succimer and Seizures

Although the incidence of lead toxicosis in small animals continues to decrease, it remains a significant malady. We have reviewed the literature of the past 45 years, which revealed 70 cases involving cats. Sources, signs, diagnosis, pathology and treatment of feline lead toxicosis are reviewed. In 84% of these cases the source of lead was old paint usually from home renovation. The most common signs in cats are anorexia, vomiting, and seizures. The younger individuals seem more likely to show CNS signs. Since signs are often vague, lead toxicosis may be significantly under diagnosed in cats. The gold standard of diagnostic tests is blood lead concentration, although it does not necessarily correlate with total body burden of lead or with metabolic effects including clinical signs. Diagnostic tests including erythropoietic protoporphyrin (EPP), urine aminolevulinic acid, and others are discussed. Gross findings on necropsy are few and include a yellow-brown discoloration of the liver often with a nutmeg-like appearance. Histological examination may reveal pathognomonic inclusion bodies in liver and renal tissues. Characteristic histological changes in the CNS include neuronal necrosis and demyelination. Treatment of lead toxicosis in cats, as in any species, involves removing the exposure, decontaminating the individual and the environment, supportive care and chelation therapy. The most recently available chelator is succimer (meso 2,3-dimercaptosuccinic acid). Succimer given orally is well tolerated and has a wide margin of safety. A high index of suspicion of lead toxicosis is warranted in cats since they often present with vague and non-specific signs. With any consistent history owners need to be asked about home renovation. Early diagnosis and treatment affords a good prognosis.

Topics: Animals; Anorexia; Cat Diseases; Cathartics; Cats; Chelating Agents; Lead Poisoning; Seizures; Succimer; Vomiting

Topics: Animals; Bird Diseases; Chelating Agents; Eagles; Edetic Acid; Fatal Outcome; Female; Fractures, Comminuted; Mercury Poisoning; Radiography; Sarcocystis; Sarcocystosis; Seizures; Succimer; Thoracic Vertebrae

Topics: Cheek; Chelation Therapy; Child, Preschool; Dimercaprol; Drug Therapy, Combination; Edema; Edetic Acid; Environmental Exposure; Foreign Bodies; Humans; Lead; Lead Poisoning; Male; Pica; Play and Playthings; Protoporphyrins; Seizures; Self-Injurious Behavior; Succimer; Wounds, Gunshot

Two cats from a single household were examined because of neurologic abnormalities suggestive of central vestibular disease. The owner had been renovating her 150-year-old house for the preceding 3 months, and renovations included chipping and sanding of old paint from windowsills and stair railings. Lead toxicosis was diagnosed on the basis of history and concentrations of lead in blood and urine. Both cats were treated with succimer. Treatment was not associated with any adverse effects, and both cats recovered completely. Ingestion of old paint from house renovations is the most common source of lead exposure in cats. Owners of cats with gastrointestinal tract or neurologic abnormalities should be questioned specifically about house renovations.

Topics: Animals; Anorexia; Cat Diseases; Cats; Chelating Agents; Female; Kidney; Lead; Lead Poisoning; Liver; Seizures; Succimer; Tissue Distribution; Vomiting

To examine the incidence, clinical and radiologic findings, and response to treatment of renovascular hypertension (RVHT) in moyamoya disease (MMD).. A retrospective analysis of medical records in six RVHT cases (8.3%) among 72 MMD patients observed from November 1987 to December 1995.. The age at onset of MMD ranged from 9 months to 7 years 1 month (mean, 3.3 years). The most common initial manifestation of MMD was transient ischemic attack. Hypertension was detected between 4 years 4 months and 12 years 3 months (mean, 7.87 years). Unstimulated plasma renin activity was elevated in all six cases. Renal ultrasonography and captopril technetium 99m-labeled dimercaptosuccinic acid scan showed abnormal findings in four of five and in three of four available studies, respectively. However, both imaging studies showed abnormal findings only in the most severely affected kidneys even with bilateral renal artery stenosis. Renal arteriography revealed bilateral lesions in three of the patients and unilateral lesions in the others. Renal angioplasty was performed in four cases but was successful in only one and partially successful in another. A renal artery specimen obtained during renal autotransplantation showed intimal fibroplasia. At the last follow-up, one patient had normal blood pressure without the use of antihypertensive agents, but the other five patients needed this medication to control blood pressure.. Because RVHT may be more commonly associated with MMD than has hitherto been appreciated, it is recommended that blood pressure be carefully followed and that diagnostic procedures for RVHT be carried out in hypertensive patients with MMD.

Topics: Adolescent; Angiography; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Biopsy; Blood Pressure; Captopril; Child; Child, Preschool; Female; Fibromuscular Dysplasia; Follow-Up Studies; Humans; Hypertension, Renovascular; Incidence; Infant; Ischemic Attack, Transient; Kidney; Kidney Transplantation; Male; Moyamoya Disease; Organotechnetium Compounds; Radionuclide Imaging; Radiopharmaceuticals; Renal Artery Obstruction; Renin; Retrospective Studies; Seizures; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tunica Intima; Ultrasonography