Rodenticide Toxicity

Allison Zwingenberger

University of California Davis

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Publication Date: 2010-01-22

History

10 year old male neutered Yorkshire Terrier with 3 day history of worsening cough and lethargy.

Physical Exam

• GEN: BARH, nervous. T=101.2, P=120, R=24
• INT: Clean full coat with no ectoparasites noted. 2 small 0.5cm dermal nodules on the right side o the thorax near the shoulder (owner states have been there for a long time unchanged).
• HEAD: Bilaterally symmetrical facial musculature. No pain on palpation of facial bones or muscles of mastication. Anterior chamber, sclera, cornea, and lens clear ou. External ear canals and pinna clean bilaterally. Moderate dental disease and halitosis. Throat palpates smooth with no cough elicited on tracheal palpation.
• MS: BCS 8/9. Ambulatory x 4. No gait abnormalities noted. Full ortho exam not preformed.
• CV: HR=120, MM=pink, CRT=not obtained due to temperament. Grade 3/6 left apical systolic murmur auscultated. Pulses strong, synchronous, and symmetrical.
• Resp: Eupneic with bronchovesicular sounds in all fields and no crackles or wheezes.
• GI/GU: Abdomen tense but not painful. No organomegaly or masses palpated.
• NS: Mentation appropriate. No obvious neuro deficits. Full neuro exam not preformed.
• LN: No peripheral lymphadenopathy detected.
• Rectal: unremarkable.
• PCV 32%, TS 7.3 (lipemic serum)

Findings

There is an ill-definded, lobar alveolar pattern in the left caudal lung lobe. There is a diffuse interstitial pattern and visible fissure lines, most likely due to a small amount of pleural effusion. The cranial mediastinum is widened on the d/v projection, however there is no evidence of a mediastinal mass on the lateral projection.

DDx

• inhaled foreign body with mediastinal abscess and pleuritis
• hemorrhage due to rodenticide toxicity
• pulmonary thromboembolism

Diagnosis

Collapsed while taking out for walk the next day. Mucous membranes were pale and the dog became dyspneic and weak. Moved to emergency room where oxygen was administered and an IV catheter was placed. T=94.8. 900ml of warm LRS was bolused over approximately 15 mins followed by 120ml per hour. An ICU panel was submitted showing hemoglobin=3.5, pH=6.981, CO2=32.5, HCO3-=7.6, Potassium=2.7, Glucose=215, Lactate=19, PCV=13, TP=3.2.

• Coagulopathy - suspected rodenticide toxicity.

The patient was treated with plasma, packed red blood cells and Vitamin K. Radiographs taken one week later were normal.