Apparent toxicosis associated with lily-of-the-valley (Convallaria majalis) ingestion in a dog

Lily-of-the-valley (Convallaria majalis), an ornamental plant found in many urban settings, was believed responsible for the sudden collapse and death of a one-year-old mixed-breed dog. Postmortem examination revealed C majalis leaf fragments in the small intestine. The dog had gross and histologic lesions consistent with cardiac shock. Because C majalis contains cardiac glycosides that have digitalis-like activity, apparent C majalis intoxication was suspected in this dog on the basis of history, exposure to the plant, clinical signs of disease, postmortem lesions, and evidence of plant parts in the intestinal tract. A toxicologic assessment of excessive exposure to C majalis was based on the aforementioned criteria.     

Summer pheasant's eye (Adonis aestivalis) poisoning in three horses

Three horses died as a result of eating grass hay containing summer pheasant's eye (Adonis aestivalis L.), a plant containing cardenolides similar to oleander and foxglove. A 9-year-old thoroughbred gelding, a 20-year-old appaloosa gelding, and a 5-year-old quarter horse gelding initially presented with signs of colic 24-48 hours after first exposure to the hay. Gastrointestinal gaseous distension was the primary finding on clinical examination of all three horses. Two horses became moribund and were euthanatized 1 day after first showing clinical signs, and the third horse was euthanatized after 4 days of medical therapy. Endocardial hemorrhage and gaseous distension of the gastrointestinal tract were the only necropsy findings in the first two horses. On microscopic examination, both horses had scattered foci of mild, acute myocardial necrosis and neutrophilic inflammation associated with endocardial and epicardial hemorrhage. The third horse that survived for 4 days had multifocal to coalescing, irregular foci of acute, subacute, and chronic myocardial degeneration and necrosis. A. aestivalis (pheasant's eye, summer adonis) was identified in the hay. Strophanthidin, the aglycone of several cardenolides present in Adonis spp., was detected by liquid chromatography-mass spectrometry-mass spectrometry in gastrointestinal contents from all three horses. Although Adonis spp. contain cardiac glycosides, cardiac lesions have not previously been described in livestock associated with consumption of adonis, and this is the first report of adonis toxicosis in North America.     

Diagnosis of Amanita toxicosis in a dog with acute hepatic necrosis.

Poisoning with amanitin-containing hepatotoxic mushrooms demands extensive efforts from clinicians, toxicologists, and pathologists. Presumptive diagnoses are established by positive identification of the suspect mushroom along with the occurrence of consistent clinical signs. If the animal dies, hepatic lesions may suggest exposure to amanitin-containing mushrooms; however, lesions are nonspecific. A 15-week-old female Dachshund was presented to the referring veterinarian for acute onset of lethargy that quickly progressed to sternal recumbency. Despite supportive care, the dog remained lethargic and died approximately 12 hours after initial presentation. A pale tan liver was noted at necropsy. Microscopically, the liver showed panlobular coagulative necrosis of hepatocytes. A presumptive diagnosis of amanitin poisoning was based on suspect history of exposure to mushrooms, clinical signs, and pathologic findings. Exposure to amanitin was confirmed through detection of alpha-amanitin in the liver by liquid chromatography/mass spectrometry. The objective of this case report is to illustrate the essential components to a successful diagnostic work-up of a suspect case of hepatotoxic mushroom poisoning. Although hepatotoxic mushroom poisoning has been documented in dogs before, confirmatory techniques for biologic specimens have not been used previously in diagnostic investigations.     

Evaluation of the toxicity of Adonis aestivalis in calves.

Toxicosis of Adonis aestivalis is well documented in horses, but little is known of its toxicity in cattle. A. aestivalis (summer pheasant's eye) was collected over multiple years, under different growing conditions, and at various stages of maturity, dried, and administered to calves to evaluate the toxicity of A. aestivalis in cattle. Four 300-lb Holstein, and 2 90-lb, preruminating Jersey calves were administered 1% body weight of ground A. aestivalis via a stomach tube and monitored for clinical signs for 2 weeks and 1 week, respectively. The Holstein calves were then fed 0.2 to 1% body weight A. aestivalis daily for 4 to 5 weeks. The Holstein calves had transient, mild cardiac abnormalities during the feeding trial. Mild, transient gastrointestinal and cardiac signs were noted in the preruminating calves. No gross or microscopic lesions were seen on necropsies performed at the end of the study. Based on the results of this study, cattle do not appear to be as susceptible to toxicosis from A. aestivalis as other species, such as horses and pigs.     

