Critical Care, Toxicology, and Wound Management

For Chapter 26

Akalis

Produces(s) an initially nonpainful, deep, and penetrating wound.

Anionic Detergent

Found in shampoos

Toxin

A poisonous substance

Cationic Detergents

Found in fabric softeners

Decontamination

Neutralization of injurious agents

Acids

Produces(s) an intially painful wound

Toxicosis

Any disease of toxic origin

St. John's Wort

Dermal

Tobaccos

Reproduction

Yew

Cardiotoxic

Lantana

Hepatotoxic

Raisins

Nephrotoxic

Marijuana

Neurotoxic

Cocklebur

Hepatotoxic

Avocado

Cardiotoxic

White and yellow sweet clover

Fungal

Bermuda Grass

Neurotoxic

Cotton

Cardiotoxic

Milkweed

Neurotoxic and Cardiotoxic

Buckwheat

Dermal

Shamrock

Nephrotoxic

Agave

Hepetotoxic

Fescue

Reproduction

Rhubarb

Dermal

Common Juniper

Hepatotoxic

Queen Anne’s lace

Dermal

Amanita Mushrooms

Hepatotoxic

Dilution - Milk or Water

Indication: To dilute contents of a corrosive or irritant ingestion

Dose: 1-3 ml/lb

Contraindications/Exceptions: Exotic animals use juicy fruits or vegetables in place of milk

Emesis - Hydrogen Peroxide

Indication: To remove contents from a toxin ingestion

Dose: 1 tsp (5 ml) body weight, not to exceed a total dose of 3 tbsp (45 ml)

Contraindications/Exceptions: Contraindicated in rodents, rabbits, birds, horses, ruminants; animals with a history of cardiovascular abnormalities, poorly controlled epilepsy, or recent abdominal surgery, or those that are severely depressed, severely dehydrated, in a coma, hyperactive, or have already vomited. Contraindicated for corrosive agents and hydrocarbon ingestion.

Activated Charocal

Indication: To adsorb (bind) ingested toxins, preventing absorption into the bloodstream

Dose: 1 to 3 g/kg body weight

Contraindications/Exceptions: Contraindicated in animals that ingested caustic materials, Ethanol, methanol, fertilizer, fluoride, petroleum distillates, heavy metals, iodides, nitrate, nitrites, sodium chloride, and chlorate are not effectively absorbed

Cathartics

Indication: To decrease gastrointestinal transit time

Dose: Administered with active charcoal, or alone

Contraindications/Exceptions: Contraindicated in patients with diarrhea or dehydration

Enemas - Plain Warm or Soapy water

Indication: To eliminate toxicants from the lower GI tract

Dose: None

Contraindications/Exceptions: Premixed human solutions are contraindicated in small animals. Enemas are not performed in birds

Gastric lavage

Indication: Gently pump out stomach contents

Dose: Repeated until the fluid removed is clear; o more than 10 ml/kg in rabbits

Contraindications/Exceptions: Contraindicated in cases of caustic or petroleum distillate. Performed under general anesthesia with a cuffed endotracheal tube

Enterogastric Lavage

Indication: Lethal oral exposure

Dose: Continued until the fluid removed is clear

Contraindications/Exceptions: None

Toxicity dose, as well _______, ________, _____, _____, and _______ of the animal.

Substance, Exposure, Breed, Age, and Size

The general rule of toxicology is to ___________. 

Treat the patient not the posionpoison.

__________ is the preferred emetic agent for dogs. 

Apomorphine Hydrochloride

Sedation that can result from the use of apomorphine hydrochloride can be reversed with ________.

Naloxone

_____ or _______ should never be used as an emetic.

Salt, Salt Water

_____% solution of hydrogen peroxide has been shown to be an effective emetic for dogs, ferrets, and ______.

3, Pigs

As a general rule, the _______ and more _______ the chocolate, the more toxic it likely is.

Darker, Bitter

Members of the Allium family that can be harmful to all animals include onions, _______, _______, _______, and ______.

Garlic, Leeks, Shallots, and Chives

________ is recommended in patients with hemoglobinuria.

Fluid DiuresisFluid

Grapes and raisins have shown to cause _______ in some dogs when eaten.

