Case Description—2 dogs were evaluated because of vomiting and lethargy (a Toy Poodle; dog 1) and acute respiratory distress, vomiting, and anorexia (a Chihuahua; dog 2). Dog 1 had been exposed to a commercial hydrocarbon waterproofing spray 24 hours before the development of clinical signs, and dog 2 was examined 18 hours after exposure to a waterproofing spray containing heptane, a highly flammable liquid hydrocarbon.
Clinical Findings—In both dogs, major gastrointestinal tract abnormalities were ruled out but respiratory status worsened. Thoracic radiography revealed a diffuse interstitial pulmonary pattern, and hypoxemia was detected.
Treatment and Outcome—Hospitalization for monitoring and care was required for both dogs. The dogs recovered with supportive care, which included administration of oxygen, fluids, and bronchodilators. Additionally, dog 1 received glucocorticoids via inhalation and supplemental enteral nutrition, whereas dog 2 was treated with an antimicrobial.
Clinical Relevance—The dogs of this report developed hydrocarbon pneumonitis following exposure to waterproofing sprays. Such sprays contain potentially toxic hydrocarbons. The severity of the adverse effects associated with exposure may have been amplified because the dogs were physically small and were exposed to a relatively large amount of aerosolized spray within small areas. Development of chemical pneumonitis in pet animals is best prevented by application of waterproofing sprays in well-ventilated or outdoor areas from which pets have been excluded. With prolonged hospitalization and considerable monitoring and care, affected dogs can recover from these exposures.
A 2-year-old 5.1-kg (11.2-lb) sexually intact male Maltese was admitted because of vomiting and seizures after a known ingestion of up to 206 mg/kg (93.6 mg/lb) of lamotrigine (a commonly prescribed human antiepileptic medication) approximately 3 hours earlier.
On presentation, the dog was having a seizure; however, the seizure stopped before interventional treatment, and the dog was obtunded, tachycardic, and hypertensive. Fluid therapy was initiated, and a bolus of injectable lipid emulsion (ILE) was administered. The dog's cardiovascular and mentation signs improved, and the dog was hospitalized for supportive care and monitoring. Hours later, the dog developed ventricular tachycardia that progressed to ventricular fibrillation, then cardiac arrest.
TREATMENT AND OUTCOME
Cardiopulmonary resuscitation, including defibrillation, was initiated. With no response after several minutes of resuscitation efforts, another bolus of ILE was administered, and the dog's heartbeat returned shortly thereafter, albeit with severe ventricular arrhythmias that were treated medically, including with sodium bicarbonate. The dog was discharged 48 hours later with no neurologic or cardiovascular abnormalities. Six months later, the owner reported that the dog was doing well and had no abnormalities.
To our knowledge, there are no previous case reports in veterinary medicine regarding the successful use of ILE to treat cardiac arrest secondary to lipophilic drug toxicoses nor the use of and physiologic response to sodium bicarbonate during treatment of lamotrigine toxicoses in dogs; therefore, findings in the dog of the present report may help other veterinarians treating similarly affected dogs in the future.
Objective—To evaluate pituitary-adrenal function in a
population of critically ill dogs by measuring serial
plasma concentrations of basal cortisol, ACTH-stimulated
cortisol, and endogenous ACTH.
Animals—20 critically ill dogs admitted to an intensive
care unit (ICU).
Procedure—Basal plasma cortisol, ACTH-stimulated
cortisol, and endogenous ACTH concentrations were
measured for each dog within 24 hours of admission
and daily until death, euthanasia, or discharge from
the ICU. Established reference ranges for healthy
dogs were used for comparison. Survival prediction
index (SPI) scores were calculated for each dog within
24 hours of admission.
Results—No significant difference was found
between initial concentrations of basal cortisol,
ACTH-stimulated cortisol, and endogenous ACTH in
13 dogs that survived and those in 7 dogs that died.
High initial basal endogenous ACTH concentrations
were correlated with subsequent high values. Low
basal ACTH-stimulated cortisol concentrations were
predictive of higher subsequent values. All basal and
ACTH-stimulated cortisol concentrations were within
or above the reference range in the 52 plasma samples
collected from the 20 dogs during hospitalization.
The SPI scores correlated with outcome (ie, alive or
dead), but none of the plasma hormone concentrations
correlated with SPI score or outcome.
Conclusions and Clinical Relevance—Results indicate
that none of the critically ill dogs in our study
population developed adrenal insufficiency during
hospitalization in the ICU. (J Am Vet Med Assoc