Household substance toxic to pets

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Household substance toxic to pets

  1. 1. COMMON HOUSEHOLD SUBSTANCES OF TOXIC POTENTALITY
  2. 2. <ul><li>Household products </li></ul><ul><ul><li>Complex chemical mixtures with multiple active ingredients designed for specific applications. </li></ul></ul><ul><ul><li>Pets at risk </li></ul></ul><ul><ul><li>Essential information to obtain from the owner </li></ul></ul><ul><ul><ul><ul><li>full trade name of the product </li></ul></ul></ul></ul><ul><ul><ul><ul><li>ingredients listed on the product label </li></ul></ul></ul></ul><ul><ul><ul><ul><li>their concentration </li></ul></ul></ul></ul><ul><ul><ul><ul><li>exposure amount </li></ul></ul></ul></ul><ul><ul><ul><ul><li>the duration of exposure, </li></ul></ul></ul></ul><ul><ul><ul><ul><li>progression of clinical signs in relation to the time of exposure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>any treatment or first aid given by the owner before presenting to the vet </li></ul></ul></ul></ul><ul><ul><ul><ul><li>The product container as sample of the suspected agents whenever possible, </li></ul></ul></ul></ul>
  3. 3. <ul><ul><li>Not predictable on the basis of physical and chemical characteristics of the individual ingredient . </li></ul></ul><ul><ul><li>The interactions between ingredients within a single product and between different products when present in combination, which further complicate the toxicological risk assessment. </li></ul></ul><ul><ul><li>Routes of exposure : dermal, oral, ocular or inhalational . </li></ul></ul>
  4. 4. <ul><li>SOAPS AND DETERGENTS </li></ul><ul><li>Hand soaps, shampoos, spray cleaners, dishwashing liquids, powders, laundry products, disinfectants, fabric softeners and sanitizers . </li></ul><ul><li>Soaps: low toxic potential and cause mild gastroenteritis with vomition, </li></ul><ul><li>Rx: </li></ul><ul><ul><ul><ul><li>use of demulcents and diluents: milk , rinsing with water for dermal and ocular exposure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>induction of emesis if soap is non alkaline( noncorrosive), if there is no spontaneous vomition within thirty minutes of ingestion </li></ul></ul></ul></ul><ul><ul><ul><ul><li>symptomatic treatment for diarrhoea and vomition </li></ul></ul></ul></ul><ul><ul><ul><ul><li>maintenance of fluid and electrolyte balance. </li></ul></ul></ul></ul>
  5. 5. <ul><li>Detergents </li></ul><ul><ul><li>phosphates, silicates or carbonates </li></ul></ul><ul><ul><li>. Nonionic, cationic and anionic detergents. </li></ul></ul><ul><ul><li>Nonionic detergents sources : shampoos, dishwash detergents,laundry detergents ) : low order of irritaion and toxicity </li></ul></ul><ul><ul><li>Anionic (alkylsodium sulfate, dishwash detergents, laundry detergents) </li></ul></ul><ul><ul><li>Cationic (benzethenium chloride, benzalkonium chloride, alkyl dimethyl zene,cetirimide, cetyl pyridinium chloride </li></ul></ul><ul><ul><li>sources: fabric softeners, germicides, disinfectants, sanitizers) detergents (Quaternary ammonium compounds) : corrosive , highly toxic . </li></ul></ul><ul><ul><li>Ethanol and isopropanol , which are often found in cationic detergent preparations significantly enhance gastrointestinal absorption and damaged skin favours percutaneous absorption . </li></ul></ul>
