Page 1139 - Veterinary Toxicology, Basic and Clinical Principles, 3rd Edition

Melamine and Cyanuric Acid Chapter | 77 1071

VetBooks.ir DIAGNOSIS pet food and milk products to increase the apparent pro-
tein concentration. Although there are some data on the
Diagnosis of melamine poisoning is based on the presence
number of infants affected, there is no way to determine
of melamine and cyanuric acid in samples of urine or kid-
the number of cats and dogs affected by the pet food
ney from affected animals, or the contaminated food or
recalls in 2007 because of a lack of veterinary care for
feed. Gas chromatograph/mass spectroscopy (GC/MS)
many animals and a lack of central reporting of morbidity
and liquid chromatography/tandem MS are used to ana-
and mortality for companion animals. Estimates vary
lyze for melamine and cyanuric acid (Cianciolo et al.,
depending on the source and have ranged from 571 to
2008; Hon et al., 2011; Puschner and Reimschuessel,
39,000 cats and dogs (Osborne et al., 2008; Puschner and
2011). Infrared spectroscopy or Raman spectroscopy can
Reimschuessel, 2011). Although many cats and dogs
be used to determine the composition of the urine crystals
succumbed to melamine toxicosis, others survived with
(Puschner and Reimschuessel, 2011). Identification of
supportive and symptomatic care. There are few data on
crystals on histopathology or urinalysis is also helpful in
the long-term effects of melamine on cats and dogs.
the diagnosis.
TREATMENT AND PROGNOSIS REFERENCES
Acheson, D., 2007. Importation of Contaminated Animal Feed
The basic treatment regimens for crystalluria and urolith-
Ingredients. Statement Before the House Committee on Agriculture.
iasis related to melamine ingestion include fluid therapy
Washington DC, United States, May 9, 2007.
and supportive care in both veterinary and pediatric
Anonymous, 2007. Specialists confer about the pet food recall. J. Am.
patients (Anonymous, 2007; Wen et al., 2010). Increased
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water intake and fluid therapy were used to increase urine Bai, X., Bai, F., Zhang, K., et al., 2010. Tissue deposition and residue
output. Because low urinary pH is associated with crystal depletion in laying hens exposed to melamine-contaminated diets.
formation in infants, alkalization of the urine was used to J. Agric. Food Chem. 58, 5414 5420.
maintain urine pH between 6.0 and 7.8 in affected chil- Baynes, R.E., Barlow, B., Mason, S.E., Riviere, J.E., 2010. Disposition
dren. Sodium bicarbonate or potassium citrate was added of melamine residues in blood and milk from dairy goats exposed to
to intravenous fluids for this purpose (Gao, 2010; Wen an oral bolus of melamine. Food Chem. Toxicol. 48, 2542 2546.
et al., 2010). Bhalla, V., Grimm, P., Chertow, G.M., Pao, A.C., 2009. Melamine neph-
rotoxicity: an emerging epidemic in an era of globalization. Kidney
Antispasmodic drugs, such as anisodamine or atropine,
Int. 7, 774 779.
were given to facilitate excretion of uroliths in children,
Brand, L.M., Murarolli, R.A., Gelven, R.E., et al., 2012. Effects of mela-
and pain management was instituted (Bhalla et al., 2009;
mine in young broiler chickens. Poultry Sci. 91, 2022 2029.
Wen et al., 2010). Most children recovered with this con-
Canelli, E., 1974. Chemical, bacteriological, and toxicological properties
servative management (Gao, 2010; Wen et al., 2010). of cyanuric acid and chlorinated isocyanurates as applied to swim-
However, hemodialysis was required in some patients, as ming pool disinfection, a review. Am. J. Pub. Health. 64, 155 162.
was surgical intervention (Wen et al., 2010). Most chil- Chen, Y., Wenjun, Y., Wang, Z., et al., 2010. Deposition of melamine in
dren recovered fully, but 12% were found to have renal eggs from laying hens exposed to melamine contaminated feed.
abnormalities 6 months after treatment (Liu et al., 2010). J. Agric. Food Chem. 58, 3512 3516.
Analysis of 586 cases reported during the pet food Cianciolo, R.E., Bischoff, K., Ebel, J., et al., 2008. Clinicopathologic,
recall of 2007 by veterinarians and accredited veterinary histologic, and toxicologic findings in 70 cats inadvertently exposed
to pet food contaminated with melamine and cyanuric acid. J. Am.
diagnostic laboratories found 451 cases matching the case
Vet. Med. Assoc. 333, 729 737.
definition of melamine toxicosis, of which 65.5% were
Clark, R., 1966. Melamine crystalluria in sheep. J. S. Afr. Vet. Med.
cats and 34.4% were dogs. Older animals and animals
Assoc. 37, 349 351.
with preexisting conditions were less likely to survive,
Cruywagen, C.W., van de Vyer, W.F.J., Stander, M.A., 2011.
and 73.3% of affected dogs and 61.5% of affected cats Quantification of melamine absorption, distribution to tissues and
died (Rumbeiha et al., 2010). However, .80% of excretion by sheep. J. Anim. Sci. 89, 2164 2169.
exposed cats during the original feeding trials survived, Dalal, R.P., Goldfarb, D.S., 2011. Melamine-related kidney stones and
suggesting that not all exposed cats became severely renal toxicity. Nat. Rev. Nephrol. 7, 267 274.
affected (Cianciolo et al., 2008). FDA, 2010. Melamine Pet Food Recall Frequently Asked Questions
February 2, 2010. Retrieved July 3, 2010, from United
States Food and Drug Administration Department of Health
CONCLUDING REMARKS and Human Services: ,http://www.fda.gov/animalveterinary/safety-
AND FUTURE DIRECTIONS health/RecallsWithdrawals/ucm129932.htm#AnimalFeed..
Gao, J.Y.S., 2010. Therapeutic effects of potassium sodium, hydrogen
Melamine poisoning in small animals and infants was citrate on melamine-induced urinary calculi in China. Chin. Med. J.
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