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Martindale DM, Haraschak JL, Thiel AJ, Samuelson JP, Buchweitz JP. Lisdexamfetamine dimesylate (Vyvanse) toxicosis in a dog. J Vet Emerg Crit Care (San Antonio) 2024; 34:193-198. [PMID: 38412018 DOI: 10.1111/vec.13370] [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: 08/05/2022] [Revised: 12/09/2022] [Accepted: 12/14/2022] [Indexed: 02/28/2024]
Abstract
OBJECTIVE To describe the presentation, management, and postmortem examination findings in a dog with confirmed lisdexamfetamine dimesylate (LDX) toxicosis. CASE SUMMARY A 3-year-old female neutered mixed breed dog initially presented with neurological signs suspected to be secondary to LDX toxicosis. The dog was treated as typical for amphetamine toxicoses but developed severe respiratory and cardiovascular signs throughout their hospitalization. The progression of the cardiopulmonary signs led to cardiopulmonary arrest, for which CPR was unsuccessful. Postmortem examination exhibited severe hemorrhage throughout multiple organ systems. Toxicology testing confirmed the presence of unaltered LDX and its metabolite, amphetamine. NEW OR UNIQUE INFORMATION PROVIDED This is the first case report documenting a severe progression of clinical signs and postmortem examination findings in a case of confirmed LDX toxicosis in a dog. Although the patient did not survive treatment, postmortem examination and microscopic evaluation of tissues allowed visualization of the extent of systemic pathophysiology. With prompt treatment, the prognosis of amphetamine toxicosis in dogs is generally considered good; however, this case report demonstrates a severe case in which even prompt and appropriate treatment did not prevent mortality. This suggests a need to establish negative prognostic indicators for which to monitor in cases of amphetamine toxicosis. Finally, this report is also unique in the fact that the LDX toxicosis was confirmed using a toxicological analysis technique not previously described clinically in dogs.
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Affiliation(s)
- Danielle M Martindale
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Jenica L Haraschak
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Andrew J Thiel
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Jonathan P Samuelson
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - John P Buchweitz
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, Lansing, Michigan, USA
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2
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Oikonomidis IL, Milne E. Clinical enzymology of the dog and cat. Aust Vet J 2023; 101:465-478. [PMID: 37767749 DOI: 10.1111/avj.13291] [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: 04/04/2023] [Revised: 08/15/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023]
Abstract
Clinical enzymology studies the enzyme activity in serum or other body fluids for the diagnosis, prognosis or monitoring of a variety of diseases. Clinical enzymology has greatly benefited from advances in technology and is now an integral part of laboratory analysis. However, to maximise the clinical benefits of serum enzyme measurement, clinicians and clinical pathologists must have a good understanding of the pathophysiology behind serum enzyme alterations. They must also be aware of the preanalytical and analytical factors that can affect the accuracy of serum enzyme activity measurement. This review article first covers the basic concepts of clinical enzymology and the general mechanisms related to serum enzyme alterations. Then, the review discusses the potential effects of various preanalytical and analytical factors on enzyme activity measurement. Lastly, it explores the pathophysiology and clinical use of various serum enzymes in canine and feline medicine. The present review article aims to be a comprehensive one-stop source for clinical pathologists and small animal practitioners.
