title: Vincristine overdose in a cat: clinical management, use of calcium folinate, and pathological lesions.
abstract: 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.
authors.affiliation: Department of Clinical Veterinary Medicine, University of Cambridge Madingley Road, Cambridge, Cambridgeshire CB3 0ES, UK. kh387@cam.ac.uk
authors.forename: Katherine
authors.initials: K
authors.lastname: Hughes
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Scase
authors.forename: Christine
authors.initials: C
authors.lastname: Ward
authors.forename: Gerry A
authors.initials: GA
authors.lastname: Polton
mesh_terms: 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*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine
references.citation: Clin Toxicol. 1979;14(1):71-8
references.pmid: 312178
references.citation: Vet J. 2008 Jul;177(1):130-3
references.pmid: 17555995
references.citation: J Am Vet Med Assoc. 1988 Nov 1;193(9):1114-7
references.pmid: 3058663
references.citation: J Korean Med Sci. 1998 Jun;13(3):334-8
references.pmid: 9681818
references.citation: Oncologist. 2001;6(2):153-61
references.pmid: 11306727
references.citation: Cancer Res. 1976 Oct;36(10):3798-802
references.pmid: 954003
references.citation: J Pediatr. 1976 Oct;89(4):671-4
references.pmid: 182948
references.citation: Am J Pediatr Hematol Oncol. 1986 Fall;8(3):266-8
references.pmid: 3490191
references.citation: Jpn J Clin Oncol. 1987 Sep;17(3):247-53
references.pmid: 3669366
references.citation: J Small Anim Pract. 2007 Jul;48(7):371-7
references.pmid: 17559520
references.citation: Pediatr Hematol Oncol. 1991 Apr-Jun;8(2):171-8
references.pmid: 1863543