GI and Liver tox II

What is the toxic component of chocolate?

Methylxanthines

What are two methylxanthines in chocolate?

Theobromine

Caffeine

Where do methylxanthines most commonluy act?

CNS

Kidneys

Cardiac/SK muscle

GI

Pancreas

What are 4 questions we should ask for chocolate tox?

Which type

How much

When

What else was eaten

At what dose should we consider chocolate tox life threatening?

Above 40mg/kg

(150mg/kg = LD50)

What are the initial signs of chocolate tox?

V/D

Hyperactivity

Polydipsia

Bloat

What are progressive signs of chocolate tox?

Tremmors/ seizures

Pancratitis - fat content

Tachy/PVC

Hyperthermia

When is it acceptable to induce emesis for a chocolate tox?

6-8hrs post ingestion still successful in most cases

-can do charcoal if not successful

How can you increase the excretion and decrease the reabsorption of methylxanthines?

Fluid diuresis

-catheter/ walk animal frequently to prevent caffeine reabsorption

What should you give to a chocolate tox that has an abnormal HR or rhythum?

Lidocaine

Betablocker

What should you give to a chocolate tx that has seizures?

Diazepam/ barbituate

What can you give for the muscle tremors caused by chocolate tox?

Benzodiazepine

Methocarbamol

What do you see on labs of chocolate tox?

Usually unremarkable

Poss pancreatic elevations

What is the prognosis of chocolate tox?

Good - 2-3 day recovery

Which animal will see macadamia nut tox?

Dogs

What are clinical signs of macadamia nut tox?

Weakness in a hind limb - no pain - usually for 1-2 days

Pos hyperthermia/ Tremors

What is tx of macadamia nut tox?

Emesis of asymptomatic w/ charcol

What are a few molds that will produce tremorgenic mycotoxins?

Aspergillus

Claviceps

Pennicilium

Which toxin from tremorgenic mycotoxins is most toxic?

Penitrem A - from penicilium -> CNS effects

How fast can we see signs from tremorgenic mycotoxins?

15-30 mins - RAPIDLY absorpbed after ingestion

What are clinical signs of tremorgenic mycotoxins?

Fince muscle tremmors, Restlessness

Seizures

Death/ Coma

What are some samples that can be sent of for dx in tremorgenic mycotoxins?

Vomitus

Suspect feed/ compost

Stomach contents

Bile - necropsy

How do you tx an asymptomatic dog w/ tremorgenic mycotoxins?

Emesis

Charcoal

How do you tx a symptomatic dog w/ tremorgenic mycotoxins?

Cautious emesis -> pos aspiration

GI lavage

IV lipid emulsion

Temp control

IV fluids

What are potential side effects of tremorgenic mycotoxins?

Rhabdomyolysis - muscle tremors

DIC -> Hyperthermia

What is prognosis of tremorgenic mycotoxins?

Good if caught early

What are a few alternative names for xylitol?

KANNIT

NEWTOL

TORCH

XYLITON

SUGAR alcohol

What animal does xylitol tox not affect?

Cats

Name a few medications it is possible to see xylitol in?

Neurontin gabapentin

Mobic meloxicam

Zegrid powder omeprazole

Liquid metronidazole

How does xylitol affect dogs?

Rapid release of insulin -> hypoglycemia

Hepatic necrosis - high dosages

How soon can we see affects w/ xylitol absorption?

w/in 30 mins of ingestion

Name a few clinical signs of xylitol absorption?

Vomiting

Weakness/ ataxia

Sizures

Hypokalemia

Why might we want to hospitalize a xylitol tox dog if its asymptomatic?

Hypoglycemia can be delayed by 12hrs -> monitor BG frequently

What tx is not recommended for xylitol tox?

Acivated charcol

How can you tx xylitol tox?

Emesis

IV dextrose if hypoglycemic

Anticonvulsance if still seizing after hypoglycemia controled

What lab values may we see abnormalities in w/ xylitol tox?

Hypokalemia

ALT (ALP as well but less severe)

Tbil

When is xylitol tox guarded?

Hepatic involvment