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PubMed2000

Aldicarb poisoning.

Aldicarb (2-methyl-2(methylthio) propanal o-[(methylamino)-carbonyl] oxime) is a pesticide manufactured since 1965. This carbamate ester is sold under the tradename, Temik, and is used as insecticide and nematicide. The Environmental Protection Agency has classified aldicarb in the highest toxicity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island, aldicarb is illegally used as a household rodenticide with a widespread risk of poisoning. Our study presents the first review of aldicarb poisoning circumstances associated with clinical and analytical findings. Moreover, the oxime treatment is discussed. Eighteen patients with cholinergic symptoms admitted to the Emergency Unit and two deceased with a history of aldicarb poisoning were included in the study. As agricultural workers, only two of them could legally use Temik. Seventy percent of the patients was managed by the Emergency Mobil Unit. Serum cholinesterase activity was always lower than 30% of the normal range and aldicarb was identified by UV spectra and retention time after liquid chromatography separation. The most common muscarinic effect was diarrhea, the main nicotinic sign fasciculation and almost half of the poisoned patients had central nervous system (CNS) depression (Glasgow Coma Score lower than 8). Four patients had serious conduction abnormalities and two of them died. These results suggest that aldicarb intoxication is always severe. Oxime treatment did not produce side effects and should be recommended whenever the pesticide involved is unknown. Effective measures should be implemented to stamp out the illicit use of aldicarb.

Adolescent↗
PubMed2004

Toxicological features of deliberate self-poisonings.

BACKGROUND: Deliberate self-poisoning (DSP) is a major health problem with increasing incidence mainly among young people. OBJECTIVE: To examine the clinical and toxicological characteristics of DSP, it is compared to unintentional (non-DSP) exposures and those characteristics which might be associated with increased toxicological risk are identified. METHODS: Two-year retrospective poison centre chart review. STATISTICS: chi2 analysis. RESULTS: 3802 DSP cases were reported. Most calls (95%) were made by physicians compared to 51% in non-DSP exposures, P <0.0001. There were almost twice as many females as males, contrary to unintentional exposures (P <0.001). Peak frequency involvement was at the age of 15-20 years for females and older for males. Only 19.8% of DSP calls were made within the first hour of exposure compared to 46% of the non-DSP calls (P < 0.001). Younger patients tended to present earlier. The vast majority of exposures occurred by ingestion and at home. Pharmaceuticals and chemicals were involved in 86% and 12% of DSP cases, respectively (compared to 29% and 44% in non-DSP exposures, respectively, P < 0.001). Psychiatric drugs were more commonly used in older age groups and analgesics among the younger. Insecticides, sodium hypochlorite and rodenticides were the most frequently used chemicals. Neurological involvement was observed in 48.2% of DSP patients compared to 16.9% in non-DSP exposures. DSP was associated with greater severity than non-DSP exposures (21% and 10% had moderate to severe toxicity, respectively, P <0.001). Severity was greater among males, aged older than 45 years, with time from exposure to consultation 8 hours or longer and with exposure to chemicals, psychiatric drugs or combinations. CONCLUSIONS: Most DSP patients were females, aged 15-20 years, used pharmaceuticals and had neurological involvement. Males, aged over 45 years, with longer time to toxicology consult and the use of chemicals were associated with increased severity. These parameters should alert the treating physician to the possibility of a poor course and hence to a more aggressive therapeutic approach.

