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178 Cleaning Products Toxicosis

○ Dermatophytosis: treatment continued 1-3 monthly. Doxycycline 5-10 mg/kg PO q 12h • Subungual SCC
months beyond complete claw regrowth or minocycline (anecdotally) 10-25 mg/kg ○ Locally invasive with low metastatic poten-
VetBooks.ir ○ Malassezia: treatment continued 2-4 weeks • Pentoxifylline 10-30 mg/kg PO q 8-12h ○ The 1- and 2-year survival rates are
and a negative repeat fungal culture from
tial: regional node or distant metastasis in
PO q 12h may be substituted for tetracycline.
< 30% of cases
claw trimmings
until resolution of lesions, then taper the
medication monthly.
beyond clinical resolution
subungual.
○ Topical antifungal products include • Cyclosporine 5 mg/kg PO q 12-24h (Atopica, 95% and 75%, respectively, if SCC is
chlorhexidine, miconazole, clotrimazole, Neoral) until resolved, then taper to lowest • Subungual melanomas
terbinafine, enilconazole, or lime sulfur. frequency that controls relapse of clinical ○ Good if localized; poor if metastasized.
• SLO signs About 50% of dogs die because of distant
○ Prednisone/prednisolone 2-4 mg/kg PO q • Azathioprine 1.5-2.2 mg/kg q 24-48h (dogs metastasis.
24h induction to halt inflammation/pain; only) as a glucocorticoid-sparing agent
weaning based on a favorable response • Onychectomy (P3 amputation) as a last resort PEARLS & CONSIDERATIONS
• Subungual SCC
○ Post-staging amputation of the affected Nutrition/Diet Comments
digit to the proximal interphalangeal level Commercial diets enriched with fatty acids may • When re-evaluating the claws, look for
○ SCC is locally invasive and metastasis help improve the integrity of the claw. normalization of growth patterns at the base
rate is low; no need for chemotherapy of the claw; growth of a new claw will take
or radiation therapy PROGNOSIS & OUTCOME weeks (roughly 1 mm/week).
• Subungual melanoma • With SLO, taper immunomodulatory
○ Radical surgical excision of malignant • Bacterial claw infections medications gradually, and treat for several
and benign-appearing areas to achieve ○ Generally good for complete resolution months beyond clinical resolution.
tumor-free margins ○ Response may be influenced by any
○ Follow-up chemotherapy, immunotherapy, underlying cause. Prevention
or radiation therapy (p. 644) • Onychomycosis Routine claw care will result in early detection
○ Prognosis is good to guarded because of claw disorders.
Chronic Treatment of incomplete resolution in dermato-
SLO: various combinations of these treatments phytic onychomycosis. May require P3 Technician Tips
are used based on individual response and amputation or pulse antifungal therapy Shortening claws using a claw file or Dremel
tolerance: for life tool tends to be more readily accepted by pets
• Omega-3 fatty acids 36 mg/kg PO q 24h ○ Prognosis for Malassezia infection is good with fragile claws.
and omega-6 fatty acids 500-1000 mg PO if underlying cause is addressed.
q 24h for a minimum of 3 months, then as ○ Response may be influenced by any Client Education
maintenance therapy underlying cause. Use patience—claws grow slowly.
• Vitamin E 10-20 IU/kg PO q 8-12h for a • SLO
minimum of 3 months or longer if improved ○ Chronic and recurrent problem if not SUGGESTED READING
• Biotin 5 mg/kg PO q 24h for a minimum treated Miller WH, et al: Diseases of eyelids, claws, anal
of 3 months or longer if improved ○ Clinical improvement is usually seen sacs, and ears. In Muller & Kirk’s Small animal
• Elimination diet for 8-12 weeks to rule out within 3 to 4 months; if not, change dermatology, ed 7, St. Louis, 2013, Elsevier
adverse food reaction as a trigger therapies. Saunders, pp 724-733.
• Tetracycline and niacinamide 500 mg of ○ Claw regrowth is good, although claws AUTHOR: Adam P. Patterson, DVM, DACVD
each for dogs > 10 kg; 250 mg of each for may be slightly deformed or friable. EDITOR: Manon Paradis, DMV, MVSc, DACVD
dogs < 10 kg PO q 8h until improvement ○ Refractory cases may require P3
(2-3 months), then taper the medication amputation.

Cleaning Products Toxicosis

BASIC INFORMATION Clinical Presentation • Ocular exposure: corneal ulcer, conjunctivitis/
blepharitis (phenol, pine oil, cationic detergents)
Definition HISTORY, CHIEF COMPLAINT • Distinct smells: bleach, pine oil
Accidental exposure (dermal, oral, or ocular) of • Observed or suspected exposure to a house-
pets to household cleaning products, including hold cleaning product Etiology and Pathophysiology
soaps, detergents, bleaches, and disinfectants. • Onset of signs can be rapid (minutes to a Source:
Bleaches are discussed in greater detail on few hours) or delayed by 6-12 hours. • Soaps are salts of fatty acids made by the
p. 13. reaction of alkali with fatty acids.
PHYSICAL EXAM FINDINGS • Detergents are surfactants in combination
Epidemiology • Hypersalivation, vomiting, diarrhea, oral with inorganic ingredients such as phos-
SPECIES, AGE, SEX ulcers (phenol, cationic detergents), lethargy, phates, silicates, or carbonates. They are
• Dogs more commonly involved than cats depression, hyperthermia classified as nonionic, anionic, cationic, or
• Cats more sensitive to cationic detergents, • Respiratory depression, dyspnea (cats), zwitterionic according to their charge present
phenol (due to poor glucuronidation), and abnormal respiratory sounds, aspiration in solution. The classification depends on
pine oil–containing products (pine oil) the active ingredient.

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