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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?
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?
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?
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?
Would you consider Intravenous Lipid Emulsion (ILE) for vitamin D poisoning?
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What is the primary goal of treatment in vitamin D poisoning cases?
What is the primary goal of treatment in vitamin D poisoning cases?
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What is the recommended daily vitamin D intake for most camelids?
What is the recommended daily vitamin D intake for most camelids?
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What is the long half-life of calcidiol (25-OH-D3) in humans and lab animals?
What is the long half-life of calcidiol (25-OH-D3) in humans and lab animals?
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Vitamin D deficiency in camelids is not a concern during reduced sunlight periods.
Vitamin D deficiency in camelids is not a concern during reduced sunlight periods.
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What factors are associated with hepatic lipidosis in camelids?
What factors are associated with hepatic lipidosis in camelids?
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What is the first thing that you want to do?
What is the first thing that you want to do?
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What would you do next in the case of ibuprofen poisoning in dogs?
What would you do next in the case of ibuprofen poisoning in dogs?
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What is the toxic dose for ibuprofen in dogs for CNS signs?
What is the toxic dose for ibuprofen in dogs for CNS signs?
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What is the first thing that you want to do if you were called to the case of organophosphate poisoning in dairy cows?
What is the first thing that you want to do if you were called to the case of organophosphate poisoning in dairy cows?
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What is the suspected antidote for organophosphate poisoning?
What is the suspected antidote for organophosphate poisoning?
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What would you initiate for decontamination in cases of organophosphate poisoning?
What would you initiate for decontamination in cases of organophosphate poisoning?
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What is the lethal dose of undiluted ethylene glycol for a cat?
What is the lethal dose of undiluted ethylene glycol for a cat?
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Ethylene glycol is the common ingredient of _____.
Ethylene glycol is the common ingredient of _____.
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What additional decontamination steps would you take in the case of ethylene glycol poisoning?
What additional decontamination steps would you take in the case of ethylene glycol poisoning?
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Estimate how much radiator fluid the cat would have had to ingest to consume the lethal dose.
Estimate how much radiator fluid the cat would have had to ingest to consume the lethal dose.
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What is the median lethal dose of monensin for horses?
What is the median lethal dose of monensin for horses?
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What is the first step you will take if called out right away for suspected monensin exposure?
What is the first step you will take if called out right away for suspected monensin exposure?
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What should be considered with any surviving horse after monensin exposure?
What should be considered with any surviving horse after monensin exposure?
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What type of poisoning is associated with bromethalin?
What type of poisoning is associated with bromethalin?
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What is the minimum lethal dose in dogs for bromethalin?
What is the minimum lethal dose in dogs for bromethalin?
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What do you proceed with if the dog defecates and the feces contain green material resembling the suspect rodenticide?
What do you proceed with if the dog defecates and the feces contain green material resembling the suspect rodenticide?
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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
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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
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Primary goal is to rapidly decrease hypercalcemia and hyperphosphatemia.
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Consider using steroids, furosemide, bisphosphonates, and phosphate-binding agents to treat hypercalcemia in camelids.
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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.