

Reproductive medicine in koi (Cyprinus carpio).

Each year more veterinarians are seeing ornamental fish patients and our knowledge of how to manage the pet fish patient is increasing at a rapid pace. A large percentage of these patients are nishikigoi (Cyprinus carpio) which are taxonomically an ornamental carp. In this country and in many parts of the world we refer to these fish as koi. Reproductive medicine problems are well documented in koi and a thorough knowledge of this subject will aid the fish practitioner in diagnosis and treatment.     

Mercury and mink. I. The use of mercury contaminated fish as a food for ranch mink.

Adult female and juvenile ranch mink were fed rations containing 50 and 75% of fish containing 0.44 ppm total mercury over a 145 day period. There was no clinical or pathological evidence of intoxication in these animals and mercury concentrations in tissue appeared to be at a level below that associated with toxicity.     

Diseases of aquarium fish--4: treatment

Prevention and treatment of aquarium fish diseases is described. A variety of husbandry factors may predispose to disease development and these should always be considered. Any treatment should first be tried on a small sample of fish as toxicity does vary between species.