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Affiliation(s)
- I L Oikonomidis
- Easter Bush Pathology, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Midlothian, United Kingdom
| | - E Milne
- Easter Bush Pathology, The Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Midlothian, United Kingdom
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3
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Santifort KM, Plonek M, Mandigers PJJ. Clinical Diagnosis of Rhabdomyolysis without Myoglobinuria or Electromyographic Abnormalities in a Dog. Animals (Basel) 2023; 13:1747. [PMID: 37889668 PMCID: PMC10251982 DOI: 10.3390/ani13111747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 10/29/2023] Open
Abstract
A 2-year-old female neutered Old German Shepherd was presented for acute non-ambulatory tetraparesis. Upon presentation to the emergency department, hematology and biochemical blood tests revealed no abnormalities aside from mildly elevated C-reactive protein levels (22.5 mg/L, reference range 0.0-10.0) and immeasurable creatine kinase (CK) activity. Neurological evaluation the next day revealed ambulatory tetraparesis, general proprioceptive deficits, mild ataxia and dubious diffuse myalgia. Withdrawal reflexes were weak on both thoracic and pelvic limbs. The CK was determined to be significantly elevated at that point (32.856 U/L, ref. range 10.0-200.0). Urinalysis revealed no abnormalities. An electromyographic (EMG) study of thoracic limb, paraspinal and pelvic limb muscles revealed no abnormalities. A magnetic resonance imaging (MRI) study of the cervicothoracic spinal cord was performed and revealed no abnormalities. A presumptive clinical diagnosis of rhabdomyolysis without myoglobinuria or EMG abnormalities was formed. Muscular biopsies were declined due to the rapid clinical improvement of the dog. A follow-up showed the progressive decline of CK activity to normal values and clinical remission of signs. A diagnosis of rhabdomyolysis was concluded based on clinical signs, consistent CK activity elevations and the response to supportive treatment for rhabdomyolysis, despite the absence of myoglobinuria and EMG abnormalities. Rhabdomyolysis should not be excluded based on the lack of EMG abnormalities or myoglobinuria in dogs.
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Affiliation(s)
- Koen Maurits Santifort
- IVC Evidensia Small Animal Referral Hospital Arnhem, 6825 MB Arnhem, The Netherlands
- IVC Evidensia Small Animal Referral Hospital Hart van Brabant, 5144 AM Waalwijk, The Netherlands
| | - Marta Plonek
- IVC Evidensia Small Animal Referral Hospital Arnhem, 6825 MB Arnhem, The Netherlands
| | - Paul J. J. Mandigers
- IVC Evidensia Small Animal Referral Hospital Arnhem, 6825 MB Arnhem, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
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Mattaliano G, Heberlein M, Cruz Benedetti I. Unanticipated hyperkalaemia and associated perioperative complications in three captive grey wolves (
Canis lupus
) undergoing general anaesthesia. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Giorgio Mattaliano
- Department for Companion Animals and Horses Anaesthesiology and Perioperative Intensive‐Care Medicine, Vetmeduni Vienna Vienna Austria
| | | | - Inga‐Catalina Cruz Benedetti
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal Saint‐Hyacinthe Quebec Canada
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Crecraft C, Prittie J, Mastrocco A. Hypoglycemia and presumptive rhabdomyolysis secondary to lisdexamfetamine toxicosis in 3 cats. J Vet Emerg Crit Care (San Antonio) 2021; 32:113-118. [PMID: 34766711 DOI: 10.1111/vec.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/14/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the clinical course and novel biochemical changes in 3 cats with lisdexamfetamine (LDX) toxicosis. SERIES SUMMARY Three cats presented with LDX exposure and initially displayed typical clinical signs of amphetamine toxicosis. However, over the course of hospitalization, hypoglycemia and markedly elevated creatine kinase levels consistent with rhabdomyolysis ensued. All cats were treated with sedatives including phenothiazines and dexmedetomidine. Two cats were hospitalized for 4 days and 1 for 5 days. All cats survived. NEW OR UNIQUE INFORMATION PROVIDED This is the first case series in cats that reports the novel biochemical changes of delayed hypoglycemia and elevated creatine kinase several days into hospitalization for the treatment of LDX toxicity. The development of delayed clinical signs suggests reconsideration of established hospitalization guidelines for amphetamine ingestion in cats.
