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800 Poisoning, General Management

body reaction (occasionally affects multiple TREATMENT control secondary bacterial or yeast infections
feet), sterile pyogranulomas, nodular derma- Treatment Overview • Immunosuppressive treatments are usually
(p. 91).
VetBooks.ir Initial Database The goal of treatment is to achieve cure or required for treating immune-mediated
tofibrosis (German shepherd dogs)
control of the disease. Sometimes, palliative
diseases.
Selection of diagnostic tests (p. 1091) is based
on evidence provided by the history and treatment is the only option (e.g., nonresectable PROGNOSIS & OUTCOME
tumors).
physical exam:
• Skin scrapings: Demodex spp Acute and Chronic Treatment Varies, depending on the cause of pododermatitis
• Wood’s lamp exam: dermatophytosis (fluo- Specifics depend on the underlying cause:
rescent strains of Microsporum canis) • Minimizing paw trauma (e.g., owner educa- PEARLS & CONSIDERATIONS
• Cytologic exam: fungal organisms, bacteria tion; use of booties)
and inflammatory cells (bacterial pododerma- • Draining lesions can benefit from soaks in Comments
titis), acantholytic keratinocytes (pemphigus), a magnesium sulfate solution (Epsom salts) • Interdigital pyoderma is often frustrating
neoplastic cells 30 mL/L of warm water q 12-24h until to treat. Even after resolution of infection,
• Elimination diet: food allergy drainage stops (5-7 days). the remaining fibrosis and scarring may
• Intradermal skin testing and/or serologic • Surgery: neoplastic lesions, surgical explora- predispose the animal to relapse.
allergy testing: atopic dermatitis tion (foreign bodies), or debridement laser • In severe, refractory cases, clinicians may
• Fecal flotation: hookworm ova surgery can be useful for removing cystic have to consider drastic surgical measures
• Radiographs: osteomyelitis, radiopaque lesions and sinuses (dogs). (fusion podoplasty).
foreign bodies • Bacterial pododermatitis, most often caused • Cases of canine pododermatitis with substan-
• CBC, biochemistry panel, urinalysis: results by Staphylococcus pseudintermedius, can neces- tial footpad involvement are more commonly
depend on the underlying cause; often sitate 8-12 weeks of appropriate systemic seen with autoimmune diseases, drug reac-
normal or nonspecific unless systemic disease antibiotics (e.g., cephalexin 22-30 mg/kg PO tions, zinc-responsive dermatosis, superficial
q 12h, amoxicillin-clavulanate 13.75-25 mg/ necrolytic dermatitis, and distemper.
Advanced or Confirmatory Testing kg PO q 12h).
• Culture: bacterial, fungal • If other bacteria are involved or the empirical Technician Tips
• Skin biopsy: foreign bodies, demodicosis or choice of antibiotic is not effective, antibiotic Patients with pododermatitis may have painful
other parasites, bacterial or fungal infections, selection should be based on culture and paws. Their reluctance to walk should not be
neoplasia, immune-mediated diseases, super- susceptibility (C&S) results. misinterpreted as stubbornness, and they may
ficial necrolytic dermatitis, zinc-responsive • Manage parasitic or fungal infections with need support to walk comfortably.
dermatosis appropriate medications.
• Antinuclear antibody (ANA): positive in most • Atopic dermatitis often requires management SUGGESTED READING
animals with SLE; typically done if there is with combination therapy: antipruritic Miller WH Jr, et al: Muller & Kirk’s Small animal
other evidence of immune mediated disease agents, allergen-specific immunotherapy, dermatology, ed 7, St. Louis, 2013, Elsevier.
(e.g., glomerulonephritis. polyarthritis) various topicals (e.g., moisturizers, antiprurit-
• Endocrine tests and serologic titers, if relevant ics, antiseptics), and antimicrobial drugs to AUTHOR: Nadia Pagé, DMV, MSc, DACVD
EDITOR: Manon Paradis, DMV, MVSc, DACVD

Poisoning, General Management Client Education
Sheet

BASIC INFORMATION • Individual behavior (some animals routinely known), maximum possible dose ingested,
ingest materials but others seldom do) time elapsed since ingestion, and time
Definition • Poisoning of companion animals is rarely elapsed since clinical signs were first
A poison is a substance that causes death or malicious. observed.
injury when introduced into or absorbed by
a living organism. CONTAGION AND ZOONOSIS PHYSICAL EXAM FINDINGS
Several animals may be affected simultaneously Depends on the poison involved; common
Synonyms by exposure to the same source. categories of signs:
Intoxication, toxicosis • Central nervous system (CNS) alterations
Clinical Presentation
Epidemiology HISTORY, CHIEF COMPLAINT and seizures (e.g., lead, metaldehyde,
organophosphates, carbamates, tremorgenic
SPECIES, AGE, SEX • Key components of the history may include mycotoxins, alcohol, blue-green algae,
• Young animals are more likely to accidentally witnessed exposure, evidence of exposure marijuana, chocolate, ivermectin)
ingest poisonous materials. (e.g., chewed medication container), and • Muscle weakness, paresis, and paralysis (e.g.,
• A cat’s unique metabolism may cause it to characteristic behavior or clinical signs. It coral snakes, black widow spiders, phenoxy
be predisposed to certain toxicoses (e.g., is common for owners to believe their animal herbicides [including 2,4-D], macadamia
acetaminophen, lilies). has been poisoned when it becomes ill for nuts, marijuana)
any reason. A thorough history can help • Acute blindness (e.g., avermectins, salt)
RISK FACTORS establish the likelihood of poisoning. • Oral mucosal lesions (e.g., corrosive acids,
• Lack of supervision • Additional important information may alkalis, cationic detergents, liquid potpourri,
• Access to poisonous materials include the exact nature of the poison (if formaldehyde)

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