D-Limonene / Xylitol Flashcards
What is D-limonene used for in animals?
control of flea, ticks, and lice
Usually a 5% solution
What is D-limonene?
Citrus oil extract from citrus peels
What percentage of D-limonene can essential oils have compared to what is used in animal flea products?
Essential oils can be up to 95% concentration vs only 5%
What animals are most sensitive to D-limonene?
Cats
but dogs and cats are susceptible
What is the most common exposure/route of absorption of D-limonene?
Absorbed readily through the skin (reaches peak plasma levels in about 10 mins)
What is the MOA of D-limonene?
Unknown - may be central and peripheral vasodilation due to a neuronal mechanism
What clinical signs are associated with D-limonene toxicosis?
Ataxia, weakness, recumbency, paralysis, CNS depression, hypothermia, and hypotension (**hypotension can be severe in cats)
Less common - skin irritation/reaction
What lesions are noted in patients with D-limonene toxicosis?
No specific lesions (unless there is a skin reaction)
**may note LEMON SCENT
What treatment is reccommended for patients with D-limonene toxicosis?
Decontaminate with a bath - make sure to keep the patient warm
Supportive care for clinical signs - patients usually recover within a day
What products can xylitol be found in?
It is a sugar alcohol that can be found in “sugar free” items like gum, some peanut butter, and other diet food products
There is no FDA regulation to have this on the label - so it’s hard to know all or what products contain it
What animals are most sensitive and susceptible to xylitol?
Dogs (some other animals have a response - but not the fatal hypoglycemia that we see in dogs)
Is xylitol absorbed fast or slow?
Slowly from the GI tract
What is the toxicity of xylitol in dogs?
moderately toxic (200 - 400mg/kg) - hypoglycemia
1 piece of sugar free gum may have 1-2 grams
Larger doses - 1.6g - 2g/kg can cause hepatic failure in dogs
What is the MOA of xylitol toxicosis in dogs?
Potent promoter of insulin release - resulting in hypoglycemia and hypokalemia
Large doses - liver failure, GI hemorrhage, and DIC
T/F: Some dogs may have a subclinical hypoglycemic phase and present in liver failure due to xylitol toxicosis
TRUE
Less common, but it can happen
What is the typical onset of clinical signs in a dog with xylitol tox?
30-60 mins up to a few hours depending on the amount
CS: weakness, ataxia, collapse, sz, vomiting/dhr, intestinal hem, icterus
Large amounts of xylitol can cause signs of liver damage and DIC within ____ hours of ingestion
48 hrs
What lesions are associated with xylitol tox?
Not specific for hypoglycemic dz
Liver failure: Petechial, ecchymotic or GI hemorrhages, hepatic necrosis or atrophy
What is the first liver enzyme that you would see elevation in due to xylitol toxicosis?
ALT
Usually noted after 48 hours:
Other lab work - hypoglycemia and hyperkalemia
prolonged clotting times, thrombocytopenia, hyperphosphatemia
T/F: When you suspect xylitol tox in a dog - you should start decontamination with toxiban (activated charcoal) right away
False - not effective
decontaminate via emesis
What treatment can be done for xylitol tox dogs?
Supportive care - Supplemental dextrose in IVF, oral feeding of sugar containing meals
Symptomatic: antiemetics, antibiotics if signs of liver failure, antacids and GI protectants
What is the prognosis of xylitol toxicosis in dogs?
Generally pretty good for hypoglycemic patients if treated quickly
patients with signs of liver failure have guarded prognosis