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Affiliation(s)
- Catherine Crecraft
- Department of Emergency and Critical Care, Animal Medical Center, New York, New York, USA
| | - Jennifer Prittie
- Department of Emergency and Critical Care, Animal Medical Center, New York, New York, USA
| | - Alicia Mastrocco
- Department of Emergency and Critical Care, Animal Medical Center, New York, New York, USA
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Gunther M, Jaffey JA, Evans J, Paige C. Case Report: Persistent Moderate-to-Severe Creatine Kinase Enzyme Activity Elevation in a Subclinical Dog. Front Vet Sci 2021; 8:757294. [PMID: 34760961 PMCID: PMC8573117 DOI: 10.3389/fvets.2021.757294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/27/2021] [Indexed: 01/04/2023] Open
Abstract
A 4-year-old, male-castrated, mixed breed dog was presented for a routine wellness examination at which time a moderate increase in serum creatine kinase (CK) enzyme activity (hyperCKemia) (15,137 IU/L; reference interval 10–200 IU/L), and moderate increases in alanine transaminase and aspartate aminotransferase enzyme activities were first identified. There was no history of clinical abnormalities (e.g., lethargy, lameness, anorexia, dysphagia, weakness, gait abnormalities, or exercise intolerance) and the physical examination was unremarkable. The dog was screened for several relevant potential infectious diseases known to cause inflammatory myopathies and was treated empirically with clindamycin. The serum total CK enzyme activity remained increased, which prompted recommendations for an echocardiogram, electromyogram (EMG), and muscle biopsy acquisition. The echocardiogram and electrocardiographic monitoring were unremarkable. The EMG and muscle biopsies were declined by the owner. The dog was evaluated several times in the subsequent 5 years and remained subclinical with unremarkable physical examinations despite a persistent moderate-to-severe hyperCKemia. Differential diagnoses considered most likely in this dog were an occult/latent hereditary muscular dystrophic disorder or idiopathic hyperCKemia, a phenomenon not yet reported in the veterinary literature. This report describes for the first time, clinical and diagnostic features of a subclinical dog with persistent moderate-to-severe hyperCKemia.
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Affiliation(s)
- Melissa Gunther
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Jason Evans
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States
| | - Christopher Paige
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States.,Valley Veterinary Cardiology, Scottsdale, AZ, United States
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Cudney SE, Wayne A, Rozanski EA. Clothes dryer-induced heat stroke in three cats. J Vet Emerg Crit Care (San Antonio) 2021; 31:800-805. [PMID: 34499793 DOI: 10.1111/vec.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the clinical course of 3 cats successfully treated following clothes dryer-induced heat stroke. CASE SERIES SUMMARY Three cats were treated after accidental clothes dryer-induced heat stroke. All cats fulfilled canine heat stroke criteria and showed evidence of heat injury, including neurological dysfunction, corneal and mucosal ulceration, and evidence of rhabdomyolysis. Coagulopathy, acute liver injury, acute kidney injury, cardiac dysfunction, and gastrointestinal signs were seen in cats with a longer duration of dryer exposure. NEW OR UNIQUE INFORMATION PROVIDED Describes the management of cats after inadvertent clothes dryer-induced heat stroke.
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Affiliation(s)
- Sarah E Cudney
- ACCESS Specialty Animal Hospitals, Culver City, California, USA
| | - Annie Wayne
- Massachusetts Veterinary Referral Hospital, Ethos Veterinary Health, Woburn, Massachusetts, USA
| | - Elizabeth A Rozanski
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
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Granfone M, Walker JM. Acute nontraumatic rhabdomyolysis in a Greyhound after albuterol toxicosis. J Vet Emerg Crit Care (San Antonio) 2021; 31:818-822. [PMID: 34450682 DOI: 10.1111/vec.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/25/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the clinical features of rhabdomyolysis due to albuterol toxicosis in a Greyhound. CASE SUMMARY A 4-year-old neutered male Greyhound was presented for albuterol toxicosis leading to severe hypokalemia and respiratory paralysis. After 3 hours of mechanical ventilation, pigmenturia and marked enlargement, firmness, and pain of the left thigh muscles were noted. Severe hyperkalemia and cardiac arrhythmias were identified after turning the patient. After discontinuation of mechanical ventilation, other muscles became involved, and the patient developed acute kidney injury and concern for multiple organ dysfunction syndrome over the next 5 days. On day 6, the patient was euthanized, and necropsy revealed myocardial and skeletal muscle necrosis, myoglobinuria, and acute tubular degeneration. NEW OR UNIQUE INFORMATION PROVIDED To the authors' knowledge, this is the first case of albuterol toxicosis leading to rhabdomyolysis.
