Toxicology 2021

Question 1

A DVM called to ask about appropriate tx options for a two-year-old MC 20-lb mixed breed dog hat had ingested an unknown amount of a rodent bait called “Tomcat” (according to the owner) less than one hour ago. The first thing you recognize immediately once you Google “Tomcat” is that there are LOTS of products on the market with that name - and the toxic principle in these products is either bromadiolone, brodifacoum, or bromethalin. The owner was asked to check the label and did confirm that the product the dog ingested contained bromethalin present at .01%.

Name the two syndromes associated with toxic bromethalin exposures in dogs and cats; indicate the one that is the most common form seen in cats.

1. Form at any toxic exposure dose or exposures < LD50 _____________________
2. Form at exposure doses > LD50 ___________________

Answer 1

Form at any toxic exposure dose or exposures < LD50: paralytic (most common form seen in cats)

Form at exposure doses > LD50: convulsant

Question 2

A DVM called to ask about appropriate tx options for a two-year-old MC 20-lb mixed breed dog hat had ingested an unknown amount of a rodent bait called “Tomcat” (according to the owner) less than one hour ago. The first thing you recognize immediately once you Google “Tomcat” is that there are LOTS of products on the market with that name - and the toxic principle in these products is either bromadiolone, brodifacoum, or bromethalin. The owner was asked to check the label and did confirm that the product the dog ingested contained bromethalin present at .01%.

Even before doing the math and calling me, the DVM recommended the owner administer 3% oral hydrogen peroxide to induce vomiting. The owner administered the appropriate amount of hydrogen peroxide TWICE in the hour prior to the DVM calling me, which yielded both times a small volume of white frothy foam with a few green pellets of the bait.

The owner says that they think it IS possible that there was enough of that bait that their dog could have ingested a toxic dose. Describe the next BEST decontamination procedure you would recommend at this time (the patient is asymptomatic and BAR, with no pre-existing health condition, not on any meds).

Answer 2

Maropitant as anti-emetic to stop vomiting after hydrogen peroxide.
Activated charcoal repeated every 6-8 hours for 24 hours.

Question 3

A DVM called to ask about appropriate tx options for a two-year-old MC 20-lb mixed breed dog that had ingested an unknown amount of a rodent bait called “Tomcat” (according to the owner) less than one hour ago. The first thing you recognize immediately once you Google “Tomcat” is that there are LOTS of products on the market with that name - and the toxic principle in these products is either bromadiolone, brodifacoum, or bromethalin. The owner was asked to check the label and did confirm that the product the dog ingested contained bromethalin present at .01%.

Brandy and Annabelle sent me an Instagram image that says “Anticoagulant rodenticide poisoning has an antidote - Vitamin K” - pretty frustrating given the inaccuracy of the statements. But also frustrating is using the term ‘antidote’ because as Brandy says, ‘it makes the treatment seem simple and downplays the severity of the situation.’ Let’s say that this dog DID ingest a toxic dose of an anticoagulant rodenticide.

You would give the asymptomatic patient ____________ for ___________ weeks.
And if you had by chance determined that the symptomatic patient had prolonged ACT, PT, and PTT times, then you would highly consider doing further diagnostic workups in the clinic along with administering an IV ______________________.

Answer 3

You would give the asymptomatic patient vitamin K1 for four weeks.
Administer IV Plasma

Question 4

Approximately 350 Hereford calves (8-9 months of age, 500-700 pounds) were kept in a dry lot. The calves were being fed hay only. A feed supplement was added to the diet at 10:00 AM at a rate of 1/2 pound/head/day. Within one hour, some of the calves were observed to be ataxic and slobbering. Some became recumbent and went into terminal seizures. By noon, 40 animals were dead. Three veterinarians were on the scene by then, treating the clinically affected animals with antihistamines, atropine, and banamine. No response to therapy was observed. Necropsies performed right at the time of death revealed ‘excessive oral and nasal froth, marked distinction of the rumen, hypermedia of the abomasal mucosa, and hypermedia and enteritis of the mid small intestines.’ It was determined that the feed supplement contained soybean meal, urea, cottonseed meal, calcium, linseed meal, manganese, copper, zinc, iron sulfate, vitamin E, and vitamin D.

