Surgical treatment of dogs with OACSM resulted in neurologic improvement and was associated with a good long-term outcome. For dogs that received medical treatment, neurologic deterioration continued but some patients did well for several years.

Seizures are a common cause of neurologic disease, and phenobarbital (PB) is the most commonly used antiepileptic drug. Chronic oral dosing can be challenging for cat owners, leading to poor compliance. The purpose of this study was to determine if the transdermal administration of PB could achieve serum PB concentrations of between 15 and 45 μg/ml in healthy cats. Nineteen healthy cats were enrolled in three groups. Transdermal PB in pluronic lecithin organogel (PLO) was applied to the pinnae for 14 days at a dosage of 3 mg/kg q12h in group 1 (n = 6 cats) and 9 mg/kg q12h in group 2 (n = 7 cats). Transdermal PB in Lipoderm Activemax was similarly applied at 9 mg/kg q12h for 14 days in group 3 (n = 6 cats). Steady-state serum PB concentrations were measured at trough, and at 2, 4 and 6 h after the morning dose on day 15. In group 1, median concentrations ranged from 6.0-7.5 μg/ml throughout the day (observed range 0-11 μg/ml). Group 2 median concentrations were 26.0 μg/ml (observed range 18.0-37.0 μg/ml). For group 3, median concentrations ranged from 15.0-17.0 μg/ml throughout the day (range 5-29 μg/ml). Side effects were mild. One cat was withdrawn from group 2 owing to ataxia and sedation. These results show therapeutic serum PB concentrations can be achieved in cats following chronic transdermal administration of PB in PLO at a dosage of 9 mg/kg q12h. More individual variation was noted using Lipoderm Activemax. Transdermal administration may be an alternative for cats that are difficult to medicate orally.

Although thoracolumbar myelopathy in rabbits is commonly secondary to vertebral fracture, vertebral synovial cysts should be considered a differential diagnosis for rabbits with slowly progressive paraparesis. Decompressive surgery and stabilization can result in a good outcome for rabbits with this condition.

Objective: Review the literature regarding the use of recombinant human erythropoietin (rHuEPO) to prevent red blood cell (RBC) transfusion in critically ill patients. Data sources: A computerized search of MEDLINE and EMBASE from 1966 through June 2003 was conducted using the terms erythropoietin, anemia, hemoglobin, critical care, intensive care, surgery, trauma, burn, and transfusion. References of selected articles were reviewed. A manual search of critical care, surgery, trauma, burn, hematology, and pharmacy journals was conducted to identify relevant abstracts. Results: Six randomized studies have evaluated exogenous administration of erythropoietin to prevent RBC transfusions in critically ill patients. Studies vary with respect to rHuEPO dosage regimens, dose of concurrently administered iron, patient characteristics, and transfusion thresholds. Administration of rHuEPO rapidly produces erythropoiesis to reduce the need for RBC transfusions. The largest study conducted to date used weekly rHuEPO administration and found a modest decrease in transfusion requirements although the time to first transfusion was delayed. Reduced intensive care unit (ICU) length of stay (LOS) was shown in only one study of surgical/trauma patients. Reduced LOS after ICU discharge was found in another study of severely ill patients (APACHE II score >22). Other clinical outcomes were not altered by rHuEPO use. No adverse events were associated with rHuEPO use although studies were not designed to evaluate safety.Conclusions: rHuEPO reduces the need for transfusions. A cost-effectiveness analysis of rHuEPO for this indication is needed. Defining an optimal dosage regimen, identifying patients most likely to respond to rHuEPO, and determining risk factors for ICU associated anaemia would provide information for appropriate rHu-EPO utilization.

Aims-To test aripiprazole for efficacy in decreasing use in methamphetamine-dependent adults, compared to placebo.Design-Participants were randomized to receive 12 weeks of aripiprazole or placebo, with a 3 month follow-up and a platform of weekly 30-minute substance abuse counseling. Setting-The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health.Participants-Ninety actively-using, methamphetamine-dependent, sexually active, adults were recruited from community venues.Measurements-The primary outcome was regression estimated reductions in weekly methamphetamine-positive urines. Secondary outcomes were study medication adherence (by self-report and medication event monitoring systems [MEMS]), sexual risk behavior, and abstinence from methamphetamine. COMPETING INTERESTSAll authors declare that they have no competing interests. AUTHORS' CONTRIBUTIONSPC directed study activities, participated in the interpretation of data, and drafted the manuscript. GS participated in study design, performed the statistical analysis and interpretation of data, and participated in drafting of the manuscript. MD participated in study design and coordination, and interpretation of data. DS coordinated the study, participated in study design, acquisition and interpretation of data, and participated in study activities. SH participated in the acquisition and interpretation of data. TM participated in study design and in study activities. JG participated in the design of the study. EV participated in the design of the study and the statistical analysis and interpretation of data. GC conceived and designed the study and participated in the conduct of the study and interpretation of data. All authors participated in the revision of the manuscript for important intellectual content and provided approval of the final version of the manuscript. Declarations of interest:The study was funded by a National Institute on Drug Abuse grant, 1 R01 DA023387-01. The funder did not play any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; nor in the preparation, review, or approval of the manuscript. Conclusion-Compared with placebo, aripiprazole did not significantly reduce methamphetamine use among actively-using, dependent adults. NIH Public Access