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Affiliation(s)
- Marcella Granfone
- School of Veterinary Medicine, Department of Medical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julie M Walker
- School of Veterinary Medicine, Department of Medical Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Chow JL, Lam A, Shelton GD. Progressive increases in creatine kinase activity in an anorexic cat with necrotising myopathy. JFMS Open Rep 2021; 7:20551169211031790. [PMID: 34350026 PMCID: PMC8287364 DOI: 10.1177/20551169211031790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 5-year-old castrated male domestic shorthair cat with weight loss and reduced
appetite was evaluated for increased and progressively rising creatine kinase (CK)
activity. The cat had recently been diagnosed with hepatic lipidosis. Muscle biopsy and
histopathology revealed mild myonecrosis and phagocytosis without obvious inflammatory
cell infiltrates. Resolution of necrotising myopathy was observed after a short course
of anti-inflammatory prednisolone and nutritional supplementation. Relevance and novel information This is the first report of a necrotising myopathy in a cat associated with
progressively increasing CK activity and decreased appetite. Anorexia in cats has been
associated with increased CK activity, but an underlying cause of this CK elevation has
only been postulated. Here we document muscle necrosis and muscle stiffness in a cat
with anorexia.
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Affiliation(s)
- Joyce Ly Chow
- Small Animal Specialist Hospital, Sydney, NSW, Australia
| | - Amy Lam
- Small Animal Specialist Hospital, Sydney, NSW, Australia
| | - G Diane Shelton
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
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10
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Severe Rhabdomyolysis Associated with Acute Amphetamine Toxicosis in a Dog. Case Rep Vet Med 2020; 2020:2816373. [PMID: 32082692 PMCID: PMC7008280 DOI: 10.1155/2020/2816373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 01/22/2020] [Indexed: 11/18/2022] Open
Abstract
A 3-year-old female spayed rat terrier presented for hyperactivity and repetitive circling to the right of less than one-hour duration. On examination, the patient was dehydrated, hyperactive, and dysphoric. Laboratory tests initially revealed elevations in creatine kinase (CK) and aspartate aminotransferase (AST). Serial chemistries indicated significant progression of CK elevation to a maximum of 181,900 U/L on day 3 along with the development of profuse myoglobinuria. A urine drug screening test was positive for amphetamine metabolites. This patient was treated with sedatives, aggressive fluid diuresis, and antioxidants. The dog recovered uneventfully with no indicators of renal dysfunction based on serial blood chemistries and was discharged five days after presentation. Follow-up blood chemistries taken four days after discharge revealed near normalization of CK and resolution of myoglobinuria. This case report describes a particularly severe case of rhabdomyolysis associated with amphetamine toxicity and its successful treatment.
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11
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Stephenson OJ, Trombetta LD. Comparative effects of Mancozeb and Disulfiram-induced striated muscle myopathies in Long-Evans rats. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2020; 74:103300. [PMID: 31805476 DOI: 10.1016/j.etap.2019.103300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
Dithiocarbamates (DTCs) like mancozeb (MZ) and disulfiram (DS) are used throughout agriculture and medicine and have been implicated in neurotoxicity. Little research has been studied on the reported myopathies caused by these compounds. Their pathogenesis and mechanism of muscle toxicity has not been fully studied. The aim of this study is to investigate if DTCs alter striated muscle tissues in vivo. Long-Evans rats were treated with either MZ or DS followed by analysis of muscle biomarkers and metal levels. DS resulted in increases in serum lactate dehydrogenase (LDH), cardiac troponin, and myoglobin levels. Creatine kinase-MB serum levels decreased. Mancozeb only showed an increase in serum LDH. Both MZ and DS-treatment resulted in altered metal levels in the myocardium but not skeletal muscle. Ultrastructural alterations included damaged mitochondria and myofibril splitting. The presence of multivesicular bodies, and alterations of the intercalated disc were also seen.
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Affiliation(s)
- Olivia J Stephenson
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Jamaica, NY 11439, USA
| | - Louis D Trombetta
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, Jamaica, NY 11439, USA.
