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605 Toxicology > Renal Toxicants > Flashcards

Renal Toxicants Flashcards

1
Q

Renal toxicants typically affect what part of the kidney?

A

the collecting ducts

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2
Q

Where might you find ethylene glycol?

A

anti-freeze, de-icers, brake fluids, condensers/heat exchangers, paints, pen inks

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3
Q

Ethylene Glycol Mechanism of Action

A

as it breaks down, produces metabolites that affect the brain and the kidney, leading to acidosis, renal tubular injury, and hypocalcemia

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4
Q

3 Stages of Ethylene Glycol Intoxication

A
  1. Inebriation
  2. Cardiopulmonary
  3. Renal Failure
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5
Q

Stage 1 Ethylene Glycol Intoxication Signs

A

ataxic, disoriented, stuporous, PUPD, seizure/coma, death

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6
Q

Stage 2 Ethylene Glycol Intoxication Signs

A

tachycardia, tachypnea, pulmonary edema, seizures, depression

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7
Q

Stage 3 Ethylene Glycol Intoxication Signs

A

anorexia, vomiting, abdominal pain (kidneys), oral ulcers, oliguria/anuria

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8
Q

Oliguria

A

production of abnormally small amount of urine

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9
Q

What kind of crystals can be formed by ethylene glycol toxicity?

A

calcium oxalate crystals (only in about 40% of cases)

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10
Q

Are clinical signs the same at every stage of ethylene glycol toxicity?

A

no

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11
Q

Ethylene Glycol Diagnostics

A

spot tests (fast), abnormal osmolar or anion gap at certain times after ingestion, fluorescence of urine or stomach contents

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12
Q

Ethylene Glycol Toxicity Treatment

A

Known, Recent - emesis and lavage
administer IV fluids, give sodium bicarbonate, give ETHANOL (Everclear!) or fomepizole (more expensive, not for cats)

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13
Q

Cholecalciferol (Vitamin D) Toxicity Mechanism of Action

A
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14
Q

Common Cause of Vitamin D toxicity?

A

rodenticides, multivitamins, plants (Florida)

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15
Q

Consequences of Vit D Toxicity

A

increase in serum calcium and phosphorus
soft tissue mineralization (irreversible)
renal failure

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16
Q

Why is the toxic dose of cholecalciferol low in dogs compared to what was tested?

A

because the contraction of bile duct results in release of bile acids and then reabsorption into the system

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17
Q

Clinical Signs of Cholecalciferol Toxicity

A

weakness, lethargy, anorexia, PUPD, [bloody] vomit, oliguria/anuria, azotemic, calcification of renal tubules and other highly vascular tissues

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18
Q

3 Methods of Decontamination of Cholecalciferol

A
  1. Emesis
  2. Activated charcoal with cathartic
  3. Cholestyramine
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19
Q

Cholestyramine

A

an anion exchange resin that binds bile acids in the intestine, therefore preventing their reabsorption

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20
Q

Treatment for Cholecalciferol Toxicity

A
  1. Normal Saline (Na to compete with calcium)
  2. Furosemide (loop diuretic to inc. calcium excretion)
  3. Prednisolone (stop calcium from being pulled from the bone, decrease intestinal absorption, inc. renal excretion of calcium)
21
Q

Bisphosphonates

A

best thing to give if calcium continues to rise in calciferol intoxication; affects the osteoclasts and osteoblasts so stops bone resorption

22
Q

How long should a dog with rodenticide toxicity be monitored daily?

A

a MINIMUM of 5 days!

23
Q

Ethylene Glycol Prognosis?

A

guarded

24
Q

Cholecalciferol Prognosis?

A

good if caught early, decreases with prolonged elevations of Ca and P

25
Q

NSAID Toxicity Mechanism of Action

A

TL;DR causes inhibition of protective prostaglandins

rapid absorption and metabolized by the liver, creating toxic metabolites; can also undergo enterohepatic recirculation

26
Q

Clinical Signs of NSAID Toxicity

A

ulceration, inc. acid and dec. bicarbonate, thin GI wall, renal failure (secondary to reduced blood flow), CNS signs

27
Q

Why might large doses of NSAIDs cause acidosis?

A

most of them are weak acids!

28
Q

Treatment for NSAID Toxicity

A

emesis, AC with cathartic, GI protectant (like sucralfate and omeprazole), IV fluids

29
Q

NSAID Toxicity Prognosis?

A

good (with aggressive tx); still risk of gastric bleed/perforation which would decrease prognosis

30
Q

Examples of Soluble Oxalate Plants

A

shamrock, rhubarb, beets, spinach, dock, greasewood

31
Q

Soluble Oxalate Mechanism of Action

A

highly water soluble so absorbed in the gut and combine with calcium in the blood causing severe hypocalcemia

32
Q

Clinical Signs of Soluble Oxalates

A

HYPOCALCEMIA, dullness, bloat, teeth grinding, twitching, excessive salvation, ataxia, depression, weight loss, death; also calcium oxalate crystals

33
Q

What species are grapes and raisins toxic to?

A

DOGS and only dogs

34
Q

How quickly do grapes cause renal failure?

A

within 72 hours

35
Q

Toxin in Grapes?

A

tartaric acid

36
Q

Clinical Signs of Grape/Raisin Ingestion

A

vomiting/diarrhea, depression, dehydration, anorexia, abdominal pain

37
Q

Treatment for Grape/Raisin Ingestion

A

emesis, activated charcoal (if large amount), IV fluids, and monitor renal values, and keep the dog peeing!

38
Q

What species is susceptible to lily toxicity?

A

CATS and cats only

39
Q

What is the toxin in lilies?

A

no one actually knows - it’s a water-soluble toxin

40
Q

Do all lilies cause renal failure?

A

NO - only Lilium and Hemerocallis spp.

41
Q

Lilium spp.

A

Easter, Tiger, Rubrum, Japanese Show

42
Q

Hemerocallis spp.

A

Day lilies

43
Q

Clinical Signs of Lily Toxicity

A

vomiting, increase in BUN/creatinine, phosphorus and potassium, casts, protein/gluco/isosthen-urias, oliguria/anuria

44
Q

4 Signs of Bracken Fern Toxicity

A
  1. Aplastic anemia
  2. Enzootic bovine hematuria
  3. Upper digestive tract tumors
  4. Thiaminase?
45
Q

Urinary tract neoplasms

A

caused by bracken fern poisoning in ruminants; aka Red Water Disease

46
Q

Main species affected by blister beetles?

A

Horses (in the hay), but sometimes cattle and sheep

47
Q

cantharidin

A

strong vesicant found in the hemolymph and genitals of the beetle –> causes blisters

48
Q

Signs of Blister Beetle Ingestion

A

ulcers in GI and urinary tracts; depression, anorexia, discomfort, restlessness, tachycardia and tachypnea - so essentially colic, then shock, acidosis and death

49
Q

Synchronous Diaphragmatic Flutter

A

a “hiccup” with each heartbeat and muscle fasciculations sometimes seen in horses who have ingested blister beetles due to hypocalcemia and hypomagnesemia

605 Toxicology (9 decks)

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