Tox Tips!
Pearls of Wisdom #1: Rat poison
One of the most common "errors" we see here is not distinguishing which type of rat poison your patient got into. We routinely reach for Phytonadione (or Vitamin K1), when the toxin may actually be bromethalin (which causes CNS signs, cerebral edema, and seizures) or a cholecalciferol (or Vitamin D3) toxicity (which causes severe hypercalcemia, mineralization of the kidneys, and kidney failure). When in doubt, check the active ingredients on the label (or call us!).
Phytonadione or Vitamin K1 is the drug of choice for treatment of anticoagulant rodenticide toxicity. The reported oral dosage range in dogs and cats is from 2 to 5 mg/kg/day. To obtain the maximum effect, the total daily dose should be divided and given twice a day. The duration of therapy depends on the main active ingredient of the rat poison. Treatment of long acting anticoagulant ingestion may need to be continued for weeks to months (often times 4-6 weeks). The blood test, prothrombin time (PT), should be used to guide the need for continued therapy. Remember your PT will be normal if your patient is on Vitamin K1. To measure when it's time to finish phytonadione treatment, the patient should have a PT tested approximately 48 hours after completion of the phytonadione. If the PT is still prolonged, an additional course of phytonadione is mandatory!
 
Pearls of Wisdom #2: Kaopectate and why we shouldn't use them in cats
Just a reminder that Kaopectate was reformulated in 2004 to contain bismuth subsalicylate. This is bad news for cats as they don't metabolize aspirin or aspirin equivalents well at all. One tablespoonful of the re-formulated children's formula and regular Kaopectate™ contains 130 mg aspirin equivalent. One tablespoonful of the re-formulated extra strength Kaopectate™ contains 230 mg aspirin equivalent. At the most, cats should receive 10 mg/kg aspirin every other day or 20-25 mg/kg aspirin once. Based on this, it is easy to see how cats can develop aspirin toxicity from the newer, reformulated Kaopectate.
|
|
|
|