Adolescent↗
PubMed2005

An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

A retrospective analysis of poisoning calls received by the National Poisons Information Centre showed a total of 2719 calls over a period of three years (April 1999-March 2002). The queries were made on poisoning management (92%) and information (8%) about various products and functioning of the centre. The data were analysed with respect to age, sex, mode and type of poisoning. The agents belonged to various groups: household products, agricultural pesticides, industrial chemicals, drugs, plants, animal bites and stings, miscellaneous and unknown groups respectively. The age ranged from less than 1 to 70 years, with the highest incidence in the range of 14-40 years, with males (57%) outnumbering females (43%). The most common mode of poisoning was suicidal (53%), followed by accidental (47%). The route of exposure was mainly oral (88%). Dermal (5%), inhalation and ocular exposure contributed 7% to the total. The highest incidence of poisoning was due to household agents (44.1%) followed by drugs (18.8%), agricultural pesticides (12.8%), industrial chemicals (8.9%), animals bites and stings (4.7%), plants (1.7%), unknown (2.9%) and miscellaneous groups (5.6%). Household products mainly comprised of pyrethroids, rodenticides, carbamates, phenyl, detergents, corrosives etc. Drugs implicated included benzodiazepines, anticonvulsants, analgesics, antihistamines, tricyclic antidepressants, thyroid hormones and oral contraceptives. Among the agricultural pesticides, aluminium phosphide was the most commonly consumed followed by organochlorines, organophosphates, ethylene dibromide, herbicides and fungicides. Copper sulphate and nitrobenzene were common among industrial chemicals. The bites and stings group comprised of snake bites, scorpion, wasp and bee stings. Poisoning due to plants was low, but datura was the most commonly ingested. An alarming feature of the study was the high incidence of poisoning in children (36.5%). The age ranged from less than 1 to 18 years and the most vulnerable age group included children from less than 1 year to 6 years. Accidental mode was the most common (79.7%). Intentional attempts were also noticed (20.2%) in the age group above 12 years. The present data may not give an exact picture of the incidence of poisoning in India, but represents a trend in our country. The Poisons Information Centre plays a vital role in providing timely management guidelines including the supply of necessary antidotes from the recently established National Antidote Bank, thereby helping to save precious lives.

Adolescent↗
PubMed2006

Calcium gluconate and sodium succinate for therapy of sodium fluoroacetate experimental intoxication in cats: clinical and electrocardiographic evaluation.

Sodium fluoroacetate (SFAC) or Compound 1080 is a potent rodenticide, largely used after 1946 for rodent and home pest control. The toxic effects of SFAC are caused by fluorocitrate action, a toxic metabolite, which has a competitive action with aconitase enzyme, leading to citrate accumulation and resulting in interference in energy production by Krebs cycle blockade. In the present study, domestic cats were intoxicated with oral doses of fluoroacetate (0.45 mg/kg). The intoxicated animals presented emesis, diarrhea with abdominal pain posture and an abdominal palpation, tachypnea, bilateral midriasis, hypothermia, hyperexcitability and convulsions. Blood gas analysis indicated decreased pH and bicarbonate levels. Serum ionized calcium was also decreased. ECG showed non-specific changes in ventricular repolarization and ventricular arrhythmias. The survival rate was 75% in the treated group with calcium gluconate and sodium succinate and 37.5% in the nontreated group.

Animals↗
PubMed1980

Vitamin K deficiency syndromes in warfarin-resistant brown rats (Rattus norvegicus).

Resistance to the anticoagulant rodenticide warfarin and an increased vitamin K requirement appear to be pleiotropic effects of the gene Rw2. A comparison of pup mortality in F2 (Rw1Rw2 x Rw1Rw2) and backcross (Rw1Rw2 x Rw1Rw1 or reciprocal) matings of wild brown rats in the laboratory revealed significantly greater losses in the F2 litters at 4-8 weeks of age. Some deaths could be attributed directly to haemorrhage resulting from vitamin K deficiency. A newborn warfarin-resistant rat from an F2 litter showed bleeding from the umbilicus and the anus, and died from internal haemorrhage at 18 weeks of age. Another warfarin-resistant male rat dying at the same age had a grossly enlarged skull.

Alleles↗
PubMed2006

Knowledge, attitudes and public health response towards plague in Petauke, Zambia.

In 2001, two plague outbreaks were reported in Zambia, one of which occurred in Petauke, Eastern Province, resulting in high morbidity and mortality. Of the community respondents, 43.4% did not know the aetiology of plague. Although rats and fleas were frequently mentioned, many respondents did not know how these were related to plague. Local belief that the plague outbreak was the result of witchcraft was prevalent. Use of rodenticides was not preferred as these were reports of they being used for poisoning people. The public health response was initially slow by both the community and also the formal health sector. Once the diagnosis of plague was made, fears of witchcraft dispelled and collaboration not only between the formal health sector and the community, but also between Zambian health workers and their Mozambican counterparts developed, and it was possible to control the outbreak.

Adolescent↗
PubMed1995

Structure-activity relationship between the hydrophobicity of alkali metal salts of warfarin [3-(alpha-acetonyl-benzyl)-4-hydroxycoumarin] and the effectiveness of the taste response to these salts in mice.

