VETgirl Q2 2020 Beat e-Newsletter










May be seen as soon as 30 minutes after ingestion but typically occur within 3 to 5 hrs GI (vomiting, diarrhea) and CNS (hyperesthesia, incoordination, hyperthermia, seizures) signs Liver damage and cirrhosis may occur 2-3 days after exposure Death from respiratory failure may occur within 4-24 hrs after exposure

Known as a molluscicide, used for the control of slugs and snails (although recently replaced by less toxic iron phosphate)

• Decontamination, if appropriate • Gastric lavage with inflated ETT should be performed if the patient is symptomatic and evidence of pellets still in stomach on radiograph; administration of 1 dose of charcoal if gastric lavage performed • Stabilization of vital signs, IV fluids, anti-emetics, acid-base monitoring, methocarbamol/anticonvulsant therapy, respiratory and CV system monitoring, supportive care

Acidosis, liver value abnormalities

Acute median LD values are 210 to 600 mg/kg for dogs and 207 mg/kg for cats Prognosis is good if survival is > 24 hrs from ingestion with early treatment

Characteristic odor of formaldehyde

Results in the disruption of the GABAergic system Monoamine oxidase, 5-hydroxytryptamine, and norepinephrine may also be involved in the toxic mechanism


may be present in the stomach contents along with bait material No consistent and pathognomonic gross or histological lesions occur in metaldehyde poisoned animals

Coins, feeds, solutions, wire, jewelry, food

• Chelation with penicillamine or trientine • Supportive care for other derangements

Increasing zinc in diet can aid in prevention

Quantitative hepatic copper values; genetic testing (some breeds)

Breeds that are homozygous for a recessive gene (Bedlington Terrier, Skye Terrier, West Highland White Terriers, Labrador Retrievers, Doberman Pinschers) have excessive copper storage in the liver


Lethargy, anorexia, vomiting, weight loss, jaundice

Sedation, malaise, ataxia, jaundice

Oral diazepam (valium) and alprazolam (not seen with parenteral administration); typically seen with chronic oral dosing

Markedly ↑↑↑ ALT ↑ T-bili, PT/PTT

Acute hepatic necrosis in 5-11 days of oral treatment

Benzodiazapines (oral) CATS ONLY

Amanita spp., Galerina spp., Conocybe spp., Lepiota spp.

• Decontamination is often too late – gastric lavage +/- activated charcoal, bathe (use protective gear) • PCV/TS/BG • Baseline Chem, CBC PT/PTT • Decontamination (emesis and AC if < 2 hrs post ingestion) • IV fluids, sequester amatoxin bile in gallbladder with octreotide CRI, NPO), ultrasound-guided bile aspiration

Alpha amanitin LD 50 (human) = 0.1 mg/kg Easily found in one mushroom

↑↑ Liver enzymes within 48-72 hrs

Microcystin binds to protein phosphatase in cytoskeleton, disorganization of actin leads to cellular collapse, intrahepatic hemorrhage, death Inhibit DNA and RNA transcription and protein synthesis; bind to actin filaments, deform cytoskeleton → hepatocyte death

Centrilobular hemorrhagic necrosis

Develop GI signs within 6-24 hrs “False” recovery period, followed by fulminant liver failure and AKI in 36-48 hrs

Amatoxin Mushrooms

Death in hrs to days with hepatotoxin GI (e.g., vomiting/diarrhea), CNS (e.g., weakness, ataxia, tremors, seizures), cardiac (e.g., collapse, pallor, tachycardia, respiratory failure, hemorrhagic and hypovolemic shock) Very acute clinical signs with neurotoxin (death can occur in minutes to hrs) – CNS signs and SLUDGE-like signs

Cyanobacteria Hepatotoxins ( Microcystis spp., Nodularia spp.,

Toxic dose – 50-11,000 mcg/kg

↑↑ Liver enzymes within a few to 24 hrs; ↑↑ PT/PTT; anemia

Diffuse hepatic necrosis

Blue-Green Algae

Prognosis – often grave

Oscillatoria spp. most common; Anabaena spp. less often) Can also contain neurotoxins

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