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16

June 2012

IN

THE

DVM Newsmagazine | dvm360.com

NEWS

Veterinary staff members sickened


by toxic dog vomit, CDC reports
Use caution when inducing vomiting in dogs that have ingested rodenticide, pet poison experts advise.
BY HEATHER BIELE, DVM
CONTENT SPECIALIST

It's a well-known fact that rodenticide


is highly toxic to people and pets as
well as rodents, but it turns out that

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the vomit of dogs that have ingested


the poison is hazardous, too. From
2006 to 2011, eight known cases of
phosphine gas poisoning were reported in veterinary hospital staff
members, according to a recent report
from the U.S. Centers for Disease Control and Prevention (CDC).
The staff members are thought to
have inhaled the gas after rodenticidepoisoned dogs vomited in their hospitals. Zinc phosphide, a rodenticide
commonly used for home and commercial use, produces phosphine, a
toxic gas, when it comes into contact
with stomach acid or water.
The CDC's National Institute for
Occupational Safety and Health received reports of the phosphine poisoning at four different veterinary
hospitals: two in Michigan, one in
Iowa and one in Washington state. All
of the reported victims were exposed
to phosphine gas after treating dogs
that ingested zinc phosphide.
In all of the cases reported, dogs
had consumed a rodenticide containing zinc phosphide and later vomited in an examination or treatment
room. Veterinary staff members that
were exposed to the toxic gas in the
vomit experienced symptoms that
included shortness of breath, difficulty breathing, dizziness, nausea and
headache. One of the affected staff
members was admitted to the emergency room after exposure, while the
others' symptoms resolved without
complication once they moved away
from the poisonous gas.
So just how worried should veterinary staff be about phosphine gas
exposure? Very worried, says Justine
Lee, DVM, associate director of veteriIN

THE

Zinc phosphide, a rodenticide commonly


used for home and commercial use, produces
phosphine, a toxic gas, when it comes into
contact with stomach acid or water.
nary services at Pet Poison Helpline
(PPH). And clinical staff members
aren't the only ones who should take
the risks of phosphine gas exposure
seriously. "It's a huge public health
risk, and veterinarians are liable when
we tell pet owners to induce vomiting
at home without warning them of the
risk ofthe gas poisoning i/iem due to
secondary exposure," Lee says.
Veterinarians need to train their
staff membersmost importantly
receptionists and techniciansabout
how the poison works before they give
recommendations to pet owners, she
says. In the case of zinc phosphide
poisoning, it's recommended to give
an antacid, not food, since food (for
example, milk or toast) tends to increase gastric acid production, which
in turn can increase phosphine gas
production. Additionally, if the dog
vomits in the car en route to the veterinary hospital, owners should be
warned to ventilate the car by safely
opening windows.
Once the pet is on site at the veterinary hospital, team members should
carefully take a patient history to
determine the type of poison the pet
ingested. Lee says. Many veterinarians assume that all rat poisons are
vit:amin Kl-dependent types and can
accidentally poison themselves and
their staffs when they induce emesis,
as evidenced by the cases reported

to the CDC, Lee says.


Pet Poison Helpline wants to remind veterinary teams that the diagnosis of zinc phosphide rodenticide
toxicity is based on history, the presence of the rodenticide in the environment and correct identification of the
active ingredient. Phosphine gas has
often been characterized as smelling
like rotten garlic, eggs or fish, but even
though this odor may be helpful in
diagnosing zinc phosphide poisoning, veterinarians should not rely on
the presence of odor alone, PPH says.
In the event that the animal vomits
at the hospital or vomiting is induced,
the American Veterinary Medical
Association (AVMA) advises staff
to remain upwind and above animal
level to reduce their contact to the
toxic gas, as the gas is heavier than
air and will sink toward the ground.
If the animal vomits in an enclosed
area, such as an examination room,
the area should be evacuated and the
localfiredepartment notified. If practical, windows and doors should be
opened and a fan placed at ground
level to evacuate the gas away from
people and other animals.
Veterinary employees or pet owners who are exposed to vomit or gastric
contents containing phosphine gas
should seek immediate medical attention if symptoms of poisoning are
present, the AVMA says, dvm

NEWS

Technician receives jail time for animal neglect


Landlord found dead dog and emaciated cats in tenant's home.

For more information about Celox'",


contact Bioniche Animal Health at

1 888.549.4503 or visit us at

www.CeloxVet.com

BIONICHE

A 30-year-old veterinary technician was


recently handed a 90-day jail sentence
and two years' probation for animal
cruelty. Stephanie Koehler of Omaha,
Neb., was found guilty of charges stemming from a 2011 investigation after
her landlord found a dead dog and two
emaciated cats in her home.
Officials were notified after Koehler's landlord entered the property
when neighbors complained of an

unkempt yard and swarms of flies


around the windows. Upon entering
the home, the landlord found a deceased rottweiler and two emaciated
cats and alerted the Nebraska Humane
Society for assistance. According to
court documents, Koehler told an investigator with the humane society
that it had been nearly two weeks since
she fed the cats. She also stated that
she didn't remove the cats from the

home when the dog died because she


didn't have a place for them.
Mark Langan, vice president of
the Nebraska Humane Society, was
pleased with the court's ruling. "We
investigate a lot of cases, but this
one really stood out," he says. "The
jail sentence was very appropriate,
because this dog died a very painful death. We hope this serves as a
wake-up call for her." dvm

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