Chapter 17 - Metals and Minerals Flashcards

1
Q

Example of nutrient excess in some metals that can cause a secondary metal deficiency.

A

Excessive amounts of one metal can cause a secondary metal deficiency by antagonizaing its absorption, transport or retention:

Excessive metal // Resultant deficiency // Affected Species

  • Cadmium // Zinc // All
  • Molybdenum // Copper // Cattle
  • Potassium // Magnesium // Cattle
  • Iron // Phosphate // Swine
  • Calcium // Zinc // Swine
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2
Q

Example of nutrient deficiencies in some metals that can enhance metal toxicity.

A

Nutrient deficiencies can enchance metal toxicity. E.g. low dietary calcium, zinc and iron enhance the absorption and toxicity of lead.

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3
Q

What is chelation?

A

Chelation is a reversible interaction between a metal and an anionic or netural molecule that has at least one pair of nonbonded electrons.

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4
Q

How can the chemical form and oxidation state (valence) of a metal affect the toxicologic effects of As and Hg

A

Inorganic forms of As and Hg primarily affect the liver, kidney and digestive tract

Organic forms predominantly accumlate in and affect the nervous system.

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5
Q

Arsenic Toxicosis:

Sources

A
  1. Environment:
    1. Ores (aresnopyrite, loellingite) mined and smelted to produce: elemental arsenic and arsenic trioxide.
    2. Arsenic in the environment exists in teh pentavalent form and may be methylated by microorganisms.
  2. Commercial forms:
    1. Inorganic:
      1. Arsenic trioxide: (former herbicide)
      2. Pentavalent and trivalent forms (Na, K, Ca salts) used as baits
    2. Organic:
      1. Trivalent:
        1. Monosodium methanearsonate (MSMA) and disodium methanearsonate (DMSA), used as herbicides
        2. Thiacetarsamide: heartworm therapy in dogs
      2. Pentavalent arsenical feed additives (arsanilic acid, sodium arsanilate, 3-nitro 4-hydroxyphenylarsonic acid)
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6
Q

Arsenic Toxicosis:

Exposure:

A

Arsenic poisoning can result from:

  • Accidental exposure of livestock to old pesticides improperly disposed of or stored
  • Arsenic-contaminated soils or burn piles (licked by animals that crave salt or minerals)
  • Contaminated waters in abandoned minig areas
  • Ant baits (sodium or potassium arsenate) - attractive to small animals, specially cats
  • Use of thiacetarsamide in dogs
  • Overdosage or extended use of organic arsenical feed additives in poultry or swine
  • Burning of wood products treated with arsenical preservatives.
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7
Q

Arsenic Toxicosis:

Toxicokinetics

A
  1. Absorption: soluble arsenicals are readily absorbed from the gastrointestinal tract and through the skin
  2. Metabolism: methylation of inorganic arsenicals occurs in vivo and may aid in detoxification.
  3. Excretion: Trivalent arsenic is excreted into the intestine via the bile. Pentavalent arsenic is excreted by the kidneys. Excretion is rapid and nearly complete within a few days.
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8
Q

Arsenic Toxicosis:

Mechanisms of Toxicologic Damage

A
  1. Trivalent arsenicals:
    1. Inhibition of cellular respiration (binding to sulfhydryl compounds: lipoic acid and alpha-keto oxidases)
    2. Capillary dilatation and degeneration (unknown mechanism)
  2. Pentavalent inorganic arsenicals (i.e. arsenates): subsitute for phosphate in oxidative phosphorylation: uncoupling of oxidative phosphoryl. produces cellular energy deficit.
  3. Pentavalent organic arsenicals (feed additivies): demyelination and axonal degeneration: interference with B vit.
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9
Q

Arsenic Toxicosis:

Toxicity

A
  1. Inorganic arsenicals: Trivalent forms 10x more toxic than pentavalent forms.
    1. Acute: single dose lethal toxicity: 1-25 mg/kg. Cats more suscept > horses > cattle and sheep > swine > birds
    2. Subacute: lower dosages over several days
    3. Chronic: generally not described.
  2. Organic arsenicals:
    1. Pigs: 500ppm dietary arsanilic acid or 250ppm 3-nitro 4-hydroxy phenylarsonic acid for 7-10 days
    2. Poultry: exposure of 2x pigs.
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10
Q

Arsenic Toxicosis:

