Peer-reviewed veterinary case report
Dog with bleeding and bone marrow failure after lomustine overdose
By Henker, Luan C et al.·Published in Veterinary clinical pathology·2019·Department of Veterinary Pathology, Brazil·View original on PubMed →
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Original publication title: Hemorrhagic diathesis and bone marrow aplasia secondary to lomustine overdose in a dog.
- Species:
- dog
Plain-English summary
A 9-year-old mixed breed dog was brought in after experiencing severe symptoms like bloody diarrhea, vomiting blood, and difficulty breathing. These issues arose after the owner accidentally gave her a much higher dose of a chemotherapy drug called lomustine than prescribed, leading to a dangerous drop in her blood cell counts. Despite treatment efforts, the dog sadly passed away, and a necropsy revealed severe bleeding in multiple organs and a lack of bone marrow function. This case highlights the risks of medication overdoses in pets and the importance of following veterinary instructions closely.
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Abstract
A 9-year-old mixed breed 13 kg spayed female dog was presented for evaluation of two masses in the right abdominal mammary gland region. Surgery was conducted to excise the masses. A grade I complex mammary gland carcinoma and high grade (grade III) mast cell tumor with an inguinal lymph node metastasis were diagnosed. Forty-seven days after the surgical procedure, the mast cell tumor relapsed, and neoadjuvant treatment with lomustine (81 mg/m) was prescribed. Thirteen days from initiation of lomustine therapy, the dog was re-presented to the hospital with bloody diarrhea, hematemesis, epistaxis, an elevated rectal temperature, depression, severe dehydration, and marked dyspnea. The CBC showed severe thrombocytopenia and leukopenia. According to the owner, lomustine (45mg per os [PO]) was mistakenly administered daily for 10 consecutive days (total dose, 810 mg/m). The dog died and a necropsy was performed. The main gross lesions consisted of severe multifocal hemorrhages in multiple organs, especially in the digestive system. Histopathologic evaluation revealed disseminated hemorrhages, as well as marked bone marrow aplasia. This report describes the clinical, hematologic, gross, and histologic findings in a fatal case of lomustine overdose in a dog.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31062418/