Carbon monoxide toxicity: a case series

Objective: To describe diagnostics, therapy, and sequelae of acute carbon monoxide (CO) toxicity because of a motor vehicle generator in 4 dogs and 2 cats. Series summary: Four dogs and 2 cats presented for recumbency, disorientation, dyspnea, and stiffness after an estimated 6–8 hour exposure to exhaust from a generator. Diagnostics included a serum carboxyhemoglobin levels evaluation, arterial blood gas analysis, pulse oximetry readings, and blood pressure measurements. Initial therapy included oxygen (O₂) administration, intravenous bronchodilators, fluids, and a hemoglobin‐based O₂ carrying (HBOC) molecule. Following administration of the HBOC, 4 of the 6 animals showed dramatic clinical improvement. Two weeks after hospital discharge, the owner reported potential hearing deficits in all animals. Brain auditory evoked response (BAER) tests were conducted in all surviving animals and some degree of hearing impairment was documented in all cases, with complete clinical resolution noted 6 weeks later. Unique information provided: This report describes the therapeutic use of an HBOC in acute isolated CO toxicity (i.e. without the complications of smoke inhalation). In addition, delayed nervous system dysfunction was documented in all surviving animals.     

Iron storage disease in captive Egyptian fruit bats (Rousettus aegyptiacus): relationship of blood iron parameters to hepatic iron concentrations and hepatic histopathology.

This study evaluated the relationship between blood iron parameters and hepatic iron concentrations, and correlation of histologic findings with hepatic iron concentrations in a captive population of Egyptian fruit bats (Rousettus aegyptiacus) and island flying foxes (Pteropus hypomelanus). Blood samples were collected for complete blood counts, plasma biochemical profiles, serum iron concentrations, total iron-binding capacity, whole-blood lead concentrations, and plasma ferritin assays. Liver samples obtained by laparotomy were divided, with one half processed for histologic examination and the other half frozen and submitted for tissue mineral analysis. The histologic sections were scored by two blinded observers for iron deposition, necrosis, and fibrosis. The Egyptian fruit bats had significantly higher liver iron (mean = 3,669 +/- 1,823 ppm) and lead (mean = 8.9 +/- 5.8 ppm) concentrations than the island flying foxes (mean [Fe] = 174 +/- 173 ppm, mean [Pb] = 1.9 +/- 0.5 ppm). Hepatic iron concentrations significantly correlated with tissue lead concentrations, histologic grading for iron and necrosis, serum iron, transferrin saturation, and plasma ferritin (P < 0.001). Blood lead concentrations negatively correlated with tissue lead concentrations (P < 0.001). When the product of transferrin saturation and serum iron was greater than 51, an individual animal had a high probability of having iron overload. When the product of these two variables was greater than 90, there was a high probability that the animal had hemochromatosis. On the basis of this study, it appears that evaluation of serum iron, transferrin saturation, and plasma ferritin are useful and noninvasive methods for diagnosis of hemochromatosis in Egyptian fruit bats.     

Successful treatment of mandibular squamous cell carcinoma in a Malayan sun bear (Helarctos malayanus).

An adult, female Malayan sun bear (Helarctos malayanus) was diagnosed with squamous cell carcinoma of the rostral mandible. Initial treatment included bilateral mandibulectomy rostral to the lingual frenulum followed by intra- and perilesional cisplatin injections. Recovery after the procedure was uneventful and the Malayan sun bear adapted well to a shortened mandible. Histopathology indicated incomplete surgical excision of the tumor; therefore, radiation therapy was instituted weekly for four treatments at 2 Gy in parallel opposed fields (total 4 Gy each treatment) with one additional cisplatin treatment. Two years after initial presentation, the animal showed no recurrence of neoplasia.     

Effects of Azoxystrobin on Mycotoxin Production in a Carbendazim-Resistant Strain ofFusarium sporotrichioides

