Sometimes you have to be quite the detective when figuring out what went wrong with your otherwise normal patient.  One day they are fine the next…a train wreck. So what happened?? 

Sometimes you have to be quite the detective when figuring out what went wrong with your otherwise normal patient.  One day they are fine the next…a train wreck. So what happened?? 

• A 6-month-old M DSH cat was presented for a routine castration and declaw procedure.
• Initial examination and all preoperative blood work were within normal limits.
• The patient recovered from both procedures without event and his mentation was normal several hours post-op.
• Buprenex and Penicillin injectables were given as part of his treatment plan.
• The following day during morning nursing rounds the patient was found foaming at the mouth, severely ataxic, and hypersensitive to sound and touch.
• Temperature was normal at 101.1 degrees and declaw bandages were in place but wet due to drooling.
• The cat was non-ambulatory due to ataxia and was experiencing horizontal nystagmus.
• A blood glucose was also normal.

Was the patient given the wrong medication? Was he exposed to some sort of environmental toxins? Could he have FIP or some other badness cooking? Turns out that the very benign looking purple flea and tick collar was the silent culprit! Overnight the cat must have been trying to chew at his bandages without much success and instead ended up chewing on the collar.  There was distinct evidence that the cat had chewed very small pin holes throughout the entire top edge of the flea and tick collar closest to his chin.  Upon further investigation the active ingredient was determined to be Tetrachlorvinphos or TCVPs, which according to the NRDC “TCVP interferes with an essential enzyme, acetylcholinesterase, which normally controls messaging between nerve cells. It kills fleas and ticks by inducing spasmodic overexcitation of the nervous system. In large doses, it can harm or kill cats, dogs and, in extreme poisoning cases, humans. At lower levels of exposure, TCVP causes a variety of poisoning symptoms, many of which can mimic common illnesses; these include nausea, vomiting, diarrhea, wheezing, sweating and tearing eyes. More severe poisoning can cause muscle twitching, drooling, seizures, respiratory paralysis and death.

• The collar was removed immediately after finding it gnawed on.
• The patient was given a dose of Cerenia and was closely monitored for seizure activity or worsening symptoms.
• Within an hour of collar removal the patient was already showing signs of dramatic improvement.

At the end of my shift the patient was ambulating well, eating and drinking normally, the nystagmus had completely resolved and he was happily purring.  I have always despised the flea collar solely due to the horrendous smell that they had and normally gave them back to the owner upon admit or threw them out.  Now I will just throw them out!