The taste responses to five alkali metal salts of warfarin, aqueous rodenticides, in laboratory mice were observed at a short measurement time of 20 min by the two-bottle preference test using a licking time monitoring system newly developed. It was made clear that the order of taste avoidance to the warfarin salts was as follows: cesium salt > rubidium salt > lithium salt > sodium salt > potassium salt. The relationship between the hydrophobicity of the warfarin salts and the effectiveness of the taste avoidance was analyzed. The effectiveness of the taste avoidance largely depended on the hydrophobicity.

Alkalies↗
PubMed1995

Age-specific carcinogenesis: environmental exposure and susceptibility.

Environmental exposures in children may occur through many routes, including diet, air, and the ingestion of various nonfood items such as medications and household materials. This article focuses on dietary exposure, but it does highlight the importance of considering other routes of exposure when assessing exposure in children. It presents many of the findings in the two recent reports, Pesticides in the Diets of Infants and Children and Science and Judgment in Risk Assessment of the National Academy of Sciences (NAS)/National Research Council (NRC). Diet is an important source of exposure for children to potential carcinogens. The trace quantities of chemicals present on or in foodstuffs are termed residues. In addition, there are substances that children may be exposed to in air and water that should be considered in a total exposure analysis. To minimize exposure of the general population to chemical residues in food, water, and air, the U.S. government has instituted regulatory controls. These are intended to limit exposures to residues while ensuring an abundant and nutritious food supply, and safe drinking water and air. The legislative framework for these controls was established by the Congress through various local and state laws and such federal laws as the Insecticide, Fungicide, and Rodenticide Act (FIFRA), the Federal Food, Drug, and Cosmetic Act (FFDCA), the Safe Drinking Water Act (SDWA), and the Clean Air Act (CAA). This article summarizes current approaches to assessing exposure and susceptibility in children.

Air Pollution↗
PubMed2003

Brodifacoum toxicosis in two neonatal puppies.

Eight out of a litter of 13 puppies were either born dead or died within 48 hours of birth. Three puppies that died shortly after birth were necropsied. Two puppies had hemorrhage in the thoracic and peritoneal cavities, intestinal serosa, and meninges. The third puppy was smaller than the other two puppies but did not have detectable hemorrhage. Brodifacoum, a second-generation coumarin anticoagulant, was detected in livers from the two puppies with hemorrhage. The dam did not have clinical signs of coagulopathy before or subsequent to whelping. The owners were confident that the dog had not been exposed to rodenticide for at least 4 weeks before whelping. A presumptive diagnosis of in utero brodifacoum toxicity was made. To the authors' knowledge this is the first time a second-generation coumarin anticoagulant has been detected in the liver of a newborn animal. This case is also unique because the dam was unaffected, suggesting that fetuses are more susceptible to brodifacoum toxicity than adult animals.

4-Hydroxycoumarins↗
PubMed2005

The genetic basis of resistance to anticoagulants in rodents.

Anticoagulant compounds, i.e., derivatives of either 4-hydroxycoumarin (e.g., warfarin, bromadiolone) or indane-1,3-dione (e.g., diphacinone, chlorophacinone), have been in worldwide use as rodenticides for >50 years. These compounds inhibit blood coagulation by repression of the vitamin K reductase reaction (VKOR). Anticoagulant-resistant rodent populations have been reported from many countries and pose a considerable problem for pest control. Resistance is transmitted as an autosomal dominant trait although, until recently, the basic genetic mutation was unknown. Here, we report on the identification of eight different mutations in the VKORC1 gene in resistant laboratory strains of brown rats and house mice and in wild-caught brown rats from various locations in Europe with five of these mutations affecting only two amino acids (Tyr139Cys, Tyr139Ser, Tyr139Phe and Leu128Gln, Leu128Ser). By recombinant expression of VKORC1 constructs in HEK293 cells we demonstrate that mutations at Tyr139 confer resistance to warfarin at variable degrees while the other mutations, in addition, dramatically reduce VKOR activity. Our data strongly argue for at least seven independent mutation events in brown rats and two in mice. They suggest that mutations in VKORC1 are the genetic basis of anticoagulant resistance in wild populations of rodents, although the mutations alone do not explain all aspects of resistance that have been reported. We hypothesize that these mutations, apart from generating structural changes in the VKORC1 protein, may induce compensatory mechanisms to maintain blood clotting. Our findings provide the basis for a DNA-based field monitoring of anticoagulant resistance in rodents.

