Chapter 5 - Therapy and Management of Toxicoses Flashcards
Mechanisms of management of toxicoses
Methods to reduce or eliminate exposure to the toxicant in acute toxicosis
- Removal from the toxic environment
- Telephone instructions
- Physical removal
-
Absorption of ingested toxicants
- Emesis
- Gastric lavage
- Adsorption therapy with activated charcoal
- Gastrotomy / rumenotomy
- Reducing dermal and ocular exposure
Telephone instructions when attempting to reduce exposure to the toxicant by removal from the toxic environment
- Serious illness (e.g. recumbent, comatose, seizuring) advise to take animal to vet
- Toxicant label
- Time of exposure: when ingested substance? If recent, this information aids in attempts at intervention by removal form the toxicant.
- Has the animal vomited? If not, emetics administered at home may be useful.
Most effective ways to remove poison from the stomach and optimum times?
Induction of emesis is the most effective means of emptying the stomach in those animals that can vomit readily.
Most effective in the first 2 hours after ingestion and limited benefit more than 4 hours after ingestion.
Dosages of therapeutic agents for acute toxicosis:
Emesis: first aid by owner
Given orally.
-
Ipecac syrup: vomiting expected in 20 minutes. Danger: excessive vomiting or CNS depression.
- dogs: 1-2ml/kg
- cats: 3 ml/kg
- Hydrogen peroxide (3%): 1-5ml/kg, not to exceed 50ml total dose in dogs or 10ml in cats.
- Liquid dishwashing detergent: 3 T in 8 oz of water at 10ml/kg. (NO: laundry and dishwasher detergents)
Dosages of therapeutic agents for acute toxicosis:
Emesis: veterinary use in dogs
-
Apomorphine: Dangers: vomiting may be excessive, CNS depression, not recommended for cats.
- 0.04mg/kg IV
- 0.08mg/kg SQ
- SC instillation of 0.25mg in saline.
Dosages of therapeutic agents for acute toxicosis:
Emesis: veterinary use in cats
-
xylazine: danges: respiratory depression, can be reversed with yohimbine (0.1mg/kg IV)
- 1.1mg/kg IM
Contraindications of emesis
Not recommeded for rodents, rabbits, horses, ruminants.
Contraindications:
- Animal is unconscious or very depressed (aspiration vomitus)
- Animal is in seizure
- Animal has ingested:
- corrosive or caustic materials: risk of rupture and further damage
- petroleum distillates or other (e.g. gasoline): risk of aspiration pneumonia.
How effective is ipecac in dogs?
Ipecac is ineffective in approximately half of the dogs treated.
Dosages of therapeutic agents for acute toxicosis:
Gastric lavage
-
Water or saline initially at 10ml/kg in stomach tube with fenestrated tip.
- lavage fluid should be tepid
- administration gentle, gravity flow
- repeat 15-25 times or until lavage fluid is clear
Dosages of therapeutic agents for acute toxicosis:
Adsorption therapy
-
Activated charcoal.
- adminstered in water slurry of 1g/5ml water at 2-5g charcoal/kg body weight
- not given concurrently with other orally adminstered drugs
- may be followed with osmotic cathartic
Mechanism of action of adsorption therapy with activated charcoal
Adsorption is the physical binding of a toxicant to an unabsorbable carrier, which is eliminated in the feces.
When is activated charcoal most effective
- It is most effective for large, nonpolar molecules
- Ionized agents are less strongly adsorbed than neutral compounds
- Relatively ineffective against ammonia and cyanide
Dosages of therapeutic agents for acute toxicosis:
Osmotic catharsis
- Sodium sulfate: 250mg/kg orally
- Sorbitol (70%) 3ml/kg orally
Either may be given 30 minutes after activated charcoal.
Not used if animal has diarrhea.
Dosages of therapeutic agents for acute toxicosis:
Cleasing of skin or hair
Animal should be washed several times using mild shampoo or liquid dishwashing detergent.
water should flow over the animal so it does not remain in contaminated rinse water.
Persons wear gloves and PPE
Long hair may be clipped
