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Markert C, Heilmann RM, Kiwitz D, Raum T, Dörfelt R. [Acute poisonings in dogs - a retrospective case study over 5 years]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2024; 52:70-87. [PMID: 38701803 DOI: 10.1055/a-2290-2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVE The aim of this retrospective study was to analyze the clinical signs, confirmed or suspected toxicants, treatments and outcomes of poisoning cases in dogs presented over a 5-year period to the emergency service of a small animal referral center. MATERIAL AND METHODS Medical records of 634 dogs were evaluated for a history of confirmed or presumed poisoning, suspected toxicant, clinical signs, treatment, and patient outcome. The probability of poisoning was graded based on the patient history, clinical findings, toxicologic examination and - in some cases - investigation of gastrointestinal contents. RESULTS Most dogs were hospitalized (77%) due to poisoning with mostly unknown toxicants (33%), food residues (18%), rodenticides (10%), tremorgenic mycotoxins (8%), medications (7%) and various plants (7%), followed by recreational drugs (5%), chemicals (4%), molluscicides (3%), antiparasitics (2%), feces (2%), nuts (2%), or toxins of animal origin (1%). Patients were presented predominantly showing neurologic signs (56%), reduced general condition (39%), and cardiovascular or hydration status abnormalities (26%). The survival rate was 97%. Most dogs were clinically unremarkable at the time of hospital discharge (70%). An additional 18% of the survivors had no apparent complications by the time of discharge. Toxicant-related complications (20.5%) included hemorrhage (4%), hepatic (4%), renal (4%), respiratory (3%), gastrointestinal (3%), cardiovascular (3%), and/or central nervous system (3%) complications, or clinically relevant hypoglycemia (0.3%). CONCLUSION AND CLINICAL RELEVANCE In the present study, poisoning in dogs was mostly associated with the ingestion of food residues, but the causative toxicant remained unidentified in many cases. Neurological signs were the major clinical presentation. The survival rate (97%) in this study was higher compared to those reported by other investigators.
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Affiliation(s)
- Carina Markert
- Abteilung Chirurgie, Tierärzte IVC Evidensia GmbH, Tierklinik Hofheim, Hofheim am Taunus
- Abteilung Internistik, Klinik für Kleintiere, Universität Leipzig
| | - Romy M Heilmann
- Abteilung Internistik, Klinik für Kleintiere, Universität Leipzig
| | - Dschaniena Kiwitz
- Abteilung Chirurgie, Tierärzte IVC Evidensia GmbH, Tierklinik Hofheim, Hofheim am Taunus
| | - Tobias Raum
- Abteilung Chirurgie, Tierärzte IVC Evidensia GmbH, Tierklinik Hofheim, Hofheim am Taunus
| | - René Dörfelt
- Abteilung Intensiv- und Notfallmedizin, Kleintierklinik, Ludwig-Maximilian-Universität München
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Charalambous M, Muñana K, Patterson EE, Platt SR, Volk HA. ACVIM Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats. J Vet Intern Med 2024; 38:19-40. [PMID: 37921621 PMCID: PMC10800221 DOI: 10.1111/jvim.16928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Seizure emergencies (ie, status epilepticus [SE] and cluster seizures [CS]), are common challenging disorders with complex pathophysiology, rapidly progressive drug-resistant and self-sustaining character, and high morbidity and mortality. Current treatment approaches are characterized by considerable variations, but official guidelines are lacking. OBJECTIVES To establish evidence-based guidelines and an agreement among board-certified specialists for the appropriate management of SE and CS in dogs and cats. ANIMALS None. MATERIALS AND METHODS A panel of 5 specialists was formed to assess and summarize evidence in the peer-reviewed literature with the aim to establish consensus clinical recommendations. Evidence from veterinary pharmacokinetic studies, basic research, and human medicine also was used to support the panel's recommendations, especially for the interventions where veterinary clinical evidence was lacking. RESULTS The majority of the evidence was on the first-line management (ie, benzodiazepines and their various administration routes) in both species. Overall, there was less evidence available on the management of emergency seizure disorders in cats in contrast to dogs. Most recommendations made by the panel were supported by a combination of a moderate level of veterinary clinical evidence and pharmacokinetic data as well as studies in humans and basic research studies. CONCLUSIONS AND CLINICAL RELEVANCE Successful management of seizure emergencies should include an early, rapid, and stage-based treatment approach consisting of interventions with moderate to preferably high ACVIM recommendations; management of complications and underlying causes related to seizure emergencies should accompany antiseizure medications.
