Toxins in the Garage Flashcards
What toxin is found in most commercial antifreezes?
Ethylene glycol
How does ethylene glycol taste?
Sweet
What is the pathophysiology of ethylene glycol toxicity?
Metabolized to oxalic acid and glycolic acid
What metabolizes ethylene glycol?
Alcohol dehydrogenase
What will you see on a urinalysis of ethylene glycol tox as early as 6h post ingestion?
Ca oxalate crystalluria
What is stage 1 of ethylene glycol toxicity and how long does it last?
Neurological phase, 30min-12h
What are clinical signs of the neuro phase of ethylene glycol toxicity?
Ataxia, knuckling, “drunken behavior”, anorexia and vomiting
What is stage 2 of ethylene glycol toxicity and how long does it last?
Cardiovascular phase, 12h-24h
Which phase of ethylene glycol toxicity often goes unnoticed?
Cardiovascular phase
What are clinical signs of the cardiovascular phase of ethylene glycol toxicity?
Tachycardia and tachypnea
What type of renal failure is assoc. w/ethylene glycol tox?
Oliguric
What blood gas abnormalities are assoc. w/ethylene glycol tox?
High anion gap, metabolic acidosis, high osmolar gap
When must treatment be given in order to combat ethylene glycol toxicity?
Before toxic metabolites are generated
What is the most effective medical treatment for ethylene glycol tox and how soon after ingestion but it be given?
Fomepizole (4-MP), w/in 8h of ingestion
What is the MoA of 4-methylprazole?
Competitive inhibition of alcohol dehydrogenase
If you choose to treat ethylene glycol toxicity with 20% ethanol, why is close monitoring required?
Can cause worsening of acidosis and diuresis and resp/CNS depression
What are symptomatic treatments for ethylene glycol tox?
GI protectants, IVFT, diuretics
What is the prognosis for ethylene glycol toxicity?
Good if tx w/in 4-8h; guarded if azotemia present; grave if oliguria/anuria present
What do household cleaners contain that can cause caustic or corrosive lesions?
Acids and alkalis
What should you absolutely NOT do if an animal has ingested a household cleaner?
DO NOT INDUCE VOMITING
Why do you not want to induce vomiting in a patient that has ingested an acid/alkali?
Further damage esophagus
How soon after ingestion of a non-dilute acid do burns appear and where will you see them?
Immediately; mouth, esophagus, stomach
How soon after ingestion of a non-dilute alkali do burns appear?
8-12h later
How do you treat an acid/alkali toxicity?
Dilute milk/water, GI protectant
Why is activated charcoal not an appropriate treatment for acid/alkali toxicity?
Does not bind acids or alkalis
What varnishing products are very irritating and painful when contacting skin and foot pads?
Paint thinners and turpentine
How do you treat a paint thinner ingestion?
Milk or water
Why do you not want to induce vomiting in a patient that has swallowed paint thinner?
Risk of aspiration pneumonia
What is the neurotoxicant produced by Aspergillus?
Penitrem A
Where might an animal ingest penitrem A?
Moldy food
What is the MoA of penitrem A?
Raises resting membrane potential = facilitates depolarization
What are clinical signs of moldy garbage intoxication?
Fine motor tremors, restlessness, hypersalivation
How severe can moldy garbage intoxication signs become?
Tonic spasms, hyperthermia, seizures
How do you treat moldy garbage intoxication?
Emesis, activated charcoal, supportive care
What supportive care helps with muscle tremors assoc. w/moldy garbage intoxication?
Methocarbamol (Robaxin)
How can you symptomatically treat seizures assoc. w/moldy garbage intoxication?
Diazepam, phenobarbital
What GI protectants can you use for treatment of moldy garbage intoxication?
H2 blockers, sucralfate
Which species has trouble with 4-MP treatment for ethylene glycol and why?
Cats need a much higher dose than dogs
