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Use of blood and blood products.

It is sometimes necessary for the practitioner to transfuse the ruminant with whole blood or plasma. These techniques are often difficult to perform in practice and are time-consuming, expensive, and stressful to the animal. Acute loss of 20-25% of the blood volume will result in marked clinical signs of anemia, including tachycardia and maniacal behavior. The PCV is only a useful tool with which to monitor acute blood loss after intravascular equilibration with other fluid compartments has occurred. An acutely developing PCV of 15% or less may require transfusion. Chronic anemia with PCV of 7-12% can be tolerated without transfusion if the animal is not stressed and no further decline in erythrocyte mass occurs. Seventy-five per cent of transfused bovine erythrocytes are destroyed within 48 hours of transfusion. A transfusion rate of 10-20 ml/kg, recipient weight, is necessary to result in any appreciable increase in PCV. A nonpregnant donor can contribute 10-15 ml of blood/kg body weight at 2-4 week intervals. Sodium citrate is an effective anticoagulant, but acid citrate dextrose should be used if blood is to be stored for more than a few hours. Blood should not be stored more than 2 weeks prior to administration. Heparin is an unsuitable anticoagulant because the quantity of heparin required for clot-free blood collection will lead to coagulation defects in the recipient. Blood crossmatching is only rarely performed in the ruminant. In field situations, it is advisable to inject 200 ml of donor blood into the adult recipient and wait 10 minutes. If no reaction occurs, the rest of the blood can probably be safely administered as long as volume overload problems do not develop. Adverse reactions are most commonly seen in very young animals or pregnant cattle. Signs of blood or plasma transfusion reaction include hiccoughing, tachycardia, tachypnea, sweating, muscle tremors, pruritus, salivation, cough, dyspnea, fever, lacrimation, hematuria, hemoglobinuria, collapse, apnea, and opisthotonos. Intravenous epinephrine HCl 1:1000 can be administered (0.2 to 0.5 ml) intravenously or (4 to 5 ml) intramuscularly if clinical signs are severe. Pretreatment with antipyretics and slowing the administration rate may decrease the febrile response. Blood or plasma administered too rapidly will also result in signs of cardiovascular overload, acute heart failure, and pulmonary hypertension and edema. Furosemide and slower administration of blood or plasma should alleviate this problem.(ABSTRACT TRUNCATED AT 400 WORDS)

Anemia↗

Plants causing sudden death in livestock.

A number of plants are capable of producing intoxication of sufficient severity as to cause death within 12 hours of the onset of clinical signs. Those most rapid in their lethal effects are the cyanogenic plants and yew. Nitrate-accumulating plants likewise are capable of causing sudden death with only a brief appearance of signs. Most toxic plants, however, typically either require a longer time for the intoxication to develop and become lethal or sudden death is the exception rather than the rule following ingestion. In these cases, diagnosis of the problem may be facilitated by recognition of arrays of clinical signs that appear. Seven major groups of presenting signs can be distinguished: dyspnea and polypnea, hemorrhage, prominent excessive muscular activity, depression and/or weakness, diarrhea and weakness, excessive salivation and/or regurgitation and/or colic, and weakness and incoordination and/or tremors. Based on these and accompanying signs in surviving animals, many of the causes of sudden death can be differentiated. In addition, pathological changes visible on necropsy and identification of plant fragments in the rumen and stomach may be of diagnostic value.

Animals↗

Organophosphorus and carbamate insecticide poisoning in large animals.

Organophosphorus and carbamate insecticides are used commonly in agriculture to control pests of crops and animals. These compounds are toxic and livestock poisoning has occurred from mistaken addition of unused insecticide to feeds and animal access to improperly disposed of materials or "empty" containers. The morbidity rate approximates a third of animals exposed and about half of those affected die. Organophosphorus and carbamate insecticides generate their toxic effects by bonding to and inhibiting ChE enzymes (most importantly, AChE), which are responsible for breaking down the neurotransmitter ACh. The accumulation of ACh results in uninhibited impulse transmission at the cholinergic endings, including autonomic preganglionic junctions, certain neurons in the central nervous system, and motor nerves to the skeletal muscles. This eventually leads to fatigue of end organs; death usually is a result of respiratory failure. The "delayed neuropathy syndrome" is caused by some OP insecticides, but the pathophysiology of this syndrome does not involve the inhibition of ChE and accumulation of neurotransmitter. Over 100 anticholinesterase insecticides are in use. Variations in toxicity exist among these compounds, but larger diversities exist in the likelihood of poisoning because of differences in formulations, solvents, and conditions of use. Young animals usually are more sensitive than adults. Some of these agents are among the most toxic of manmade chemicals. These insecticides generally do not accumulate in tissues. The "chronic" effects depend on accrued physiological changes from frequent exposure to nonlethal doses. Clinical signs occur within minutes to a few hours and include the muscarinic signs of salivation, excessive lacrimation, frequent urination, and diarrhea. Concurrent nicotinic effects include muscular tremors followed by weakness and paralysis. Topical exposure results in similar poisoning but the onset of clinical signs may be delayed. Certain pour-on insecticides may cause a delayed (more than a week) syndrome in some breeds. Diagnosis of OP or carbamate insecticide poisoning is made by (1) interpretation of clinical signs and history that are consistent with this poisoning, (2) detection of the chemical compound in stomach or rumen contents and tissues, and (3) demonstration of the adverse biological effect, ChE inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Listeriosis.

