Electrolyte Derangements, Hyperlactatemia, and Cardiac Abnormalities Secondary to Refeeding in Three Dogs: Case Report

Author(s):  
Catherine Crecraft ◽  
Jennifer Prittie

ABSTRACT Three dogs that presented to the emergency service in severely emaciated body conditions were admitted to the hospital for monitoring and refeeding. During their hospitalization, all three dogs developed electrolyte derangements or required supplementation to prevent hypophosphatemia and hypomagnesemia. Additionally, all dogs developed hyperlactatemia, which was suspected to be secondary to thiamine deficiency. Two dogs were reported to have cardiac abnormalities, including cardiac arrhythmias, systolic dysfunction, and spontaneous echogenic contrast. These cases highlight the complexity of refeeding syndrome and its associated complications that extend beyond electrolyte deficiencies.

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098667
Author(s):  
Alberto Lo Gullo ◽  
Carmela Rifici ◽  
Santina Caliri ◽  
Antonina Donato ◽  
Maria Cristina De Cola ◽  
...  

Refeeding syndrome can occur in malnourished patients with acute pancreatitis who have electrolyte imbalances. Refeeding syndrome is characterized by severe electrolyte imbalances (mainly hypophosphatemia, hypomagnesemia, and hypokalemia), vitamin deficiency (mainly thiamine deficiency), fluid overload, and salt retention resulting in organ dysfunction and cardiac arrhythmias. We herein report a case involving a patient with severe pancreatitis and gallbladder stones who developed refeeding syndrome with shock and loss of consciousness. The patient was treated by opportune vitamin and electrolyte supplementation therapy and showed substantial improvement after 2 weeks of hospitalization, gaining the ability to eat small bites of solid food orally. Early diagnosis and treatment of refeeding syndrome may reduce morbidity and mortality in patients with acute pancreatitis. Patients should be fasted only if alimentation is contraindicated, and electrolyte values must be closely monitored.


Psihiatru ro ◽  
2019 ◽  
Vol 58 (3) (1) ◽  
pp. 18-20
Author(s):  
Cătălina Crişan ◽  
Laura Grosu ◽  
Oana Vanţa

Gayet-Wernicke encephalopathy is an acute neuropsychiatric condition caused by thiamine deficiency. Only a small percentage of patients experience all three symptoms, with ophtalmoplegia, ataxia and confusion, and the full triad occurs more frequently among those who have overused alcohol. The evolution is toward full recovery, Korsakoff syndrome, dementia or death. We present the case of a 56-year-old patient, known with a diagnostic of alcoholism, who was admitted for a complicated withdrawal syndrome with delirium and who developed encephalopathy and dementia syndrome.


2020 ◽  
Vol 16 (3) ◽  
pp. 241-246
Author(s):  
Dipesh Ludhwani ◽  
Belaal Sheikh ◽  
Vasu K Patel ◽  
Khushali Jhaveri ◽  
Mohammad Kizilbash ◽  
...  

Background: Takotsubo Cardiomyopathy (TTC) is an uncommon cause of acute reversible ventricular systolic dysfunction in the absence of obstructive Coronary Artery Disease (CAD). Typically manifesting as apical wall ballooning, TTC can rarely present atypically with apical wall sparing. Case report: A 62-year-old female presented with complaints of chest pain and features mimicking acute coronary syndrome. Coronary angiogram revealed no obstructive CAD and left ventriculogram showed reduced ejection fraction, normal left ventricular apex and hypokinetic mid-ventricles consistent with atypical TTC. The patient was discharged home on heart failure medications and a follow-up transthoracic echocardiogram demonstrated improved left ventricular function with no wall motion abnormality. Conclusion: This case report provides an insight into the diagnosis and management of TTC in the absence of pathognomic features.


2020 ◽  
Vol 173 (1) ◽  
pp. 72-73 ◽  
Author(s):  
Jorge C. Kattah

2017 ◽  
Vol 41 (S1) ◽  
pp. S517-S517
Author(s):  
A. Adrián ◽  
C. Noval Canga ◽  
H. Rebeca ◽  
S. Isabel ◽  
G. Sofía ◽  
...  

