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- Author or Editor: William B. Thomas x
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OBJECTIVE To determine the prevalence of depressed pelvic limb reflexes and changes in those reflexes over time in dogs with acute thoracolumbar myelopathy.
DESIGN Prospective study.
ANIMALS 34 dogs.
PROCEDURES Dogs with acute pelvic limb paralysis caused by acute noncompressive nucleus pulposus extrusion (ANNPE), fibrocartilaginous embolism (FCE), or compressive intervertebral disk herniation (IVDH) within the T3-L3 spinal cord segments were enrolled in the study. Dogs with depressed or absent pelvic limb withdrawal reflexes as determined by 2 examiners were classified as affected and underwent additional testing to rule out multifocal lesions. Pelvic limb reflexes of affected dogs were reassessed every 12 hours until they returned to normal. Neurologic examinations were performed at 4 and 8 weeks after initial examination for some dogs.
RESULTS Compressive IVDH, ANNPE, and FCE were diagnosed in 30, 1, and 3 dogs, respectively. Nine (5 with compressive IVDH and all 4 with FCE or ANNPE) of 34 (26%) dogs were classified as affected. Patellar reflexes were depressed in 2 of 9 affected dogs. The median time required for withdrawal reflexes to return to normal was 60 hours (range, 12 to 156 hours). Onset duration of paralysis was negatively associated with the odds of a dog being classified as affected.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs with focal thoracolumbar spinal cord lesions, especially those with peracute onset of paralysis, can develop transient depression of pelvic limb reflexes. Awareness of this phenomenon is important for veterinarians to accurately localize lesions and develop appropriate diagnostic plans and prognoses.
Objective—To evaluate the pharmacokinetics of diazepam administered per rectum via compounded (ie, not commercially available) suppositories and determine whether a dose of 2 mg/kg in this formulation would result in plasma concentrations shown to be effective for control of status epilepticus or cluster seizures (ie, 150 to 300 ng/mL) in dogs within a clinically useful interval (10 to 15 minutes).
Animals—6 healthy mixed-breed dogs.
Procedures—Dogs were randomly assigned to 2 groups of 3 dogs each in a crossover-design study. Diazepam (2 mg/kg) was administered IV or via suppository per rectum, and blood samples were collected at predetermined time points. Following a 6- or 7-day washout period, each group received the alternate treatment. Plasma concentrations of diazepam and nordiazepam were analyzed via reversed phase high-performance liquid chromatography.
Results—Plasma concentrations of diazepam and nordiazepam exceeded the targeted range ≤ 3 minutes after IV administration in all dogs. After suppository administration, targeted concentrations of diazepam were not detected in any dogs, and targeted concentrations of nordiazepam were detected after 90 minutes (n = 2 dogs) or 120 minutes (3) or were not achieved (1).
Conclusions and Clinical Relevance—On the basis of these results, administration of 2 mg of diazepam/kg via the compounded suppositories used in the present study cannot be recommended for emergency treatment of seizures in dogs.
OBJECTIVE To evaluate the pharmacokinetics of zonisamide following rectal administration of 20 or 30 mg/kg suspended in sterile water or polyethylene glycol (PEG) to healthy dogs and determine whether either dose resulted in plasma zonisamide concentrations within the recommended therapeutic target range (10 to 40 μg/mL).
ANIMALS 8 healthy mixed-breed dogs.
PROCEDURES Each dog received each of 2 doses (20 or 30 mg/kg) of zonisamide suspended in each of 2 delivery substrates (sterile water or PEG) in a randomized crossover study with a 7-day washout period between phases. A blood sample was collected from each dog immediately before and at predetermined times for 48 hours after zonisamide administration. Plasma zonisamide concentrations were determined by high-performance liquid chromatography, and data were analyzed with a noncompartmental model.
RESULTS Mean maximum plasma concentration, time to maximum plasma concentration, mean residence time, and elimination half-life did not differ significantly among the 4 treatments. The mean maximum plasma concentration for all 4 treatments was less than the therapeutic target range. The mean ± SD area under the concentration-time curve for the 30 mg/kg-in-water treatment (391.94 ± 237.00 h•μg/mL) was significantly greater than that for the 20 mg/kg-in-water (146.19 ± 66.27 h•μg/mL) and 20 mg/kg-in-PEG (87.09 ± 96.87 h•μg/mL) treatments.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that rectal administration of zonisamide at doses of 20 and 30 mg/kg failed to achieve plasma zonisamide concentrations within the recommended therapeutic target range. Therefore, rectal administration of zonisamide cannot be recommended as a suitable alternative to oral administration.
Objective—To test the ability of a single injection of a sustained-release formulation of moxidectin (moxidectin SR) to protect dogs against heartworm infection for 180 days after inoculation with infective thirdstage larvae (L3) of Dirofilaria immitis.
Animals—32 adult mixed-breed dogs.
Procedure—Dogs were allocated to 4 groups on the basis of weight and sex. Dogs were injected SC with saline (0.9% NaCl) solution or moxidectin SR at the rate of 0.06, 0.17, or 0.5 mg/kg of body weight (day 0). Each dog was inoculated SC with 50 D immitis L3 180 days later. On days 330 and 331, dogs were euthanatized. The heart, lungs, and thoracic cavity were examined, and number and sex of heartworms were determined.