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Affiliation(s)
| | - Karen Muñana
- North Carolina State UniversityRaleighNorth CarolinaUSA
| | | | | | - Holger A. Volk
- University of Veterinary Medicine HannoverHannoverGermany
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Stabile F, De Risio L. Response to Levetiracetam Treatment and Long-Term Follow-Up in Dogs With Reactive Seizures Due to Probable Exogenous Toxicity. Front Vet Sci 2021; 8:773942. [PMID: 34869747 PMCID: PMC8634145 DOI: 10.3389/fvets.2021.773942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Limited information is available on the long-term follow-up and seizure recurrence in dogs with reactive seizures due to suspected exogenous toxicity. The purpose of this study was to report the long-term follow-up of 13 dogs referred to a single referral hospital, diagnosed with reactive seizures and treated with a standardized levetiracetam protocol. All dogs received a loading levetiracetam dose of 60 mg/kg/IV once, followed by a maintenance dose of 20 mg/kg every 8 h as part of an open-label clinical study. Levetiracetam was withdrawn after a 6-months seizure-free period by reducing levetiracetam to 20 mg/kg every 12 h for a 4-week seizure-free period, followed by levetiracetam 20 mg/kg every 24 h for a 4-week seizure-free period, before levetiracetam treatment was stopped. No adverse effects of the treatment were reported. No dogs experienced any seizures after discharge or after levetiracetam withdrawal. Median follow-up time from time of discharge was of 78 months (=6 years 6 months). The result of this study supports the use of levetiracetam for treatment of reactive seizures due to exogenous substance intoxication. Moreover, our results do not support the need for long-term antiepileptic treatment in cases of reactive seizures due to exogenous intoxication.
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Affiliation(s)
- Fabio Stabile
- Neurology and Neurosurgery Unit, Southfields Veterinary Specialists, Linnaeus, Basildon, United Kingdom
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Cicvaric A, Bulat T, Bormann D, Yang J, Auer B, Milenkovic I, Cabatic M, Milicevic R, Monje FJ. Sustained consumption of cocoa-based dark chocolate enhances seizure-like events in the mouse hippocampus. Food Funct 2018; 9:1532-1544. [PMID: 29431797 DOI: 10.1039/c7fo01668a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
While the consumption of caffeine and cocoa has been associated with a variety of health benefits to humans, some authors have proposed that excessive caffeine intake may increase the frequency of epileptic seizures in humans and reduce the efficiency of antiepileptic drugs. Little is known, however, about the proconvulsant potential of the sustained, excessive intake of cocoa on hippocampal neural circuits. Using the mouse as an experimental model, we examined the effects of the chronic consumption of food enriched in cocoa-based dark chocolate on motor and mood-related behaviours as well as on the excitability properties of hippocampal neurons. Cocoa food enrichment did not affect body weights or mood-related behaviours but rather promoted general locomotion and improved motor coordination. However, ex vivo electrophysiological analysis revealed a significant enhancement in seizure-like population spike bursting at the neurogenic dentate gyrus, which was paralleled by a significant reduction in the levels of GABA-α1 receptors thus suggesting that an excessive dietary intake of cocoa-enriched food might alter some of the synaptic elements involved in epileptogenesis. These data invite further multidisciplinary research aiming to elucidate the potential deleterious effects of chocolate abuse on behaviour and brain hyperexcitability.
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Affiliation(s)
- Ana Cicvaric
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Tanja Bulat
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Daniel Bormann
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Jiaye Yang
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Bastian Auer
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Ivan Milenkovic
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Maureen Cabatic
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Radoslav Milicevic
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
| | - Francisco J Monje
- Department of Neurophysiology and Neuropharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria.