Amino Acid Motifs↗
PubMed2003

A study of childhood poisoning at National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi.

A retrospective analysis of the poisoning calls received by the National Poisons Information Centre (NPIC) showed a total of 2,720 calls during a period of three years (April 1999-March 2002). Poisoning in children was reported in 995 calls (36.6%). The age ranged from less than 1 yr to 18 yr and the age groups involved were divided into four categories (0-6 yr, >6-12 yr, >12-16 yr, >16-18 yr). The most vulnerable age group included children from less than one year to 6 yr old. Males outnumbered females (M=628, F=367). Although the accidental mode was the commonest (79.7%), intentional attempts were also noticed (20.2%) in the >12-16 yr and >16-18 yr age groups. In the majority of cases, the route was oral (96.8%) followed by dermal exposure (3.2%) comprising bites and stings. Various types of agents belonged to classes of household products (47.0%), drugs (21.8%), industrial chemicals (7.9%), agricultural pesticides (9.1%), bites and stings (3.2%), plants (1.5%), miscellaneous products (5.3%) and unknown products (4.0%). The incidence of poisoning was highest due to household products comprising mainly pyrethroids, parad/thermometer mercury, rodenticides, phenyl, detergents and corrosives, etc. Poisoning due to drugs mainly included anticonvulsants, thyroid hormones, benzodiazepines, analgesics and oral contraceptives. Among the agricultural pesticides aluminium phosphide was the most commonly consumed, followed by organochlorines and organophosphates, etc. Paint thinners were common among industrial chemicals. Bites and stings were mainly snake bites and scorpion stings. Poisoning due to plants was low and Datura was commonly ingested. Although these data may not give an exact picture of the incidence rate in our country, due to underreporting of calls to the Centre and because the actual incidence might be higher or even variable, but they do give the trend in India, indicating that a strong emphasis should be placed on a prevention campaign which can at least reduce the occurrence of accidental pediatric poisoning.

Adolescent↗
PubMed2005

Extracts of Azadirachta indica and Melia azedarach seeds inhibit folliculogenesis in albino rats.

The seed oil of Azadirachta indica A. Juss (neem) is used in traditional medicine for its antidiabetic, spermicidal, antifertility, antibacterial, and wound healing properties. The present study was undertaken to investigate the quantitative aspects of follicular development in cyclic female albino rats (135 +/- 10 g; 8 groups with 6 animals in each group) after oral administration of polar (PF) and non-polar (NPF) fractions of A. indica seed extract at 3 and 6 mg kg body weight-1 day-1 and Melia azedarach Linn. (dharek) seed extract at 24 mg kg body weight-1 day-1 for 18 days. The extracts were prepared using a flash evaporator at 35 degrees C and then dissolved in olive oil to prepare doses on a per kg body weight basis. There was a significant reduction (P = 0.05) in the number of normal single layered follicles (A. indica: 0.67 +/- 0.33 and 4.67 +/- 2.03 after 3 and 6 mg/kg NPF, and 3.33 +/- 1.67 and 1.00 +/- 1.00 after 3 and 6 mg/kg PF vs control: 72.67 +/- 9.14 and M. azedarach: 0.60 +/- 0.40 and 1.80 +/- 1.2 after 24 mg/kg PF and NPF, respectively, vs control: 73.40 +/- 7.02) and follicles in various stages (I-VII) of follicular development in all treatment groups. These extracts also significantly reduced (P = 0.05) the total number of normal follicles in the neem (14.67 +/- 5.93 and 1.00 +/- 1.00 after 3 and 6 mg/kg PF and 3.67 +/- 0.88 and 5.33 +/- 2.03 after 3 and 6 mg/kg NPF) and dharek (13.00 +/- 3.58 and 14.60 +/- 2.25 after 24 mg/kg NPF and PF) treatments compared to control (216.00 +/- 15.72 and 222.20 +/- 19.52, respectively). Currently, indiscriminate use of persistent and toxic rodenticides to control rodent populations has created serious problems such as resistance and environmental contamination. Therefore, it becomes necessary to use ecologically safe and biologically active botanical substances that are metabolized and are not passed on to the next trophic level, and that interfere with the reproductive potential particularly growth and differentiation of follicles. This may help elevate the socio-economic status of the country. Thus, the present study is an attempt to investigate the effects of A. indica and M. azedarach seed extracts on reproduction of albino rats.

