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652 Metaldehyde Toxicosis

• As required per protocol for chemotherapy • In this author’s experience, owners rarely (indistinguishable from blood) but does not
patients (e.g., CBC): quality-of-life assess- agree to continue with repeat pericardio- clot. If blood clots form in the discarded effu-
VetBooks.ir warranted or required of acute decompensation. this important observation should be brought
sion during the pericardiocentesis procedure,
centesis after more than two or three episodes
ments, repeat thoracic radiographs as
to the attention of the clinician performing
the procedure (catheter may be in the heart).
PROGNOSIS & OUTCOME
PEARLS & CONSIDERATIONS
• When obtaining thoracic radiographs, the
• Poor to fair; survival depends on rate of Comments dorsoventral and ventrodorsal views are
accumulation of the fluid and degree of • Thoracocentesis should be considered sometimes useful when identifying pleural
compensation, which are both variable from before blood or urine sample acquisition effusion. Ask the clinician about her/his
patient to patient. or radiographic or ultrasonographic studies preferences.
• Many patients are euthanized at the time of for patients that are unstable. The removal of
diagnosis. even a small amount of fluid can dramatically Client Education
• For those that are treated, the reported relieve the respiratory embarrassment and • Teaching the client to monitor respiratory
survival time varies considerably (weeks to stabilize the patient. rate can give the client and clinician an
years). • Although it shares similarities with mesothe- objective measure of progression and acuity
• Some animals may have a dramatic improve- lioma in terms of distribution (body cavity of decompensation in the patient.
ment after centesis and a prolonged period surfaces), carcinomatosis refers to seeding of • PleuralPort management for dedicated clients
(weeks to months) without clinical signs, pleural or peritoneal surfaces with malignant
whereas others have a recrudescence of fluid carcinoma cells. SUGGESTED READING
accumulation and return of tamponade or ○ Management of dogs and cats with Rebhun RB, et al: Mesothelioma. In Withrow SJ, et
dyspnea in hours or days. carcinomatosis may include treatment al, editors: Withrow and MacEwen’s Small animal
• A good quality of life for months to 1-2 years with intracavitary chemotherapeutics as clinical oncology, ed 5, St. Louis, 2013, Saunders,
with pericardial or pleural mesothelioma is described for mesothelioma. pp 696.
realistically possible if a good response to the AUTHOR: Carlos O. Rodriguez, Jr., DVM, PhD,
first centesis occurs and owners are willing Technician Tips DACVIM
to follow-up regularly with centesis on an • The pericardial effusion caused by meso- EDITOR: Kenneth M. Rassnick, DVM, DACVIM
as-needed basis. thelioma is usually thick and hemorrhagic

Metaldehyde Toxicosis Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS Etiology and Pathophysiology
Hyperthermia and its complications (e.g., • In mollusks, the mechanism of action is fatal
Definition coagulopathy) dehydration, seizures, and paralysis.
An acute intoxication from accidental ingestion Clinical Presentation • The mechanism of action in mammals is
of household molluscicide (snail bait), character- not fully elucidated, but involvement of
ized by vomiting, tremors, and seizures HISTORY, CHIEF COMPLAINT the CNS is evident. It is suspected that
• History of exposure or access to product metaldehyde and its metabolite acetylal-
Synonyms • Signs consistent with exposure: ataxia, dehyde affect several neurotransmitters in
• Snail and slug bait or pellets tremors, seizures the CNS, including 5-hydroxytryptamine,
• Corry’s Slug and Snail Death, Deadline Slug norepinephrine, gamma-aminobutyric
Bait, Eliminator Snail and Slug Bait, Ortho PHYSICAL EXAM FINDINGS acid (GABA), and monoamine oxidase
Bug-Geta, Vigoro Snail and Slug Killer, and • Central nervous system (CNS) (MAO).
many others ○ Ataxia
○ Tremors
Epidemiology ○ Seizures DIAGNOSIS
SPECIES, AGE, SEX ○ Hyperesthesia Diagnostic Overview
• Dogs are more commonly exposed due to ○ Nystagmus Diagnosis is typically based on observed
indiscriminate eating habits. • Gastrointestinal (GI) exposure, presence of toxin in environment,
• All breeds, all ages, and both sexes are ○ Hypersalivation or clinical signs consistent with exposure.
susceptible ○ Vomiting There are no clinically expedient tests
○ Diarrhea available.
RISK FACTORS • Cardiovascular
• Patients with pre-existing liver issues may ○ Tachycardia Differential Diagnosis
be more sensitive to effects. • Nonspecific • Toxic
• Outdoor pets, use of snail bait in pet’s ○ Dehydration ○ Bromethalin
environment ○ Hyperthermia (commonly severe, second- ○ Pyrethroid
ary to muscle activity) ○ Tremorgenic mycotoxin
GEOGRAPHY AND SEASONALITY ○ Tachypnea, panting ○ Strychnine
Areas where slugs and snails are common pests: ○ Methylxanthines
West Coast, particularly Northwest United States ○ Organophosphates, carbamates

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