Thirty‐six dogs with aortic thromboembolism were identified in a retrospective study conducted using case material from the small animal necropsy service of the University of Pennsylvania, from 1977 through 1992. No age, breed, or sex predisposition was found. Thirty dogs presented with primary complaints referable to the aortic thromboembolus and the duration of signs varied from hours to months. In 16 dogs, the presence of the thromboembolus was confirmed antemortem by ultrasound or angiography. Coagulograms were performed in 11 animals, and were consistent with consumptive hemostatic disorders in 8. The aortic occlusions were determined to be emboli in 11 dogs, associated with cardiac disease (9 dogs) and neoplastic emboli (2 dogs). In 18 dogs, the aortic occlusions were determined to be caused by primary aortic thrombi. Nine of these dogs had renal disease and four dogs had severe atherosclerosis associated with thyroid disease. In seven dogs, it could not determined if the aortic occlusions were due to primary aortic thrombi or due to emboli. In 25 dogs, the aorta was the only vessel occluded; but in 11 dogs, thrombi were identified in vessels outside of the systemic arterial system. In 9 dogs, the pulmonary arteries contained thromboemboli; one dog had thrombi in the portal vein and pulmonary arteries, and one dog a cranial vena caval thrombus. Nine of 11 dogs with multiple vascular thrombi, as well as some of the dogs with primary aortic thrombi, may have had either a propensity for thrombosis (a hypercoagulable state) or an inability to lyse thrombi (a hypothrombolytic state).
The new SPI2 objectively stratified clinical patients into groups according to severity of disease. This index could provide an important tool for clinical research.
Prognosis depends on the severity of disease, which in turn depends on both organism and host factors. Clinical syndromes associated with a poorer prognosis include red biliary syndrome, acute renal failure, acute respiratory distress syndrome, neurologic dysfunction, acute pancreatitis, cardiac dysfunction, and hypoglycemia.
Hypercoagulability was prevalent in dogs with PLN but could not be predicted based upon the presence or degree of proteinuria, systemic arterial hypertension, hypoalbuminemia, or low AT activity. The prevalance of thromboembolism was low in this population with PLN.
Three dogs were examined because of acute pancreatitis. In all 3, distension of the gallbladder was seen ultrasonographically, and extrahepatic biliary tract obstruction (EHBO) was diagnosed on the basis of ultrasonographic findings and serum biochemical abnormalities (i.e., high serum bilirubin and cholesterol concentrations and increased hepatic enzyme activities). In all 3 dogs, percutaneous ultrasound-guided cholecystocentesis (PUCC) was used to decompress the gallbladder, with cholecystocentesis performed multiple times in 1 dog. Serum bilirubin concentration was substantially decreased following the procedure in all 3 dogs. Two of the 3 dogs did not require surgery to resolve the obstruction. In the third dog, an exploratory laparotomy was performed because of concerns about development of abdominal effusion following the procedure. Bile staining of the mesenteric fat was seen during the laparotomy, but no defect in the gallbladder wall could be identified. In most dogs with EHBO secondary to pancreatitis, the obstruction resolves spontaneously as the acute pancreatitis improves so that surgery is not required. In those few dogs in which EHBO does not resolve or in which EHBO results in complications, therapeutic PUCC may be useful in relieving gallbladder distension.
Objective: This report describes the perioperative management of a dog with a right adrenal pheochromocytoma that presented with acute retroperitoneal hemorrhage, cardiac arrhythmia and hypertension. Additionally, a summary of pheochromocytoma and the idiosyncrasies of perioperative management of a pheochromocytoma are provided. Summary: A 7-year old male, neutered, Dalmation was presented for acute collapse, abdominal pain and tachycardia. Physical examination findings were consistent with hypoperfusion concurrent with multiple cardiac arrhythmias and hypertension. Abdominal ultrasound revealed retroperitoneal effusion and a right adrenal mass intimately associated with the caudal vena cava. Incomplete right adrenalectomy was performed. Histopathology confirmed a pheochromocytoma. Unique information provided: To the authors' knowledge, this is the first definitive report of acute retroperitoneal hemorrhage as the initial clinical manifestation of histologically confirmed adrenal pheochromocytoma in the dog. (J Vet Emerg Crit Care 2001; 11(3): 221-227)
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