The recognition and treatment of the intermediate syndrome of organophosphate poisoning in a dog

Abstract

AbstractObjective: To discuss a new clinical presentation of organophosphate toxicity called the intermediate syndrome in a dog.Case summary: A mixed breed dog presented with generalized weakness, hypoventilation and hypoxemia. The weakness was most marked in the thoracic limbs, cervical and respiratory muscles. The history revealed a likely exposure to an organophosphate compound. The other dog in the household demonstrated mild clinical signs of organophosphate toxicity. A blood cholinesterase level was markedly reduced. Therapy included placement of a tracheostomy tube and mechanical ventilation. The dog gradually improved over the following 8 days but had persistent cervical ventroflexion for a total of 4 weeks.New or unique information provided: Organophosphate toxicity can present as a paralysis following the acute cholinergic crisis. The muscular weakness predominantly affects the thoracic limb and neck muscles but cranial nerve deficits can also occur. Dogs can die from the associated respiratory depression. Oxime therapy is indicated in the treatment of this syndrome.