Renal Toxicology 3

What are the toxic kidney plants?

Lilium, Soluble and insoluble oxalates, pigweed, oaks, grapes/raisins, vit D, bracken fern

What species is susceptible to lilies?

Cats

What is the MOA of lillies?

Unknown, but toxin is soluble and damages renal tubular epithelial cells

ALL parts of common, exposure is usually pollen

What are the C/S of lillies?

Initial salivation, anorexia, vomiting

Then polyuria and dehydration

Then weakness, recumbency, death days later

How do you treat lillies?

Decontaminant for recent exposures

Monitor bloodwork

IV fluids

Hemo or peritoneal dialysis

Prognosis is great with mild signs but once urine output stops its bad

What are sources of soluble oxalates?

Beets, docks, rhubarb, lamb’s quarters, kochia scoparia, shamrock, halogeton

What is the MOA of soluble oxalate plants?

Sodium and potassium oxalate rapidly absorbed from GI tract and form calcium oxalate that crystallizes in kidney

What has the highest concentration of oxalate?

Rapidly growing plants in the leaves

What are C/S of soluble oxalates?

More often in sheep with bradycardia, salivation, bloat, teeth grinding, seizures, death

Hypocalcemia maybe hyperkalemia

What is the main lesion from soluble oxalates?

Calcium oxalate crystals in kidney leading to tubular necrosis

What does insoluble oxalates cause?

Trauma, NOT kidney failure

What is the MOA of insoluble oxalates?

Preformed calcium oxalate crystals that causes local reactions with kinins and histamines

How does insoluble oxalates work?

Plants have idioblasts that contain oxalate crystals in a gel matrix that is broken during mechanical digestion

Individual oxalate crystals are then propelled into the adjacent tissue

What are the C/S of insoluble oxalates?

Immediate pain and irritation upon chewing

Headshaking, hypersalivation

Swelling of mm

Can rarely lead to arrhythmias

How do you treat insoluble oxalates?

Rinse mouth, activated charcoal, oral calcium

Signs usually go away 2-4 hours after treatment

What is the MOA of pigweed?

Usually chronic phenolic compounds that leads to acute tubular necrosis and perirenal edema

What are the C/S of oak?

Anorexia, weight loss, depression, PU/PD, icterus, increased BUN, low USG, pale swollen kidneys

How do you diagnose oak?

GI contents

How do you treat oak?

Emesis, IV fluids, preventative

Calcium hydroxide

What species gets grapes/raisin tox?

Dogs mostly

What is the MOA of grapes?

Tartaric acid

Develops AKI 72 hours later

What are the C/S of grapes/raisins?

Vomiting, diarrhea, lethargy, weakness

PU/PD
AKI

How do you treat grapes/raisins?

IV fluids, emesis, dialysis