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626 Mass, Abdominal

DIAGNOSIS TREATMENT Drug Interactions
Other CNS depressants (barbiturates, benzodi-
Treatment Overview
VetBooks.ir Intoxication is suspected based on typical If presented soon after consumption, decon- Recommended Monitoring
Diagnostic Overview
azepines, opioids) may exacerbate signs.
clinical signs. Some clients may be reluctant
tamination of the patient (induction of emesis,
to admit exposure or may not be aware that
indicated. In asymptomatic animals presenting
the agent is in their home. Exposure can be potential administration of activated charcoal) is Heart rate, blood pressure, body temperature
confirmed by testing the pet’s urine with an > 1 hour after possible ingestion, treating with PROGNOSIS & OUTCOME
over-the-counter illicit drug test kit. A low activated charcoal only and monitoring for onset
rate of life-threatening intoxications means a of signs without further treatment is acceptable. Excellent with treatment; fatalities are rare
test kit can be obtained at some point during After signs manifest, provide supportive care.
the first few hours of treatment/observation if PEARLS & CONSIDERATIONS
definitive confirmation is needed (e.g., uncertain Acute General Treatment
history). Decontamination of the patient (p. 1087): Comments
• Emesis (p. 1188) can be induced within • Until proved otherwise, a dog presenting
Differential Diagnosis 15-30 minutes of exposure in asymptomatic with acute-onset ataxia, CNS depression,
Toxicologic: patients. and urinary incontinence that improves with
• Ethylene glycol toxicosis ○ Dogs: use 3% hydrogen peroxide at stimulation and then gets worse again with
• Macadamia nut toxicosis 2.2 mL/kg PO, max 45 mL. Repeat decreased stimulation should be suspected
• Ivermectin toxicosis once if emesis does not occur first time. of marijuana ingestion.
• Other CNS depressants, such as benzodiaz- Apomorphine may not work as an emetic • Marijuana may be mixed with other sub-
epines, barbiturates, and opioids because of the strong central antiemetic stances for smoking (e.g., phencyclidine
Spontaneous, non-toxicologic: effect of marijuana. [PCP]), which may alter the patient’s signs
• The onset of clinical signs can mimic • Activated charcoal: indicated for patients and prognosis.
metabolic or toxic CNS disorders, but acute without clinical signs when emesis is absent. • Legalization of marijuana use in some states
decompensation of primary CNS diseases In patients with clinical signs or large inges- may increase marijuana toxicosis incidence
(e.g., granulomatous meningoencephalitis, tions, multiple doses may be used every 8 among dogs.
neoplasia, others) is possible, especially in hours to reduce enterohepatic recirculation; • Ingestion of synthetic marijuana, marketed
an animal that is not closely observed by 1-2 g/kg or labeled dosage of commercial as a legal high with street names such as
its owner. products. CAUTION: risk of hypernatremia K2 and spice, can cause much more severe
• A sudden onset of signs with resolution when using repeated doses of charcoal CNS signs in dogs, sometimes lasting up to
and no recurrence within 24 hours makes products. 3 days.
intoxication much more likely than the Supportive care:
non-toxicologic diagnoses. • IV fluids as needed for dehydration, Technician Tips
hypovolemia With the increase in use of medical marijuana
Initial Database • Thermoregulation (heat source for and legalization in some areas, the number of
• Arterial blood pressure (p. 1065): normal or hypothermia) animal exposures is increasing. Some medical
below normal; normal (systolic) > 120 mm • Monitor cardiovascular function. Atropine marijuana, including ones marketed to dogs,
Hg in clinical setting 0.022-0.044 mg/kg IM or SQ for bradycardia contain cannabinoids (CBDs), which are not
• CBC, serum biochemistry panel, urinalysis: in normotensive patients expected to cause the neurologic signs associated
unremarkable; used to assess for pre-existing • Control tremors with diazepam at a low dose with THC.
conditions of 0.25 mg/kg IV.
• Monitor for signs of aspiration pneumonia in SUGGESTED READING
Advanced or Confirmatory Testing recumbent animals. Pass cuffed endotracheal Meola SD, et al: Evaluation of trends in marijuana
• Over-the-counter illicit drug test kits (urine) tube if needed, ensuring a mouth gag/ toxicosis in dogs living in a state with legalized
can help confirm exposure if used early in speculum is also used to avoid the patient medical marijuana: 125 dogs (2005-2010). J Vet
the course of exposure. CAUTION: the kits biting and transecting the tube when Emerg Crit Care (San Antonio) 22:690-696, 2012.
have not been validated in dogs; a negative recovering. AUTHOR: Eric Dunayer, VMD, MS, DABT, DABVT
result does not exclude exposure because • Control vomiting with metoclopramide EDITOR: Tina Wismer, DVM, MS, DABVT, DABT
false-negatives occur. 0.2-0.4 mg/kg q 6h PO, SQ, or IM or
• Confirmatory testing can also be done at a maropitant 1 mg/kg SQ or 2 mg/kg PO q
diagnostic laboratory. 24h after ingested material has been expelled.

Mass, Abdominal Client Education
Sheet

BASIC INFORMATION • Cystic structures or intestinal foreign body Epidemiology
can cause a mass effect
Definition SPECIES, AGE, SEX
• An abnormal collection of cells and cellular Synonym Any dog or cat; neoplastic masses tend to occur
components within the abdominal cavity that Abdominal tumor in older animals and intestinal foreign bodies
may cause abdominal distention in younger animals

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