Yael Merbl

Resolution of persistent pneumothorax by use of blood pleurodesis in a dog after surgical correction of a diaphragmatic hernia.

CASE DESCRIPTION A 15-kg (33-lb) pregnant female mixed-breed dog of unknown age was referred because of a 10-day history of difficulty breathing. CLINICAL FINDINGS Physical examination findings were dyspnea, tachypnea, decreased bronchovesicular sounds (bilateral), muffled heart sounds, and abdominal distention with palpable fetuses. Hematologic abnormalities included anemia, leukocytosis, and thrombocytosis. Abnormalities detected during serum biochemical analysis included decreases in concentrations of albumin, sodium, triglycerides, and total calcium and increases in activities of alkaline phosphatase, alanine aminotransferase, gamma-glutamyltransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. Thoracic radiography revealed a diaphragmatic hernia with fetuses and a soft tissue or fluid opacity within the thoracic cavity. TREATMENT AND OUTCOME Exploratory celiotomy, ovariohysterectomy, partial sternotomy, placement of a right-sided thoracostomy tube, and herniorrhaphy were performed. After surgery, pneumothorax developed, and the thoracostomy tube was used to remove pleural effusion and free air. The pneumothorax did not resolve after continuous drainage of the thoracic cavity for 4 days. Autologous blood pleurodesis was performed by infusion of 80 mL (6 mL/kg [2.73 mL/lb]) of whole blood. The pneumothorax resolved immediately after injection of the blood. CONCLUSIONS AND CLINICAL RELEVANCE Blood pleurodesis was used for resolution of pneumothorax in a dog after correction of a diaphragmatic hernia. Blood pleurodesis may provide a simple, safe, and inexpensive medical treatment for resolution of persistent (duration>5 days) pneumothorax when surgery is not an option.

Reversible Paralysis and Loss of Deep Pain Sensation After Topical Intrathecal Morphine Administration Following Durotomy

Objective To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. Study Design Clinical report. Animals Dogs (n = 2). Methods A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9–T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12–T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. Results Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. Conclusions Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.OBJECTIVE To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. STUDY DESIGN Clinical report. ANIMALS Dogs (n = 2). METHODS A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9-T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12-T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. RESULTS Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. CONCLUSIONS Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.

Tremor-Salivation Syndrome in Canine following Pyrethroid/PermethrinIntoxication

A 17-month-old male King Charles cavalier was presented with acute onset of generalized body tremors, facial twitching and salivation after being exposed to 2 different classes of compounds of the pyrethrins/pyrethroids group as well as to imidacloprid. Bifenthrin toxicity was confirmed by gas chromatography mass spectrometry. Pyrethroid toxicosis in dogs is to the best of our knowledge rarely reported in the literature. The dog displayed neurological signs highly characteristic of Tremor-Salivation-syndrome associated with pyrethroid toxicosis. The plasma half-life of bifenthrin in dogs was 7.6 hr). Initial therapy consisted of diazepam, methocarbamol and IV fluids, followed by general anesthesia with isofluran and diazepam CRI. Supportive nursing care was provided as needed. Twenty-four hours post admission, the dogs was no longer under general anesthesia. Seventy two hours post admission the dog was discharged had no menace response, was alert and responsive when stimulated, ataxic while walking and showed normal eating behavior.

TAENIA MULTICEPS BRAIN CYST REMOVAL IN TWO WILD NUBIAN IBEX (CAPRA NUBIANAS)

Abstract: Two wild adult Nubian ibex (Capra nubiana) were captured and admitted to the Hebrew University Veterinary Teaching Hospital with various neurologic signs, including alerted mentation, head tilt, and pathologic nystagmus. The lesion in the central nervous system was localized to the forebrain in one ibex and to the cerebellum of the other. Both ibexs were diagnosed with brain cyst using computed tomography (CT). Craniectomy was performed to remove the cysts, and both animals returned to their natural environment after a rehabilitation period. Parasitologic examination revealed cysts of Taenia multiceps coenurus. This is the first report to describe the neurologic signs, CT findings, surgical procedure, and follow-up postsurgery information in wild Capra nubiana.

Retrospective evaluation of the use of autologous blood-patch treatment for persistent pneumothorax in 8 dogs (2009-2012).