The signs of bovine listeriosis include depression and variable cranial nerve deficits indicative of brain stem inflammation. Because a wide range of cranial nerve deficits exists in bovine listeriosis patients, a thorough neurologic examination and cerebrospinal fluid analysis are essential to accurate diagnosis. Treatment should consist of intensive antibiotic therapy owing to the intracellular location of the causative organisms and should also address metabolic acidosis in those patients with loss of buffer because of excessive salivation. The public health implications of bovine listeriosis require the veterinarian to protect all persons attending the bovine patient affected with listeriosis.

Animals↗

Oral pilocarpine for the treatment of keratoconjunctivitis sicca with central corneal irregularity.

A 31-year-old female physician with bilateral myopia had unilateral myopic laser in situ keratomileusis in the right eye. The patient was overcorrected with the initial treatment and had 2 subsequent hyperopic treatments, resulting in central corneal irregularity. During the course of treatment, the patient was diagnosed with Sjögren's syndrome with marked keratoconjunctivitis sicca. The patient had anisometropia, aniseikonia, and monocular diplopia and was unable to tolerate contact lenses. Oral pilocarpine (Salagen) was prescribed, which improved salivation, lacrimation, and keratoconjunctivitis sicca. The patient was able to tolerate rigid gas-permeable contact lenses to achieve 20/20 visual acuity in both eyes and regain binocular vision.

Administration, Oral↗

Evidence for a glutamatergic input to pontine preganglionic neurons of the superior salivatory nucleus in rat.

Parasympathetic preganglionic neurons of the superior salivatory nucleus (SSN), which projects to the pterygopalatine ganglion (PPG), modulate salivation, lacrimation, and cerebrovascular tone. Our previous studies suggest that excitatory projections from the nucleus tractus solitarii modulate cerebrovascular tone by actions on SSN neurons. In this study we sought to test the hypothesis that N-methyl-D-aspartate (NMDA) type glutamate receptors and vesicular glutamate transporters (VGLUT) are present in the SSN and that SSN neurons receive glutamatergic input. In six rats we injected tetramethylrhodamine dextran (TRD), a fluorescent tracer, unilaterally into the PPG to label SSN neurons. Four days later, rats were perfused and brain stem sections containing the SSN were processed for fluorescent immunohistochemistry for N-methyl-D-aspartate receptor subunit 1 (NMDAR1) and vesicular glutamate transporters (VGLUT1 and VGLUT2). Confocal laser scanning microscopy showed that 88+/-3% of TRD-labeled SSN neurons contained NMDAR1-immunoreactivity (IR). The surrounding neuropil contained numerous fibers labeled for VGLUT2-IR, but not VGLUT1-IR. Double fluorescent immunohistochemistry for NMDAR1 and VGLUT2 revealed that fibers containing VGLUT2-IR were often in close proximity to cell bodies or proximal dendrites of TRD-labeled SSN neurons that were positive for NMDAR1-IR. These studies support our hypothesis that NMDA receptors and VGLUT are present in the SSN. They further provide support for the suggestion that there are glutamatergic inputs to SSN neurons and would be consistent with an excitatory input that could regulate cerebrovascular tone.

Animals↗

Dose-response and time-course of neurobehavioral changes following oral chlorpyrifos in rats of different ages.