Causes of poor performance of horses during training, racing, or showing: 348 cases (1992-1996)

OBJECTIVE: To determine results for horses undergoing a high-speed treadmill examination, including videoendoscopy of the pharynx and larynx before and during exercise, echocardiography before and after exercise, and electrocardiography before, during, and after exercise, because of poor performance. DESIGN: Retrospective study. ANIMALS: 348 horses. RESULTS: A definitive diagnosis was obtained for 256 (73.5%) horses. One hundred forty-eight horses had dynamic obstruction of the airway during exercise, 33 had clinically important cardiac arrhythmias alone, 22 had a combination of dynamic airway obstruction and clinically important cardiac arrhythmias, 19 had poor cardiac fractional shortening immediately after exercise, 10 had exertional rhabdomyolyis, 15 had clinically apparent lameness, and 9 had other disorders. Thirty-nine of the horses with dynamic obstruction of the airway during exercise had multiple airway abnormalities. Fifty-three horses also had subclinical myopathy CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a complete evaluation, including a high-speed treadmill examination, should be conducted in horses with poor performance, regardless or whether horses do or do not have a history of abnormal respiratory noises and particularly if the horses have grade-II or -III left laryngeal hemiplegia.     

Prevalence of gastric ulcers in endurance horses--a preliminary report

Gastric endoscopy was performed at the end of a 50 or 80 km endurance ride. Gastric ulceration was evident in 67% of the horses with ulcers on the squamous region of the stomach found in 57% of the horses and active bleeding of the glandular mucosa in 27%. Three horses (10%) had lesions only on the glandular mucosa. Values of albumin, creatinine and glucose were higher in horses without gastric lesions. We conclude that horses from endurance competitions have a high prevalence of gastric ulceration that is similar to that observed in performance horses. However the severity of ulceration is less severe than has been reported in Thoroughbred race horses in active training. Owners should be aware of the high prevalence of gastric ulceration in horses that perform in endurance competitions. The high incidence of active bleeding from the glandular mucosa of the stomach in these horses requires further investigation.     

Plants poisonous to horses in Europe

Poisoning of horses by plants is a relatively common veterinary problem and may occur when the fresh plant is ingested in pasture or when the plant contaminates hay, silage and feed. In Europe, horses are particularly at risk of poisoning by Cynoglossum officinale (houndstongue), Datura stramonium (jimson weed), Hypericum perforatum (St. John's wort), Nerium oleander (oleander), Pteridium aquilinum (bracken fern), Robinia pseudoacacia (black locust), Senecio jacobaea (tansy ragwort), Taxus baccata (European yew) and Thuja occidentalis (white cedar). For each of these poisonous plants the information given in this review includes plant distribution, conditions of poisoning, toxic active principles and clinical signs.     

Spatial vector changes during ventricular depolarisation using a semi-orthogonal lead system--a study of 190 cases.

The paper describes the spatial vector changes during ventricular depolarisation in 190 horses using a semi-orthogonal ECG lead system. The replacement of planar vector loops by a plot of 3 parameters to depict the changing spatial vector, with a time base on the X axis, is described and illustrated. Some horses with diastolic murmurs and some with a history of respiratory problems formed 2 distinct groups. As a result of these findings a possible relationship between the vector changes and the anatomical siting of the ventricles is suggested and discussed. Attention is drawn to certain measurements which appear to have possible use in assessing the significance of cardiac electrical activity in relation to changes in the ventricular myocardium.     

Prevalence of Anoplocephala perfoliata and lesions of Draschia megastoma in Thoroughbreds in Kentucky at necropsy

A total of 396 Thoroughbreds (86 males, 293 females, and 17 geldings) in Kentucky, 1 to 30 years of age, were examined at necropsy for presence of Anoplocephala perfoliata (2 female horses were not examined) in the cecum for lesions of Draschia megastoma in the stomach, during the 1-year period of Mar 1, 1982 through Feb 28, 1983. Prevalence of A perfoliata was 53% and of lesions of D megastoma was 63%. All lesions of D megastoma were partially or entirely in the glandular region of the stomach. Distances of the midpoint of these lesions from the margo plicatus varied from 0 to 290 mm. The center of about 88% of the lesions was within 50 mm of the margo plicatus . Measurements of the size of the lesions, exclusive of masses, indicated that about 95% were less than or equal to 50 mm in diameter. There appeared to be a higher infection rate of lesions of D megastoma in younger horses (81% in 1 to 7 year olds) than in older horses (41% in 8 to 30 year olds) with a few exceptions.     