Diagnosis: Clinical signs

A
  1. Inorganic or organic trivalent arsenicals:
    1. Acute or peracute poisoning:
      1. Vomiting and intense abdominal pain
      2. Weakness, staggering, ataxia, recumbency
      3. Weak, rapid pulse with signs of shock (hypotension, dehydration, hemoconcentration, hypothermia)
      4. Rapid onset of severe, watery diarrhea
      5. Rumen and GI atony
    2. Subacute poisoning: when animals survive acute poisining and live for > 3 days.
      1. Watery diarrhea continues
      2. Oliguria and proteinuria + polyuria and signs of kidney damage.
      3. Dehydration, acidosis, azotemia may cause death.
  2. Organic pentavalent arsenical feed additives:
    1. 2-4 days: ataxia, incoordination, torticollis, blindness.
    2. Pigs: weak, sitting-dog posture, paralyzed in lateral recumbency
    3. Appetite normal, animals are cognizant, some blindess.
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11
Q

Arsenic Toxicosis:

Diagnosis: Lesions

A
  1. Gross lesions:
    1. GI irriation: mucosal congestion, submucosal edema, epithelial necrosis, accumulation of fluids in atonic intestine
    2. Subacute: intestinal capillary dilatation, submucosal congestion and edema, intestinal epithelial necrosis, renal tubular necrosis, hepatic fatty degeneration.
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12
Q

Arsenic Toxicosis:

Diagnosis: Laboratory diagnosis

A
  1. Packed cell volume increases
  2. Blood urea nitrogen (BUN) increases
  3. Urinalysis: proteinuria, increased specific gravity, casts.
  4. Chemical residues in tissues or body fluids:
    1. AM: urine, vomitus, feces, hair. Chronic poisoning: inorgan. As accumulates in epidermis and hair (weeks-months)
    2. PM:
      1. Inorgan: acute: liver and kidney, rapidly excreted by animals that survive.
      2. Organ: pentavalent accumulate in nervous tissue (weeks)
  5. Analysis of suspected baits, feed, plants or soil
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13
Q

Arsenic Toxicosis:

Treatment

A

Early intervention:

  1. Emergency and supportive therapy: correction of shock, acidosis and dehydration.
  2. GI detoxification: emetics, activated charcoal, cathartic agents or gastric lavage (recent)
  3. Antidotes:
    1. Dimercaprol (British antilewisite, BAL): prior to onset of clinical signs.
    2. Thiocitc acid: more effective than 1 in cattle
    3. Mesodimercaptosuccinic acid (MSMA) and dimercaptosuccinic acid (DMSA)

Convalescent animals: bland diets with reduced amounts of protein; vitamin supplementation.

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14
Q

Arsenic Toxicosis:

Prognosis

A
  1. Inorgan. trivalent arsenicals: Mortality rate is high among acutely poisoned animals.
  2. Organic pentavalent arsenicals: high morbidity rate but low mortality if good nursing and supportive care. Recovery: 2-4 weeks.
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15
Q

Copper Toxicosis:

Sources

A

Sources include:

  • copper sulfate foot baths
  • fungicides
  • algicides
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16
Q

Acute Copper Toxicosis:

Mechanisms of toxicologic damage

A

Copper salts act as direct tissue irritants and oxidants and cause coagulative necrosis of the GI mucosa.

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17
Q

Acute Copper Toxicosis:

Toxicity

A

Single oral toxic dosage is 25-50mg/kg body weight.

18
Q

Acute Copper Toxicosis:

Diagnosis: Clinical signs and Lesions

A
  1. Signs: Rapid onset of salivation, nausea, vomiting, colic, fluid or hemorraghic diarrhea (sometimes green-tinged) with rapid dehydration, shock and death.
  2. Lesions: severe gastroenteritis, congestion of the liver, kidneys and spleen.
19
Q

Acute Copper Toxicosis:

Differential Diagnoses:

A
  • Toxicoses:
    • Arsenic
    • Mercury
    • Selenium
  • Infectious gastroenteritis (acute salmonellosis, canine parvovirus…)
20
Q

Chronic Copper Toxicosis in sheep:

Sources

A
  • Feed additives (copper sulfate, copper oxide, copper chloride)
  • Natural copper in soils and plants
  • Soils contaminated by mining or smelting
  • Soils and plants fertilized with used poultry litter or swine manure
21
Q

Chronic Copper Toxicosis in sheep:

Mechanisms of toxicologic damage

A
  1. Accumulation in hepatic mitochondria and lysosomes (can be seen histol. with rubeanic acid staining) causes cellular degeneration or necrosis.
    1. In ruminan. is associated with copper, molybdenum and sulfate imbalances.
    2. Can be secondary to liver damage from xenobiotics or plants: Heliotropium and cause excess accumulation.
  2. Acute hemolytic crisis: stress may precipitate sudden loss of stored copper from the liver to the blood.
    1. Excess copper oxidases erythrocyte membranes => hemolysis.
    2. Oxidation of hemoglobin to form methemoglobin, no transport of oxygen (aggravate acute hemolytic crisis).
22
Q