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Brida AL, O' Toole TE, Sutherland-Smith J, Pirie C, Kowaleski MP. Compartment syndrome of the muscles of mastication in a working dog following a traumatic training incident. J Vet Emerg Crit Care (San Antonio) 2019; 29:321-325. [PMID: 31066176 DOI: 10.1111/vec.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 03/13/2017] [Accepted: 03/27/2017] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe acute compartment syndrome (CS) of the muscles of mastication in a working dog associated with a traumatic training event. CASE SUMMARY A 2.5-year-old male Belgian Malinois was evaluated for acute blindness, severe diffuse swelling of the head, and inability to close the jaw following a traumatic incident during a bite training drill. During the exercise, the maxillary canine teeth were locked on a bite sleeve. Magnetic resonance imaging of the head and ocular system identified diffuse muscle swelling and hyperintensity, most severe in the muscles of mastication. Ocular abnormalities were not identified. Rhabdomyolysis, CS, and indirect optic nerve injury were supported by measurement of increased intramuscular pressure. Bilateral decompressive fasciotomies over the masseter and temporalis muscles resulted in immediate and marked resolution of the swelling and jaw movement. Blindness, however, did not resolve. NEW OR UNIQUE INFORMATION PROVIDED CS involving the muscles of mastication may occur as a complication of bite training and may result in irreversible and even life-threatening complications. Emergent decompressive fasciotomy is indicated to reverse swelling; however, visual deficits may not resolve.
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Affiliation(s)
- Amy L Brida
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Therese E O' Toole
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - James Sutherland-Smith
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Christopher Pirie
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Michael P Kowaleski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
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Exertional myopathy and hyoid luxation in a greyhound. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chen H, Aroch I, Segev G. Acute kidney injury secondary to traumatic rhabdomyolysis in a dog. J Vet Emerg Crit Care (San Antonio) 2018; 28:585-590. [PMID: 30222253 DOI: 10.1111/vec.12765] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/21/2016] [Accepted: 11/08/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To describe the clinical course and successful management of a dog with crush syndrome, rhabdomyolysis, myoglobinuria, and associated acute kidney injury (AKI). CASE SUMMARY An 8-year-old female, neutered, mixed-breed dog was referred to the Veterinary Teaching Hospital due to crush injury and suspected AKI. Blood tests and urinalysis showed markedly increased serum creatine kinase activity, myoglobinuria, and AKI. The dog was managed successfully with intermittent hemodialysis, and completely recovered. NEW OR UNIQUE INFORMATION PROVIDED This is the first report of a dog with crush syndrome with secondary myoglobinuria and AKI.
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Affiliation(s)
- Hilla Chen
- Koret School of Veterinary Medicine and Hebrew University Veterinary Teaching Hospital, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Koret School of Veterinary Medicine and Hebrew University Veterinary Teaching Hospital, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Koret School of Veterinary Medicine and Hebrew University Veterinary Teaching Hospital, The Hebrew University of Jerusalem, Rehovot, Israel
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A Nonsense Variant in the ACADVL Gene in German Hunting Terriers with Exercise Induced Metabolic Myopathy. G3-GENES GENOMES GENETICS 2018; 8:1545-1554. [PMID: 29491033 PMCID: PMC5940147 DOI: 10.1534/g3.118.200084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Several enzymes are involved in fatty acid oxidation, which is a key process in mitochondrial energy production. Inherited defects affecting any step of fatty acid oxidation can result in clinical disease. We present here an extended family of German Hunting Terriers with 10 dogs affected by clinical signs of exercise induced weakness, muscle pain, and suspected rhabdomyolysis. The combination of clinical signs, muscle histopathology and acylcarnitine analysis with an elevated tetradecenoylcarnitine (C14:1) peak suggested a possible diagnosis of acyl-CoA dehydrogenase very long chain deficiency (ACADVLD). Whole genome sequence analysis of one affected dog and 191 controls revealed a nonsense variant in the ACADVL gene encoding acyl-CoA dehydrogenase very long chain, c.1728C>A or p.(Tyr576*). The variant showed perfect association with the phenotype in the 10 affected and more than 500 control dogs of various breeds. Pathogenic variants in the ACADVL gene have been reported in humans with similar myopathic phenotypes. We therefore considered the detected variant to be the most likely candidate causative variant for the observed exercise induced myopathy. To our knowledge, this is the first description of this disease in dogs, which we propose to name exercise induced metabolic myopathy (EIMM), and the identification of the first canine pathogenic ACADVL variant. Our findings provide a large animal model for a known human disease and will enable genetic testing to avoid the unintentional breeding of affected offspring.