Animals↗
PubMed2006

Ecologically based management of rodents in the real world: applied to a mixed agroecosystem in Vietnam.

Rodents cause significant damage to lowland irrigated rice crops in the Red River Delta of Vietnam. A four-year study was conducted in 1999-2002 to examine the effectiveness of applying rodent control practices using the principles of ecologically based pest management. Four 100-150 ha study sites adjacent to villages were selected and farmers on two treated sites were asked to follow a set of rodent management practices, while farmers on the untreated sites were asked not to change their typical practices. Farmers on the treated sites were encouraged to use trap-barrier systems (TBS's; 0.065-ha early planted crop surrounded by a plastic fence with multiple capture traps; one TBS for every 10-15 ha), to work together over large areas by destroying burrows in refuge habitats soon after planting (before the rats reestablish in the fields and before the onset of breeding), synchronizing planting and harvesting of the their rice crops, cleaning up weeds and piles of straw, and keeping bund (embankment) size small (<30 cm) to prevent burrowing. A 75% reduction in the use of rodenticides and plastic barrier fences (without traps or an early crop) was achieved on treated sites. The abundance of rodents was low after implementation of the management practices across all sites. There was no evidence for an effect of treatment on the abundance of rodents captured each month using live-capture traps, and no difference in damage between treatments or in yields obtained from the rice crops. Therefore, ecologically based rodent management was equally effective as typical practices for rodent management. Farmers on the treated sites spent considerably less money applying rodent control practices, which was reflected in the comparative increase in the partial benefit:cost of applying ecologically based rodent management from 3:1 on treated sites and untreated sites prior to the implementation of treatments to 17:1 on treated sites in the final year of the project.

Agriculture↗
PubMed1991

Pesticide poisoning surveillance through regional poison control centers.

The purpose of this study is to describe pesticide exposure in the population of callers to Minnesota Regional Poison Centers. Case files from 1988 reporting pesticide exposure to humans were identified in cooperation with the Minnesota Center for Health Statistics. Data analysis was conducted by computer using SAS statistical package. Of the 1,428 case files indicating pesticide as the primary substance of exposure to Minnesota residents, a mean age of 5 years (range, one month to 85 years) was identified; 50 percent of all cases were below age 3 years. Males accounted for 1.3 times as many cases as females. Insecticide was identified in the largest percentage of case files (74 percent) followed by herbicide (12 percent), rodenticide (11 percent) and fungicide-nonmedicinal (3 percent). Ingestion was the most common route of exposure; 85 percent of all calls originated from a residence. While insecticides are still the most common types of pesticide call, herbicide has surpassed insecticide in production and sales in the US. In this study, herbicide type exposure calls present a much different picture than other pesticide types. The usefulness of poison control centers for examination of pesticide poisoning is explored. Since reporting occurs coincidental with the exposure and its associated symptoms, each pesticide poisoning report could potentially serve as a true sentinel health event.

Adolescent↗
PubMed2003

Thallium toxicity and the role of Prussian blue in therapy.

