Intoxications Flashcards

Question

Clinical signs of Anticoagulant rat poison intoxication.

Answer 1

During the first 36–72h following ingestion of the anticoagulant, the patient is usually clinically normal as the clotting factors are slowly depleted. In animals with some underlying illnesses hemorrhage can occur as early as 24–48h following exposure. Clinical signs: Lethargy, weakness, anemia, difficulty breathing (dyspnea), coughing & hemoptysis. Bleeding into body cavities or joints, external hemorrhage (GI tract, surgical sites, orifices). Abdominal distention, bruising, hematomas, muffled heart sounds. Central nervous system signs in severe cases. Sudden death in cases of severe internal bleeding – hypovolemic shock!

Answer 2

Induced vomiting is effective within 4–8h of ingestion. If vomiting is not successful or contraindicated, oral vitamin K1 should be started. - Asymptomatic patients: start prophylactic vitamin K1 or monitor patient’s PT. If PT is normal at 72h, no treatment is needed. If PT increases, start vitamin K1 treatment. PT monitoring should not occur while administering vitamin K1, can lead to false readings. - Vitamin K1: 3–5 mg/kg twice per day. Duration of treatment depends on the specific rodenticide. - Symptomatic patients: stabilization, oxygen treatment and blood or plasma transfusions. Oral vitamin K1 treatment. Hospitalization until PT normalizes. Prognosis of ingesting anticoagulant rodenticides depends on if the patient is able to survive the first 48hours of acute coagulopathy. If the patient survives, the prognosis improves.

Answer 3

hypoglycemia occurs due to xylitol’s direct stimulation of insulin secretion from the pancreas (seen within 10-15 mins). The mechanism of hepatic necrosis is unknown, but hypothesized either by ATP depletion or by production of reactive oxygen species during the metabolism of xylitol in the liver.

Answer 4

Vomiting Diarrhea Lethargy Weakness Seizures Potentially death (measurement of severe hypoglycemia can put you on the right track + anamenesis)

Answer 5

Emesis (not in case of 100% xylitol products over 30 mins ago, or in case neuro signs are present). IV fluids + dextrose bolus, then parenteral fluids containing 2.5-5% dextrose. Monitoring of blood glucose every 1-4h and liver enzymes. Small frequent meals, as long as patient isn’t vomiting. Drugs: Liver protectant/supportive + antiemetics. Good prognosis with lower doses and prompt treatment. Fair to guarded prognosis with larger ingestions. Guarded prognosis for patients with liver failure.

Answer 6

Permethrin is widely used as an ectoparasitic for dogs, but it’s highly toxic to cats. Cats lack the liver enzyme glucuronyl transferase, which is needed to break down permethrin efficiently, leading to toxic accumulation in their bodies. Some cats are so sensitive that even brief contact with a dog treated with a spot-on product containing concentrated permethrin (45%–65% permethrin) can cause symptoms of toxicity.

Answer 7

Paresthesia in all animals after dermal application. Ear twicthing, paw/tail licking, hiding and hyperexcitability. In cats: weakness, tremors, shaking, ataxia, seizures and paralysis. Severe poisoning signs including seizures, tremors and in extreme cases death. * In dogs: nervousness, rubbing of application site, agitation, shaking of legs and mild muscle fasciculation can occur if overdosed.

Answer 8

- intravenous fluid support to maintain electrolyte balance - thermoregulation support - decontamination by washing - benzodiazepines for seizure control - intravenous lipid emulsion (off-label use) can be considered - methocarbamol (muscle relaxant) to reduce tremors Prognosis: Depends on severity of the exposure and time of treatment initiation. When caught early and managed effectively, recovery is often achievable.

Answer 9

vomiting, anorexia, diarrhea, respiratory distress and signs of shock. Cats have more methemoglobinemia and dogs, hepatotoxicity with GI and CNS signs, but either syndrome is possible in both species.

Answer 10

induce vomiting within 2 hours of ingestion, administer activated charcoal, antioxidants therapy with N-acetylcysteine 140mg/kg I/V initial dose. Prognosis depends on the amount of acetaminophen ingested and the amount of time before treatment begins.

