15. Food and random plant toxicites (TWO LECTURES)

nope

Are there confirmed cases of raisin/grape toxicities in cats?

sultana

Ew, whats that?

dried

Is dried or whole fruit more likely to cause adverse effects?

false; large variability, some animals are asymptomatic, some have symptoms after 1 grape (symptoms are not associated with toxicity)

true/false: The more grapes a dog eats, the worse the signs are in any animal (duh)

tartaric acid

The exact mechanism is not confirmed, but what is the SUSPECT toxic principle?

rapid onset, within 24 hours

When do you see onset of clinical signs of grape toxicity?

vomiting

What signs of grape toxicity occur after 24 hours?

dull, dehydrated, oliguria/anuria

What does an animal look like who has grape toxicity?

reflects renal failure: hyperphosphatemia, azotemia, hyperkalemia, isosthenuria, +/- casts in urine

there is no confirmatory testing for grape toxicity but what does the minimum database look like?

emesis, gastric lavage, activated charcoal, fluids (if kidneys are clearly affected... but not more than they pee out)

you should treat grape ingestion aggressively... what is done following recent ingestion?

store toxins

If you don't make pee... you just _________________.

So you'll have to discuss dialysis with the owner if we're not urinating

mortality up to 75%

the prognosis of grape ingestion is good if decontamination occurs quickly (Dr. Gerken sends them home), but if they enter oliguric/anuric renal failure... what is the prognosis?

macadamia nuts

Whos this guy

dogs

Macadamia nut ingestion is only reported in ______________, but all those dogs lived and recovered

0.7-4.9 g/kg (varies wildly, likely due to dogs diet)

Maccadamia nut toxicity dose is what?

IgE

The mechanism of action for macadamia nuts is unknown but in humans with allergies to this is is _______ driven

non specific signs, maybe increase in lipase/triglycerides/ALP, no confirmatory test

What is the minimum database/tests that say we ate macadamia nuts?

weakness, depression, vomiting, ataxia, tremors, hyperthermia

What are the clinical signs of macadamia nut ingestion

6-24 hours

When do dogs develop macadamia nut signs?

emesis and maybe activated charcoal

If you get an asymptomatic dog who has eaten macadamia nuts... what do you do?

supportive care at home, maybe fluids, maybe antiemetics, treat like gastroenteritis

If you get a symptomatic dog who has eaten macadamia nuts... what do you do?

excellent

What is the prognosis for macadamia nut ingestion?

within 24-48 hours

when should macadamia nut toxicity resolve? Even with minimal intervention

methyxanthines

what group do foods with caffeine or theobromine belong to?

cats

The lethal dose of caffeine is not necessarily known? But are dogs or cats more sensitive?

40 mg

(yikes, Lauren Hamner is sitting next to me and drinking a dutchbros energy drink with 220 mg not even on a day before an exam)

What is the average mg amount of caffeine in a cup of coffee?

more toxic

With regards to chocolate, more bitter = ______________

mild GI signs

20 mg/kg of theobromine will cause what in a dog?

severe cardiac signs

40-50 mg/kg of theobromine will cause what in a dog?

neuro signs, seizures

over 60 mg/kg of theobromine will cause what in a dog?

2, 0.2

less than _______ oz/kg of milk chocolate and less than _______ oz/kg of baking chocolate is potentially lethal to dogs

true

true/false: caffeine is abosorbed FAST, like within 30-60 minutes, and is widely distributed through the WHOLE body

liver, bile, enterohepatic recirculation

Caffeine is metabolized in the ________, excreted in the _______, and undergoes ________________________ before it gets excreted

WAY slower

Compared to caffeine, theobromine is excreted [faster/slower]

liver, urinary bladder

Theobromine is metabolized primarily by the __________ but before excretion, metabolites are reabsorbed in the ____________________

inhibits phosphodiesterase activity, increase cyclic AMP levels

The mechanism of action of caffeine and theobromine is ____________________ which will have what affect overall?

cerebral cortical stimulation, seizures, myocardial contraction, smooth muscle relaxation, diuresis

What are the results of overconsumption of caffeine and theobromine (think amped up on coffee)

2 hours, restlessness, hyperactivity, vomiting

caffeine has an onset within ______ hours of what signs?

panting, weakness, tachycardia, diuresis, muscle tremors, seizures, hyperthermia

after the initial restlessness, clinical signs of caffeine will progress to what?

2-4, restlessness, panting, vomiting, diuresis

Theobromine has an onset within ______ hours of what signs?

arrhythmias, muscle rigidity, ataxia, seizures, tachycardia, hyperthermia

after the initial restlessness, clinical signs of theobromine will progress to what?

sustain basic life functions, decrease further absorption (urinary catheter), symptomatic relief

What are the main treatment goals of caffeine/theobromine toxicity?

true

true/false: you should determine the maximum dose of caffeine/chocolate and treat your patient for that dose

induce emesis, gastric lavage, activated charcoal

If you have acute exposure of chocolate/caffeine you should do what things? (acute is like 6 hours because of chocolates slow absorption)

IV fluids, bladder emptying via UCath, manage tremors/seizures/arrythmias

In more chronic cases of chocolate/caffeine exposure, what shuold you do?

