title: Presumptive cocaine toxicosis in 19 dogs: 2004-2012.
abstract: OBJECTIVE
  To characterize the incidence, signalment, presenting complaint, history, clinical signs, diagnostic test results, complications, treatment, length of hospitalization, and outcome of dogs presenting with presumptive cocaine toxicosis.
  
  
  METHODS
  Retrospective study from March 1, 2004 to March 1, 2012.
  
  
  METHODS
  Twenty-four hour urban university veterinary teaching hospital.
  
  
  METHODS
  Nineteen dogs presenting with clinical signs consistent with cocaine toxicosis and having a positive urine cocaine test.
  
  
  METHODS
  None.
  
  
  RESULTS
  All dogs had neurological abnormalities including bilateral mydriasis (11/19 [58%]), hyperexcitability/hyperesthesia (10/19 [53%]), ataxia (8/19 [42%]), focal or generalized muscle tremors (8/19 [42%]), reduced mental awareness (6/19 [32%]), and seizures (3/19 [16%]). Other signs included weakness (7/19 [37%]), vomiting (6/19 [32%]), and lethargy (3/19 [16%]). Tachycardia was apparent in 10/19 (53%) dogs, hypertension in 4/19 (21%), and hyperthermia in 5/19 (26%). Sinus tachycardia was the only reported cardiac arrhythmia. Bloodwork findings included hyperglycemia in 4/19 (21%) dogs, and increased plasma lactate concentration in 9/19 (47%). Most dogs (16/19 [84%]) were hospitalized for supportive care, which generally included isotonic crystalloid fluid administration, and treatment with sedative or anxiolytic drugs including diazepam, midazolam, acepromazine, and chlorpromazine. Two dogs required further anticonvulsant therapy (phenobarbital and propofol) and 1 dog was treated with a constant rate infusion of esmolol. All dogs survived to discharge, and the median length of hospitalization was 15 hours (10-30 h).
  
  
  CONCLUSIONS
  Cocaine toxicosis was infrequently suspected. Neurological signs predominated, but cardiovascular alterations were also frequently reported. Hospitalization for monitoring and supportive care is recommended given the potential for life-threatening complications such as seizures, hypertensive crisis, and tachyarrhythmias. The prognosis for survival to hospital discharge can be good with the appropriate supportive care.
authors.affiliation: Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, PA, 19104-6010.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Thomas
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Drobatz
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Mandell
mesh_terms: D000818:Animals; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001007:Anxiety / Q000139:chemically induced* / Q000188:drug therapy; D003042:Cocaine / Q000506:poisoning*; D004283:Dog Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D004285:Dogs; D005440:Fluid Therapy; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D006993:Hypnotics and Sedatives; D003042:Cocaine
keywords: canine; illicit drugs; sympathomimetics; toxicology