  6. 6. <ul><li>Signs </li></ul><ul><ul><ul><li>vomition, diarrhoea, gastrointestinal discomfort, intravascular hemolysis in impaired liver condition, dermal irritation, corneal damage ; Oral-Corrosive damage, salivation, haematemesis, muscle weakness, respiratory and CNS depression, seizures, collapse, comapredominantly seen with cationic detergents. </li></ul></ul></ul><ul><li>Treatment </li></ul><ul><ul><ul><li>Dilution with milk, water, egg white </li></ul></ul></ul><ul><ul><ul><li>Administering act.charcoal </li></ul></ul></ul><ul><ul><ul><li>Saline cathartics, fluids, antibiotic, analgesics and thorough washing the skin with soap and water </li></ul></ul></ul><ul><ul><ul><li>Eye lavage with isothermic isotonic saline for 20minutes . </li></ul></ul></ul>
  7. 7. <ul><li>Shampoos </li></ul><ul><ul><li>Selenium sulfide shampoos have low toxic potential , primarily causing gastroenteritis; treated by gastric decontamination, dilution with egg white, milk, activated charcoal. </li></ul></ul><ul><ul><li>Zinc based ( zinc pyridinethione) antidandruff shampoos are more toxic, resulting in gastroenteritis;retinal detachment on ocular exposure . </li></ul></ul><ul><ul><li>Gastric decontamination; emesis induction, lavage along with IV fluids and thorough eye rinsing with saline is the therapy </li></ul></ul>
  8. 8. <ul><li>CORROSIVES </li></ul><ul><li>Acidic corrosive (HCL,HNO3,H2SO4, H3PO4) product </li></ul><ul><ul><li>Antirust compounds, toilet bowl cleaners, automobile batteries, gun barrel cleaning fluid and swimming pool cleaning agents. </li></ul></ul><ul><li>Alkaline (NaOH, KOH,Na2CO3, NH4OH,KMnO4) products </li></ul><ul><ul><li>drain cleaners, washing products, liquid cleansers and toilet bowl products. </li></ul></ul><ul><li>On dermal and ocular exposure : </li></ul><ul><li>serious burns, extremely painful, corneal/conjuctival necrosis, perforation and opacity which may not be evident immediately. </li></ul><ul><li>On ingestion </li></ul><ul><li>corrosive burns of mucosal membranes appear firstly as milky white or grey, which later turns to wrinkled black. Animal may vocalize or depressed; manifest pain by panting, inability to swallow. Haematemesis, abdominal pain, polydypsia, respiratory distress, shock, secondary pneumonia from aspiration of vapours, gastrointestinal bleeding, perforation and fistula. </li></ul>
  9. 9. <ul><li>CORROSIVES…contd </li></ul><ul><li>Treatment </li></ul><ul><li>Oral dilution with egg white , milk or water </li></ul><ul><li>Skin and eyes thourghly flushed with copious water and sterile saline respectively </li></ul><ul><li>Therapy for shock: IV fluids, steroids within 48 hours, which reduce the fibroblastic activity and inflammation, reduce the stricture from circumferential alkaline burns . </li></ul><ul><li>Analgesics and antibiotics prophylactically in animals with perforations . </li></ul>
  10. 10. CORROSIVES <ul><li>Contraindications </li></ul><ul><li>Attempts to neutralize burns chemically, as exothermic reactions produce elevated local heat and thermal burns. </li></ul><ul><li>Gastric lavage and induction of emesis </li></ul><ul><li>Charcoal is ineffective in binding to caustics </li></ul>
  11. 11. <ul><li>DISINFECTANTS </li></ul><ul><li>QACs, phenol, pine oil, bleaches, alcohols; are more toxic than soaps and detergent compounds </li></ul><ul><li>Phenols </li></ul><ul><ul><ul><li>Highly reactive and corrosive contact poisons </li></ul></ul></ul><ul><ul><ul><li>Nephrotoxic, hepatotoxic and neurotoxic; rapidly absorbed through ingestion, inhalation or skin. </li></ul></ul></ul><ul><ul><ul><li>Cats are highly sensitive to phenolic compounds. </li></ul></ul></ul><ul><ul><ul><li>Sources of phenolic compounds include flooring materials, coal tar, creosote, tar paper. </li></ul></ul></ul><ul><ul><li>Dermal exposure : in intense pain, areas of coagulative necrosis; treated by glycerol, polyethylene glycol washing, thorough rinsing with water , dressings soaked in 0.5% soda bica. </li></ul></ul><ul><ul><li>Ocular exposure : corrosive burns of mouth, oropharynx, oesophagus. vomition, salivation, hyperactivity, ataxia, panting, weakness, tremor, coma, seizures, methhaemoglobinaemia, respiratory alkalosis, L,Kdamage. </li></ul></ul>
