Slug/snail bait- metaldehyde toxicity 40%

Question 1

Cause (slug bait)- chemical, purpose, form, how absorbed

Answer 1

Metaldehyde, a tetramer of acetaldehyde, is used as a molluscicide to kill snails and slugs, and as a solid fuel.
Metaldehyde-based molluscicides are formulated as pellets, liquids, powders, granules, and gels/pastes. Metaldehyde easily crosses the blood/brain barrier.

Question 2

Pathophysiology and mechanism of action (slug bait)

Answer 2

Although the water solubility of metaldehyde is poor, it is absorbed from the gastrointestinal (GI) tract.
The exact mechanism of action of metaldehyde is unknown.

Question 3

Clinical signs (slug bait)

Answer 3

Clinical signs generally begin within 30-180 minutes after ingestion. Signs include vomiting, hypersalivation, anxiety, restlessness, tachycardia, tachypnea/panting, hyperesthesia, nystagmus, mydriasis, tremors, rigidity, convulsions, hyperthermia, and opisthotonos. Profound CNS depression progressing to coma may develop. Death due to respiratory failure, DIC, and/or multiorgan failure can occur within hours of exposure.

Question 4

Treatment (slug bait)

Answer 4

No antidote- emesis, gastric lavage, cathartics
Manage life-threatening clinical signs first- IV fluids, antiseizure. Provide supplemental oxygen as needed. Treat hyperthermia but avoid overly aggressive cooling measures, especially once tremors or convulsions have resolved. Manage seizures as needed (beware that barbiturates can complete with cytochrome P450 for toxin removal. Treat acidosis if pH < 7.2. Methcarbamol for muscle tremors.

Question 5

Prognosis (slug bait)

Answer 5

Prognosis depends on the amount ingested and promptness of veterinary intervention. Patients surviving the first 24 hours generally have a good prognosis, although delayed liver injury is a rare possibility. Monitor blood gases, body temperature, cardiovascular status, coagulation tests, and liver enzymes.