TREATMENT & MANAGEMENT PROTOCOLS OF POISONING IN ANIMALS
Post no-539 Dt-20/01/2018
Compiled & shared by-DR RAJESH KUMAR SINGH ,JAMSHEDPUR, 9431309542,rajeshsinghvet@gmail.com
What is Poisoning?
Poisons, especially insecticides are fast acting as the molecules attach to the blood cells and spread throughout the body. Poisons affect the animal body in different ways depending on the active ingredient. Some toxins attack the blood cells, causing internal bleeding, others target the central nervous system, affecting the brain and the heart, whereas other poisons target the organs, slowly shutting each vital organ down. Poisoning in animals is always an emergency situation that must be treated as soon as possible by a veterinary professional. Animal owners that wait to seek medical attention or attempt to treat the poisoning at home without veterinary consult risk the possibility of sudden death. Poisoning in animals involves the ingestion, absorption, or inhalation of a toxic substance. Plants, medications, insecticides, chemicals and even human food products can poison an animal . If you witness your animal/pet coming into contact with or ingesting a product you know to be toxic, you can find medical care before the poison spread throughout the body. Unfortunately, the majority of pet/ farm animal poisoning cases occur when the owner is not present and the only way a pet/farm owner would be alerted is with the exhibition of symptoms. Animals who have been poisoned will likely begin to salivate profusely from the mouth, its behavior may change from calm to anxious or excited, and the pet/animal may begin to vomit. Depending on the type of toxin, an animal could quickly go into shock, seizing and losing consciousness within a few hours.
Diagnosis of Poisoning
❖ Symptomatic evidence
Circumstantial evidence
• Pathological evidence
Analytical evidence ( T.L.C/HPLC/GC/LCMS )
Treatment of Poisoning
First aid measures that can be followed in cases of poisoning in pets include the following. Collect the following information if possible:
❖ Exact name of the plant or poison.
• How much the animal has consumed or came in contact with. it ❖ How long ago exposure or ingestion has occurred.
The animal’s vital signs (temperature, heart rate, breathing rate, capillary refill time, and color of mucous membrane
❖ The animals weight. –
Specific home therapy is based on getting rid of the pet’s body of the toxin and this includes’the following.
Topical poisons
• Wash the animal with large volumes of water. If your pet is having a reaction to a flea
product a mild hand soap or shampoo can be used. If it is an oil-based toxin (such as
petroleum products), use dishwashing liquids.
❖ If the poison is in the eye, flush with large volumes of water. ❖ If the poison is a powder, you need to dust or vacuum it off. ❖ Inhaled poisons
❖ Take the animal to fresh air as fast as possible.
Ingested Poisons
It is advisable to induce vomiting, but always check with your Veterinarian before attempting to induce vomition. In cases of poisoning with some caustic substances it may be appropriate to
administer milk, but this needs to be decided on a case to case basis. Do not try to induce vomiting in the following circumstances when. • The animal is having difficulty in breathing
The animal is exhibiting seizures, depressed or abnormally excited. ❖ The animal is unconscious.
❖ The toxin is a caustic substance, an acidic substance or a petroleum-based product
• The heart rate is very slow.
Cat: Normal Rate – 160-220 beats/minute
Dog: Normal Rate ( beats per minute)
Small sized breeds less than 15 kgs. 100-160 Medium to large. sized breeds 60-100
Puppy 120-160.
How to induce vomiting
Administer household hydrogen peroxide 3% orally at a dose of one teaspoon (5MI) per 5kg of body weight. This may be repeated, every 15 to 20 minutes up to three times. Place 1 teaspoon of table salt into the animals mouth. Always save the vomitus to show your Veterinarian. Never use Ipecac syrup which may be toxic to dogs and cats:
Garbage and food poisoning
Dogs and cats that roam unsupervised eat decaying, rotten carcasses or other food substances that has been contaminated by bacteria and the toxins they elaborate and thus shows symptoms of poisoning due to bacterial toxins which tend to cause severe gastrointestinal upset. The clinical signs in such cases include vomiting, bloody diarrhea, fever, abdominal pain, and malaise. Severely effected animals can go into shock and even die as a result of the absorbed bacterial toxins. Mild cases may probably exhibit no untoward symptoms. But if symptoms are severe or last more than a couple of days, then that case has to be attended and treated symptomatically.