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Thrift E, Wimpole JA, Child G, Brown N, Gandolfi B, Malik R. Exercise-induced hyperthermia syndrome (canine stress syndrome) in four related male English springer spaniels. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2017; 8:59-68. [PMID: 30050857 PMCID: PMC6042503 DOI: 10.2147/vmrr.s123836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This retrospective study describes the signalment, clinical presentation, diagnostic findings, and mode of inheritance in four young male English springer spaniel dogs with presumptive canine stress syndrome. MATERIALS AND METHODS Appropriate cases were located through medical searches of medical records of two large private referral centers. Inclusion criteria comprised of English springer spaniel dogs with tachypnea and hyperthermia that subsequently developed weakness or collapse, with or without signs of hemorrhage, soon after a period of mild-to-moderate exercise. The pedigrees of the four affected dogs, as well as eleven related English springer spaniels, were then analyzed to determine a presumptive mode of genetic inheritance. RESULTS Four dogs met the inclusion criteria. All four were male, suggesting the possibility of a recessive sex-linked heritable disorder. Pedigree analysis suggests that more dogs may be potentially affected, although these dogs may have never had the concurrent triggering drug/activity/event to precipitate the clinical syndrome. There was complete resolution of clinical signs in three of the four dogs with aggressive symptomatic and supportive therapy, with one dog dying during treatment. CONCLUSION Dogs with canine stress syndrome have the potential for rapid recovery if treated aggressively and the complications of the disease (eg, coagulopathy) are anticipated. All four dogs were male, suggesting the possibility of a recessive sex-linked mode of inheritance. Further genetic analyses should be strongly considered by those involved with the English springer spaniel breed, either with a genome-wide association study using canine single-nucleotide polymorphism arrays or whole-genome sequencing of affected and closely related dogs.
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Affiliation(s)
| | | | - Georgina Child
- Small Animal Specialist Hospital, Sydney, NSW, Australia
| | | | - Barbara Gandolfi
- Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Richard Malik
- Centre for Veterinary Education, University of Sydney, Sydney, NSW, Australia
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Sehl J, Gruber AD, Lazzerini K, Loderstedt S. Ischaemic paraspinal myopathy along with myelopathy due to putative fibrocartilaginous embolism in a dog. VETERINARY RECORD CASE REPORTS 2017. [DOI: 10.1136/vetreccr-2016-000400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Julia Sehl
- Department of Veterinary Medicine at the Freie Universität BerlinBerlinGermany
| | - Achim D Gruber
- Department of Veterinary Medicine at the Freie Universität BerlinInstitute of Veterinary PathologyBerlinGermany
| | | | - Shenja Loderstedt
- Department of Veterinary Medicine at the Freie Universität BerlinSmall Animal ClinicBerlinGermany
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Skeletal Muscle. PATHOLOGIC BASIS OF VETERINARY DISEASE 2017. [PMCID: PMC7158298 DOI: 10.1016/b978-0-323-35775-3.00015-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Abstract
A 9 yr old spayed female cocker spaniel presented for an acute onset of weakness. Rhabdomyolysis and myoglobinuria were found 36 hr after presentation. The dog was managed for several electrolyte and mineral abnormalities and rhabdomyolysis-induced acute renal failure. The diagnosis of idiopathic necrotizing myopathy was determined by histopathology and by the exclusion of underlying infectious agents and metabolic defects. The dog recovered completely from the acute crisis and acute renal failure.
