scholarly journals Persistent pit viper envenomation in a cat

2017 ◽  
Vol 3 (2) ◽  
pp. 205511691773746 ◽  
Author(s):  
Igor Yankin ◽  
Michael Schaer ◽  
Matthew Johnson ◽  
Tessa Meland ◽  
Leonel A Londoño
Keyword(s):  
Blood Cells ◽  
Clinical Course ◽  
Clinical Signs ◽  
Complete Recovery ◽  
Coagulation Time ◽  
Packed Red Blood Cells ◽  
Case Summary ◽  
Bite Wounds ◽  
Activated Coagulation Time ◽  
Severe Coagulopathy

Case summary A 4-year-old female spayed, indoor/outdoor domestic mediumhair cat presented with multiple bleeding puncture wounds and hemorrhagic shock. The cat was diagnosed with suspected pit viper envenomation based on the location and appearance of the bite wounds, as well as the presence of severe coagulopathy with prolonged activated coagulation time (762 s), which responded to antivenom administration. The clinical course of the cat was unique owing to the prolonged clinical signs of envenomation that appeared as intermittent coagulopathy and hemorrhage over a 2 week period. Five vials of antivenom were administered and three units of packed red blood cells were transfused over a 7 day period. The cat made a complete recovery with cessation of hemorrhage and normalization of clotting times. Relevance and novel information This is the first report of persistent pit viper venom-induced coagulopathy in the feline veterinary literature.

Clinical Predictability of Intraventricular Hemorrhage in Preterm Infants

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 30-34
Author(s):  
Anthony Lazzara ◽  
Peter Ahmann ◽  
Francine Dykes ◽  
Alfred W. Brann ◽  
James Schwartz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Preterm Infants ◽  
Blood Cells ◽  
Intraventricular Hemorrhage ◽  
Neonatal Intensive Care ◽  
Clinical Signs ◽  
Packed Red Blood Cells

Ninety-eight infants of less than 35 weeks' gestation, consecutively admitted to a regional neonatal intensive care unit, were followed prior to computerized tomography (CT) scan for clinical signs of subependymal and/or intraventricular hemorrhage. The presence or absence of intracerebral hemorrhage was confirmed by CT scan in all patients, and the severity of hemorrhage was quantitated as mild, moderate, or marked. Thirty-seven out of 98 infants (38%) demonstrated intracerebral hemorrhage on CT scan; 20 of 37 (54%) were predicted clinically. Clinical predictability was related to severity of hemorrhage as quantitated by CT scan. Clinical signs that were found helpful in predicting subependymal and/ or intraventricular hemorrhage were fall in hematocrit, failure of rise in hematocrit with transfusion of packed red blood cells, tight fontanel, decrease in spontaneous activity, decreased tone, abnormal eye signs, and seizures.

scholarly journals Conventional treatment of a metaldehyde-intoxicated cat with additional use of low-dose intravenous lipid emulsion

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692094017
Author(s):  
Ilaria Bergamini ◽  
Clara Mattavelli ◽  
Giorgio Grossi ◽  
Ilaria Magagnoli ◽  
Massimo Giunti
Keyword(s):  
Lipid Emulsion ◽  
Low Dose ◽  
Clinical Signs ◽  
Complete Recovery ◽  
Acute Onset ◽  
Pupillary Light ◽  
Case Summary ◽  
Bilateral Absence ◽  
Constant Rate ◽  
Rate Infusion

Case summary An adult male intact domestic shorthair cat was presented for acute onset of generalised tremors, stupor, horizontal nystagmus, anisocoria and bilateral absence of pupillary light and palpebral reflexes. Response to intravenous (IV) administration of benzodiazepines was minimal; thus, the induction of general anaesthesia with propofol, midazolam and dexmedetomidine was necessary to control clinical signs. Following a clinical suspicion of neurotoxicosis, a low-dose constant rate infusion (CRI) of IV lipid emulsion (ILE) was started. Phenobarbital and a low-dose CRI of ketamine were also used for neuroprotective purposes. Metaldehyde intoxication was confirmed by qualitative faecal toxicological analysis after discharge. Anaesthetic drugs were progressively tapered and stopped after 28 h and extubation was possible after 44 h. The cat was discharged 8 days after admission with a complete recovery of the clinical signs. Relevance and novel information To the authors’ knowledge, this is the first report to describe a case of metaldehyde toxicosis in a cat treated with intensive supportive care and an additional low-dose CRI of ILE.

