Today's Veterinary Practice

JUL-AUG 2017

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53 JULY/AUGUST 2017 ■ TVPJOURNAL.COM CONTINUING EDUCATION Anaphylactic Shock: How to Effectively Diagnose and Treat Jennifer L. Lyons, MS, and Jordan R. Scherk, DVM, DACVECC Blue Pearl Veterinary Partners, Midvale, Utah Anaphylaxis is defined as the acute onset of a hypersensitivity reaction causing the release of mediators from mast cells and basophils. Anaphylaxis may be a life-threatening condition that can involve one or more organ systems. Often, a specific cause for anaphylaxis is not known. Anaphylaxis may be brought on by anaphylactic or anaphylactoid reactions; treatment is the same regardless of reaction type. 1,2 Veterinarians are seeing an increasing number of anaphylaxis patients because of the range of substances patients are exposed to, such as vaccines, new medications, and those from outdoor physical exposures 3 (see Specific Causes of Anaphylaxis ). However, anaphylaxis is often misdiagnosed because definitive criteria to distinguish anaphylaxis from an allergic reaction are lacking. 10 This article reviews anaphylaxis pathophysiology, diagnostic criteria, treatment, and clinical examples. PATHOPHYSIOLOGY Anaphylactic reactions are classified into 4 separate categories: type I, or immunologic IgE mediated; types II and III, which are immunologic IgE independent; and type IV, or nonimmunologic. Most anaphylaxis patients are likely to have type I reactions, but it is unclear why. 2 Anaphylactic Reaction: Immunologic IgE Mediated In immunologic IgE-mediated reactions, patients do not show clinical signs at the initial allergen exposure. Upon reexposure, IgE antibodies are produced, and the allergen forms a "bridge" that cross- links these antibodies via a high-affinity receptor, FcεRI, located in the membrane of mast cells and basophils. After binding, shutterstock.com/Irina Kozorog CONTINUING EDUCATION BEES POSE AN ANAPHYLACTIC THREAT because the venom in their stings contains peptide 401, phospholipase A2, melittin, and hyaluronidase.

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