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CASE REPORTS
Use of Procainamide for Conversion of Acute Onset AF Following Pericardiocentesis in a Dog
R Fries, A Saunders
ABSTRACT A 9 yr old spayed female golden retriever was evalu- ated for anorexia and suspected gastric dilatation. Subsequent evaluation the following day determined the dog to have pericardial effusion. Muffled heart sounds and jugular pulses were noted on physical exam, and the dog was diagnosed with pleural and pericar- dial effusion. A sinus rhythm with a rate of 142 beats/ min was documented on a surface electrocardiogram (EKG). Following pericardiocentesis, the heart rate in- creased to 260 beats/min, the rhythm became irregu- lar, and the systemic blood pressure decreased. Atrial fibrillation (AF) was confirmed by electrocardiography. Procainamide was administered IV over 15 min, result- ing in successful conversion of AF to sinus rhythm and clinical improvement. Procainamide is one of several antiarrhythmic medications that are used for the con- version of acute AF in humans; however, its utility and efficacy in dogs in the setting of AF has not previously been reported. This case highlights a unique complica- tion of performing a pericardiocentesis that requires im- mediate treatment and describes a potential treatment option for the conversion of acute AF in dogs.
CASE REPORTS Toxic Shock Syndrome in Two Dogs JE Slovak, VJ Parker, KL Deitz
ABSTRACT Two young, unrelated, spayed female Labrador retriev- ers were evaluated for severe, diffuse, generalized ery- thema and edema of the skin. Both dogs exhibited signs of disseminated intravascular coagulopathy and were euthanized. On postmortem examination, toxic shock syndrome (TSS) was diagnosed based on histopathology and supported by skin cultures. TSS is a rarely reported disease in veterinary medicine and can cause acute and profound clinical signs. Rapid recognition of this disease process and immediate treatment may improve the clinical outcome.
CASE REPORTS
Mineralocorticoid Before Glucocorticoid Deficiency in a Dog with Primary Hypoadrenocorticism and Hypothyroidism
M McGonigle, JF Randolph, SA Center, RE Goldstein
ABSTRACT A dog with an unexpected clinical presentation of pri- mary hypoadrenocorticism was evaluated for clinical signs and electrolyte abnormalities characteristic of Addison’s disease. Although the initial adrenocortico- tropic hormone (ACTH) stimulation test documented se- rum cortisol concentrations within the reference range, subsequent assessments confirmed hypoaldosteronism. Mineralocorticoid replacement promptly normalized electrolytes and transiently improved clinical illness. Six weeks after initial ACTH stimulation testing, the dog be- came glucocorticoid deficient. Concurrent primary hy- pothyroidism was also documented. Hypoaldosteronism preceding hypocortisolemia is a unique presentation of canine Addison’s disease.
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jaaha.org for more information. Trends magazine, November 2012
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