Rodenticid intoxication in 20 bleeding dogs: Diagnosis and therapy

Anticoagulant rodenticide intoxication was retrospectively evaluated in 20 bleeding dogs at the Small Animal Clinic, University of Berlin. The most co mmon presenting signs were lethargy (90 %), pallor (75 %), and dyspnea (65 %). Seventeen dogs bled into body cavities or developed hematomas and 8 dog s had surface bleeding. Pleural effusions, pulmonary infiltrates, and peric ardial effusions were detected in 11, 9, and I dog, respectively. An abdomi nal effusion was noted in 7 dogs, and one dog had a hemometra. 90 % of the dogs were anemic, 60 % mildly to moderately thrombocytopenic, and 80 % (12/ 15) had a hypoproteinemia. The prothrombin time (PT) and activated partial thromboplastin time (aPTT) were markedly prolonged in all dogs (PT: 40 grea ter than or equal to 100 s, aPTT: 27.3 greater than or equal to 100 s) [nor mal range PT: 14.6-20.4 s; aPTT: 13.2-18.2 s] and approximately half of the dogs had either a normo- (44 %, 4/9) or hyperfibrinogenemia (56 %, 5/9) [1 .3-3.3 g/l]. No fibrin degradation products (FDP) were detected in the plas ma of 9 dogs tested. Treatment included the administration of vitamin K-1 ( 20/20), DEA 1.1 compatible whole blood (4/20), packed red blood cells (11/2 0), and/or fresh frozen plasma (19/20), as well as supportive care. Initial ly, all dogs received vitamin K-1 subcutaneously (2.5-5.8 mg/kg body weight ). On the second and third day vitamin K-1 at a dose of 1.5 to 3.1 mg/kg tw ice daily was administered subcutaneously and orally in 6 and 12 dogs, resp ectively. The maintenance dose was 1.0 to 2.6 mg/kg twice daily per os over 3 to 10 weeks. Coagulation times improved in the 17 surviving animals with in 24 hours. PT and aPTT normalized in 3 dogs within 24 hours, in 9 dogs wi thin 48 hours and in 5 dogs within 72 hours. Three dogs died within the fir st 72 hours due to intrathoracic hemorrhage. Despite severe hemorrhage an 8 5 % survival rate was achieved with immediate intensive therapy including v itamin K-1 and blood products.