Diabetes mellitus associated with autonomic and peripheral neuropathy after Vacor rodenticide poisoning: a review.
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A moribund, emaciated California quail (Callipepla californica) that was found in an orchard in the state of Washington had an impacted crop and gizzard. Pellets containing the anticoagulant chlorophacinone (Rozol, RO) were in the crop; the gizzard contents consisted of a pink mass of paraffin that was selectively accumulated from the paraffinized pellets. The plasma prothrombin time of 28 sec was near that determined for control quail. The signs of RO intoxication seen in the moribund wild quail were duplicated in captive quail given ad libitum diets of either RO or another paraffinized chlorophacinone pellet (Mr. Rat Guard II, MRG). This left little doubt that paraffin impaction of the gizzard was the primary problem. All captive quail fed RO or MRG pellets showed no increases in prothrombin times compared to control values, died in an emaciated condition, and had gizzards impacted with paraffin.
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A 71-year-old man presented with a recurrent bleeding diathesis requiring frequent blood transfusions, vitamin K and fresh frozen plasma. Extensive investigations revealed vitamin K deficiency. After repeated interviews the patient admitted to deliberately ingesting rat poison. Superwarfarins are an uncommon cause of deranged clotting and specialised tests are available to identify them. They can cause prolonged coagulation abnormalities and may require treatment with oral vitamin K for several months after just a single dose.
The binding properties of 3-(1'-phenyl-2'-acetylethyl)-4-hydroxycoumarine (warfarin-Na) to serum albumin of mice and rats were determined by using the equilibrium dialysis. The binding percentage (beta), the binding capacity (K), and the association constant (K1) were calculated. The results are characteristic for a strong binding of warfarin to serum albumin of rats but only a small one to serum albumin of mice, caused probably by the different albumin structures of these species.
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