Toxocologic Emergencies: Metaldehyde Toxicity, Ethylene Glycol Toxicity, Acetaminophen Toxicity, Metal Toxicities

Question 1

What toxicity is this?

1. Toxin causes serious CNS abnormalities​in animals, its mechanism of action is unknown​
2. Clinical signs include anxiety, hypersalivation, hyperesthesia, ataxia, muscle tremors, tachycardia, seizures, hyperthermia​
3. Death may occur from respiratory failure as disease progresses​

Answer 1

Metaldehyde Toxicity

snail/slug bait

Question 2

What toxicity is treated this way?

1. No specific antidote​
2. Treatment is supportive and symptomatic​
3. Administration of sodium bicarbonate IV may be needed for severe metabolic acidosis

Answer 2

Metaldehyde Toxicity

snail/slug bait

Question 3

What toxicity is this?

1. Toxin is metabolized by liver into metabolites that cause metabolic acidosis and renal failure​
2. One of the metabolites, oxalic acid, may combine with calcium to form calcium oxalate crystals in the renal tubule​

Answer 3

Ethylene Glycol Toxicity

Question 4

What toxicity has these clinical signs?

1. Stage I– CNS abnormalities (depression, ataxia, knucking, seizures, coma, death), anorexia, vomiting hypothermia​
2. Stage II– Cardiorespiratory abnormalities (tachypnea, tachycardia)​
3. Stage III– Renal abnormalities (severe depression, vomiting, diarrhea, dehydration, azotemia, oliguric renal failure)​

Answer 4

Ethylene Glycol Toxicity

Question 5

What toxicity is diagnosed this way?
1. hx, clinical signs, laboratory tests (metabolic acidosis, calcium oxalate monohydrate crystals in urine), and a poison test kit​

Answer 5

Ethylene Glycol Toxicity

Question 6

What toxicity is treated this way?

1. Administer antidote for poisoning​
   a. Fomepizole (4-methypyrazole) IV at time of presentation and then at 12, 24, and 36 hrs.​
   b. Ethanol IV as a CRI until renal function can be stabilized​
2. Supportive and symptomatic treatment– including diuresis and possible peritoneal dialysis​

Answer 6

Ethylene Glycol Toxicity

Question 7

What toxicity is this?

1. Common OTC analgesic medication used by humans​
2. Cats are unable to metabolize acetaminophen​efficiently enough to prevent the formation of a toxic metabolite​
3. Toxic metabolite causes methemoglobinemia, Heinz body formation, hemolytic anemia, hepatic necrosis​

Answer 7

Acetaminophen Toxicity

Question 8

What toxicity has these clinical signs?
1. salivation, vomiting, hypothermia, depression, brown or cyanotic mucous membranes, dark/chocolate colored blood and urine, respiratory distress, swelling of face and paws, death​

Answer 8

Acetaminophen Toxicity

Question 9

What toxicity has this treatment?

1. Oxygen supplementation​
2. Administer antidote– N-acetylcysteine (Mucomyst) IV or PO​
3. Administer S-adenosyl-methionine (SAMe) and vitamin C​
4. Supportive therapy​

Answer 9

Acetaminophen Toxicity

Question 10

What is a toxic dose of Acetaminophen for dogs and cats? (2)

Answer 10

cat 50-60 mg/kg

dog 160-600 mg/kg​

Question 11

What kind of metal toxicity is this?

1. Found in paint, batteries, linoleum, plumbing supplies, improperly glazed ceramic water bowls, fishing sinkers, shotgun pellets​
2. Causes GI and CNS abnormalities (vomiting, abdominal pain, anxiousness, compulsive pacing, chomping of jaws, vocalizing, muscle tremors, seizures, blindness)​
3. Diagnose by measuring lead levels in blood​
4. Treat with calcium EDTA SC and D-penicillamine PO​

Answer 11

lead

Question 12

What metal toxicity is this?

1. Found in pennies, skin preparations, galvanized metal​
2. Causes intravascular hemolysis​
3. Clinical signs include depression, anorexia, vomiting, diarrhea, abdominal pain, hemolytic anemia with hemoglobinuria and icterus, renal failure​
4. Diagnose by measuring lead levels in blood​
5. Treat with calcium EDTA SC and D-penicillamine PO​

Answer 12

zinc