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CASE REPORT Methocarbamol CRI for Symptomatic Treatment of Pyrethroid Intoxication: A Report of Three Cases
WE Draper, L Bolfer, E Cottam, M McMichael, T Schubert
Pyrethroids are popular for use in companion animals due to their relatively low mammalian toxicity and ef- ficacy against arthropods. Nonetheless, pyrethroid in- toxication has been reported in cats and dogs, and cats appear to be more susceptible due to difficulty in bio- transformation and excretion of pyrethroids. Pyrethroid intoxications are generally due to either the improper use or accidental ingestion of approved products. Methocarbamol, given as intermittent injections, is a common first-line treatment choice for the tremors as- sociated with pyrethroid intoxication. Two cats and one dog were treated with a methocarbamol continuous rate infusion (CRI) for pyrethroid intoxication. Clinical signs of toxicity resolved within a few hr in all three cases, with no adverse drug effects. A methocarbamol CRI can be considered in animals presenting with pyre- throid intoxication.
CASE REPORT Bifocal Femoral Deformity Correction and Lengthening Using a Circular Fixator Construct in a Dog
JV Coutin, DD Lewis, SE Kim, DJ Reese
A 7 mo old male rottweiler was evaluated for a right hind limb lameness caused by malunion of a Salter- Harris type II fracture. Radiographs and computed tomography (CT) revealed that the right distal femur had valgus, procurvatum, external rotation, and was 35% (70 mm) shorter than the contralateral femur. Distal femoral wedge ostectomies were performed to acutely correct the angular and rotational deformities. Lengthening of the femur was accomplished by distrac- tion osteogenesis performed over 53 days at a second, proximal diaphyseal osteotomy using a circular fixator construct. This bifocal approach yielded approximately 30 mm of femoral lengthening and a confluent column of regenerate bone that bridged the distraction gap. When evaluated 14 mo after surgery, the dog held the right hip, stifle, and hock in a slightly extended posture when standing and had a subtle asymmetric hind limb gait. The stride of the right hind limb was slightly short- ened with compensatory circumduction of the left hind limb during the swing phase of the stride.
This case report highlights an unusually prolonged, asymptomatic, disease-free interval in an aged male Labrador retriever that underwent partial pancreatecto- my for a functionally active pancreatic insulinoma with histologically confirmed hepatic metastasis. The patient developed pancreatitis and nonseptic suppurative peri- tonitis 24 hr after surgical resection of the insulinoma and was managed medically until discharge. Three mo after surgery, the dog was diagnosed with exocrine pan- creatic insufficiency (EPI) that was effectively managed with parenteral pancreatic enzymes. Due to normal glu- cose levels 3 mo postsurgically, liver samples from the initial surgery were resubmitted for immunohistochem- istry. Results confirmed insulinoma metastasis with insulin expression. Ten mo postsurgically, the blood glu- cose was normal and serum insulin levels were slightly above the upper reference limit. The first hypoglycemic episode was documented 23 mo postoperatively, which was effectively managed with prednisone. The cause for the prolonged disease remission and survival was unknown, but was possibly a result of pancreatitis and peritonitis, partial spontaneous regression of metastatic lesions, or idiopathic. Despite life-threatening postop- erative complications, this patient enjoyed a profoundly longer than expected survival. This case highlights the importance of removing the primary tumor (insulino- ma) despite the presence of metastatic disease.
JAAHA is available in print and online. Log on to
jaaha.org for more information. Trends magazine, May 2013
CASE REPORT Prolonged Survival in an Aged Labrador Retriever with a Metastatic Insulinoma
J Rychel, DR Worley, CS Hardy, BT Webb
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