Editor’s Note
Greetings veterinarians! I hope this newsletter finds you doing well this Fall. For this issue, I started out looking for toxicity updates to stay “on brand” for Halloween, but took a detour when a couple of other recent papers caught my eye.
The Study Spotlight addresses a call most of us will receive at some point: a dog has consumed trilostane that was not meant for it. A 403-case review of poison control data gives useful context for how these exposure tend to play out.
Two shorter studies follow. One describes a creative way to close simple lacerations without sedation or sutures. The other looks at a diagnostic sample that is often discarded during kennel cleaning but may be helpful for quicker diagnosis of blastomycosis.
The protocol note is a nice reminder of aseptic technique, looking at a study that evaluated nail stickers and the bacterial load after surgical scrub. The paper’s headline conclusion is stronger than its data, however the practical recommendation holds up regardless.
As always, this newsletter is intended to bring your attention to recent literature and I strongly recommend reading the papers in full. If one of these papers changes something on your floor, I would love to hear about it.
Lastly, if you find Briefed Vet helpful, please recommend to your friends! I’d love a few more subscribers to keep things going.
Thanks for your support,
Study Spotlight
Most dogs that ate a single unintended dose of trilostane showed no signs, and signs that did occur resolved within 24 hours
Summers L, Schuett J, Stern L. Clinical Findings, Treatment Recommendations, and Outcome in Dogs Following Ingestion of a Single Unintended Dose of Trilostane: 403 Cases (2008-2023). J Vet Emerg Crit Care. 2026;36(3):351-356. doi:10.111/vec.70112
What They Did
Retrospective study of 403 dogs from the ASPCA Animal Poison Control Center AnTox database, February 2008 to August 2023. Dogs were included after a single, unintended ingestion of trilostane. Dogs with possible concurrent exposure to other agents, repeated exposures, incomplete data, or signs judged unrelated to trilostane were excluded. Dogs with comorbidities and concurrent medications were included. Data came from poison control consultations, not from medical records. Most dogs (248/403, 61.5%) had eaten another dog’s prescription; 147/403 (36.5%) had eaten extra doses of their own.
What They Found
Clinical signs were reported in 41/403 dogs (10.2%), most often vomoiting (17/41), lethargy (15/41) and diarrhea (7/41). Median onset was 2.5h after exposure (range 0.25-72h). Dogs with signs had ingested a higher median dose than dogs without (10 vs 2.94 mg/kg; p<0.05). However, development of signs did not differ between dogs that ingested more than the labeled dosage of 2.2-6.7 mg/kg/day (n = 132) and those at or below it (n = 271). Follow-up at 24h was available for 200/403 dogs. Of these, 188 had no signs, and no dog had signs persisting beyond 24 h. Only 4/403 dogs (0.99%) were reported to have received veterinary care. Two were treated as outpatients, one was hospitalized for 24 hours, and one was euthanized after cardiopulmonary arrest. That dog had a reported cardiac comorbidity, and the authors could not determine whether the trilostane contributed. Mild hyperkalemia (5.1-5.5 mmol/L) was reported in 7 of the 9 dogs with bloodwork submitted. The paper reports medians, ranges, and p-values; no confidence intervals are provided.
On The Floor
In my reading, these data support a measured approach for triaging over the phone for a single accidental ingestion: calculate the dose in mg/kg, ask about comorbidities, and set clear return criteria. In our hospital, we still prefer to bring them in to induce vomiting if possible. If the owners are unwilling to come in, for an otherwise stable dog, home monitoring with those criteria appears reasonable in many cases. Lower the threshold to examine dogs with a high mg/kg dose, significant comorbidities (cardiac disease in particular) or active signs is also reasonable. Signs persisting beyond 24 h fall outside what this dataset describes. In that situation, the authors suggest assessing for iatrogenic hypoadrenocorticism with an ACTH stimulation test when bloodwork supports the suspicion. With most exposures involving another dog’s prescription, highlighting safety recommendations for storage and dispensing in multi-dog households at the time of prescription is recommended for client education.
The Caveat
This is a retrospective, consultation-based data, and follow-up was available for fewer than half of the dogs. No dog underwent adrenal axis testing, so subclinical iatrogenic hypoadrenocorticism cannot be excluded. The effect of comorbidities and concurrent medications was not evaluated. The absence of a detected difference between above-level and at-or-below-level doses does not establish that higher doses are safe; the study was not designed to define a safe threshold. Cases reaching poison control may also differ from those that present directly to an emergency hospital.