Draw the chemical structure of urea AND describe the toxic mechanism of action of urea in this scenario all the way through to the cause of death.

Answer 4

Urea and water are converted to ammonia and CO2 by the enzyme urease.
The micro flora get overwhelmed by the NH3, so the rumen buffers it to NH4 or ammonium.
However, NH4 does not cross the rumen wall readily, causing the rumen pH to increase.
This causes rumen alkalosis and metabolic acidosis, eventually leading to hyperkalemia-induced cardiac failure.

Question 5

Approximately 350 Hereford calves (8-9 months of age, 500-700 pounds) were kept in a dry lot. The calves were being fed hay only. A feed supplement was added to the diet at 10:00 AM at a rate of 1/2 pound/head/day. Within one hour, some of the calves were observed to be ataxic and slobbering. Some became recumbent and went into terminal seizures. By noon, 40 animals were dead. Three veterinarians were on the scene by then, treating the clinically affected animals with antihistamines, atropine, and banamine. No response to therapy was observed. Necropsies performed right at the time of death revealed ‘excessive oral and nasal froth, marked distinction of the rumen, hypermedia of the abomasal mucosa, and hypermedia and enteritis of the mid small intestines.’ It was determined that the feed supplement contained soybean meal, urea, cottonseed meal, calcium, linseed meal, manganese, copper, zinc, iron sulfate, vitamin E, and vitamin D.

In urea poisoned ruminants, the rumen pH is __________.

Answer 5

Basic

Question 6

Approximately 350 Hereford calves (8-9 months of age, 500-700 pounds) were kept in a dry lot. The calves were being fed hay only. A feed supplement was added to the diet at 10:00 AM at a rate of 1/2 pound/head/day. Within one hour, some of the calves were observed to be ataxic and slobbering. Some became recumbent and went into terminal seizures. By noon, 40 animals were dead. Three veterinarians were on the scene by then, treating the clinically affected animals with antihistamines, atropine, and banamine. No response to therapy was observed. Necropsies performed right at the time of death revealed ‘excessive oral and nasal froth, marked distinction of the rumen, hypermedia of the abomasal mucosa, and hypermedia and enteritis of the mid small intestines.’ It was determined that the feed supplement contained soybean meal, urea, cottonseed meal, calcium, linseed meal, manganese, copper, zinc, iron sulfate, vitamin E, and vitamin D.

Instead of antihistamines, atropine, and banamine, name the TWO oral treatments one should have instituted if you could that would slow down the enzyme and trap the toxic metabolite in the rumen.
________________________ and ______________________.

Answer 6

Cold water and vinegar

Question 7

Approximately 350 Hereford calves (8-9 months of age, 500-700 pounds) were kept in a dry lot. The calves were being fed hay only. A feed supplement was added to the diet at 10:00 AM at a rate of 1/2 pound/head/day. Within one hour, some of the calves were observed to be ataxic and slobbering. Some became recumbent and went into terminal seizures. By noon, 40 animals were dead. Three veterinarians were on the scene by then, treating the clinically affected animals with antihistamines, atropine, and banamine. No response to therapy was observed. Necropsies performed right at the time of death revealed ‘excessive oral and nasal froth, marked distinction of the rumen, hypermedia of the abomasal mucosa, and hypermedia and enteritis of the mid small intestines.’ It was determined that the feed supplement contained soybean meal, urea, cottonseed meal, calcium, linseed meal, manganese, copper, zinc, iron sulfate, vitamin E, and vitamin D.

