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.
Hematuria, or preputial hemorrhagic discharge, is an extremely common clinical sign; it can be associated with a wide range of diseases, including, even if only rarely, penile foreign bodies. The aim of this retrospective study was to describe the diagnosis and therapy involving migration from the preputial ostium or penile urethra of a foreign body (awn grass) embedded in the connective tissue surrounding the penis, or in deeper inguinal tissues, in dogs with hematuria or preputial hemorrhagic discharge. In the selected cases, signaling, history, clinical signs, results of laboratory exams, endoscopic and ultrasonographic evaluation, and the technique used for foreign body removal were evaluated. Dogs with hemorrhagic discharge consequent to a penile foreign body represented 2% of the entire population considered. At physical examination, the most common features were the presence of swelling of the glans and hyperemia associated with a penile fistula (4/6 dogs), and pain during penile exteriorization (3/6 dogs). Laboratory results showed mild neutrophilic leukocytosis in 2/3 dogs and reticulocytosis in 1/3 dogs. Endoscopy, performed in 2/6 dogs, did not reveal any alterations associated with passage of the foreign body. Ultrasonography was useful in reaching a definitive diagnosis, identifying the position of the grass awn in 6/6 cases and permitting its removal in all dogs using an ultrasound-guided technique. This case report suggested that penile foreign bodies are a rare, but possible, cause of hematuria or hemorrhagic discharge in male dogs, and that ultrasonography is a useful technique in the making of a differential diagnosis and removal of foreign bodies.
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