  12. 12. <ul><li>DISINFECTANTS…contd </li></ul><ul><ul><li>Treatment : </li></ul></ul><ul><ul><li>Demulcents-milk, egg white, gastric lavage </li></ul></ul><ul><ul><li>Emesis(contraindicated if severe damage) </li></ul></ul><ul><ul><li>Activated charcoal, saline cathartic, </li></ul></ul><ul><ul><li>1% methylene blue, 4mg/kg;IV; ascorbic acid 20mg/kg,PO; N-acetyl cysteine 140mg/kgIV, 70mg/kg PO. q,id for 3 days. </li></ul></ul><ul><ul><li>Ocular exposure is treated by sterile saline wash. </li></ul></ul>
  13. 13. <ul><li>Bleaches </li></ul><ul><li>sodium hypochlorite. Calcium hypochlorite and trichloroisocyanuric acid in industrial strength bleaching solutions ,swimming pool chlorine products and chlorine laundry bleaches. </li></ul><ul><li>Non chlorine bleach preparations or colorfast bleaches contain sodium peroxide, sodium perborate or enzymatic detergents. </li></ul><ul><li>Toxicity is of lower degree </li></ul><ul><li>Irritation of oropharynx, salivation, vomition and abdominal pain. Bleaching of hairs, pulmonary irritation- coughing , dyspnoea and retching on inhalation </li></ul><ul><li>Nonchlorine bleach products, (sodium perborate, sodium peroxide) are alkaline and severe gastric irritatants causing renal damage, CNS excitation. </li></ul>
  14. 14. <ul><li>Treatment </li></ul><ul><li>Milk and water orally </li></ul><ul><li>Washing with soap and rinsing with abundant water/sterile saline on dermal/ocular exposure. </li></ul><ul><li>Induction of emesis and orogastric lavage is contraindicated to avoid the risk of causing further oesophageal irritation. </li></ul><ul><li>Milk of magnesia (2-3ml/kg) can be administered </li></ul><ul><li>symptomatically </li></ul>
  15. 15. <ul><li>Boric acid </li></ul><ul><li>ingredient in ant and roach killers </li></ul><ul><li>Vomition(blue-green vomitus), renal damage, CNS excitation and depression. </li></ul><ul><li>Gastric decontamination with emesis induction </li></ul><ul><li>Gastroprotectants ( activated charcoal is ineffective) </li></ul><ul><li>Cathartics, IVfluid therapy and antiemetics </li></ul>
  16. 16. <ul><li>SOLVENTS AND ALCOHOLS </li></ul><ul><li>Acetone: sources: nail polish remover, varnishes, glues </li></ul><ul><li>Isopropanol ( perfumes,cologne, grooming products ) </li></ul><ul><li>Methanol ( antifreeze products, automotive wind shield clesnser, consumer products ) </li></ul><ul><li>Alcohol (alcoholic beverages, cosmetics, mouthwashes ,common baker’s and brewer’s yeast). </li></ul><ul><li>Act charcoal ineffective in binding to alcohols </li></ul><ul><li>CNS and respiratory depression acidosis, ataxia, hypothermia, cardiac arrest, coma; which is treated by emesis induction, (if < 2 hrs); IV fluid Ringers lactate/ saline solution with NaHCO3(1-3mEq/kg). </li></ul><ul><li>Ethanol reduce severity of methanol poisoning. </li></ul>
  17. 17. <ul><li>Petroleum distillates </li></ul><ul><li>Cyclohexane, alkanes and alkenes. </li></ul><ul><li>sources: gasoline (petrol), kerosene, motor fuels, solvent paints and vehicles for pesticides . </li></ul><ul><li>Because of low surface tension, chance of aspiration is most common . </li></ul><ul><li>Dermal exposure :dermatitis. </li></ul><ul><li>Oral exposure results in aspiration pneumonia, cough, hyperthermia, cyanosis, CNS depression and pulmonary oedema .. </li></ul><ul><li>Emetics and oily purgatives are contraindicated </li></ul><ul><li>Gastric lavage and activated charcoal should be reserved for ingestion of large amount(2ml/kg) or when other toxicants are present . </li></ul><ul><li>Oxygen therapy, rest , flushing the skin and eyes with water and IV fluids </li></ul><ul><li>Other solvents (eg: acetone, turpentine) should not be used </li></ul>
