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Adulterated Diets 37

• Thoracic radiographs and abdominal ultra- PEARLS & CONSIDERATIONS ○ If mitotane is used for treatment, the
sound q 2-3 months to check for metastasis. Comments owners must contact the clinic and return
VetBooks.ir PROGNOSIS & OUTCOME • Most surgeons require abdominal CT before sign of decreased water intake or Diseases and Disorders
for an ACTH stimulation test at the first
adrenalectomy.
appetite.
• Adrenalectomy: up to 20% mortality rate;
stabilization with trilostane to decrease skin
2-4 year median survival if patient survives • Cats particularly benefit from preoperative ○ Treatment is for life.
the perioperative period. fragility and improve wound healing. SUGGESTED READING
• Medical therapy • Adrenalectomy should be performed by a Arenas C, et al: Long-term survival of dogs
○ Approximately 1 year without metastatic board-certified surgeon in a facility with with adrenal-dependent hyperadrenocorticism: a
disease 24-hour monitoring. comparison between mitotane and twice daily
○ Approximately 2 months with metastatic trilostane treatment. J Vet Intern Med 28:473-480,
disease Technician Tips 2014.
○ No difference in survival between mitotane • If medical treatment is elected, make sure AUTHOR: Patty Lathan, VMD, MS, DAVCIM
or trilostane, if PDH-type protocol used the owners understand that EDITOR: Ellen N. Behrend, VMD, PhD, DACVIM
for mitotane

Adulterated Diets

BASIC INFORMATION Etiology and Pathophysiology
Multiple possibilities; common ones include these:
Definition
Food containing a deleterious or toxic substance
in sufficient concentration to cause illness Etiologic Agent Source Associated Pathophysiology
(uncommon) Mycotoxins
Synonym Aflatoxin Corn, peanuts Anorexia, icterus, ascites, hemorrhage, pale
Food-borne illness yellow-to-orange liver, edematous gallbladder,
hepatic fibrosis (chronic)
Epidemiology Deoxynivalenol Grains Anorexia, weight loss, vomiting
SPECIES, AGE, SEX Tremorgenic mycotoxins (e.g., Moldy food Fine muscle tremors, ataxia, seizures,
Any dog or cat, but young, old, physiologically penitrem A, roquefortine, prostration, polyuria, polydipsia
stressed, or immune-compromised animals are verruculogen)
more susceptible. Enterotoxigenic bacteria (e.g., Contaminated or Vomiting, diarrhea, abdominal pain, distention,
Salmonella, certain E. coli strains, spoiled food dehydration, gastrointestinal stasis to
CONTAGION AND ZOONOSIS Clostridium, Staphylococcus) hyperactivity. C. botulinum produces
If adulterant is a pathogenic microbe (e.g., progressive ascending flaccid paralysis
Salmonella spp.), potential exists for spread to Metals
other animals and people from contact with Nutritive (e.g., zinc, selenium, Over formulation Depends on specific metal
diet or infected biological material. copper, iodine)
Clinical Presentation Non-nutritive (e.g., lead, mercury, Contaminant Depends on specific metal
DISEASE FORMS/SUBTYPES cadmium)
Depends on specific etiological agent. Vitamin D Overformulation Anorexia, lethargy, vomiting, diarrhea,
hypercalcemia, soft tissue calcification, renal
HISTORY, CHIEF COMPLAINT failure
Frequently causes vomiting and/or diarrhea. Vitamin A Overformulation Anorexia, lethargy, weight loss, skin thickening
Other common complaints are food refusal/ and peeling, bone malformation, hemorrhage,
anorexia, lethargy, polydipsia/polyuria, anuria, decreased liver and kidney function
jaundice, seizures, coma, or death. History often Pesticides Contaminant Depends on specific pesticide
includes feeding a new product or new package Melamine + cyanuric acid Contaminant Kidney failure
of regularly used product within 1-30 days of
illness.
PHYSICAL EXAM FINDINGS DIAGNOSIS
Depends on specific etiologic agent findings consistent with a specific substance or
Diagnostic Overview class of substances; 2) detecting the substance
Animals have usually eaten or refused food in the food at concentrations sufficient to
within a day of becoming clinically ill, implicat- produce observed clinical and pathophysiologic
ing the food as a possible cause of illness. findings; and 3) in some instances, detecting
Definitive proof that illness was caused by the the same substance or a metabolite in a sample
food requires: 1) clinical and pathophysiologic from the animal.

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