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VMS4008 > Toxicities in Small Animals > Flashcards

Toxicities in Small Animals Flashcards

1
Q

Top 10 pet toxins?

A
  • Over-the-counter meications
  • Human food
  • Human prescriptrion
  • Chocolate
  • Plants
  • Household toxicant
  • vet products
  • Rodenticides
  • Insecticides
  • Garden proucts
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2
Q

What details on tox emergency call ?

A
  • Advise to bring to clinic
  • Ctainers/inserts/vomitus/plant
  • Careful advice
  • Petroleum, acids, alkalis
  • Warn owner to avoid contact with vomitus/ source of toxin
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3
Q

What History considerations?

A

Be careful – owners think sick dogs have been poisoned
* Ask detailed questions*
* Did owner witness exposure?
* Other evidence of exposure?
* How much was the pet exposed to?
* Are signs getting worse or better?
* Ask about illicit substances – owners may not volunteer this information

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4
Q

When to suspect poisoning ?

A
  • Reent use of pesticides/ chmicals in / around house
  • Possible access to human/veterinary meds
  • Exposure to garbage
  • Malicious exposure
  • Sudden illness without infectious cause
  • New environment/ new human activity
  • New plants/ flower bouquets
  • New food – or very old food
  • Animal had access to areas not
    commonly allowed – garage, shed
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5
Q

What should u not forget while doing PE?

A

GLOVES!

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6
Q

If toxin is known what additional exams?

A
  • Choline-esterase in organophosphate cases
  • Ethylene glycol in serum
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7
Q

In suspected cases / additional monitoring?

A
  • CBC? Serum chemistry, urinalysis
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8
Q

Toxo analyses ?

A
  • Gastric content
  • Vomitus
  • Faeces
  • Urine
  • Food/water / suspected
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9
Q

Treatment goals for toxins?

A
  • Prevent furhter exposure - coat decontamination
  • Dec absorption - GI decontamniation
  • Improve elimination
  • Supportive care and antidotes
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10
Q

What useful mes might we give?

A
  • Emetics – apomorphine
  • Activated charcoal
  • Vitamin K1
  • Fresh frozen plasma
  • Intralipid (for lipophilic drug poisoning)
  • Acetylcysteine (acetominophen tox)
  • Methocarbamol (tetanus associated spasms)
  • Snake antivenom
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11
Q

How do we prevent exposure/ Decontaminate coat ?

A
  • Both human & animal
  • Remove poison and bait containing poison
  • Wash or brush coat
  • Remove vomitus containing poison
  • Mild detergent
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12
Q

How do we decrease GI absorption?

A
  • Emetics – apomorphine
  • Activated charcoal
  • Vitamin K1
  • Fresh frozen plasma
  • Intralipid
  • Acetylcysteine
  • Methocarbamol
  • Snake antivenom
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13
Q

How long after toxin ingestion is too long to induce emesis?

A

over 60 mins

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14
Q

When is it not safe to decontaminate patient ?

A

Seiures/ unconscious - NO EMESIS

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15
Q

When is it safe for type of poison to decontaminate?

A
  • Caustic substances - petroleum
  • Activated charcoal dangerous in hypernatraemia
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16
Q

Describe the seps of Gastric Lavage

A
  • Light anaesthesia
  • Tracheal intubation- CUFF
  • Large bore stomach tube
  • 10ml/kg warm water
  • Gently massage/palpate stomach
  • Drain by gravity (see photo)
  • Repeat if needed – mostly clear fluid drained
  • BEWARE: if already passed into intestines or if particles too big for tube
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17
Q

What do we use to improve elimination/ avoid reabsorption?

A
  • Ativated charcoal
  • Laxative - lactulose, Sorbitol
  • Fluid diuresis in renally excreted toxins

Sorbitol – latest paper shows
charcoal with or without sorbitol is equally effective – BUT
make sure patient passes faeces

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18
Q

What are ILE?

A

Intravenous Lipid emulsions -> act as a trap for lipophilic toxins
- dec free substance in circulation

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19
Q

What substances are lipophilic?

A

Organophosphates, carbamates, permethrin, macrolytic lactones -
ivermectin, marijuana, lidocaine, NSAIDs, bromethalin, amphetamine,
amlodipine, phenobarbital

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20
Q

What supportive care for toxicosis?

A
  • Oxygen
  • Fluid and electrolytes
  • Seizure control/ sedation
  • Anti-emetics and gastric protectants
  • Tube feeding
  • Mechanical ventilation
  • Maintain euglycaemia
  • Haematology and coagulation
  • Nursing care
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21
Q

What specific antidotes do we have ?