People get urea or NPN intoxication in ruminants mixed up with nitrate poisoning all the time. Draw the chemical structure of nitrate AND describe its toxic mechanism of action.

Answer 7

NO3 gets converted to NO2 in the rumen.

NO2 gets absorbed from the rumen into the bloodstream and causes methemoglobinemia.

Question 8

Approximately 350 Hereford calves (8-9 months of age, 500-700 pounds) were kept in a dry lot. The calves were being fed hay only. A feed supplement was added to the diet at 10:00 AM at a rate of 1/2 pound/head/day. Within one hour, some of the calves were observed to be ataxic and slobbering. Some became recumbent and went into terminal seizures. By noon, 40 animals were dead. Three veterinarians were on the scene by then, treating the clinically affected animals with antihistamines, atropine, and banamine. No response to therapy was observed. Necropsies performed right at the time of death revealed ‘excessive oral and nasal froth, marked distinction of the rumen, hypermedia of the abomasal mucosa, and hypermedia and enteritis of the mid small intestines.’ It was determined that the feed supplement contained soybean meal, urea, cottonseed meal, calcium, linseed meal, manganese, copper, zinc, iron sulfate, vitamin E, and vitamin D.

For both nitrate and urea intoxications, the BEST sample to submit to the toxicology lab to confirm your suspicions from a dead cow would be: _______________________.

Answer 8

Eyeball

Question 9

A three-year-old, MI, 61lb Catahoula dog presented to the DVM for mild muscle tremors, that rapidly progressed to extreme extensor rigidity. The dog has spent the afternoon in a fenced-in yard, and the owners are suspicious that their neighbor is to blame for potentially ‘poisoning their dog’. Of all the toxicants we discussed that can cause excitation, strychnine is one that can cause extreme extensor rigidity and tonic seizure activity. Describe strychnine’s mechanism of action that explains why you see the extensor rigidity an/or tonic seizures.

Answer 9

Strychnine is a reversible antagonist of glycine at the post-synaptic sites.
This causes reflex stimulation where extensor muscles predominate resulting in extensor rigidity and tonic seizures.

Question 10

T/F: Strychnine poisoned patients often exhibit enhanced sensitivity to external stimuli, and the best sample to submit to the tox lab to confirm your suspicions is stomach contents.

Answer 10

TRUE

Question 11

T/F: The clinical signs of extensor rigidity are like dogs suffering from tetanus.

Answer 11

TRUE

Question 12

Bobcat, a five-year-old FS 12.9kg Border collie/Australian shepherd mix presented to the clinic for ingestion of an ant poison whose active ingredient is bifenthrin. Bobcat had got into the garage through an open door sometime during the afternoon and chewed through the bag that had been left on the floor. At presentation she was described as QAR and was exhibiting full body muscle tremors with mild ataxia. Both eyes were dilated, and she was exhibiting hypersensitivity to noise and stimulation. Hydration status was adequate.

Asses the vitals.
T - 106.8 F
P - 150 beats/min
R - 45 breaths/min

Answer 12

T - 106.8 F. HIGH
P - 150 beats/min HIGH
R - 45 breaths/min HIGH

Question 13

Bobcat, a five-year-old FS 12.9kg Border collie/Australian shepherd mix presented to the clinic for ingestion of an ant poison whose active ingredient is bifenthrin. Bobcat had got into the garage through an open door sometime during the afternoon and chewed through the bag that had been left on the floor. At presentation she was described as QAR and was exhibiting full body muscle tremors with mild ataxia. Both eyes were dilated, and she was exhibiting hypersensitivity to noise and stimulation. Hydration status was adequate.

Of all the drugs one can use to control the tremors, knowing that the exposure is bifenthrin, which is a pyrethrum, the BEST drug you would start with first should be __________________.

