Random Household Poisons Flashcards
What is Xylitol and its mechanism of action? how do animals get poisoned?
5 carbon sugar alcohol (low cal sugar)
common with ingestion of baked good, gum, candy, toothpaste
stimulates massive release of insulin from pancreas = sudden severe hypoglycaemia
mechanism of hepatic necrosis is unknown
What are the clinical signs of xylitol poisoning?
hypoglycemia within 10-60min
- vomiting, weakness, ataxia, tremors, seizures
hepatic damage 9-72 hours (can occur without hypoglycemia)
- vomiting, depression, lethargy, abdominal tenderness, icterus, petechial/ecchymotic hemorrhage, melena, hepatic encephalopathy
- elevated liver enzymes, hyperbilirubinemia, increase clotting times, electrolyte derangement
What is the Dx of xylitol poisoning?
hypoglycemia + clinical signs
hepatic failure + clin path
diffuse hepatic necrosis + biliary hyperplasia
What is the treatment of xylitol poisoning?
decontam if approp + cathartic
prophylactic oral sugar supplementation
IV dextrose if hypoglycemic (25% bolus followed by 2.5-5% in fluids for 12-48 hours)
hourly blood glucose for 24+ hours, monitor electrolytes (K), liver function for 72hours
hepatic protectants and antioxidants (vits K, C and E)
What is the prognosis of xylitol poisoning?
generally good except with liver failure
What is the common outcome of grapes/raisin ingestion? Whats the toxic agent? toxic dose?
renal failure
toxic agent not identified
usually large amounts, but can be as low as 3mg raisins/kg
50% unaffected but some with previous ingestion (no signs) are affected later
What are the clinical signs from grapes/raisins?
vomiting within 2-6 hours
diarrhea, anorexia, lathargy, abdominal pain
at 12-24hours
- azotemia
- increase Ca/P
- oliguria/anuria
- proteinuria with granular cysts
What is the Dx for grapes/raisins?
ARF (clinpath/urinalysis) 12-72h after exposure
proximal renal tubule degen and necrosis (sparing distal tubules and basement membranes)
mineralization of kidneys +/- other organs
What is the treatment for grapes/raisins?
emesis/GL if early + AC and cathartic IV fluid diuresis (48-72 hours) monitor BUN, Cr, Ca, P, K, urine SG for 72h symptomatic and supportive care consider peritoneal or hemodialysis
What is the Px for grapes/raisins?
poor if present with ARF
What does ingestion of paintballs and playdough cause in dogs/cats? whats in them?
fluid electrolyte imbalances and acid base abnormalities
polyethelene glycol, sorbitol, glycerin, propylene glycol, mineral oil, dyes, pigskin
Whats the MOA of paintballs and playdough?
painballs act as osmotic cathartics to pull fluid into the GIT
What’s the toxic dose of paintballs/playdough?
5-10 paintballs to 30kg dog
playdough can contain up to 8g NaCl/tbsp (2g/kg toxic)
What are the clinical signs of paintballs/playdough?
paintballs - rapid movement of water into GI Playdough - direct Na uptake - increased plasma and EC osmolality, intracellular dehydration, hypernatremia, metabolic acidosis, hypokalemia
Signs
- vomiting, diarrhea, dehydration (prerenal azotemia) polydipsia, ataxia, tremors
less common
weakness, hypovolemia, tachycardia, hypotension, blindness, seizures, hyperthermia and death
What is the Dx of paintballs and playdough?
clin path (serum electrolyte anomalies PM edema of GIT mucosa and cerebral cellular shrinkage
What is the Tx for paintballs and playdough?
emesis, GL if asymptomatic (not AC)
monitor hydration, acid base and electrolyte status
rehydrate hypernatremic dogs slowly with 0.45% saline + 2.5% dextrose
What is the Px of paintballs and playdough
good if treated appropriately
What is dangerous about alkaline dry cells and lithium batteries?
alkaline dry cell = corrosive
- if chewed skin and mucosal necrosis
lithium disc batteries can be lodged in esophagus and cause burn without leaking
What are the clinical signs of battery ingestion?
