Toxocologic Emergencies: Anticoagulant Rodenticide Toxicity and Other Rodenticides

Question 1

How do anticoagulant rodenticides cause anticoagulant effects?

Answer 1

Toxins inactivate the enzyme required to activate vitamin K​

Question 2

Active vitamin K is needed to produce what coagulation factors? (4)

Answer 2

2, 7, 9, 10

Question 3

What do these things cause?

1. First-generation rodenticides (e.g. warfarin, pidone, diphacinone, chlorophacinone) decrease clotting factor levels for 7-10 days​
2. Second-generation rodenticides(e.g. brodifacoum, bromdiolone) decrease clotting factor levels for 3-4 wks.​

Answer 3

Depletion of coagulation factors leads to abnormal hemostasis​

Question 4

What are these the clinical signs for?
1. lethargy, vomiting, anorexia, ataxia, diarrhea, hemorrhage, melena, dyspnea, epistaxis, external hemorrhage/bruising, pale mm’s, sudden death from excessive internal hemorrhage​

Answer 4

Anticoagulant Rodenticide Toxicity

Question 5

What is diagnosed this way?

1. hx, clinical signs, prolonged bleeding time tests (PT, aPTT, ACT), response to vitamin K therapy​

Answer 5

Anticoagulant Rodenticide Toxicity

Question 6

How is Anticoagulant Rodenticide Toxicity treated? (2)

Answer 6

1. Vitamin K 1

2. Symptomatic and supportive therapy

Question 7

What type of rodenticide toxicity is this?

1. Formulated as green pellets in a packet​
2. Potent neurotoxin causing hyperexcitability, muscle tremors, seizures, and death​

Answer 7

Bromethalin (Assault, Trounce, Vengeance)​

Question 8

What type of rodenticide toxicity is this?

1. Rodenticide converted to vitamin D3 causes calcium reabsorption leading to hypercalcemia​
2. Calcium deposition in soft tissues (e.g. blood vessels, kidney, stomach wall) can lead to hemorrhaging and renal failure. High calcium levels can lead to cardiac dysrhythmias and death​​

Answer 8

Cholecalciferol (Ortho Mouse-B-Gone, Rampage)​

Question 9

What type of rodenticide toxicity is this?

1. Formulated as meal, pellet or strip​
2. Reacts with HCl acid in stomach to form toxic phosphine gas smells like garlic/rotten fish, damages capillary endothelium and RBC’s within the kidneys, liver, and lungs​
3. Clinical signs include lethargy, salivation, vomiting, abdominal distension, pulmonary edema, cyanosis, hypotension, shock, seizures, death​
4. Supportive therapy including oxygen supplementation and IV fluid administration​
5. If vomiting is induced, it should be done outside or in a well ventilated area​

Answer 9

Zinc phosphide (Acme Mole and Gopher Killer, Mr. Rat Guard, Phosvin)​