ObjectivesShow with a case report how psychiatric pathology may face differential diagnosis problems when sociocultural aspects are involved.Methods and materialsSeventy-three year old man, born in Colombia. During the last two months, he had come many times to the emergency service due to behavioural changes. He does not have previous psychiatric history. His daughter refers that one of the patient's sisters has been diagnosed of “mystical madness”. The previous days he abandoned his medical treatment saying that he “gets in touch with his wife and that he wants to meet her”. Since his wife's dead, he had presented an excessively adapted behaviour, without grief symptoms. The first hospitalization day he said we wanted to get married with one of his daughters, with a sexual content speech, being able to get emotional when he spoke about his dead wife. Now the patient is under frequent reviews, and it is thought the differential diagnosis of depression with psychotic symptoms, due to the lack of symptoms remission.ConclusionWhenever we face different psychiatric diagnosis we don’t keep in mind some sociocultural factors, which could be masked and raise different doubts. It is important to keep in mind that each country or ethnical have their own cultural habits which are going to deeply influence patient's personality.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Gamaliel Vázquez Estudillo ◽  
Junior J. Araiza Navarro ◽  
Martin F. Tellez Romero ◽  
Rogelio Mata Cruz ◽  
Ivanhoe Larracilla Salazar ◽  
...  

The exact incidence of round ligament varicosities (RLV) is uncertain, due to the fact that there are few cases reported in the literature, and in many cases, they can be confused with inguinal hernias. A 26-year-old female with 26.3 weeks of gestation by date of last menstruation, who went to the emergency service of the Naval Regional Hospital of Tampico with the presence of an increase in volume in the left inguinal region, accompanied by pain, which increased standing and decreasing with the dorsal decubitus, the physical examination confirmed an increase in volume at the left inguinal level. An ultrasound of the inguinal region was requested to rule out an inguinal hernia as the first diagnosis, Doppler ultrasound revealed RLV. The patient was treated conservatively and at two weeks after the resolution of the pregnancy, the RLV presented a spontaneous regression and her symptoms completely resolved. This is the first case of round ligament varicosities reported in present institution. It is important to be aware of this pathology, to perform extension studies (Doppler ultrasound) to avoid unnecessary surgery in pregnant women.


2017 ◽  
Vol 41 (S1) ◽  
pp. S540-S540
Author(s):  
D. Pereira ◽  
I. Carreira Figueiredo ◽  
M. Marinho ◽  
R. Fernandes ◽  
V. Viveiros

IntroductionAlthough rarely reported, antidepressant discontinuation may induce hypomania or mania even in the absence of bipolar disorder [1,2].ObjectivesWe report two cases of antidepressant withdrawal induced mania.MethodsClinical process consultation and PubMed search were performed in November 2016 using the search keywords antidepressant, mania and discontinuation.ResultsCase report 1: a dysthymic 60 years old woman with 20 years of psychiatric following had been treated with venlafaxine 150 mg/daily the past year. She abruptly stopped taking this drug, developing heightened mood, irritability and racing thoughts five days later. She was admitted at our hospital, initiating then valproate and antipsychotics. Two weeks later, the hypomania clinical state remitted completely.Case report 2: a 64 years old woman, with a 12-year-old diagnosis of unipolar depression was brought to our emergency service with complaints of disorganized behavior, paranoid delusional ideas, excessive speech, irritable mood and reduced need for sleep, 1 week after abrupt trazodone 150 mg/daily discontinuation. Valproic acid 1000 mg/daily and olanzapine 20 mg/daily were introduced, with gradual improvement of symptoms. Two weeks later she was completely asymptomatic.ConclusionPsychiatrists should be aware of the risk of antidepressant withdrawal induced mania. More studies should be conducted about this subject, aiming for the clarification of risk factors and the establishment of clinical criteria for this phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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