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Orito K, Kawarai-Shimamura A, Ogawa A, Nakamura A. Safety and efficacy of intravenous administration for tranexamic acid-induced emesis in dogs with accidental ingestion of foreign substances. J Vet Med Sci 2017; 79:1978-1982. [PMID: 29093310 PMCID: PMC5745175 DOI: 10.1292/jvms.17-0463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A prospective observational study was performed in canine clinical medicine to evaluate
the emetic action and adverse effects of tranexamic acid. Veterinarians treated 137 dogs
with a single dose of tranexamic acid (50 mg/kg, IV) after accidental ingestion of foreign
substances. If needed, a second (median, 50 mg/kg; range, 20–50 mg/kg, IV) or third dose
(median, 50 mg/kg; range, 25–50 mg/kg, IV) was administered. Tranexamic acid induced
emesis in 116 of 137 (84.7%) dogs. Median time to onset of emesis was 116.5 sec (range,
26–370 sec), median duration of emesis was 151.5 sec (range, 30–780 sec), and median
number of emesis episodes was 2 (range, 1–8). Second and third administrations of
tranexamic acid induced emesis in 64.7 and 66.7% of dogs, respectively. In total, IV
administration of tranexamic acid successfully induced emesis in 129 of 137 (94.2%) dogs.
Adverse effects included a tonic-clonic convulsion and hemostatic disorder in two
different dogs, both of which recovered after receiving medical care. Tranexamic acid
induced emesis in most dogs following a single-dose. When a single dose was not
sufficient, an additional dosage effectively induced emesis. Overall, adverse effects were
considered low and self-limiting.
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Affiliation(s)
- Kensuke Orito
- Laboratory of Physiology II, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - Asako Kawarai-Shimamura
- Corporate Planning Department, Anicom Holdings, Inc., 8-17-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Atsushi Ogawa
- Corporate Planning Department, Anicom Holdings, Inc., 8-17-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Atsushi Nakamura
- Tokyo Jonan Regional Veterinary Medicine Promotional Association Animal Medical Center, 8-19-12, Fukasawa, Setagaya-ku, Tokyo 158-0081, Japan
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Hassdenteufel E, Lehmann H, Schneider M, Moritz A. [Emergency management of intoxications in the dog and cat]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2016; 44:438-449. [PMID: 27849101 DOI: 10.15654/tpk-160889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 11/07/2016] [Indexed: 06/06/2023]
Abstract
Intoxications may lead to life-threatening emergencies. While stabilising the patient, therapy should focus on a rapid and effective elimination of the toxin. General measures for decontamination (gastrointestinal, dermal, ocular) aim to effectively decrease the absorption of the poisonous substance. Further classification of the substance and its properties can assist with the choice of specific treatment options, including dialysis and specific antidotal therapy. In recent years, treatment with lipid emulsions for enhanced elimination of lipophilic substances has become an important therapeutic option. In affected patients, it can rapidly improve clinical signs while side effects and complications are rarely encountered with this form of therapy.
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Affiliation(s)
- Esther Hassdenteufel
- Dr. Esther Hassdenteufel, Klinik für Kleintiere, Justus-Liebig-Universität Gießen, Frankfurter Straße 126, 35392 Gießen, E-Mail:
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Bhatti SFM, De Risio L, Muñana K, Penderis J, Stein VM, Tipold A, Berendt M, Farquhar RG, Fischer A, Long S, Löscher W, Mandigers PJJ, Matiasek K, Pakozdy A, Patterson EE, Platt S, Podell M, Potschka H, Rusbridge C, Volk HA. International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res 2015; 11:176. [PMID: 26316233 PMCID: PMC4552371 DOI: 10.1186/s12917-015-0464-z] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/14/2022] Open
Abstract
In Europe, the number of antiepileptic drugs (AEDs) licensed for dogs has grown considerably over the last years. Nevertheless, the same questions remain, which include, 1) when to start treatment, 2) which drug is best used initially, 3) which adjunctive AED can be advised if treatment with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors' experience. With this paper it is aimed to provide a consensus for the management of canine idiopathic epilepsy. Furthermore, for the management of structural epilepsy AEDs are inevitable in addition to treating the underlying cause, if possible.
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Affiliation(s)
- Sofie F M Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, United Kingdom.
| | - Karen Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, United Kingdom.
| | - Veronika M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Mette Berendt
- Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Robyn G Farquhar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, United Kingdom.
| | - Andrea Fischer
- Clinical Veterinary Medicine, Ludwig-Maximillians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia.
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Bünteweg 17, 30559, Hannover, Germany.
| | - Paul J J Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands.
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Edward E Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, United Kingdom.
- School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, United Kingdom.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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