A retrospective evaluation of hops ingestion in 177 dogs (2005-2018).

OBJECTIVE: To describe the clinical signs and outcomes observed after Humulus lupulus (hops) ingestion in dogs. A secondary objective was to note any trends in the number of hops-related phone calls made to an animal poison control center over a 13-year period. DESIGN: Retrospective study (2005-2018). SETTING: An animal poison control center. ANIMALS: One hundred and seventy-seven dogs with known or suspected hops ingestion. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 177 calls were made to Pet Poison Helpline between 2005 and 2018 involving hops ingestion in dogs. Outcomes were determined in 83 cases; 79 of 83 (95.2%) survived. Clinical signs associated with hops ingestion were observed in 74.0% (131/177). Commonly observed clinical signs were tachypnea (98/131), hyperthermia (65/131), and vomiting (44/131). Severe hyperthermia (>41.4°C, [>106°F]) developed in 8 dogs and 3 of those dogs did not survive. A fourth nonsurvivor was found deceased at home. The majority of symptomatic dogs developed clinical signs between 2 and 8 hours postingestion. Resolution of clinical signs occurred in less than 24 hours in all survivors except in one. Cases consulted with Pet Poison Helpline related to hops ingestion increased from 2005 to 2018 relative to the total amount of cases managed overall. CONCLUSIONS: The most common clinical signs associated with hops ingestion include tachypnea, hyperthermia, and vomiting; however, not all dogs develop clinical signs. While prognosis is good with 95.2% of dogs in this population surviving, some dogs can develop a severe and fatal hyperthermia.

Toxicology of Marijuana, Synthetic Cannabinoids, and Cannabidiol in Dogs and Cats.

Pet exposure to marijuana-containing products-both recreational and medicinal-along with exposure to extracts such as cannabidiol is increasing in conjunction with greater accessibility. Cannabis products are even sold for use in pets. In addition, exposure to illegal synthetic cannabinoids remains concerning. Veterinarians need to be able to recognize associated clinical signs and understand when cases have the potential for severity. This article provides a brief history of cannabis along with a review of the endocannabinoid system, common cannabis products, expected clinical signs, and medical treatment approaches associated with cannabis exposure in pets.

Baclofen toxicosis in dogs and cats: 145 cases (2004-2010).

OBJECTIVE: To identify dogs and cats with baclofen toxicosis and characterize the patient population, clinical signs, and outcome. DESIGN: Retrospective case series. ANIMALS: 140 dogs and 5 cats with baclofen toxicosis. PROCEDURES: An animal poison control center electronic database was reviewed from November 2004 through April 2010 to identify dogs and cats with baclofen toxicosis. Information on signalment, clinical signs, and amount of baclofen ingested was obtained. Clinical signs were categorized as CNS, gastrointestinal, general malaise, cardiovascular, respiratory, or urogenital. Follow-up communications were performed to determine overall outcome. RESULTS: Dogs had a median age of 0.67 years (range, 0.1 to 15 years) and cats of 1 year (range, 0.7 to 16 years). Of 145 patients, 133 (92%) developed clinical signs of baclofen toxicosis. A total of 259 signs fell within defined categories: CNS (121/259 [46.7%]), gastrointestinal (69/259 [26.6%]), general malaise (27/259 [10.4%]), cardiovascular (23/259 [8.9%]), respiratory (14/259 [5.4%]), and urogenital (5/259 [1.9%]). For 68 dogs with known survival status, survival rate was 83.8% (57/68); of these dogs, the amount of baclofen ingested was known for 53 (46 survivors and 7 nonsurvivors). Amount of baclofen ingested was significantly lower in survivor dogs (median, 4.2 mg/kg [1.91 mg/lb]; range, 0.61 to 61 mg/kg [0.28 to 27.7 mg/lb]), compared with nonsurvivor dogs (median, 14 mg/kg [6.4 mg/lb]; range, 2.3 to 52.3 mg/kg [1.04 to 23.77 mg/lb]. Of 5 cats, 2 survived, 1 died, and 2 had unknown outcomes. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical signs of baclofen toxicosis occurred in most patients, with the CNS being the system most commonly affected.

Potential zinc phosphide rodenticide toxicosis in dogs: 362 cases (2004-2009).

OBJECTIVE: To evaluate records of dogs exposed to zinc phosphide rodenticides and characterize the patient population, including breed, sex, age, body weight, time since exposure, development of clinical signs, clinical signs observed, treatments performed, veterinary care received, outcome, and overall prognosis. DESIGN: Retrospective case series. ANIMALS: 362 dogs with presumed zinc phosphide exposure. PROCEDURES: An electronic computer database from an animal poison control center was searched to identify dogs that ingested zinc phosphide between November 2004 and July 2009. RESULTS: Accurate information regarding development of clinical signs was available in 94.5% (342/362) of cases. Over half the dogs (58.8% [201/342]) did not develop clinical signs, and specific clinical signs were reported for the remaining 41.2% (141/342) of dogs. There were 180 total clinical signs recorded for these 141 dogs, with some dogs having developed > 1 category of clinical signs. Clinical signs involving the gastrointestinal tract were the most commonly reported type of clinical sign (66.7% [n = 120/180 reported signs]), followed by generalized malaise (17.8% [32/180]), CNS signs (8.9% [16/180]), respiratory signs (3.3% [6/180]), and cardiovascular signs (1.7% [3/180]). Approximately 65% (234/362) of patients received veterinary care (including decontamination via induction of emesis, gastric lavage, or activated charcoal administration), and of these dogs, 51.3% (120/234) were hospitalized. For the 296 dogs for which survival data were available, the survival rate was 98.3% (291/296). CONCLUSIONS AND CLINICAL RELEVANCE: Overall, the prognosis for zinc phosphide toxicosis was good. Zinc phosphide rodenticide toxicosis is a potential public health concern, and veterinary staff should be aware of this commonly used rodenticide.

