Enzootic calcinosis in sheep in Uruguay: a brief review and report of two outbreaks / Calcinose enzoótica em ovinos no Uruguai: revisão de literatura e descrição de dois surtos

This study aimed to do a brief review of enzootic calcinosis in sheep and to report two outbreaks of Nierembergia rivularis poisoning in sheep in Uruguay. The outbreaks occurred in farms located on an island (Outbreak A) and on the border (Outbreak B) of the Rincón del Bonete lake. Sheep of all ages were affected, with the exception of suckling lambs. The first clinical signs occurred in early October, and deaths occurred from December to February. Outbreaks A and B had morbidity of 10%, and the mortality was 7.2% and 2.8% in Outbreaks A and B, respectively. The clinical signs included weight loss, retracted abdomen, stiff gait, and kyphosis. An autopsy was performed on one sheep from each outbreak. Pulmonary and arterial calcification, nephrocalcinosis, and osteopetrosis were observed in gross and microscopic examination in both sheep. Thyroid C-cell hyperplasia and carcinoma was observed in sheep A. Sheep B showed thyroid C-cell hyperplasia and parathyroid chief cell atrophy. The parathyroid was not examined in the sheep from Outbreak A. The differential diagnosis of enzootic calcinosis in southern South America should consider four toxic plants in the Solanaceae family: Solanum glaucophyllum, Solanum stuckertii, Nierembergia veitchii, and Nierembergia rivularis.(AU)

Este trabalho faz uma breve revisão da calcinose enzoótica em ovinos e descreve dois surtos de intoxicação por Nierembergia rivularis em ovinos no Uruguai. Os surtos ocorreram em propriedades localizadas em uma ilha (Surto A), e nas margens (Surto B) do lago do Rincón del Bonete. Foram afetados ovinos de todas as idades, exceto cordeiros lactentes. Os primeiros sinais clínicos ocorreram no início de outubro e as mortes de dezembro a fevereiro. Morbidade de 10% foi observada nos Surtos A e B. A mortalidade foi de 7,2% e 2,8% nos Surtos A e B, respectivamente. Os sinais clínicos incluíram perda de peso, abdômen retraído, marcha rígida e cifose. Foram necropsiados um animal de cada rebanho. Observou-se mineralização arterial e pulmonar, nefrocalcinose e osteopetrose no exame macroscópico e histológico dos dois ovinos. Hiperplasia e carcinoma de células C da tireoide foram observados no ovino A. O ovino B apresentou hiperplasia de células C da tireoide e atrofia das células principais da paratireoide. As paratireoides do ovino A não foram examinadas. O diagnóstico diferencial da calcinose enzoótica no Sul da América do Sul deve considerar quatro plantas calcinogênicas da família Solanaceae: Solanum glaucophyllum, Solanum stuckertii, Nierembergia veitchii e Nierembergia rivularis.(AU)

Hypoventilation, cardiac dysrhythmia, and cardiac arrest following acute Brunfelsia species (Yesterday, today, tomorrow) intoxication in a dog.

BACKGROUND: Intoxication following ingestion of the popular garden shrub 'Yesterday, today, tomorrow' (Brunfelsia sp.) is known to result in gastrointestinal and central nervous system clinical signs in dogs. CASE REPORT: A 2-year-old dog developed acute-onset vomiting, profuse diarrhoea and ptyalism after unsupervised access to an enclosed backyard that contained a Brunfelsia sp. shrub. During initial assessment the watery diarrhoea contained plant material and the dog appeared painful on abdominal palpation. Soon after admission, severe neurological abnormalities developed. Decontamination was undertaken by gastric and colonic lavage under general anaesthesia, but on recovery the patient had generalised seizures that were unresponsive to benzodiazepines. Following treatment with multiple antiepileptic medications and endotracheal intubation for loss of gag reflex, the patient developed respiratory failure requiring mechanical ventilation. Four days after initial presentation, the patient developed cardiac dysrhythmia leading to fatal cardiac arrest. Plant material recovered from the shrub and the patient's gastrointestinal tract were identified as Brunfelsia spp. CONCLUSION: This is the first report of hypoventilation, severe cardiac dysrhythmia and cardiac arrest associated with Brunfelsia sp. intoxication in a dog. Previous reports described clinical signs of gastrointestinal disease and mild cardiac dysrhythmia progressing to seizure activity and opisthotonus. Electrocardiography should form part of patient monitoring and mechanical ventilation considered for patients that develop respiratory failure, especially if massive ingestion is suspected.

Poisoning by Brunfelsia uniflora in sheep and donkeys.

