Veterinary and human toxicology
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Paraquat is a restricted use herbicide which is extremely toxic to companion animals when ingested. This report details one incident of malicious poisoning involving 6 dogs. ⋯ Diagnosis was initiated by a modified dithionite spot test on vomitus from 1 dog. Subsequent tissue paraquat levels ranged from non-detectable to 1 ppm.
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beta 2-adrenergic agonists, particularly clenbuterol, are illegally used as growth promoters to obtain lean in meat. Their administration in feedlots can constitute a severe risk for animal welfare and exposes consumers to involuntary drug consumption at pharmacological active concentrations. Reported poisoning episodes have been associated with the consumption of beef liver where clenbuterol residues concentrate. ⋯ Concentrations in the meats ranged from 0.8 to 7.4 mg/kg. These analytical data provided evidence of the seriousness of the poisoning and helped the National Health System identify other possible misinterpreted cases. This case demonstrates that clenbuterol poisoning can also occur after consumption of beef meat other than liver.
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Three outbreaks of Xanthium cavanillesii intoxication occurred in the spring in the State of Rio Grande do Sul, southern Brazil. All outbreaks were observed in paddocks with sandy soils in flood plains along water streams. The paddocks had been under water, and after water withdrawal cattle were introduced to those areas which had seedlings of X cavanillesii and shortage of other forage. ⋯ Clinical signs and gross and microscopic lesions were similar to those observed in field cases. X cavanillesii in the 4-leaf stage with the attached cotyledons was also toxic for cattle and sheep, but the same plant without cotyledons lost its liver toxicity. The lethal dose of cotyledons divided in 5 daily doses was not toxic for cattle and sheep, demonstrating the non-cumulative effect of the plant.
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A 43-y-old Caucasian female applied 4 ounces of dimethyl sulfoxide (DMSO) to her lower abdomen for treatment of interstitial cystitis. Within 24 h she developed fatigue, cyanosis and dyspnea with mild exertion. She sought medical attention 10 d later, at which time initial laboratory tests revealed a methemoglobin level of 47%. ⋯ Repeat analysis the day following admission using an outside lab demonstrated a sulfhemoglobin level of 6.2% and a methemoglobin level of < 0.1%. No prior reports have associated sulfhemoglobin formation with DMSO application. Carbon monoxide-oximetry may falsely identify sulfhemoglobin as methemoglobin; sulfhemoglobinemia should be considered in cases of methemoglobinemia refractory to methylene blue therapy.
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Review Case Reports
Acute caffeine ingestion fatalities: management issues.
Caffeine is used and abused on a daily basis in different beverages, OTC products, and as a prescribed medication. The strength varies widely from negligible in decaffeinated drinks to medicinal grade of 200 mg/tablet. ⋯ However, within a 4-mo period, the Panhandle Poison Center recorded 2 deaths due to caffeine overdose. The abrupt onset of intractable seizures needs to be anticipated in order to appropriately manage the victims and to prevent the adverse outcome.