Meet Emmie. She presented on Saturday, January 11th to the hospital for lethargy and not eating or drinking for 1 day. She had no diarrhea and her vaccines are current. The pet is not usually one to get into things, but she was out of the client’s sight for a bit a few days prior, and it is possible. On physical exam, pet had an increased respiratory rate and her gums were very pale. Blood work and radiographs were ordered by Dr. Widdel. The blood work showed low platelets and anemia (low red blood cell count). Other blood tests included those for tick diseases (which were negative), and microscopy to rule out immune mediated disease where the body attacks its own red blood cells. Microscopic examination of Emmie’s blood showed that her body was already trying to replace lost red blood cells and there was no cellular evidence of immune mediate disease. Radiographs showed fluid in the chest. The chest was tapped and revealed the fluid in the chest was blood, which did not clot. From these clinical findings, the doctor came up with a tentative diagnosis of rodenticide toxicity (rat/mouse poison). Treatment was started including IV fluids to rehydrate the pet, steroids to help open up airways so she could breathe easier, and Vitamin K to promote blood clotting.
The next morning, her condition was declining; she was having more trouble breathing and the anemia was worse. A repeat radiograph showed fluid in the chest as well as the lungs. A blood transfusion was recommended and the owner consented. Blood was collected from a donor, Dr.Piller’s dog, Elmo. The donor’s blood was transfused into her slowly throughout the day. Patients need to be observed very closely during transfusions to watch for signs of allergic or anaphylactic reaction. By the end of the day, her red blood cell count had increased and her gum color had become a more normal pink color. She also continued to receive IV fluids to keep her hydrated, Vitamin K, and Minocycline (antibiotic to combat any pneumonia that could develop from congestion in the lungs).
By day 3, the pet was showing marked improvement. Her red blood cell count had increased. The patient was more energetic, her respiratory rate was normal, and her gums were pink. Supportive care with IV fluids, Vitamin K, and Minocycline was continued.
On day 4, the patient was much improved; her red blood cell count was nearly normal, and she was discharged from the hospital and sent home with her family to continue to recover. She will be kept on Vitamin K for 30 days and Minocycline for 2 weeks. A recheck appointment is scheduled to make sure she is continuing to return to normal and maintain sufficient cell counts.
Rodenticide is a very common toxicity seen in dogs. The intention is to kill rats and mice by disabling the ability to clot the blood, causing the rodent to bleed to death internally. It has a sweet taste to it, which entices rodents to eat it, but unfortunately is also liked by dogs. It takes approximately 24-48 after ingestion for clinical signs to develop which include: abdominal distention, difficulty breathing, bruising – best seen on hairless areas like gums and under the ears. Though we see rodenticide toxicity year round, it tends to be more common in the Spring when people are opening up their cabins for the summer, or in the Fall when dogs are taken to hunting camp.