At a Glance
01- Glued fur closed simple lacerations without sedation and shortened time to discharge in a small pilot study
Codd CM, Kwong GPS, Atilla A. Fur apposition technique— a new technique for simple laceration closure in small animals (dogs and cats): a pilot study. J Am Vet Med Assoc. 2026;264(3):305-311. doi:10.2460/javma.25.04.0278
This prospective, nonrandomized, controlled feasibility study was conducted at one emergency hospital from June 2022 to September 2023. It enrolled 12 animals (10 dogs, 2 cats) with 16 simple lacerations. Eligible wounds were under 10 cm, involved only skin and subcutis, were not dirty, and had surrounding fur longer than 1 cm. The fur apposition technique (FAT) started with application of topical 2% lidocaine jelly for at least 30 minutes, then the wound was lavaged. Fur bundles on each side of the wound were twisted across it and secured with skin glue— the technique is shown in a step by step diagram in the paper. All of this occurred without sedation or general anesthesia compared to sutured wounds which were closed under sedation or general anesthesia. All 16 wounds were classified as healed at recheck. Median time to discharge was 43 minutes with FAT and 118 minutes with suturing. Repair time (10 min vs 15 min) and wound healing percentage (92.73% vs 89.28%) did not differ. Group assignment was not random, students performed 7 of 8 FAT closures, and all animals received antibiotics.
On the floor: For a cooperative patient with a short, uncomplicated laceration and adequate fur length, FAT is a reasonable no-sedation option to consider. It also may be a lower cost option to offer to clients when applicable. This pilot does not establish equivalence to suturing, but it’s a clever idea worth knowing about.
02- Blastomyces was identified on cytology of spontaneously expectorated sputum in 6 of 7 confirmed cases.
Apelgren CC, Ludwik TM, Heinrich DA, Racette MA. Utility of Cytology of Spontaneously Expectorated Sputum Samples in the Diagnosis of Blastomycosis in Dogs. J Vet Emerg Crit Care. 2026;36(3):431-434.doi:10.1111/vec.70125
This retrospective study reviewed records from two university teaching hospitals from 2015 to 2023. It included 16 dogs with a productive cough whose sputum was collected from a kennel or floor surface after spontaneous expectoration, placed directly on a slide, and read by a board-certified clinical pathologist. Blastomycosis was confirmed by urine Blastomyces antigen EIA, non-sputum cytology, or necropsy. Seven dogs had blastomycosis, all confirmed by EIA. Organisms were seen on sputum cytology in 6 of the 7. None of the 9 dogs without blastomycosis had organisms seen on sputum. EIA results took 2 to 8 days (median 4 days). Dogs with positive sputum cytology started antifungal therapy a median of 4h after presentation (range 2-24h). The authors state that the sample was too small to estimate sensitivity or specificity. They also note that large-form Blastomyces can resemble Coccidioides, so region and travel history should inform interpretation.
On the floor: In a blastomycosis-endemic area, a dog that expectorates in the kennel has provided a noninvasive cytology sample worth submitting. A negative smear does not exclude blastomycosis, and confirmatory testing should still be pursued.
Protocol Note
Nail Stickers and the Surgical Scrub
A recent study published in JAVMA looked at 48 veterinary staff members and measured their fingernail bacterial counts with and without nail stickers. After a 4% chlorhexidine scrub, bacterial counts rose between the day nail stickers were applied and one week of wear (P<.001). The authors conclude that wearing stickers increased bacterial load, but counts after one week did not differ significantly from the no-sticker baseline (P=.059). Infection rates were not measured.
Protocol reminder: I know some of us might be far removed from vet school, but don’t get too relaxed and forget proper aseptic technique! Before scrubbing in, keep nails short, remove nail stickers and other adhesive nail products, remove jewelry, and complete the full timed scrub for contact time on the product label.
Tsao N, Morrison B, Kwong GPS, Atilla A. The effect of nail sticker use on hand surface bacterial counts after surgical scrubbing. J Am Vet Med Assoc. 2026;264(3):332-338. doi.10.2460/javma.25.07.0491