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Fatal attraction - common poisons exposed

 

  
 

Talk given by Alex Campbell, Manager of VPIS (London) at the FAB Conference, November 2007

VETERINARY POISONS INFORMATION SERVICE

London Centre
Guy’s & St Thomas’ NHS Foundation Trust,
Medical Toxicology Unit,
Avonley Road,
London, SE14 5ER
Tel: 020 7635 9195
Fax: 020 7771 5309
E-mail: vpis@gstt.nhs.uk

Leeds Centre
The General Infirmary,
Great George Street,
Leeds, LS1 3EX
Tel.: 0113 245 0530                   
Fax.: 0113 244 5849     

Most common enquiries to VPIS (London) concerning cats in 2006

Agent

No of calls

Ranking
in 2005

No. of calls
 in 2005

1. Permethrin

246

1

221

2. Lilium spp

181

2

204

3. Agent unknown

79

3

93

4. White spirit

60

6

41

5. Paracetamol

46

12

27

6. Neem Oil / Margosa Oil

45

23

19

7. Petroleum distillate

39

4

61

8. Pyrethroid unknown

36

8

33

9. Fipronil

33

10

30

10. Inseciticide unknown

33

11

27

11. Praziquantel

32

15

22

12. Luminous necklaces

31

22

19

13. Carprofen

27

19

20

14. Creosote

26

5

41

15. Benzalkonium chloride

25

13

24

16. Bleach

25

24

18

17. Glyphosate

25

17

20

18. Difenacoum

24

9

31

19. Ibuprofen

24

 

 

20. Bendiocarb

22

14

22

21. Metaldehyde

22

16

21

22. Disinfectant

21

 

 

23. Poinsettia

21

 

 

24. Detergent NK

20

 

 

VPIS database – Feline cases with fatal outcomes

 

Died

Euthanased

Total

1. Permethrin

38

43

81

2. Agent unknown

34

19

53

3. Ethylene glycol / antifreeze

13

37

37

4. Lilium spp

9

17

26

5. Paracetamol

12

12

24

6. Glyphosate

11

6

17

7. Benzyl benzoate

8

6

14

8. Insecticide unknown

9

5

14

9. Metaldehyde

5

8

13

10. Paraquat

5

4

9

11. Creosote

6

2

8

12. Fipronil

6

2

8

13. Difenacoum

5

1

6

14. Piperazine

2

4

6

15. Pyrethroid unknown

3

3

6

16. Alphachloralose

4

1

5

17. Diazinon/dimpylate

3

2

5

18. Disinfectant

2

3

5

19. Herbicide unknown

1

4

5

20. Neem oil/margosa oil

2

3

5

21. Bendiocarb

1

3

4

22. Codeine

2

2

4

23. Tea tree oil

3

1

4

 

Management of Poisoning Cases

1. First-aid

2. Going to the veterinary surgery

3. Decontamination – skin, eyes, stomach, other

4. What happens next?

 

The Common Poisons

Permethrin
Common sources:                      Canine spot-on treatments, wood preservatives, ant killers
Reason for high toxicity:             Metabolic
Toxic dose:                               Hard to establish
Common signs:                         Salivation, tremors, twitching, convulsions, hyperthermia, tachycardia
Onset:                                      1-3 hours usually
Basic treatments:                      Decontamination, collaring, isolation
                                                Control of convulsions
                                                Supportive measures
Specific antidotes:                     None
Prognosis:                                 Good with prompt intervention
                         

Lilies
Common sources:                      Houseplants, floral arrangements
Reason for high toxicity:             Unknown
Toxic dose:                               Unknown
Common signs:                         Early gastric signs, renal failure
Onset:                                      Gastric signs – 1-4 hours, renal signs 18 hours onwards
Basic treatments:                      Decontamination
                                                Aggressive intravenous fluid therapy
                                                Supportive measures
Specific antidotes:                     None
Prognosis:                                 Good with early diagnosis and prompt intervention, otherwise poor

 

Antifreeze / Ethylene Glycol
Common sources:                      Garages, spills,
Reason for high toxicity:             Metabolic
Toxic dose:                               1.4 ml /kg body weigh. i.e. less than 5ml!
Common signs:                         Vomiting, ataxia, weakness, collapse, coma, renal failure
Onset:                                      Immediate
Basic treatments:                      Decontamination
                                                Intravenous fluid therapy
                                                Supportive measures
Specific antidotes:                     Ethanol
Prognosis:                                 Very poor, unless treatment initiated within the hour. Even then prognosis must be guarded.


Paracetamol
Common sources:                      Human medications, inadvertent owner use
Reason for high toxicity:             Metabolic
Toxic dose:                               more than 20mg/kg body weight. i.e. one tablet can kill
Common signs:                         Vomiting, depression, cyanosis, paw oedema, methaemoglobinaemia, respiratory difficulties, liver damage
Onset:                                      1-4 hours, Liver damage after 24 hours
Basic treatments:                      Decontamination
                                                Intravenous fluid therapy
                                                Supportive measures
Specific antidotes:                     N-acetyl-cysteine, ascorbic acid,
Prognosis:                                 Good with prompt intervention and use of antidote(s)

 

White spirit / Petroleum distillates
Common sources:                      Fuel spills, home decorating products
Reason for high toxicity:             Irritancy, volaltility
Toxic dose:                               Hard to establish
Common signs:                         Buccal irritation / ulceration, vomiting, anorexia, skin irritation, respiratory distress, pulmonary oedema
Onset:                                      Rapid
Basic treatments:                      Decontamination
                                                Supportive measures
                                                Respiratory assessment
                                                Ventilation if required
Specific antidotes:                     None
Prognosis:                                 Favourable

 

Disinfectants
Common sources:                      Home cleaners
Reason for high toxicity:             Irritancy
Toxic dose:                               Hard to establish
Common signs:                         buccal irritation / ulceration, salivation, vomiting, anorexia, skin irritation
Onset:                                      Rapid
Basic treatments:                      Decontamination
                                                Supportive measures
                                                Respiratory assessment
Specific antidotes:                     None
Prognosis:                                 Favourable

 

 

 

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