Veterinary Taxicology

TREATMENT

• Correcting low PCV and/or hypovolemia and providing clotting factors as needed using transfusion of fresh whole blood.
• Fresh or frozen plasma or whole blood may be administered.
• Affected animals should be handled with care and sedated if necessary. Promazine is contraindicated.
• Vitamin K is the specific antidote. This has to be administered subcutaneously at several places to increase the absorption and the needle used should be the smallest possible needle to reduce haemorrhage at the site of injection. This drug should not be given intravenously as there may be anaphylactic reactions. Vitamin K1 (phytonadione, phylloquinone) is the most effective form of the various forms of the vitamin.
• It is similar to the natural form of the vitamin and works rapidly.
• Oral vitamin K is faster acting and more effective than the parenteral form. It is absorbed from the GI tract and transported directly to the liver via the portal vein.
• It should be given with food to enhance its absorption. Note - Do not use vitamin K3 (menadione) in Equidae.
• Deaths have occurred from use of injectable menadione at manufacturer's recommended dosages.
• Mechanism of toxicity is unknown, but acute renal failure is observed.
• Pasture and green forages provide some vitamin K and may lessen the need somewhat for prolonged treatment of anticoagulant-exposed herbivores.
• Oxygen may be beneficial in severely dyspneic animals.
• The patient should be kept warm and still until stabilized.
• During treatment coagulation time has to be monitered.
• Protein bound drugs should be avoided as much as possible.
• Contraindicated drugs during recovery period include corticosteroids, sulfa drugs, antihistamines, phenylbutazone, epinephrine and aspirin.
• If the case is presented within a short period after exposure, emesis may be induced or giving gastric lavage or cathartics is useful.
• If the animal is on treatment advice the owner not to administer large volumes of fatty foods and restrict exercise during treatment period.