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Asorey I, Corletto F. Suspected systemic gas embolism associated with lung tissue perforation caused by a previously inserted chest drain in a dog. J Vet Emerg Crit Care (San Antonio) 2023; 33:613-618. [PMID: 37573257 DOI: 10.1111/vec.13318] [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: 02/14/2022] [Revised: 05/11/2022] [Accepted: 05/28/2022] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To report a case of systemic gas embolism associated with removal of a chest drain perforating a lung lobe in a dog undergoing sternotomy under general anesthesia and intermittent positive pressure ventilation. CASE SUMMARY An 8-year-old Cocker Spaniel underwent an exploratory thoracotomy via median sternotomy for surgical management of pyothorax that was treated conservatively for 7 days prior to referral following bilateral chest drain placement. The surgical procedure consisted of a subphrenic mediastinectomy and pericardiectomy. During surgery, it became apparent that the right drain was perforating the right middle lung lobe. Sudden desaturation and rapid hemodynamic deterioration occurred after the drain was removed. A systemic gas embolism was suspected on the basis of clinical signs and results of an arterial blood gas analysis, and immediate supportive treatment was started with an adequate response. Once the surgical procedure was completed, a clear "mill wheel" sound was audible on cardiac auscultation and point-of-care cardiac ultrasound confirmed the presence of gas bubbles in the cardiac chambers. The dog recovered from anesthesia and was managed in the intensive care unit where arterial blood gas analyses were nearly normal and the dog made a full recovery. NEW OR UNIQUE INFORMATION PROVIDED In people, there are reports of fatal air embolism related to the use of chest drains. To our knowledge, this is the first case report in dogs of a systemic gas embolism during open-chest surgery caused by a chest drain perforating a lung lobe. Immediate recognition and aggressive treatment of this life-threatening condition should be provided in order to achieve a favorable outcome.
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Hritz R, Mullen KR, Mason G, Schaffer PA. Catheter‐associated air embolism of the brain in a hospitalised horse. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rachel Hritz
- Department of Clinical Sciences Colorado State University Fort Collins Colorado USA
| | | | - Gary Mason
- Department of Microbiology, Immunology, and Pathology Colorado State University Fort Collins Colorado USA
| | - Paula A. Schaffer
- Department of Microbiology, Immunology, and Pathology Colorado State University Fort Collins Colorado USA
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Easton‐Jones CA, Marr CM, Peter VG, Foote AK. Vascular air embolisation and expansile sphenopalatine sinus haematoma secondary to a fracture of the rostral skull in a horse. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - C. M. Marr
- Rossdales Equine Hospital and Diagnostic Centre Exning UK
| | - V. G. Peter
- Rossdales Equine Hospital and Diagnostic Centre Exning UK
| | - A. K. Foote
- Rossdales Equine Hospital and Diagnostic Centre Exning UK
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Hess EK, Reinhart JM, Anderson MJ, Jannasch AS, Taylor SD. Pharmacokinetics of thiamine (vitamin B1) in adult horses after administration of three single intravenous doses. J Vet Pharmacol Ther 2021; 44:937-944. [PMID: 34407222 DOI: 10.1111/jvp.13007] [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: 04/24/2021] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
Thiamine is a vital co-factor for several anti-inflammatory and antioxidant processes that are critical for mitigation of sepsis-associated inflammation, but pharmacokinetic (PK) analysis has not been reported in horses. We hypothesized that IV thiamine hydrochloride (TH) at increasing dosages would result in corresponding increases in plasma thiamine concentrations without causing adverse effects. A randomized cross-over study was performed in 9 healthy horses that each received TH at 5, 10, and 20 mg/kg IV. Blood was collected immediately prior to drug administration and at several time points thereafter. High-performance liquid chromatography with mass spectrometry was used to quantify thiamine concentrations at each time point. Non-compartmental PK methods showed that IV TH resulted in supraphysiologic plasma concentrations with a short half-life (0.77-1.12 h) and no adverse clinical signs were observed. The terminal rate constant decreased as the dosage increased (p < .0001) and clearance significantly decreased at the 20 mg/kg dosage (p = .0011). The area under the curve (AUC) increased in a non-linear fashion. These findings suggest that thiamine follows non-linear elimination kinetics in horses, which is likely due to saturation of renal elimination. Future studies are needed to identify therapeutic plasma concentrations and develop thiamine dosing recommendations for horses.