A
  • Antivenom for snakes and spiders
  • Atropine for cholinesterase inhibitors
  • Bisphosphonates for VitD3/cholecalciferol
  • Chelating agents for heavy metals
  • Fomepizole/ ethanol for ethylene glycol
  • Naloxone for opioids
  • Vit K1 for anticoagulant rodenticides
  • Acetylcysteine for paracetamol toxicity

often none available

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22
Q

What is a common toxicosis of cats

(they can’t metabolize it)

A

Acetaminophen (paracetamol)

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23
Q

What signs will we see with Paracetamol tox in cats?

A
  • Haemolytic anaemia
  • Heinz bodies
  • Methaemoglobinaemia
  • Brown blood & mucus membranes
  • Facial oedema
  • Acute hepatic failure
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24
Q

What does Acetaminophen poisoning look like in Dogs?

A
  • Hepatic failure more common and BIG OVERDOSE
    • Anorexia, vomiting, abdominal pain, respiratory distress,
      icterus.
  • Rarely erythrocyte damage alone.
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25
Q

What Tx for Acetaminophen tox?

A
  • Gi decontamination
  • N-acetylcysteine binds metabolites
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26
Q

What supportive care for Paracetamol tox?

A
  • Fluid therapy
  • Blood transfusion
  • Liver support like SAMe
  • Gastric protectanrs
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27
Q

Prognosis for acetaminophen tox?

A
  • Prognosis guarded to poor
  • Better when cats presented wihtin 11’ hours and ogs within 72 hrs
28
Q

Mycotoxins are found in ….

A

Mouldy foods or compost

29
Q

What symptoms of mycotoxin poisoning?

A

vomiting, ataxia, muscle tremors, tachycardia, tachypnoea,
nystagmus, mydriasis

30
Q

What tx for mycotoxin toxicity?

A

Gi decontmaination, activated charcoal, IV fluids, diaepam for tremors

And aflat

31
Q

What is mycotoxin tox called? what does it primarily cause?

A

Aflatoxicosis -> liver failure

32
Q

What does Onion/Garlic cause ?

A

Erythrocyte damage to Heinz bodies

(within 24 hrs top days)

33
Q

What symptoms of Garlic/ onion tox?

A

V+ Abd pain, Heinz body anaemia

34
Q

Tx for onion/garlic tox?

A

Decontaminate GIT, activated charchoal, monitor RBC parameters

35
Q

Describe Lead tox

A
  • Not only old paint! ingested
  • GIT and CNS signs
36
Q

Symptoms of LEad tox?

A

anorexia, vomiting, diarrhoea, salivating, aneamia, PUPD,
blindness, nystagmus.

37
Q

Tx for Lead Tox?

A

GIT decontamination, laxative, Chelation if severe – Ca-
EDTA.

38
Q

What causes Organophosphate and Carbamate poisoning?

A

Many pesticides

39
Q

What does Organophosphate cause?

A

OP and carbamate bind to (acetylcholine esterase)AChE – continued
nerve stimulation

40
Q

What different types of OP and carbamate tox can we get?

A
  • Muscarinic (Salivation, Vomiting, Diarrhoea, Lacrimation, Dyspnoea, Bradycardia,
    Miosis)
  • Nicotinic (muscle trmors and weakness)
  • CNS (depression seizure)
41
Q

How can we get Pyrethroid poisoning?

A

Owners use dog products on cats - rapidly absorbed in GIt -> central and peripheral NS effects (Interfetres with sodium channels

hypersalivation, midl tremors, vomiting diarrhoea

42
Q

Describe tox with Metaldehyde (slug killer)

A
  • Rapid onset
  • Msucle spasms, hyperaesthesai, hyperthermia
  • Resp distress, cyanosis
43
Q

Should u induce emesis with OPS/ carbamates/ Pyrethroids/ Metaldehyde

A

NO!

44
Q

Tx for OPS/ CARBAMATES/ PYRETHROIDS/ METALDEHYDE

A

decontamination, activated charcoal, atropine for severe salivation or bradycardia, diazepam for seizures, methocarbamol as muscle relaxant for tremors (can give rectally), ILE (lipids), supportive
care

45
Q

Describe rodenticide poisoning

A
  • Signs in 3-5 days
  • Different active ingredients differ in severity of dx and duration of Vit K rq - findout WHICH ONE
46
Q

What symptoms of rodenticide poisoning?

A

Lethargy, weakness, body cavity haemorrhage with respiratory distress, skin hemorrhages, haematomas, joint swelling/lameness, pale mm’s, overt bleeding, hypovolaemic shock, sudden death

47
Q

How does Anticoagulant rodenticide poiosning work?

