Bovis ISSN 2398-2993

Drug reactions: anaphylaxis and urticaria

Contributor(s): Gayle Hallowell , Alex Dugdale

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Definition

  • Anaphylaxis is a type-I IgE-mediated immediate hypersensitivity reaction involving degranulation of mast cells and basophils.
  • Anaphylactoid reactions include immune, but not IgE-mediated reactions and also direct non-immune-mediated release of mediators from mast cells and/or basophils or result from direct complement activation.
    • Clinical signs are similar to anaphylaxis and some authorities suggest to use only the term ‘anaphylaxis’ to cover all types of reactions as the approach to treatment is the same, regardless of inciting mechanism.
  • In humans the incidence of anaphylaxis under anesthesia ranges from 1 in 3,500 to 1 in 13,000.
  • Anaphylaxis is a clinical syndrome that will affect multiple organs.
  • It is unanticipated and often sudden in onset.
  • Urticaria presents as skin swellings that pit with digital pressure and are often associated with immediate-type hypersensitivity reaction.
Anaphylaxis and anaphylactoid reactions are very very rarely reported in cattle; urticaria is seen occasionally following administration of alpha-2 agonists.

Prevention

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Diagnosis

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Drugs involved

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Management

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMed Resource.
  • Okushima S, Chesnel M-A, Clutton R E (2013) A possible anaphylactoid reaction in a cow after intravenous meloxicam. Vet Anaesth Analg 40, 333-334 PubMed.
  • Armitage-Chan E (2010) Anaphylaxis and anaesthesia. Vet Anaesth Analg 37, 306-310 PubMed.
  • Hepner D L & Castells M C (2003) Anaphylaxis during the perioperative period. Anaesthesia Analgesia 97(5), 1381-1395 PubMed.

Other sources of information

  • Bishop Y (2000) Ed The Veterinary Formulary. 5th edn. British Veterinary Association and Royal Pharmaceutical Society.
  • Valverde A & Sinclair M (2015) Chapter 49 Ruminant Anesthesia and Chapter 51 Ruminant and Swine Local Anesthetic and Analgesic TechniquesIn: Veterinary Anesthesia and Analgesia. Blackwell Publishing.
  • Clarke K & Trim C (2014) Patient Monitoring and Clinical Measurement and Anaesthesia of Cattle. Veterinary Anaesthesia (Eleventh Edition), Elsevier.


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