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Paraquat and Diquat Toxicoses 756.e7

Technician Tips Kustritz MV, et al: Theriogenology question of the Wasik SM, et al: Combined preputial advancement
Hairs around the preputial orifice should be month: priapism or paraphimosis. J Am Vet Med and phallopexy as a revision technique for treating
Assoc 214(10):1483-1484, 1999.
paraphimosis in a dog. Aust Vet J 92(11):433-436,
VetBooks.ir Client Education Ndiritu CG: Lesions of the canine penis and prepuce. 2014. Diseases and Disorders
kept short in long-haired dogs.
Mod Vet Pract 60(9):712-715, 1979.
Olsen D, et al: Surgical correction of a congenital
Paraphimosis may occur as a learned behavior
SHEETS
secondary to penile licking (masturba- preputial and penile deformity in a dog. J Am RELATED CLIENT EDUCATION
Anim Hosp Assoc 37(2):187-192, 2001.
tion). Owners should be cautioned not to Papazoglou LG: Idiopathic chronic penile protrusion
promote paraphimosis by positive behavioral in the dog: a report of six cases. J Small Anim Pract Castration (Routine): Considerations and
reinforcement. 42(10):510-513, 2001. Planning
Pavletic MM, et al: Subtotal penile amputation and Consent to Perform Castration, Canine
SUGGESTED READING preputial urethrostomy in a dog. J Am Vet Med Consent to Perform General Anesthesia
Assoc 230:375-377, 2007.
Kutzler MA: Paraphimosis. In Monnet E, editor: Rochat MC: Paraphimosis and priapism. In Silver- How to Assemble and Use an Elizabethan Collar
Small animal soft tissue surgery, Ames, IA, 2013, stein DC, et al, editors: Small animal critical care How to Monitor Anesthetic Recovery Postop-
Wiley-Blackwell, pp 686-690. medicine, St. Louis, 2009, Saunders, pp 615-618. eratively Once Home
Root Kustritz MV: Disorders of the canine penis. Vet AUTHOR & EDITOR: Michelle A. Kutzler, DVM, PhD,
ADDITIONAL SUGGESTED Clin North Am Small Anim Pract 31(2):247-258, DACT
READINGS 2001.
Chaffee VW, et al: Canine paraphimosis: sequel to Somerville ME, et al: Phallopexy for treatment of
inefficient preputial muscles. Vet Med Small Anim paraphimosis in the dog. J Am Anim Hosp Assoc
Clin 70(12):1418-1420, 1975. 37(4):397-400, 2001.

Paraquat and Diquat Toxicoses Client Education
Sheet

BASIC INFORMATION occurs 3-5 days after exposure and is often DIAGNOSIS
fatal.
Definition • Diquat: vomiting, lethargy, anorexia, Diagnostic Overview
Paraquat and diquat are synthetic, nonselective diarrhea, possibly oral ulcers, hemorrhagic The clinical diagnosis is made from the history,
contact herbicides. Paraquat is a restricted use gastroenteritis, and acute kidney injury physical exam, and observed or suspected expo-
chemical. Diquat can be present in common sure. Delayed pulmonary effects (3-5 days from
yard products, typically at low concentrations. PHYSICAL EXAM FINDINGS paraquat) support the diagnosis during/after
• Paraquat: oral, esophageal, and gastric irrita- treatment. Analysis for paraquat and diquat in
Synonyms tion and ulceration, abdominal pain, tachy- serum or urine is difficult and requires special
• Paraquat: 1,1-dimethyl-4,4-bipyridium pnea, dyspnea; evidence of hepatotoxicity expertise. Contact the state diagnostic lab for
• Diquat: 1,1-ethylene-2,2-bipyridyldiylium and nephrotoxicity; dermatitis and chemical specifics.
burns may occur with topical exposures
Epidemiology • Diquat: oral, pharyngeal mucosal ulcer- Differential Diagnosis
Most exposures are oral, although toxicity can ations, vomiting, diarrhea. With large • Caustic or corrosive agent (acids, alkali, cat-
develop with large dermal exposures. exposures or concentrated products, may ionic detergents, liquid potpourri) or any GI
see nephrotoxicity; with topical exposures to irritant
SPECIES, AGE, SEX concentrated solutions, dermal irritation and • Lung diseases (viral, bacterial, parasitic,
Dogs are more commonly involved than cats. burns fungal, neoplasia), aspiration
• Renal disease
CONTAGION AND ZOONOSIS Etiology and Pathophysiology
Paraquat: users and veterinary personnel should • Paraquat concentrates in lung tissue. Free Initial Database
wear gloves and protective clothing. radicals are produced, causing cellular injury. • Paraquat
Cell injury leads to mononuclear macrophage ○ CBC, chemistry, and urinalysis
GEOGRAPHY AND SEASONALITY activation and pulmonary fibrosis, which can ○ Thoracic radiographs and blood gasses
Accidental poisonings are more common during be fatal 3-14 days after ingestion. Paraquat • Diquat
growing seasons; paraquat has been used for is a restricted-use pesticide (RUP) due to ○ CBC, chemistry, and urinalysis
malicious poisonings of dogs. its toxicity; only certified applicators can
purchase and use the product. Treating Advanced or Confirmatory Testing
Clinical Presentation dyspnea with supplemental O 2 provides • Analysis of stomach contents, plasma, blood,
HISTORY, CHIEF COMPLAINT more fuel for the production of free radicals, tissues, urine: samples best obtained within 48
• Known/suspected exposure to paraquat or accelerating pulmonary injury. hours of exposure; contact the laboratory first
diquat herbicide • The mechanism of diquat toxicity is similar, • Histopathologic lesions
• Paraquat: vomiting, oral and gastrointestinal but diquat does not accumulate in the lungs ○ Paraquat: pulmonary edema, hemorrhage,
(GI) ulcerations, dermal ulcerations, lethargy, (no pulmonary fibrosis). The hydroxyl radical congestion, eventually fibrosis; hepatic
abdominal pain within a few hours; followed initiates lipid peroxidation in biological congestion with centrizonal degeneration;
by tachypnea, dyspnea, pulmonary edema, membranes and can cause cell death. The renal tubular necrosis
elevated renal and liver values, seizures within exact mechanism of diquat-associated renal ○ Diquat: GI congestion and ulcerations,
48 hours. Progressive pulmonary fibrosis toxicity is unknown. renal tubular damage

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