Carbendazim-resistant (RS) and control (CS) strains ofFusarium sporotrichioides Sherb., previously developed in our laboratory, were exposed to graded concentrations of azoxystrob in in broth media under shake-culture conditions for 2, 3, 4 and 8 days. Azoxystrobin concentrations were 0, 1, 10 and 100 mg 1^-1 broth and cultures were incubated at a constant 25°C. Mycelial growth was significantly affected by strain (P<0.01), azoxystrobin concentration (P<0.001) and incubation time (P<0.001). Combined results for the four incubation times showed that CS yielded higher mycelial mass than RS (P<0.01) only in the absence of azoxystrobin. At fungicide additions of 1, 10 and 100 mg P^-1 mycelial growth was reduced (P<0.001) with minimal strain differences (P>0.05) at all three doses of azoxystrobin. Significant (P<0.05 or better) strain-fungicide interactions were recorded in trichothecene production following exposure to azoxystrobin. At 4 and 8 days of incubation, the 10 mg 1^-1 addition of azoxystrobin stimulated T-2 toxin synthesis (P<0.05) only in RS cultures. In contrast, T-2 toxin enhancement in CS cultures occurred only on day 8 but at a lower level of azoxystrobin (1 mg1^-1). Thus, the stimulation of T-2 toxin synthesis depended upon strain and azoxystrobin level. Production of diocetoxyscirpenol (DAS) was affected by a more complex set of interactions. Overall means showed that, in comparison with initial values (on day 2 or 3), DAS output maximized significantly(P<0.05) on day 4 in RS cultures and on day 8 in CS. Marked strain effects were observed on exposure to the 10 mg 1^-1 level of azoxystrobin. At this level, DAS production was enhanced in RS only after 4 (P<0.01 ) and 8 (P<0.05) days of incubation, while in contrast, CS reduced DAS production. As with T-2 toxin, DAS production in CS was stimulated (P<0.05 or better) only at low exposure levels of azoxystrobin. In the case of neosolaniol (NEO), however, the main effect of strain was significant (P<0.05), with CS producing consistently more of the mycotoxin than RS on day 4 of the experiment. At this point, the NEO:T-2 toxin ratio was also higher in CS (0.63) than in RS (0.12), a feature reported by us previously. In conclusion, the present investigation has shown for the first time that the development of resistance to one fungicide can affect trichothecene production inF. sporotrichioides on exposure to a second fungicide. These results have been incorporated into a new classification scheme for fungicide efficacy which is also presented in this paper. http://www.phytoparasitica.org posting Oct. 7,2001.     

Hemostatic changes in dogs with naturally occurring sepsis

Sepsis is a frequent source of morbidity and mortality in critically ill patients. The goal of this case control study was to measure hemostatic changes in dogs with naturally occurring sepsis. Blood was collected within 24 hours of admission from 20 dogs that fulfilled the criteria for sepsis. Sepsis was defined as histologic or microbiological confirmation of infection and 2 or more of the following criteria: hypo- or hyperthermia, tachycardia, tachypnea, or leukopenia, leukocytosis, or > 3% bands. Culture and sensitivities were performed on appropriate samples from all septic dogs. Twenty-eight control dogs were enrolled on the basis of normal results of physical examination, CBC, serum biochemistry, and coagulation profile. Plasma samples were analyzed for prothrombin time (PT), partial thromboplastin time (PTT), fibrin(ogen) degradation products (FDP), D-dimer (DD) concentrations, antithrombin (AT) activity, and protein C (PC) activity. Data were compared between groups by chi-square or independent t-tests. PC (P < .001) and AT (P < .001) activities were significantly lower in dogs with sepsis compared to controls. Dogs with sepsis had significantly higher PT (P = .007), PTT (P = .005), D-dimer (P = .005), and FDP (P = .001) compared to controls. Platelet counts were not significantly different between groups. Ten of the 20 septic dogs (50%) died, but no association was identified between any of the measured variables and outcome. These findings are consistent with previous studies in animals with experimentally induced disease and in clinical studies of humans. On the basis of these results, further investigation of the role of AT and PC in canine sepsis is warranted.     

Serum nitrate and nitrite in dogs with spontaneous cardiac disease

The purpose of this study was to determine whether nitric oxide (NO) concentrations are high in dogs with chronic valvular disease (CVD) and dilated cardiomyopathy (DCM) compared to healthy controls and to determine whether NO concentrations are correlated with type of cardiac disease, disease severity, medical therapy, or serum tumor necrosis factor (TNF) and interleukin-1 (IL-1). Blood was collected from 32 dogs with DCM, from 10 dogs with CVD, and from 10 healthy controls. Indirect determination of NO concentrations was performed by a commercial photoabsorbance assay that uses a Greiss reagent to measure the concentration of nitrite and nitrate (NN), end products of NO metabolism. TNF and IL-1 activities were measured by bioassay. Mean NN concentrations were significantly higher in dogs with heart disease (median, 4.57 microM; range, 0.00-31.05 microM) than in controls (median, 0.00 microM; range, 0.00-6.16 microM; P = .04). NN concentrations in dogs with cardiac disease were not correlated with type or severity of cardiac disease, medication type, or TNF and IL-1 concentrations. NN concentrations were inversely correlated with fractional shortening. The results of this study suggest that metabolites of NO are increased in some dogs with cardiac disease, but these increases appear to be independent of disease severity, TNF and IL-1 concentrations, and type of pharmacologic intervention.     