Young rats have been shown in several laboratories to be more sensitive to the neurotoxic effects of acute exposure to chlorpyrifos. To examine the neurobehavioral effects of chlorpyrifos as a function of age and dose, we conducted dose-response and time-course assessments in rats of three different ages (postnatal day, or PND, 17, 27, and adults). Doses were selected to span the effective dose range in each age group: PND17 - 4, 10, 20 mg/kg; PND27 - 10, 25, 50 mg/kg; adult - 10, 50, 100 mg/kg. Rats were tested at the time of peak effect on the day of dosing, and again at 1 and 3 days, and at 1 and 2 weeks after a single oral dose. There were age- and sex-related differences in the recovery of these behavioral effects; the adult males recovered from the behavioral effects more quickly than the other age groups, and the adult females showed the slowest recovery (up to at least 3 days). Although these doses had been shown previously to produce a similar degree of cholinesterase inhibition, the neurobehavioral alterations fell into the following three patterns of effect as a function of age. (1) Some endpoints (e.g., gait abnormalities, tremor) showed a dose-response curve that was shifted to the right in the older animals. Calculated ED50 values indicated that the PND17 rats were three- to five-fold more sensitive than the adults. (2) Some measures showed less effect in the youngest rats; for example, maximal motor activity decreases were half as great as with adults. (3) A few effects that were typically observed in adults, e.g., salivation, were not seen at all in the PND17 rats. Thus, differential responses on these neurobehavioral endpoints were observed as a function of age. These data suggest that, for some endpoints, young rats are more sensitive to a range of chlorpyrifos doses; however, the magnitude of age-related differences depends on the specific endpoint and time of assessment, as well as age and sex of the test subject.

Administration, Oral↗

Muscarinic supersensitivity and impaired receptor desensitization in G protein-coupled receptor kinase 5-deficient mice.

G protein-coupled receptor kinase 5 (GRK5) is a member of a family of enzymes that phosphorylate activated G protein-coupled receptors (GPCR). To address the physiological importance of GRK5-mediated regulation of GPCRs, mice bearing targeted deletion of the GRK5 gene (GRK5-KO) were generated. GRK5-KO mice exhibited mild spontaneous hypothermia as well as pronounced behavioral supersensitivity upon challenge with the nonselective muscarinic agonist oxotremorine. Classical cholinergic responses such as hypothermia, hypoactivity, tremor, and salivation were enhanced in GRK5-KO animals. The antinociceptive effect of oxotremorine was also potentiated and prolonged. Muscarinic receptors in brains from GRK5-KO mice resisted oxotremorine-induced desensitization, as assessed by oxotremorine-stimulated [5S]GTPgammaS binding. These data demonstrate that elimination of GRK5 results in cholinergic supersensitivity and impaired muscarinic receptor desensitization and suggest that a deficit of GPCR desensitization may be an underlying cause of behavioral supersensitivity.

Analgesics↗

[On the subject of the cyclic vomiting syndrome].

The cyclic vomiting syndrome is defined by episodes of vomiting lasting from hours to days with free intervals between episodes. Various symptoms can be associated with vomiting: nausea, abdominal pain, photophobia, fever, pallor, dehydratation, excess salivation, social withdrawal. Some factors often precipitate the crisis: infection, psychological stresses, menstruation. Excluding a medical condition, especially a gastro-intestinal or a neurological disease is compulsory for the diagnostic of cyclic vomiting syndrome. The cyclic vomiting syndrome shares many common features with migraine including treatment. Due to negative paraclinical testing, a psychiatric disease is often suspected in these children. Pathophysiology of cyclic vomiting syndrome is unknown. As for migraine, mitochondrial and ionic channels abnormalities are thought to play a role. Overactivation of hypothalamic-pituitary-adrenal axis and autonomic dysfunction seem to be involved too. Three clinical vignets will illustrate these aspects.

Adolescent↗

An outbreak of Streptococcus equi ssp. zooepidemicus infection of probable human origin in Wanderoos (Macaca silenus)--case report.

Three out of ten young to adult wanderoos (M. silenus) of a breeding colony at the Rheine Zoo died within two days from a peracute illness, characterized by salivation, vomiting, apathy and minor CNS symptoms. Streptococcus equi ssp. zooepidemicus was isolated in pure cultures from all organs of two animals investigated bacteriologically. The strains were penicillin-susceptible, and penicillin treatment of all remaining animals cured two already sick animals and prevented further cases. A volunteer worker with upper respiratory disease was suspected as source of infection; contact with equine materials and rodents could be excluded.

Animals↗

Removal of the laryngeal mask airway in children: deep anesthesia versus awake.

