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Atypical bromethalin intoxication in a dog: pathologic features and identification of an isomeric breakdown product.

Bates MC, Roady P, Lehner AF, Buchweitz JP, Heggem-Perry B, Lezmi S - BMC Vet. Res. (2015)

Bottom Line: Bromethalin exposure and tissue absorption was confirmed by identification of one of two isomeric 543.7 molecular weight (MW) breakdown products in the patient's adipose and kidney samples using gas chromatography (GC) combined with tandem quadrupole mass spectrometry (MS/MS).Meningeal hemorrhages are atypical of bromethalin intoxication, and might have been caused by hyperthermia, secondary to tremors or hypernatremia.Identification of one of two isomeric breakdown products in the adipose tissue and kidney provides an additional molecule to the toxicologic testing regime for bromethalin intoxication.

View Article: PubMed Central - PubMed

Affiliation: College of Veterinary Medicine, Department of Pathobiology & Veterinary Diagnostic Laboratory, University of Illinois, 2001 S. Lincoln Ave, Urbana, IL, 61802, USA. mbates@illinois.edu.

ABSTRACT

Background: Definitive post mortem confirmation of intoxication by the neurotoxic rodenticide bromethalin can be challenging. Brain lesions are not specific and detection of bromethalin and its metabolites are unpredictable due to rapid photodegradation and inconsistent behavior in tissues.

Case presentation: A 2-year-old dog presented with rapid onset of severe muscle tremors and death within hours after a known ingestion of a reportedly low dosage of bromethalin and subsequent decontamination using activated charcoal. Marked meningeal hemorrhages and multifocal myelin sheath vacuolation were observed in the brain. A marked reactive astrocytosis and neuronal hypoxia/necrosis were identified using immunohistochemistry (IHC) for glial fibrillary acidic protein (GFAP) and for neuron specific protein (NeuN). Bromethalin exposure and tissue absorption was confirmed by identification of one of two isomeric 543.7 molecular weight (MW) breakdown products in the patient's adipose and kidney samples using gas chromatography (GC) combined with tandem quadrupole mass spectrometry (MS/MS).

Conclusions: The severity of clinical signs and subsequent death of this dog was not expected with the low dosage of bromethalin reportedly ingested, and the use of activated charcoal possibly precipitated a hypernatremic status. Meningeal hemorrhages are atypical of bromethalin intoxication, and might have been caused by hyperthermia, secondary to tremors or hypernatremia. Identification of one of two isomeric breakdown products in the adipose tissue and kidney provides an additional molecule to the toxicologic testing regime for bromethalin intoxication.

No MeSH data available.


Related in: MedlinePlus

Brain, cortical lesions. a Gross image of brain at necropsy showing marked meningeal congestion and hemorrhages. b In the cortical grey matter are shrunken and hypereosinophilic neurons as well as mild vacuoles of the neuropil (spongiosis), H&E stain 400x. c and e) Control canine brain IHC for GFAP (red) and NeuN (black). Note intense black stain of normal neurons and scattered red staining of normal, resting astrocytes (100x and 400x). d and f): IHC for GFAP and NeuN on brain sections from the bromethalin intoxicated dog: Note marked decrease in NeuN (black) staining in neurons compared to control and increase in GFAP (red) indicating enlargement of astrocyte cell bodies and astrocytic processes in the glia limitans. (100x and 400x)
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Fig1: Brain, cortical lesions. a Gross image of brain at necropsy showing marked meningeal congestion and hemorrhages. b In the cortical grey matter are shrunken and hypereosinophilic neurons as well as mild vacuoles of the neuropil (spongiosis), H&E stain 400x. c and e) Control canine brain IHC for GFAP (red) and NeuN (black). Note intense black stain of normal neurons and scattered red staining of normal, resting astrocytes (100x and 400x). d and f): IHC for GFAP and NeuN on brain sections from the bromethalin intoxicated dog: Note marked decrease in NeuN (black) staining in neurons compared to control and increase in GFAP (red) indicating enlargement of astrocyte cell bodies and astrocytic processes in the glia limitans. (100x and 400x)

Mentions: At necropsy the stomach and entire intestinal tract were filled with activated charcoal. The meninges were diffusely red to dark red, wet and gelatinous (hemorrhagic) (Fig. 1a). Histologically, neurons within the cortical grey matter were occasionally, multifocally slightly shrunken and hypereosinophilic suggesting hypoxia and necrosis (Fig. 1b). The surrounding neuropil was pale and multifocally vacuolated (spongiosis). Cerebral and meningeal blood vessels were severely congested. The leptomeninges were diffusely and markedly expanded by hemorrhage (Fig. 1d).Fig. 1


Atypical bromethalin intoxication in a dog: pathologic features and identification of an isomeric breakdown product.