Kidney Failure

________ is the only toxin that will cause intermittent seizures.

Lead

________ and ________ are effective chelating agents that can be administered in the case of lead poisoning.

Succimer, Calcium Ethylenediaminetetraacetic

Signs of nicotine poisoning usually occur ________ minutes of ingestion.

15/45

________ is commonly found in snail or slug bait and is highly toxic. 

Metaldehyde

Anticoagulant rodenticides act by competitive inhibition of vitamin ___. 

K

__________ is the most dangerous type of antifreeze. 

Ethylene Glycol

_______ are more sensitive to acetaminophen than dogs. 

Cats

Initial signs of marijuana toxicity in dogs ________ that can progress into ________ and ________.

Nervousness, Disorientation, and Depression

An ataxic animal dribbling urine is considered to be intoxicated by ________ until proven otherwise.

Marijuana

Ingestion of members of the Rhododendron family can lead to __________.

Cardiovascular Dysfunction

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The best way to prevent serious problems from toxicosis is to have emetics and activated charcoal on hand.

False

The best way to prevent serious problems resulting from toxicosis is poison prevention. Exercising caution with harmful substances by “pet proofing” the home environment is the only safe choice

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Taking a good history will be critical for preparation for the toxicologic emergency. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The general rule of toxicology is to “treat the patient, not the poison.” 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Decontamination is performed to prevent other animals from similar ingestion.

False

Decontamination is performed to prevent absorption of toxicants

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. With any ocular exposure, the eyes should be flushed repeatedly with tepid water or saline solution for a minimum of 20 to 30 minutes.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. To remove sticky substances from birds, work a small amount of vegetable oil, mineral oil, mayonnaise, or peanut butter through the rest of the substance until it breaks down into “gummy balls.”

False

To remove sticky substances from mammals, NOT BIRDS, work a small amount of vegetable oil, mineral oil, mayonnaise or peanut butter through the rest of the substance until it breaks down into “gummy balls.” For birds, follow the same instruction, but do not use mineral oil as it is very difficult to remove from feathers

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Hypothermia is not a concern when treating a patient for toxicosis.

Hypothermia can cause further complications when treating a patient for toxicosis

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Emesis is contraindicated in rodents, rabbits, birds, horses, and ruminants. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Emesis is more likely to be productive if the animal is fed a large, moist meal before inducing vomiting.

False

Emesis is more likely to be productive if the animal is fed a small, moist meal before inducing vomiting

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Food-grade hydrogen peroxide is an acceptable grade for animal use.

False

Do not use food grade hydrogen peroxide as it is about 100 times more concentrated and can cause severe gastrointestinal hemorrhage

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Salt water should be administered within 10 minutes of arrival to the clinic when ingestion of a caustic agent is suspected.

False

Salt or salt water should never be used as an emetic

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Chocolate contains theobromine and caffeine, which are both classified as methylxanthines.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. If ingested by dogs, macadamia nuts may cause weakness, depression, vomiting, ataxia, tremors, and hyperthermia.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Grapes and raisins, when eaten, cause cardiovascular episodes in cats.

False

Grapes and raisins have been shown to cause kidney failure in some when eaten

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Alkali burns are initially nonpainful. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Acid and alkali burns are treated the same.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Bathing and dilution are the cornerstones in treating contact with bleach.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The treatment for zinc ingestion is dilution.

False

It is imperative to remove the source of zinc from the GI tract via endoscopy or surgery. Chelators can be used once the object/s have been removed

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Lead must be in an acidic environment to be absorbed into the bloodstream

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Toxicity risks for the ingestion of dangerous plants are similar for all plant types.

False

Toxicity risk varies greatly depending on the species of the plant and type of animal involved

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. One of the most potent plant toxins is contained in the castor bean, for which there is no anecdote.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Delaying treatment for the ingestion of an Easter lily in a cat beyond 18 hours frequently results in death. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Outdoor plants contain calcium oxalate crystals; common houseplants do not.

False

Common houseplants contain calcium oxalate crystals

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Cats are extremely sensitive to concentrated permethrin. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The first step in treating symptomatic cats exposed to permethrin compounds is emesis.

