TVT - usage of Vincristine

Swarupmay Majumdar Gagan Gaudi
not able to post so sharing it over here

A lab female around 3 and 1/2 years of age was being treated by other vet for tvt. Before that she was being treated by another quack. In total the female recieved 4 doses of vincristine at about a week interval between each dose. The bitch came to me on tuesday night with history of vomitting for the last ... See More5-6 days. The owner of the bitch was not told to stop per os. Fever was 104.8 degrre f, i put her on rl, ranitidine, ondansteron, catosal and novalgin all i/v and sent the blood sample for testing.

23 June at 15:36 · Comment · · Flag

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    Swarupmay Majumdar

    Blood report says hb-15.9, tlc-19150, platelets-1.12 lakh, sgot-44, sgpt-105, bun-42.6, creatinine-9. Since there was clear cut kidney involved i avoided oxy and added ampilox to the treatment. For 1 and half days i followed the same treatment twice a day and the bitch was doing well and the vomiting was reduced to almost once in 6 hrs. On the third day (Friday morning) 30 minutes after the owner left he came back carrying the bitch and said that she had some kind of fit and is not able to get up. The bitch was showing signs of shock, pupil dilated, temperature raised upto 109 degrees. I tried every thing dexona, antipyretics, ice water enema, temp. Got down to 107 degrees but not lower and then after few hrs the bitch died. Now was it a heat stroke because the bitch was being brought from almost 30 ks away and in an auto and the weather condition every body knows or can there be anything else. When the bitch left my clinic she was very much normal she urinated and there were no signs of such thing as the owner stayed with me for almost 10-15 minutes after the treatment was over.

    23 June at 15:37 ·
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    Rahima Razak leukocytosis and thrombocutopenia, elevated creatinine and Sgpt... mostly signs of lepto. leukocytosis may due to pyometra... for lepto, amoxicillin dose is 22 mg/kg... fits would have come bcoz bun would have elevated later and caused uremic encephalopathy...lactuloseorally would have been tried....

    23 June at 15:48 ·
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    Rahima Razak dog had pyometra???? if not then lepto...advanced stage,,,,

    23 June at 15:54 ·
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    Gagan Gaudi no there was no pyometra. the kidney and liver involvement what i feel was because of vincristine which was given at a weekly interval and 4 doses were given.

    23 June at 16:38 · · 2 people
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    Rahima Razak ya i just now read about vincristine... its said that it causes thrombocytopenia, and liver disease and at sometimes seizures and collapse...but didnt mention about kidney????? may be combined...because leukocytosis makes me suspicious of lepto...

    23 June at 18:36 ·
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    Rajshankar Tony Sarma

    Was this just Vincristine or a full-on COP protocol? In the latter, leucocytosis is a side effect, as are alterations in some of the liver parameters. Vincristine alone will cause liver perturbations, but it's again hard to read on this database because the action of the liver detoxifying vincristine will cause elevations of various parameters (as would be the case with other toxins such as barbiturates or alcohol). I'm not as familiar with the parameters you refer to here; I use ALT, AST, GGT, ALP and BAST as my routine liver parameters. The latter is particularly important in differentiating a reactive liver from a failing one.
    
    This animal's temperature could be because of seizures (e.g. renal, hepatoencephalopathic - although CREA here was only 9? If so, that's (low) reference range so need to be careful with reading a solitary BUN elevation specifically as evidence of renal disease). Alternatively, uncontrolled hyperthermia can cause convulsions, so it's unfortunately difficult to be clear here. As said above, Vincristine can cause seizures, but at standard COP dose rates, I've never seen them.
    
    A sad case; we can't always win, unfortunately.

    24 June at 07:10 ·