Diagnosis and Treatment

of Animals Poisoned with

Organophosphate Insecticides
     PROJECT SAFEGUARD:
       SAFE PESTICIDE PRACTICES
U.S. ENVIRONMENTAL PROTECTION AGENCY

Office of Pesticide Programs
Washington, D.C. 20460

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DIAGNOSIS AND TREATMENT OF ANIMALS
POISONED WITH  ORGANOPHOSPHATE INSECTICIDES

                               John I. Freeman, D.V.M., M.P.H.
                            Chief, Veterinary Public Health Section
                             North Carolina State Board of Health
The  use of organophosphate  insecticides
has  increased steadily  during  the  past
several  years  and, due to  the  recent
cancellation of DDT  products, this  up-
ward trend is expected to continue. Some
of the  more acutely  toxic organophos-
phate  compounds  (particularly methyl
parathion)  will be among the chemicals
replacing DDT in the future; as their use
becomes more commonplace  throughout
agriculture, the risk to livestock and pets
will increase.
The   organophosphate  insecticides  are
inhibitors of the enzyme cholinesterase
and thus allow the accumulation of large
amounts  of   acetylcholine.  Specific
antidotes  are  available  for treating this
condition, and a favorable prognosis  can
be expected. Essential to the successful
management of an animal or  a herd that
has been exposed to an  organophosphate
compound  are 1) determination that the
animal is  in  an acute cholinergic condi-
tion,  and  2)  prompt  and   aggressive
therapy.
Organophosphate   poisoning  should   be
considered  in the differential  diagnosis
when an  animal  presents the following
signs:  sweating,  miosis, tearing,  excess
salivation and other excessive  respiratory
tract  secretions,   vomiting,   cyanosis,
papilledema,   uncontrollable  muscle
twitches,  convulsions,  coma,  loss   of
reflexes,  and  loss of sphincter control
(last four seen only in severe  cases). The
degree  and   severity  of  the  above
symptoms  are   variable  and   often
dependent  upon duration and extent of
exposure. When an animal presents any of
the above signs, or a combination thereof,
the owner  or  attendant should be ques-
tioned about  any  possible  exposure  to
pesticides,  particularly  during  the   12
hours preceding onset.  If the history is
not revealing,  but the signs are  strongly
suggestive of organophosphate poisoning,
the owner or attendant should be further
questioned  concerning the  presence  of
organophosphate compounds on the farm
or  in and  around  the  household.  The
presence  of organophosphate compounds
in the animal's environment, along with
strong suggestive signs, is reasonably good
evidence  to begin  treatment on a pre-
sumptive  diagnosis  ot organophosphate
poisoning. Cases do occur  in the absence
of established history of exposure.
Management of Animal:
1) Artificial respiration or resuscitation if
   animal   is  cyanotic.  (Atropine
   administered to a cyanotic animal may
   produce ventricular fibrillation.)
2) Atropine   sulfate  administered  I.V.
   until  signs of atropinization appear
   (decreased salivation; dilation of pupil;
   dry, flushed skin; and tachycardia).
   Dosage guide: (1 grain = 65 mg)
   Dog and cat        0.1 - 0.2 mg/kg
   Cattle             0.5 - 1.0 mg/kg
   Horses            0.1 - 0.2 mg/kg
   Repeated  doses  may  be required  as
   often  as every 10 minutes except in
   ruminants   where  the  effects   of
   atropine sulfate generally last for 1  to
   2 hours.

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3) Protopam® Chloride (2-PAM chloride,
   I.V.
   Dosage guide:
   Dog and cat        20 mg/kg
   Cattle             20 mg/kg
   Horses             4 mg/kg
   May  be repeated after 1 hour if signs
   persist or reappear.
4. Decontamination of hair and skin with
   soap  and water if exposure via dermal
   route;  emetics  or  gastric  lavage  if
   exposure via ingestion.
NOTE: Morphine, aminophylline,  and pheno-
thiazine are contraindicated.
Atropine  sulfate relieves many  of the
acute cholinergic  signs  and  may  be
sufficient therapy in those animals where
only  a  mild exposure has  occurred.  In
cases where moderate  to  severe exposure
to organophosphates has occurred, both
atropine and Protopam®  Chloride should
be administered. It should  be kept  in
mind that  a relapse  or  reappearance of
signs may occur due to continued absorp-
tion   from   the  gastrointestinal  tract,
particularly  in  ruminant  animals. There-
fore,  a   mild  degree  of atropinization,
along with close surveillance,  should be
maintained for 24 to 48 hours  in non-
ruminants  and up  to 5 to  8 days  in
ruminants.

® Ayerst  Laboratories, New York, N.Y. 10017
  jrbamate insecticide poisonings produce
a similar clinical picture. However, they
are  reversible  cholinesterase inhibitors,
and  severe  poisoning  with these com-
pounds  is  uncommon.  Protopam®
Chloride should not be used in an animal
that  has been  exposed  to carbamate
insecticides.
          Selected References

Woodward, G. T. 1952. The treatment of
   organic phosphate  insecticide poison-
   ings with atropine sulfate and 2-PAM.
   Vet.Med. 52:571-578.
Younger, R. L, and F. C. Wright. 1971.
   Acute coumaphos toxicosis in cattle:
   antidotal  therapy  with  pralidoxime
   chloride  and atropine,  and  related
   alterations   of   blood   and   serum
   enzymatic activity. Am. J.  Vet.  Res.
   32:1053-1063.
Szabuniewiez,  M., E. M. Bailey, and D. O.
   Wiersig.   1971.  Treatment  of some
   common   poisonings  in   animals.
   VM/SAC 66(12) :1197-1205.
Oehme, F. W.  Personal  communication.
   (Comparative Toxicology Laboratory,
   Kansas  State University, Manhattan,
   Kan. 66506)
                        U.S.  Environmental  Protection Ager;
                        Region V,  Library
                        230  South Dearborn Street
                        Chicago.  Miinois   60604
                            6B2233373

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