False

The first step for treating symptomatic cats exposed to permethrin compounds involves controlling muscle tremors with methocarbamol

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Cats are very sensitive to bromethalin; dogs are more resistant.

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. Vitamin B12 increases the absorption of calcium, stimulates bone resorption, and kidney reabsorption of calcium.

False

Vitamin D₃, cholecalciferol, increases the absorption of calcium, stimulates bone resorption, and enhances kidney reabsorption of calcium

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The smell of rotten fish in the air could signal a phosphine gas, dangerous to both humans and animals. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true.Large ingestions of methanol require monitoring for acidosis. 

True

Read the following statements and write “True” for true or “False” for false in the blanks provided. If a statement is false, correct the statement to make it true. The ingestion of ethylene glycol can cause acute renal failure.

True

Apples and cherries can cause problems in grazing animals.

Seeds, bark, and leaves contain cyanide; problems most commonly seen in grazing animals

The ingestion of certain grasses (Dallis, Perennial ryegrass, Bermuda, Phalaris) can cause grass staggers and tremors

due to a fungal infection of the plant

Aspiration is a concern with the ingestion of ethanol.

Aspiration is a concern as ethanol affects the closing of the epiglottis during vomiting

In treating cocaine ingestion, emesis should only be induced within 15 minutes of ingestion.

Due to the quick onset, emesis should only be induced within 15 minutes of ingestion because the patient can rapidly deteriorate. An alternative is gastric lavage under anesthesia, followed by administration of activated charcoal

Aspirin can be used therapeutically in both dogs and cats but must be used cautiously in cats.

Because of their inability to rapidly metabolize and excrete salicylates, cats must be monitored very closely when treated with aspirin

In cats, 10 mg/kg of acetaminophen has produced signs of toxicity.

Cats are more sensitive to acetaminophen as they are deficient in the enzyme glucuronides that detoxifies acetaminophen

The test kit for EG poisoning must be used very carefully with consultation of the package insert and directions.

The blood sample should be obtained before giving any treatment, as both activated charcoal and some injectable medications can cause a false-positive result

When managing a zinc phosphide case, if any staff members have a headache or shortness of breath, they should seek medical attention.

Following ingestion, phosphide is converted to phosphine gas by stomach acid. The released phosphine gas causes severe respiratory distress. Phosphine gas exposures are also dangerous to animal owners and veterinary staff. If people in the area can smell it, they are being exposed to an amount that can cause health problems

Guinea pigs are not affected by bromethalin.

They cannot make the toxic metabolite (desmethylbromethalin)

A drooling cat should be evaluated for ingestion of topical insecticides or sprays.

Dogs and cats are physically unable to spit out a bitter taste, so when they have a bad taste in their mouth, they drool

Clinical signs associated with the ingestion of calcium oxalate-containing plants include oral irritation; intense burning and irritation of the mouth, lips, and tongue; excessive drooling; vomiting; and difficulty in swallowing.

Chewing of the plant material can cause the needle- like crystals to be expelled into the oral cavity and can result in painful oropharyngeal edema

Ingestion of raw yeast bread dough can be life-threatening to dogs.

Ethanol and carbon dioxide are produced during the rising process resulting in intoxication and bloating

Onions and other members of the Allium family can be harmful to all animals.

Pieces of onion, onion powder, or even cooked onion can cause damage to red blood cells (RBCs), which could result in anemia. The primary toxic principle in n-propyl disulfide, which causes oxidative damage to erythrocytes, resulting in hemolysis

Cats are considered to be at higher risk for onion toxicity

due to the higher number of free sulfhydryl groups on their hemoglobin (8 vs 4 for dogs and 2 for humans)

The veterinary staff should take extra steps to keep the bladder empty either through catheterization or frequent walking in a patient who has ingested chocolate.

Caffeine can be reabsorbed by the bladder wall, which may result in extended times of clinical signs

As a general rule, the darker and more bitter the chocolate, the more toxic it likely is.

Unsweetened baking chocolate contains almost seven times more theobromine as milk chocolate, and white chocolate (a combination of cocoa butter, sugar, butterfat, milk solids, and flavorings without coca beans) contains negligible amounts of methylxanthines