{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T12:47:09Z","timestamp":1746881229855,"version":"3.37.3"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Vet Emergen Crit Care"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To document clinical complications and intervention options associated with norepinephrine (NE) extravasation in dogs and cats.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cases were identified between 2015 and 2021. Because this is an uncommon complication, the findings are compiled as a descriptive retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Cases were provided from 4 universities and 2 private practice groups in the United States, Canada, and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Animals<\/jats:title><jats:p>Fourteen patients (13 dogs, 1 cat) that experienced extravasation events (16 total).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Small animal patients were included where extravasation of a NE constant rate infusion (CRI) was documented. Records were reviewed for information, including suspected underlying condition, description of the interventions pursued after identification of extravasation, clinical signs after extravasation, and survival to discharge or reason for patient death or euthanasia. When available, information was collected pertaining to the NE dose, dilution, total duration of CRI, and duration of CRI before extravasation was recognized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>The most commonly reported clinical signs after extravasation of NE were skin necrosis (<jats:italic>n\u00a0<\/jats:italic>=\u00a09 [64.3%]) and swelling (<jats:italic>n<\/jats:italic>\u00a0=\u00a06 [42.9%]). In 10 of 16 events (62.5%), discontinuation of the NE CRI and\/or application of a warm compress to the extravasation site were performed; these were the most common nonpharmacological rescue measures. Two patients received subcutaneous phentolamine, and 1 patient underwent hyperbaric oxygen therapy. While surgical intervention was recommended for 4 dogs, 2 improved without surgical debridement. The overall survival rate from underlying disease processes was 57% (<jats:italic>n<\/jats:italic>\u00a0=\u00a08), with only 1 patient (7%) euthanized due to an injury from the extravasation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Severe lesions can result from NE extravasation in dogs and cats, leading to euthanasia. Although phentolamine remains the treatment of choice, lesions may heal with alternative supportive measures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vec.13442","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T10:25:51Z","timestamp":1739787951000},"page":"73-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multicenter retrospective evaluation of norepinephrine extravasation in dogs and cats (2015\u20132021): 14 cases"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6284-7018","authenticated-orcid":false,"given":"Maria P.","family":"Vasquez","sequence":"first","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine Washington State University  Pullman Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8924-8445","authenticated-orcid":false,"given":"Meredith","family":"Daly","sequence":"additional","affiliation":[{"name":"Blue Pearl  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1361-2148","authenticated-orcid":false,"given":"Corrin J.","family":"Boyd","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine Murdoch University  Murdoch Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn E.","family":"Crandell","sequence":"additional","affiliation":[{"name":"Toronto Animal Health Partners  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5399-932X","authenticated-orcid":false,"given":"Kelly E.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Colorado State University  Fort Collins Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin Long","family":"Mays","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Medicine University of Illinois Urbana\u2010Champaign  Urbana Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tandi","family":"Ngwenyama","sequence":"additional","affiliation":[{"name":"Oregon State University Veterinary Teaching Hospital  Corvallis Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-3022","authenticated-orcid":false,"given":"Jennifer","family":"Ortolani","sequence":"additional","affiliation":[{"name":"VCA SouthPaws Veterinary Specialists and Emergency Center  Fairfax Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5125-7314","authenticated-orcid":false,"given":"M. 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