Adverse interaction between colchicine and ketoconazole in a Chinese shar pei

Evaluation for Postoperative Infections Following Cutaneous Punch Biopsies in Dogs and Cats: 154 Cases (2013-2018)

Antimicrobial stewardship is becoming more important every day with increasing bacterial resistance and limitations on antibiotics. Prophylactic antibiotics are not necessary with all procedures, which has been shown previously with a variety of human and veterinary surgeries. Medical records were retrospectively evaluated for cases who had a cutaneous punch biopsy performed between 2013 and 2018 including the following information: species, signalment, concurrent diseases, concurrent medications, location of biopsy, histopathologic diagnosis, and bacterial infections postoperatively. The prevalence of secondary infections, due to punch biopsies in all animals, was 1.9% and further divided into 2.3% (3/128) of dogs and 0% (0/26) of cats. It was determined that the relative risk of developing complications from punch biopsy was 0.06 (0.01-0.93) when diagnosing a dermatologic disease versus a cutaneous mass (neoplastic and nonneoplastic), which was statistically significant. The risk increased 2.16 (0.16-59.91) times if the biopsy site was the trunk, which includes the neck, thorax, and abdomen. These results indicate that in veterinary medicine, postoperative complications are uncommon with cutaneous punch biopsies. The administration of prophylactic antibiotics in dogs and cats is unnecessary when performing a punch biopsy when there is no infection present at the time of biopsy.

[Accidental colchicine intoxication in a cross-breed dog]

A 2-year old cross-breed dog presented due to acute vomiting and progressive lethargy following ingestion of the owner's anti-gout medication (colchicine, 0.35 mg/kg) 1-3 hours prior to presentation.The dog developed signs of all 3 stages of colchicine poisoning (gastrointestinal phase, multi-organ phase, recovery phase) and the clinical course was complicated by the presence of multi-organ dysfunction syndrome (MODS) and numerous negative prognostic factors.This case report describes the clinical and laboratory effects of colchicine poisoning and represents the first successful treatment of an accidental colchicine ingestion in a dog in Europe.

Survival of a dog with accidental colchicine overdose

OBJECTIVE

To describe the treatment and clinical course of a dog accidentally prescribed 10 times the recommended dose of colchicine (0.3 mg/kg/d instead of 0.03 mg/kg/d).

CASE SUMMARY

After glaucoma surgery, a 1-year-old male neutered Pomeranian weighing 6.8 kg was prescribed 1,000 μg colchicine twice a day per os. The dog presented to the emergency department after the first dose with vomiting and was treated as an outpatient. Two colchicine doses later, the dog represented with vomiting, ocular pain, and increased intraocular pressure. The dog's vital signs were normal, and the dog was admitted for rehydration, analgesia, and revision glaucoma surgery the next day. Two hours after revision surgery, the dog developed vomiting and diarrhea. Postoperatively, the dog was hypothermic (36.3°C), persistently hypertensive (227 mm Hg), and bradycardic (60/min). Biochemistry revealed metabolic acidosis and increased hepatic enzyme activities. Mannitol was administered for presumed cerebral edema. Later, the dog developed bradycardia due to second-degree atrioventricular heart block, which responded to atropine. Total hospitalization was 9 days. Treatment included IV fluids, IV lipid emulsion, N-acetylcysteine, activated charcoal, gastroprotectants, antiemetics, opioids, antimicrobials, and barrier nursing due to transient neutropenia.

NEW OR UNIQUE INFORMATION PROVIDED

This is the first report to describe the successful treatment of a dog with colchicine overdose. The systemic effects were presumed to be secondary to colchicine toxicosis rather than diet, infection, or other drug reaction, and may have been compounded by a second anesthetic episode. Gastrointestinal signs, symptoms of cerebral edema, cardiac arrhythmias, and neutropenia were documented. One other report of colchicine overdose in a dog exists, and that patient was euthanized. This report demonstrates that complete recovery with intensive care is possible; however, the prognosis remains guarded.

Hepatic Fibrosis in Dogs

Hepatic fibrosis is commonly diagnosed in dogs, often as a sequela to chronic hepatitis (CH). The development of fibrosis is a crucial event in the progression of hepatic disease that is of prognostic value. The pathophysiology of hepatic fibrosis in human patients and rodent models has been studied extensively. Although less is known about this process in dogs, evidence suggests that fibrogenic mechanisms are similar between species and that activation of hepatic stellate cells is a key step. Diagnosis and staging of hepatic fibrosis in dogs requires histopathological examination of a liver biopsy specimen. However, performing a liver biopsy is invasive and assessment of fibrotic stage is complicated by the absence of a universally accepted staging scheme in veterinary medicine. Serum biomarkers that can discriminate among different fibrosis stages are used in human patients, but such markers must be more completely evaluated in dogs before clinical use. When successful treatment of its underlying cause is feasible, reversal of hepatic fibrosis has been shown to be possible in rodent models and human patients. Reversal of fibrosis has not been well documented in dogs, but successful treatment of CH is possible. In human medicine, better understanding of the pathomechanisms of hepatic fibrosis is leading to the development of novel treatment strategies. In time, these may be applied to dogs. This article comparatively reviews the pathogenesis of hepatic fibrosis, its diagnosis, and its treatment in dogs.