Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel.
Department of Small Animal Emergency and Critical Care, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel; Department of Toxicology, Kimron Veterinary Institute, Bet Dagan, 5025000, Israel; Department of Small Animal Internal Medicine, The Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot, 761001, Israel.
Vet J. 2019 Sep;251:105349. doi: 10.1016/j.tvjl.2019.105349. Epub 2019 Jul 31.
Organophosphates (OP) and carbamates are commonly used insecticides and important intoxication sources of humans and animals. Nevertheless, large scale studies of these intoxications in dogs are unavailable. The medical records of dogs presented to a veterinary hospital were reviewed retrospectively. The study included 102 dogs definitely diagnosed with acute OP or carbamate intoxication. The most common presenting clinical signs included muscle tremor, hypersalivation, miosis, weakness, vomiting and diarrhea. Hypersalivation, muscle tremor and tachypnea were significantly (P < 0.05) associated with survival to discharge; while weakness, mental dullness, anorexia, pale mucous membranes and paddling were significantly associated with death. Common laboratory abnormalities included decreased butyrylcholine esterase activity, acidemia, increased total plasma protein, leukocytosis, hypochloridemia, hyperbilirubinemia, increased creatinine and alanine transaminase (ALT), aspartate transaminase (AST) and creatine kinase activities, and prolonged activated partial thromboplastin time (aPTT). Compared to the survivors, the non-survivors showed significantly: higher frequencies of thrombocytopenia, hypocarbemia, prolonged prothrombin time (PT), hypernatremia, hyperkalemia, hypocholesterolemia, hypoproteinemia, hypertriglyceridemia, increased ALT activity and increased urea concentration; lower median concentrations of venous blood bicarbonate, serum chloride and total CO; and higher medians of PT, serum total bilirubin and urea concentrations, and ALT and AST activities. Intoxicated dogs were commonly treated with diphenhydramine, atropine-sulfate, antibiotics, diazepam and pralidoxime, while some (19.2%) required general anesthesia and mechanical ventilation. The survival rate of dogs treated by gastric lavage was higher (P = 0.041) compared to that of the remaining dogs. Development of respiratory failure and mechanical ventilation requirement were significantly associated (P < 0.001) with death. The mortality rate was 17%.
有机磷 (OP) 和氨基甲酸酯类是常用的杀虫剂,也是人类和动物中毒的重要来源。然而,目前缺乏对这些中毒的大规模研究。本研究回顾性分析了一家兽医医院收治的 102 例明确诊断为急性 OP 或氨基甲酸酯类中毒的犬的病历。最常见的临床表现包括肌肉震颤、流涎过多、瞳孔缩小、无力、呕吐和腹泻。流涎过多、肌肉震颤和呼吸急促与存活出院显著相关(P<0.05);而无力、精神沉郁、厌食、黏膜苍白和划桨样运动与死亡显著相关。常见的实验室异常包括丁酰胆碱酯酶活性降低、酸中毒、总血浆蛋白增加、白细胞增多、低氯血症、高胆红素血症、肌酐和丙氨酸转氨酶 (ALT)、天门冬氨酸转氨酶 (AST) 和肌酸激酶活性增加,以及部分凝血活酶时间 (aPTT) 延长。与存活组相比,非存活组的血小板减少、低碳酸血症、凝血酶原时间 (PT) 延长、高钠血症、高钾血症、低胆固醇血症、低蛋白血症、高甘油三酯血症、ALT 活性增加和尿素浓度增加的频率显著更高;静脉血碳酸氢盐、血清氯和总 CO 浓度中位数更低;PT、血清总胆红素和尿素浓度、ALT 和 AST 活性中位数更高。中毒犬通常接受苯海拉明、硫酸阿托品、抗生素、地西泮和氯解磷定治疗,部分犬(19.2%)需要全身麻醉和机械通气。接受洗胃治疗的犬的存活率(P=0.041)高于未接受洗胃的犬。呼吸衰竭的发生和机械通气的需要与死亡显著相关(P<0.001)。死亡率为 17%。