Successful management of a kitten with chlorpyrifos and cypermethrin toxicosis with pralidoxime and atropine

Abstract

Case summary Organophosphates and pyrethroids have been widely used as agricultural and domestic insecticides. This case report describes a 3-month-old free-roaming female kitten, weighing 930 g, that developed hypersalivation, hypothermia, dyspnoea due to increased bronchial secretion, bradycardia, miosis and neurological signs, including restlessness, ataxia, disorientation, apparent hallucination, muscle twitching and seizures within 6 h of accidental ingestion of an insecticide containing chlorpyrifos (500 g/l) and cypermethrin (50 g/l). The kitten was treated empirically with intramuscular atropine and dexamethasone, and rectal diazepam. The history of insecticide exposure was obtained after 6 h of treatment and intramuscular 2-pyridine aldoxime methochloride (pralidoxime [2-PAM]) and atropine therapy was started 2 h later. Recovery was complicated by suspected aspiration, but there were no sequelae from the insecticide exposure and by 7 days post-ingestion the kitten was normal and playful. Relevance and novel information To the best of our knowledge, this is the first report of successful management of chlorpyrifos and cypermethrin toxicosis in a cat in Bangladesh. This case report suggests that 2-PAM followed by atropine and other supportive therapy may be an effective strategy to manage a cat poisoned by chlorpyrifos and cypermethrin; however, expanded clinical trials are needed.

Atropine sulfate as a continuous intravenous infusion for the treatment of organophosphate toxicity in a cat

“…[6][7][8][9] Published treatment protocols for small animal patients include the administration of intermittent intramuscular and intravenous bolus dosing of atropine sulfate and pralidoxime (2-PAM), which act via anticholinergic and AChE enzyme re-activator pathways, respectively, to alleviate muscarinic and nicotinic clinical signs. 3,[10][11][12][13][14] There is no established protocol describing the treatment of severe OP toxicosis in cats with continuous rate intravenous infusion (CRI) of the aforementioned medications, despite evidence that it may be beneficial in humans.…”