12-36

signs of caffeine/chocolate usually last _________ hours

favorable with decontamination, guarded with seizure/arrythmias

What is the prognosis of chocolate or caffeine ingestion?

xylitol

________: a white substance that looks and tastes like sugar and is classified as a carbohydrate

dogs

The margin of safety is quite high for xylitol in species other than _______________

hypoglycemia

In dogs, 0.1 mg/kg of xylitol is associated with ______________-

30 minutes

Xylitol is absorbed readily from the GI tract and reaches peak plasma levels are reached after ______________

liver

xylitol is metabolized primarily in the ________

promotes insulin release

How does xylitol cause hypoglycemia???

unknown (naturally)

What is the MOA for xylitol?

vomiting, hypoglycemia, lethargy, ataxia, collapse, seizures, hepatic dysfunction, coagulopathy

What are the clinical signs

72 hours

Hypoglycemia occurs quickly with xylitol... but how long does it take for them to show signs of hepatic dysfunction?

SERIAL BG CHECKS, chemistry shows hepatopathy, coag profile, repeat chem for liver values after 72 hours

What is the minimum database for xylitol exposure?

emesis, NOT activated charcoal, no specific antidote, small high carb meals, IV fluids, dextrose, support liver therapy

What is the treatment for xylitol?

good with hypoglycemia, guarded with hepatic dysfunction, poor with liver failure

What is the prognosis for xylitol toxicity?

allium

What genus do onions/garlic/leeks/chives belong to?

sulfur-containing oxidants

Garlic/onions/leeks contain a large variety of _____________-

true

true/false: all alliums present a little differently, some have toxin in their raw forms, some only present after chopping/heating/GI microbes... etc

hemolysis, oxidative injury

HUGE POINT: garlic/onions and other alliums cause __________________ of errythrocytes due to ___________________

heinz bodies

What will you see on blood smears as evidence of oxidative damage?

heinz bodies, methemoglobinemia, hemolysis

________________ and _______________ levels rise within 24 hours of allium ingestion and peaks at 3 days, but _________ is commonly delayed for 3-5 days

none

what are the early signs of garlic/onion ingestion?

Tachypnea, Lethargy, Tachycardia, Icterus, Pigmenturia, Exercise intolerance

What are the signs of onion/garlic toxicity 3-5 days later

regenerative heinz body anemia

What do you see on a CBC for garlic ingestion?

hyperbilirubinemia, maybe kidney injury

What do you see on chemistries for garlic ingestion?

hemoglobinuria, casts

What do you see on UA for garlic/onion dogs?

false, drier is worse

true/false: drying garlic and onions typically inactivates whatever toxin makes them bad

emesis, activated charcoal

What treatment is for acute onion/garlic ingestion? (less than 2 hours)

IV fluids, blood products, no specific antidote, supportive care for GI signs

What is the treatment of garlic/onion ingestion if the animal is already symptomatic

depends

What is the prognosis for onion/garlic ingestion?

birds, horses, cows, sheeps, goats

Who are avacados most toxic to?

persin

What is the toxin in avocados?

leaves, fruit, and seed

Where is the persin toxin located in avocado plants? (most concentrated listed first)

true

true/false: Persin, the toxin in avocados may be fungicidal or may be useful in breast cancer treatments????

cardiovascular necrosis, (tachycardia, weakness, labored breathing - open mouth/tail bob)

What does persin cause in birds? (SHE SAID THIS ONE THING WAS THE ANSWER TO PERSIN)

cardiotoxic, edema in head/neck/face, mastitis, gastritis

What does persin cause in horses/sheep/cows and goats?

cyanide, foreign body obstruction

Eating a TON of cherry pits can technically cause ______________ toxicosis, but we're really just worried about them causing a _____________________

sago palm

What is this plant from the Southern US or Hawaii that is kept as a bonsai type houseplant?

Azoglucosides (cyasin), B-methylamino-L-alanine, Unknown

What are the three primary toxins in a sago palm?

hepatotoxicity

What does azoglucoside toxin cause?

neurotoxicity

What does B-methylamino-L-alanine cause?

seeds (BUT ALL PARTS ARE TOXIC)

ALL parts of the sago palm (hugely important), but the ________ contains the most cyasin - 2 seeds can cause signs

15 minutes (neuro) - hours - days

When do we see signs of sago palm ingestion?

GI (initially), liver (2-3 days), CNS (2-3 days)

What are the three main organ systems affected by sago palm ingestion?

Inappetence, anorexia, vomiting, Hematemesis, Generalized malaise, dehydration, Diarrhea, melena, Abdominal pain (due to inflamed intestines), Icterus, ascites, Tremors, seizures, coma, death

What are clinical signs of sago palm ingestion

sclera

What is the easiest place to see icterus/ascites as evidence of liver damage?

amenia, thrombocytopenia

What do you see on a CBC if a dog ate sago palm?

high liver elevations, hypoglycemia

What do you see on a chemistry if a dog ate sago palm?

Coag profile

What test should you run in addition to CBC/Chem if you think they ate sago palm?

AGGRESSIVE decontamination, emesis (if aware), gastric lavage (if NOT mentally aware), activated charcoal (but we dont know if it binds well)

What is the treatment for acute cases of sago palm ingestion>

IV fluids, vitamin K, blood products, hepatoprotectorants, GI support, lactulose (decrease ammonia producing bacteria)

What are some supportive therapies for dogs who ate sago palm and are in liver failure?

50%

The prognosis for sago palm ingestion used to be AWFUL, and has gotten a lot better, but now, if we're already in liver failure, our mortality rate is around _________________

true

true/false: unfortunately, although the immediate mortality rate is 50%... most develop some sort of cirrhosis and die later on....

leaves and flowers

What part of the lily is toxic?

nephrotoxic

All species of lilium genera and day lily family are ________ in Cats specifically

cats

lily toxicity really only manifests in _______