  18. 18. <ul><li>BATTERIES </li></ul><ul><li>Automotive or dry cell batteries: sulfuric acid, that can be irritating on contact with eyes, skin and gastrointestinal tract. </li></ul><ul><li>Sources of small disc/button batteries: in calculators, cameras, hearing aids, watches , the content being mainly mercuric oxide . </li></ul><ul><li>The dry cell batteries: in toy flash lights, contain the alkaline ( NaOH, KOH; alkaline batteries) or acidic compounds (ammonium chloride, manganese dioxide, heavy metals- Li, Ni, Zn, Ag, Cd) </li></ul>
  19. 19. <ul><li>Most of the intact batteries pass through digestive tract within 24 to 36 hours without producing any major adverse effects, except for mechanical obstruction occasionally. </li></ul><ul><li>Gastrointestinal distress may occur resulting from retention and obstruction, which has to be diagnosed by radiography and has to be corrected by endoscopy and surgery </li></ul><ul><li>Chewed and split apart: corrosive damage </li></ul><ul><li>Timely surgical intervention </li></ul><ul><li>Administration of saline cathartics, enemas and appropriate chelation therapy with specific chelating agents if any (eg: DMSA or D-Penicillamine as for Pb), can minimize the corrosive damage caused. </li></ul>
  20. 20. <ul><li>CYANOACRYLATE ADHESIVES ( SUPERGLUE) </li></ul><ul><ul><li>Uncured : an almost instantaneous bond on contact with hair/skin resulting in annoyance and frustration of the animal </li></ul></ul><ul><ul><li>Cured ones are nontoxic upon ingestion </li></ul></ul><ul><ul><li>Treatment </li></ul></ul><ul><ul><li>Dermal </li></ul></ul><ul><ul><ul><ul><li>Soaked with warm soapy water as quickly as possible. and with acetone for several minutes, if area is away from face or eye. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Hairs clipped to reduce the tension on skin. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Surfaces should not be pulled apart, with direct opposing actions </li></ul></ul></ul></ul>
  21. 21. <ul><li>CYANOACRYLATE ADHESIVES …contd </li></ul><ul><ul><li>Ocular : Eyelid/eyeball is thoroughly washed with warm water and Elizabeth collar is applied to prevent self trauma. </li></ul></ul><ul><ul><li>Open eyes on its own with no residual tissue damage within 2-3 days and hence forceful manipulation should not be done. </li></ul></ul>
  22. 22. <ul><li>MATCHES, FIREWORKS AND MOTHBALLS </li></ul><ul><li>Signs manifested with ingestion of about 20 matches ( content: potassium chlorate ). </li></ul><ul><li>An oxidizing agent , cause methhaemoglobinemia. </li></ul><ul><li>KNO3,NaNO2, potassium perchlorate, sulfur, various hydrocarbons) metals(mercury, copper, strontium, barium, phosporous) </li></ul><ul><li>haemorrhagic gastroenteritis, haemolysis , hepatic injury and methhemoglobinemia on ingestion . </li></ul><ul><li>Emesis induction , activated charcoal, saline cathartic and treatment of MethHbnemia is recommended . </li></ul>
  23. 23. <ul><li>OVER THE COUNTER DRUGS </li></ul><ul><li>Cough and cold medications : </li></ul><ul><li>antihistaminics, decongestants, antitussives, expectorants and analgesic . </li></ul><ul><li>Toxicity signs are mainly related to the sedative effects of antihistaminics, in addition to dry mucous membrane, ataxia, salivation and vomition, which are treated symptomatically. </li></ul><ul><li>Signs of sympathetic overstimulation like hyperactivity, vomition, mydriasis, tachycardia, hyperthermia, disorientation and seizures are noticed. </li></ul><ul><li>Treatment involves induction of emesis within one hour of ingestion. </li></ul><ul><li>Tachycardia : beta blocker propranolol, 0.02-0.06mg/kg, slow IV </li></ul><ul><li>Reflex bradycardia controlled by atropine sulphate, 0.02-0.04mg/kg.IV; </li></ul><ul><li>Anticonvulsant, diazepam is given at a total dose of 2.5-10mg, IV. </li></ul>