Household cleaners
Toilet bowl cleaners, bleach, detergents, drain cleaners, and pine oils help keep our homes clean which is a healthy thing, but these products can be highly poisonous to dogs and cats .The best remedy is prevention of these products from ingested by pets.. Keep all cleaners out of reach 0’01 animals, tightly closed when not in use to prevent accidental spills and ingestion by pets. Also be sure to keep pets out of newly cleaned areas to avoid paw injuries from walking in the newly applied cleaning solution and mouth burns frorn the animal then licking itself.
In case of accidental exposure to cleaning products, it is generally recommended to flush the skin and mouth with water to wash away remaining chemicals, and then call your veterinarian for further instructions. For milder cases, an absorbent like activated charcoal may suffice as
treatment
Teflon inhalation poisoning
Birds are very sensitive to the fumes of teflon. The problem occurs when pots or pans with nonstick surfaces are left on a hot stove and forgotten. If the pan gets hot enough, toxic particles are released into the air that causes lung damage to birds. Birds are unable to clear the toxic particles by exhaling, coughing, etc. and are therefore more susceptible to this type of poisoning.
This occurs from eating stuff that contain lead such as fishing and other weights, lead
shot, lead-containing paint, motor oil. It is commonly believed that significant amounts of lead are present in soil and in various sources of dust that have accumulated from years of vehicle
emissions from leaded gasoline Clinical signs for animal suffering lead poisoning usually include vomiting, constipation diarrhea, painful abdomen as well as depression, blindness, circling, muscle tremors, and seizures. Onset of signs is usually relatively quick but signs can progress more slowly if the animal is slowly being exposed to the poison over time..
Zinc poisoning
This occurs most frequently when dogs ingest zinc in the form of coins. The metal interacts with components of the animal’s red blood cells and can cause weakness, trembling, loss of appetite.
Household medicaments:
The medicine cabinet is another major repository of pet poisoning substances. Over the counter analgesics/NSAIDS are responsible for many poisonings, and are not safe for dogs, except in very narrowly defined amounts. The following are presented to impress on the fact that easily available over-the-counter drugs often given to dogs by their owners are potentially dangerous at some level of ingestion. The most common cases were ibuprofen, acetaminophen, aspirin and indomethacin.
Aspirin (salicylic acid) in toxic doses disrupts the acid/base balance and may result in metabolic acidosis (low blood pH) or compensated respiratory alkalosis (high blood pH). Symptoms include restlessness, hyperventilation, deafness, tachycardia (rapid pulse), nausea, vomiting, hyperthermia (high temperature), dehydration, pulmonary edema (abnormally large amounts of fluid in
intercellular tissue spaces), acute renal (kidney) failure, hypokalaemia (less alkaline than normal), hypoglycemia (abnormally low blood glucose levels), hypothrombinaemia (deficiency of thrombin in blood which leads to abnormal bleeding).. Stupor and coma are indications of severe poisoning. Some proprietary medicaments commonly used to combat infections often precipitated gastro
intestinal disturbances and diarrhea.
Acute poisoning with NSAIDS with narrow safety ranges may produce symptoms of nausea, vomiting, epigastric pain, deafness, dizziness, and oliguria (diminished urine output relative to fluids intake). apnea (cessation of breathing) and near coma, hepatic (liver) and renal (kidney) failure are possible. Mefenamic acid preparations which are used to treat moderate pain and
dysmenorrhea and may cause convulsions in overdose quantities. Acetaminophen is available as over-the-counter products with antihistamines and decongestants
Treatment
induction of vomition:
The absolute minimum requirement for poison treatment is Syrup of Ipecac, 3% hydrogen peroxide, activated charcoal and vegetable or mineral oil. Some also keep diazepam on hand to reduce convulsions, a blood volume expander and IV kit to treat for shock.. If a dog is on a farm where concentrated agricultural pesticides are mixed, it might be worthwhile to keep atropine and 2-PAM in case of organophosphate poisoning. It should be noted that organophosphates do not have to be ingested. They are capable of intoxicating on contact itself.
When a dog has been poisoned, drooling of saliva, vomiting, fatigue or weakness and , convulsions are the symptoms noticed .The above symptoms are also noticed in cases like distemper etc., and a case of poisoning should be differentiated
The first aid generally breaks out into the following two protocols based upon the types of poisoning substance:
. Corrosives – do not induce vomiting, give some oil orally.
