Intoxication in dogs and cats: a basic approach to decontamination

Abstract

Background: There are two types of intoxicated patient that present to veterinary practices: the asymptomatic patient with a known exposure and the patient with clinical signs that may (or may not) be due to a toxin or poison. Deciding when (or if) to treat these patients is often an inexact science and the decision must be made based on numerous risk factors, the owner’s level of comfort with risk and any financial constraints.Aim of the article: This article is the first in a series of four and aims to provide a basic overview of the approach to decontamination of an asymptomatic patient presented with a known intoxication. It also outlines therapies that may be considered in both symptomatic and asymptomatic patients, and these will be discussed in more detail in future articles.

Supporting the intoxicated patient: toxicants affecting the haematological and renal systems

“…Because most agents ingested are second-generation rodenticides, treatment should be continued for a minimum of four weeks unless the specific agent is known, in which case the duration of therapy required can be ascertained by contacting a poisons information service (Humm and Greensmith 2019). If the patient is re-exposed during this time, it is not protected and the treatment needs to be continued for four weeks beyond the most recent exposure.…”

“…Owners may present asymptomatic patients with a known recent ingestion of a renal toxicant. Decontamination should be performed in these patients as described in the first article of this series (Humm and Greensmith 2019). Some renal toxicants have a specific antidote, such as ethylene glycol (see below), and if complete decontamination cannot be guaranteed, therapy should be rapidly instigated.…”

“…The first article in this series discussed the basic approach to decontamination of the asymptomatic patient exposed to a toxicant (Humm and Greensmith 2019), while the second discussed toxicants affecting the neurological and cardiovascular systems (Tinson and Cook 2020). This article will focus specifically on toxicants that impact on the haematological and renal systems.…”

Supporting the intoxicated patient: toxicants affecting the gastrointestinal and hepatobiliary systems

“…Intravenous lipid emulsion therapy (Humm and Greensmith 2019) has also shown promise in the management of naproxen, carprofen and ibuprofen toxicity, and should be considered in patients with recent large-dose NSAID intoxication (Bolfer and others 2014, Herring and others 2015, Chumbler and others 2020).…”

“…The previous articles in this series have highlighted the approach to decontamination of the asymptomatic patient exposed to a toxicant (Humm and Greensmith 2019) and toxicants affecting the neurological and cardiovascular systems (Tinson and Cook 2020) and haematological and renal systems (Humm and Tinson 2020). This final article focuses on toxicants that affect the gastrointestinal or hepatobiliary systems.…”