title: Extravasation injury associated with parenteral nutrition in a cat with presumptive gastrinomas.
abstract: OBJECTIVE
  To describe the pathologic consequences of parenteral nutrition (PN) extravasation into the mediastinum of a cat.
  
  
  METHODS
  An 8-year-old domestic short hair cat with persistent vomiting and anorexia was initiated on PN for nutritional support. PN was being administered at a rate of 12.9 mL/h when inadvertent jugular catheter migration resulted in thrombophlebitis and cellulitis and 40-80 mL of PN extravasated into the SC and mediastinal tissues. The cat was euthanized 36 hours after the extravasation of PN due to poor prognosis related to the gastric complications associated with a presumed primary gastrinoma. Grossly there was excessive mediastinal lymphatic drainage and pronounced edema in the cervical SC and mediastinal tissue. Histopathologic examination of the PN-extravasated area revealed a severe mixed inflammatory reaction, represented by a severe neutrophilic and mild histiocytic infiltrate with lymphoplasmacytic perivascular cuffing. No bacterial agents were observed or cultured from this area.
  
  
  CONCLUSIONS
  This is the first case report of a foreign body-type reaction due to extravasation of PN (extravasation injury) in a cat. Extravasation of PN is not without pathologic consequence, and can result in a severe inflammatory reaction in affected tissues.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA. jw37@cornell.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: Wakshlag
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Schoeffler
authors.forename: Duncan S
authors.initials: DS
authors.lastname: Russell
authors.forename: Rachael S
authors.initials: RS
authors.lastname: Peters-Mo
authors.forename: Olivier
authors.initials: O
authors.lastname: Toulza
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000209:etiology* / Q000473:pathology; D002415:Cats; D004067:Digestive System Neoplasms / Q000473:pathology / Q000662:veterinary*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000662:veterinary*; D015408:Gastrinoma / Q000473:pathology / Q000662:veterinary*; D007249:Inflammation / Q000139:chemically induced / Q000473:pathology / Q000662:veterinary*; D008297:Male; D008482:Mediastinum / Q000473:pathology; D010288:Parenteral Nutrition / Q000009:adverse effects*