Canine Flashcards
Amlodipine
Vasodilator - calcium channel blocker
For systemic hypertension
Side effect: hypotension, bradycardia
PO
Enalapril
ACE Inhibitor - blocks angiotensin 2 –> vasodilation of glomerular efferent arterioles, decreased GFR, decreased intraglomerular pressure
Used as vasodilator –> congestive heart failure, systemic hypertension
Also used for CRF, PLN
Side effects: hypotension, look at renal values and electrolytes
PO
Furosemide
Loop diuretic –> reduced sodium and cl- reabsorption –> more water excreted
Diuretic for CHF cases to reduce pulmonary edema; oliguria or anuria cases cautiously
Side effects: fluid/electrolyte changes, azotemia, hydration and blood work levels; advise owners on PU/PD and to give enough water
Given PO and IV
Lidocaine
Antiarrthymic –> voltage gated sodium channel blocker
Used for ventricular tachycardia
Used cautiously with hepatic disease, less efficiency with hypokalemia
Given IV
Pimobendan
Inotropic drug with vasodilatory properties –> calcium sensitizer and selective inhibitor of PDE3
Adjunctive disease for CHF with dilated cardiomyopathy, mitral valve disease
Not for cats, contraindicated for HCM
Use with caution for arrythmia cases
Given PO
Spironolactone
Competitive inhibitor with aldosterone in the distal tubules - aldosterone antagonist
Diuretic agent –> CHF, some renal conditions (nephrotic syndrome)
Weak diuretic so may be combined with another
Potassium sparing - monitor for hyperkalemia
Ethylene glycol toxicity
Antifreeze
Converted from ethylene glycol to glycolic acid and oxalic acid by alcohol dehydrogenase
Clinical signs
-Phase 1: Neurologic (30 min - 12 hrs) –> druken behavior, stupor, coma, anorexia, vomiting, Ca oxalate crystalluria seen after 6 hrs, PU/PD
-Phase 2: Cardiovascular (12-24 hrs) –> tachpnea, tachycardia
-Phase 3: Renal (12 - 72 hrs) –> oliguric renal failure, high anion gap metabolic acidosis, elevated osmolar gap, hypocalcemia, hyperglycemia
Treatment: before toxic metabolites formed
- 4-methylpyrazole (4-MP): competitive inhibitor of ADH; use within 8 hrs of ingestion
-20% ethanol: competitive inhibitor of ADH; use within 4-8 hrs
-Symptomatic therapy: GI protectant, IV fluid, diuretic in oliguric patient
-Hemodialysis
Prognosis: good is caught early; guarded if azotemia and grave is oliguric/anuric without dialysis
Household Cleaners
Acids - caustic
Alkali - corrosive
Lesions from acids can show before alkali
Treatment: dilute milk or water, GI protectants for several days, monitor for esophageal/GI ulcerations and strictures, NO VOMITING, NO ACTIVATED CHARCOAL (doesn’t bind)
Contact poison control for specific product recommendations
Painting and Varnishing Products
Most fairly non-toxic and cause GI upset
Do not remove from fur with paint thinner or turpentine –> irritating and painful on skin/footpad; if ingested, dilute with milk/water; NO VOMITING for risk of aspiration pneumonia
Moldy Garbage Intoxication (Garbage Intoxication)
Aspergillus spp produces neurotoxin, penitrem A –> raises resting membrane potential to facilitate depolarization
Clinical signs: incoordination, fine muscle tremors, panting, restlessness, hypersalivation, tonic spasms, hyperthermia, ataxia, seizures, vomiting
Treatment
- GI decontamination: emesis, activated charcoal
- Supportive care: muscle tremors with methocarbamol, seizures with diazepam/phenobarbital, GI protectants (H2 blocker, sucralfate)
Anticoagulant Rodenticide Toxicity
Warfarin, brodifacoum
Inhibits Vitamin K1 epoxide reductase –> prevents activation of vitamin K coagulation factors 2,7,9,10
Clinical signs: 3-7 days after ingestion; hemorrhage
- hemorrhage into body cavity and lungs, signs of shock (pale mm, prolonged CRT, tachycardia, weak pulses); abdominal distention, respiratory distress
Diagnosis: elevated PT time first (factor 7 depleted first)
Treatment:
-recent ingestion: emesis (2-4 hrs), activated charcoal (8-12 hrs); check PT 36-72 hrs after ingestion to see if treatment is necessary or give vitamin K1 for 4 weeks and recheck PT 2-3 days after therapy
-Possible recent ingestion: perform PT and only induce emesis is PT is normal, activated charcoal, vitamin K1 for 4 weeks, recheck PT after 2-3 days
-hemorrhage secondary to coagulopathy present: plasma transfusion (for immediate hemostasis); if dyspnea from pleural space hemorrhage (thoracocentesis, supplemental O2, mechanical ventilation); isotonic crystalloids and/or colloids for volume support; vitamin K1 for 4 weeks and recheck PT for 48-72 hrs
Bromethalin Rodenticide Toxicity
Inhibits oxidative phosphorylation and ATP production especially in neurons –> loss of osmotic gradient maintenance, cerebral edema, increased ICP
Clinical signs
-high doses: tremors, seizures, hyperexcitability, hyperthermia within 12 hrs
-low doses: ascending paralysis beginning in hindlimbs days to weeks after ingestion
Treatment
-acute: Gi decontamination (emesis, gastric lavage, activated charcoal)
-seizure treatment
- mannitol or furosemide for cerebral edema to decrease ICP
Cholecalciferol Rodenticide Toxicity
Precursor converted to vitamin D after ingestion –> increased intestinal absorption of calcium and mobilization from bones –> severe hypercalcemia, hyperphosphatemia and organ injury
Clinical signs: PU/PD, GI upset, acute renal failure, cardiac arrythmias, azotemia
Treatment:
-acute: emesis and activated charcoal
-hypercalcemia: saline diuretic and loop diuretic (urinary excretion of calcium), corticosteroids (urinary retention and decreased intestinal absorption of calcium), bisphosphonates (inhibit osteoclast activity and bone reabsorption)
-azotemia: supportive care for acute renal failure
Guarded to grave prognosis once progression to renal failure occurs
Idiopathic Trigeminal Neuritis
Dogs - peracute onset of dropped jaw and inability to close mouth but no CN V sensory deficits
Normal, alert, and no difficulty swallowing food place in back of mouth
Treatment: supportive care with fluids, hand feeding soft foods
Excellent prognosis in regaining function to normal in 4 weeks
Warfarin, brodifacoum toxicity target organ
Blood - clotting factors leading to anticoagulation and hemorrhage