  24. 24. <ul><li>Methylxanthines </li></ul><ul><li>coffee, tea, chocolates, cola/soft drinks, asthma, analgesic and cold medications. </li></ul><ul><li>Dogs are most commonly poisoned by ingestion of coffee beans, chocolate and tablets. </li></ul><ul><li>Caffeine, theophyllline and theobromine are the primary toxic agents. </li></ul><ul><li>vomition, diarrhoea, polyuria, weakness, hyperexcitability, tremors, seizures, coma and death resulting from cardiac tachyarrhythmias </li></ul>
  25. 25. <ul><li>If ingestion is less than 2 hours, emetics administration </li></ul><ul><li>Activated charcoal and saline cathartic is indicated. </li></ul><ul><li>Since methylxanthines undergo enterohepatic recycling, charcoal should be administered every 3-6 hours until symptoms disappear. </li></ul><ul><li>Antiarrythmics (lidocaine, without epinephrine; 1-2mg/kg,IV- loading dose; 40-60mg/kg/min infusion rate, slow IV- as maintenance dose) or beta blocker(metoprolol; 0.1- 0.3mg/kg,PO,tid) to control arrhythmia </li></ul><ul><li>Diazepam or phenobarbitol to control seizures </li></ul><ul><li>Fluid therapy </li></ul><ul><li>Corticosteroids and erythromycin to be - avoided </li></ul>
  26. 26. <ul><li>Bronchodilators </li></ul><ul><li>β 2 agonists : albuterol, salbutamol, salmetrol, metaproterenol, in the form of tablets, antiasthma.inhalers, nebulisers powder sprays </li></ul><ul><li>Also activate β1 receptor in heart and CNS. </li></ul><ul><li>Anxiety, vomition, tachycardia, ventricualr arrhythmia, muscle weakness, twitching, anxiety and hypokalemia. </li></ul><ul><li>Emetics and adsorbents (2 hours of exposure ) </li></ul><ul><li>Diazepam/ acepromazine for- muscle twitching </li></ul><ul><li>IV fluids </li></ul><ul><li>Potassium , β1 blocker propranolol(0.1-1mg/kg,tid,IV ) </li></ul>
  27. 27. <ul><li>Aspirin </li></ul><ul><ul><li>CNS depression, anorexia, vomiting, gastric hemorrhage, haematemesis , toxic hepatitis, anemia, bone marrow hypoplasia, hyerpnea hyperthermia, hyperglycemia, and glycosuria. </li></ul></ul><ul><ul><li>Treatment is by GI decontamination with emetics, activated charcoal and cathartics, within 4 hours of ingestion . </li></ul></ul><ul><ul><li>Acid-base imbalance is corrected witha slow infusion of sodium bicarbonate, carefully monitored and adjusted to avoid pulmonary edema being developed </li></ul></ul><ul><ul><li>The resulting hyperthermia should be controlled by external cooling; the use of antipyretic drugs should be avoided . </li></ul></ul>
  28. 28. <ul><li>Paracetamol </li></ul><ul><li>Dirty brown colored gums, dyspnoea, haematuria, jaundice ,facial and paw edema , cyanosis, hypothermia, and vomiting. </li></ul><ul><li>Less common signs include coma, generalized weakness, and death </li></ul><ul><li>If ingestion is less than 2 hours, emetics, activated charcoal and saline or osmotic cathartic are indicated. </li></ul><ul><li>If severe cyanosis is present, oxygen therapy should administered, and the animal should be subjected to as little stress as possible . </li></ul><ul><li>IV Administration of acetylcysteine, 140mg/kg/hr for 7 hours; Ascorbic acid, 30 mg/kg orally to reduce methemoglobinemia to Hb . </li></ul><ul><li>Supportive care including fluid therapy for possible metabolic acidosis is also recommended . </li></ul><ul><li>The other drugs used for NSAID toxicosis include ranitidine,omeprazole,metoclopramide, sucralfate and misoprostol </li></ul>
