Ivermectin

Worm medication used orally and parenterally in most species (Heartguard, Ivomec, Eqvalen, Zimecterin) Cumulative toxicant Young animals more susceptible Often a problem in dogs given horse paste

Ivermectin
Dogs-6ug/kg =heartworm preventive dose; 2.5 mg/kg PO =mydriasis, 5mg/kg PO= muscle tremors, 40 mg/kg PO= death Collies, Aust. Shepherd, Shelties, Border Collies0.1 -0.2 mg/kg PO or SC causes toxicity and death Cats-0.5mg/kg=mydriasis and tremors Equine-2mg/kg=ataxia and blindness Cattle and Sheep-4mg/kg=ataxia/death

Ivermectin
Mechanism of action is to increase GABA release, affinity of GABA receptor and direct GABA agonist Onset time is hours to 1 day, affects CNS Clinical signs-hypersalivation (dogs), tremors, bradycardia, convulsions, coma, mydriasis, blindness, ataxia Can see anaphylactic reactions in dogs No visible lesions

Ivermectin
Diagnosis
History of administration Brain ivermectin concentration >100ppb

Treatment
Short acting barbiturate for convulsions (no benzos) IV physostigmine (0.04mg/kg) BID in comatose animals Flumanezil and moxidectin-expt. Benzo antagonists Epinephrine, fluids for anaphylaxis

Household Cleaners
Product warning label indicates level of toxicity
No label = LD50 > 5 g/kg Caution = 0.5 5 g/kg Warning = 50 500 mg/kg Danger: Poison = <50 mg/kg

Soaps, Shampoos, Detergents

Most have low toxicity Usually cause only vomiting and diarrhea Cationic surfactants are found in contact lens solutions, fabric softeners, swimming pool algicides; can cause neuromuscular and ganglionic blockade as well as GI ulcerations, acidosis and shock Anionic surfactants are in many cleaning products like shampoos have the potential to cause hemolysis

Disinfectant Cleaners
Products like Lysol contain phenolic compounds mixed with detergents Pine oil based compounds like Pine Sol These products are especially toxic to cats due to metabolism by glucuronidation; can cause liver injury, jaundice, and renal damage in conjunction with GI problems Phenolics also found in creosote and tar paper; watch out for pigs

Alkaline Compounds
Ammonia, Oven Cleaner, Most Drain Openers All have pH of >12 which can cause burns (ulcerations) Ulcers can be very severe, especially with granular drain openers Ingestions causes GI ulcerations, vomiting, salivation, dysphagia (esophageal stricture), dyspnea Bleach and scouring powders with bleach usually not high enough pH to cause ulceration; can be a problem if mixed with ammonia = chloramine gas

Acidic Compounds
Toilet bowl cleaners, concrete cleaner, Lime-A-Way, some drain openers Can cause severe burns, but usually not as deep as alkali Signs and treatment similar to alkaline products

Treating Household Cleaner Ingestions

If a potentially toxic amount of a noncorrosive compound ingested, emesis should be induced; no activated charcoal unless systemic effects are expected For corrosive compounds 1) dilute with milk or water, 2) determine exactly how much of what material was ingested

Treating Toxic Corrosive Ingestions

If there is pain, dysphagia, excessive drooling, or ulceration and the exposure was potentially toxic:
Establish airway and get esophagoscopy If esophagus cant be examined quickly, start corticosteroids If examination indicates burns, give corticosteroids Symptomatic and supportive care

Drano Ingestion Initial Visit

Drano Ingestion Final Visit

Petroleum Products
Gasoline, mineral spirits, kerosene, lighter fluid, nail polish remover, solvents, motor oil, furniture polish Biggest worry is aspiration causing hydrocarbon pneumonia Pneumonia risk related to viscosity; less viscous = more toxic

Systemic Toxicity of Hydrocarbons

Most hydrocarbons are CNS depressants Some volatile hydrocarbons sensitize the heart to catecholamines and can cause sudden death due to cardiac arrest Many hydrocarbons cause dermal irritation and hair loss

Signs of Hydrocarbon Toxicity

Depression, lethargy, ataxia, seizures, coma Dyspnea, coughing, wheezing, X-ray changes in lungs with pneumonia
Spontaneous vomiting and aspiration often occurs with more volatile compounds

Treating Hydrocarbon Ingestions

Wash for dermal exposures Do not try to increase viscosity by adding heavier compound Do not induce emesis unless a large, life threatening ingestion (>1 ml/kg) Monitor for pneumonia; treat with antibiotics if present

Oak (Acorn) Poisoning

Red Oak are most toxic due to high tannins, Live Oak is questionable problems are seasonal, usually in fall after a storm or during summer droughts primarily affects cattle; calves are more susceptible Toxic priniciple is thought to tannins or their metabolites Animals must consume large amounts of acorns or buds to be toxic

Oak poisoning
Cases have relatively low morbidity with moderate mortality (35-80%) Animals usually ingested acorns for 1 week prior to signs Symptoms are primarily renal and GI-anorexia, depression, weakness and possible nasal discharge; progresses to rumen atony, black tarry diarrhea, ventral edema, dehydration. terminal animals are often recumbent near water

Cyanogenetic Plants
Wild and choke cherry, Sudan and Johnson grass, Flax, Sugar beet tops, Arrow grass contain glycosides with cyanide groups

Thiaminases
Horsetails and Bracken Ferns Thiaminases destroy thiamine causing neurological problems; causes aplastic anemia in ruminants Primarily affects horses and ruminants Usually occurs if other forage is inadequate

Bracken Fern

Calcium Oxalate plants

Members of Araceae family contain calcium oxalates; Dieffenbachia (Dumb Cane), Philodendron, Elephant ear, Calla lily, Arum lily, Caladium All parts of plant are toxic; stalk more toxic than leaves Usually occurs in cats, dogs, birds, and lizards Rarely life-threatening

Calcium Oxalate plants

Preformed calcium oxalate crystals embed in all parts of GI tract; also contain proteolytic enzymes that cause histamine release Onset time is immediate; primarily affects GI system Clinical signs include head shaking, salivation, dyspnea, vomiting, diarrhea, loss of voice

Calcium Oxalate plants

Diagnosis is by history of exposure and compatible clinical signs Treatment
Rinse mouth with water Anithistamines for dyspnea Demulcents (Kao-pectate; no Pepto in cats) Fluids for severe vomiting and diarrhea

Precatory Bean; Rosary Pea

Grows in Carribean Commonly sold as rosary beads Extremely toxic, 1 pea can kill a child or dog Severe enteritis leads to shock

Castor Bean
Common plant in S. Florida Mole plant Seeds are extremely toxic due to ricin

Oleander
Contains cardiac glycosides (much like digitalis) Highly toxic

Cassia
Coffeeweed, sicklepod Causes muscle degeneration

Crotalaria
Rattlebox Causes liver injury

Cycas and Zamia

Sago Palms, Coontie Plants Seeds are especially toxic Causes liver injury

Sesbania
Seeds are most toxic part Produce severe hemorrhagic or necrotic enteritis

Cestrum
Day and night blooming jessamine Contains Vitamin D Kidney damage

Lantana
Causes photosensitization secondary to liver injury