Chronic Copper Toxicosis in sheep:

Toxicity

A
  1. Normal feed copper levels (10-20ppm) cause hepatic copper accumulation when molybdenum <1-2ppm or sulfate is not available. (Grains and forages contain <1ppm molybdenum.
  2. 2-10 weeks exposure
23
Q

Chronic Copper Toxicosis in sheep:

Diagnosis: clinical signs and Lesions

A
  1. Clinical signs of acute hemolytic crisis: acute anemia. Weakness, anorexia, fever, icterus, pale mucous membranes, dyspnea.
  2. Lesions: liver, kidney, spleen.
    1. Gross: hepatic icterus; enlarged, pulpy spleen; dark, bluish-black kidneys (gunmetal kidneys)
    2. Micro: swollen, necrotic hepatocytes, vacuolation, periportal fibrosis, renal tubular necrosis, hemogloing casts in renal tubules, excessive fragmented erythrocytes in the spleen.
24
Q

Chronic Copper Toxicosis in sheep:

Diagnosis: laboratory diagnosis

A
  1. Elevated bilirubin, hemoglobinemia, hemoglobinuria.
  2. Elevated levels of hepatic enzymes (AST, LDH, SDH, arginase)
  3. Elevated serum/blood copper levels (> 1.5ppm)
  4. Copper levels in liver > 150ppm and kidneys > 15ppm
25
Q

Chronic Copper Toxicosis in sheep:

Differential diagnoses

A
  1. Infectious diseases: leptospirosis, bacillary hemoglobinuria, babesiosis, anaplasmosis.
  2. Plant toxicoses: onions, Brassica, red maple (Acer rubrum)
  3. Drug toxicoses: phenothiazine anthelmintic toxicosis.
26
Q

Chronic Copper Toxicosis in sheep:

Prevention

A

Death within 24-48h of acute hemolytic crisis. Mortality high. Prevention is important!.

  1. Feeding rations to ensure maintenance of the maximum copper:molybdenum ratio of 6:1.
  2. Copper sulfate added to feed.
  3. Addtion of molybdate to rations (2-4ppm)
  4. Dosing with 50mg ammonium molybdate and 0.3-1.0 g thiosulfate per day
  5. Supplemental zinc (250ppm) reduces hepatic copper accumulation.
27
Q

Chronic Copper Toxicosis in sheep:

Treatment

A
  1. Ammonium tetrathiomolybdate: rapid binding and excretion of copper.
  2. D-penicillamine (50 mg/kg orally, 6 days)
  3. Subacute cases: molybdenized copper phosphate sprayed on pastures at 4 oz per acre.
28
Q

Chronic Hepatic Copper accumulation in dogs:

Etiology, breeds and ages most affected

A

Chronic canine hepatic copper accumulation is inherited as an autosomal recessive trait.

Most common in Bedlington terriers, also West Highland white terriers, Doberman pinschers and others.

Usuall appears at 2-6y with no prior signs.

29
Q

Chronic Hepatic Copper accumulation in dogs:

Mechanism of toxicologic damage

A

Copper accumulates in the lysosomes of hepatocytes until the storage capacity is exceeded. Release the copper to the cytoplasm: necrosis and inflammation.

30
Q

Chronic Hepatic Copper accumulation in dogs:

Diagnosis: clinical signs and Lesions

A

Clinical signs:

  1. Young dogs (<6y): acute with vomiting, anorexia, weakness, dehydration.
  2. Older dogs: anorexia, weight loss, icterus, ascites, hepatic encephalopathy.
  3. Hemolytic crisis (rare)

Lesions:

  1. Gross: Liver: large and necrotic to small and cirrhotic.
  2. Micro: focal hepatitis, chronic active hepatitis, cirrhosis. Coper stains (e.g. rubeanic acid) show copper accumulation in hepatocytes.
31
Q

Chronic Hepatic Copper accumulation in dogs:

Laboratory diagnosis

A
  1. Elevated liver enzymes (ALT, AP) and bilirubin.
  2. Copper level in liver >1,000ppm (dry-weight basis). Hepatic biopsy confirms presence of copper.
  3. Serum copper levels normal
  4. Plasma ceruplasmin levels are normal.

[ceruplasmin is a copper-binding protein that is produced in the liver and released to the plasma to bind copper.

