Topical flurbiprofen toxicosis in a cat

Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat

An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.

Dermatological topical products used in the US population and their toxicity to dogs and cats

BACKGROUND

Many dermatological topicals are available for human use and may be toxic to dogs and cats. No epidemiological studies have been performed in the US population on the use of dermatological topical prescription drugs, and their toxicosis to dogs and cats.

OBJECTIVES

Summarize the variety of dermatological topical prescriptions potentially used by pet owners in the United States (US), and describe the epidemiology of dog and cat exposures and toxicities.

ANIMALS/SUBJECTS

A dataset of 10,170 individuals from the National Health and Nutrition Examination Survey (NHANES) representative of 311,065,381 US residents. There were 61,169 dog and cat cases with exposure to dermatological topicals from the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Poison Control Center (APCC) database.

METHODS AND MATERIALS

Prescription medication data were analyzed from NHANES 2011-2014 survey respondents. The APCC database was searched for records of dermatological topical drug cases between January 2001 and January 2018.

RESULTS

Prescription dermatological topical medications were used by 1.33 ± 0.21% of the US population. Dermatological topical products (177, veterinary and human) resulted in 61,169 exposure calls to the APCC. Clinical signs developed in 38% (22,910). A human-labelled product was involved in 15% (3,463) with 74% (2,545) involving a prescription product.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

Pets in households with humans receiving dermatological prescription topicals may be at risk for toxicosis. Multiple human-labelled dermatological topicals can cause death or major illness to dogs and cats at low dosages. Increased public awareness, especially attention to home storage practices for human-labelled dermatological topicals, may reduce the risk of exposure and toxicosis to dogs and cats.