Successful management of lisdexamfetamine intoxication in a dog despite complications of hypoglycemia and rhabdomyolysis.
Bibliographic record
Abstract
A 15-year-old castrated male beagle-cross dog was presented with neuromuscular, cardiovascular, and gastrointestinal signs 7 h after accidental ingestion of a toxic dose (33 mg/kg) of the amphetamine lisdexamfetamine dimesylate. Clinical and clinicopathological abnormalities noted included dysphoria, mydriasis, hyperesthesia, muscle tremors, tachycardia, tachypnea, hyperthermia, hematochezia, mild hypoglycemia, hemoconcentration, and metabolic acidosis. Initial treatment with intravenous (IV) acepromazine, butorphanol, methocarbamol, and rectal cyproheptadine, along with IV fluids with 5% dextrose added, was inadequate to control clinical signs. The dog was stabilized effectively following administration of IV constant-rate infusions (CRIs) of dexmedetomidine (1 to 3 μg/kg per hour) and butorphanol (0.2 mg/kg per hour). The dog was maintained on this CRI protocol for 20 h and weaned off without redeveloping neuromuscular and cardiovascular signs. Serum biochemical analysis and urinalysis at that time revealed marked elevation of creatine kinase (100-fold), mild to moderate elevation of liver enzymes (ALP: 2.4-fold, ALT: 9.5-fold, GLDH: 4-fold), and the presence of myoglobinuria, indicative of rhabdomyolysis and possible concurrent hepatic injury. The animal recovered with supportive care and was discharged 44 h after presentation. One week after discharge, the dog was clinically normal and serum biochemical analysis and urinalysis confirmed resolution of rhabdomyolysis. No evidence of kidney failure secondary to the rhabdomyolysis was noted. To the best of the authors' knowledge, this is the first report of survival following lisdexamfetamine intoxication in a dog. Clinical signs resolved completely with supportive and symptomatic therapies mainly consisting of IV fluid therapy and sedative administration. There were no long-term complications reported. Key clinical message: Aggressive medical therapies, including IV CRIs of dexmedetomidine and butorphanol, in addition to IV fluids, were effective for managing a dog with severe lisdexamfetamine intoxication. The dog recovered uneventfully following 44 h of hospitalization, with no evidence of long-term complications secondary to the rhabdomyolysis associated with the toxicosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".