Veterinary Medicine - January 2008 - (Page 14)

Toxicology Brief PEER-REVIEWED ate discrepancy between the calculated hematocrit and spun hematocrit in the female and a mild discrepancy between the calculated hematocrit and spun hematocrit in the male. A decreased mean corpuscular hemoglobin concentration (MCHC) and a high or high normal mean corpuscular volume (MCV) were noted in both dogs. The coagulation proﬁle in the female dog revealed a mild increase in prothrombin time and a marked increase in the D-dimer concentration (Table 2). The female dog had severely elevated sodium and chloride concentrations (Table 3). The anion gap was moderately elevated, with a marked decrease in the enzymatic carbon dioxide concentration. The blood urea nitrogen (BUN) concentration was mildly elevated, and the creatinine concentration was at the high TABLE 2 Selected Coagulation Proﬁle Results Parameter Prothrombin time (sec) D-dimer (ng/ml) Female Dog 9.8 > 5,250 Reference Interval* 6–7.5 116.2–371.5 *Reference interval values from ACL 9000, Beckman Coulter, Fullerton, Calif. end of the reference interval. The female dog’s magnesium, phosphorus, glucose, and calcium concentrations were also elevated. A moderate hypocholesterolemia was also observed. In the male dog, the serum sodium, chloride, BUN, creatinine, and magnesium concentrations were elevated, as were the alanine transaminase and alkaline phosphatase activities and the anion gap (Table 3). Decreased calcium, total protein, and enzymatic carbon dioxide concentrations were also present. Treatment, radiographic examination, and outcome The dogs were admitted to the intensive care unit, and ﬂow-by oxygen was administered. Initial intravenous ﬂuid therapy consisted of boluses of warmed lactated Ringer’s solution. The animals were dried and placed under warm-air circulating blankets to treat the hypothermia. Initial gastroprotectant therapy was limited to intravenous famotidine because of continued vomiting episodes. Thoracic and abdominal radiographic examination of the female dog revealed interstitial and peribronchial inﬁltrates in the right middle and cranial lung lobes, with distention of the stomach and small intestines by a mixture of ﬂuid and air. These ﬁndings were consistent with severe gastroenteritis and pneumonia. Since pulmonary complications resulting from bleach aspiration are reported to contribute to death in people,3 aspiration of bleach or vomitus was given primary consideration as a cause of the pulmonary radiographic abnormalities. Despite continued treatment with ﬂuid therapy and anti-inﬂammatory doses of intravenous dexamethasone in both dogs and intravenous calcium supplementation in the male dog, the animals continued to clinically deteriorate. The TABLE 3 Serum Chemistry Proﬁle Results Parameter Female Dog Male Dog Reference Interval* Glucose (mg/dl) 215 133 60–135 Cholesterol (mg/dl) 86 218 120–247 BUN (mg/dl) 40 39 5–29 Creatinine (mg/dl) 1.8 2.5 0.3–2 Magnesium (mg/dl) 3.1 2.9 1.7–2.1 Calcium (mg/dl) 15.5 6.9 9.3–11.8 Phosphorus (mg/dl) 7.5 5 2.9–6.2 Total protein (g/dl) 6.8 5.6 5.7–7.8 Albumin (g/dl) 3.2 2.9 2.4–3.6 Globulin (g/dl) 3.7 2.7 1.7–3.8 ALT (U/L) 91 178 10–130 ALP (U/L) 116 281 24–147 GGT (U/L) 9 8 0–25 Total bilirubin (mg/dl) 0.2 0.1 0–0.8 Sodium (mmol/L) 192 167 139–147 Potassium (mmol/L) 4.4 4.6 3.3–4.6 Chloride (mmol/L) 160 132 107–116 Enzymatic CO2 (mmol/L) 9 9 21–28 Anion gap (calculated) (mmol/L) 28 31 10–18 *Reference interval values from VITROS 250, Ortho-Clinical Diagnostics Inc., Rochester, N.Y. 14 January 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2008

Veterinary Medicine - January 2008 Contents Digital Extra Letters Toxicology Brief Idea Exchange A Challenging Case: Phimosis in a Young Adult Dog The Indications and Technique for Continuous Ambulatory Electrocardiographic Recording in Dogs A Review of Selected Systemic Antifungal Drugs for Use in Dogs and Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2008

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