Today's Veterinary Practice

TVP_JUL-AUG2018

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CLINICAL INSIGHTS todaysveterinarypractice.com JULY/AUGUST 2018 81 Dermal exposures can cause pain and erythema. Bathing with a liquid dishwashing detergent and administration of a mild short-acting opiate, such as butorphanol, typically resolve dermal signs. If the product is not removed, chemical burns are possible. Inhalation may occur, especially if the product contains heptane. Heptane is a very small molecule and thus can penetrate the alveoli more easily than can many other solvents. It can interfere with oxygen exchange in the lungs, and it may also induce chemical pneumonitis. This is most likely with inhalation, especially if ventilation is poor. Animals may become symptomatic within a few minutes to several hours after exposure to heptane. Signs include dyspnea, tachypnea, abdominal breathing, and wheezing. Radiographs generally show changes associated with noncardiogenic pulmonary edema. Treatment includes steroids, oxygen, and bronchodilators. If aspiration pneumonia is present, antibiotics are needed. Severe cases might require ventilator assistance. Heptane products are gradually being removed from the marketplace. Lead Paint Lead paint is one of the most problematic paints artists use. Other substances that may contain lead include glazes and pigments. Lead exposure is most common in dogs, cats, and psittacine birds. 2 Clinical signs of lead toxicosis and diagnostic differentials vary by species ( TABLE 1 ). Toxic doses may be acute (e.g., 600 to 1000 mg/kg in dogs) or cumulative (e.g., 3 to 30 mg/kg per day in dogs). The form of lead makes a difference in toxicity. In dogs, lead acetate has a lethal dose low (LD lo ) of 300 mg/kg, whereas lead oxide has an LD lo of 1400 mg/kg and lead sulfate has an LD lo of 2000 mg/kg. Different brands of paints contain different salt forms of lead at different concentrations. 4 The LD lo is the lowest amount of a substance that causes death. Young animals absorb lead more readily than do adults. 5 Onset of signs varies depending on the amount ingested, the salt form of lead ingested, and whether exposures were acute or chronic. Emesis is TABLE 1 Potential Clinical Signs of Lead Toxicosis and Diagnostic Differentials 5,6 SPECIES ACUTE SIGNS CHRONIC SIGNS DIAGNOSTIC DIFFERENTIALS Dogs and cats Anorexia Agitation Behavior changes Ataxia Intermittent seizures Vomiting/diarrhea Abdominal discomfort Anorexia Personality changes Lethargy Ataxia Intermittent seizures Weight loss Anemia Megaesophagus (rare, primarily cats) Rabies Viral encephalitides (e.g., distemper and feline infectious peritonitis) Granulomatous meningoencephalitis Hepatic encephalopathy Epilepsy and other neurologic conditions Various gastrointestinal disorders Psittacine birds Rarely seen Seizures Death Depression Weakness Regurgitation Polyuria/polydipsia Seizures Hemoglobinuria Diarrhea Proventricular dilatation syndrome Psittacine beak and feather disease Viral/bacterial encephalitides Hepatic disease

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