Anticoagulant rodenticide poisoning

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Sections available in full article Introduction, Presenting signs, Acute presentation, Geographic incidence, Age predisposition, Cost considerations, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Prevention, Control, Prophylaxis, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s), Organization(s),
Contributors Dr LarryThompson DVM PhDDipABVT
Mr Alexander Campbell BSc
Synonyms Brodifacoum Bromadiolone Chlorofacinone Coumafen Coumatetralyl Difethialone Diphacinone Warfarin

Introduction

  • Anticoagulant rodenticides available commercially in cereal-based baits at a concentration of 0.005%.
  • Some professional-use products may be at concentrations as high as 0.1%.
  • Second generation anticoagulants are more toxic in repeated small doses than a single dose.
  • Cause : ingestion of contaminated bait → blocks action of Vitamin K1.
  • Signs : delayed from 2-10 days post-exposure: internal and external hemorrhage and bruising.
  • Treatment : SQ vitamin K1, whole blood transfusion.
    Do not use vitamin K3 as it is less effective.
  • Prognosis : good with appropriate therapy.

Diagnosis

Clinical signs

Generalized hemorrhagic syndrome
  • Signs related to site of bleeding:
    • Coughing or dyspnea (intrathoracic or pulmonary hemorrhage).
    • Epistaxis Epistaxis.
    • Hemorrhagic gastroenteritis (intestinal).
    • Hematuria (genitourinary).
    • Cardiac tamponade - right sided failure (hemopericardium).
    • Seizures (meningeal or cerebral bleeding).
    • Partial paralysis (subcutaneous and intramuscular).
Other signs
  • Pallor due to anemia or hypovolemia (especially apparent in final stages).
  • Hypothermia.

Diagnosis

Differential diagnosis

  • Other coagulopathies: primary Hemostatic disorder: primary inherited , secondary Hemostatic disorder: acquired , acquired.
  • DIC Disseminated intravascular coagulation.
  • Vit K1 responsive coagulopathies.
  • Cirrhosis Liver: cirrhosis.
  • Malabsorption syndromes Malabsorption.
  • Chronic cholestasis.

Sequelae

Prognosis

  • Good: if treatment started soon after exposure and clotting time carefully monitored.
  • Guarded: if severe case.
  • Depends on site and severity of hemorrhage.

Expected response to treatment

  • Decreased clotting time.
  • Color returns to mucous membranes.
  • Patient becomes more alert/responsive.
  • Resorption hematoma/hemorrhages.
  • Increase in erythrocyte count and PCV in longer term.

Reasons for treatment failure

  • Non-detection of hemorrhage, eg internal.
  • Delay in treatment.
  • Inadequate doses vitamin K1 given.
  • Inadequate supportive therapy (plasma or blood) in 24 h delay in vitamin K1 therapy becoming effective.
  • Insufficient duration of treatment.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Blocker T L et al (1999) Acute tracheal obstruction associated with anticoagulant rodenticide intoxication in a dog. JSAP 40 (12), 577-80 PubMed.
  • Sheafer S E , Couto C G (1999) Anticoagulant rodenticide toxicity in 21 dogs. JAVMA 35 , 38-46 PubMed.
  • Lewis D C et al( 1997) Thrombocytopenia in dogs with anticoagulent rodenticide induced haemorrhage- eight cases (1990-1995). JAAHA 33 , 417-422 PubMed.
  • Berry C R et al (1993) Thoracic radiographic features of anticoagulant rodenticide toxicity in 14 dogs. Vet Rad 34 , 391-396
  • Mayer S (1991) Poisons - coumarin derivatives. In Practice 12 , 174-174.

Other sources of information

  • Campbell A (VPIS) (2002) The management of anticoagulant rodenticide poisoning in companion animals. UK VET 7 (3), 23-25.

Organization(s)


UK
  • Rentokil Initial plc , Research and Development Division, Felcourt, East Grinstead, West Sussex, RH19 2JY, UK. Tel: +44 (0)1342 833022; Fax: +44 (0)1342 326229.

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