Page 2104 - Cote clinical veterinary advisor dogs and cats 4th

Zinc Phosphide Intoxication 1051

damage. Dose adjustments should be made PEARLS & CONSIDERATIONS Technician Tips
accordingly. Comments Label may provide information on the amount
VetBooks.ir Possible Complications • Hypoglycemia can occur at xylitol dosages product. In some cases, the label may be Diseases and Diseases and Disorders Disorders
of xylitol or other sugar-free alcohols in the
of > 100 mg/kg.
necessary because the same brand and similarly
• Coagulopathy secondary to acute liver
failure and/or disseminated intravascular
xylitol.
coagulation • Hepatotoxicity typically occurs at dosages named products may be made with or without
> 500 mg/kg.
• Hepatic encephalopathy (p. 440) • Amount of xylitol in gums and candies varies
• Hyperthermia secondary to seizures widely; sugar-free gums can contain as little Client Education
as 1 mg of xylitol per piece, and some brands Keep xylitol-containing gum, baked goods,
Recommended Monitoring may contain up to 2 g per piece. oral hygiene products, and other sources away
• Monitor blood glucose every 2-4 hours for • Some medications (liquids and chewables), from dogs.
12-24 hours in all patients (whether showing rinses, toothpastes, foods (peanut butter,
overt signs of hypoglycemia or not). barbeque sauce), and throat lozenges may SUGGESTED READING
• Recheck serum biochemistry profile (liver also contain xylitol (variable amounts). DuHadway MR, et al: Retrospective evaluation of
enzyme levels) at 24 hours. If elevated, • Sorbitol, mannitol, erythritol, or maltitol xylitol ingestion in dogs: 192 cases (2007-2012).
monitor until they return to normal. syrup present in some sugar-free products J Vet Emerg Crit Care 25:646-654, 2015.
• Recheck coagulation profile at 24 hours if is not expected to induce hypoglycemia or AUTHOR: Irina D. Meadows, DVM, DABT
liver enzymes elevated. Monitor until return liver damage in dogs. EDITOR: Tina Wismer, DVM, MS, DABT, DABVT
to normal. • Splenda (sucralose), Sweet’n Low (saccharin,
• Neurologic signs of hypoglycemia dextrose, and cream of tartar), and Equal
(aspartame, dextrose, and maltodextrin) do
PROGNOSIS & OUTCOME not contain xylitol.
For dogs with hypoglycemia but no hepatic Prevention
necrosis, prognosis is excellent. Guarded if Keep xylitol-containing products out of reach
hepatic necrosis and coagulopathy develops. of dogs.

Zinc Phosphide Intoxication Client Education
Sheet

BASIC INFORMATION for humans. If handling a phosphine-intoxicated Mechanism of toxicosis:
animal, ensure good ventilation, and contact • Onset of clinical signs in most cases is 15
Definition human poison control (1-800-222-1222) if minutes to 4 hours after ingestion; occasion-
Zinc phosphide is a metallophosphide roden- a human exposure has occurred (see Acute ally delayed up to 18 hours.
ticide available as 0.5%-10% bait. Acute General Treatment below). • Corrosive effects of zinc phosphide can cause
toxicosis occurs from ingestion of bait and is signs of cranial abdominal (gastric) pain and
characterized by vomiting (± blood), lethargy, GEOGRAPHY AND SEASONALITY bloody vomiting.
respiratory distress, muscle tremors, seizures, Increased incidence during greater rodent • Gastric acid hydrolysis of zinc phosphide
and death. activity and mobility after harvest liberates highly toxic phosphine gas, which
is rapidly absorbed by passive diffusion.
Synonyms Clinical Presentation • Phosphine disrupts cellular respiration by
Gopher or mole killer; Zn 3P 2, trizinc di- HISTORY, CHIEF COMPLAINT interfering with electron transport (cyto-
phosphide • History of exposure chrome c) in the mitochondria, leading
• Vomiting with or without blood to cellular hypoxia, generation of reactive
Epidemiology • Agitation, abdominal discomfort oxygen species, and lipid peroxidation,
SPECIES, AGE, SEX • Vocalization, teeth grinding especially in tissues with high oxygen
All species are susceptible; dogs are more • Dyspnea demand.
frequently involved. • Muscle tremors, seizure • Death is from cardiac arrest most commonly
resulting from hypotensive shock, seizures,
GENETICS, BREED PREDISPOSITION PHYSICAL EXAM FINDINGS and pulmonary compromise.
Animals that do not vomit are at greater risk As above, with potential of harsh lung sounds
for toxic effects. and crackles (due to pulmonary edema), cranial DIAGNOSIS
abdominal pain, cardiac arrhythmias, shock,
CONTAGION AND ZOONOSIS slight garlic or rotten fish odor Diagnostic Overview
Public health significance to veterinary person- Tentative diagnosis is based on history of
nel and owners: human inhalation of phosphine Etiology and Pathophysiology exposure and clinical signs because timely
gas can occur during decontamination or Source: testing is not available. Characteristic rotten
spontaneous emesis (risk of pulmonary and • Baits are available as commercial grain-based fish or garlic smell supports diagnosis but
other effects in humans). The typical garlic pellets, tracking powders, or paste (Sweeney’s poses risk of pulmonary toxicosis to humans.
or dead fish odor of phosphine may not be Poison Peanuts Mole and Gopher Bait, Dexol Diagnosis is confirmed by presence of zinc
detectable at low but hazardous concentrations Gopher Killer Pellets, ZP Rodent Bait). phosphide in the stomach contents, liver, or

www.ExpertConsult.com
www
.ExpertConsult.com