Lecture 2 Flashcards by Danika Boltz

What are the different methylxanthine toxins?

-caffeine
-theobromine
-theophylline

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Which products can cause methylxanthine toxicosis?

-coffee
-tea
-OTC stimulants
-diet pills
-chocolate
-energy drinks
-cacao beans
-asthma medications

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Which species are affected by methylxanthine toxicosis?

all species

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What are the three body systems primarily affected in methylxanthine toxicosis?

-GI
-CV
-neuro

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What are the clinical effects of methylxanthines?

-signs in 2 to 12 h
-vomiting and diarrhea
-PUPD
-increased heart rate and arrhythmia risk
-decreased BP
-hyperactivity/restlessness/muscle tremors
-hyperthermia
-ataxia
-seizures
-pancreatitis later on

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What are the decontamination methods used with methylxanthines?

-emesis (up to 6+ hours)
-gastric lavage (severe, lethal doses)
-activated charcoal

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What is the management for mild methylxanthine toxicosis?

outpatient treatment:
-SQ fluids
-cerenia

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What is the management for severe methylxanthine toxicosis?

-IV fluids
-management of tachycardia/arrhythmias
-anticonvulsants
-antiemetics
-anti-arrhythmics
-EKG, HR, and temp. monitoring
-frequent walks or indwelling urinary cath.

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What is the prognosis for methylxanthine toxicosis?

good prognosis

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What are the characteristics of xylitol?

-found in over 1900 products
-amount is variable in gum by brand
-only in dogs

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What are the big consequences of xylitol toxicity?

-hypoglycemia
-hepatotoxicity
-coagulopathy

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What are the clinical signs of hypoglycemia due to xylitol toxicity?

-lethargy
-weakness
-collapse
-ataxia
-seizures

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What are the clinical signs of hepatotoxicity due to xylitol toxicity?

-anorexia
-vomiting
-melena
-abdominal pain
-icterus
-epistaxis
-petechiation
-hemorrhage

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Why is it important that xylitol can cause vomiting?

animals may assist in their own decontamination by vomiting up some of the product before receiving medical care

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What are the bloodwork findings in xylitol toxicity?

BG:
-hypoglycemia (check immediately)

CHEM:
-inc. ALT, ALP, AST, Tbili
-dec. K, P, glucose

COAG PROFILE:
-dec. platelets
-inc. PT and PTT

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What are the management steps for xylitol toxicity?

-emesis if stable
-hospitalize 12 to 24 h if > 0.1g/kg ingestion
-dextrose if hypoglycemic
-KCl if K is low
-SAMe, silymarin, N-acetylcysteine
-fresh frozen plasma
-vitamin K

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Which method of decontamination is not effective for xylitol toxicity?

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activated charcoal

What is the prognosis for xylitol toxicity?

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good prognosis

What can cause grape/raisin toxicity?

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-all types/colors of grapes
-grape crushings
-raisins
-currants
-sultanas

What are the characteristics of grape/raisin toxicity?

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-suspected to be caused by tartaric acid
-causes acute tubular necrosis
-lack of dose-response relationship
-dogs lack transporter in kidney; leads to proximal tubule build up
-dogs only for kidney injury
-can cause GI signs in cats

What are the clinical signs of grape/raisin toxicity?

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-vomiting
-anorexia
-lethargy
-diarrhea
-acute renal failure
-possible forebrain, cerebellar, and/or vestibular signs

What is the chemistry profile in grape/raisin toxicity?

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-creatinine > BUN
-increased Ca
-increased P
-possible hyperkalemia
-possible changes to ALT, ALP, lipase, amylase

What are the urinalysis findings in grape/raisin toxicity?

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-isosthenuria/hyposthenuria
-proteinuria
-glucosuria
-hyaline or granular casts

What is the management for grape/raisin toxicity?

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-decontamination: emesis +/- single AC dose
-IV or SQ fluid therapy for 48h
-dialysis for severe cases

What is the prognosis for grape/raisin toxicity?

-good for acute cases -50% mortality rate with concurrent azotemia

What are products containing tamarinds/tartaric acid?

-tamarind fruit -cream of tartar -tamarind paste -grapes

What are the characteristics of tartaric acid toxicity?

-dogs are sensitive -causes extensive renal tubular necrosis -diagnostics and treatment are similar to grapes/raisins -guarded prognosis

Which products can lead to onion/garlic toxicity?

-onions -shallots -leeks -garlic -chives *all preparations of above products

Which species are sensitive to onions and garlic, in order of most to least severe?

-cats -dogs/cattle/horses -sheep/goats/mice

What are the toxic effects of Allium sp.?

-oxidative damage to hemoglobin/poor O2 delivery to tissues -increased RBC fragility leading to hemolysis and anemia -vasodilation -hypotension -gastric/small intestinal mucosal irritation

What are the clinical effects of onion/garlic toxicity?

-acute GI signs -anemia -pale mm -increased HR and RR -icterus -hematuria -hemoglobinemia -hemoglobinuria -hypotension w/ garlic

What are the CBC findings in onion/garlic toxicity?

-regenerative anemia -heinz bodies -eccentrocytosis -leukocytosis

What are the CHEM findings in onion/garlic toxicity?

-increased Tbili -increased AST -increased ALT

What are the urinalysis findings in onion/garlic toxicity?

-hemoglobinuria -bilirubinuria -hemosiderin/hemoglobin casts

What is the management for onion/garlic toxicity?

-emesis -single dose of AC -monitor PCV and CBC up to a week -IV fluids -packed RBC transfusion -N-acetylcysteine, Vit. E, Vit. C

Which marijuana products can cause toxicity?

-Cannabis sativa and Cannabis indica plants -THC -hemp -cannabidiol/CBD -concentrates -synthetic cannabinoids

What are the characteristics of marijuana as a toxin?

-pets can eat edible goods, plants, or prescription meds -highly lipophilic -hepatic metabolism with enterohepatic recirculation -onset of signs in 30 to 60 minutes -recovery within 24 to 72 hr

What are the common clinical effects of marijuana?

-depression -ataxia -mydriasis -hyperesthesia -ptyalism -tremors -bradycardia -urinary incontinence

What are less common clinical effects of marijuana?

-agitation/aggression -bradypnea -hypotension -tachycardia -nystagmus

How is marijuana toxicity diagnosed?

-compatible clinical signs +/- history -urine drug screens

How is marijuana toxicity managed?

-emesis -single dose of AC -antiemetics -hospitalization for synthetic products -ILE if severe -dialysis if severe -mechanical ventilation if severe

Lecture 2 Flashcards

(41 cards)