Toxicosis Exposure Assessment and Decontamination

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Questions and Answers

What is the total amount of vitamin D consumed by the cria over the first five days of life?

500,000 IU

What is the additional dosage of vitamin D administered on Day 5?

7,500 IU

What was the decontamination approach for the vitamin D poisoning in this case?

Too late for activated charcoal

Would you consider Intravenous Lipid Emulsion (ILE) for vitamin D poisoning?

Yes, because it has been effective in similar cases. Signup and view all the answers

What is the primary goal of treatment in vitamin D poisoning cases?

Rapidly decrease hypercalcemia and hyperphosphatemia Signup and view all the answers

What is the recommended daily vitamin D intake for most camelids?

30 IU/kg Signup and view all the answers

What is the long half-life of calcidiol (25-OH-D3) in humans and lab animals?

2-3 weeks Signup and view all the answers

Vitamin D deficiency in camelids is not a concern during reduced sunlight periods.

False Signup and view all the answers

What factors are associated with hepatic lipidosis in camelids?

Infectious disease, parasitism, stress, poor nutrition, and possibly obesity Signup and view all the answers

What is the first thing that you want to do?

Exposure assessment Signup and view all the answers

What would you do next in the case of ibuprofen poisoning in dogs?

Recommend bringing both dogs to the clinic ASAP. Signup and view all the answers

What is the toxic dose for ibuprofen in dogs for CNS signs?

400 mg/kg Signup and view all the answers

What is the first thing that you want to do if you were called to the case of organophosphate poisoning in dairy cows?

Stop further exposure, remove feed. Signup and view all the answers

What is the suspected antidote for organophosphate poisoning?

Atropine Signup and view all the answers

What would you initiate for decontamination in cases of organophosphate poisoning?

Try to corral and give activated charcoal. Signup and view all the answers

What is the lethal dose of undiluted ethylene glycol for a cat?

1.5 ml/kg Signup and view all the answers

Ethylene glycol is the common ingredient of _____.

antifreeze Signup and view all the answers

What additional decontamination steps would you take in the case of ethylene glycol poisoning?

No additional decontamination steps would be recommended. Signup and view all the answers

Estimate how much radiator fluid the cat would have had to ingest to consume the lethal dose.

12 ml for 50% fluid. Signup and view all the answers

What is the median lethal dose of monensin for horses?

2-3 mg/kg Signup and view all the answers

What is the first step you will take if called out right away for suspected monensin exposure?

Stop further exposure, remove feed. Signup and view all the answers

What should be considered with any surviving horse after monensin exposure?

Cardiac abnormalities can persist. Signup and view all the answers

What type of poisoning is associated with bromethalin?

Neurotoxic rodenticide Signup and view all the answers

What is the minimum lethal dose in dogs for bromethalin?

2.5 mg/kg Signup and view all the answers

What do you proceed with if the dog defecates and the feces contain green material resembling the suspect rodenticide?

Proceed with decontamination protocols. Signup and view all the answers

Study Notes

Exposure Assessment

Exposure assessment is a critical first step in managing toxicosis cases
Determining the amount of toxicant ingested is crucial for determining the severity of exposure
Understanding the toxicant’s pharmacokinetic properties is essential, including absorption, distribution, metabolism, and elimination

Decontamination Approaches

Several decontamination approaches are available, including:
- Emesis: inducing vomiting to remove the toxicant from the stomach
- Gastric lavage: flushing the stomach with fluids to remove the toxicant
- Activated charcoal: adsorbing the toxicant in the gastrointestinal tract
- Intralipid emulsion therapy (ILE): a lipid emulsion that acts as a “lipid sink” to remove lipophilic toxicants from the bloodstream

Factors Influencing Decontamination Decisions

Time since exposure:
- Early interventions are generally more effective
- If significant time has passed, decontamination may be less beneficial
Toxicant’s properties:
- The properties of the toxicant, like absorption rate and potential for enterohepatic recirculation, influence the effectiveness of decontamination
Animal’s condition:
- The animal’s overall health and clinical signs play a role in deciding which decontamination method is appropriate

Residue Considerations and Public Health

Food-producing animals:
- Potential residue concerns need to be considered, especially regarding the withdrawal period for the toxicant
Public health:
- It's crucial to ensure that animal products are safe for human consumption following a toxicosis incident