Results—A mean of 35.9 heartworms was recovered from untreated control dogs. Fourteen worms were recovered from 1 of 8 dogs given moxidectin SR at the lowest dosage, and none of the dogs in the 2 highest moxidectin treatment groups were infected. Small barely palpable granulomas were detected at injection sites of moxidectin-treated dogs. Frequency and size of granulomas were positively correlated with dose of moxidectin administered.
Conclusions and Clinical Relevance—A single dose of moxidectin SR at a dosage as low as 0.17 mg/kg can safely and reliably confer complete protection against infection after challenge-exposure with D immitis L3, and protection lasts for at least 180 days. This mode of prophylactic treatment against infection with heartworms effectively eliminates failure of prophylaxis that results from erratic administration of medications designed for monthly administration. (Am J Vet Res 2001;62:1721–1726)
OBJECTIVE To evaluate pharmacokinetics of ammonium tetrathiomolybdate (TTM) after IV and oral administration to dogs and effects of TTM administration on trace mineral concentrations.
ANIMALS 8 adult Beagles and Beagle crossbreds (4 sexually intact males and 4 sexually intact females).
PROCEDURES Dogs received TTM (1 mg/kg) IV and orally in a randomized crossover study. Serum molybdenum and copper concentrations were measured via inductively coupled plasma mass spectrometry in samples obtained 0 to 72 hours after administration. Pharmacokinetics was determined via noncompartmental analysis.
RESULTS For IV administration, mean ± SD terminal elimination rate constant, maximum concentration, area under the curve, and half-life were 0.03 ± 0.01 hours−1, 4.9 ± 0.6 μg/mL, 30.7 ± 5.4 μg/mL•h, and 27.7 ± 6.8 hours, respectively. For oral administration, mean ± SD terminal elimination rate constant, time to maximum concentration, maximum concentration, area under the curve, and half-life were 0.03 ± 0.01 hours−1, 3.0 ± 3.5 hours, 0.2 ± 0.4 μg/mL, 6.5 ± 8.0 μg/mL•h, and 26.8 ± 8.0 hours, respectively. Oral bioavailability was 21 ± 22%. Serum copper concentrations increased significantly after IV and oral administration. Emesis occurred after IV (2 dogs) and oral administration (3 dogs).
CONCLUSIONS AND CLINICAL RELEVANCE Pharmacokinetics for TTM after a single IV and oral administration was determined for clinically normal dogs. Absorption of TTM after oral administration was variable. Increased serum copper concentrations suggested that TTM mobilized tissue copper. Further studies will be needed to evaluate the potential therapeutic use of TTM in copper-associated chronic hepatitis of dogs.
Objective—To identify predictive factors of long-term outcome after dorsal decompressive laminectomy for the treatment of degenerative lumbosacral stenosis (DLSS) in dogs.
Sample Population—69 client-owned dogs.
Procedure—Medical records of dogs that had undergone dorsal laminectomy at North Carolina State University and the University of Tennessee between 1987 and 1997 were reviewed. Dogs with diskospondylitis, traumatic lesions, or neoplasia of the lumbosacral region were excluded. All dogs had evidence of cauda equina compression on myelography, epidurography, computed tomography, or magnetic resonance imaging, along with subsequent confirmation of the lesion at surgery. Follow-up was performed by telephone inquiries to the referring veterinarian, the owner, or both, using a detailed questionnaire.
Results—The outcome was excellent or good in 54 of 69 (78%) dogs over a mean follow-up period of 38 ± 22 months. Five of these 54 dogs had been incontinent for a median of 2 weeks prior to surgery. Six of the 15 dogs with a poor outcome had been incontinent for a median of 8 weeks before surgery. A significant correlation was detected between the presence of urinary and fecal incontinence prior to surgery and outcome. When duration of signs was considered, urinary incontinence was the only variable that significantly affected outcome.
Conclusions and Clinical Relevance—Decompressive laminectomy is an effective treatment for DLSS, although dogs with urinary or fecal incontinence have a worse prognosis than dogs that are continent before surgery. Chronic urinary incontinence is a predictor of poor outcome for dogs with DLSS. (J Am Vet Med Assoc 2001;219:624–628)
Case Description—An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits.
Clinical Findings—The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass lesion involving the right parietal, temporal, and occipital lobes; the mass was in broad-based contact with the skull and smoothly marginated and had strong homogenous enhancement after contrast agent administration. During craniectomy, samples of the mass were collected for cytologic and histopathologic evaluations and microbial culture. A diagnosis of Blastomyces dermatitidis—associated meningoencephalitis with secondary pyogranulomatous inflammation was made.
Treatment and Outcome—Amphotericin B (0.25 mg/kg [0.11 mg/lb], IV) was administered on alternate days (cumulative dose, 1.75 mg/kg [0.8 mg/lb]). To minimize the risk of nephrotoxicosis, assessments of serum biochemical variables (urea nitrogen and creatinine concentrations) and urinalyses were performed at intervals. The third dose of amphotericin B was postponed 48 hours because the cat became azotemic. The cat subsequently received fluconazole (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 5.5 months. Six months after discontinuation of that treatment, the cat appeared healthy and had no signs of relapse.
Clinical Relevance—Brain infection with B dermatitidis is typically associated with widespread disseminated disease. The cat of this report had no evidence of systemic disease. Blastomycosis of the CNS should be considered as a differential diagnosis for brain lesions in cats from areas in which B dermatitidis is endemic.