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- Author or Editor: Michael Grafinger x
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Abstract
Case Description—A healthy 6-year-old 28.5-kg (62.7-lb) spayed female Boxer undergoing surgical repair of a ruptured cranial cruciate ligament was inadvertently administered an overdose of morphine (1.3 mg/kg [0.59 mg/lb]) via subarachnoid injection.
Clinical Findings—50 minutes after administration of the overdose, mild multifocal myoclonic contractions became apparent at the level of the tail; the contractions migrated cranially and progressively increased in intensity and frequency during completion of the surgery.
Treatment and Outcome—The myoclonic contractions were refractory to treatment with midazolam, naloxone, phenobarbital, and pentobarbital; only atracurium (0.1 mg/kg [0.045 mg/lb], IV) was effective in controlling the movements. The dog developed hypertension, dysphoria, hyperthermia, and hypercapnia. The dog remained anesthetized and ventilated mechanically; treatments included continuous rate IV infusions of propofol (1 mg/kg/h [0.45 mg/lb/h]), diazepam (0.25 mg/kg/h [0.11 mg/lb/h]), atracurium (0.1 to 0.3 mg/kg/h [0.045 to 0.14 mg/lb/h]), and naloxone (0.02 mg/kg/h [0.009 mg/lb/h]). Twenty-two hours after the overdose, the myoclonus was no longer present, and the dog was able to ventilate without mechanical assistance. The dog remained sedated until 60 hours after the overdose, at which time its mentation improved, including recognition of caregivers and response to voice commands. No neurologic abnormalities were detectable at discharge (approx 68 hours after the overdose) or at a recheck evaluation 1 week later.
Clinical Relevance—Although intrathecal administration of an overdose of morphine can be associated with major and potentially fatal complications, it is possible that affected dogs can completely recover with immediate treatment and extensive supportive care.
Abstract
Case Description—An adult male American bullfrog (Rana catesbeiana) was evaluated by the North Carolina State University College of Veterinary Medicine's Turtle Rescue Team following vehicular trauma.
Clinical Findings—A fracture of the left femur was suspected on examination and palpation of the hind limbs, but no other injuries or abnormalities were detected. While the bullfrog was sedated, whole-body radiographic views were obtained, which revealed a closed midshaft comminuted fracture of the left femur.
Treatment and Outcome—The fracture was repaired by use of an internal fixation technique that included Kirschner wires, a positive-profile pin secured along the femur with encircling sutures, and polymethylmethacrylate molded around the entire apparatus. There were no major complications during the postoperative rehabilitation period. One year after surgery, radiography revealed complete fracture healing and the bullfrog was released back into the wild.
Clinical Relevance—Presently, there are no widely accepted methods for fracture fixation in amphibians. Factors associated with their aquatic environment and lengthy fracture healing time must be addressed when planning fracture fixation strategies. In the bullfrog of this report, the applied internal fixation method provided effective long-term stabilization of the femur, allowed for normal movement, and enabled the bullfrog to be housed in an aquatic environment immediately after surgery.