A
  • Inhibit enzyme Vitamin K1 reductase
  • Vitamin K 1 NB in activation Vitamin K1 dependent clotting
    factors (II,VII,X)
  • When circulating factors are consumed – bleed
  • PT, PTT, PIVKAs and D-dimers increase
48
Q

Tx for anticoagulant poisoning?

A
  • Recent exposure (3h) – GI decontamination; measure PT and PTT at 24 and
    72 hours
  • Symptomatic patients – blood and plasma transfusions, chest drain (not
    always indicated!), fluids, O2, feed, vitamin K1(expensive – 2-4 weeks)
  • Vit K1 iv followed by oral
    with fatty meal
  • Repeat PT and PTT
  • 48 hours after last dose
49
Q

What is Alphacholoralose? What signs?

A

Rodenticide that affects CNS =>
* Mixed CNS signs: excitation, depression, tremors, hyperesthesia, seizures
* Other: Hypothermia (more common in cats), salivation, miosis, ataxia, and coma (more common in dogs)

50
Q

Describe Ethylene glycol poisoning?

A

radiator antifreeze -> sweet taste
- 5ml to kill a cat, 20 ml to kill a dog

(toxic metabolite glycoaldehyde)

51
Q

Describe stage 1 (0mins-12h) of ethylene glycol tox?

A
  • Cns signs due to metabolites (rowsy, stumbling, stupor, vomiting, drunken state, may go unnoticed)
52
Q

Describe stage 2 (12-24h) of ethylene glycol toxicity?

A

Metabolic acidosis (tachycardia, tachypnoea)

53
Q

Stage 3 (24-72h) of ethylene glycol tox?

A

Acute renal failure due to calcium oxalate that precipitates in microvasculature and renal tubules

54
Q

What Tx for ethylene glycol tox?

A
  • Recent exposure
  • Gastric decontamination
  • Renal failure – prognosis POOR
  • Fluids
  • Electrolytes
  • Mannitol
  • Furosemide
  • Dopamine
  • Dialysis
  • Antidotes: fomepizole, ethanol
55
Q

Describe signs and cause of grape/raisin toxicity?

A
  • MEchanism unknown, dried fruit worse
  • Signs: V+ D+ anorexia, ataxia, weakness, **acute renal failure **
56
Q

What Tx and Pg for raisin/grape tox?

A

Tx: Decontaminate GIt, charcoal, fluids for ARF
Pg good if no ARF

57
Q

Lilies ingested can cause….

A

Renal tubular necrosis

Also V+ PUPD, anorexia, pancreatitis, renal failure

58
Q

Tx and Pg for Lilly tox?

A

Tx = decontaminate skin and GIT, activated
charcoal, IV fluids.
* Monitor kidneys.
* Prognosis good if no ARF.

59
Q

Describe Blue green algae toxicity

A
  • Bacteria in water source – cyanobacteria.
  • Fresh/salt water – more in summer.
  • Affects GIT, liver, CNS within minutes to days.
60
Q

Signs, tx and pg for algae ?

A
  • Vomiting (blood), salivating, diarrhoea, twitching, seizures, respiratory
    distress, collapse, sudden death.
  • Treatment: decontaminate skin and GIT, charcoal, fluids,
    anticonvulsants.
  • Monitor liver, kidneys and electrolytes.
61
Q

Describe Chocolate Toxicity

A
  • Dark chocolate worse
  • theobromine is the toxic substance
  • Pg usually good
62
Q

Signs and Tx of Chocolate tox?

A
  • Signs: vomiting, abdominal pain, PU/PD, ataxia, tachycardia
    (bradycardia), hypertension, irritability/excitability.
  • Treatment: decontaminate, activated charcoal, fluids, sedation, beta
    blockers.
63
Q

Descrribe Xylitol poisoning

A
  • Insulin release with severe hypoglycaemia, liver damage, seizures.
  • In gum, sweeteners, sweets, baked goods, toothpaste, peanut butter.
  • Within 30-60 min.
64
Q

Signs and Tx of Xylitol Poisoning?

A
  • Lethargy, ataxia, tremors, seizures, vomiting, coma.
  • Treatment: Decontaminate GIT (NO EMESIS), dextrose.supplementation, fluids, anti-emetics, GI and liver protectants.
65
Q

What to do for Battery ingestion?

A

Many will pass no problem -> leaking batteries problem
DON’T INDUCE EMESIS

66
Q

When to remove batteries via surgery/ endoS

A
  • Leaks/ damage sene on radiograph
  • Too large to pass
  • Not moving or 24 hrs
67
Q

Marijuana overdose?

A
  • Ataxia, CNS dullness, tremors.
  • Vomiting, bradycardia, mydriasis, hypothermia, urinary incontinence.
  • Treatment: decontamination, anticonvulsants if needed, ILE, supportive
    care.

VMS4008 (42 decks)

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