RESUMEN

In collaboration with the American College of Veterinary Pathologists.

Asunto(s)

Patología Veterinaria , Veterinarios , Animales , Humanos , Estados Unidos

RESUMEN

The objective of this study was to evaluate the pharmacokinetics of the standard cytarabine (Ara-C) protocol (50 mg/m2 subcutaneously every 12 hr for 2 days) used for dogs with neuroinflammatory disease and compare it to two more practical protocols (a single 200 mg/m2 subcutaneous dose and two 100 mg/m2 subcutaneous doses every 12 hr). Four client-owned dogs previously diagnosed with meningoencephalomyelitis of unknown origin were administered three distinct Ara-C protocols with a 21-day washout between each protocol. A complete blood count was performed seven days after each dosing protocol to assess for clinically relevant myelosuppression. No adverse events were observed. Plasma Ara-C concentrations were measured using a validated liquid chromatography coupled to tandem mass spectrometry assay. The mean maximal concentrations in this study were 4,230, 9,293, and 16,675 ng/ml for a single dose of 50, 100, and 200 mg/m2 , respectively. There was a linear relationship between dose and drug exposure. Drug exposure was similar regardless of the dosing protocol when the total dose was analyzed, with an area under the concentration versus time curve of 37,026, 38,465, and 32,510 ng × hr/ml for 50, 100, and 200 mg/m2 , respectively.

Asunto(s)

Citarabina/farmacocinética , Citarabina/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Meningoencefalitis/veterinaria , Animales , Área Bajo la Curva , Citarabina/administración & dosificación , Enfermedades de los Perros/sangre , Perros , Relación Dosis-Respuesta a Droga , Femenino , Semivida , Inmunosupresores/administración & dosificación , Inmunosupresores/farmacocinética , Inmunosupresores/uso terapéutico , Inyecciones Subcutáneas , Masculino , Meningoencefalitis/tratamiento farmacológico

RESUMEN

The cavernous sinus (CS) is a paired venous sinus that runs along either side of the pituitary gland on the floor of the calvarium. Cavernous sinus syndrome (CSS) refers to deficits in more than one of the cranial nerves III, IV, V, and VI, as they are in close association in this region. The purpose of this study was to identify the presenting complaints, neurologic findings, diagnosis, and outcomes in dogs and cats with confirmed cavernous sinus syndrome (CSS). Medical records between 2002 and 2015 were reviewed. Inclusion criteria were neurologic signs consistent with CSS and advanced imaging and/or post-mortem examination. Thirteen dogs and 2 cats were included. Twelve dogs received advanced imaging. Post-mortem examination was performed on 2 cats and 3 dogs. Dogs were 6 -13 years (mean= 10.8 years) of age and comprised of several different breeds. Both cats were male neutered domestic shorthair, ages 3 and 14 years. Presenting complaints included mydriasis (N=4), behavior changes (N=3), hyporexia (N=3), ptosis (N=2), ataxia (N=2), pain (N=2), weakness (N=2), lethargy (N=2), and one each of epiphora, ocular swelling, polydipsia, seizures, facial muscle atrophy, dysphagia, and head tilt. Neurologic signs included ophthalmoparesis/plegia (N=13), reduced/absent pupillary light response (N= 11), mydriasis (N= 10), reduced/absent corneal sensation (N= 7), ptosis (N= 6), reduced facial sensation (N= 2), and enophthalmos (N=1). Thirteen patients had a mass lesion within the cavernous sinus, 6 of which were confirmed neoplastic via histopathology. Median survival time for the 4 patients treated with radiation therapy was 1035 days (range 150-2280). Median survival for the 4 patients that received medical treatment was 360 days (range 7-1260 days), and for the 5 non-treated patients 14 days (range 0-90 days). In conclusion mydriasis and ophthalmoplegia are common signs of CSS. A mass lesion within the CS is the most common cause. Survival time may be improved with radiation therapy.