Retrospective evaluation of the use of hemodialysis in dogs with suspected metaldehyde poisoning (2012–2017): 11 cases

Abstract

Objective To evaluate dogs treated with hemodialysis for severe metaldehyde intoxication and to compare them with conventionally‐managed patients. Design Retrospective study (2012–2017). Setting University teaching hospital. Animals Data from 18 dogs with severe metaldehyde intoxication were analyzed. Eleven dogs were treated with intermittent hemodialysis and 7 managed conventionally. Interventions None. Measurement and main results Metaldehyde poisoning was diagnosed based on clinical signs and toxicological analysis or presence of turquoise material in the gastrointestinal content. Clinical signs, additional treatments, dialysis prescription, duration of anesthesia and hospitalization, complications, and outcome were documented. Results were analyzed by t‐test, Mann–Whitney U‐test, and Chi‐square test. P < 0.05 was considered significant. Dialysis was performed for median (range) 180 min (150–420 min) with median of 2.28 L/kg (1.66–4.48 L/kg) blood volume processed. In the hemodialysis group, anesthesia was discontinued at a median of 3.0 hours (1.5–6.7 h) after starting dialysis. The conventional‐group received general anesthesia for a median of 17.5 hours (7.0–30.5 h). No further anticonvulsive treatment was necessary for the hemodialysis group. Time to hospital discharge was shorter in dialyzed dogs (median 18 h; 15–41 h) compared to conventionally treated dogs (median 89 h; 61–168 h; P = 0.0014). Aspiration pneumonia was reported in 5 conventionally treated dogs and none of the dialyzed dogs (P = 0.001). Five dialyzed dogs developed hematoma at the dialysis catheter site. One dog in each group was euthanized. Conclusion Hemodialysis significantly decreases the requirement for anesthesia and length of hospitalization in dogs with metaldehyde intoxication. Aspiration pneumonia occurred less often in dialyzed patients. Prospective studies are warranted to confirm the clinical utility of hemodialysis in dogs with metaldehyde poisoning.

A prospective study on clinical signs, management, outcomes, and delayed neurologic sequelae due to metaldehyde poisoning in 26 dogs

“…Many factors are involved in the toxicity and final outcome, including the dose of metaldehyde ingested, other comorbidities, the severity of clinical signs, and interval from onset of signs to initiation of treatment. Intravenous lipid emulsion therapy or hemodyalisis was not used in our cases but successful management of metaldehyde poisoning in dogs was already described ( Lelescu et al , 2018 ; Teichmann-Knorrn et al , 2020 ). Interestingly, none of the dogs that responded to diazepam received phenobarbital treatment.…”

“…Metaldehyde poisoning in dogs is described worldwide in several retrospective studies ( Studdert, 1985 ; Robertson et al , 1992 ; Yas-Natan et al , 2007 ; Bates et al , 2012 ; De Roma et al , 2017 ; Teichmann-Knorrn et al , 2020 ) as well as for numerous other domestic or wildlife species, such as cats, cattle, red fox, or birds ( Firth, 1992 ; Berny et al , 2010 ; Guitart et al , 2010 ; Wang et al , 2011 ; Sabater et al , 2014 ; Bille et al , 2016 ). These have raised questions about the consequences of using or storing metaldehyde close to dogs.…”

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

“…Veterinary studies describing extracorporeal techniques consistently describe thrombotic complications related to the filter or the central venous catheter. However, across all studies reviewed, no systemic thrombotic complications were noted in dogs undergoing membrane therapeutic plasma exchange (n = 51), [324][325][326] intermittent hemodialysis (n = 183), 327,328 or centrifugal apheresis (n = 4). 329 Anticoagulation strategies, when used, were limited to the duration of the session and varied among the studies reviewed.…”

Suspected veterinary poisoning cases: A retrospective toxicoepidemiology study (2009-2019) in south-eastern Italy

“…Molluschicides: Molluschicides were the toxicological class more involved in poisoning animals cases and metaldehyde was the molecule more found according to literature [45,47,48]. Metaldehyde was found in 143 dogs, 28 cats, 1 fox and 1 pigeon.…”