. Non-coi+osives – induce vomiting followed by gastric lavage and/or activated charcoal
slurry.
“Do not induce Vomiting” poisons:
❖ Acids -do not induce vomiting; rinse mouth and any other areas which came in contact with
the acid; give 1-2 tablespoons of cooking or mineral oil.
❖ Alkalis (Laundry detergents, ammonia, paint removers)-Do not induce vomiting; rinse
mouth and any other areas which came in contact with the acid; give 1-2 tablespoons of
cooking or mineral oil.
❖ Petroleum distillates (Gasoline, paint thinner, charcoal lighter)—Do not induce vomiting;
rinse mouth and any other areas which came in contact with the acid; give 1-2 tablespoons of cooking or mineral oil.
❖ Stinging nettles (Bull nettles, nettle spurge, etc.)— Do not induce vomiting; rinse mouth
and any other areas which came in contact with the acid; give 1-2 tablespoons of cooking
or mineral oil. Note: may exhibit slow and irregular pulse.
“Induce Vomiting” poisons:
4-Aminopyridine is an extremely toxic white powder ‘sometimes used as a bird repellent. The cries and excited behavior of affected birds frighten away other birds. Symptoms
include excitability, increased salivation, tremors, in coordination, convulsions, and cardiac or respiratory arrest. In responsive cases, induce vomiting or give activated charcoal
slurry. Seizures may require anti-convulsant medications.
❖ Anticoagulant rodenticides- induce vomiting, abdominal pain, bloody stool and lethargy. If
ingestion has occurred less then 12 hours you may induce vomiting; give activated
charcoal slurry. Follow-up care: Vitamin K treatment by veterinarian. The new generation
of rodenticides can persist in the body for up to six months, as the liver keeps changing
them to another form of anticoagulant, therefore treatment should continue for at least six
months.
❖ Anti-depressants. Overdose symptoms include drowsiness, agitation, hyperactive reflexes,
muscle twitching, rigidity, convulsions, respiratory depression, coma, hypotension (low
blood pressure), arrhythmia (irregular pulse). Induce vomiting if responsive; give activated
charcoal slurry. Treat seizures with diazepam. Arousal using toe pinches can keep them
from drifting into coma while on the way to the vet.
••• Arsenic (Herbicides, insecticides)—Induce vomiting; give activated charcoal slurry;
antidotes are available from veterinarians. The follow-on treatment is beyond home care. ❖ Aspirin and salicylates – Induce vomiting; give activated charcoal slurry. Follow up
treatment may include giving sodium bicarbonate to cause alkalinisation of the urine to increasyxcretion of salicylates. Antacids may be required to counteract gastric irritation.
• Barbiturates- characteristic signs and symptoms include drowsiness, ataxia (failure of
mus’culaqcoordination), confusion, stupor and coma. Deaths may occur from cardiac and. respiratory arrests. Induce vomiting; give activated charcoal slurry. Hypotension may be corrected by various_ blood volume expanders. vasoconstrictors, such as dopamine or dobutamine may be required to increase blood pressure..
❖ Carbamate insecticides- Induce vomiting; give activated charcoal slurry; atropine
administration should be started as soon as possible under the supervision of a
veterinarian.
❖ Calcium cyanamide -used as a fertilizer, insecticide and herbicide. Cyanamide has
different toxic properties than cyanide. Symptoms include vertigo, dyspnea (difficult or
labored breathing), tachycardia (abnormally quick pulse) and hypotension. In such cases of poisoning induce vomiting, give activated charcoal slurry and sorbitol. Atropine can be used as an antidote. Give IV fluids (plasma or blood) if needed and vasopressor drugs if necessary.
❖ Chocolate -. While chocolate is not poisonous, theobromine which is found in chocolate
induced poisoning. Theobromine triggers epileptic seizures in susceptible animals and can cause cardiac irregularity leading to myocardial infarct and death. Additionally, chocolate irritates the gastrointestinal tract, even to the extent that it causes such internal bleeding That it can kill within a couple of days. In such cases induce vomiting; give activated
charcoal slurry.
