title: Survival and prognostic indicators for cycad intoxication in dogs.
abstract: BACKGROUND
  Cycad palms are commonly used in landscaping and ingestion by dogs can cause disease or death.
  
  
  OBJECTIVE
  Determine the morbidity and case fatality of cycad palm toxicosis in dogs from Louisiana, and examine putative prognostic factors.
  
  
  METHODS
  Thirty-four client-owned dogs with confirmed cycad palm toxicosis between 2003 and 2010.
  
  
  METHODS
  Retrospective cohort study. Search of all medical records for animals with cycad palm toxicosis.
  
  
  RESULTS
  Seventeen of 34 (50%) dogs died or were euthanized as a direct consequence of cycad intoxication. There were no differences in presenting signs and physical examination findings between survivors and nonsurvivors. Nonsurvivors had higher serum alanine transaminase activity (median 196 U/L; range 16-4,123 versus 113.5; 48-1,530) and total bilirubin concentration (0.5 mg/dL; 0.1-6.2 versus 0.25; 0-1.7) upon presentation, and their initial serum concentrations of albumin (2.9 g/dL; 1.4-4.1 versus 3.3; 2.2-3.9) were lower than those of survivors. Nadir serum albumin concentration was also lower in nonsurvivors (1.9; 1.4-3.7 versus 3.2; 1.8-3.5). A higher proportion of nonsurvivors had prolonged coagulation times, prothrombin time. and partial thromboplastin time. In a multivariate model, administration of charcoal at initial presentation was associated with longer survival (heart rate [HR] 0.019, 95% CI 0.001-0.644), while high serum aspartate aminotransferase activity was a negative prognostic factor (HR 118.2, 95% CI 2.89-4,826).
  
  
  CONCLUSIONS
  Cycad intoxication is associated with a higher case fatality than previously published. Several laboratory parameters might help differentiating potential nonsurvivors from survivors. Administration of charcoal as part of the emergency treatment appears to have a protective effect.
authors.affiliation: Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, LA 70803, USA.
authors.forename: D
authors.initials: D
authors.lastname: Ferguson
authors.forename: M
authors.initials: M
authors.lastname: Crowe
authors.forename: L
authors.initials: L
authors.lastname: McLaughlin
authors.forename: F
authors.initials: F
authors.lastname: Gaschen
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001663:Bilirubin / Q000097:blood; D002606:Charcoal / Q000627:therapeutic use*; D015331:Cohort Studies; D032462:Cycadopsida / Q000506:poisoning*; D004283:Dog Diseases / Q000097:blood / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D004285:Dogs; D008145:Louisiana; D008297:Male; D015999:Multivariate Analysis; D010314:Partial Thromboplastin Time / Q000662:veterinary; D011379:Prognosis; D011517:Prothrombin Time / Q000662:veterinary; D012189:Retrospective Studies; D012621:Seasons; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin; D002606:Charcoal; D000410:Alanine Transaminase; D001663:Bilirubin