Mr. Rosenbaum et Rl. Kerlin, ERYTHEMA MULTIFORME MAJOR AND DISSEMINATED INTRAVASCULAR COAGULATION IN A DOG FOLLOWING APPLICATION OF A D-LIMONENE-BASED INSECTICIDAL DIP, Journal of the American Veterinary Medical Association, 207(10), 1995, pp. 1315
Erythema multiforme major and disseminated intravascular coagulation d
eveloped in a dog 24 hours after exposure to a d-limonene-based insect
icidal dip. Clinical signs included severe lethargy and weakness, ulce
ration of the oral mucosa, and erythematous serpiginous, annular, and
arciform lesions on the head, trunk, and limbs. Clinicopathologic abno
rmalities included leukocytosis with neutrophilia, normocytic normochr
omic anemia, thrombocytopenia, prolongation of prothrombin and partial
thromboplastin times, increased fibrin degradation products, hypoprot
einemia, hyponatremia, hypochloremia, azotemia, high serum alanine ami
notransferase, and alkaline phosphatase activities, and high serum bil
irubin concentration. Despite intensive supportive care, the dog devel
oped severe intrathoracic and abdominal hemorrhage and died. Necropsy
revealed severe diffuse epidermal necrosis and widespread hemorrhage w
ithin organs. Insecticidal dips containing d-limonene have the potenti
al to induce various toxic effects, including, possibly, erythema mult
iforme major, and should be used cautiously.