Severe Vaginal Bleeding Associated with Recombinant Interferon Beta-1B

1997 ◽  
Vol 31 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Leslie A Pakulski ◽  
Linda M DiMarco
Keyword(s):  
Blood Cells ◽  
White Woman ◽  
Vaginal Bleeding ◽  
Interferon Beta ◽  
Stable Condition ◽  
Menstrual Disorders ◽  
Recombinant Interferon ◽  
Packed Red Blood Cells ◽  
Case Summary ◽  
First Case

OBJECTIVE: To report a case of severe vaginal bleeding associated with interferon beta-1b (IFN-β). CASE SUMMARY: A 19-year-old white woman diagnosed with multiple sclerosis was treated with IFN-β 4 million IU every other day for 1 month. After 1 month, the dosage was increased to 8 million IU. The patient subsequently experienced severe vaginal bleeding. Because her hemoglobin was 3.9 g/dL, she was admitted to the hospital for treatment and observation. IFN-β was discontinued and she was treated with conjugated estrogens and received 2 units of packed red blood cells. The bleeding ceased and the patient was discharged in stable condition. DISCUSSION: Menstrual disorders of mild-to-moderate severity were reported during clinical trials with IFN-β. This is the first case report regarding severe vaginal bleeding probably associated with IFN-β. The mechanism for development of IFN-β-reiated menstrual disorders is unknown. CONCLUSIONS: Reports of menstrual disorders associated with recombinant IFN-β are rare; however, clinicians should be aware that this complication can occur. Should menstrual disorders occur with no other etiologic factors identified, IFN-β should be discontinued, with improvement expected shortly thereafter.

scholarly journals Severe muscle fasciculations and tremor in a cat with hypochloraemic metabolic alkalosis secondary to duodenal obstruction

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691668642
Author(s):  
Alison Jukes ◽  
Marcus Gunew ◽  
Rhett Marshall
Keyword(s):  
Foreign Body ◽  
Intestinal Obstruction ◽  
Duodenal Obstruction ◽  
Metabolic Alkalosis ◽  
Clinical Signs ◽  
Complete Recovery ◽  
Acid Base ◽  
Case Summary ◽  
Cerebellar Diseases ◽  
History Of

Case summary An 18-month-old, female spayed, Australian Mist cat presented with a 24 h history of muscle tremors and inappetence progressing to collapse with generalised muscle fasciculations. The cat was diagnosed with a hypochloraemic metabolic alkalosis due to a duodenal foreign body found to be a trichobezoar at coeliotomy. The cat made a complete recovery after enterotomy to remove the trichobezoar, with cessation of neuromuscular clinical signs and normalisation of its electrolyte and acid–base imbalances. Relevance and novel information Muscle fasciculations and tremors in cats can be caused by intoxications, metabolic derangements, encephalomyelitis, feline hyperaesthesia syndrome and cerebellar diseases. The presenting clinical signs of severe muscle fasciculations and tremors have not previously been reported in association with an intestinal obstruction in the cat.

The Effect of Lysed Platelets on Neutralization of Heparin In Vitro with Protamine as Measured by the Activated Coagulation Time (ACT)

1991 ◽  
Vol 66 (02) ◽  
pp. 213-217 ◽  
Author(s):  
Arthur P Bode ◽  
William J Castellani ◽  
Edna D Hodges ◽  
Susan Yelverton
Keyword(s):  
Platelet Rich Plasma ◽  
Coagulation Time ◽  
Platelet Factor ◽  
Platelet Suspension ◽  
Antiheparin Activity ◽  
Unit Increase ◽  
Heparin Anticoagulation ◽  
Heparin Activity ◽  
Activated Coagulation Time

SummaryThe effect of lysed platelets on the activated coagulation time (ACT) was studied in heparinized whole blood during titration with protamine. Frozen-thawed washed platelet suspension, or a chromatography fraction thereof, or autologous frozen-thawed platelet-rich plasma was added in various dilutions to freshly drawn blood anticoagulated with 3,000 USP units/1 heparin. After a 10 min incubation, the amount of protamine needed to restore the ACT to baseline ("protamine titration dose") was determined. We found that the protamine titration dose decreased in proportion to the amount of lysed platelet material added; expressed as a percentage of the total number of platelets present, each unit increase in lysed platelets produced a 1.7% ±0.8 (SD) reduction in the protamine dose needed to normalize the ACT. A heparin activity assay showed that this effect was not due to antiheparin activity of lysed platelets such as platelet factor 4 (PF4). Our data indicate that the procoagulant activity of platelet membranes reduced the sensitivity of the ACT to heparin. These findings suggest that membranous platelet microparticles may cause an inaccurate calculation, based on the ACT, of a protamine dose to reverse heparin anticoagulation in cardiopulmonary bypass procedures.

