Akzidentelle Colchicinintoxikation bei einem Mischlingshund

Zusammenfassung

Eine 2 Jahre alte Mischlingshündin wurde aufgrund von akutem Erbrechen und zunehmender Apathie vorgestellt. Die Hündin hatte etwa 1–3 Stunden vor Vorstellung das Gichtmittel ihres Besitzers (0,35 mg/kg Colchicin) aufgenommen.

Während des stationären Aufenthaltes durchlief die Hündin alle beschriebenen Stadien (gastrointestinale Phase, Multiorganphase, Erholungsphase) einer Colchicinvergiftung, wobei der Verlauf durch das Vorliegen eines Multiorgandysfunktionssyndroms (MODS) und zahlreicher negativ prognostischer Faktoren verkompliziert wurde.

Diese Kasuistik beschreibt die klinischen und labordiagnostischen Auswirkungen einer Colchicinvergiftung bei einem Hund und stellt die erste erfolgreiche Behandlung einer solchen in Europa dar.

Abstract

A 2-year old cross-breed dog presented due to acute vomiting and progressive lethargy following ingestion of the owner’s anti-gout medication (colchicine, 0.35 mg/kg) 1–3 hours prior to presentation.

The dog developed signs of all 3 stages of colchicine poisoning (gastrointestinal phase, multi-organ phase, recovery phase) and the clinical course was complicated by the presence of multi-organ dysfunction syndrome (MODS) and numerous negative prognostic factors.

This case report describes the clinical and laboratory effects of colchicine poisoning and represents the first successful treatment of an accidental colchicine ingestion in a dog in Europe.

Schlüsselwörter

Hund - Colchicin - Vergiftung - Multiorgandysfunktionssyndrom (MODS) - intravenöse Lipidtherapie

Key words

Dog - colchicine - toxicosis - multi-organ dysfunction syndrome (MODS) - intravenous lipid therapy

