Diagnosis and Therapy of Anticoagulant Rodenticide Intoxications

Assessment of toxicity and potential risk of the anticoagulant rodenticide diphacinone using Eastern screech-owls (Megascops asio)

“…These observations are consistent with several anticoagulant rodenticide dosing trials in raptors (Savarie et al 1979;Mendenhall and Pank 1980;Radvanyi et al 1988;Newton et al 1990), but do contrast findings of principally microscopic hemorrhage (but not frank external bleeding) in the acute DPN dosing study in American kestrels . In the absence of frank external bleeding, observations of depression, weakness and pallor were noted in DPN-dosed kestrels and screech-owls, and are considered key signs of potential rodenticide poisoning (Mount 1988). Heptaocellular vacuolation and necrosis were present in the most severely affected individuals, and have been previously reported in FGAR and SGAR poisoning cases in both birds and mammals (DuVall et al 1989;Shivaprasad and Galey 2001).…”

Anticoagulant rodenticide screening in dogs: 123 cases (1996–2003)

“…Other differentials that should be considered in patients initially examined with coagulation abnormalities include DIC associated with a variety of diseases including neoplasia; liver failure; angiostrongylosis; autoimmune thrombocytopenia; and hereditary coagulation disorders, many of which are associated with a poor prognosis. 2,[12][13][14] The AR screening provides definitive information as to whether the coagulopathy is a result of AR toxicosis. This allows clinicians to better guide owners when making decisions about treatment versus euthanasia because of the high cost of blood products and intensive care that some of these patients require.…”

“…22 This study reiterates the clinical impression that AR intoxication should be suspected more strongly in patients with PT prolongation that is more severe than the aPTT prolongation, if both are not prolonged beyond measurement. 2,4,8,17 A recent study 23 evaluated the usefulness of PT in dogs 48 to 72 hours after known or highly suspected ingestion of AR rodenticides and gastrointestinal decontamination. Only 8% had prolongation of their PT by 72 hours and required treatment with vitamin K 1 .…”

“…When patients are initially examined with severe coagulopathies, the differential diagnoses that should be considered include AR intoxication, DIC secondary to neoplasia or other disease processes including angiostrongylosis, heat stroke, sepsis or systemic inflammatory response syndrome, hemophilia or other hereditary coagulation disorders, liver failure, or severe autoimmune disease such as immune-mediated thrombocytopenia. 2,[12][13][14] Anticoagulant rodenticide intoxication is generally regarded as having the best prognosis of these disease processes, making correct diagnosis and treatment essential.…”

Bleeding Disorders

“…110 FSP, D-dimer, and fibrinogen concentrations are generally normal. PT prolongation occurs first, reflecting the short half-life of fVII (4 to 6 hours).…”