Page 1403 - Cote clinical veterinary advisor dogs and cats 4th

710 Opiate/Opioid Toxicosis

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A B C
OPEN-MOUTH JAW LOCKING A, Clinical photograph of a cat with the mouth in a fixed, wide-open position
(double-headed arrow); note the more ventrally positioned left mandibular dental arch and no contact between upper
and lower teeth. B, Dorsoventral radiographic view of the same cat shows the left mandibular coronoid process (asterisk)
contacting the zygomatic arch. C, Three-dimensional CT reconstruction of the same cat demonstrates displacement of
the left mandibular coronoid process (arrow) ventrolateral to the zygomatic arch. (Copyright Dr. Alexander M. Reiter,
University of Pennsylvania.)

PROGNOSIS & OUTCOME • Manual locking of an apparently unaffected Client Education
side should be attempted before surgery of Selective breeding
• Poor with conservative therapy (manual the affected side because both sides can be
unlocking and tape muzzling) due to high affected (requiring resective surgery on both SUGGESTED READING
rate of recurrence sides). Reiter AM: Symphysiotomy, symphysiectomy and
• Excellent with resective surgery intermandibular arthrodesis in a cat with open-
Technician Tips mouth jaw locking—case report and literature
PEARLS & CONSIDERATIONS • Practice how to fabricate a tape muzzle. review. J Vet Dent 21:147, 2004.
• Know the difference between rostrodorsal AUTHOR & EDITOR: Alexander M. Reiter, DVM, Dr.med.
Comments TMJ luxation and open-mouth jaw locking. vet., DAVDC, DEVDC
• Size 4 dental films or phosphor plates are very • Be able to use size 4 dental films or phosphor
useful for taking dorsoventral/ventrodorsal, plates for imaging the TMJ and associated
lateral oblique, and rostrocaudal radiographic tissues.
projections of the temporomandibular joints
in the cat.

Opiate/Opioid Toxicosis Client Education
Sheet

BASIC INFORMATION GENETICS, BREED PREDISPOSITION bottle of medication chewed open, pills
Dogs with the MDR1/ABCB1-Δ (p. 638) dropped on the floor, and so on
Definition gene mutation and all cats are more sensitive • Clinical signs indicating possible expo-
Opioids are naturally occurring, semisynthetic, to opioids. sure: lethargy, weakness, vocalization,
and synthetic substances that act at opioid ataxia
receptors to inhibit presynaptic release and RISK FACTORS
postsynaptic response to excitatory neurotrans- • Young animals with incomplete blood-brain PHYSICAL EXAM FINDINGS
mitters, thereby impeding pain transmission. barriers may show more severe signs. • Lethargy or depression
Opioids are used in human and veterinary • Neonates with underdeveloped livers may • Ataxia
medicine to treat pain (severe, moderate, or be unable to adequately metabolize opioids. • Gastrointestinal (GI) signs: diarrhea (dogs),
chronic), diarrhea, and cough and are a drug • Geriatric animals with underlying hepatic vomiting (cats)
of abuse in humans. Originally opiates referred or renal disease may have inadequate • Bradycardia or tachycardia
to the natural alkaloids, and opioids were the metabolism or delayed excretion. • Tachypnea (cats)
synthetics; now opioid is used for the entire • Narcotic dogs in all fields of service are at • Body temperature normal or low in dogs,
family. risk for accidental exposure. may be increased in cats
• Respiratory rate may be depressed
Epidemiology Clinical Presentation • Mydriasis
SPECIES, AGE, SEX HISTORY, CHIEF COMPLAINT • Hypersalivation
Accidental exposures more often reported in • Recognized accidental exposure: owner gave
dogs than cats. his/her own medication to the pet in error,

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