The use of intravenous lipid emulsion as an antidote in veterinary toxicology.

OBJECTIVE: To review the use of IV lipid emulsion (ILE) for the treatment of toxicities related to fat-soluble agents; evaluate current human and veterinary literature; and to provide proposed guidelines for the use of this emerging therapy in veterinary medicine and toxicology. DATA SOURCES: Human and veterinary medical literature. HUMAN DATA SYNTHESIS: Human data are composed mostly of case reports describing the response to treatment with ILE as variant from mild improvement to complete resolution of clinical signs, which is suspected to be due to the variability of lipid solubility of the drugs. The use of ILE therapy has been advocated as an antidote in cases of local anesthetic and other lipophilic drug toxicoses, particularly in the face of cardiopulmonary arrest and unsuccessful cardiopulmonary cerebral resuscitation. VETERINARY DATA SYNTHESIS: The use of ILE therapy in veterinary medicine has recently been advocated by animal poison control centers for toxicoses associated with fat-soluble agents, but there are only few clinical reports documenting successful use of this therapy. Evidence for the use of ILE in both human and veterinary medicine is composed primarily from experimental animal data. CONCLUSIONS: The use of ILE appears to be a safe therapy for the poisoned animal patient, but is warranted only with certain toxicoses. Adverse events associated with ILE in veterinary medicine are rare and anecdotal. Standard resuscitation protocols should be exhausted before considering this therapy and the potential side effects should be evaluated before administration of ILE as a potential antidote in cases of lipophilic drug toxicoses. Further research is waranted.

Corneal ulceration in a dog following exposure to the defensive spray of a walkingstick insect (Anisomorpha spp.).

OBJECTIVE: To describe a case of corneal ulceration in a dog resulting from ocular exposure to the defensive spray of a walkingstick insect (Anisomorpha spp.). CASE SUMMARY: A 4-year-old, male Chihuahua in southeastern Louisiana presented to an emergency veterinary hospital approximately 20 hours after it was witnessed to have come in close proximity to a walkingstick insect. Within seconds of approaching the insect, the dog yelped, jumped backwards and developed lacrimation, blepharospasm, and periocular swelling of the left eye. Upon presentation, the dog was found to have blepharospasms and miosis of the left eye. Fluorescein stain was applied to the affected eye and diffuse corneal uptake of stain was noted. A diffuse superficial corneal ulceration was diagnosed and treated supportively with ocular flushing, topical antibiotics, ocular lubrication, and a 1% solution of ocular atropine, as well as systemic nonsteroidal anti-inflammatory agents. Clinical signs resolved 10 days after injury. NEW OR UNIQUE INFORMATION PROVIDED: While most species of walkingstick insects are considered harmless, certain species in the southeastern United States have the ability to spray defensive venom at their predators. Upon ocular exposure to the venom, the victim may experience intense pain followed by blurred vision, conjunctivitis, keratitis, and corneal ulceration. To date, there is only 1 previous reported case of ocular exposure to walkingstick venom in a dog although both children and animals may be at higher risk for ocular exposure due to their curious nature and proximity in size to the insect. Superficial corneal and conjunctival damage can occur following direct exposure to the defensive chemical spray of the Northern and Southern Twostriped walkingstick insects found in the southeastern United States and may be considered a differential diagnosis in cases involving diffuse corneal ulceration.

Adverse effects associated with inadvertent intravenous penicillin G procaine-penicillin G benzathine administration in two dogs and a cat.

CASE DESCRIPTION: 2 dogs and a cat were inadvertently given penicillin G procaine-penicillin G benzathine IV instead of propofol during induction of anesthesia for routine dental prophylaxis. One dog and the cat required hospitalization because of severe neurologic impairment and cardiopulmonary arrest (cat); the remaining dog did not develop any clinical signs. CLINICAL FINDINGS: In the 2 animals that developed signs consistent with an immediate adverse reaction, clinical signs included muscle tremors, seizures, blindness, vocalization, agitation, and transient loss of vision. Hypothermia, pruritus, hypotension, and cardiac arrest were also documented. TREATMENT AND OUTCOME: The 2 affected patients responded to treatment with anticonvulsant medications, centrally acting muscle relaxants, sedation, and intensive supportive care including IV fluid administration and oxygen supplementation as needed. Cardiopulmonary cerebral resuscitation was performed successfully in the cat. The dog that did not develop any clinical signs was not treated. The 2 affected patients recovered fully and were discharged from the hospital after 3 to 4 days with no apparent sequelae. CLINICAL RELEVANCE: Penicillin G procaine-penicillin G benzathine and propofol are common drugs in veterinary practice and may both be administered to patients undergoing elective procedures. Because of their similar milky white appearance, veterinarians should label syringes and take care to avoid this medication error. There is no specific antidote for penicillin orprocaine toxicosis. Aggressive and immediate treatment is required in patients that develop an adverse reaction to ensure a successful outcome.