Answer 13

Methocarbamol

Question 14

Bobcat, a five-year-old FS 12.9kg Border collie/Australian shepherd mix presented to the clinic for ingestion of an ant poison whose active ingredient is bifenthrin. Bobcat had got into the garage through an open door sometime during the afternoon and chewed through the bag that had been left on the floor. At presentation she was described as QAR and was exhibiting full body muscle tremors with mild ataxia. Both eyes were dilated, and she was exhibiting hypersensitivity to noise and stimulation. Hydration status was adequate.

Once the tremors subsided, active cooling measures were taken (IV fluids, fan, rubbing alcohol on paws) to reduce the temperature. Indicate the temperature when you would STOP the cooling measures to avoid a rebound hypothermia.

Answer 14

102.5 - 103.5 F

Question 15

T/F: Temporary blindness has been reported in 30% of pyrethrum/pyrethrum/pyrethrums poisoned dogs.

Answer 15

TRUE

Question 16

T/F: Following topical exposures to spot-on products and a thorough bathing, application of vitamin D gel to the spot-on site has been shown to reduce the signs associated with paresthesia.

Answer 16

FALSE - vitamin E

Question 17

Bobcat, a five-year-old FS 12.9kg Border collie/Australian shepherd mix presented to the clinic for ingestion of an ant poison whose active ingredient is bifenthrin. Bobcat had got into the garage through an open door sometime during the afternoon and chewed through the bag that had been left on the floor. At presentation she was described as QAR and was exhibiting full body muscle tremors with mild ataxia. Both eyes were dilated, and she was exhibiting hypersensitivity to noise and stimulation. Hydration status was adequate.

Now that Bobcat is sedated and the muscle tremors appear to be under control for the moment, do you or don’t you want to initiate any GI decontamination procedures? If no, state why not. If yes, state why AND what you would want to do.

Answer 17

Yes - wash mouth because it is irritating and give activated charcoal to remove from stomach and GIT.

Question 18

A 36lb two-year-old FS Border collie/mixed breed dog that is possibly two weeks pregnant presented to the DVM exhibiting ataxia, mild tremors, and bilateral blindness. The dog had access to a horse pasture where the client was deworming three horses the day before with oral ivermectin mixed with applesauce to make it more palatable. There is a concern that she has the ‘mutation’ that would make her more sensitive to the potential toxic effect of ivermectin.

Describe this mutation AND how this makes dogs more sensitive to ivermectin and the other ivermectin-like drugs and prolongs the half-life in the body.

Answer 18

The MDR1 mutation causes a lack of p-glycoprotein production, which is needed for active transportation of ivermectin-like drugs out of the blood-brain barrier and is needed for biliary and renal excretion.

This causes a buildup of the drug in the brain with no way to leave, as well as prolonged half-life due to impaired biliary and renal excretion.

This mutation is most common in herding breeds like collies and aussies.

Question 19

Bobcat, a five-year-old FS 12.9kg Border collie/Australian shepherd mix presented to the clinic for ingestion of an ant poison whose active ingredient is bifenthrin. Bobcat had got into the garage through an open door sometime during the afternoon and chewed through the bag that had been left on the floor. At presentation she was described as QAR and was exhibiting full body muscle tremors with mild ataxia. Both eyes were dilated, and she was exhibiting hypersensitivity to noise and stimulation. Hydration status was adequate.

All of the following are TRUE regarding ivermectin and ivermectin-like poisonings EXCEPT (choose ONE BEST answer):

• Clinical signs can persist for hours, days, or weeks depending on dose and mutation status of the patient.
• The severity and duration of the clinical signs is an extremely effective predictor in determining prognosis of poisoned animals.
• This is one poisoning where IV lipid therapy is recommended; except it may not work in patients with the genetic mutation.
• Multiple doses of activated charcoal along with excellent symptomatic and supportive care are important treatment modalities to enhance fecal excretion and to avoid secondary complications.
• It is recommended to avoid excessive use of benzodiazepines because though they might control sings of excitation its use may prolong the elation/depression due to their GABA agonist effect.