STUDY OBJECTIVE: To compare the incidence of adverse airway events identified with removal of the laryngeal mask airway (LMA) from an awake child or from a child before his or her airway reflexes had returned. DESIGN: Prospective, randomized study. SETTING: University-affiliated children's hospital. PATIENTS: 333 ASA physical status I and II patients ages 1.5 to 15 years undergoing elective surgery. INTERVENTIONS: At the time of removal of the LMA at the end of surgery, patients were anesthetized or had intact airway reflexes. MEASUREMENTS AND MAIN RESULTS: Any airway problems occurring within 15 minutes of LMA removal were recorded. These problems included airway obstruction (laryngeal spasm and biting of the LMA), peripheral hemoglobin oxygen saturation less than 90%, stridor requiring manipulation of the airway, vomiting, retching, and excessive salivation. Airway problems occurred after LMA removal among 23 children who had their LMA removed prior to return of airway reflexes, and among 13 subjects who had their LMA removed after the return of airway reflexes. CONCLUSION: Removal of the LMA during anesthesia and after return of airway reflexes results in a similar incidence of airway problems in children.

Adolescent↗

Total intravenous anesthesia with ketamine for pediatric interventional cardiac procedures.

OBJECTIVE: To evaluate the safety and efficacy of ketamine in pediatric patients undergoing interventional cardiac procedures. DESIGN: A retrospective clinical study. SETTING: A single, tertiary referral center. PARTICIPANTS: Patients (n = 107) undergoing interventional cardiac procedures between July 1996 and July 1998. INTERVENTIONS: Each patient received a bolus of ketamine, 1 mg/kg intravenously, followed by an infusion of 50 to 75 microg/kg/min for the duration of the procedure. MEASUREMENTS AND MAIN RESULTS: Hemodynamic and respiratory parameters were noted. All patients were breathing spontaneously. Average infusion dose of ketamine was 51.40+/-3.54 microg/kg/min (mean +/- standard deviation). Increases in heart rate and mean arterial pressure by more than 20% from baseline values were seen in 10 and 9 patients, respectively. Transient apnea and excessive salivation were seen in two patients each. Excessive movement of extremities was seen in six patients. There were no episodes of unpleasant dreams or hallucinations. There were two deaths (1.9%) related to the interventional procedures. CONCLUSION: The technique described is a simple, safe, and effective method for anesthetizing children in the cardiac catheterization laboratory for interventional procedures.

Adolescent↗

Experimental comparison of ketamine with a combination of ketamine, butorphanol and medetomidine for general anaesthesia of the Eurasian badger (Meles meles L.).

The refinement of anaesthetic regimes is central to improving the welfare of captured wildlife. The Eurasian badger (Meles meles) has been the subject of an intensive long-term ecological and epidemiological study at Woodchester Park, Gloucestershire, England. During routine trapping operations (June 21st, 2000-January 23rd, 2001) an experimental trial was conducted on 89 badgers to compare the physiological effects of anaesthesia using ketamine hydrochloride alone, and in conjunction with medetomidine hydrochloride and butorphanol tartrate. The mixture induced a significantly longer period of anaesthesia, and either substantially reduced or eliminated the adverse effects associated with ketamine anaesthesia (e.g., excessive salivation, bouts of sneezing, rough recoveries, and muscle rigidity). In a sub-sample of badgers given the mixture, anaesthesia was reversed using atipamezole hydrochloride. Under ketamine anaesthesia, heart rates were initially significantly higher and respiration rates were consistently higher, than in badgers given the mixture. In all badgers heart rates declined and respiration rates increased during anaesthesia, but the rate of change was greatest in animals given only ketamine. Overall, the mixture provided a more balanced anaesthesia characterised by muscle relaxation and complete unconsciousness.

Anesthesia, General↗

Autonomic dysfunction in Parkinson's disease: a comprehensive symptom survey.

BACKGROUND: Autonomic dysfunction occurs in Parkinson's disease (PD), but few studies have addressed it in a comprehensive manner. METHODS: Autonomic symptoms were evaluated by a questionnaire in sixty-eight subjects (44 patients and 24 controls). RESULTS: PD patients experienced higher frequency and severity of autonomic dysfunction. When all autonomic symptoms were pooled into an aggregate score, differences between patients and controls were highly statistically significant (p<0.0001). 'Increased salivation', 'frequency of dysphagia', decreased 'BM (bowel movement) frequency', i.e. constipation, and 'orthostatic dizziness' were more frequent in PD patients (p<0.05). A prediction model to determine the predictors of autonomic dysfunction was unsuccessful. CONCLUSION: Differences in the prevalence of autonomic symptoms in PD and non-parkinsonian controls are apparent from this study.

