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Treatment of Cyanobacterial (Microcystin) Toxicosis Using Oral Cholestyramine: Case Report of a Dog from Montana
Flathead Animal Clinic, 344 1st Ave. W., Kalispell, MT 59901, USA
Friendship Hospital for Animals, 4105 Brandywine St. NW, Washington, DC 20016, USA
Department of Ocean Sciences, University of California Santa Cruz, A-312 Earth & Marine Sciences Building Santa Cruz, CA 95064, USA
Marine Wildlife Veterinary Care and Research Center, Department of Fish and Game, Office of Spill Prevention and Response, 1451 Shaffer Rd, Santa Cruz, CA 95060, USA
Monterey Bay Aquarium, 886 Cannery Row, Monterey, CA 93940, USA
* Author to whom correspondence should be addressed.
Received: 16 April 2013; in revised form: 6 May 2013 / Accepted: 15 May 2013 / Published: 29 May 2013
(This article belongs to the Special Issue Cyanotoxins
Abstract: A two and a half year old spayed female Miniature Australian Shepherd presented to a Montana veterinary clinic with acute onset of anorexia, vomiting and depression. Two days prior, the dog was exposed to an algal bloom in a community lake. Within h, the animal became lethargic and anorexic, and progressed to severe depression and vomiting. A complete blood count and serum chemistry panel suggested acute hepatitis, and a severe coagulopathy was noted clinically. Feces from the affected dog were positive for the cyanobacterial biotoxin, microcystin-LA (217 ppb). The dog was hospitalized for eight days. Supportive therapy consisted of fluids, mucosal protectants, vitamins, antibiotics, and nutritional supplements. On day five of hospitalization, a bile acid sequestrant, cholestyramine, was administered orally. Rapid clinical improvement was noted within 48 h of initiating oral cholestyramine therapy. At 17 days post-exposure the dog was clinically normal, and remained clinically normal at re-check, one year post-exposure. To our knowledge, this is the first report of successful treatment of canine cyanobacterial (microcystin) toxicosis. Untreated microcystin intoxication is commonly fatal, and can result in significant liver damage in surviving animals. The clinical success of this case suggests that oral administration of cholestyramine, in combination with supportive therapy, could significantly reduce hospitalization time, cost-of-care and mortality for microcystin-poisoned animals
Keywords: acute hepatitis; blue-green algae; cholestyramine; cyanobacteria; hepatotoxin; microsystin; poisoning; silibinin
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Rankin, K.A.; Alroy, K.A.; Kudela, R.M.; Oates, S.C.; Murray, M.J.; Miller, M.A. Treatment of Cyanobacterial (Microcystin) Toxicosis Using Oral Cholestyramine: Case Report of a Dog from Montana. Toxins 2013, 5, 1051-1063.
Rankin KA, Alroy KA, Kudela RM, Oates SC, Murray MJ, Miller MA. Treatment of Cyanobacterial (Microcystin) Toxicosis Using Oral Cholestyramine: Case Report of a Dog from Montana. Toxins. 2013; 5(6):1051-1063.
Rankin, Kelly A.; Alroy, Karen A.; Kudela, Raphael M.; Oates, Stori C.; Murray, Michael J.; Miller, Melissa A. 2013. "Treatment of Cyanobacterial (Microcystin) Toxicosis Using Oral Cholestyramine: Case Report of a Dog from Montana." Toxins 5, no. 6: 1051-1063.