Answer 19

FALSE: The severity and duration of the clinical signs is an extremely effective predictor in determining prognosis of poisoned animals.

Question 20

Dr. Laura Chen sent me an image of a chick that had anasarca with pulmonary edema, along with paired edematous Ovid testes in the middle of the image. This chick is one of a flock of 10-day-old chicks, that had experienced a 50% mortality event after the client had introduced a new electrolyte solution into their pen, and the concern is a salt-intoxication.

Swine are a very sensitive species to salt intoxication - name the specific lesion you see in the CNS of salt-intoxicated swine: _______________________________.

And talking about swine, poliomyelomalacia is a specific lesion seen when swine are overdosed with _________________.

Answer 20

Eosinophilic meningoencephalitis

Selenium

Question 21

Dr. Laura Chen sent me an image of a chick that had anasarca with pulmonary edema, along with paired edematous Ovid testes in the middle of the image. This chick is one of a flock of 10-day-old chicks, that had experienced a 50% mortality event after the client had introduced a new electrolyte solution into their pen, and the concern is a salt-intoxication.

Now back to the chicks, that at the time of the mortality event, were being kept in the house with the owner. Our first thought was polytetrafluoroethylene (PTFE) exposure causing the mortality event - describe specifically where PTFE comes from.

Answer 21

A coating on many items including non-stick cookware and heat lamps

Question 22

Name the mycotoxin that is produced by several Fusarium spp. of mold growing on grain that acts as a weak estrogen in cattle and swine: _______________________.

Answer 22

Zearalenone

Question 23

T/F: Slaframine is a mycotoxin that acts as a potent salivary gland M3 agonist, and is most commonly found in corn and cottonseed.

Answer 23

FALSE - slaframine is most commonly found in alfalfa and clovers

Question 24

History: A 74lb MI Labrador dog vomited a large amount of unknown food substance that the owner thought was ‘rat bait.’ Over the next 48 hours, the dog was anorexic, vomiting repeatedly, and was exhibiting severe respiratory distress before he abruptly died. A necropsy was performed, and the histologic findings were severe pulmonary hemorrhage and necrosis with focal ulcerative enteritis. The urine tested positive for paraquat.

Explain why oxygen therapy is risky for paraquat-poisoned dogs.

Answer 24

Oxygen is the substrate to produce free radicals, which are what cause lung damage.

Question 25

I am hoping by now you should know what your options are to induce emesis in dogs and cats; and, how to reverse any side effects - fill in the blanks.

		Emetic				Reversal Agent Cats		D\_\_\_\_\_\_\_\_\_\_\_\_\_		A\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
		X\_\_\_\_\_\_\_\_\_\_\_\_\_		Y\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
		H\_\_\_\_\_\_\_\_\_\_\_\_\_		N\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dogs A_____________ N_______________

Answer 25

Emetic Reversal Agent
Cats Dexmedetomidine Atipamezole
Xylazine Yohimbine
Hydromorphone Naloxone

Dogs Apomorphine Naloxone

Question 26

History: Twenty-five cow/calf pairs are being kept in a large 200-acre pasture, that had not been grazed for five years. Over the last five days, the owner’s complaint is ‘acute death’ in three calves and another calf showed ‘acute neurologic signs.’ Necropsy on one calf: the DVM noted pale skeletal muscle on gross examination and submitted tissues to WADDL for histopathology and toxicology. She specifically wanted us to look for lead!

It is common to see clinical signs of lead intoxication in calves and no signs in adults, even when they are together in the same pasture with the same access to a lead source. Describe specifically the MOST IMPORTANT reason why young animals are more sensitive than older animals to lead, whatever form it is.

Answer 26

Young animals have enhanced absorption of lead.

Question 27

Name the MOST COMMON source of lead for cattle: ___________________.

