McDermott Fergal M, Kan Anne A, Hunault Claudine C, Robben Joris H, de Lange Dylan W, Dijkman Marieke A
Section of Emergency and Intensive Care Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands.
Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, Netherlands.
Front Vet Sci. 2025 Feb 5;12:1528327. doi: 10.3389/fvets.2025.1528327. eCollection 2025.
Soluble thallium salts are highly toxic, with mortality rates exceeding 70% in animals compared to 6%-15% in humans. Early identification of thallium intoxicated patients and decreasing the toxic load by targeted treatment using Prussian Blue are associated with a better outcome in humans. Prussian blue, however, is rarely available or used in veterinary settings. Here we present a rare report of the successful use of Prussian Blue in the management of a dog with a thallium intoxication. A 5-year-old miniature Schnauzer, ingested a thallium sulfate based rodenticide leading to lethargy, anorexia, regurgitation, abdominal pain, borborygmi, constipation, ataxia, dermatitis and progressive alopecia. Intervention involved supportive care with subcutaneous fluids, carprofen, butylscopolamine and dexamethasone in combination with targeted treatment using the chelating agent Prussian blue (15 days) followed by activated charcoal (4 days). The serum thallium concentration on the 5th day of the Prussian Blue treatment was 196 mcg/L confirming thallium intoxication. The serum thallium concentrations were 20.7 mcg/L and 21.5 mcg/L on days 14 and 34 of treatment, respectively. The calculated elimination half-life during the during PB treatment was 2.8 days. The patient showed gradual improvement over several weeks, achieving full recovery at 11 weeks. This case emphasizes the importance of a timely diagnosis and the early start of targeted therapy using Prussian blue, in the management of thallium intoxication in veterinary patients.
可溶性铊盐具有高毒性，动物的死亡率超过70%，而人类的死亡率为6%-15%。早期识别铊中毒患者并通过使用普鲁士蓝进行靶向治疗来降低毒性负荷，与人类更好的预后相关。然而，普鲁士蓝在兽医环境中很少可得或使用。在此，我们报告一例罕见的成功使用普鲁士蓝治疗铊中毒犬的病例。一只5岁的迷你雪纳瑞犬摄入了一种基于硫酸铊的灭鼠剂，导致嗜睡、厌食、反流、腹痛、肠鸣音、便秘、共济失调、皮炎和进行性脱毛。干预措施包括皮下补液、卡洛芬、丁溴东莨菪碱和地塞米松的支持治疗，以及使用螯合剂普鲁士蓝进行靶向治疗（15天），随后使用活性炭（4天）。普鲁士蓝治疗第5天时血清铊浓度为196μg/L，证实为铊中毒。治疗第14天和第34天时血清铊浓度分别为20.7μg/L和21.5μg/L。普鲁士蓝治疗期间计算出的消除半衰期为2.8天。患者在数周内逐渐好转，11周时完全康复。该病例强调了及时诊断和尽早开始使用普鲁士蓝进行靶向治疗在兽医患者铊中毒管理中的重要性。
