Walton Stuart, Ryan Kirk A, Davis Jennifer L, Acierno Mark
Section of Companion Animal Medicine, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, 70803.
College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607.
J Vet Emerg Crit Care (San Antonio). 2017 Jul;27(4):444-450. doi: 10.1111/vec.12607. Epub 2017 May 8.
To describe the treatment of a meloxicam overdose in a dog with therapeutic plasma exchange (TPE).
A 6-month-old female Bulldog, presented for routine laparoscopic ovariectomy. Postoperatively the dog received an accidental overdose of meloxicam (1 mg/kg IV [intravenously]). The patient was treated with supportive medical therapy and TPE over 210 minutes achieving 1.2 plasma volume exchanges. During therapy, heparinized blood and effluent samples were collected. Meloxicam concentrations were determined in the samples by high pressure liquid chromatography. Post TPE, the dog continued to receive supportive medical therapy and was discharged 48 hours after the overdose. The dog remained asymptomatic for meloxicam intoxication. Follow-up rechecks at 1 and 6 weeks were unremarkable with no further treatment required.
This report describes the successful use of TPE adjunctively following an acute meloxicam overdose. An 82% reduction of plasma meloxicam concentration was achieved over 210 minutes. Twenty-four hours after therapy, a 47% sustained reduction of plasma meloxicam was measured after redistribution of drug between body compartments.
描述采用治疗性血浆置换(TPE)治疗犬美洛昔康过量中毒的情况。
一只6月龄雌性斗牛犬因常规腹腔镜卵巢切除术就诊。术后该犬意外过量注射美洛昔康(静脉注射1mg/kg)。对该患者进行了210分钟的支持性药物治疗和TPE,实现了1.2倍血浆容量置换。治疗期间,采集了肝素化血液和流出液样本。通过高压液相色谱法测定样本中美洛昔康的浓度。TPE治疗后,该犬继续接受支持性药物治疗,并在过量用药48小时后出院。该犬未出现美洛昔康中毒的症状。在1周和6周时的随访复查未见异常,无需进一步治疗。
本报告描述了急性美洛昔康过量中毒后成功辅助使用TPE的情况。在210分钟内血浆美洛昔康浓度降低了82%。治疗24小时后,在药物在身体各腔室重新分布后,测得血浆美洛昔康持续降低了47%。