Salinomycin toxicosis in horses

CASE DESCRIPTION: A 4-month-old American Paint filly was evaluated because of sudden onset of ataxia that progressed to recumbency. Five additional horses from the same and neighboring premises developed signs of poor performance, generalized weakness, ataxia, and recumbency; 2 of those horses were also evaluated. A new batch of a commercial feed supplement had been introduced to the horses' diet on each farm within the preceding 3 days. CLINICAL FINDINGS: Other than recumbency, findings of physical and neurologic examinations of the foal were unremarkable. The other 2 horses had generalized weakness and mild ataxia, and 1 horse also had persistent tachycardia. The foal had mild leukocytosis with neutrophilia, hyperglycemia, and mildly high serum creatine kinase activity. Results of cervical radiography, CSF analysis, and assessments of heavy metals and selenium concentrations in blood and vitamin E concentration in serum were within reference limits. Feed analysis revealed high concentrations of the ionophore antimicrobial salinomycin. TREATMENT AND OUTCOME: The 5 affected horses survived, but the foal was euthanized. At necropsy, a major histopathologic finding was severe vacuolation within neurons of the dorsal root ganglia, which was compatible with ionophore toxicosis. The surviving horses developed muscle atrophy, persistent weakness, and ataxia. CLINICAL RELEVANCE: In horses, ionophore toxicosis should be considered as a differential diagnosis for acute weakness, ataxia, recumbency, or sudden death. Furthermore, ionophore toxicosis should be considered as a cause of poor performance, weakness, muscle wasting, and cardiac arrhythmias in horses. Surviving horses may have impaired athletic performance.     

EXPERIMENTAL POISONING OF HORSES AND CATTLE WITH SWAINSONA CANESCENS VAR HORNIANA

Horses and cattle fed swainsona ( Swainsona canescens var horniana ) over a period of 8 to 10 weeks lost condition and became incoordinated and hypersensitive. Histotogical examination of tissues from affected animals revealed the characteristic changes of widespread cellular vacuolation and axonal spheroids in the CNS.
Cattle withdrawn from the toxic plant after being fed for varying periods up to 8 weeks returned to normal.
Serum α-mannosidase activity declined significantly in cattle during the test period, whereas in horses the activity rose. Serum alkaline phosphatase levels increased significantly in cattle but not in horses.
The similarity of the clinical signs of disease in horses was noted to those seen in Indigofera linnaei poisoning (Birdsville disease). Differential diagnosis can be made by botanical observations and by an increased frequency of vacuolated lymphocytes in the blood in swainsona poisoning.     

The prevalence and anatomical distribution of equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark

Reasons for performing study: The prevalence (up to 93% in Thoroughbred racehorses) and severity of equine gastric ulceration syndrome (EGUS) have been correlated with the type of training and associated management practices. However, there have been few reports to confirm these findings in nonracehorses in Europe. Objectives: To describe the prevalence, anatomical distribution, severity and number of gastric ulceration lesions in a population of Danish pleasure horses; and to investigate differences for groups based on age, breed type and workload. Methods: A total of 201 horses not in active race‐training, age 7 months‐27 years, were evaluated, representing 23 different stables from all 5 regions of Denmark. These horses were considered to be healthy by the owner and not on veterinary treatment for EGUS. Endoscopically observed ulcer lesion scores were based on the number present (0–4) and severity (0–5). The presence or absence of ulcers in the glandular and/or nonglandular regions of the stomach was recorded and which site the most severe ulcers were found. Results: The prevalence of EGUS severity score ≥2 was 53%. The most severe lesions were commonly observed at the margo plicatus. Although older horses were not more likely to be affected by clinically significant EGUS they were more likely to have lesions in both the glandular and nonglandular regions. Differences in location of EGUS lesions were identified in different age groups, breed types and in horses exposed to different levels of work. Conclusion and potential relevance: This study confirms that gastric ulceration can be prevalent in a group of apparently clinically normal horses, not in intensive work. Further investigation of reasons for differences in EGUS location between different populations may aid toward the development of novel preventive measures.     

Nigropallidal encephalomalacia in horses grazing Rhaponticum repens (creeping knapweed)

Nigropallidal encephalomalacia was diagnosed in two horses in northern Victoria that had a history of long-term pasture access to a dense growth of Rhaponticum repens. The region in which the affected horses lived had received well above average rainfall for several months preceding the poisoning. Affected horses had sudden onset of subcutaneous oedema of the head, impaired prehension and mastication, dullness, lethargy and repeated chewing-like jaw movements. Diagnosis was confirmed at necropsy, with characteristic malacic lesions in the substantia nigra and globus pallidus of the brain. This is the first documented case of nigropallidal encephalomalacia in Australian horses associated with R. repens.     

