Ionophore toxicosis Flashcards

1
Q

5 uses of ionophores?

A
  • Anticoccidial in poultry, cattle, and goats
  • Growth promoter feed additive in cattle
  • Monensin is approved to improve efficiency of milk production in dairy cattle in the US
  • Reduction of bloat and rumen acidosis in ruminants
  • Prevention of tryptophan-induced atypical bovine pulmonary emphysema
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2
Q

Examples of ionophores?

A
  • Monensin
  • Lasalocid
  • Salinomycin
  • Narasin
  • Semduramicin sodium
  • Laidlomycin propionate potassium
  • Carboxylic acid derivatives antibiotics
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3
Q

Solubility?

A

Slightly soluble in water, soluble in organic solvents and oils

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4
Q

Form lipid-soluble complexes with what?

A

With polar cations (Na, Ca, K Mg) that are transported across cellular membranes

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5
Q

What is the most common source of ionophore toxicosis?

A

Monensin

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6
Q

What are 3 other sources of ionophore toxicosis?

A
  • Eating feeds that contain more than the recommended levels in chickens, cattle and swine
  • Eating feeds with added ionophores, accidentally or intentionally, in horses, sheep and dogs
  • Malicious poisoning in horses
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7
Q

Which animals are susceptible to ionophore toxicosis? Which species are the least, intermediate, and most sensitive?

A
  • All animals susceptible
  • Equine are the most sensitive, cattle are intermediate, and poultry are the least sensitive
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8
Q

T/F: Horses that ingest recommended ionophore levels for cattle are poisoned

A

FALSE–they are not poisoned

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9
Q

Concurrent administration of which drugs increases toxicosis?

A
  • Tiamulin
  • Chloramphenicol
  • Erythromycin
  • Sulfonamides
  • Cardiac glycosides
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10
Q

Toxicokinetics of monensin

Absorbence: ruminants vs. monogastrics?

A
  • Ruminants absorb about 50%
  • Monogastric animals absorb most of it
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11
Q

Toxicokinetics of monensin

Where is it distributed?

A

Throughout the body

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12
Q

Toxicokinetics of monensin

T/F: Blood and tissue levels are relatively small, but monensin accumulates in tissues of animals when given in high doses

A

FALSE–monensin does not accumulate in tissues when given in high doses (the rest is true)

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13
Q

Toxicokinetics of monensin

Metabolization and excretion?

A

Rapidly metabolized by P-450 oxidative demethylation enzymes in the liver (slow metabolism in equines because they have the lowest oxidative demethylases) and excreted mainly in bile

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14
Q

Mechanism of action

What does ionophore toxicosis disrupt?

A

Disrupts transmembrane electrochemical gradients

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15
Q

Mechanism of action

What are the main targets?

A

The mitochondria of highly energetic tissues (myocardium, skeletal muscles, and the kidney)

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16
Q

Mechanism of action

Ionophore toxicosis causes an influx of what?

A

Influx of the sodium-ionophore complex increasing intracellular Na accompanied by increasing intracellular Ca

17
Q

Mechanism of action

Ionophore toxicosis causes sequestering of, inhibition of, and decreased what? What does this lead to?

A

Sequestering of Ca by mitochondria and inhibition of mitochondria and decreased ATP and energy–> increased cytoplasmic Ca

18
Q

Mechanism of action

What is the cell death due to?

A

Disrupting homeostatic mechanisms

19
Q

Mechanism of action

Ionophore toxicosis also causes catecholamine release, which results in what?

A

Oxidation products and free radicals causing sarcolemmal membrane damage

Disruption of ion concentrations in excitable cells (neurons, myocardium, skeletal muscles, smooth muscles) alters their functions

20
Q

Pretty chart explaining mechanism of action

(actually it’s pretty ugly/boring)

21
Q

Clinical signs in horses?

A
  • Rapid onset
  • Anorexia, profuse sweating, colic, depression, incoordination, hyperventilation, tachycardia, tachyarrhythmias, prostration, and death
22
Q

Clinical signs in cattle?

A

Anorexia, diarrhea, depression, labored breathing, ataxia, prostration, and death

23
Q

Clinical signs in poultry?

A

Anorexia, diarrhea, ataxia, resting on the knees with wings and legs directed outward, decreased egg production

24
Q

Clinical signs in dogs?

A

Ataxia, muscle weakness of hind limbs, respiratory paralysis, dysuria, constipation, and depression

25
Lesions?
* Mainly cardiac muscle lesions in horses (pale cardiac muscles, white streaks of necrosis in the myocardium), and also skeletal muscle lesions * Mainly skeletal muscle lesions in sheep, swine, and dogs (pale skeletal muscles) * Both skeletal and cardiac muscle lesions in cattle and poultry
26
Chemical analysis for ionophores (detection, best samples, other samples)?
* Methods detect ppb levels * Best sample is feed * Other samples are GI contents, liver, and feces
27
Which enzymes are elevated following ionophore toxicosis?
* Creatinine phosphokinase (CPK) * Aspartate transaminase (AST) * Lactic dehydrogenase (LDH) * Alkaline phosphatase (ALP)
28
What is decreased on the clinical pathology? What remains unchanged? What is increased (besides enzymes)?
* Decreased serum Ca and K (during first 12hrs) * No change in Na * Increased PCV
29
Diagnosis?
* History of feed-related problem * Clinical signs * Lesions * Lab diagnosis
30
**DDx** General (all species)?
Include other myopathy and neuropathy conditions
31
**DDx** Horses
* Colic * Blister beetle ingestion (cantharidin toxicosis) * Azoturia
32
**DDx** Cattle?
Vitamin E/selenium deficiency
33
**DDx: poisonous plants** Plants affecting skeletal muscle?
* Coffee senna (*Senna occidentalis*) * Coyotillo (*Karwinskia humboldtiana*) * White snakeroot (*Eupatorium rugosum*)
34
**DDx: poisonous plants** Plants that are cardiotoxic?
* Oleander * *Taxus spp.* * Milkweed * Vetch
35
**DDx** Poultry
* Nutritional myopathy * Coffee senna toxicosis * Botulism * Na-water deprivation toxicosis * Mycotoxicosis (moniliformin cyclopiazonic acid) * Round-heart disease * Downer syndrome (viral arthritis)
36
Is there a specific antidote for ionophore toxicosis?
Nope, that'd be too easy
37
Treatment
* Remove medicated feed * Decreasing absorption * Activated charcoal * Mineral oil * Saline cathartics
38
Symptomatic treatment
* IV fluids and electrolyte therapy (to correct hypovolemia and support cardiovascular and renal functions) * Potassium to correct hypokalemia (\<2 mEq/L) * Monitor cardiac function for several months * Horses should not be ridden or stressed for several months * Vitamin E and selenium may decrease muscle damage especially in cattle and swine
39
Prognosis?
* Horses that survive may suffer myocardial scarring and necrosis * Horses may not reach previous performance