Case 1: Ibuprofen Toxicosis in Dogs

Ibuprofen is a common over-the-counter pain medication that can be toxic to dogs
The toxic dose varies based on individual dog size
GI signs:
- Single ingestion of 100-125 mg/kg or greater
Renal damage:
- 175 mg/kg
CNS signs:
- 400 mg/kg

Case 2: Organophosphate Poisoning in Dairy Cows

Organophosphates (OPs) are potent insecticides often used in agriculture
OPs inhibit acetylcholinesterase (AChE) activity, resulting in acetylcholine accumulation and cholinergic toxicity
Clinical signs:
- Excessive salivation, miosis, bradycardia, muscle tremors, convulsions, muscle paralysis
Atropine:
- A competitive antagonist of muscarinic cholinergic receptors
- Can be used as a diagnostic tool in suspected OP poisoning

Case 3: Organophosphate Poisoning in Beef Cattle

Dichlorvos is a restricted-use insecticide that can cause OP poisoning in cattle
Dermal exposure:
- Dichlorvos readily absorbed through the skin
Antidote:
- Atropine may be considered
- 2-PAM (pralidoxime) may be effective if aging of AChE has not occurred

Case 4: Ethylene Glycol Poisoning in Cats

Ethylene glycol (EG) is a common ingredient in antifreeze, highly toxic to cats
Rapidly absorbed from the GI tract, metabolized in the liver, and eliminated in urine
Clinical signs:
- Symptoms typically develop within several hours
- Anorexia, vomiting, lethargy, tremors, seizures
Decontamination:
- Limited efficacy once absorbed
- Emesis and gastric lavage may be helpful if performed early

Case 5: Monensin Poisoning in Horses

Monensin is an ionophore antibiotic used as a feed additive in ruminants
Highly toxic to horses, even small doses can be lethal
Clinical signs:
- Anorexia, weakness, lethargy, muscle tremors, colic, cardiovascular effects
Decontamination: Activated charcoal may be helpful to reduce absorption

Case 6: Bromethalin Poisoning in Dogs

Bromethalin is a neurotoxic rodenticide commonly used in rat baits
Rapdily absorbed and metabolized in the liver, high lipid solubility
Clinical signs:
- Convulsant syndrome, muscle tremors, hyperthermia, seizures
- Paralytic syndrome, ascending ataxia, muscle weakness, CNS depression
Decontamination:
- Emesis and multiple-dose activated charcoal may improve outcomes

Case 7: Vitamin D poisoning in Alpacas

Vitamin D supplementation is commonly used in camelids, but overdosing can be severe
Vitamin D is essential for calcium absorption and bone health
Clinical signs:
- Anorexia, lethargy, dehydration, hypercalcemia, kidney damage
Decontamination:
- Intralipid emulsion therapy (ILE) may be effective due to vitamin D’s lipophilic properties### Vitamin D Poisoning Treatment
Primary goal is to rapidly decrease hypercalcemia and hyperphosphatemia.
Consider using steroids, furosemide, bisphosphonates, and phosphate-binding agents to treat hypercalcemia in camelids.
No data supports the use of these treatments in camelids.

Vitamin D in Camelids

North American cria consuming milk may have limited vitamin D intake, especially during periods of reduced sunlight.
Daily vitamin D intake of 30 IU/kg is recommended to prevent deficiency in most camelids.
The half-life of calcidiol (25OH-D3) is 2-3 weeks, but this is not confirmed for camelids.
Cholecalciferol released from stores in muscle and adipose reenters circulation and becomes 25-hydroxylated, contributing to the long half-life.
A small decline in serum calcidiol occurs during "vitamin D winter" when solar-derived UVB radiation is minimal.

Hepatic Lipidosis in Camelids

High mortality associated with lipid accumulation in the liver.
Potential precipitating factors include infectious disease, parasitism, stress, poor nutrition, and possibly obesity.
Onset may be acute.

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Description

This quiz covers the essential components of exposure assessment in managing toxicosis cases, detailing various decontamination approaches. Furthermore, it discusses factors influencing the effectiveness of decontamination decisions such as time since exposure. Test your knowledge on these critical aspects of toxicology.