Answer 27

Batteries

Question 28

ALL the following are TRUE regarding lead poisoning EXCEPT (choose ONE BEST answer):

• Lead leaches out of its source in the acidic environment of the upper GIT as well as from lead shot embedded in the skeletal muscle tissue.
• The central nervous system (blindness) and the peripheral nervous system (wing paralysis, pharyngeal paralysis) are common targets for lead.
• In lead poisoned dogs and cats, gastrointestinal signs (lead colic) are generally the first signs reported.
• Lead chelations include CaEDTA (cattle, birds) and succimer (dog, cat, birds), and all lead poisoned patients should receive thiamine.
• In dogs and cats, when one sees an increase in uncleared RBCs and basophilic stippling when there is no evidence of anemia, think lead.

Answer 28

FALSE: Lead leaches out of its source in the acidic environment of the upper GIT as well as from lead shot embedded in skeletal muscle tissue.

Question 29

Name the MOST COMMON source of lead poisoning for bald and golden eagles AND how they are getting it.

Answer 29

Lead shots from scavenging on animals with the shot in their muscle

Question 30

A hyacinth macaw presented to the DVM for same day onset of weakness, unable to support head, and dyspnea. Radiographs revealed metallic densities in the gizzard and proventriculus. The macaw spends most of his time in his metal cage but is allowed access to the house when the owners are home. Histopathologic diagnosis: renal tubule necrosis, hepatic necrosis with periportal biliary hyperplasia, and mild random pancreatic cell necrosis. In addition to lead, another element on the periodic table needs to be considered as a toxicology differential for indoor or caged birds, particularly those with the lesions described.

Name the element: __________________.

Answer 30

Zinc

Question 31

The mycotoxin Fumosin, produced by Fusarium molds growing on corn or corn screenings, causes a specific neurologic disease in horses called ______________________________________. (You cannot call it moldy corn poisoning.)

Answer 31

Equine leukoencephalomalacia

Question 32

Ovine. History: several animals have developed neurologic signs (hind end ataxia, blindness) that have progressed over several weeks. One ewe was euthanized, and fixed brain was submitted to WADDL: diffuse neuronal and astrocyte vacuolation and swelling, mild to severe. This lesion is consistent with the toxin swainsonine that is a mycotoxin associated with ALL the following EXCEPT (choose ONE BEST answer):

Ipomoea sp. (morning glory)
Astragalus sp. (locoweed)
Vicia villosa (hairy vetch)
Oxytropis sp. (locoweed)
Swainsona sp. (swainsona)

Answer 32

Vicia villosa (hairy vetch)

Question 33

Select TRUE or FALSE for each of the four statements below regarding ergot and fescue poisoning.

Ergot or sclerotia body is produced by the fungus Claviceps spp. when it invades and replaces the seed of grasses and grains, and ergotamine is one of the mycotoxins typically present at the highest concentrations.

Cattle ingesting tall fescue infected with the endophyte Neotyphodium coenophialum as well as cattle ingesting ergot can develop dry gangrene of the distal extremities, particularly in the winter months.

Summer slump associated with fescue poisoning typically occurs in the warm summer months, and cattle display significant hypothermia due to peripheral vasodilation.

Reproductive problems in horses have been reported with fescue, which include prolonged gestation in pares, thickened placentas, large weak dysmature foals, agalactia and abortions.

Answer 33

Ergot or sclerotia body is produced by the fungus Claviceps spp. when it invades and replaces the seed of grasses and grains, and ergotamine is one of the mycotoxins typically present at the highest concentrations. (TRUE)

Cattle ingesting tall fescue infected with the endophyte Neotyphodium coenophialum as well as cattle ingesting ergot can develop dry gangrene of the distal extremities, particularly in the winter months. (TRUE)

Summer slump associated with fescue poisoning typically occurs in the warm summer months, and cattle display significant hypothermia due to peripheral vasodilation. (FALSE) - hyperthermia due to peripheral vasoconstriction

Reproductive problems in horses have been reported with fescue, which include prolonged gestation in pares, thickened placentas, large weak dysmature foals, a galactic, and abortions. (TRUE)

Question 34

Many horses suffering from chronic selenium intoxication are lame due to circumferential cracks in their hooves right below the coronary band, leading to separation of tissues from the hoof wall. Name the other very characteristic changes these animals also often display.

