Issue #28
Meet the Toxicology Team:
Dr Andrea Morden-Moore, DVM
I am originally from New Mexico, and spent my formative years in the West
(Colorado, Wyoming, and Montana). I moved to the Midwest in high school
and have been in Illinois since 1972. I attended the University of Illinois in
the early 70's with the intention of attending veterinary school. I instead got
my Master's degree in Ecology and spent 20 years working for the University
or allied agencies in biological/ecological research. I went back to school to
get my Veterinary degree at, you guessed it- University of Illinois, and
graduated in 2001. I was in private practice (small animal, including exotics)
for 7 years in the surrounding area. I live in Springfield and have seven
dogs, five of whom are rescues, many birds, guinea pigs, hamster, and a koi
pond. I've been married for twenty-eight
years; my husband is a professor in forensics and pathobiology at
Parkland College.
Whitney Murray, CVT
I was born and raised in St. Mary’s, Ohio. I had a passion for music and
a love of animals from a young age. After high school, I went off to the
College of Wooster with the intent of becoming a concert pianist.
However, I quickly discovered that I couldn’t see making a living as a
starving musician, so I went back home to
figure out what I wanted to do with myself.
After working for a while, and becoming a certified dog trainer, I decided to
go back to college full time, and become a Vet Tech. I completed my
associate’s degree program at Bradford School in Columbus, Ohio in
December of 2007. I came to the APCC in March of 2008, and I now reside in
Urbana with my boyfriend Jon, my cat Kidy, and my shih tzu, Chandler.
Emily Paulin, CVT
I was born & raised in Chicago, IL. After graduating from high school, I moved from the north side of
the city to the south side to attend the Illinois Institute of Technology to study engineering. After 2
years, I had a change of heart, and my love for animals took me even further south to the Vet Tech
Institute in Tinley Park, IL. During my last semester there, I had to complete a class project
researching a prospective employer, which is how I learned about the ASPCA Animal Poison Control
Center. From there, I was determined to start my veterinary career with the ASPCA APCC, and in
August, I landed a job working on the hotline. This lead me even further south to Champaign, Illinois,
where I live with my 4 cats, 2 brussels griffon mix dogs, 2 guinea pigs, and last but not least, my
fiancé, Rick.
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Who’s New at the Poison Center
We are pleased to announce our newest toxicology team members: Dr Laura Stern and Dr Maja Vito
who each started in May as a Consulting Veterinarian in Clinical Toxicology.
What’s New on Our Website: Visit the ASPCA’s Virtual Pet
Behaviorist!
The ASPCA is excited to announce that this innovative tool for pet
parents, veterinary professionals and others interested in animal
behavior is now live at http://www.aspcabehavior.org/.
Ask the Virtual Pet Behaviorist provides 24/7 behavior advice
from our nationally recognized team of experts. Have a burning
question at 2 a.m. about why your cat is urinating out of the litter
box? No problem! Simply enter your pet’s information and behavior
problem into our user-friendly database, and you’ll receive step-bystep advice right from the comfort of your home- beginning first
with a recommendation to work with your local veterinarian to first
rule out any potential health problems that may be related to to the
pet’s behavior.
Did you know?
We are now in the final stages of having a check-by-phone option available soon for the convenience
of your clients. We are hoping to have the system in place by late summer or early fall. Look for more
details coming soon!
Reminder: The 900 number was discontinued as of January 2009.
Summer Hazards for Pets
Summer brings days of fun in the sun, but summer can also bring
hazards to our pets. Lawn and garden products, toxic plants and
mushrooms, and other outdoor hazards such as charcoal lighter
fluid and pool chemicals, can pose problems if pets get into them.
Below is a list of relative toxicity of various summer hazards to
which a pet may be exposed.
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Low Toxicity: (may cause gastrointestinal upset, but unlikely to cause serious problems unless very
large amounts are ingested)
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Glow jewelry
N-P-K fertilizers (no added insecticide or herbicide; iron level <1%)
Bone meal (no added insecticide or herbicide)
Mosquito coils (foreign body potential from coil material)
Mosquito Dunks (Bacillus thuringiensis)
Charcoal briquettes (unused, no added lighter fluid)
Termite stakes, ant baits, yard insecticides, and roach baits containing sulfluramid (N-ethylperfluorooctanesulfonamide) or hydramethylnon (2% or less)
Moderate toxicity: (may cause significant signs beyond mild gastrointestinal upset)
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Charcoal lighter fluid
Moldy items from trash, yard or compost pile (tremorgenic mycotoxins)
Diazinon or chlorpyrifos (Dursban) granules (>2%)
DEET-containing insect repellants
Citronella lamps/torches
Spring blooming bulbs (see our website under Publications for more information)
High toxicity: (potential for very serious or life-threatening signs)
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Pool chemicals (concentrated hypochlorites, cationic detergents)
Metaldehyde containing snail/slug baits
Zinc phosphide-containing systemic insecticides
Methomyl-containing fly baits
Disulfoton-containing insecticides (found in some rose and flower care products)
Rodenticides (anticoagulants, bromethalin, cholecalciferol)
Practice Tips
Looking for additional ways to expand your knowledge in clinical toxicology? The ASPCA Animal Poison
Control Center offers 2 to 4 weeks externships to veterinary students and graduate veterinarians.