alkaline dry cell
- rapid irritation
- grayish black material in mouth
- coughing/retching/gagging
- progression to dyspnea/stridor, vomiting coffee grounds, melena, fever
lithium
- lodge in folds, necrosis/perforation (in 15min with 3volt)
What is the Dx for batteries?
find the battery inspect
examine oral area
radiographs
What is the treatment for batteries?
chewed - rinse mouth - monitor for signs - soft diet - antibiotics - GI protectants - pain meds Swallowed - push into stomach if intact - high fiber, monitor - chewed or stuck need to be removed
What is dangerous about essential oils?
volatile organic constituents of pants
lipophilic and well absorbed through MM/skin
potentially toxic in animals (little studies)
What is the toxic agent and MOA of pennyroyal oil? what is it used for typically?
toxic agent: pulegone
bioactivated by P450 to a hepatotoxic metabolite
- depletes glutathione –> ROAS damage
flea repellant and abortifacient
What are the clinical signs of pennyroyal oil?
2g/kg
- listless (2h)
- vomiting (2h)
- diarrhea, hemoptysis, epistaxis, seizures and death (30h)
hepatocellular necrosis in PM
what is the treatment for pennyroyal oil?
decontam
S&S care for acute renal failure
hepatoprotectants (silymarin and N-acetylcysteine)
What is the toxic agent in citrus oils?
limonene and linalool
D-limonene safe but pure citrus oil is not
What are the clinical signs of citrus oil?
hypersalivation tremors ataxia lateral recumbancy coma and death
What is the treatment for citrus oil?
decontamination
S&S care
What is the toxic agent in wintergreen oil? what is it used for?
methyl salicylate (liver converts to salicylic acid) used to treat muscle pain highly toxic orally (5ml = 7grams of aspirin)
What are the clinical signs of wintergreen oil?
cats
- depression, anorexia, emesis, gastric hemorrhage, hepatitis, anemia, bone marrow hypoplasia, hyperpnea, fever, coma, death
interferes with platelet function
What is the Tx for wintergreen oil?
decontam
S&S care
What is the toxic agent of melaleuca/tea tree oil? What is it used for?
terpene hydrocarbons
used as topical antiseptic/antibacterial and anti-inflammatory
used for flea control sometimes
What are the clinical signs of melaleuca?
similar in cats and dogs
hypothermia, ataxia, dehydration, nervousness, tremors, coma
serum AST ALT elevated
death
What is the treatment for melaleuca?
decontam
S&S care
What is the toxic agent in liquid potpourri?
contain essential oils and cationic detergents
irritating to skin or MM
What are the clinical signs of liquid potpourtti?
GI irritation or caustic injury emesis dyspnea (secondary to pulmonary edema) hypotention CNS depression ocular exposure --> corneal injury
What is the Tx for liquid potpourri?
decontam (bathing, occular irrigation, dilution with water or milk) GI protectants (sucralfate) H2 blockers PPIs S&S care pain control
What does lily poisoning cause and what parts are toxic?
all parts (unknown agent) acute renal failure in cats (maybe dogs) few bites can cause death
What are the clinical signs of lily poisoning?
2-12h
- vomiting, anorexia, lethargy, hypersalivation, depression
- polyuria, ataxia, tremors, vocalization
24-96h
- oliguric or anuric ARF
- vomiting, dehydration, progressive depression, uremic breath, recumbancy, dyspnea, bradycardia, seizures
What is the Dx of lily poisoning?
CHEM - increase BUN and Cr (18-24h) - increase P and K - acidosis urinalysis - glucosuria, proteinuria, granular casts PM - swollen edematous kidney, prox conv tub necrosis, intact basement membrane
What is the Tx for lily poisoning?
emesis/GL (1-2h, less than 6 improves) AC and cathartic IV fluids (2-3x maintenance) to diuresis for 48h supportive care for ARF monitor urine output and chem (48h)
What is the Px for lily poisoning?
fair if aggressively treated within 18h
100% mortality if delayed and ARF develops
- hemodialysis or transplant?