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Affiliation(s)
- Emily K Hess
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Jennifer M Reinhart
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Melinda J Anderson
- Department of Basic Medical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Amber S Jannasch
- Bindley Bioscience Center, Purdue University, West Lafayette, IN, USA
| | - Sandra D Taylor
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021; 11:ani11061777. [PMID: 34198637 PMCID: PMC8232193 DOI: 10.3390/ani11061777] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Recovery is the most dangerous phase of general anaesthesia in horses. Numerous publications have reported about this phase, but structured reviews that try to reduce the risk of bias of narrative reviews/expert opinions, focussing on the topic are missing. Therefore, the aim of the present article was to publish the first structured review as a summary of the literature focussing on the recovery phase after general anaesthesia in horses. The objective was to summarise the available literature, taking into account the scientific evidence of the individual studies. A structured approach was followed with two experts in the field independently deciding on article inclusion and its level of scientific evidence. A total number of 444 articles, sorted by topics and classified based on their levels of evidence, were finally included into the present summary. The most important findings were summarised and discussed. The present structured review can be used as a compilation of the publications that, to date, focus on the recovery phase after general anaesthesia in adult horses. This type of review tries to minimise the risk of bias inherent to narrative reviews/expert opinions. Abstract Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.
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Kantyka ME, Kuemmerle J, Becsek A, Ringer SK. Venous air embolism during stifle arthroscopy in a horse. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. E. Kantyka
- Section of Anaesthesiology and Pain Therapy Department of Clinical Veterinary Medicine Vetsuisse Faculty University of Bern BernSwitzerland
| | - J. Kuemmerle
- Clinic for Equine Surgery Equine Department Vetsuisse Faculty University of Zurich ZurichSwitzerland
| | - A. Becsek
- Clinic for Equine Internal Medicine Vetsuisse Faculty University of Zurich ZurichSwitzerland
| | - S. K. Ringer
- Section Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty University of Zurich Zurich Switzerland
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8
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Desaturation and hypotension in a dog undergoing balloon valvuloplasty for pulmonic stenosis. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Makra Z, Bodó G, Veres‐Nyéki KO. Central blindness following general anaesthesia due to suspected catheter‐related venous air embolism in a gelding. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Zita Makra
- Equine Department and ClinicUniversity of Veterinary MedicineÜllőHungary
| | - Gábor Bodó
- Equine Department and ClinicUniversity of Veterinary MedicineÜllőHungary
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Merlin T, Hewetson M, Veres‐Nyeki K. Putative postanaesthetic pulmonary oedema in a horse. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tristan Merlin
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | - Michael Hewetson
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | - Kata Veres‐Nyeki
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
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Parkinson NJ, McKenzie HC, Barton MH, Davis JL, Dunkel B, Johnson AL, MacDonald ES. Catheter-associated venous air embolism in hospitalized horses: 32 cases. J Vet Intern Med 2018; 32:805-814. [PMID: 29460300 PMCID: PMC5866986 DOI: 10.1111/jvim.15057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/20/2018] [Accepted: 01/11/2018] [Indexed: 01/29/2023] Open
Abstract
Background Venous air embolism is a potentially life‐threatening complication of IV catheter use in horses. Despite widespread anecdotal reports of their occurrence, few cases have been reported in the literature and the prognosis is currently unknown. Hypothesis/Objectives Our objective was to describe the surrounding circumstances, clinical signs, treatment, progression, and outcome of venous air embolism in hospitalized horses. Animals Thirty‐two horses with acute onset of compatible clinical signs associated with IV catheter disconnection or damage. Methods Multicenter retrospective study. Data extracted from clinical records included signalment, presenting complaint, catheter details, clinical signs, treatments, and outcome. Results Most cases resulted from extension set disconnection occurring within approximately 24 hours after catheter placement. In fewer horses, extension set damage was cited as a cause. Common clinical signs included tachycardia, tachypnea, recumbency, muscle fasciculations and agitation, with abnormal behavior including kicking and flank biting. Less commonly, pathological arrhythmias or more severe neurologic signs, including blindness and seizures, were noted. Progression was unpredictable, with some affected horses developing delayed‐onset neurologic signs. Mortality was 6/32 (19%), including 2 cases of sudden death and other horses euthanized because of persistent neurologic deficits. Negative outcomes were more common in horses with recorded blindness, sweating or recumbency, but blindness resolved in 5/8 affected horses. Conclusions and Clinical Importance The prognosis for resolution of clinical signs after air embolism is fair, but permanent neurologic deficits or pathologic cardiac arrhythmias can arise. Unpredictable progression warrants close monitoring. Systematic clinic‐based surveillance could provide additional useful information to aid prevention.