Endogenous Heparinoids Detected by anti-Xa Activity are Present in Blood during Acute Variceal Bleeding in Cirrhosis. A Prospective Study

2014 ◽  
Vol 23 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Christos Triantos ◽  
Emmanuel Louvros ◽  
Maria Kalafateli ◽  
Anne Riddell ◽  
Ulrich Thalheimer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Variceal Bleeding ◽  
Blood Cells ◽  
Venous Pressure ◽  
White Blood Cells ◽  
International Normalized Ratio ◽  
Ulcer Bleeding ◽  
Factor X ◽  
Packed Red Blood Cells ◽  
Bacterial Peritonitis

Background & Aims: Endogenous heparinoids have been detected by thromboelastography and quantified by clotting based anti-Xa activity assays in patients with cirrhosis, but their presence in variceal bleeding has not been established yet.Methods: Clotting based anti-Xa activity was measured in A) 30 cirrhotics with variceal bleeding, B) 15 noncirrhotics with peptic ulcer bleeding, C) 10 cirrhotics without infection or bleeding, and D) 10 cirrhotics with hepatocellular carcinoma (HCC).Results: Anti-Xa activity was not detected in ulcer bleeders or in cirrhotics without infection or bleedingbut was present in seven (23%) variceal bleeders (median levels: 0.03 u/mL (0.01-0.07)) and was quantifiable for 3 days in six of seven patients. Four of seven variceal bleeders with anti-Xa activity present had HCC (p=0.023). Age, creatinine, platelet count and total infections the second day from admission were significantly correlated with the presence of measureable anti-Xa levels (p=0.014, 0.032, 0.004 and 0.019, respectively). In the HCC group, anti-Xa activity was present in three patients (30%) [median levels: 0.05 u/mL (0.01-0.06)].Conclusions: In this study, variceal bleeders and 30% of the patients with HCC had endogenous heparinoids that were detected by a clotting based anti-Xa activity assay, whereas there was no anti Xa activity present in patients with cirrhosis without infection, or bleeding or HCC, nor in those with ulcer bleeding. Thus, the anti-Xa activity is likely to be a response to bacterial infection and/or presence of HCC in cirrhosis.List of abbreviations: AFP, alpha-fetoprotein; aPTT, activated partial thromboplastin time; CP, Child-Pugh; FXa, activated factor X; GAGS, glycosaminoglycans; Hb, hemoglobin; HCC, hepatocellular carcinoma; HVPG, hepatic venous pressure gradient; INR, International normalized ratio; LMWHs, low molecular weight heparins; MELD, Model for End-stage Liver Disease; PPP, platelet-poor plasma; PRBC, packed red blood cells; PT, prothrombin time; SBP, sponataneous bacterial peritonitis; TEG, thromboelastography; WBC, white blood cells.

scholarly journals Blood Donations and Transfusions during the COVID-19 Pandemic in Spain: Impact According to Autonomous Communities and Hospitals

2021 ◽  
Vol 18 (7) ◽  
pp. 3480
Author(s):  
José Antonio García-Erce ◽  
Íñigo Romón-Alonso ◽  
Carlos Jericó ◽  
José María Domingo-Morera ◽  
José Luis Arroyo-Rodríguez ◽  
...  
Keyword(s):  
Blood Cells ◽  
Blood Components ◽  
Health Ministry ◽  
State Of Emergency ◽  
Blood Donations ◽  
Autonomous Communities ◽  
Packed Red Blood Cells ◽  
Average Decrease ◽  
A Prospective Study ◽  
The Impact

Worldwide, the COVID-19 pandemic has caused a decline in blood donations, between 30% and 70% in some of the most affected countries. In Spain, during the initial eight weeks after the State of Emergency was decreed on 14 March 2020, in the weekly reports of the Health Ministry, an average decrease of 20% was observed between 11 and week 25 compared with the 2018 donation. We aimed to investigate the impact of the COVID-19 pandemic on blood donations and blood distribution in four autonomous communities, and to explore the evolution of the consumption of blood components (BCs) in ten hospitals of six autonomous communities. We performed a prospective study of grouped cohorts on the donation and distribution of blood in four regional transfusion centers in four autonomous communities in Spain, and a retrospective study of the consumption of blood components in ten hospitals in six autonomous communities. Regarding donations, there was no significant decrease in donations, with differences between autonomous communities, which started between 1 and 15 March 2020 (−11%). The increase in donations in phase II (from 26 May 2020) stands out. Regarding consumption, there was a significant reduction in the consumption of packed red blood cells (RBCs) (24.5%), plasma (45.3%), and platelets (25.3%) in the central period (16 March–10 May). The reduction in the consumption of RBCs was significant in the period from 1–15 March. Conclusions: The COVID-19 pandemic has affected the donation and consumption of BCs.

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