Department of Clinical Sciences, Small Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
Department of Clinical Sciences, Large Animal Internal Medicine, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
J Vet Intern Med. 2021 May;35(3):1626-1630. doi: 10.1111/jvim.16124. Epub 2021 May 2.
A 12 week-old Nigerian dwarf (Capra aegagrus hircus) buck kid was hospitalized for management of obstructive urolithiasis. Postoperatively, he was inadvertently administered 16-times greater than his calculated dose of a nonsteroidal anti-inflammatory drug (NSAID; 17.5 mg/kg flunixin meglumine, IV). The goat was treated with intravenous administration of lipid emulsion (ILE) prior to membrane-based therapeutic plasma exchange (mTPE) under general anesthesia. The increased coagulability inherent to small ruminants in comparison with dogs and cats warranted specific adjustments in the prescription of anticoagulation, blood flow, and filtration fraction to avoid circuit clotting during mTPE. Serum flunixin meglumine concentration measured before, during, and after mTPE revealed marked reduction in drug concentration. After the combined treatments, no clinical evidence of NSAID gastrointestinal or renal toxicosis was detected. This case report describes successful management of flunixin meglumine overdose in a small ruminant using combined ILE and mTPE.
一只 12 周龄的尼日利亚矮山羊(Capra aegagrus hircus)公羊羔因梗阻性尿石症住院治疗。术后,它意外地接受了比计算剂量高出 16 倍的非甾体抗炎药(NSAID;17.5 mg/kg 氟尼辛葡甲胺,静脉注射)。在全身麻醉下进行基于膜的治疗性血浆置换(mTPE)之前,给这只山羊静脉内给予了脂肪乳剂(ILE)治疗。与犬和猫相比,小反刍动物的凝血功能增加,因此需要对抗凝、血流和滤过分数进行特定调整,以避免 mTPE 过程中回路凝结。在 mTPE 前后测量的氟尼辛葡甲胺的血清浓度表明药物浓度明显降低。联合治疗后,未发现 NSAID 胃肠道或肾毒性的临床证据。本病例报告描述了使用 ILE 和 mTPE 联合治疗成功治疗小反刍动物氟尼辛葡甲胺过量。