❖ Cyanide (rodenticide) – Cyanide is one of the most rapidly acting of all poisons with death
occurring in just a few minutes. Symptoms usually appear within seconds to minutes after
exposure, and include giddiness, palpitations, dyspnea, loss of consciousness,
convulsions and death. If responsive, induce vomiting; give activated charcoal slurry.
Administer 100% oxygen as soon as possible as oxygen contributes to the reversal of the
cyanide-cytochrome complex. Antidotes include dicobalt edetate , amyl nitrate, and a
sodium nitrate and sodium thiosulphate solution .
❖ Ethylene glycol ( antifreeze, color film processing solutions (diethylene glycol) , heat- .._
exchange fluids, ice-rink freezing equipment, as well as in windshield deicer, brake, and transmission fluids) – Quick treatment is necessary to prevent the formation of toxic
metabolites. Symptoms are similar to alcohol intoxication and include staggering (ataxia), excessive thirst, (polydipsia), excessive urination (polyuria), nausea, vomiting. If treatment is provided less than 4 hours after ingestion, absorption can be prevented through emesis (vomiting) and gastric lavage (stomach wash)
❖ Phenols, creosote, fungicides, herbicides, wood preservatives -. Puppies chewing
preserved lumber and ingesting the pieces can develop a problem. Symptoms include salivation,,vomiting, dyspnea, dizziness, loss of pupillary reflexes, hyperthermia,
convulsions and coma. Vascular collapse is the usual cause of death, with respiratory depression a contributing factor. Induce vomiting; give activated charcoal slurry. In the case of creosote or lysol poisoning, if pharyngeal redness or swelling are evident, induced vomiting and gastric lavage may be contraindicated. diazepam may be required to control tremors or seizures.
Sodium Chlorate- A defoliant and soil sterilant. Onset of symptoms may be delayed as much as twelve hours after ingestion. Symptoms include vomiting, abdominal pain,
diarrhea, hypotension. hyperalkalemia resulting from potassium released from destruction of red cells may further cause,cardiac effects. Death results•from shock, anoxemia (lack of oxygen in the blood), heart failure or disseminated intravascular coagulatiokInduce
vomiting; give activated charcoal slurry. Give sodium thiosulfate to decompose.Lemaining chlorate. Sorbitol may be administered if diarrhea is not present. Oxygen may be
necessary if respiration is depressed. IV fluids may be used to sustain chlorate excretion with sodium bicarbonate as necessary, to maintain urine pH in the alkaline range. Blood transfusion may be required.
❖ Strychnine (rodenticide)—Symptoms include exaggerated reflexes and muscle
contractions, especially in the dog’s legs. If responsive, and the reflexive.symptoms have not yet started, induce vomiting; give activated charcoal slurry. Otherwise, these symptoms can be controlled at the vets with IV succinylcholine. diazepam may be also be useful for controlling convulsions. By keeping the dog very quiet, you may be able to avoid the onset of convulsions.
❖ Sympathomimetic agents (amphetamines, adrenaline, ephedrine, various “cold and flu”
decongestants, cough mixtures, appetite suppressants—Symptoms include sympathetic
over activity with irritability, agitation, hyperactivity, dilated pupils, tachycardia. Confused
mental states may be observed, and in the severe overdose, seizures and cardiac failure.
Induce vomiting; give activated charcoal slurry followed by a cathartic. For hypertensive
reactions, nifedipine may be used. Diazepam may be used to reduce hyperactivity and
convulsions.
Theophylline and related drugs -these common asthma medications tend to be left out where they can be reached easily, thus giving access to an inquisitive dog. Clinical
features of overdose by ingestion include nausea, severe and intractable vomiting,
abdominal pain, gastrointestinal hemorrhage with severe toxicity, agitation, restlessness, dilated pupils, convulsion and cardiac effects. Induce vomiting, if vomiting has not already occurred; give activated charcoal slurry if vomiting can be controlled. Control convulsions with diazepam .. Hydration may be required as a result of extensive vomiting. Most cases can be treated satisfactorily with supportive measures..
