Toxicology Lecture 4 Therapy And Management

Front 1

What are the first 3 steps of therapy and management of toxicosis?

Back 1

1) Assess animal's physiological state & time of exposure
2) Obtain label of possible intoxicants in environment
-Use antidote if there is one
3) Remove animals from toxic environment
-change feed, water, pasture
-Dermal decontamination

Front 2

When do you perform dermal decontamination?

Back 2

Oil based toxins i.e. pyrethrins, organophosphates, caustic chemicals

Front 3

How do you perform dermal decontamination?

Back 3

Wash with tepid water and liquid dish washing soap--> multiple times
-Clip hair if long
-If caustic, acidic or alkaline exposure--> flush skin w/ copious water x 15-20 min

Front 4

What would you tell an owner if they call for a telephone consult because their dog got a toxin in their eye?

Back 4

-flush eye w/ physiological saline or tepid water for 15-20 minutes
- *Keep animal from rubbing eyes
-Avoid use of ophthalmic ointments or medications

Front 5

When should you tell a client to seek immediate veterinary attention because of ocular contamination?

Back 5

When see blepharospasm (twitch of eyelid), pupil size change, ocular discharge

Front 6

What can you tell a client to do on a phone consult when an animal needs GI decontamination?

Back 6

Induce vomiting as home remedy
-Best 1st hour (17-62%), up to 4 hours if:
-large wad of xylitol gum, large amounts of chocolate, grapes & raisins, blood or bone meal, foreign objects etc.

Front 7

How do you induce vomiting?

Back 7

-3% H2O2--> 2-5 mL/kg BW in dogs, not cats
-Liquid dish soap ~10 mL/kg of mix 3tbs + 8oz water
-Apomorphine in dogs only--> tablet in subconjunctival sac or IV or IM
-Xylazine esp in cats. (can reverse sedative effects after)

Front 8

Can you use 7% syrup of ipecac or salt to induce vomiting?

Back 8

NO

Front 9

What are 5 contraindications to emesis?

Back 9

1) Longer than 1-2 hrs post ingestion (except for exceptions noted above)
2) In an unconscious or very obtund animal
3) In animal in respiratory distress
4) Ingestion of corrosive or caustic materials
-Oven cleaner
5) If clinical signs of toxicosis are present

Front 10

When performing a gastric lavage, time is of the essence bc after 1 hr, only ___-____% of toxin is recovered.

Back 10

8.6-13%

Front 11

What are 3 indications of a gastric lavage?

Back 11

-In metaldehyde and organophosphate toxicosis even if animal is showing signs
-Large amount of bone meal, chocolate, iron tables
-Ingestion of toxic (near LD50) doses of Ca channel blockers, beta-blockers organophosphates

Front 12

Can you use activated charcoal and do a gastric lavage?

Back 12

Yes, can use with activated charcoal during and after

Front 13

When is a gastric lavage contraindicated?

Back 13

W/ corrosive toxins

Front 14

How do you perform a gastric lavage?

Back 14

Animal must be anesthetized and intubated
-Infuse w/ warm water and aspirate often
-Repeat until fluid is clear

Front 15

How do you administer activated charcoal?

Back 15

Dose is 2-5 g in water slurry w/ 1 g in 5 mL water

Front 16

When should you add cathartic sodium sulfate or 70% Na sorbitol to activated charcoal?

Back 16

Has varying affinities so:
-good w/ nonpolar toxins
-Heavy metals & ethylene
-Glycol not well absorbed

Front 17

What is a whole bowel irrigation?

Back 17

Where perform a gastric lavage and high enema w/ stomach tube per rectum

Front 18

How do you perform an enema in a ruminant?

Back 18

Add water to slight distension and then lower stomach tube to drain off, repeat

Front 19

How can you surgically remove foreign bodies?

Back 19

Per os or laparotomy or rumenotomy
-Zinc pennies, lead substances, toxic metals
-Radiographs might indicate location

Front 20

What can you give animals with cerebral edema, heart failure, ascites, pulmonary edema and acute renal failure?

Back 20

Diuresis

Front 21

What are 3 drugs you can give for seizure control?

Back 21

1) Diazepam
-Give IV, short half life so give every 20 minutes x 3 times
2) Phenobarbital if diazepam fails
3) Pentobarbital
-Use if all above fail

Front 22

Why can dogs develop hyperthermia from toxicosis?

Back 22

Results from seizure or myoclonus activity

Front 23

What can you do for a hyperthermic animal?

Back 23

Cold baths, ice packs, or cooled IV fluids
-Control dehydration w/ IV fluids
IV THERAPY

Front 24

Why is it so important to administer IV fluids to toxic animals?

Back 24

To force diuresis of toxins that are eliminated via the kidney
-Vasodilate and flush the renal tubules especially w/ nephrotoxic agents ie NSAIDS, lilies, etc

Front 25

What is essential for an effective toxicological diagnosis?

Back 25

Knowledge of a known exposure and the circumstances surrounding exposure

Front 26

What good is doing a CBC, serum chemistry and blood gas analysis of a toxic animal?

Back 26

All are useful tools done in clinic to evaluate clinical signs and formulate a treatment plan

Front 27

What are 8 necropsy specimens that should be collected?

Back 27

1) Brain
2) Ocular fluid
3) Injection site
4) Stomach and intestinal contents
5) Colon contents
6) Liver
7) Kidney
8) Urine -if present

Front 28

How should brain samples from necropsy be preserved?

Back 28

1/2 frozen
1/2 formalin
-Leave midline in formalin for pathologist

Front 29

How should you preserve ocular fluid? Injection site? Stomach and intestinal contents? Colon contents? Kidneys?

Back 29

Freeze them all!

Front 30

What should you do with collected urine specimens?

Back 30

1/2 chilled, 1/2 frozen

Front 31

How much rumen or stomach contents should you collect at necropsy?

Back 31

~500 g
-But rumen may degrade some toxicants e.g. nitrates, mycotoxins

Front 32

Why is quantitative analysis of rumen contents difficult?

Back 32

Variability of concentrations and lack of correlation w/ toxic levels in tissue