Vincristine overdose in a cat: clinical management, use of calcium folinate, and pathological lesions.
A 6-year-old female neutered Burmese cat received a 10 times overdose (5mg/m(2)) of vincristine, administered in error. Supportive therapy, including administration of calcium folinate, was instigated within 8h. Despite treatment, the patient exhibited deterioration in renal and respiratory function and died 72 h after overdose. Necropsy was performed within 24h of death. Gross examination revealed pulmonary oedema and a pale brown liver with a prominent lobular pattern. Histological examination revealed marked apoptosis and necrosis of the bone marrow myeloid series, and mild to moderate apoptosis and necrosis of the erythroid and megakaryocyte series. Multifocal necrosis of the renal tubules, hepatocytes, and small intestinal crypt epithelium was also observed. Use of calcium folinate as a rescue therapy following vincristine overdose in humans has been previously documented. If treatment is to be successful in cases of vincristine overdose in cats, then a more complete understanding of the pathogenesis of vincristine toxicity in companion animal species is required.
Hughes
Katherine
K
Department of Clinical Veterinary Medicine, University of Cambridge Madingley Road, Cambridge, Cambridgeshire CB3 0ES, UK. kh387@cam.ac.uk
Scase
Timothy J
TJ
Ward
Christine
C
Polton
Gerry A
GA
D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000506:poisoning*; D002371:Cat Diseases / Q000139:chemically induced* / Q000473:pathology; D002415:Cats; D017809:Fatal Outcome; D005260:Female; D011654:Pulmonary Edema / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D051437:Renal Insufficiency / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D014750:Vincristine / Q000506:poisoning*
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine
Clin Toxicol. 1979;14(1):71-8
312178
Vet J. 2008 Jul;177(1):130-3
17555995
J Am Vet Med Assoc. 1988 Nov 1;193(9):1114-7
3058663
J Korean Med Sci. 1998 Jun;13(3):334-8
9681818
Oncologist. 2001;6(2):153-61
11306727
Cancer Res. 1976 Oct;36(10):3798-802
954003
J Pediatr. 1976 Oct;89(4):671-4
182948
Am J Pediatr Hematol Oncol. 1986 Fall;8(3):266-8
3490191
Jpn J Clin Oncol. 1987 Sep;17(3):247-53
3669366
J Small Anim Pract. 2007 Jul;48(7):371-7
17559520
Pediatr Hematol Oncol. 1991 Apr-Jun;8(2):171-8
1863543