Tobacco (chewing or snuff) – It is unlikely that a dog will chew on a tobacco plant, or even ingest a cigarette or do much more than mouth a cigar. It is not unlikely that a puppy, will eat pleasantly palatable chewing tobacco, with untoward effects. Nicotine, an active
ingredient in tobacco, is extremely toxic and very little is required to kill a dog. Remember, tobacco has a history of having been used as an insecticide, and has very potent
properties, other than causing cancer. Ingest enough of it, and you will not have to wait for cancer. After ingestion, a dog may present with central nervous system derangement, miosis, hypersalivation, vomiting, diarrhea, tachycardia, hypertension, and hyperthermia, followed by total collapse. Induce vomiting if conscious and responsive; give activated charcoal slurry and provide follow-on supportive treatment.
Plant Poisons
Poisonous plants are common, and are within easy access for most dogs. It is virtually ImPossible to eliminate poisonous plants from most dogs’ environments. A complete list of poisonous plants is beyond the scope of this article.-Treatment generally involves inducing vomiting, giving activated charcoal slurry, with CPR and supportive treatment as necessary.
Plant poisoning mechanisms are extremely varied, but can be broken down into the twelve
basic categories Treatment varies somewhat by category. Most adult dogs leave toxic plants alone, but this cannot be said of puppies before their brains have caught up with their mobility and ability to mouth, chew’and swallow. : What puppy can resist mouthing mushrooms? There are no
approved antidotes for mush room poisoning. However, the human literature does list recoveries after liver transplants! The preceding was to set the stage for other really poisonous plants like oleander and dumb cane and jimson weed and choke cherry.
Ornamental Plants
The Oleander bush, the laurel bush, or trim the privet hedge, do not leave the trimmings on the grass to be mulched up next time you mow the lawn with a mulching lawnmower. Your dog may just drop a sticky bone on a mulched pile of trimmings and go off to chew his bone later. It is not just puppies that are at risk from poisoning; adults dogs may not set out to intentionally chew or ingest a poisonous plant, but they can come by the poisons quite innocently or by grooming
themselves.
Categories of Poisonous Plants by their Active Ingredients
Oxalates- irritating: swollen mouth , tongue pain, sore lips; Histamines
1. Alkaloids
2. Saponic gylcosides
3. Coumarin glycosides
4. Toxalbumins
5. Solanine glycosides
6. Digitalis glycosides
7. Cyanogentic glycosides
8. Taxine (alkolid)
9. Nicotinic stimulants
10. Atropinelike agents
Plants which are poisonous to pets
Aloe Vera (Medicine Plant) Indian Laurel
Apple (Seeds) Indian Rubber Plant
Avocado (fruit &,pit) Marijuana
Asparagus Fern Morning Glory
Autumn Crocus Nightshade
Cherry (seeds & wilting leaves) Onion
Christmas Cactus Oleander
Chrysanthemum Plum (wilting leaves and seeds)
Croton Rhododendron
Corn Plant Tulip
Castor Bean Peach (wilting leaves & pits,
Daffodil Hibiscus
Foxglove Hyacinth
Recovery
The road to recovery after a major poioning episode may be long and uphill. Nutritional support is considered by many to be effective. First reduce the workload of the liver and the kidney. A bland diet of cooked white rice is recommended for several days. Do not feed any proteins or fats
because these are processed by the liver and kidneys. To counteract the effects of the Phase I metabolites, some veterinarians suggest giving antioxidant vitamins and minerals. These include Ester-C or calcium ascorbate, vitamin E, selenium, beta carotene, bioflavonoids, selenium, copper, zinc and manganese, Coenzyme Q10, thiols (from garlic) and superoxide dismutase. Support for the Phase II enzymes: Do not fast the animal. Substances used by Phase II enzymes include
sulfhydryl donors (N-acetylcysteine,’cysteine, cystine, methionine and glutathione), sulfates (good sources are glutathione and cystine), pantothenic acid (B5), glycine, taurine, glutamine, arginine, ornithine, selenium and riboflavin.
Conclusion
Prevention is better than cure. Potential for serious poisoning is everywhere. Anything you would do to “poison proof your house, yard, garden, garage, etc., is worth doing for your dogs. Unfortunately, it is not feasible to remove all potential toxins from the environment. Therefore, being prepared includes knowing what toxins are in the environment, where they are located, and what to do in a poisoning situation. We suggest that dog owners conduct a survey of their animal’s environment. Write down the potential toxins to include the active ingredients in each product, and keep that survey with a copy of this article and one or both of the books mentioned immediately available for reference.