OBJECTIVE To describe the clinical course, outcome and success rate of 8 dogs with persistent pneumothorax treated with autologous blood-patch pleurodesis (ABP). DESIGN Retrospective case series. SETTING University teaching hospital ANIMALS Eight client-owned dogs. INTERVENTION Non-coagulated blood was aseptically collected from the jugular vein and injected immediately into the pleural cavity of dogs with persistent pneumothorax. MEASUREMENTS AND MAIN RESULTS The procedure was successful in 7 of 8 dogs. The median duration of pneumothorax until the ABP was performed was 4 days (range 2-6 days). Pneumothorax resolved immediately after 1 treatment in 4 dogs. Pleurodesis was repeated once in 3 dogs, and twice in 1 case after which it resolved in 3 of the 4 dogs. Out of a total of 13 ABP procedures performed in 8 dogs, 5 (62.5%) were successful after 1 procedure and the success rate increased to 87.5% after additional procedures. One dog failed ABP and was euthanized 3 days later due to continued deterioration and a hospital acquired pneumonia. Mild to moderate complications occurred in 2 other dogs and resolved in both. CONCLUSIONS ABP is a simple, inexpensive, and relatively safe procedure which can be considered in dogs with persistent pneumothorax that have failed conservative or surgical management. Infections following ABP were documented in 2 of the 8 dogs and resolved in 1 dog.

DORSAL LAMINECTOMY TO RELIEVE SPINAL CORD COMPRESSION IN A CAPTIVE SYRIAN BEAR (URSUS ARCTOS SYRIACUS)

Abstract A 19-yr-old captive male Syrian bear (Ursus arctos syriacus) presented with a right hind limb lameness that progressed to nonambulatory paraparesis over the course of 2 wk. When night enclosure confinement and a short course of glucocorticoids and antibiotics did not lead to improvement, radiographs were performed, followed by cerebrospinal fluid analysis and myelography, revealing a dynamic spinal cord compression at the level of T2–T3. Dorsal laminectomy of both T2 and T3 was performed to allow decompression. The bear recovered uneventfully with first sign of neurological improvement apparent at 10 days postoperatively. Following 6 mo of rehabilitation the bear was walking and using his hind limbs normally.

Reversible Paralysis and Loss of Deep Pain Sensation After Topical Intrathecal Morphine Administration Following Durotomy: Reversible Paralysis and Absent Deep Pain After Spinal Morphine Administration

Objective To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. Study Design Clinical report. Animals Dogs (n = 2). Methods A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9–T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12–T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. Results Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. Conclusions Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.OBJECTIVE To report 2 dogs that developed temporary pelvic limb paralysis with loss of deep pain sensation after topical intrathecal morphine administration during spinal surgery. STUDY DESIGN Clinical report. ANIMALS Dogs (n = 2). METHODS A 5-year-old castrated male French Bulldog with a subarachnoid diverticulum at T9-T10 and a 9.5-year-old castrated male Belgian Shepherd dog with a herniated disc at T12-T13 and intradural component, had Gelfoam soaked with morphine placed over the dura mater defect. RESULTS Pelvic limb paralysis and loss of deep pain sensation was noticed immediately after recovery from anesthesia. After intravenous naloxone administration, both dogs immediately regained ambulation and normal pain sensation; however the effect was temporary lasting only a few hours. Permanent resolution of clinical signs occurred 24 hours after surgery. CONCLUSIONS Topical intrathecal morphine administration resulted in temporary pelvic limb paralysis and loss of deep pain sensation. This route of administration should be used cautiously until further determination of the efficacy and adverse effects associated with topical intrathecal morphine administration.

Intermediate syndrome of chlorpyriphos toxicity (Polaris) in a caracal (Caracal caracal).

Abstract A 5-yr-old spayed female caracal (Caracal caracal) was presented with complaints of acute onset of mental dullness, ataxia, and ventroflexion of 24-hr duration. The animals garden territory was sprayed a day earlier with an organophosphate (OP) insecticide (chlorpyriphos-methyl). The caracal was treated for OP toxicosis and mildly improved. It was discharged a day later at the owners request, although clinical signs did not resolve. During the following week, the caracal was confined to prevent further toxin exposure but did not improve and was presented 8 days later with similar clinical signs. Serum butyril-cholinesterase activity was markedly low. The relatively long interval from OP exposure, along with the duration of clinical signs, suggested an intermediate syndrome of OP toxicity. The caracal was treated symptomatically and progressively improved. It was discharged after 8 days of hospitalization and made full recovery 30 days later. This is the first report of OP toxicity in a caracal, suspected to progress to an intermediate syndrome of OP poisoning.