Kentucky Coffee Tree intoxication in a dog with cerebellovestibular signs, bradycardia, hypotension, and hypoglycemia
Troxel MT, Poppenga RH. Kentucky Coffee Tree intoxication in a dog with cerebellovestibular signs, bradycardia, hypotension, and hypoglycemia. J Vet Int Med 2005;19:599-601.
This case report describes the signs shown by a dog with presumed Kentucky Coffee Tree ( Gymnocladus dioica ) poisoning. The case report is unique in that it presents signs other than expected vomiting, hypotension and bradycardia. In addition, the dog in this case report developed neurologic signs consistent with cerebellar and vestibular dysfunction. Supportive care and tincture of time resulted in reversal of all signs except persistent ocular disease
A 6 year old, 6.9 kg Patterdale Terrier was referred to the emergency hospital with a one day history of peracute vomiting, lethargy, and ptyalism. Seeds from a Kentucky Coffee Tree were present in the vomit. Other signs on presentation included bradycardia, dehydration, hypoglycemia, and neurologic signs (ocular and vestibular). Historical treatment by the referring DVM included IV fluids, atropine, and metoclopramide. Treatment in the emergency hospital included activated charcoal, diphenhydramine, and IV fluids. Further treatment for persistent vomiting included chlorpromazine and famotidine.
A complete neurologic examination showed cerebellar and vestibular ataxia. The dog had a base-wide stance, leaned towards the right, exhibited intermittent head and truncal sway, and had hypermetria in the thoracic limbs. Ocular deficiencies included bilateral mydriasis with absent PLR and a diminished menace response in the left eye. Other abnormalities included positional ventral strabismus, vertical downbeat nystagmus, and postural reactions.
Vomiting resolved completely and the remaining clinical signs improved over 2 days. Persistent ocular lesions were consistent with chronic and progressive retinal degeneration and felt to be a post inflammatory change. Neurological signs persisted and were rechecked at 1 week and 1 month after discharge. At one month, the dog's signs were within reference limits except for chronic ocular disease.
The Kentucky Coffee Tree is a large tree found throughout the Eastern United States . Common names include American coffee berry, chicot, coffee-bean, Kentucky mahogany, nicker tree and stump tree. Seed pods are flat and hard, measuring about 6-10 x 1-1.5 inches. The toxin is unidentified but may be cytosine, a quinolizidine alkaloid with nicotine like action. It appears to be a heat labile and water soluble toxin. The toxin is found in leaves, sprouts, seeds, and the gelatin material surrounding the seeds in their pods.
Toxicity has been reported in sheep, cattle, horses, and humans. Signs generally develop within one hour of ingestion and include the GI tract (irritation, vomiting, and diarrhea), hypotension, respiratory depression and bradycardia. Death may occur in one day with or without prior signs.
Previously reported neurologic signs were symmetrical and included depression, muscle paralysis and convulsions. The authors postulate that the signs observed in this dog may not be from the toxin but rather a cerebrovascular accident. An MRI showed no signs suggestive of infarction but in the absence of a post mortem examination could not completely rule it out.
Poisoning in dogs and cats from the Kentucky Coffee Bean tree is not expected to occur very often. It should be considered, however, in animals with known exposures and consistent signs.
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