Medication used in intentional drug overdose in Flanders 2008-2013

Background : Intentional drug overdose is the most common method of self-harm. As psychiatric disorders are very common in self-harm patients, the medication used to treat these disorders can become the means for the self-harm act. The present study aimed at investigating an association between the use of prescribed medication (analgesics and antipyretics, anti-epileptics, antipsychotics, antidepressants and psychostimulants) as a method of self-harm and prescription rates of this medication in Flanders. We investigated the possible effect of gender, alcohol use during the self-harm act and a history of self-harm. Methods : Data from the multicenter study of self-harm in Flanders between 2008 and 2013 were used. The significance of differences in percentages was calculated by GEE and the strength by odds ratios (OR). Results : There was an increase in the odds of using antidepressants (0.8%) and antipsychotics (2%) among females when the rate of prescription increases. Analgesics and antipyretics (39.3/1,000) and antidepressants (124.9/1,000) were the most commonly prescribed drugs among females. Antidepressants (63.9/1,000) and antipsychotics (26.5/1,000) were the most commonly prescribed drugs among males. Antidepressants and analgesics and antipyretics were the most frequently used medications for self-harm. Analgesics and antipyretics during the self-harm act were more common among first-timers, while repeaters more commonly overdosed using antipsychotics and antidepressants. Conclusion : These findings suggest that the availability of medication via prescriptions plays an important role in the choice of the medication ingested during the self-harm act. Precautions are necessary when prescribing medication, including restrictions on the number of prescriptions and the return of unused medication to pharmacies after cessation of treatment. These issues should be a focus of attention in the education and training of physicians and pharmacists

Phenotypic characterization of paroxysmal dyskinesia in Maltese dogs

Background Paroxysmal dyskinesias (PDs) are a group of central nervous system diseases characterized by episodes of abnormal involuntary hyperkinetic movement without altered consciousness that increasingly have been recognized in dogs. Objectives To present the phenotypical characterization, treatment, and outcome of a PD observed in Maltese dogs. Animals Client-owned Maltese dogs (n = 19) with presumed diagnosis of PD. Methods Data were collected retrospectively from medical records (2014-2019), and supporting information was added prospectively by using a questionnaire directed to the owners of the affected dogs. Results The episodes were characterized mainly by sudden dystonia of >= 1 limbs and generalized body tremors with preserved consciousness. The mean age of clinical onset was 5.4 years. Episode frequency varied widely both among and within individuals. Median episode duration was 4.5 minutes. Most episodes were stress- or exercise-induced. Acetazolamide was administered to 6 dogs, and 4 dogs experienced a decrease in episode frequency. In 7 dogs that received a gluten-free diet, 6 dogs became episode-free. In 4 dogs, the episodes stopped spontaneously and in 2 dogs no medication or specific diet was given and the episodes continued at the same frequency. Conclusions and Clinical Importance Given the breed predisposition and regional distribution of the disease, additional research should focus on elucidating the underlying genetic cause doing so might advance both our understanding of the pathophysiology and treatment of this disease, not only in dogs, but also in humans. Regardless of the treatment protocol selected, prognosis appears fair to good

Sole prednisolone therapy in canine meningoencephalitis of unknown etiology

Meningoencephalitis of unknown etiology (MUE) is a frequently diagnosed and often fatal disease in veterinary neurology. The aim of this retrospective study was to assess the efficacy of three different sole prednisolone treatment schedules in dogs diagnosed with MUE. The dogs were diagnosed clinically with MUE based on previously described inclusion criteria, and treated with a three-, eight- or eighteen-week-tapering prednisolone schedule. Thirty eight dogs were included in the study. Seventeen, fifteen and six dogs received the three-, eight- and eighteen-week tapering schedule, respectively. Overall, 37% of the dogs died or were euthanized because of MUE, and a significant difference in survival time was seen between the three treatment schedules. Surprisingly, the highest number of dogs that died because of MUE was seen in the eight week treatment schedule (56%), followed by the three-week (26%) and eighteen-week (0%) treatment schedule. Based on the results of this study, no definitive conclusions can be drawn regarding the ideal prednisolone dosing protocol for dogs diagnosed with MUE. However, a more aggressive and immunosuppressive treatment protocol might lead to a better outcome

Neurological signs and imaging findings in three cats with multiple articular process hypertrophy = Neurologische symptomen en resultaten van medische beeldvorming bijdrie katten met hypertrofie van multipele articulaire processen

An eight-year-old British Shorthair (case 1), an eleven-year-old British Shorthair (case 2) and a six-year-old European Shorthair cat (case 3) showed signs of chronic T3–L3 myelopathy. Computed tomography of the thoracolumbar and lumbosacral region was performed in all three cases and magnetic resonance imaging was only performed in case 2. Cross sectional imaging revealed an enlargement of the articular process joints from T2 to T5 in case 1, from T11 to T13 in case 2 and from T10 to T13 in case 3 causing spinal cord compression. Based on the severity of the spinal cord compression, surgical decompression by hemilaminectomy was performed in case 1. In cases 2 and 3, conservative treatment was instituted, although this condition could have been an incidental finding in these two cases. To the authors’ knowledge, this is the first report describing the neurological signs, imaging findings and short-term outcome in cats with multiple thoracolumbar articular process hypertrophy

Repetitive transcranial magnetic stimulation in drug‐resistant idiopathic epilepsy of dogs : a noninvasive neurostimulation technique

Background Although repetitive transcranial magnetic stimulation (rTMS) has been assessed in epileptic humans, clinical trials in epileptic dogs can provide additional insight. Objectives Evaluate the potential antiepileptic effect of rTMS in dogs. Animals Twelve client-owned dogs with drug-resistant idiopathic epilepsy (IE). Methods Single-blinded randomized sham-controlled clinical trial (dogs allocated to active or sham rTMS) (I) and open-labeled uncontrolled clinical trial (dogs received active rTMS after sham rTMS) (II). Monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), and number of cluster seizures (CS) were evaluated for a 3-month pre-TMS and post-rTMS period and safety was assessed. The lasting effect period of rTMS was assessed in each dog treated by active stimulation using the MSF ratio (proportion of post-TMS to pre-rTMS MSF) and treatment was considered effective if the ratio was No adverse effects were reported. In trial I, MSF and MSDF decreased significantly (P= .04) in the active group (n = 7). In the sham group (n = 5), no significant changes were found (P= .84 and .29, respectively). Cluster seizures did not change significantly in either group. No significant differences were detected between the groups. In trial II, previously sham-treated dogs (n = 5) received active rTMS and significant decreases in MSF and MSDF were noted (P= .03 and .008, respectively). The overall effect of rTMS lasted for 4 months; thereafter, the MSF ratio was >1. Conclusions and Clinical Importance Repetitive transcranial magnetic stimulation may be a safe adjunctive treatment option for dogs with drug-resistant IE, but large-scale studies are needed to establish firm conclusions