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Affiliation(s)
- Nicholas J Parkinson
- Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia.,Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, United Kingdom
| | - Harold C McKenzie
- Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Michelle H Barton
- University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Jennifer L Davis
- Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Bettina Dunkel
- The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - Amy L Johnson
- New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania
| | - Elizabeth S MacDonald
- Marion duPont Scott Equine Medical Center, Virginia Maryland College of Veterinary Medicine, Leesburg, Virginia
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Nelson BB, Goodrich LR, Barrett MF, Grinstaff MW, Kawcak CE. Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities. Equine Vet J 2017; 49:410-424. [DOI: 10.1111/evj.12689] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences, Colorado State University; Fort Collins Colorado USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences, Colorado State University; Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences, Colorado State University; Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry, Materials Science & Engineering and Medicine; Boston University; Boston Massachusetts USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences, Colorado State University; Fort Collins Colorado USA
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Mortera-Balsa V, van Oostrom H, Yeamans C, Gutierrez-Quintana R, Penderis J, Granger N. Suspected air embolism through the thoracic ventral internal vertebral venous plexus during hemilaminectomy in dogs. J Small Anim Pract 2017; 58:355-358. [PMID: 28394460 DOI: 10.1111/jsap.12665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 01/05/2023]
Abstract
Venous air embolism entering via the ventral internal vertebral venous plexus was suspected during thoracic spinal surgery in two dogs. In both cases, air was seen bubbling from a pool of blood on the floor of the vertebral canal accompanied by sudden cardiopulmonary disturbances: low end-tidal carbon dioxide pressure, tachycardia and reduction in oxygen in the blood. One dog became dyspnoeic and one died.
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Affiliation(s)
- V Mortera-Balsa
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
| | - H van Oostrom
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
| | - C Yeamans
- School of Veterinary Sciences, Small Animal Hospital, University of Glasgow, Glasgow, G61 1QH, UK
| | - R Gutierrez-Quintana
- School of Veterinary Sciences, Small Animal Hospital, University of Glasgow, Glasgow, G61 1QH, UK
| | - J Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling, FK7 7LE, UK
| | - N Granger
- School of Veterinary Sciences, Small Animal Hospital, University of Bristol, Langford, BS40 5DU, UK
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Gordon E, Schlipf JW, Husby KA, Tornquist SJ, Bildfell RJ, Semevolos SA. Two occurrences of presumptive venous air embolism in a gelding during cystoscopy and perineal urethrotomy. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E. Gordon
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
| | - J. W. Schlipf
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
| | - K. A. Husby
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
| | - S. J. Tornquist
- Department of Biomedical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
| | - R. J. Bildfell
- Department of Biomedical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
| | - S. A. Semevolos
- Department of Clinical Sciences; College of Veterinary Medicine; Oregon State University; Corvallis USA
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Romagnoli N, Rinnovati R, Lukacs RM, Spadari A, Dondi F. Suspected venous air embolism during urinary tract endoscopy in a standing horse. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- N. Romagnoli
- Department of Veterinary Medical Sciences; Alma Mater Studiorum; University of Bologna; Italy
| | - R. Rinnovati
- Department of Veterinary Medical Sciences; Alma Mater Studiorum; University of Bologna; Italy
| | - R. M. Lukacs
- Department of Veterinary Medical Sciences; Alma Mater Studiorum; University of Bologna; Italy
| | - A. Spadari
- Department of Veterinary Medical Sciences; Alma Mater Studiorum; University of Bologna; Italy
| | - F. Dondi
- Department of Veterinary Medical Sciences; Alma Mater Studiorum; University of Bologna; Italy
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Affiliation(s)
- R. Nolen-Walston
- New Bolton Center; University of Pennsylvania; Kennett Square USA
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Chebroux A, McMillan M. Transient millwheel heart murmur and cardiorespiratory alterations in a dachshund during hemilaminectomy. VETERINARY RECORD CASE REPORTS 2014. [DOI: 10.1136/vetreccr-2014-000103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alexandre Chebroux