Aged↗

Overweight children overeat after exposure to food cues.

Overweight is becoming more common in children, but we know nearly nothing about the eating behavior of overweight children. Learning theory predicts that overeating follows from learned associations between the smell and taste of palatable food on the one hand and intake on the other hand. It was tested whether overweight children overeat after confrontation to these cues. They indeed failed to regulate food intake after both the exposure to the intense smell of tasty food (without eating it) and after eating a small preload of appetizing food, whereas normal-weight children decreased their intake after both cues. Overweight children are thus more vulnerable to triggers of overeating. Their overeating was not related to psychological factors like mood, body esteem, and a restrained eating style, but it was related to cue-elicited salivation flow. Apart from supporting the cue reactivity model of overeating, the data point to an interesting satiety phenomenon in normal eaters after prolonged and intense smelling palatable food without eating it.

Journal Article↗

Energy exchanges associated with eating and rumination in sheep given grass diets of different physical forms.

1. Energy exchanges and other physiological functions associated with eating and rumination were determined in four experiments. Sheep were given chopped, dried grass (DGC), pelleted, dried grass (DGP) or fresh grass (FGC). 2. In Expt I a preliminary study was made using all three diets. The dry matter (DM) of DGP was eaten significantly faster than that of chopped diets. Sheep salivated most during eating and ruminated longest when given DGC. Rates of contraction for the reticulo-rumen did not differ significantly between diets during idling and rumination, but were significantly faster during eating with DGP. The apparent energy costs of eating were 17, 109 and 176 kJ/kg DM eaten for DGP, DGC and FGC respectively, but these probably underestimated the true energy cost. 3. Expt 2 compared DGP and DGC at two levels of intake. The mean energy costs of eating DGP and DGC were 23.5 and 267 kI/kg DM respectively. The mean energy costs of eating between the energy cost of eating and the duration of the meal. The proportion of time the sheep spent ruminating DGC was about 23% but less than 1% for DGP. There was no significant relationship between heat production and the time spent ruminating. 4. In Expt 3 four sheep were offered fresh grass and, later, an equivalent DM intake after the material had been dried. The sheep ate the dried meal significantly faster. The mean energy costs of eating were 208 and 346 kJ/kg DM for DGC and FGC respectively. In this experiment the sheep ruminated significantly longer when given FGC, and the energy cost of rumination was 0.11 kJ/min. 5. Increases in heat production during and after fistula-feeding only 2-8% of those obtained during eating, indicating that nearly all the increase in heat production during eating could be attributed to the energy cost of eating per se. 6. The contribution of the energy costs of eating and rumination to the heat increment of feeding and the energy requirement for maintenance of sheep are discussed.

Animal Feed↗

Epilepsy with reversible bulbar dysfunction.

In patients with focal epilepsy, focal neurological dysfunction can occur due to status epilepticus and also as a post-ictal phenomenon. Bulbar dysfunction as evident by drooling, dysarthria, swallowing difficulties, and palatal-glossalpharyngeal weakness has been reported in conjunction with epilepsy. This is non-progressive and is correlated in its severity with the frequency of seizures. Accompanying EEG discharges are often localized to rolandic areas that cortically represent oral movements and salivation. We report a 6-year-old male and a 6 1/2-year-old female with progressive bulbar dysfunction resulting from epilepsy. Ictal EEGs in patient 1 did not confirm a diagnosis of epilepsy. With no evidence of a cortical or brainstem focus from EEG or MRI, it is very difficult to explain the mechanism of bulbar dysfunction. The complete restoration of bulbar function after treatment with antiepileptic drugs demonstrates the need to consider epilepsy in similar clinical situations.

Anticonvulsants↗

Role of irradiation in the suppression of parotid secretions.

Suppression of salivary flow is of value in the management of salivary fistulae and sialectasia. It may also be beneficial in mentally defective patients and those with neurological palsies lacking control of their salivation. Nine patients were treated by irradiation to the parotid gland to control salivary flow; eight had complete resolution of symptoms and one had partial relief. Irradiation was effective as primary treatment and after failed surgery and/or drug treatment. Low doses were effective and there were no significant acute or long-term side effects. Its use avoids long-term medication and their potential side effects and may reduce the need for surgery.

Adult↗