Answer 11

shock (tachycardia, tachypnea, hypothermia, weakness, collapse), brown MMs, respiratory distress, cyanosis, lethargy, coma and face & paw edema.

Answer 12

True lilies are nephrotoxic to cats but may cause GIT upset in dogs. Hybrid lilies are toxic to both cats and dogs, causing GIT upset and possibly other symptoms. The mechanism of action and toxin are unknown. However, the toxin is water-soluble and acts very rapidly, causing severe acute kidney injury (AKI) that targets the renal tubules provoking necrosis. Three systems are affected: renal, GIT, and nervous.

Answer 13

Clinical picture develops within 6 to 12 hours after ingestion. Early signs show vomiting, anorexia and lethargy followed by signs of AKI: polyuria/oliguria/anuria, dehydration, diarrhea and depression. Some cats express CNS signs with ataxia, head pressing, disorientation, tremors and seizures. In some rare cases, the animal may develop pancreatitis.

Answer 14

Induce vomiting (before symptoms start) IV-fluid therapy: at least for 48-72 hours, isotonic crystalloids, initially at 2-3x maintenance for 48 hours then adjust accordingly to patient’s needs. activated charcoal for binding toxins & cathartic for increasing bowel movements (if not dehydrated / diarrhea) Other treatment considerations: diazepam (seizures), gastroprotectants, antiemetics, analgesics Good to excellent if cat is treated in less than 18h + 48-72h of fluid therapy. Poor to grave if delayed treatment in more than 18h → chronic kidney injury may occur.

Answer 15

Metaldehyde is a chemical used in slug and snail bait and is often a blue-green pellet. Metaldehyde decreases the concentration of gamma-aminobutyric acid, an inhibitory neurotransmitter that causes CNS excitation. Decreased concentrations of serotonin (5-hydroxytryptamine) and norepinephrine in the CNS decrease the threshold for seizures.

Answer 16

Signs can appear in a few minutes and up to 3 hours. Dose-dependent signs and similar in most species. Early signs (within 1-3 hours of ingestion): hyperesthesia (heightened sensitivity to stimuli), hyperthermia, restlessness, anxiety, severe muscle tremors and ataxia. Progressive signs: Seizures, tachycardia, tachypnea, hypersalivation, vomiting, diarrhea, mydriasis, nystagmus (cats), cyanosis, acidosis and coma, leading to death without treatment.

Answer 17

No specific treatment, but supportive care during the first 24h results in full recovery of most patients in 2-3 days’ time. care includes; IV fluids, sedation and anesthesia. Activated charcoal is used for gastric lavage and decontamination. Cold water provisions are used to treat the hyperthermia.

Answer 18

Toxic ingredient in chocolate is 2 methylxanthines: theobromine and caffeine, both constituents contribute to chocolate toxicosis. Theobromine and caffeine competitively inhibit cellular adenosine receptors, resulting in CNS stimulation, diuresis, and tachycardia. Methylxanthines also increase intracellular calcium levels by increasing cellular calcium entry and inhibiting intracellular sequestration of calcium by the sarcoplasmic reticulum of striated muscle. The net effect is increased strength and contractility of skeletal and cardiac muscle.

Answer 19

* Usually within 6–12 hours of ingestion. * GI tract: vomiting and diarrhea * Cardiovascular: tachycardia, arrhythmias, and hypertension * CNS: ataxia, muscle tremors, seizure activity and hyperexcitability * Renal/urological: polyuria, polydipsia and urinary incontinence * Respiratory: tachypnea, respiratory failure * Endocrine/metabolic: hypokalemia Death generally due to cardiac arrhythmias, hyperthermia, or respiratory failure.

Answer 20

Induce emesis if patient is not yet showing clinical signs. Activated charcoal, gastric lavage if indicated Supportive care and treatment of seizures with benzos, lidocaine for ventricular arrhythmias, beta blockers if tachyarrhythmias.