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Shelton GD. Routine and specialized laboratory testing for the diagnosis of neuromuscular diseases in dogs and cats. Vet Clin Pathol 2010; 39:278-95. [PMID: 20726955 DOI: 10.1111/j.1939-165x.2010.00244.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The diagnosis of neuromuscular diseases can be challenging. The first step is recognition that the disease involves the neuromuscular system (muscle, neuromuscular junction, peripheral nerve, and ventral horn cells of the spinal cord). Many neuromuscular diseases share clinical signs and cannot be distinguished based on clinical examination. Routine laboratory screening, including a CBC, biochemical profile, and urinalysis, can identify some of the most common systemic abnormalities that cause muscle weakness and myalgia, such as hypo- and hyperglycemia, electrolyte disorders, or thyroid abnormalities, and may suggest a specific diagnosis, such as diabetes mellitus, hypo- or hyperadrenocorticism, renal failure, or hypothyroidism. Increased creatine kinase activity, increased cardiac troponin I concentration, and myoglobinuria are useful in detecting skeletal and cardiac muscle damage. Identification of acetylcholine receptor antibodies is diagnostic for acquired myasthenia gravis. For primary muscle or peripheral nerve diseases, tissue biopsy is the most direct way to determine specific pathology, correctly classify the disease, and determine the course of additional laboratory testing. For example, inflammatory, necrotizing, dystrophic, metabolic, or congenital myopathies require different laboratory testing procedures for further characterization. Many neuromuscular diseases are inherited or breed-associated, and DNA-based tests may already be established or may be feasible to develop after the disorder has been accurately characterized. This review focuses on both routine and specialized laboratory testing necessary to reach a definitive diagnosis and determine an accurate prognosis for neuromuscular diseases.
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Affiliation(s)
- G Diane Shelton
- Department of Pathology, School of Medicine, University of California-San Diego, La Jolla, CA 92093, USA.
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Diagnostic and prognostic value of serum creatine-kinase activity in ill cats: a retrospective study of 601 cases. J Feline Med Surg 2010; 12:466-75. [PMID: 20236849 DOI: 10.1016/j.jfms.2010.01.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2010] [Indexed: 11/21/2022]
Abstract
In veterinary medicine, serum creatine-kinase (CK) activity is mostly used to assess skeletal muscle damage. This retrospective study aimed to evaluate the prevalence of increased CK activity in a large, ill-cat population and to characterise associated diseases, clinical and laboratory findings and its prognostic value. Cats with a complete serum biochemistry analysis were consecutively enrolled, divided into two CK activity-based groups (within and above reference interval) and compared. The study included 601 cats. Median serum CK was 402 U/l (range 16-506870). Increased CK (>250 U/l) was observed in 364 (60%) cats, and>30-fold its upper reference limit in 43 (7%). Cats with increased CK had greater (P < or = 0.05) body weight, and were more likely to have a history of collapse, dyspnoea, abnormal lung sounds, cyanosis, shock and paraplegia, higher median serum alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase activities and total bilirubin and triglyceride concentrations, but lower, median total protein, albumin, globulin and cholesterol concentrations and proportion of anorexia than cats with normal CK. Cardiac diseases, trauma, bite wounds, systemic bacterial infections, prior anaesthesia and intramuscular injections were more common (P < or = 0.05) in cats with increased compared to normal CK activity. The hospitalisation period was longer (P=0.007) and treatment cost and mortality were higher (P<0.005) in cats with increased CK activity. However, CK activity was an inaccurate outcome predictor (area under the receiver operator characteristics curve 0.58). Increased CK activity is very common in ill cats.
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De Risio L, McConnell JF, de Stefani A, Matiasek L, Lujan Feliu-Pascual A, Shelton GD. Imaging diagnosis--acute necrotizing myopathy in a dog. Vet Radiol Ultrasound 2009; 50:639-43. [PMID: 19999349 DOI: 10.1111/j.1740-8261.2009.01596.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Luisa De Risio
- Neurology/Neurosurgery Unit, Centre for Small Animal Studies, the Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK.
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Shelton GD. From dog to man: the broad spectrum of inflammatory myopathies. Neuromuscul Disord 2007; 17:663-70. [PMID: 17629703 DOI: 10.1016/j.nmd.2007.06.466] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Accepted: 06/13/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this review is to describe the various forms of inflammatory myopathy that occur spontaneously in dogs, and discuss the similarities and differences between inflammatory myopathy in dogs and humans. Some interesting muscle-specific autoantigens have recently been discovered in canine autoimmune myositis, and they are associated with specific forms of inflammatory myopathy. These autoantigens may now be investigated in humans. Furthermore, the association of distinct inflammatory myopathies with certain breeds of dogs point to important genetic components of inflammatory myopathy that can now be studied using dogs as both parallel disorders and animal models. Other canine myositides, associated with infectious and histiocytic diseases, may also be relevant to similar human disorders.
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Affiliation(s)
- G Diane Shelton
- Department of Pathology, University of California, San Diego, La Jolla, CA 92093-0709, USA.
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