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Marijuana Toxicosis 625

respiratory signs, other signs suggesting internal prognosis than well-differentiated, receptor–positive tumors may benefit from
low-grade or noninvasive lesions.
metastasis) ○ Clinical stage: a worse prognosis is associ- concurrent OHE.
VetBooks.ir PROGNOSIS & OUTCOME ated with Prevention Diseases and Disorders
OHE at age < 6 months can significantly reduce
Large tumors (stages II-V)
■
• Dogs with benign mammary tumors are
cured by complete surgical excision. ■ ■ Lymph node involvement (stages IV-V) risk of mammary tumor development.
Distant metastasis (stage V)
• Prognosis for dogs with malignant mammary • Disease-free interval of 24 months for Technician Tips
gland tumors is extremely variable and ranges malignant tumors in 27%-55% of cases Because the timing of OHE is an important
from a cure with surgery (especially low- contributor to the risk of mammary tumor
grade malignancy) to rapid recurrence and PEARLS & CONSIDERATIONS development, it is important to inquire about its
metastasis within the first year after surgical timing when collecting history on new patients.
excision. Prognostic factors include Comments
○ Tumor size: tumors < 3 cm have a better • Canine mammary tumors represent a het- Client Education
prognosis than tumors > 3 cm. erogeneous group of tumors with different • Early-age OHE of bitches not intended for
○ Tumor histologic characteristics prognoses. breeding
Epithelial tumors (adenocarcinomas, • Multicentric mammary tumors occur in > • Regular exam of the mammary chain
■
cystadenocarcinomas, carcinomas) may 50% of affected dogs; multiple tumor types • Prompt presentation for veterinary exam
have a better prognosis than sarcomas occurring concurrently or sequentially are when abnormalities are found
and carcinosarcomas. Median survival common.
times are 6.5 months (solid carci- • Highest-risk patients that can benefit most SUGGESTED READING
noma), 12 months (invasive tumor), from postoperative adjuvant chemotherapy Kristiansen VM, et al: Effect of ovariohysterectomy at
29 months (noninvasive tumor), 10 still need to be identified. They may include the time of tumor removal in dogs with mammary
months (sarcoma), and 18 months patients with advanced clinical stages (II-V), carcinomas: a randomized controlled trial. J Vet
(carcinosarcoma). histologic evidence of vascular/lymphatic Intern Med 30:230-241, 2016.
Inflammatory carcinomas have a grave invasion, and/or high degree of anaplasia
■ AUTHOR: Erin K. Malone, DVM, DACVIM
prognosis. on histopathologic evaluation. EDITOR: Kenneth M. Rassnick, DVM, DACVIM
Anaplastic and high-grade, invasive • The benefit of OHE at the time of mammary
■
tumors with stromal or lymphatic tumor surgery remains controversial, but a
or vascular infiltration carry a worse subset of dogs with differentiated estrogen

Marijuana Toxicosis Client Education
Sheet

BASIC INFORMATION • Specific history of exposure may be with- • It is also used medicinally by humans (e.g.,
held by owner because of illicit nature of to treat nausea and improve appetite in
Definition marijuana in some states. cancer patients, reduce intraocular pressure
Common toxicosis resulting from ingestion of in glaucoma patients) in the plant form or
Cannabis sativa alkaloids and characterized by PHYSICAL EXAM FINDINGS as synthetic THC (e.g., Marinol, Cesamet).
central nervous system (CNS) depression, ataxia, • Common: bradycardia, hypothermia (body Mechanism of toxicosis:
vomiting, hypothermia, urinary incontinence, temperature: 98°F-99°F [36.7°C-37.2°C]), • The predominant psychoactive portion of
bradycardia, hyperreflexia, possibly coma and mydriasis, urinary incontinence/dribbling, marijuana is THC, which is believed to act
seizures weakness, ataxia on a unique cannabinoid receptor in the
• Possible: hyperesthesia, ptyalism, recumbency, brain that is primarily responsible for the
Synonyms tachycardia, tremors, coma CNS effects (ataxia and depression).
Common names: marijuana, Cannabis, grass, • Cannabinoids also enhance CNS formation
hashish, hemp, Mary Jane, pot, reefer, Delta- Etiology and Pathophysiology of norepinephrine, dopamine, and serotonin;
9-tetrahydrocannabinol (THC) • Marijuana refers to a mixture of cut and dried stimulate the release of dopamine; and
flowers, leaves, and stems of the leafy green enhance gamma-aminobutyric acid (GABA)
Epidemiology hemp plant, Cannabis sativa. It grows in warm, turnover.
SPECIES, AGE, SEX moist climates or is grown artificially indoors • When taken orally, THC goes through
• Most commonly exposed animals: dogs (greenhouses) and can be rolled into cigarettes substantial initial hepatic metabolism
(96%), cats (3%), other species (1%) or incorporated into food (e.g., brownies). (first-pass effect). It is highly lipophilic and
• Young dogs more commonly exposed • Exposure by pet animals is mostly accidental, distributes to the brain and other fatty tissues
but occasionally, it is intentional or mali- after absorption.
Clinical Presentation cious. Sometimes, drug-detection dogs ingest • Clinical signs in dogs may last 24-96 hours.
HISTORY, CHIEF COMPLAINT marijuana accidentally. • Oral LD50 of THC in rats = 666 mg/kg, mice
• History of exposure to marijuana or edibles/ • Marijuana is a Schedule I controlled sub- = 482 mg/kg. Clinical effects of marijuana
medibles (medicinal edibles) containing the stance commonly used as a recreational drug. are seen at much lower doses than this.
active compound THC Although considered illicit by U.S. federal • THC content of marijuana (plant material)
• Ataxia, CNS depression, tremors, vomiting regulations, it has been legalized for human is 1%-8%, extract is 28%, and hash oil is
within 30 minutes of ingestion use in many states. up to 50%.

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