Approach to a Poisoned Pet Flashcards
What are the top 10 toxins?
OTC meds
Food
Human prescription meds
Chocolate
Plants
Household toxins
Veterinary products
Rodenticides
Insecticides
Recreational Drugs
5 main areas of acute management of intoxication
ABCDs (airway, breathing, circulatory)
Control hemorrhage, seizures and muscle tremors
Assess metabolic and medical abnorms/ plan for tx
GI contamination
Supportive care
Decontamination
Ocular decontamination (flush with water)
Dermal decon (PPE, soap)
GI decon
Ion exchange resins
Cathartics
Activated charcoal
GI contamination
Purpose: ↓ absorption
Emesis, gastric lavage and whole bowel irrigation
Contraindications to emesis
Going up hurts like going down
Oil/ petroleum
↑ chance of aspiration
Seizing, sedated animal
Home use emetics
7% syrup Ipecac
3% peroxide (NOT CATS)
Table salt
Liquid dishwashing liquids
Veterinary use emetics
Apomorphine (conjunctiva)→ reversal: naloxone
Xylazine (limited effectiveness in cats)
Dexmetatomidine (cats) → reversal: atipamazole
Ropinirole
Gastric lavage
For large quantities of toxins that sit on the stomach (kitty litter) or have a narrow safety index (organophosphate, seizures, comatose)
15-20 L of fluid
Whole bowel irrigation
Indication: sustained release tablets
Clears the entire GI
Contra: obstruction
Ion exchange resins
Binds toxin to carrier → traps in stool → excretion
Ex: cholestyramine
Osmotic cathartics
↓ the time allowed for toxin to absorb (speed transit time)
Two forms: saline (Na sulfate, Mg sulfate, Mg citrate) and saccharide (sorbitol)
Activated charcoal
Universal antidote that absorbs the toxin
Used with cathartic (sorbitol)
Enterohepatic circulation
Hydration and multiple doses
Contraindications for activated charcoal
Toxicants that don’t bind: EG, xylitol and heavy metals
Hypernatremia, Gi obstruction/ perforation, CNS depression
Other forms of decontamination
Forced diuresis
Ion trapping (changes in urine pH)
Lipid emulsion (lipid sink- fat soluble compounds- ivermectins, weed, permethrin)
Therapeutic plasma exchange (TPE)
Apheresis tx
Plasma component of blood removed and replaced with solution (crystalloid/ colloid)