Poisoning by raticidas

Questions and answers on poisoning by raticidas

1. - As they act?
The warfarínicos raticidas act inhibiting vitamin K, this vitamin is fundamental for the coagulation since several factors of the coagulation depend on her (II, VII, IX and X).
The liver is the one in charge to synthesize it and for that reason in diseases of the east organ we can have an a similar sintomatología.

2. - That types there is?
Several types of warfarinicos raticidas exist, basically the difference this given by the greater power and durability of the toxic in the blood, very important divergence for the prognosis and the treatment.
The only form to identify them is by the anamnesis because the clinical signs are equal.

* Average toxicity: 1ª generation: warfarina.
* High toxicity: 2ª generation: derivatives of the 4-hidroxicoumarina brodifacoum, bromodiolona, clorofacinona, the coumatetralil, difacinona, and lflocoumafén

3. - What symptoms and signs produce?
The signs take between 2 and 5 days in beginning, since they must exhaust the factors of
coagulation and vitamin K.
It can produce sobreacute sintomatología with sudden death by vascular collapse, or cerebral, pericárdica or torácica hemorrhage, without previous signs.
In other cases (subacute poisoning) there are symptoms of a failure of the coagulation, as they are: multiple hemorrhages: petequias or equimosis (small hematomas) in skin and mucous, melena (mat fecal with blood), hematuria (it tinkles with blood), epistaxis (bled by nose of pulmonary origin), hemotórax (it collects of blood in thorax), hematemesis (vomits with blood), pulmonary hemorrhage, etc.
The inspection the veterinarian can observe the pale or cianóticas mucous (bluish), fast and weak, disnea pulse, lethargy and as we already said hematomas in different parts from the body.

4. - As he arrives himself at the diagnosis?
The Veterinary Doctor arrived at the diagnosis by the anamnesis, the sintomatología and the analyses of laboratory
The hematológicas but used tests are those of coagulation with a result of:

* Increase of the time of coagulation
* Increase of the time of prothrombin
* Increase of partial tromboplastina
* Normal plaquetas and fibrinógeno

Is important to arrive at diagnosis accurate to make diagnosis differential, that consists of discarding other pathologies that even attend with symptoms and similar signs, with results of similar laboratories (difficult that equal): CID, Hemofilia, Disease of Von Willebran, Trombocitopenias-Trombocitopatías (plaquetarias enfremedades), Hepatopatías (enfemedades of Hg), etc.

5. - As is the recommended treatment?
* It is important to identify as warfarina it was administered (of being possible)
* To induce the vomit or to make gastric washing if the ingestion has been recent. To administer to activated charcoal and a cathartic one of sodium chloride (if recently time that ingerio)
* If the animal is stable it can directly begin administering the antidote: K1 vitamin (Konakion-Roche). Initially to administer 3 - 5 mg/kg IM, SC or IV depending on the generation of the warfarina (eye! in endovenosa injection risk of anaphylactic shock exists), to repeat the dose to the 12 hours and later to give a dose of maintenance of 5mg/kg/día in 2 takings during 2-3 weeks or but for the case of those of second
* If the animal has a massive hemorrhage and this in hemorrágico shock is necessary to make a transfusion sanguineous and to take measures deapoyo symptomatic for the shock and fluidoterapia.
Not to administer furosemida nor aminofilina since they inhibit the plaquetaria function
* Once controlled the bled ones it must be continued the treatment with the buccal administration of fitonadiona until the times of protombina are standardized (what it can take months with these ?superwarfarínicos?).
* Toracocentesis to alleviate the disnea to present/display pleural spill (risk of causing a new hemorrhage).

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