Thallium salts have been used as medicinal agents, as key ingredients in a variety of manufacturing processes, and as a potent rodenticide. Additionally, environmental concerns are growing, as thallium is a waste product of coal combustion and the manufacturing of cement. Thallium salts are rapidly and nearly completely absorbed by virtually all routes, with gastrointestinal exposure being the most common route to produce toxicity. Thallium enters cells by a unique process governed by its similarity in charge and ionic radius to potassium. Although the exact mechanism of toxicity has not been established, thallium interferes with energy production at essential steps in glycolysis, the Krebs cycle, and oxidative phosphorylation. Additional effects include inhibition of sodium-potassium-adenosine triphosphatase and binding to sulfhydryl groups. The major manifestations of toxicity consist of a rapidly progressive, ascending, extremely painful sensory neuropathy and alopecia. Unlike exposure to most metal salts, gastrointestinal symptoms of thallium toxicity are relatively minor, and constipation is more characteristic than diarrhoea. Many other findings such as an autonomic neuropathy, cranial nerve abnormalities, altered mental status, motor weakness, cardiac, hepatic, and renal effects are described, but are less specific. Thallium also crosses the placenta freely and produces abnormalities in animals as well as fetal demise, overt toxicity and congenital abnormalities in humans. There are no controlled trials of treatments in thallium-poisoned patients. Thus, the literature is predominated by very small animal studies and case reports with very limited data. Strong evidence speaks against the use of traditional metal chelators such as dimercaprol (British Anti-Lewisite) and penicillamine, and the latter may cause redistribution of thallium into the central nervous system. Likewise, forced potassium diuresis appears harmful. The use of single- or multiple-dose activated charcoal is supported by in vitro binding experiments and some animal data, and charcoal haemoperfusion may be a useful adjunct. Multiple animal studies give evidence for enhanced elimination and improved survival with Prussian blue. Unfortunately, despite the fact that many humans have been treated with Prussian blue, the data presented are insufficient to comment definitively on its efficacy. However, Prussian blue's safety profile is superior to that of other proposed therapies and it should be considered the drug of choice in acute thallium poisoning. Public health efforts should focus on greater restrictions on access to, and use of, thallium salts.

Animals↗
PubMed1994

Chemicals used by the poultry industry.

The safe and effective use of chemicals within the live production phases of the poultry industry requires the implementation of integrated health programs. Chemical programs will vary with regard to phase, intended usage, and method and frequency of application. The term "chemicals" herein presented excludes drugs and non-nutritive feed additives, with primary emphasis on sanitation products (i.e., detergents, disinfectants, sanitizers, deodorizers, descalers, and possible combinations), pesticides (i.e., insecticides and rodenticides), and brief mention of soil litter treatments for environmental management of air quality at the farm level. Chemical usage by phase, location, and frequency of application are summarized. Products that are effective, environmentally and user friendly, and applied within label specification will provide for safe, economical, and long-term success of poultry health programs. Such programs must be supported by management and maintained through education and product stewardship administered cooperatively with chemical suppliers, technical consultants, and end users.

Agrochemicals↗
PubMed2006

Patient with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV: epidemiological, clinical and therapeutic results after 14 years of follow-up.

Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus (HBV) infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood. In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived with polyneuropathy and paralysis of the lower limbs, and has been wheelchair-bound since then. During participation in a follow-up study conducted among HBV carriers, abdominal ultrasound detected a two-centimeter liver mass consistent with hepatocellular carcinoma. The tumor was confirmed by computed tomography (CT) and magnetic resonance image (MRI). Because of his significant comorbidity, the patient received palliative treatment with transarterial lipiodol chemoembolization (TACE) on three occasions (1996, 1997 and 1999). At his most recent visit in May 2005, the patient was asymptomatic, liver enzymes were normal and the tumor was in remission on ultrasound.

Arsenic Poisoning↗
PubMedDate not supplied

Clinical signs, clinicopathological findings, etiology, and outcome associated with hemoptysis in dogs: 36 cases (1990-1999).

Hemoptysis, the expectoration of blood or bloody mucus from the respiratory tract at or below the larynx, was retrospectively evaluated in 36 dogs. Cough, tachypnea, and dyspnea were common historical and physical examination signs. Anemia was documented in 11 dogs, but was severe in only one dog. Other clinicopathological findings reflected the underlying diseases. All thoracic radiographs obtained were abnormal; alveolar and interstitial patterns were most common. Diseases predisposing to hemoptysis included bacterial bronchopneumonia (n=7), neoplasia (n=5), trauma (n=5), immune-mediated thrombocytopenia (n=4), heartworm disease (n=4), rodenticide poisoning (n=3), lung-lobe torsion (n=1), left-sided congestive heart failure (n=1), pulmonary hypertension (n=1), and foreign-body pneumonia (n=1). Four additional dogs had more than one underlying disease process. Nine dogs were either euthanized or died in the hospital during the initial visit. While at least half of the 27 dogs discharged went on to completely recover, five dogs discharged were known to have either died or been euthanized as a result of their disease in <6 months.

Animals↗