Please contact Dr Tina Wismer (twismer@aspca.org) for further information.
When calling us, our triage sheet(.pdf) can be helpful in collecting the information we need to assist
you with a poisoning case. Copies may be printed and kept next to the phone.
Toxicant Update Atomoxetine
Atomoxetine is a selective norepinephrine reuptake inhibitor that is
used to treat Attention-Deficit/Hyperactivity Disorder (ADHD). The
trade name for atomoxetine is Strattera. The exact mechanism by
which atomoxetine produces its therapeutic effects in ADHD is
unknown. It is thought to enhance noradrenergic function via
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selective inhibition of the presynaptic norepinephrine transporter. This medication stimulates the
cardiovascular system and central nervous system. This drug is rapidly absorbed orally (usually in 30
minutes to 2 hrs) from the gastrointestinal tract and signs can include: vomiting, tachycardia,
disorientation, agitation, vocalization, hypertension and tremors. Signs will typically last 12-24 hours.
Doses of concern in dogs are about 2-3 mg/kg and any amount in a cat is a concern. Treatments
typically include emesis (in asymptomatic patients very soon after the ingestion and without
precluding health problems), activated charcoal, vitals monitoring, fluids, and using valium for tremors
and possibly vasodilators (nitroglycerine, etc) if needed.
Case Study: Alpha Lipoic Acid
History: Owner accidentally gave her cat her own medication (250 mg alpha lipoic acid), instead of his
prescribed antibiotic. This is a 3 year old, 11 pound, MC, DMH named Toby. The exposure was one
hour ago. Owner called because the cat vomited.
1. Your CVT calls The ASPCA Animal Poison Control Center, and reaches Dr. Judy Holding who makes
which of the following recommendations?
a. This is an antioxidant. Antioxidants are safe across the board, so further signs are not expected.
b. Vomiting should be induced at home by owner. Call back with emesis results.
c. Monitor at home for other signs. If signs other than vomiting occur, bring the cat in.
d. Bring cat into the clinic immediately
2. When the cat arrives at the clinic, the cat is ataxic. Which of the following may explain why the
patient is ataxic?
a. He’s probably just a little wobbly because he vomited
b. High potassium
c. Low glucose
d. High glucose
3. Dr. Holding has you check the glucose and it is low. Besides ataxia and hypoglycemia, hat other
signs will Dr. Holding recommend you monitor for?
a. Tremors and seizures
b. Acute renal failure
c. Liver failure
d. All of the above
e. Only two of the above
Answers to questions above:
1. d
2. c
3. d
Alpha lipoic acid (thioctic acid) is used to treat amanita poisoning, diabetes, HIV, diabetic
polyneuropathy, cataracts, and glaucoma. It is very readily absorbed, and accumulates in tissue. In
cats, it is highly protein bound. The therapeutic dose used in dogs is up to 200 mg/day, and cats 1-5
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mg/kg, with a maximum of 25 mg/day. The oral LD50 in dogs is 400-500 mg/kg. In cats, 13 mg/kg is
the minimum toxic dose. The Minimum Lethal Dose in dogs based on APCC data is 331 mg/kg. Cats
are ten times more sensitive than other species.
Expected clinical signs include hypersalivation, vomiting, ataxia, tremors, and hypoglycemia. We could
also potentially see seizures, elevated liver enzymes, and acute renal failure.
4. Based on the potential for signs, what treatment recommendations will Dr. Holding make for this
patient?
Answer: Treatment consists of decontamination if appropriate. Since cat is symptomatic,
decontamination would not be recommended. Monitor glucose, liver enzymes, renal values and
electrolytes. IV fluids should be started in symptomatic patients. IV dextrose may be needed for
hypoglycemia. Sam-E and milk thistle, and/or N-acetylcysteine may be indicated for liver support.
Symptomatic and supportive care may include controlling vomiting, tremors, seizures.
Veterinary Lifeline Partner Program
If you are not a member of the Veterinary Lifeline Partner Program and would like to join,
sign up here or call (888) 332-3651 to be prepared for any poison emergency.
Authors:
Linda Dolder, DVM, APCC Consulting Veterinarian in Clinical Toxicology
Sharon Welch, DVM, APCC Consulting Veterinarian in Clinical Toxicology
Editor:
Sharon Gwaltney, DVM, PhD, DABT, DABVT, Vice President/Medical Director
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