Intoxications: Phone Conversations Part 2

Intoxications: Phone Conversations
January 25, 2018
Five Things I Wish I Could Tell Myself When Starting Uni
June 20, 2018

This patient presented after owners attempted to induce emesis at home with a salt slurry. The patient arrived cyanotic and seizing. There was severe pharyngeal swelling occluding the upper airways.

Building on from last week’s blog on telephone advise, this is what I advise that owners can do at home if they have been exposed to a toxin. The main routes of exposure are ocular, dermal and gastrointestinal.

  • Ocular
    • Acids and alkalis cause the most severe effects as they can cause ongoing damage sometime after initial contact.
    • Eye irrigation (avoid contact lens solution as this can cause further irritation)
      • Tepid water, saline or distilled water
      • 20 to 30 minutes (ideally)
      • Rinse from medial to lateral to avoid contamination of the other eye
    • Once the eye(s) have been flushed, then recommend for the animal to be taken to the veterinary clinic for further assessment. Corneal ulceration can be difficult to see with the naked eye.

Photo of the patients’ blood gas analysis and electrolyte panel. Note the sodium concentration.

 

  • Dermal:
    • Owners need to take precautions to protect themselves to avoid contact with the toxin.
    • The aim here is to remove as much of the toxin off the skin off their pet without the owners exposing themselves to the toxin
    • The most common method is bathing or rinsing with a mild dish soap in warm water
    • If it is a dry power and it is safe to do so vacuuming off the powders may be trialed unless risk of aerosolsation of the toxin is high
  • Gastrointestinal:
    • Oral exposure: Ideally wearing gloves instruct the owners to wipe the inside of the lips and over the gums using a damp dish cloth to try to remove any toxin remaining on the mucosal membranes. Warn that the pet may try to bite if so stop immediately.
    • Ingested toxins: Whether to induce emesis or not depends on the type of toxin but either way I do not recommend emesis induction to be performed at home. I have seen disastrous effects from salt slurry’s.
    • Emesis induction is most safely performed in a clinical setting and the medications that can be administered are safer and are more effective.
  • Seizures:
    • Nothing can be done at home to stop a seizure. If a toxin is causing a pet to seizure then it is unlikely for the seizures to stop, and will require medications.
    • The pet will need to be brought down immediately.
    • I inform owners to not to try to put their fingers in their pets mouth, as they are very unlikely to choke on their own tongue.
    • Wrap them in a blanket to help prevent injury to the owners – either being bitten or scratched
    • Once in the car, keep the head slightly down as if they do vomit or have large amounts of foam then it is allowed to fall out of the mouth, not build up the back of the mouth and lead to aspiration.

Next week I will be discussing, Gastric Lavage – more harm than good?