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Small Animal > Poisoning > Flashcards

Poisoning Flashcards

1
Q

Skin Decontamination

A

Prevent grooming (self and others)
Clip the coat
Lots of warm water and gentle detergents

Do not bathe seizuring animals !

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2
Q

Ocular Decontamination

A

Irrigate the eye for at least 15 minutes
Water / saline

Fluoroscein assessment

Corticosteroids only if no ulceration

Viscotears / topical antibiotics

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3
Q

Methods of gut decontamination

A 
apomorphine (dogs only)
xylazine
syrup of ipecac
3% hydrogen peroxide
gastric lavage
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4
Q

Apomorphine

  • use
  • dosage
  • side effects
A
  • induction of emesis
  • 0.44mg/kg IM or S/C
  • Moderately effective
  • Sedation and cardiorespiratory depression
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5
Q

Syrup of Ipecac

  • uses
  • pharmacological properties
  • side effects
A

induction of emesis
Slow onset and less reliable
Gastric irritation and stimulation of CRTZ
Do not confuse with the more concentrated extract
Repeat doses can cause cardiotoxicity

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6
Q

Hydrogen Peroxide

  • use
  • dosage
  • side effects
  • warning
A

induction of emesis
1-2ml/kg P.O (max 10mls in cats and 50mls dogs)
Mild gastric irritation.
Repeat administration no more than once.

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7
Q

Activated charcoal

  • how
  • effectiveness
  • directions
A

Binds toxin and stops further absorption

Variable effects on different toxins

Liquid and powder > tablets

Give in food or via stomach tube every 4 hours

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8
Q

Acetaminophen

  • fatal doses
  • cats prone
  • when are clinical signs seen
A

500mg/kg probably fatal in dogs
200mg/kg fatal in cats

cats lack glucuronyl transferase enzymes which bind to it and make it inactive

clincial signs seen within 4 hours

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9
Q

Acetaminophen

  • clinical signs (general)
  • <12 hours (6)
  • 2-7 days (6)
A

Hepatic necrosis
Methaemoglobin formation (chocolate blood)
Heinz body anaemia

Resulting haemolytic anaemia leads to tissue hypoxia

less than 12 hours:

  • anaemia
  • hypoxia
  • cyanosis
  • tachypnoea
  • tachycardia
  • facial/paw oedeam

2-7 days:

  • haematuria
  • anemia
  • icterus
  • liver failure
  • seizures/coma
  • renal failure

death normally after 2-7 days

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10
Q

Diagnosis of acetaminophen poisoning

A

History / clinical signs

Methaemoglobin

Heinz bodies

Liver and renal disease

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11
Q

Treatment for acetaminophen poisoning

A

-Required if >10mg/kg (cats) or >150mg/kg (dogs)
-Emetics if < 1-2 hour post ingestion
-Absorbents ?
-Supportive care – IVFT, oxygen, blood products
-N-acetylcysteine
promotes metabolism to non toxic form
- S-adenosylmethionine (S-AME)
- Ascorbic acid – converts methgb to haemoglobin
- Cimetidine in dogs

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12
Q

Metaldehyde

A

Molluscicide : pellets or solutions

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13
Q

Metaldehyde

  • clinical signs onset
  • clinical signs (4)
A

Onset of clinical signs seen from 30mins – 3 hours

Hyperaesthesia, tremors, seizures and hyperthermia
Decreases inhibitor neurotransmitters

Death due to respiratory arrest / seizures

If survives may have chronic neurological abnormalities

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14
Q

Treatment of metaldehyde

A

Treat regardless of dose ingested

Emetics if asymptomatic – OBSERVE

If seizures
Diazepam (propofol if non responsive)
+/- gastric lavage

IVFT and nursing care
Gradual recovery normally seen

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15
Q

Anti-coagulant Rodenticides

A

Inhibition of vitamin K activation

very prolonged duration of action is seen

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16
Q

Mechanism of action

A

Vit K changes Vit K1 epoxide (inactive) to Vit K hdroquinone (active).
Vit K hydroquinone changes coagualation factor precursors into activate cogaculation factor precursors.

17
Q

CS of metaldehyde poisoning

A

Delayed absorption (12-24 hours)

2-5 days until coagulopathy develops

Lethargy and dyspnoea

Epistaxis / haemoabdomen

18
Q

Diagnosis of Metaldehyde poisoning

A

Prolonged Prothrombin Time (PT) – most sensitive (extrinsic pathway)
Vitamin K dependent factor with shortest half life – Factor VII

Prolonged APTT

Platelets – normal or decreased

PIVKA – proteins induced by vitamin K antagonism

19
Q

Treatment of metaldehyde poisoning

A

Immediate support
Oxygen
Transfusion (clotting factors and red cells)

Prevent further absorption
Emetics if recent ingestion (<4h)
Adsorbents (charcoal)

Vitamin K1
Loading dose of 5mg/kg/sc
Clotting factors improve within 6 hours
Then 2.5-5mg/kg PO or S/C every 24 hours
Continue for up to 4 weeks

Caution when stopping (check PT 48 h after stopping)

20
Q

Ethylene glycol

A

Anti-freeze intoxication

Fatality seen if volume ingested > 6.6mg/kg

21
Q

Disease progression of ethylene glycol poisoning

A

< 12 hours
Neurological signs (ataxia, twitching, seizures)
Renal disease
Acidosis

12-24 hours
Cardiac / respiratory system affected

24-72 hours
Renal – azotaemia, anuria and hyperkalaemia

22
Q

Diagnosis of ethylene glycol poisoning

A

Acidosis (serum pH < 7.3)
Azotaemia
Hypocalcaemia
Calcium oxalate crystals in urine

23
Q

Treatment of ethylene glycol poisoning

A

Emetics?
Absorbents not useful
Diazepam for seizures
Correct acidosis

IVFT - monitor urine output and electrolytes

Ethanol
Best used within 12 hours
Can be given IV or via stomach tube

4-Methylpyrazole (dogs only)
Inhibits activity of alcohol dehydrogenase
Less side effects

24
Q

Theobromide

A

Toxic dose in dogs = 100-150mg/kg

White chocolate – 0.25mg/ oz
Milk chocolate – 44mg/oz (treatment needed if > 9g/kg)
Baking chocolate – 400 mg / oz (treatment needed if > 1g/kg)

25
Q

CS of theobromide poisoning

A 
Direct stimulation of CNS and cardiac muscles
	Seizures 
	Arrhythmias 
	Muscle tremors
	Hyperactivity
	Ataxia
	Death

Pancreatitis
Gastroenteritis

26
Q

Theobromide treatment

A

Gastric evacuation – Apomorphine

IV fluid diuresis

ECG – Ventricular tachycardia Lidocaine
Supraventricular tachycardia Propanolol

Seizure watch – Diazpeam / Midazolam

Gastroprotectants – Omeprazole

27
Q

Xylitol

  • what
  • toxic doses
A

sugar substitute
Toxic dose
Hypoglycaemia – 0.15g/kg (30mins)
Hepatic necrosis – 1.4g/kg (<3 days)

Gum contains 0.3 – 1g/ piece

28
Q

Treatment of xylitol

A

Decontamination – charcoal of questionable use

Monitoring – glucose / ALT / clotting times

Supportive care – Fluids / dextrose

Liver protectants – N-acetylcysteine, S-AME

Small Animal (35 decks)

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