A rare clinical feature of acute opioid intoxication in dog – Case report and review of literature

Abstract

A 2-year old male mixed Spitz dog was referred to the Teaching Hospital of the College of Veterinary Medicine, University of Tehran. The case had a history of incidental exposure to “Crack” .In clinical examination restlessness, panting, tachycardia, mydriasis and absence of pupillary light reflex was evident. The animal underwent intravenous fluid therapy. Urine sample was taken and sent to a local laboratory. Using Thin Layer Chromatography (TLC), morphine was detected in urine specimen. Regarding the positive opioid result Naloxane was prescribed. The patient showed full recovery at follow-up visit. Commonly reported clinical signs of opioid toxicosis include CNS depression, respiratory depression, hypotension and death. Some animals especially cats, horses, cattle or swine can show CNS excitation instead of CNS depression. Dogs given toxic doses of morphine exhibit salivation, nausea, emesis, defecation, increased respiration and less commonly, urination early after administration. This is followed by respiratory and CNS depression, ataxia and bronchiolar constriction. Severely intoxicated animals exhibit stupor, coma, seizures and cyanosis with peripheral vasodilatation and hypoperfusion. Miosis is observed initially but mydriasis may ensue if hypoxia is severe. While opioids depress CNS function in dogs, they often cause CNS stimulation in cats. Hypothermia is observed in dogs while hyperthermia may be observed in cats. The clinical manifestations of intoxication following opioid exposure may vary somewhat due to differences in receptor binding of the individual drugs. There have been regular reports of a concentrated or heroin, which is reportedly more pure than other heroin available in Iran. Because of its intensity, crack heroin is associated with increased emergency visits, and overdose deaths.