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Treating Sago Palm Toxicosis
Dogs are commonly exposed to trimmings of sago plants when outdoors, while cats are generally exposed to the toxin from indoor palm plants.
Sago palm plants are part of two different types of plants collectively referred to as Cycads, Cycas sp.and Zamia sp, and the concerns are similar for all plants in these two geneses.
Cycads can cause CNS signs in cattle (referred to as Zamia Staggers), but we will be concentrating on dogs and cats in this article.
The first signs we typically see are GI related and start within 12 hours post ingestion. We will see vomiting and diarrhea, often both with blood.
We can see the development of hemorrhagic gastroenteritis, severe abdominal pain, dehydration and shock. We can also see neurologic signs, such as tremors and seizures. One of the biggest concerns is for hepatotoxicity and potentially hepatic necrosis.
Bloodwork should be monitored closely, and increased liver enzymes can take up to 48 hours to occur. Additionally, we can see hyperbilirubinemia, hypoglycemia, hypoproteinemia, thrombocytopenia, coagulopathy, blood loss anemia and either leukopenia or leukocytosis.
Treatment is often extensive and intensive. If there is a recent ingestion and the pet is asymptomatic, decontamination can be attempted, and emesis may recover plant material or seeds from the plant. Activated charcoal is effective for this, but often pets are too symptomatic for charcoal by the time that they present to the hospital.
- Intravenous fluids are indicated for this exposure, and we will typically add dextrose and B Vitamins to help protect the liver and prevent and/or treat hypoglycemia.
- Liver protectants should be administered as well, and whole blood may be indicated for patients with significant blood loss and/or anemia.
- Plasma transfusions can help improve oncotic pressure and provide clotting factors to coagulopathic patients.
- Colloids may also be indicated, once bleeding is controlled.
- Antiemetics are typically indicated and several may be necessary to control vomiting.
- Gastroprotectants will help with the irritating effects of the Sago palm.
- Seizures are typically treated with antiepileptics.