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Hydrocephalus 481

PHYSICAL EXAM FINDINGS • Coagulation profile in cases of severe pro- Possible Complications
• Hyperthermia longed hyperthermia: possible disseminated Severe hyperthermia may cause DIC and/or
VetBooks.ir • Tachypnea, panting • Urinalysis: myoglobinuria Recommended Monitoring Diseases and Disorders
intravascular coagulation (DIC)
myoglobinuria, resulting in AKI.
• Tachycardia
• Agitation, anxiety, hyperactivity, pacing
• Injected mucous membranes
• Death TREATMENT • Monitor temperature frequently, initially q
1-2h.
Treatment Overview • Monitor heart rate and blood pressure.
Etiology and Pathophysiology Soon after ingestion (<1 hour after ingestion), • Monitor electrolytes and acid-base status.
• Toxic principle is unknown. decontaminate asymptomatic patients. Symp-
• Although exact mechanism is unknown, tomatic and supportive care is used to treat most PROGNOSIS & OUTCOME
theories include clinical signs, although dantrolene is specific
○ Inhibition of electron transfer (oxidative for the treatment of malignant hyperthermia. Prognosis is good if addressed quickly but
uncoupling) becomes guarded to poor in cases with severe
○ Alteration of mitochondrial activity Acute General Treatment hyperthermia.
○ Serotonin syndrome • Decontamination (p. 1087):
○ If ingestion occurred < 1 hour before PEARLS & CONSIDERATIONS
DIAGNOSIS presentation and dog is free of signs,
induce emesis (p. 1188). Comments
Diagnostic Overview ○ Enemas to stimulate fecal elimination of Many clients are not aware of the potential
The medical history includes the presence of plant material (warm water, 10 mL/kg dangers of hops ingestions and assume hops are
hops in the environment, as well as a poten- [p. 1099]) safe because they are used to make beer designed
tial ingestion. Clinical signs are expected as ○ Activated charcoal 1-2 g/kg if asymptomatic for human consumption. The client may not
early as 30-60 minutes up to 12 hours after • Fluids, IV crystalloids to reduce risk of acute volunteer information about hops ingestion,
exposure. Most animals recover with therapy kidney injury (AKI) from myoglobinuria believing the information is irrelevant. If clinical
within 12-24 hours after ingestion. There (p. 23) signs are consistent with hops ingestion, ask the
are no rapid tests to confirm the ingestion ○ Address electrolyte disorders, if present. client specifically about access to or ingestion
of hops. • External cooling (e.g., fans, cool water baths of hops.
[p. 421])
Differential Diagnosis • Methocarbamol 50-220 mg/kg slow IV to Prevention
• Malignant hyperthermia effect, no faster than 2 mL/min for tremors • Prevent pets from hops exposure (dispose
• Hyperthermia (heat stroke, exogenous heat • Diazepam 0.5-2 mg/kg IV or midazolam of spent hops immediately, choose different
source) 0.5-1 mg/kg IV for significant stimulatory plants for landscaping).
• Fever (infectious, immune-mediated, neoplasia, signs or tremors • Do not put spent hops in compost piles.
inflammatory) • Specific antagonist:
• Amphetamines ○ To treat hyperthermia, dantrolene should Technician Tips
• Selective serotonin reuptake inhibitors be given at 2-3 mg/kg IV or 3.5 mg/kg If dantrolene is not routinely part of the clinic’s
(SSRIs) (p. 1281) PO, q 4-8h, depending on the recurrence pharmacy, find out where dantrolene can be
• 5-Hydroxytryptophan of hyperthermia obtained quickly before an emergency, and keep
• Aspirin ○ If dantrolene is not available, cypro- the information in an easily accessible location.
• Metaldehyde heptadine may be given at 1.1 mg/kg
PO or per rectum q 4-6h. Reports of Client Education
Initial Database cyproheptadine efficacy in controlling Educate clients about the dangers of hops to
• Body temperature > 102.5°F malignant hyperthermia are mixed. their dogs.
• Respiratory rate: tachypnea • Diazepam and acepromazine have NOT been
• Heart rate: tachycardia effective for hyperthermia treatment. SUGGESTED READING
• CBC: mild elevations in white blood cells • Address complications of hyperthermia, as Duncan K, et al: Malignant hyperthermia-like reac-
may be noted. necessary (p. 421). tion secondary to ingestion of hops in five dogs. J
• Electrolytes: hyperkalemia, hypercalce- Am Vet Med Assoc 210:51, 1997.
mia, and hyperphosphatemia have been Behavior/Exercise AUTHOR: Charlotte Means, DVM, MLIS, DABVT, DABT
reported. Dogs should be kept caged and quiet until clini- EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
• Chemistry panel: creatine kinase (marked ele- cal signs resolve. Exercise should be restricted
vation), azotemia secondary to myoglobinuria for 3-5 days after recovery to prevent additional
• Acid-base status myoglobinuria formation.

Hydrocephalus Bonus Material Client Education
Online
Sheet

Epidemiology GENETICS, BREED PREDISPOSITION
BASIC INFORMATION
SPECIES, AGE, SEX • Toy breeds: Chihuahua, toy poodle, Pomera-
Definition • Congenital: dog, cat at birth or within several nian, Lhasa apso, pug, Pekingese, and Cairn,
An increase in volume of cerebrospinal fluid months of age Yorkshire, Manchester, and Maltese terriers
(CSF) in the ventricular system of the brain • Acquired: any • Brachycephalic breeds: Boston terrier, English
that causes signs of encephalopathy bulldog
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