Objective: To describe the clinical presentation of a dog with hemolytic anemia secondary to zinc toxicosis after 1-week use of "max strength" 40% diaper rash cream.Case Summary: A 2-year-old female neutered Maltese presented for vomiting, lethargy, pigmenturia, and pale mucous membranes. "Max Strength" zinc oxide cream had been applied to the patient daily for a week prior to presentation. Clinical examination revealed light pink to pale mucous membranes and tachycardia. Hematology demonstrated large numbers of spherocytes and a strongly regenerative anemia.Plasma zinc concentrations were markedly increased. A diagnosis of hemolytic anemia secondary to subacute zinc toxicosis was made and supportive therapy was instigated.The patient ultimately recovered uneventfully. Acute or subacute zinc toxicosis resulting in hemolytic anemia is not frequently observed, and this case was also unusual in that the zinc source was diaper cream, which historically has been thought to require very large quantities to cause toxicosis.
New or Unique Information Provided:To the authors' knowledge, there is only one previously reported case of hemolytic anemia secondary to diaper cream use in a hospital setting but no previous reports involving toxicosis secondary to prolonged application at home by owners. Most commercial diaper creams contain zinc oxide, which historically was thought to have poor gastrointestinal absorption and would require a large quantity to cause significant toxicosis and hemolytic anemia. Moreover, this case emphasizes the potential risks associated with zinc oxide cream use, the significance of client education if using these creams, as well as the importance of history in elucidating the underlying cause of hemolytic anemia.
In this study, adult intact male and female (n = 10) naked mole rats (Heterocephalus glaber) were anesthetized by using a combination of ketamine (20 mg/kg IM), and alfaxalone (4.0 mg/kg IM). Induction and recovery times were recorded. Vital parameters, including heart rate, respiratory rate, and reflexes, were monitored every 5 min during the anesthetic period. Anesthetic induction was smooth and rapid. Induction time was significantly longer in male rats (median, 325 s; range, 180 to 385 s) than in females (median, 145 s; range, 118 to 180 s). In addition, overall duration of loss of righting reflex was shorter in male mole rats (median, 50 min; range, 36 to 65 min) than females (median, 70 min; range, 60 to 85 min). Males largelyhad intact withdrawal reflexes, whereas females showed variable loss of both forelimb and hindlimb withdrawal reflexes. Neither recovery time (mean ± 1 SD, 16 ± 13 min) nor vital parameters differed between sexes. None of animals showed any anesthesia-related adverse responses. According to these findings, intramuscular AK is a safe and effective protocol that provides brief, light anesthesia in male naked mole rats and deeper anesthesia in females. We recommend adding analgesics when this AK protocol is used for pain-inducing or invasive procedures, and further studies evaluating higher doses anddifferent combinations are indicated.
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