Answer 34

Hair loss on the mane and tail

Question 35

A six-year-old Labrador named Chelsea presented to the emergency service for an acute onset of ‘shaking and hypersensitivity to loud noises.’ The owners left Chelsea in an enclosed backyard for three hours, unattended. When they returned, they noted that Chelsea had broken though the chicken wire surrounding the compost pile and there were several piles of vomit in the backyard with compost material in the vomit.

Compost is an amazing source for Penicilium spp. growth; and that mold can produce two tremorgenic mycotoxins. Name them: __________________ and ____________________.

Name the drug you will reach for FIRST to control the muscle tremors.

Answer 35

Roquefortine
Penitrem A

Methocarbamol

Question 36

A six-year-old Labrador named Chelsea presented to the emergency service for an acute onset of ‘shaking and hypersensitivity to loud noises.’ The owners left Chelsea in an enclosed backyard for three hours, unattended. When they returned, they noted that Chelsea had broken though the chicken wire surrounding the compost pile and there were several piles of vomit in the backyard with compost material in the vomit.

There is a tremorgenic stagger syndrome described in livestock associated with the ingestion of the mycotoxin lolitrem - name the disease.

Answer 36

Perennial Ryegrass Staggers

Question 37

A six-year-old Labrador named Chelsea presented to the emergency service for an acute onset of ‘shaking and hypersensitivity to loud noises.’ The owners left Chelsea in an enclosed backyard for three hours, unattended. When they returned, they noted that Chelsea had broken though the chicken wire surrounding the compost pile and there were several piles of vomit in the backyard with compost material in the vomit.

Name at least two other items that might reasonably be found in compost that could be problematic to dogs.

Answer 37

Caffeine

Hops

Question 38

Ingestion of chocolate covered coffee beans is not an unusual scenario. A five-year-old, mixed breed dog ingested two cups!

ALL of the following are TRUE regarding methylxanthine exposures in companion animals EXCEPT (choose ONE BEST answer):

• Theobromine and caffeine are considered excitants; once ingested, theobromine has a long half-life while caffeine has a shorter half-life.
• Theobromine is known to delay gastric emptying; therefore, decontamination procedures should be considered well beyond the routine 1-2 hour post-exposure window.
• Hyperactivity, tremors, cardiac arrhythmias (tachycardia), and tonic-clinic seizures can be seen in high dose exposures.
• Monitoring amylase and lipase is essential because death following chocolate ingestions is mostly due to pancreatitis because of the high sugar content.
• High dose chocolate exposures warrant consideration of multiple doses of activated charcoal or cholestyramine due to enterohepatic recirculating of theobromine.

Answer 38

FALSE: Monitoring amylase and lipase is essential because death following chocolate ingestions is mostly due to pancreatitis because of the high sugar content.

Question 39

Name the molluscicide (slug and snail bait) that can cause muscle tremors in affected animals and is often referred as the ‘shake and bake’ syndrome.

Answer 39

Metaldehyde

Question 40

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

ALL the following factors are associated with blooms EXCEPT (choose ONE BEST answer):

• High light intensity
• High oxygen concentration
• High nutrients (phosphates, sulfates, nitrates)
• Warmish water temperature and just the right pH
• Quiet weather conditions for 3-5 days

Answer 40

FALSE: High oxygen concentration

Question 41

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

T/F: Depending on where you are standing in the US, blooms can potentially occur all year round.

Answer 41

TRUE

Question 42

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

The neurotoxin anatoxin-a mimics the neurotransmitter ______________________.
The neurotoxin anatoxin-a(s) inhibits the enzyme _____________________.