Diagnosis of zinc phosphide poisoning in chickens using a new analytical approach

Approximately 200 chickens were found dead after the flooring of a slat-and-litter house was breached. No clinical signs of illness were observed in the surviving birds. During necropsy, rolled oats were found in the chickens' crops and gizzards, and the contents had a petroleum-like odor. Histopathologic examination revealed severe pulmonary edema and congestion of the chickens' lungs, hearts, livers, and kidneys. Based on the history and necropsy findings, zinc phosphide exposure was suspected. Diagnosis of zinc phosphide poisoning has previously been based on history of exposure, identification of the bait material in the gastrointestinal tract, and chemical detection of phosphine gas. However, currently available diagnostic methods are nonconfirmatory, and may produce false positive results. The objective of this case report was to determine whether the sudden death described in these chickens was caused by the ingestion of zinc phosphide, by developing a sensitive and highly specific gas chromatography/mass spectrometry (GC/MS) methodology for analysis of the gastrointestinal samples submitted to the laboratory. It was also found that the determination of zinc concentrations in liver or kidney tissue or stomach contents is not a reliable indicator of zinc phosphide poisoning.     

Gastric impaction and large colon volvulus: Can one lead to the other?

The possibility of stomach impaction resulting in large colon volvulus is raised by authors reporting the findings of both lesions in 7 horses. Although this combination of lesions has not been reported before, it is interesting to consider the effect of a gastric impaction compressing the colon as the stomach increases in size with firm ingesta. Anatomically, the stomach is dorsal to the colon, and might therefore compress the colon. As to how this might result in volvulus, it is interesting to speculate on the possible roles of gas accumulation or other changes in the intracolonic environment, such as composition in microbiota. The report of 7 horses also highlights the need to thoroughly explore any horse taken to surgery because of intractable colic in case there is more than one lesion.     

Double-outlet right ventricle in a 10-month-old Friesian filly

A 10-month-old Friesian filly had a presentation that was consistent with chronic left- and right-sided congestive heart failure. Clinical pathology findings included abnormal haematological and biochemical variables, abnormal blood gas values and increased serum concentration of cardiac troponin I. Echocardiography revealed cardiac chamber dilation and dextropositioning of the aorta. Radiography revealed a generally enlarged heart and pulmonary interstitial infiltration. These findings were supported at necropsy and the diagnosis of double-outlet right ventricle was confirmed. The pathological changes and physiological responses subsequent to double-outlet right ventricle have not previously been described in detail in horses. Clinical progression closely resembles that seen in humans, in whom antemortem diagnosis relies on echocardiography. In horses, complex cardiac disease presents a diagnostic challenge to the clinician. Appropriate therapy must be based on an accurate diagnosis.     

Multifocal discrete osteolysis in a horse with silicate associated osteoporosis

Silicate associated osteoporosis (SAO) was diagnosed post-mortem in an adult horse with the shortest documented exposure to cytotoxic silicates of 2 years. The horse was evaluated for a 6-month history of progressive back tenderness and acute onset of lameness. The horse had a marked (4/5) (American Association of Equine Practitioners scale) left forelimb lameness, moderate (2/5) hindlimb ataxia and weakness, and cervical pain upon palpation. Physical examination did not reveal clinical skeletal deformities or respiratory compromise. Radiographs revealed widespread, discrete, sharply delineated, osteolytic lesions in the skull, vertebral column, ribs, scapulae and middle phalanx (P2) of the left forelimb and a diffuse bronchointerstitial lung pattern. The presumptive clinical diagnosis was widespread, metastatic osteolytic neoplasia. Due to the poor quality of life and grave prognosis, the horse was humanely euthanised. Post-mortem examination revealed pulmonary silicosis in the lungs and hilar lymph nodes and osteolytic lesions with numerous, large osteoclasts and disorganised bone remodelling both consistent with SAO. SAO should be included as a differential diagnosis for horses with widespread, multifocal, discrete osteolysis and history of exposure to endemic regions with possible cytotoxic silicate inhalation. Exposure time of 2 years is potentially sufficient to develop SAO.     

Equine toxicoses: Investigative strategies and approaches for performance horses

The investigation of suspect toxicosis is one of the most complex diagnostic problems faced by equine practitioners, requiring a wide range of clinical skills. When poisoning occurs, there is often no clear evidence of exposure to a toxic agent. Establishing an accurate diagnosis of poisoning requires a systematic approach, beginning with a comprehensive history, followed by clinical examination of affected horses, clinical pathologic testing, postmortem examinations, and analytic toxicology testing. The diagnosis of potential toxicosis in performance horses especially in the racetrack environment presents unique challenges to the veterinarian. Economic concerns including wagering, competition, inflated animal values, and insurance issues combine to create a situation in which intentional poisonings using obscure toxicants and unusual routes of exposure may occur. Collection of an accurate history is frequently confounded under these circumstances. This problem, coupled with the wide range of potential malicious toxic agents available, reinforces the requirement to approach these cases in a thorough and systematic fashion. Throughout the investigative process, potential medicolegal issues should be kept in the forefront. Care must be taken to maintain complete and accurate medical records and to maintain chain of custody on all antemortem and postmortem samples submitted to the diagnostic laboratory, because suspicious or unexplained deaths frequently end up in court.