  29. 29. <ul><li>Benzoyl peroxide </li></ul><ul><li>Many OTC antiacne prerparations. </li></ul><ul><li>Exposure results in H2O2 production </li></ul><ul><li>Gastroenteritis, gastric dilatation, dermal irritation and blistering. </li></ul><ul><li>Gastroprotectants and antiemetics are indicated and emesis should not be induced. </li></ul><ul><li>Xylitol </li></ul><ul><li>a sweetener used in sugar free products, chewing gums </li></ul><ul><li>induce hypoglycaemia by stimulating insulin secretion </li></ul><ul><li>weakness, ataxia, seizures and collapse . </li></ul><ul><li>Inducing emesis ,administering activated charcoal, 50% dextrose IV and liver tonics </li></ul>
  30. 30. <ul><li>INSECTICDES </li></ul><ul><li>Amitraz </li></ul><ul><ul><li>Ingestion of a tick collar. </li></ul></ul><ul><ul><li>Ataxia, bradycardia, CNS depression, vomition, diarrhoea, and seizures. </li></ul></ul><ul><ul><li>Decontamination ( emesis, activated charcoal, saline cathartic) </li></ul></ul><ul><ul><li>Repeated injections of yohimbine ( 0.1mg/kg.IV) or atepamizole </li></ul></ul><ul><ul><li>Physical retrieval of the collar through endoscopy. </li></ul></ul><ul><ul><li>Atropine has to be avoided as it may increase the absorption. </li></ul></ul>
  31. 31. <ul><li>FERTILISERS </li></ul><ul><ul><li>Composed of urea or ammonium salts, phosphates, nitrates, potash and metal salts </li></ul></ul><ul><ul><li>vomition, diarrhoea, metabolic acidosis, diuresis, electrolyte disturbances: hyperkalemia, hyperphosphatemia, hyperammonemia and hyperosmolarity. (nitrate/nitrites cause formation of methhemoglobin) </li></ul></ul><ul><ul><li>Treatment is symptomatic with milk, egg white, water, emesis induction, gastric lavage </li></ul></ul><ul><ul><li>Antiemetics, IV fluid to control hydration, electrolyte imbalance and blood pressure. </li></ul></ul>
  32. 32. <ul><li>GRAPES </li></ul><ul><ul><li>Toxic to dogs. </li></ul></ul><ul><ul><li>Vomition, diarrhoea(( with visible grapes in fecal matter), hypertension, lethargy appear within 24 hours of ingestion </li></ul></ul><ul><ul><li>Signs of ARF (polyuria, polydipsia,vomition) and anuria. </li></ul></ul><ul><ul><li>Treatment : gastric lavage, gastroprotectants, antiemetics with repeated doses of activated charcoal </li></ul></ul><ul><ul><li>Calcium channel blockers (diltiazem; 0.5-1.5mg/kg, PO,q8h; verapamil, 0.05mg/kg,IV, every 30 min) to control hypertension </li></ul></ul><ul><ul><li>IV fluid therapy for maintaining renal perfusion. </li></ul></ul><ul><ul><li>In cases of severe oliguric or anuric renal failure, dopamine, furosemide and mannitol can be useful in increasing urine output along with peritoneal or hemodialysis. </li></ul></ul>
  33. 33. <ul><li>ONIONS AND GARLIC </li></ul><ul><ul><li>Sulfoxide compounds that cause oxidative damage of RBCs </li></ul></ul><ul><ul><li>Anemia, methhemoglobinemia and intravascular hemolysis , manifestd by tachypnea, tachycardia, vomition, diarrhoea, pale mucous membranes,weakness, haemoglobinuria. </li></ul></ul><ul><ul><li>IV fluid diuresis, induction of emesis, gastric lavage, activated charcoal and cathartic administration are indicated, with blood transfusion in case of severe anaemia. </li></ul></ul><ul><ul><li>OTHER Non toxic </li></ul></ul><ul><li>Silica gel packets, lipsticks, ball point pen, chalk, indelible markers, newspapers, water colours, pencil lead(graphite), petroleum jelly, calamine lotion, ink </li></ul>

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