Poisonings Flashcards
Preparations for Poisonings
- Xylazine, Dex, Apomorphine to induce vomiting
- Activated charcoal +/- cathartic
- IV Fluids
- Antidote, if applicable
Poisoning Signs
(8)
- Excitability
- Ataxia
- Muscle tremors / Convulsions
- Salivation / Vomiting
- Diarrhea
- Weakness / Depression
- Ulcers on skin
- Shock
Objective of Treatment
Treat the patient, not the poison
* maintain respiration and preserve vitals
* dilute poison
* remove poison from system
* neutralize with antidote, if applicable
Poisoning Diagnostic Tests
- PCV / TP
- Urinalysis and SG
- BUN and BG
Vomiting
When Not To
- Corrosive or petroleum products
- Poison will cause sedation or seizures
- It has been 2-4 hours since ingestion
Gastric Lavage
When to do
- Perform if emetics are not effective
- Patient is unconscious
- Patient has reduced gag reflex
Gastric Lavage and Vomiting
Accuracy
Not guaranteed
* removes only 50% of the stomach contents
Types of Absorbents
- Activated Charcoal
- Kaopectate
Administrating Absorbents
Given in the GI tract to soak up poisons like a sponge
Absorbents
Not Effective For
- Alcohol
- Xylitol
- Heavy metals
- Antifreeze
Fluid Administration
- Intralipids
- IV Fluids helps dilute the body
- Frequent urination good for Chocolate and Coffee poisonings
Cathartics
Increase the speed of passage of GI contents
* give with first dose of absorbents
* ex: sorbitol and epsom salts
Acetaminophen
Cat vs Dog
- Cats = more sensitive; tissue hypoxia
- Dogs = liver failure
Acetaminophen
How it affects cats
- Causes tissue hypoxia
- Red blood cells converted to no longer carry oxygen
Acetaminophen
Cat Symptoms
- Vomiting
- Depression
- Edema/swelling of face and paws
- Dark brown blood, urine, and mm*
*because of the methemoglobin
Acetaminophen Treatment
- Induced vomiting if applicable
- Vitamin C
- Oxyglobin
Organophosphate
- Act by increasing parasympathetic activity
- Cats more sensitive than dogs
Organophosphate Symptoms
- Vomiting / Salivating
- Diarrhea
- Small pupils
- Muscle tremors / Seizures
Organophosphate Treatments
- Atropine, large doses
- Vomiting if oral and applicable
- Bath if topical
Pyrethrin / Permethrin
- Insecticide more common than organophosphates
- Common toxicity in cats
- Active ingredient for Advantage II
- “All-Natural”
Pyrethrin / Permethrin
Poisoning Symptoms
- Tremors / Muscle twitching
- Salivating / Vomiting
- Ataxia
Similar to OP toxicity - have owner bring product in
Pyrethrin / Permethrin Treatments
- Valium or Propofol (any anesthetic that controls temors) + methocarbamol
- Thermal support
- Fluids - Intralipids
Zinc Toxicity Sources
Ingestion of
* pennies
* crate screws
* battery covers
* old bird cages
Zinc Toxicity Signs
- Vomiting
- Diarrhea
- Anorexia
- Depression
- Hemolytic Anemia
Zinc Toxicity
Hemolytic Anemia
Causes kidney damage
* may see red in urine - hemoglobins
* elevated BUN often seen
Zinc Toxicity Treatment
- Remove source of zinc via endoscopy (ideal) or surgery
- Provide fluids support for kidneys
- Transfusion if anemia is severe
Zinc Toxicity Considerations
Post-Treatment
Zinc may remain in the system even after removal of foreign body
Anticoagulant Rodenticide
- No longer available
- Prevents Vitamin K recycling
Anticoagulant Rodenticide Symptoms
- May be delayed
- Really variable - bleeding from anywhere
Anticoagulant Rodenticide Diagnosis
History and Blood Tests
* anemia, but can be mild
* coagulation panel
* PIVKA test
Anticoagulant Rodenticide Treatment
- Induce vomiting (if applicable) and give activated charcoal
- Antidote: Vitamin K
- Blood transfusion - if symptoms of anemia or bleeding
Anticoagulant Rodenticide
Vitamin K Administration
Needs to be given at least a week after exposure, depending on the product ingested
* give with a fatty meal
Bromethalin Rodenticide
- Causes neurologic issues
- Decreases conduction of nerve impulses
Bromethalin Rodenticide
Symptoms
Signs show with 24 hours or up to 2 weeks later
* muscle tremors / seizures
* ataxia
* coma
* paralysis
* death
Bromethalin Rodenticide
Treatment
- Induce vomiting, if applicable
- Fluids
- Activated charcoal
Chocolate Poisoning
Active ingrediant is a stimulant, similar to caffeine, leading to toxicity
Chocolate Poisoning Symptoms
Start within 4-6 hours after ingestion
* vomiting / diarrhea
* restlessness / panting
* elevated HR / abdnormal heart rhythms
* muscle tremors / seizures
Chocolate Poisoning Treatment
Treat like basic poisoning
* vomiting, if applicable
* activated charcoal
* fluids most important - toxin excreted in urine*
*catheter or frequent walks - can be reabsorbed back into system
Xylitol
What it is / What is does
Sugar-free products
Causes
* low blood sugar
* liver necrosis
Xylitol Treatment
- Vomiting may not help due to product quickly dissolving
- IV fluids with Dextrose
Ibuprofen / NSAID Treatment
- Induce vomiting, if applicable
- Give activated charcoal
- Fluid support
- Diuresis
- Protect GI tract
- Intralipids
Ibuprofen / NSAID Causes
- Severe vomiting
- Gastric ulceration
- Kidney damage
Ibuprofen / NSAID Diagnosis
- BUN
- Creatinine
Ibuprofen / NSAID
Treatment - Medications
- Pepcid / Femotidine injection to decrease acid production in stomach
- Sucralfate to form pastey-like substance, sticks to ulcers on GI mucosa
Antifreeze Poisoning
- Takes very little amount
- Metabolism causes acidosis
- Metabolism occurs quickly
Antifreeze Poisoning Metabolism
- Acidosis occurs
- Formation of calcium oxalate crystals
- Crystals go into kidney tubules; no way to dissolve or remove
- Clog up and prevent urine formation
- End result is anuric renal failure
Antifreeze Poisoning Symptoms
Stage 1
* neurological signs
* start within 30 min-12 hours after
Stage 2
* increased HR and RR
* 12-24 hours after
Stage 3
* renal disease
* 24-72 hours after
Antifreeze Poisoning
Lab Results
- Increased BUN and Creatinine
- Acidosis
- Hyperglycemia
- Calcium oxalate or hippuric acid crystals in urine
- Positive in-house ethylene glycol test
Antifreeze Poisoning Treatment
- Fluids
- Treat for seizures
- Ethanol or Antizol therapy - alter metabolism of ethylene glycol to not form crystals
- Continue treatment for 36 hours after ingestion