Bates MC, Roady P, Lehner AF, Buchweitz JP, Heggem-Perry B, Lezmi S - BMC Vet. Res. (2015)

Brain, cortical lesions. a Gross image of brain at necropsy showing marked meningeal congestion and hemorrhages. b In the cortical grey matter are shrunken and hypereosinophilic neurons as well as mild vacuoles of the neuropil (spongiosis), H&E stain 400x. c and e) Control canine brain IHC for GFAP (red) and NeuN (black). Note intense black stain of normal neurons and scattered red staining of normal, resting astrocytes (100x and 400x). d and f): IHC for GFAP and NeuN on brain sections from the bromethalin intoxicated dog: Note marked decrease in NeuN (black) staining in neurons compared to control and increase in GFAP (red) indicating enlargement of astrocyte cell bodies and astrocytic processes in the glia limitans. (100x and 400x)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4584469&req=5

Fig1: Brain, cortical lesions. a Gross image of brain at necropsy showing marked meningeal congestion and hemorrhages. b In the cortical grey matter are shrunken and hypereosinophilic neurons as well as mild vacuoles of the neuropil (spongiosis), H&E stain 400x. c and e) Control canine brain IHC for GFAP (red) and NeuN (black). Note intense black stain of normal neurons and scattered red staining of normal, resting astrocytes (100x and 400x). d and f): IHC for GFAP and NeuN on brain sections from the bromethalin intoxicated dog: Note marked decrease in NeuN (black) staining in neurons compared to control and increase in GFAP (red) indicating enlargement of astrocyte cell bodies and astrocytic processes in the glia limitans. (100x and 400x)
Mentions: At necropsy the stomach and entire intestinal tract were filled with activated charcoal. The meninges were diffusely red to dark red, wet and gelatinous (hemorrhagic) (Fig. 1a). Histologically, neurons within the cortical grey matter were occasionally, multifocally slightly shrunken and hypereosinophilic suggesting hypoxia and necrosis (Fig. 1b). The surrounding neuropil was pale and multifocally vacuolated (spongiosis). Cerebral and meningeal blood vessels were severely congested. The leptomeninges were diffusely and markedly expanded by hemorrhage (Fig. 1d).Fig. 1

Bottom Line: Bromethalin exposure and tissue absorption was confirmed by identification of one of two isomeric 543.7 molecular weight (MW) breakdown products in the patient's adipose and kidney samples using gas chromatography (GC) combined with tandem quadrupole mass spectrometry (MS/MS).Meningeal hemorrhages are atypical of bromethalin intoxication, and might have been caused by hyperthermia, secondary to tremors or hypernatremia.Identification of one of two isomeric breakdown products in the adipose tissue and kidney provides an additional molecule to the toxicologic testing regime for bromethalin intoxication.

View Article: PubMed Central - PubMed

Affiliation: College of Veterinary Medicine, Department of Pathobiology & Veterinary Diagnostic Laboratory, University of Illinois, 2001 S. Lincoln Ave, Urbana, IL, 61802, USA. mbates@illinois.edu.

ABSTRACT

Background: Definitive post mortem confirmation of intoxication by the neurotoxic rodenticide bromethalin can be challenging. Brain lesions are not specific and detection of bromethalin and its metabolites are unpredictable due to rapid photodegradation and inconsistent behavior in tissues.

Case presentation: A 2-year-old dog presented with rapid onset of severe muscle tremors and death within hours after a known ingestion of a reportedly low dosage of bromethalin and subsequent decontamination using activated charcoal. Marked meningeal hemorrhages and multifocal myelin sheath vacuolation were observed in the brain. A marked reactive astrocytosis and neuronal hypoxia/necrosis were identified using immunohistochemistry (IHC) for glial fibrillary acidic protein (GFAP) and for neuron specific protein (NeuN). Bromethalin exposure and tissue absorption was confirmed by identification of one of two isomeric 543.7 molecular weight (MW) breakdown products in the patient's adipose and kidney samples using gas chromatography (GC) combined with tandem quadrupole mass spectrometry (MS/MS).

Conclusions: The severity of clinical signs and subsequent death of this dog was not expected with the low dosage of bromethalin reportedly ingested, and the use of activated charcoal possibly precipitated a hypernatremic status. Meningeal hemorrhages are atypical of bromethalin intoxication, and might have been caused by hyperthermia, secondary to tremors or hypernatremia. Identification of one of two isomeric breakdown products in the adipose tissue and kidney provides an additional molecule to the toxicologic testing regime for bromethalin intoxication.

No MeSH data available.


Related in: MedlinePlus