A suspected intermediate syndrome and intussusception following propoxur toxicity in a dog

Abstract

An 8‐month‐old, mixed breed dog was referred because of vomiting, generalised muscle tremors and miosis. A few hours before the presentation, the owners saw the dog eating something during the daily walk. The dog was initially treated with fluids, atropine, dexmedetomidine, maropitant and midazolam. Complete blood exams showed a marked reduction of cholinesterase activity. Blood toxicology tests revealed the presence of propoxur. Twenty‐four hours after the presentation, the dog developed a small intestinal intussusception. After an initial improvement, the dog developed weakness and respiratory difficulties. The neurological examination showed obtundation, severe generalised muscle weakness of neck and limbs, reduced flexor reflexes in the four limbs and a short and shallow respiratory pattern, suggesting suspected intermediate syndrome. The dog's neurologic conditions progressively improved, and he was discharged 5 days after presentation with only mild impairment of the neck strength.

Suspected intermediate syndrome in a dog after organophosphate poisoning

“…OPIDP is characterized by mental dullness, pelvic limb weakness, and ataxia 12 . Uncommon sequelae of AChE (OP/carbamate) poisoning reported in the literature for both people and animals include megaesophagus and intussusception in dogs and bilateral vocal cord paralysis with intermediate syndrome in an adult human 13–15 …”

“…12 Uncommon sequelae of AChE (OP/carbamate) poisoning reported in the literature for both people and animals include megaesophagus and intussusception in dogs and bilateral vocal cord paralysis with intermediate syndrome in an adult human. [13][14][15] Intermediate syndrome has been reported to occur in approximately 20% of human patients after oral exposure to OP pesticides. 7 A true incident rate in veterinary medicine is unknown, with only rare cases described in veterinary literature, including the successful treatment of 1 caracal and 1 dog after known OP poisoning.…”