Comparative diagnostic test characteristics of oscillometric and Doppler ultrasonographic methods in the detection of systolic hypertension in dogs

Comparison of test characteristics allows a clinician to choose the optimal diagnostic test method for an individual patient. This study assessed the comparative test characteristics of noninvasive (NI) blood pressure measurement methods (oscillometric and Doppler) and used this information to develop optimal cutoff values for diagnosis of systolic hypertension in dogs by these NI methods. Simultaneous NI (oscillometric or Doppler methods) and invasive (arterial puncture [AP]) systolic blood pressure (SBP) measurements were obtained prospectively from normal dogs and dogs suspected of having systemic hypertension based on clinical signs. Oscillometric SBP readings were obtained from the distal hind limb (Osc-L, n = 54) or the proximal tail (T. n = 27). Doppler BP measurements were obtained using a forelimb cuff (n = 57). AP-SBP was categorized as hypertensive if > or = 160 mmHg, and sensitivity (Se). specificity (Sp), and likelihood ratios (LR) were calculated for diagnostic cutoff values ranging from 130 to 220 mmHg. Receiver operator characteristic (ROC) curves were analyzed to determine optimal cutoff values for diagnosis of AP-SBP > or = 160 mmHg. Optimal NI SBP cutoff values considered to reflect AP values > or = 160 mmHg were: Osc-L = 160 mmHg (Se: 65%, Sp: 85%. LR = 4.33: 1), Osc-T = 150 mmHg (Se: 84%, Sp: 75%, LR = 3.36: 1), and Doppler = 160 mmHg (Se: 71%,     

The advantages and disadvantages of endoscopy

Endoscopy is generally a very safe and effective tool in the diagnosis and therapy of various gastrointestinal (GI) disorders, and must be used in conjunction with other diagnostic modalities. Endoscopy should not be a substitute for a complete work-up. There are many advantages of endoscopy, including minimal morbidity and mortality, and the sensitivity of this modality in the diagnosis of mucosal disorders of the GI tract. However, complications may occur, and there are limitations to endoscopy. This article will provide an overview of when to choose GI endoscopy and when other procedures might provide more information.     

Minimum alveolar concentration of sevoflurane in spontaneously breathing llamas and alpacas

OBJECTIVE: To determine the minimum alveolar concentration (MAC) of sevoflurane in spontaneously breathing llamas and alpacas. DESIGN: Prospective study. ANIMALS: 6 healthy adult llamas and 6 healthy adult alpacas. PROCEDURE: Anesthesia was induced with sevoflurane delivered with oxygen through a mask. An endotracheal tube was inserted, and a port for continuous measurement of end-tidal and inspired sevoflurane concentrations was placed between the endotracheal tube and the breathing circuit. After equilibration at an end-tidal-to-inspired sevoflurane concentration ratio > 0.90 for 15 minutes, a 50-Hz, 80-mA electrical stimulus was applied to the antebrachium until a response was obtained (ie, gross purposeful movement) or for up to 1 minute. The vaporizer setting was increased or decreased to effect a 10 to 20% change in end-tidal sevoflurane concentration, and equilibration and stimulus were repeated. The MAC was defined as the mean of the lowest end-tidal sevoflurane concentration that prevented a positive response and the highest concentration that allowed a positive response. RESULTS: Mean +/- SD MAC of sevoflurane was 2.29 +/- 0.14% in llamas and 2.33 +/- 0.09% in alpacas. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of sevoflurane in llamas and alpacas was similar to that reported for other species.     

Effects on plasma endotoxin and eicosanoid concentrations and serum cytokine activities in horses competing in a 48-, 83-, or 159-km endurance ride under similar terrain and weather conditions

OBJECTIVE: To determine plasma endotoxin concentration in horses competing in a 48-, 83-, or 159-km endurance race and its importance with regard to physical, hematologic, or serum and plasma biochemical variables. ANIMAL: 3 horses. PROCEDURE: Weight and rectal temperature measurements and blood samples were obtained before, during, and after exercise. Blood samples were analyzed for plasma endotoxin concentration; serum antiendotoxin antibody titers; thromboxane B2 (TxB2) and 6-keto-prostaglandin F1alpha (PGF1alpha) concentrations; tumor necrosis factor alpha (TNFalpha) and interleukin-6 (IL-6) activities; WBC, plasma protein, lactate, serum electrolyte, and calcium concentrations; PCV; and creatine kinase activity. RESULTS: Detection of plasma endotoxin increased during exercise for horses competing at all distances but occurred more frequently in the 48- and 83-km groups. Plasma lactate concentration was significantly greater when endotoxin was concurrently detected. Endotoxin in plasma was not significantly associated with success of race completion. Plasma TxB2 and PGF1alpha concentrations and serum IL-6 activity significantly increased with exercise. Horses that had an excellent fitness level (as perceived by their owners) had greater decreases in serum antiendotoxin antibody titers during exercise than did horses perceived as less fit. In horses with better finish times, TxB2 and PGF1alpha concentrations were significantly greater and TNFalpha activity was significantly less than that of slower horses. CONCLUSIONS AND CLINICAL RELEVANCE: Endotoxemia developed during endurance racing, but was significantly correlated with increased plasma lactate concentration and not with other variables indicative of endotoxemia. Plasma TxB2 and PGF1alpha concentrations and serum TNFalpha activity may be associated with performance success.