A recent local case of a dog suspected to have been poisoned at an area dog park ended tragically. The dog exhibited clinical signs shortly after arriving at the park, and they progressed rapidly. Despite being rushed to a local veterinarian, the condition quickly became fatal.
According to a news report in The Post and Courier, Hazmat crews combed the city of Charleston-owned dog park at Bees Landing Recreation Area in West Ashley for two hours Monday after the park temporarily was closed and strychnine poisoning was suspected. No sign of poison was found.
The dog exhibited signs of poisoning, including severe muscle tension, lockjaw, high fever and, ultimately, cardiac arrest. Based on the appearance and rapid progression of symptoms, the veterinarian suspected a toxic culprit, and the No. 1 suspect was strychnine.
Strychnine acts by blocking glycine, which helps muscles to relax. Without glycine, the muscles will contract in an uncontrolled way, resulting in severe muscle rigidity, which ultimately asphyxiates the victim. Strychnine has been used in various animal poisons, such as for moles, rats, mice, gophers and coyotes. There is no specific treatment for strychnine poisoning. Instead, treatment is directed at countering symptoms and preventing absorption of poison in the digestive tract.
It can take up to two hours for the poison to be fully absorbed, so initial treatment is directed at inducing vomiting, and/or flushing out the stomach. Activated charcoal is given to bind what remains in the digestive tract. Muscle relaxants are beneficial and the patient should be monitored closely for airway function.
However, it’s not the goal to tell readers exactly how to treat this particular intoxication. For many toxins the treatment is similar: get them to vomit, pump their stomach, provide for the airway, fluid support, etc. Furthermore, the presenting signs of many toxins also are similar. But there are subtle yet important differences in the nature of various compounds, such as their rate of absorption and mechanism of action, that would dictate the prognosis, treatment and monitoring requirements for each.
For example, bromethaline is a neurotoxin used in rat baits. Metaldehyde is a poison used in slug and snail baits, as well as some rat poisons. Intoxications with either of these could show clinical signs that are similar to strychnine intoxication. So, outward clinical symptoms may not be enough to diagnose the problem.
The more common rodenticides work in two different ways. One class causes disturbances in the animal’s ability to clot its blood. Another essentially gives the rodents an overdose of vitamin D, which disrupts calcium metabolism. But both can cause bleeding, and their treatment protocols are very different in important ways.
Besides a plethora of potential poisons, there also are more natural conditions, such as seizure disorders, tick-borne illnesses and diseases of the liver, kidney or bone marrow, that can cause many or all of the same symptoms of intoxicants.
“Sherlock Holmes” author Sir Arthur Conan Doyle once said that the three essential traits of a good detective are strong powers of observation, a robust imagination and an absolute body of knowledge and facts to draw from.
I (Henri Bianucci) believe that these also are the traits required of an effective clinician. The problem is that when an emergency clinician is presented with a case, he or she must rely upon the client to provide the essential facts of the case. Otherwise, they are forced to rely largely upon observation and imagination to guide their diagnostic and treatment plan.
If you suspect that your pet has been exposed to a poison, seek veterinary care immediately, but try and bring along as much information as you can. Simply stating, for example, that you think the dog has eaten rat poison will narrow down the list but will not identify the actual poison. Use your powers of observation, look for remnants of the poison such as crumbs or even saliva stains. Note the color and smell. Many toxins, like strychnine, or anticoagulants, are given a characteristic identifying coloring.
Look for packages or bait dispensers that may have been left behind. If you have an exterminator, have their information available, too. Gather whatever you can to help pinpoint the offending compound.
It also is important to try and narrow down the timing of the exposure. Various compounds are absorbed differently, and the time that they are ingested can be a critical point in guiding initial treatment.
Finally, it is also important to have a list of all medications that the dog is taking, and any pertinent health issues they are having, such as epilepsy or diabetes. It can be embarrassing, but you should also be prepared to discuss any drugs you may be taking, legal or illegal, that your pet may have access to. What is said in the ER will remain between you and the veterinarian, and the more facts you can provide, the more likely your pet will receive the correct care, in a timely fashion, resulting in a far better chance of survival.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.
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