Farmers in the State of Piauí in northeastern Brazil reported nervous signs in ruminants and donkeys after ingestion of Brunfelsia uniflora at the start of the rainy season when the plant is flowering. Leaves of the plant, collected at the start or at the end of the rainy season, were administered in single doses of 5-20 g/kg body weight to 8 sheep and 3 donkeys. Two sheep and 1 donkey that ingested 10 g/kg of the plant in November at the start of the rainy season, when the plant was flowering, developed severe convulsions and diarrhea. One sheep was euthanized and autopsied, and no significant lesions were found. The other sheep and the donkey recovered. Four sheep and one donkey that ingested 10 or 20 g/kg of leaves collected in April, at the end of the rainy season, did not show clinical signs. One donkey that ingested 5 g/kg of leaves collected in November developed diarrhea and recovered. These results demonstrate the toxicity of B. uniflora for livestock and suggest that the plant is toxic at these doses only during the start of the rainy season.

Intoxicação por Metternichia princeps (Solanaceae) em caprinos no estado da Bahia / Poisoning by Metternichia princeps (Solanaceae) in goats in the state of Bahia, Brazil

Descreve-se um surto de intoxicação por Metternichia princepsem caprinos no Estado da Bahia. De oito caprinos, três morreram, dos quais dois foram necropsiados; cinco não adoeceram. Os principais sinais clínicos caracterizaram-se por secreção nasal mucosa, emagrecimento, diarreia, apatia, debilidade leve, andar cambaleante, flexão dos membros torácicos e pélvicos, decúbito esterno-abdominal e decúbito lateral, seguidos de morte após aproximadamente dois dias de evolução clínica. Na necropsia foi observado edema pulmonar, hidrotórax, hidropericárdio, ascite, rins pálidos, edema perirrenal e hemorragias no tecido subcutâneo. Microscopicamente nos rins havia acentuada necrose de coagulação do epitélio tubular e túbulos com regeneração do epitélio. No pulmão havia acentuada congestão associada a edema interalveolar e interseptal. Na bioquímica sanguínea observou-se aumento na ureia, creatinina e creatinina fosfoquinase.

An outbreak of poisoning by Metternichia princepsis reported in goats from the State of Bahia. Out of eight goats three showed symptoms of poisoning and died; on two of them post-mortem examinations were performed. The main clinical signs were nasal mucous secretion, weight loss, diarrhea, lethargy, mild weakness, staggering gait, flexion of the fore and hind limbs, sternal recumbence, and lateral recumbence followed by death after approximately two days of clinical manifestations. The serum concentration of urea and creatinine and the serum activities of creatine phosphokinase were increased. At necropsy pulmonary edema, hydrothorax, hydropericardium, ascites, pale kidneys, perirenal edema and hemorrhages in the subcutaneous tissue were observed. Microscopically the kidneys showed accentuated coagulation necrosis of the tubular epithelium and tubules and epithelial regeneration. In the lungs there was accentuated congestion associated with interalveolar and interseptal edema.

Enzootic calcinosis caused by Nierembergia rivularis in sheep.

Enzootic calcinosis was diagnosed in sheep in Uruguay in pastures containing the plant Nierembergia rivularis. In a flock of 200 sheep, 20 were affected and 12 died. Clinical signs were anorexia, weight loss followed by cachexia, stiffness, and kyphosis. At necropsy and histologic examination, mineral deposits were observed on the medial layer of the arteries, heart, lungs, and kidneys. Similar lesions were also observed in 3 sheep forced to graze in an area containing the plant, while no lesions were observed in a control sheep that grazed in an area free of N. rivularis. It is concluded that N. rivularis is a calcinogenic plant for sheep.

Suspected Vestia foetida poisoning in young goats.

CASE HISTORY: Two crossbred, castrated male goats, a 5-month-old and an 8-month-old, were observed ingesting Vestia foetida (Solanaceae). Later, the goats were seen standing splay-legged and apparently disoriented. CLINICAL FINDINGS: When examined, both goats were in sternal recumbency and had mydriasis; the younger goat had a diminished menace response. When the goats were made to stand, they were ataxic and had muscle fasciculations of the hindquarters and face. Both had halitosis consistent with the odour of crushed Vestia leaves. The animals were treated with a mixture of vitamins and intravenous diazepam. The older goat recovered but the younger goat died and was necropsied. This animal had severe periacinar necrosis and fatty change in the liver, as well as fatty nephrosis. DIAGNOSIS: Probable Vestia foetida poisoning. CLINICAL RELEVANCE: The introduction of Vestia foetida to New Zealand and the apparent palatability of the plant necessitate that veterinarians and owners be knowledgeable about its potential toxicity. Differential diagnoses for the liver lesions (in New Zealand) would include Cestrum poisoning, acute seneciosis, acute blue-green algal poisoning, and acute and chronic copper poisoning.

