Hypoglycemia Associated With Oleander Toxicity in a Dog

Abstract

Oleander poisoning typically results in cardiac arrhythmias, hyperkalemia, and gastrointestinal irritation, and can be fatal. Oleander extracts have also been studied experimentally as hypoglycemic agents. Here, we describe a dog with confirmed oleander toxicosis presenting with classical symptoms and also hypoglycemia. After excluding other likely causes of hypoglycemia, the finding was attributed to oleander toxicosis, which has not been previously reported in dogs. A 7-year-old female spayed Maltese was presented to the emergency service after ingesting oleander leaves. Toxicosis was confirmed by measurement of digoxin using a competitive binding immunoassay, patient level 0.7 ng/mL (0.9 nmol/L) 24-h post-ingestion. Clinical symptoms included vomiting, cardiac arrhythmia, mild hyperkalemia, and hypoglycemia. Treatment was successful with aggressive supportive care, and the dog was discharged from the hospital after 48 h and made a full recovery. This case reviews the presentation and treatment of oleander toxicity but also highlights possible effects of oleander on blood sugar in dogs. Hypoglycemia in this dog, attributed to oleander poisoning, is interesting as it supports experimental research into hypoglycemic properties of oleander extracts.

Outbreak of Oleander (Nerium oleander) Poisoning in Dairy Cattle: Clinical and Food Safety Implications

“…Apart from a slight electrolyte imbalance, neither hyperglycemia nor hyperkalemia were noticed. Nevertheless, the prognostic value of such alterations in veterinary patients has not been determined, and hypoglycemia, rather than hyperglycemia, has been associated with oleander toxicity in a dog [25].…”

A Probable Fatal Case of Oleander (Nerium oleander) Poisoning on a Cattle Farm: A New Method of Detection and Quantification of the Oleandrin Toxin in Rumen

“…Oleander is considered the most important cause of livestock poisoning in South Africa [17]. Accidental intoxications have been reported in horses [18,19,20,21], donkeys [22], cattle [23,24,25], camelids such as llama and alpaca [26,27], dogs [9,11,28], cats [11,29], and pet birds [30].…”

“…When the quantity of toxic substances is not immediately lethal, colic pains, weakness, ruminal atony, hypersalivation, changes in normal heart rhythm, dyspnea and coma can be observed. In addition, renal damage has been noted in horses with oleander toxicosis [7,20,28]. Symptoms at the cardiac level are usually arrhythmias because of increased sympathetic tone, leading to sinus arrest, tachycardia, bradycardia or atrioventricular block.…”

Successful use of digoxin‐specific immune Fab in the treatment of severeNerium oleandertoxicosis in a dog

“…This patient did not develop hyperkalemia, which is the most common electrolyte derangement. The dog did develop hypoglycemia, which has been reported in oleander toxicity, but in this case, it was thought to be due to the severity of systemic injury.…”