- Department of Veterinary MedicineUniversity of CambridgeCambridgeCambridgeshireUK
| | - Matthew McMillan
- Department of Veterinary MedicineUniversity of CambridgeCambridgeCambridgeshireUK
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Boitout V, Mahler SP. Non-fatal high-rate iatrogenic venous air embolism in a cat. Vet Anaesth Analg 2013; 40:336-8. [PMID: 23406567 DOI: 10.1111/vaa.12020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dawson DR. Toxins and adverse drug reactions affecting the equine nervous system. Vet Clin North Am Equine Pract 2011; 27:507-26. [PMID: 22100042 DOI: 10.1016/j.cveq.2011.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article provides an overview of the more common toxins and adverse drug reactions, along with more rare toxins and reactions (Table 1), that result in neurologic dysfunction in horses. A wide variety of symptoms, treatments, and outcomes are seen with toxic neurologic disease in horses. An in-depth history and thorough physical examination are needed to determine if a toxin or adverse drug reaction is responsible for the clinical signs. Once a toxin or adverse drug reaction is identified, the specific antidote, if available, and supportive care should be administered promptly.
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Affiliation(s)
- Dominic R Dawson
- William Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, One Garrod Avenue, Davis, CA 95616, USA.
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Abstract
CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were confirmed. Oxygen and furosemide were administered. The horse was assisted to standing with a sling. Therapy continued with bilateral intra-nasal oxygen insufflation. Ancillary medical therapy included flunixin meglumine, penicillin, gentamycin and dimethylsulfoxide. Following 7 hours of treatment the arterial oxygen tensions began to increase towards normal values. CASE 2: An 11-year old, 528 kg Paint horse was anesthetized for surgery of a submandibular mass. The 4-hour anesthetic period was unremarkable. The OT tube was left in situ for the recovery. During recovery, the horse was slightly agitated and stood after three attempts. Clinical signs consistent with pulmonary edema and arterial hypoxemia (PaO(2): 5 kPa [37.5 mmHg]) subsequently developed following extubation. Respiratory signs resolved with medical therapy, including unilateral nasal oxygen insufflation, furosemide, flunixin meglumine and dimethylsulfoxide. The diagnosis of pulmonary edema in these horses was made by clinical signs and arterial blood-gas analysis. While pulmonary radiographs were not taken to confirm the diagnosis, the clinical signs following anesthesia support the diagnosis in both cases. The etiology of pulmonary edema was most likely multifactorial.
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Affiliation(s)
- M Johanna Kaartinen
- Université de Montréal, 1500 Rue des vétérinaires, C.P. 5000, Saint-Hyacinthe, Quebec J2S 7C6, Canada.
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Gunew M, Marshall R, Lui M, Astley C. Fatal venous air embolism in a cat undergoing dental extractions. J Small Anim Pract 2008; 49:601-4. [PMID: 19006491 DOI: 10.1111/j.1748-5827.2008.00606.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A five-year-old domestic shorthair cat underwent general anaesthesia and tooth extractions. Immediately after use of a high-speed, air-driven, water-cooled dental drill, the cat suffered cardiac arrest and attempted resuscitation was unsuccessful. Post-mortem radiographs showed air in the vena cava, right atrium, right auricle and right ventricle, hepatic and renal veins. These findings were confirmed at post-mortem examination. The cause of death was massive air embolism. There are reports of fatal venous air embolism in the human literature from the use of high-speed, air-driven, water-cooled dental drills. In this case, we believe that the air jet from the cooling system provided an enormous pressure gradient allowing air entry through an alveolar bone fracture or the inflamed gingival tissues. This is the first report of fatal venous air embolism associated with the use of a high-speed dental drill in the veterinary literature.
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Affiliation(s)
- M Gunew
- The Cat Clinic, 189 Creek Road, Mt Gravatt, Brisbane, QLD 4122, Australia
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Sams LM, Hofmeister EH. Anesthesia case of the month. Treatment of colic of approximately 24 hours' duration. J Am Vet Med Assoc 2008; 232:206-9. [PMID: 18275386 DOI: 10.2460/javma.232.2.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Lisa M Sams
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
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