32
Q

Chronic Hepatic Copper accumulation in dogs:

Treatment and prevention

A

Treatment:

  1. Ongoing chelation therapy with D-penicillamine for months, years, lifetime.
  2. Adjunctive supportive therapy:
    1. Corticosteroids (0.5-1.0 mg/day) [to stablize hepatic lysosomal membranes]
    2. Ascorbid acid (500-1000 mg/day) to enhance excretion.

Prevention: copper intake in diet limited to 5-10ppm.

33
Q

Iron Toxicosis:

Sources

A
  1. Preparations for oral supplementation of iron, including powders, tablets, premixes.
    1. Ferrous fumarate (C4H2FeO4)
    2. Ferrous sulfate (FeSO₄·xH₂O)
    3. Ferric phosphate (FePO₄)
    4. Ferrous carbonate (FeCO₃)
  2. Injectable iron preparations for prevention of neonatal anemia or use as hematinics
    1. Ferric ammonium citrate ((NH₄)₅[Fe(C₆H₄O₇)₂])
    2. Iron-dextran complexes
34
Q

Iron Toxicosis:

Exposure

A

Iron toxicity most often occurs as teh result of accidental ingestion of oral supplements or overdosage.

35
Q

Iron Toxicosis:

Mechanism of toxicologic damage

A
  1. Normally: levels of iron maintained by selective absorption (energy-dependent carrier)
    1. ferrous iron oxidized to ferric iron and bound to transferrin (ß-1 glycoprotein)
    2. used for oxygen transport (hemo-, myoglbin). Excess is stored as hemosiderin or ferritin.
  2. Excessive dose: circulates in plasma as free iron
    1. direct damage to epithelial cells (e.g. gastric mucosa) - corrosive and strong oxidant
    2. mitochondrial damage: hepatic necrosis
    3. cardiovascular collapse (increased capillary permeability)
36
Q

Iron Toxicosis:

Toxicity (oral preparations)

A

No mechanism for excreting irong, toxicity depends on the amount of iron already present in the body.

  1. Toxicity injectables > orals. Oral:
    1. moderately toxic: 20-60 mg/kg bw.
    2. severely toxic: > 60 mg/kg bw
    3. lethal: > 200 mg/kg
37
Q

Iron Toxicosis:

Toxicity: diets with high iron in piglets

A

Diets > 5,000ppm of iron interfere with phosphate absorption and can lead to retarded growth and rickets in pigles.

38
Q

Iron Toxicosis:

Diagnosis: clinical signs

A
  1. Oral preparations:
    1. < 6h: drowsiness, depression, vomiting, hemorrhagic diarrhea
    2. 6-24h: apparent improvement
    3. >24h: diarreha returns, DH, acute liver necrosis, shock acidosis, coma
    4. Ocassionaly: acute hemolytic anemia, icterus, hemoglobinemia, coagulopathy.
  2. Injectable preparations: 2 syndromes:
    1. severe depression, shock, acidosis from excessive circulating iron.
    2. peracute anaphylactic-like reaction (almost immediately after injection not dosage related) related to histamine release.
39
Q

Iron Toxicosis:

Diagnosis: lesions

A
  1. Oral preparations:
    1. mucosal necrosis, ulceration
    2. enteritis, intestinal contents: fluid to hemorrhagic
    3. congestion of spleen, liver, kidneys
    4. liver necrosis, icterus, hemoglobinuria
  2. Injectable preparations: yellowish-brown discoloration of tissues and local lymph nodes and edema at or near the injection site
40
Q

Iron Toxicosis:

Diagnosis: laboratory diagnosis

A
  1. Elevated serum iron levels: 1.5x-2x normal (100-300ug/dl)
  2. increased saturation of serum total iron-binding capacity (TIBC). No correlation with severity
  3. Hemoconcentration (shock and DH)
  4. Acidosis
  5. increased serum hepatic enzymes and bilirubin
  6. Hemoglobinuria
  7. Elevated iron in liver
  8. Abdominal radiographs: ingestion of iron tablets
41
Q

Iron Toxicosis:

Treatment

A
  1. Decontamination of GI tract <4h (if no vomiting or diarrhea)
    1. NO activated charcoal
    2. Milk of magnesia: precipitate iron as insoluble iron hydroxide
  2. Supportive to control shock, DH and acidosis
  3. Chelation therapy:
    1. Deferoxamine parenterally + oral ascorbic acid
    2. urine is reddish-brown
    3. Monitor serum iron levels 2-3 days
  4. Convalescent care: residual intestinal scarring and liver damage.