Answer 42

Anatoxin-a mimics the neurotransmitter acetylcholine

Anatoxin-a(s) inhibits the enzyme acetylcholinesterase

Question 43

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

The actions of these two toxins lead to muscle tremors and muscarinic signs, very similar to what is seen with organophosphate and carbamate poisonings. Name the mnemonic for the muscarinic signs and tell me what each letter stands for.

Answer 43

DUMBSLED
Diarrhea
Urination
Myosis
Bradycardia
Salivation
Lacrimation
Emesis
Dyspnea

Question 44

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

Sometimes instead of presenting with muscarinic and nicotine signs, OP and carbamate poisoned dogs exhibit anorexia, neuromuscular weakness, and ventroflexion of the neck. Name this syndrome.

Answer 44

Intermediate syndrome

Question 45

Jenelle sent me a picture of a feed supplement that was recommended to give to her sister’s puppy. Jenelle was looking at the label and saw that the first ingredient listed was blue-green algae. Poisonings associated with Cyanobacteria blooms are quite common in all animal species.

Micro cyst in, modular in, and cylinders per option are toxins produced by some Cyanobacteria that primarily target the ________________.

Answer 45

Liver

Question 46

Cats that bite into glow jewelry exhibit what prominent clinical signs?

Answer 46

Salivation

Catnip-like behavior change

Question 47

This is another one of my favorite plants. Poisonings in livestock are common in some areas of the Pacific Northwest, including Montana. People think it is an onion because of the bulb-like root, but the root is covered with a black, papery sheath and the flower is distinctly different than onion flowers. Name the plant.

Answer 47

Death camas

Question 48

I have been waiting for this gem to flower ever since Claudia and Andrew brought this back with them from Arizona. This evergreen cardiotoxic shrub does not like the cold weather of the Palouse - hence the trip from Phoenix. Give the genus or best common name.

Answer 48

Oleander

Question 49

Dr. Tina Miller was presented with a one-year-old FS Border collie/mix who on Saturday evening vomited up a piece of a mushroom. Thirty minutes after vomiting, she was ataxic, exhibiting involuntary muscle movements, had a horizontal nystagmus, was biting the air, was exhibiting hypersensitivity to stimuli, and barely responsive. The mushroom was later identified as Amanita panther in a or pantherinoides, that contains the neurotoxins music of and ibotenic acid, that causes psychotropic signs. The patient survived thanks to Dr. Miller’s excellent treatment plan.

You rarely can identify the mushroom in time to help you with the appropriate treatment so you need to prepare for whatever might happen; treat whatever signs you see and prevent other signs from occurring. ALL the following would be consistent and recommended with a mushroom poisoning EXCEPT (choose ONE BEST answer):

• Regardless of mushroom type, almost all poisonings start off with signs of gastroenteritis (vomiting or diarrhea, or both).
• You need to have atropine ready in case you begin to see muscarinic signs due to this mushrooms that contain muscarine.
• Establish at least a baseline serum chemistry panel, because there are those mushrooms that are hepatotoxic and nephrotoxic.
• Send the patient home when stable with the liver protectants omeprazole and ranitidine for two weeks’ worth of treatment and recheck the serum chemistry panel at 48 hours post exposure.

Answer 49

FALSE: Send the patient home when stable with the liver protectants omeprazole and ranitidine for two weeks’ worth of treatment and recheck the serum chemistry panel at 48 hours post exposure.

Omeprazole and ranitidine are GI protectants.

Question 50

Marine scientists say they have found what they believe to be as many as 25,000 barrels possibly containing DDT (a toxic pesticide banned decades ago in the US) off the Southern California coast near Catalina Island. DDT is an example of what class of pesticides (it is one of the topics we talked about in class and I have not asked a question about on the exam).

Answer 50

Chlorinated hydrocarbon