Suspected bromadiolone poisoning

Re: Suspected bromadiolone poisoning

Lucy Fleming — Thu, 05 Feb 2015 08:29:25 GMT

Nope, neither do I! I've heard it advocated to 'make sure you are dosing vitamin K high enough' though (admittedly not daily)

Re: Suspected bromadiolone poisoning

Birte Toft — Wed, 04 Feb 2015 18:19:09 GMT

[quote user="Lucy Fleming"]

I presume you mean carry on treatment for 3 weeks, not carry on testing daily for 3 weeks?

[/quote]

Yes, we'll treat for three weeks and then re-test. As long as the dog isn't showing signs of haemorrhaging, I don't see much point in testing during treatment.

Re: Suspected bromadiolone poisoning

Lucy Fleming — Wed, 04 Feb 2015 09:36:18 GMT

I presume you mean carry on treatment for 3 weeks, not carry on testing daily for 3 weeks?

Re: Suspected bromadiolone poisoning

Birte Toft — Tue, 03 Feb 2015 22:01:31 GMT

Thanks for all the input! When the dog came in yesterday, almost 48 hours after access to the poison, its PT was slightly elevated and we started treatment. Tested again today, and PT and APTT were both high, so we'll carry on for a minimum of three weeks.

Re: Suspected bromadiolone poisoning

Bob Russell — Mon, 02 Feb 2015 18:13:27 GMT

[quote user="Hannah Wynne Richards"]

I'd sooner treat - the expense of Vit K is nothing like the expense of transfusing a haemmorrhaging dog!

Wynne

[/quote]

Expensive stuff out of stock but cheaper Konakion seems to be back unless I misunderstood the conversation with Henry Schein

Re: Suspected bromadiolone poisoning

Hannah Wynne Richards — Mon, 02 Feb 2015 17:27:47 GMT

I'd sooner treat - the expense of Vit K is nothing like the expense of transfusing a haemmorrhaging dog!

Wynne

Re: Suspected bromadiolone poisoning

Thomas Johnson — Mon, 02 Feb 2015 15:26:22 GMT

[quote user="Birte Toft"]I'm taking over a patient tomorrow, a large mixed breed dog which may have eaten an unknown quantity of bromadiolone rat poison yesterday. (The poison was gone, nobody knows how much was left before the dog got access to it.) The dog was seen by a vet this morning. It was asymptomatic, PT and APTT within normal ranges, as would be expected at this stage anyway. Their suggested plan of action is to repeat the blood test daily for three days. Given the long duration of action of bromadiolone, this doesn't seem long enough. We have in-house PT and APTT testing, but repeated testing for 3-4 weeks will be more expensive than prophylactic vitamin K1. Then again, either of those options will be cheaper than treating a haemorrhaging dog in two weeks. Any thoughts on what the best approach is?

[/quote]

I would have though that if it hasn't developed clotting problems by day 3 it isn't going to, the drug may persist in its system for another 4 weeks, but as long as the dog doesn't eat any more so that you're getting a cumulative effect that shouldn't be a problem.

Re: Suspected bromadiolone poisoning

Braden Collins — Mon, 02 Feb 2015 01:07:23 GMT

Our approach is to test PT/PTT 48 hours post-ingestion. That way you can normally detect prolonged clotting times but the animal won't have developed clinical bleeding at that point. If prolonged at this point I will do 4 weeks vit k then retest PT/PTT 48 hours after last tablet. If normal, then the animal doesn't need treatment. I think testing daily for 3 days is a bit of overkill as there won't be prolonged clotting in the first 24 hours.

I don't like to do a "short course" of vit k as many of these toxins have an effect for 4-6 weeks, so a 3 week course would run the risk of being too short if significant amounts ingested, and unnecessary if little was absorbed.

Re: Suspected bromadiolone poisoning

Birte Toft — Sun, 01 Feb 2015 21:46:49 GMT

[quote user="Yantha Smyth"]

I wrote the figures down last time I was on the phone to the VPIS, and now can't find them! Some of the baits have a very high dose required for toxicity- 750g/kg, but there are a couple with much lower TDs- they tend to be commercial grade baits. Not much use as i don't have the specific names and amounts to hand, but could be worthwhile contacting VPIS and getting the TD in g/kg for the bait in question- if its one of the lower TD ones and its a large dog, the chances of it eating 20kg+ of bait are going to be pretty slim.

[/quote]

Thanks for that! It turns out this is one of the lower TD baits, and I doubt there is any chance that the dog had access to enough poison to cause problems. It would have needed to eat 8-10kg of bait, and the photo the owner sent me was of a 500g container.

Re: Suspected bromadiolone poisoning

Yantha Smyth — Sun, 01 Feb 2015 18:47:06 GMT

Re: Suspected bromadiolone poisoning

Michael Woodhouse — Sun, 01 Feb 2015 17:38:52 GMT

We see a lot of these in a rural area (I was doing a blood transfusion on a farm Collie on Christmas Day). Would generally check clotting a couple of times and only treat if needed. Now the vitamin K is licensed it is very expensive.

Re: Suspected bromadiolone poisoning

Busybee — Sun, 01 Feb 2015 17:06:40 GMT

Correction: according to the latest formulary, 2nd generation products should be treated with vit K at 2.5mg/kg q8-12hrs for 3 weeks then test coagulation status 3 weeks after stopping treatment.

Re: Suspected bromadiolone poisoning

Busybee — Sun, 01 Feb 2015 17:03:52 GMT

Personally, I would get the dog on 3 weeks of vit K and retest haematology and PT/APTT 72hrs after the last tablet. Yes it's expensive. However if the owners do not want to pay then that is their decision - make notes! - and offer them the other options. I don't think it's worth the risk not to treat.