Publication History

Received: 26 September 2020

Accepted: 21 January 2021

Article published online:
02 March 2022

• Literatur

• 1 Putterman C, Ben-Chetrit E, Caraco Y. et al. Colchicine intoxication: Clinical pharmacology, risk factors, features, and management. Semin Arthritis Rheum 1991; 21 (03) 143-55
• 2 Leung YY, Yao Hui LL, Kraus VB. Colchicine—Update on mechanisms of action and therapeutic uses. Semin Arthritis Rheum 2015; 45 (03) 341-50
• 3 Slobodnick A, Shah B, Pillinger MH. et al. Colchicine: Old and New. Am J Med 2015; 128 (05) 461-70
• 4 Finkelstein Y, Aks SE, Hutson JR. et al. Colchicine poisoning: the dark side of an ancient drug. Clin Toxicol 2010; 48 (05) 407-14
• 5 Terkeltaub RA. Colchicine update: 2008. Semin Arthritis Rheum 2009; 38 (06) 411-9
• 6 Slobodnick A, Shah B, Krasnokutsky S. et al. Update on colchicine, 2017. Rheumatology 2018; 57 (Suppl. 01) i4-11
• 7 Padeh S, Gerstein M, Berkun Y. Colchicine is a Safe Drug in Children with Familial Mediterranean Fever. J Pediatr 2012; 161 (06) 1142-6
• 8 Suehisa S, Tagami H, Inoue F. et al. Colchicine in the treatment of acute febrile neutrophilic dermatosis (Sweet’s syndrome). Br J Dermatol 1983; 108 (01) 99-101
• 9 Cacoub PP. Colchicine for treatment of acute or recurrent pericarditis. The Lancet 2014; 383 (9936): 2193-4
• 10 Rahimi M, Alizadeh R, Hassanian-Moghaddam H. et al. Clinical Manifestations and Outcomes of Colchicine Poisoning Cases; a Cross Sectional Study. Arch Acad Emerg Med 2020; 8 (01) e53
• 11 Erden A, Karagoz H, Gümüscü HH. et al. Colchicine intoxication: a report of two suicide cases. Ther Clin Risk Manag 2013; 9: 505-9
• 12 Harris R, Marx G, Gillett M. et al. Colchicine-induced bone marrow suppression: treatment with granulocyte colony-stimulating factor. J Emerg Med 2000; 18 (04) 435-40
• 13 Bismuth C, Gaultier M, Conso F. [Medullary aplasia after acute colchicine poisoning. 20 cases]. Nouv Presse Med 1977; 6 (19) 1625-9
• 14 Wagenaar Z. Accidental colchicine poisoning in a dog. Can Vet J 2004; 45 (01) 55-7
• 15 Hayem G. Chinese Shar-Pei dogs: a model for human Mediterranean fever?. Joint Bone Spine 2013; 80 (04) 353-4
• 16 Graham KL, Donaldson D, Billson FA. et al. Use of a 350-mm 2 Baerveldt glaucoma drainage device to maintain vision and control intraocular pressure in dogs with glaucoma: a retrospective study (2013–2016). Vet Ophthalmol 2017; 20 (05) 427-34
• 17 Brown SA, Williams JE, Saylor DK. Endotracheal Stent Granulation Stenosis Resolution after Colchicine Therapy in a Dog. J. Vet. Intern. Med. 2008; 22 (04) 1052-5
• 18 Lechner ES, Cooke KL. Dysuria caused by a partially obstructing urethral membrane in a female dog. J Am Vet Med Assoc 2011; 239 (06) 818-22
• 19 Goodman IH. Survival of a dog with accidental colchicine overdose. J Vet Emerg Crit Care 2020; 30 (01) 74-80
• 20 Harris RD, Gillett MJ. Colchicine poisoning-overview and new directions. J Emerg Med 2009; 10 (02) 161-7
• 21 Goodnough LT. Iron deficiency syndromes and iron-restricted erythropoiesis (CME). Transfusion 2012; 52 (07) 1584-92
• 22 Fernandez AL, Lee JA, Rahilly L. et al. The use of intravenous lipid emulsion as an antidote in veterinary toxicology: IV lipid emulsion as antidote in veterinary toxicology. J Vet Emerg Crit Care 2011; 21 (04) 309-20
• 23 Abbott CE, Xu R, Sigal SH. Colchicine-Induced Hepatotoxicity. ACG Case Rep J 2017; 4: e120
• 24 Boruchow IB. Bone marrow depression associated with acute colchicine toxicity in the presence of hepatic dysfunction. Cancer 1966; 19 (04) 541-3
• 25 Borron SW, Scherrmann J, Baud FJ. Markedly altered colchicine kinetics in a fatal intoxication: Examination of contributing factors. Hum Exp Toxicol 1996; 15 (11) 885-90
• 26 McAlister A, Center SA, Bender H. et al. Adverse Interaction Between Colchicine and Ketoconazole in a Chinese Shar Pei. J Am Anim Hosp Assoc 2014; 50 (06) 417-23
• 27 Niel E, Scherrmann J-M. Colchicine today. Joint Bone Spine 2006; 73 (06) 672-8
• 28 Rochdi M, Sabouraud A, Baud FJ. et al. Toxicokinetics of colchicine in humans: analysis of tissue, plasma and urine data in ten cases. Hum Exp Toxicol 1992; 11 (06) 510-6
• 29 Chen Y-J, Huang S-M, Liu C-Y. et al. Hepatobiliary excretion and enterohepatic circulation of colchicine in rats. Int. J. Pharm. 2008; 350 (01/02) 230-9
• 30 Wallace SL, Ertel NH. Plasma levels of colchicine after oral administration of a single dose. Metabolism 1973; 22 (05) 749-53
• 31 Deveaux M, Hubert N, Demarly C. Colchicine poisoning: case report of two suicides. Forensic Sci. Int. 2004; 143 (02/03) 219-22
• 32 Horioka K, Tanaka H, Isozaki S. et al. Acute Colchicine Poisoning Causes Endotoxemia via the Destruction of Intestinal Barrier Function: The Curative Effect of Endotoxin Prevention in a Murine Model. Dig Dis Sci 2020; 65 (01) 132-40
• 33 Kenney EM, Rozanski EA, Rush JE. et al. Association between outcome and organ system dysfunction in dogs with sepsis: 114 cases (2003–2007). J Am Vet Med Assoc 2010; 236 (01) 83-7
• 34 Stapczynski JS, Rothstein RJ, Gaye WA. et al. Colchicine overdose: report of two cases and review of the literature. Ann Emerg Med 1981; 10 (07) 364-9
• 35 Nafi A, Begum M, Hamid N. et al. Colchicine Induced Hypoglycemia: A Case Report. J Natl Inst Neurosci Bangladesh 2019; 5 (01) 87-9
• 36 Boyd CJ, Claus MA, Raisis AL. et al. Hypocoagulability and Platelet Dysfunction Are Exacerbated by Synthetic Colloids in a Canine Hemorrhagic Shock Model. Front Vet Sci 2018; 5: 279
• 37 Boyd CJ, Claus MA, Raisis AL. et al. Evaluation of biomarkers of kidney injury following 4 % succinylated gelatin and 6 % hydroxyethyl starch 130/0.4 administration in a canine hemorrhagic shock model. J Vet Emerg Crit Care 2019; 29 (02) 132-42
• 38 Karacabey BN, Demirkol D, Aygün F. et al. ABSTRACT 795: PLASMA EXCHANGE TREATMENT IN A CASE OF COLCHICINE INTOXICATION. Pediatr. Crit. Care Med. 2014; 15: 178
• 39 Kaplan A, Whelan M. The use of IV lipid emulsion for lipophilic drug toxicities. J Am Anim Hosp Assoc 2012; 48 (04) 221-7
• 40 Cheng CW, Hendrickson JE, Tormey CA. et al. Therapeutic Plasma Exchange and Its Impact on Drug Levels. Am. J. Clin. Pathol. 2017; 148 (03) 190-8