Pet poison helpline Flashcards
Purpose of pet poison helpline
-initial exposure assessment
-toxin concern
-treatment recommendations
Steps when calling hotline
- call taken by vet tech or vet
- history obtained
- assessment made as to risk concern
- treatment needs determined
- follow up by vet clinic as needed throughout patients care
Partnership with clinics
-work closely with vet for each individual case
-case reports emailed for records
-provide client education materials
-provide free RACE approved CE for vet professionals
Top dog toxins
- chocolate
- grapes and raisins
- anticoagulants rodenticide (higher in Canada than US)
- ibuprofen
- xylitol
6.acetaminophen - Vit D3
- Onions
- Marijuana
- unknown
Top cat toxins
- Lillies
- chocolate
- garlic
- amphetamine combos
- ibuprofen
- onions
- venlafaxine
- Anticoagulant rodenticides
9.Vit D3 - acetaminophen
What information do you need to know
-when?
-how much?
-what?
-species? breed? age?
-preexisting medical conditions?
-clinical signs?
Patient assessment/stability?
Are they stable?
-vitals, neurologic state, hydration status, lab results
Any current/past medical concerns?
-recent illness, surgery, medications, medical diseases
Why ask about species and breed?
-Species differences with toxicities
- Breed:
-Brachycephalic breeds increased emesis
-ABCB1 (MDR-1) gene mutation risk= higher toxicity risk with certain drugs
Why ask about age?
-hepatic metabolism lower under 12 wks
-cardiac output more HR dependent in young animals
-potentially lower toxic dose for neonates or geriatric patients
-renal compromise and hepatic impairment in older patients
Why ask about weight?
-differences between toxic and non toxic ingestions
-accurate weights needed to properly assess toxicity risk
-decontamination preferences in large vs small breeds
-added risks with obesity
Is there colour coding for rodenticides based on active gradient?
No- there is no industry standard for colour coding
Importance of assessing the toxicity
Many categories of toxins and sometimes only certain ones are toxic
Eg. Lilies- renal toxicity with Lilium and Hemerocallis sp, not the others
Eg. gum- does not always mean xylitol present
Ask about route of exposure?
Exposure route affects toxicity concern
-dermal, oral, cular, inhaled
-liquid on skin/hair
-expansive glues (hydrocarbons, corrosives)
Ask about dose or amount of toxin exposed to?
-chewed medication container
-full bottle- almost empty vs new
-Baits (1 block/pellet/bag/bucket)
- liquid ingestions (bowlful, few laps; whether diluted vs concentrated)
Ask about time since exposure?
Large factor
-rate of absorption
-can be do effective decontamination methods eg. induce vomiting
-when signs would be expected
Ask about the location that the exposure occurred?
-allows you to address other potential confounding factors
-determine severity differences
-agricultural/industrial concentrations vs residential
Other potential assessment questions with toxicity?
-other factors?
-extenuating circumstances or environmental factors?
-was it malicious?
-are there other animals involved?
If toxin is expired, will that mean less affect on animal?
No, can be full potency or increased potency
Reading chemical labels with cautions
Caution or warning= less severe, usually mild irritation
Reading labels with danger label
-usually corrosive
-indicated greater precaution/long term damage
-may be on products with fire risks
-often on specialty products intended for rough jobs (oven cleaners/drain openers)
Decontamination methods
-emesis
-activated charcoal
-cathartics
-gastric lavage
-whole bowel irrigation
-endoscopy and surgical removal
Indications for emesis
-aymptomatic
-foods
-medications
-large ingestions
-rodenticides
-small dull foreign objects
-no breed or health risk
Contraindications for emesis
-symptomatic
-already vomited
-history of aspiration pneumonia
-sharp objects
-corrosive agents
-volatile and non viscous hydrocarbons (gas, kerosene)
Safe emesis up to 6 hrs after ingestion
-grapes
-chocolate
-gum
-large plant ingestion
-massive ingestion
-drugs decreasing gastric emptying (opioids, salicylates, anticholinergics, tricyclic antidepressants)
Emesis drugs in dogs
-Apomorphine- dopaminergic drug
-hydrogen peroxide
-Ropinirole (only in USA)
Emesis drugs in cats
-Xylazine (alpha 2)
-dexmedetomidine (alpha 2)
*can cause excessive sedation and cardiovascular collapse
What drugs are not recommended for emesis in cats
-hydrogen peroxide= hemorrhagic gastritis in cats
-apomorphine- CRTZ triggered by alpha2s in cats not dopaminergic
Activated charcoal and cathartics
-high absorptive capacity; substances bind to charcoal by weak covalent bonds
*cannot give unless gut is moving
Pros of activated charcoal
-available and inexpensive
-binds most toxicants
-may decreased absorption by 25-30% with delayed administration
-can give with food
Cons for activated charcoal
-window for administration
-hypernatremia
-difficult to administer
-messy
-vomiting after admin
-diarrhea/changes to stool
-binds to therapeutic medications
-unknown benefit
What does activated charcoal not work with?
-cleaning products
-car products
-alcohols
-heavy metals
Contraindications for activated charcoal
-dehydration
-hypernatremia
-hypovolemic shock
-decreased GI motility
-vomiting
-surgery
-endoscopy
-GI obstruction
-risk for aspiration
Cathartics
-draws water into GI, accelerates speed of drugs, decreases toxin absorption time
eg. Sorbitol
-often in activated charcoal products
Gastric lavage
-used for animals that don’t vomit or unsuccessful emesis
-use stomach tube to last rib,
-need anesthesia and secure airway
Whole bowel irrigation
-give polyethylene glycol until what comes out is the same as what you put in
-rarely used
-used for iron, enteric coated drugs, drug packets
Endoscopy
-used for coins, non leaky batteries, fentanyl patches, bottles/patches, metals
Surgical removal
-Used if cannot remove with endoscopy but may delay pending stability of patient, cost, equipment and staff
eg. Glue, sharp objects, medication bezoars, leaking battery, yeast bread
