Hypertonic solutions affect platelet function and whole blood coagulation to a greater extent than saline and HES. At clinically relevant dilutions, only CTPFA was markedly more affected by hypertonic solutions than by saline. At high dilutions, HES significantly affects coagulation but to no greater extent than saline at clinically relevant dilutions.

OBJECTIVE To determine mortality rates for dogs with severe anaphylaxis and identify potential prognostic factors. ANIMALS 67 dogs with suspected anaphylaxis graded as severe. PROCEDURES Dogs were classified on the basis of outcome as survivors and nonsurvivors. Medical records were reviewed, and data were extracted including signalment, examination findings, time to hospital admission from onset of clinical signs, CBC results, serum biochemical analysis results, coagulation testing results, and findings on abdominal ultrasonography. Initial treatment within the first 6 hours after hospital admission was recorded for analysis, specifically including the use of epinephrine, diphenhydramine, corticosteroids, antimicrobials, fresh-frozen plasma, and supplemental dextrose. RESULTS The overall mortality rate was 14.9% (10/67) for dogs with anaphylaxis graded as severe. Serum phosphorus concentration and prothrombin time (PT) were significantly higher in nonsurvivors, compared with survivors. Nonsurvivors had lower presenting body temperatures than survivors. Serum phosphorus concentration ≥ 12.0 mmol/L, hypoglycemia within 6 hours after hospital admission, high PT value, concurrently high PT and partial thromboplastin time (PTT) values > 50% above the reference range limit, and the need for supplemental dextrose were associated with death. The incidences of coagulopathy and peritoneal effusion were unexpectedly high (85.2% and 65.5% of dogs, respectively) but were not indicative of survival. CONCLUSIONS AND CLINICAL RELEVANCE Despite the poor presenting clinical condition seen in dogs with severe anaphylaxis, the rate of survival with treatment was fairly high. Coagulopathy and the presence of peritoneal effusion were common findings in dogs with severe anaphylaxis. Serum phosphorus concentration ≥ 12.0 mmol/L, high PT value, concurrent increases of PT and PTT values > 50% above reference range limits, hypoglycemia within 6 hours after hospital admission, and the need for supplemental dextrose were associated with death.

Naproxen is a nonsteroidal anti-inflammatory drug with a long half-life and narrow margin of safety in dogs. Ingestion of > 5 mg/kg has been associated with adverse gastrointestinal effects, including ulceration. At doses > 10-25 mg/kg, acute kidney failure has been reported, and at doses > 50 mg/kg, neurologic abnormalities occur. This is the first reported use of IVLE for treatment of naproxen overdose with documented decrease in serum toxin concentrations shortly after administration. No long-standing gastrointestinal, renal, or neurologic effects occurred in these dogs.

A 3-year-old female spayed rat terrier presented for hyperactivity and repetitive circling to the right of less than one-hour duration. On examination, the patient was dehydrated, hyperactive, and dysphoric. Laboratory tests initially revealed elevations in creatine kinase (CK) and aspartate aminotransferase (AST). Serial chemistries indicated significant progression of CK elevation to a maximum of 181,900 U/L on day 3 along with the development of profuse myoglobinuria. A urine drug screening test was positive for amphetamine metabolites. This patient was treated with sedatives, aggressive fluid diuresis, and antioxidants. The dog recovered uneventfully with no indicators of renal dysfunction based on serial blood chemistries and was discharged five days after presentation. Follow-up blood chemistries taken four days after discharge revealed near normalization of CK and resolution of myoglobinuria. This case report describes a particularly severe case of rhabdomyolysis associated with amphetamine toxicity and its successful treatment.