Angel's trumpet (Brugmansia arborea) and mydriasis in a child--a case report.

We report a case of anisocoria in a 6-year old child who felt out of an inflatable swimming pool in the garden. After instillation of pilocarpine 1% the dilated pupil constricted, which is an important clinical sign associated with intracranial trauma. There was evidence of exposure to angel's trumpet (Brugmansia arborea), a plant known to contain anticholinergic substances. As the results of further neurological examination turned out to be normal, we believe the mydriasis was due to an accidental exposure to angel's trumpet. The time lag between exposure and presentation at the emergency room, the probably low volume of the plant extract in the eye and the unpredictable concentration of alkaloids in the plant, can influence and question the reliability of the pilocarpine test in this case.

Presumed Angel's trumpet (Brugmansia) poisoning: clinical effects and epidemiology.

OBJECTIVE: To investigate the pattern and epidemiology of anticholinergic plant poisoning, and to characterize its time course and clinical features. METHODS: We reviewed all anticholinergic plant poisonings using a prospective database of all poisonings admitted to a major toxicology unit in Australia. All patients that presented with anticholinergic plant poisoning between July 1990 and June 2000 were included. Patient demographics, details of poisoning, diagnostic clinical features, adverse effects (seizures, arrhythmias, hypotension, accidental injury), and treatments required were obtained. Important diagnostic features were analysed and compared to previous studies. RESULTS: Thirty-three patients were presumed to have ingested Brugmansia spp. (Angel's trumpet) based on their description of the plant; median age 18 years (interquartile range 16-20); 82% males. Thirty-one ingested a brewed tea or parts of the plant (flower). Thirty-one used it recreationally. Common clinical features were: mydriasis (100%), mean duration 29 h (SD 13) and delirium (88%) with a mean duration of 18 h (SD 12). Tachycardia only occurred in 11 of the 33 patients (33%). In 24 patients where the time of ingestion was certain, 7 of 8 (88%) patients presenting within 5 h had tachycardia and only 5 out of 16 (31%) presenting after 5 h had tachycardia. There were no deaths, seizures or arrhythmias (excepting tachycardia). One patient had hypotension and two sustained accidental traumatic injuries. Nineteen patients required sedation, mainly with benzodiazepines. Physostigmine was used diagnostically in eight cases. CONCLUSIONS: Anticholinergic plant abuse is sporadic in nature. Most cases were moderate in severity, requiring sedation only, and severe toxicity was rare. Mydriasis and delirium were the commonest features, the later having important implications for management.

[Accidental drowning due to tropane alkaloid abuse]. / Ertrinkungsunfall bei Tropanalkaloidbeeinflussung.

The cause of drowning deaths in good swimmers may be difficult to solve. After homicide, suicide and other kinds of immersion deaths have been ruled out, not only alcohol and narcotics, but also other psychotropic substances such as thornapple and angel's trumpet should be taken into consideration--at least in adolescents and young adults. The article reports on an accidental death by drowning under the influence of tropane alkaloids after consumption of a decoction of the flowers of angel's trumpet.

Effects of plant-induced hypervitaminosis D on cutaneous structure, cell differentiation and cell proliferation in cattle.

Solanum glaucophyllum (Sg) (synonym S. malacoxylon) is a plant toxic to cattle due to its high levels of 1,25-dihydroxyvitamin D3 as glycoside derivatives. Sg causes a disease characterized by wasting and calcification of soft tissues. The effects of vitamin D are not only important in calcium homeostasis, but also in immune regulation, cell growth and cell differentiation. Skin samples in Sg-intoxicated and control heifers were studied histologically. Cellular differentiation and proliferation were analysed by immunohistochemical expression of cytokeratins, involucrin and proliferating cell nuclear antigen (PCNA). The results were obtained by image processing and analysis and were statistically evaluated. Sg-intoxicated cattle showed atrophy of epidermis and severe involution of hair follicles and of sebaceous and sweat glands. As judged by PCNA expression, cellular proliferation was reduced, even though the reduction was not statistically significant. The analysed markers of differentiation, e.g. involucrin and cytokeratins 10 and 11, changed in relation to Sg-poisoning. The possible pathogenesis of the skin lesions is discussed.

[Nightshade plants act almost like LSD. Poisoning cases are on the rise]. / Nachtschattengewächse wirken fast wie LSD. Vergiftungsfälle häufen sich.

Intoxicated states can be induced not only by the typical narcotic drugs, but also by other psychotropic substances, such as the thorn-apple and angel's trumpet. In recent times there has been an increase in the reported number of cases of such intoxications. Clinical symptoms, toxicological analysis and possible forms of treatment are discussed.