Don't sweat it! Toxicology cases that can be handled at home (Proceedings)


Don't sweat it! Toxicology cases that can be handled at home (Proceedings)

First, a word of caution.... Assess each individual situation carefully and remember that anything can be dangerous in the right quantity (even water). Also, consider health status of patient. Once you take all these into account, there are many exposures that you may be able to talk clients through managing at home.

Silica Gel packets are commonly ingested or chewed on by dogs. Silica gel is considered chemically and biologically inert. When silica gel is ingested, mild GI signs are possible. There is the potential for a foreign body obstruction if the whole packet is eaten.

Oxygen Absorbers are found in packaged foods. They contain iron powder, sodium chloride and carbon. By the time they are eaten by your patient the iron powder has been converted to ferric oxide (rust). The risk is for GI upset and irritation and foreign body obstruction is possible. Systemic iron toxicity is not likely. You can recommend giving MgOH to bind with the iron and monitor for more than mild GI signs (diarrhea can develop from MgOH).

Ant and Roach Traps contain multiple active ingredients including chlorpyrifos, sulfluramid, fipronil, propoxur, boric acid, and hydramethylnon at very low concentrations. These are not likely to cause any significant clinical effects. Bait containing avermectins and arsenic are potentially more serious (avermectins in Collie breeds or dogs with microfilaria and arsenic in cats). Baits also contain inert ingredients such as peanut butter, breadcrumbs, sugar and vegetable or animal fats to attract the insects. These may cause GI upset and the plastic or metal may pose a foreign body hazard.

Birth Control Pill packets contain 21 tablets of estrogen and/or progesterone and possibly 7 placebo pills. The hormone pills contain low estrogen levels <0.04 mg/tablet and some oral contraceptives contain iron. The levels of concern for estrogen are dosages > 1mg/kg (which could lead to bone marrow suppression) and for iron are dosages > 20 mg/kg (which could lead to iron intoxication). These levels are not often reached by ingestion of birth control pills. If a 25 lb (11.4 kg) dog eats 21 days worth of pills, the dosage is 21 x 0.04 mg/tablet = 0.84 mg. 0.84 mg divided by 11.4 kg = 0.07 mg/kg. So we wouldn't be worried in this dog until he ingested 1 mg/kg or 300 tablets! The ingestion of plastic could cause a gastrointestinal foreign body. NuvaRing® is a contraceptive intravaginal insert containing 11.7 mg of etonogestrel (a progesterone) and 2.7 mg of ethinyl estradiol (an estrogen). Ingestion of this product rarely reaches 1mg/kg, the level of concern for estrogen but can present a possible foreign body risk.

Soaps and Anionic/Nonionic Detergents are found in many bar soaps, hand dishwashing detergents and many household cleaners. They are GI irritants. No corrosive injury or systemic effects are expected with ingestion. Treatment included symptomatic and supportive care.