Fact or Fiction
Xylitol is toxic to both dogs and cats.
Fiction. Humans and other species (eg, cats, rabbits, ferrets) are not affected.
This antibiotic is linked to esophageal erosion, yet maybe due to this counseling point it is rarely seen.
Doxycycline. Give with water.
Atropine is commonly used agent that protect against carbamides and organophosphates overdose, name at least 5 of the signs of a cholinergic crisis.
Salivation, Lacrimation, Urination, Diarrhea, Dyspnea, Emesis, Bradycardia.
Boxers have a breed associated adverse effect with this sedative causing hypotension, bradycardia and profound sedation.
Acepromazine
Tylenol's antidote and its mechanism of action
NAC. NAC provides cysteine for the replenishment and maintenance of hepatic glutathione stores, enhances the sulfation pathway of elimination and may directly reduce NAPQI back to acetaminophen. Virtually 100% effective in preventing liver damage when given within 8 hours of the overdose. After this time efficacy falls substantially, affording only a very limited window of time in which to successfully prevent serious hepatotoxicity.
Sodium sulfate. Sulfate donor to promote sulfation of acetaminophen. Sulfation is the primary elimination pathway for cats but is quickly saturated leading to toxic NAPQI formation.
Apomorphine exerts its action through this receptor.
Dopamine 1/2 Agonist.
All grape products can cause kidney failure.
Fiction. Products such as grape jelly, wine, grape juice, and grape seed extract have not been associated with renal failure development.
This chemotherapy agent uniquely cause acute, fulminant pulmonary edema in cats.
Cisplatin.
This reversal agent for ethylene glycol in dogs and its mechanism of action.
Fomepizole (4-Methylpyrazole). Competitive inhibitor of alcohol dehydrogenase.
Ethanol (20%). Provides alternative substrate for alcohol dehydrogenase and therefore inhibits the metabolism of ethylene glycol to its much more toxic metabolites.
Following anesthesia, this breed(s) has documented prolonged recovery times with propofol and thiopental.
Greyhounds/Sighthounds.
Xylitol is found in many household and commercially products, name 3 (at least one prescription product) and how it exerts its toxicity.
Sugar-free gum, mints, candy, jams, syrups dental products, peanut butter, baked goods, vitamins, OTC products.
Prescription Products:
Toxic effects: a potent stimulator of insulin release in dogs; rapid-onset hypoglycemia.
Rain digested a 1/2 lb bag of M&Ms. She is 5 hours out from the nearest hospital. What's considered our best household emetic and at what approximate dose? Concerns?
3% Hydrogen Peroxide. Dose: 1 mL/1 lb.
Burnt bread and green tea are relatively effective agents and have comparative efficacy to some pharmaceuticals in toxicosis treatment.
Fiction. BB sections do not function similarly as adsorbents. Tea does contain tannins, which historically have been used to treat grayanotoxin plant exposure. The tannins are thought to slow down the GI absorption of the toxin, but haven't shown to be exceedingly beneficial in the literature.
Potassium Bromide
This agent is used for iron toxicity. Describe its mechanism of action.
Deferoxamine is an iron-chelating agent. During chelation, the drug molecules bind to metal molecules to make stable water-soluble metal complexes. Deferoxamine is the molecule that binds to and removes iron from the blood, which then easily passes from the body (mostly dissolved in urine, may turn wine color)
This is said to be the most poisonous animal on the planet.
Box Jellyfish
A 5 kg schnauzer ingested 20 capsules of Vitamin D3 supplement. What are we worried about it and how do we treat it?
Hypercalcemia, which can progress to multiple organ failure. Treatment options include 0.9% NaCl fluid therapy, furosemide, corticosteroids and possibly biphosphonates (Pamidronate). Calcitonin, the antidote previously recommended for cholecalciferol poisoning.
Name 3 commonly ingested substances or products that should never require induction of emesis.
Acidic or Alkaline Cleaners: esophageal injury and possible aspiration
Batteries: esophageal perforation if corrosive material leaks into the esophagus
Detergents: oral or esophageal irritation and aspiration.
Hydrocarbons: high aspiration risk
SSRI: rapid effect; aspiration risk
Sharps
Cats cannot maintain a vegan diet due to deficiencies in protein and carbohydrate content, vitamin C, taurine and coQ10.
Fiction. Deficiencies are due to:
We avoid this purine antagonist immunosuppressant in cats because it highly prone to myelosuppression.
Azathioprine
Name 2 of 3 possible antidotes for xylazine overdose, their mechanism of action and 2 possible side effects.
Atipamezole, Tolazine (tolazoline), Yohimbine of which are alpha 2 antagonists. Tachycardia, agitation, tremors, arrhythmias are common side effects.
Chelating agent in the treatment of copper-associated hepatitis in dogs.
D-Penicillamine
Loperamide is a non-centrally acting _____ antidiarrheal. Our main concern with dogs and cats is risk of neurotoxicity if this is present.
Opioid. MDR1 (ABCB1) polymorphisms.
A bottle of Warfarin tablets are ingested by Kovu. Is emesis recommended? What is our concern and when do we expect to see it?
Induce emesis within 6 hours if possible. Risk for body cavity hemorrhage (hemoabdomen, hemothorax), hematomas, or bleeding into joints. Treat with Vitamin K (phytonadione). At 3-7 days after ingestion, a severe coagulopathy can develop.
Activated Charcoal risks include:
Fact
Amitraz a FDA approved agent for __________ mange is avoided in cats due to _________ .
1) Demodectic mange for dogs 2) severe ataxia, bradycardia
Rank the potency of these opioids from highest to lowest: Morphine (mg), Tramadol (mg), Fentanyl Patch (mcg), Hydrocodone (mg). Name the reversal agent and what forms it comes in.
Fentanyl (MME 7), Morphine MME 1), Hydrocodone (MME 1), Tramadol (MME 0.1). Naloxone: injection, auto-injection, nasal spray. 0.4 mg/mL injection, 2 and 4 mg nasal spray.
Foxglove and Convallaria majalis (lily of the valley) is treated with this agent; it can also be used Bufo toad toxicosis. This should be monitored.
Digoxin immune Fab (Digibind). Monitor: hypokalemia, anaphylaxis, temperature. Expensive, rapid acting and efficacious.
Pseudoephedrine and phenylephrine are used with caution in dogs and cats for what respective problems. What are our concerns?
Dogs: Urinary incontinence (pseudoephedrine 0.2-0.4 mg/kg PO 8-12)
Cats: Rhinitis (phenylephrine 1-2 drops IN q 12-24)
Narrow therapeutic index. Signs and symptoms include: vomiting, lethargy, diarrhea, restlessness, agitation, hyperactivity, tachycardia, and tremors.
Name two advantages/strengths of both apomorphine and ropinirole.
Apomorphine: quicker onset, high success rate (90-100%), availability, historic use/comfort/reliability, cheap
Ropinirole: can be used when IV administration is difficult, non-invasive, cleaner/better reversal due to specificity, no equipment needed, no dosing calculations, cheap