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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 (internal capsule) from dog after bromethalin ingestion and activated charcoal administration. a H&E stained section of the intoxicated dog showing vacuolization of myelin sheaths (400x). b Control brain white matter stained for GFAP (red) (400x). c White matter of canine brain after bromethalin ingestion IHC for GFAP (red), note increased astrocyte cell bodies and astrocytic processes (400x)
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Fig2: Brain (internal capsule) from dog after bromethalin ingestion and activated charcoal administration. a H&E stained section of the intoxicated dog showing vacuolization of myelin sheaths (400x). b Control brain white matter stained for GFAP (red) (400x). c White matter of canine brain after bromethalin ingestion IHC for GFAP (red), note increased astrocyte cell bodies and astrocytic processes (400x)

Mentions: Within white matter tracts of the cerebrum, internal capsule, cerebellum and brainstem, the myelin sheaths were multifocally swollen with variably sized, clear vacuoles that occasionally contain scant amounts of finely fibrillar, eosinophilic material (fragmented myelin) (Fig. 2a). Compare to a control brain sample (Fig. 2b), astrocytes within the adjacent cortical gray matter were frequently swollen, and exhibited astrocytosis as previously described (Fig. 2c).Fig. 2


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 (internal capsule) from dog after bromethalin ingestion and activated charcoal administration. a H&E stained section of the intoxicated dog showing vacuolization of myelin sheaths (400x). b Control brain white matter stained for GFAP (red) (400x). c White matter of canine brain after bromethalin ingestion IHC for GFAP (red), note increased astrocyte cell bodies and astrocytic processes (400x)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Brain (internal capsule) from dog after bromethalin ingestion and activated charcoal administration. a H&E stained section of the intoxicated dog showing vacuolization of myelin sheaths (400x). b Control brain white matter stained for GFAP (red) (400x). c White matter of canine brain after bromethalin ingestion IHC for GFAP (red), note increased astrocyte cell bodies and astrocytic processes (400x)
Mentions: Within white matter tracts of the cerebrum, internal capsule, cerebellum and brainstem, the myelin sheaths were multifocally swollen with variably sized, clear vacuoles that occasionally contain scant amounts of finely fibrillar, eosinophilic material (fragmented myelin) (Fig. 2a). Compare to a control brain sample (Fig. 2b), astrocytes within the adjacent cortical gray matter were frequently swollen, and exhibited astrocytosis as previously described (Fig. 2c).Fig. 2

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