SCINTIGRAPHIC ASSESSMENT OF DISTAL EXTREMITY PERFUSION IN 17 PATIENTS

To assess the role of scintigraphic evaluation of distal limb perfusion, the medical records and scintigraphic perfusion images of 17 animals(8dogs, 2cats, 2calves, 4birds and 1 ferret) with clinical signs of distal limb ischemia were examined retrospectively. Images were obtained at 5 and 10 minutes following injection of ^99m Tc-MDP, or ^99mTc-DTPA. The initial scintigraphic diagnoses of 17 animals included complete ischemia(8/17), partially reduced perfusion(5/17), and normal to increased perfusion(4/17). In 4 of the animals with partially reduced perfusion, follow-up scans indicatd progression to complete ischemia(1/4) or normal to increased perfusion(3/4). Nine of 17 animals had a final scintigraphic diagnosis of complete distal limb ischemia, and these animals were either euthanized(5/9)or had limb amputation(4/9).A final diagnosis of complete ischemia was supported with either repeat scanning(3/10), continued clinical observation(6/10)and /or pathological examination(10/10).Clinical Scintigraphy provided a safe and noninvasive assessment of distal limb perfusison, which corresponded with clinical outcome.     

Determination of cardiac output in neonatal foals by ultrasound velocity dilution and its comparison to the lithium dilution method

Objective – To compare cardiac output (CO) measured by use of lithium dilution (LiDCO) and ultrasound velocity dilution (UDCO) in conditions of high, intermediate, and low CO in anesthetized foals.
Design – Original prospective study.
Setting – University teaching hospital.
Animals – Six foals 1–3 days of age (38–45 kg).
Interventions – Neonatal foals were anesthetized and instrumented to measure direct blood pressure, heart rate, arterial blood gases, and CO. The CO was measured by use of LiDCO and UDCO techniques. Measurements were obtained from each foal at baseline and during low, intermediate, and high CO states. Measurements were converted to cardiac index (cardiac index=CO/body weight) values for statistical analysis. Agreement between the 2 methods was determined using Bland and Altman analysis and concordance correlation coefficients.
Measurements and Main Results – LiDCO determinations of CO ranged between 4.0 and 14.0 L/min resulting in cardiac index ranging between 75.5 and 310 mL/kg/min. There was no significant effect of blood pressure variation on bias or relative bias ( P =0.62 and 0.93, respectively). The mean bias and relative bias of UDCO (±SD) compared with LiDCO were −20.1±39.2 mL/kg/min and −7.7±23.4%, respectively. Concordance correlation coefficient between LiDCO and UDCO was 0.833.
Conclusions – When compared with LiDCO, the UDCO technique has acceptable clinical utility for measuring CO in healthy anesthetized newborn foals.     

Renal Allograft Survival in Outbred Mongrel Dogs Using Rabbit Anti-Dog Thymocyte Serum in Combination With Immunosuppressive Drug Therapy With or Without Donor Bone Marrow

Therapeutic renal transplantation in dogs is currently being investigated as a treatment for end-stage renal disease. This pilot study examines the effect of donor bone marrow (DBM) infusion and antithymocyte serum (ATS) in combination with immunosuppressive drug therapy in prolonging renal allograft survival in dogs. Seven normal outbred mongrel dogs received an unmatched renal allograft. All dogs received rabbit anti-dog thymocyte serum (RADTS), prednisone (Pr), cyclosporine-A (CsA) and azathioprine (Aza). In addition, three dogs (group 1 test) received DBM and four dogs (group 2 control) did not receive DBM. Serum CsA levels were measured throughout the study. Immunosuppressive therapy was gradually reduced with Pr, CsA, and Aza withdrawn at 200,450, and 680 days, respectively. Allograft rejection was treated with prednisolone sodium succinate. One dog in group 1 and one in group 2 died as a result of infectious canine rhinotracheitis and rejection early in the study. Renal allograft torsion occurred in one group 1 dog. The remaining four dogs survived the 2 years of the study. The dogs in group 2 (three dogs) all rejected the renal allograft after total drug withdrawal, the surviving dog in group 1 did not. This study demonstrates that RADTS, Pr, CsA, and Aza in combination can prolong renal allograft survival in mongrel dogs, whereas DBM may enhance the unresponsive state.     

Acute polyneuromyopathy with respiratory failure secondary to monensin intoxication in a dog

Objective

To describe a successfully managed case of polyneuropathy and respiratory failure secondary to presumed monensin intoxication.

Case Summary

A 9‐month‐old Australian Shepherd was evaluated for progressive generalized weakness and respiratory distress. Several days preceding presentation, the dog was seen playing with a monensin capsule, and had free access to a barn where the product was stored and where chewed capsules were subsequently found. The dog was presented with flaccid tetraparesis, hyperthermia, and severe respiratory distress. Bloodwork and urinalysis revealed marked increase in serum creatine kinase concentration and presumed myoglobinuria. Cardiac troponin I level was markedly increased. Management included mechanical ventilation for 5 days, fluid‐therapy, active cooling, antimicrobial therapy, analgesia, gastroprotectants, antiemetics, enteral feedings, continuous nursing care, and physiotherapy. Intravenous lipid rescue therapy was administered with lack of improvement in respiratory function and muscle strength. The patient completely recovered and was discharged after 12 days of hospitalization.

New or Unique Information Provided

Monensin intoxication should be considered in the differential diagnosis of acute polyneuromyopathy and respiratory failure in dogs with access to this compound. Respiratory failure secondary to monensin intoxication does not necessarily carry a poor prognosis if mechanical ventilation can be provided as a bridge until return of respiratory function is achieved.