title: Suspected synthetic cannabinoid toxicosis in a dog.
abstract: OBJECTIVE
  To describe the effects of suspected synthetic cannabinoid (SC) toxicosis and the response to intravenous lipid emulsion (ILE) therapy in a dog.
  
  
  METHODS
  A 2-year-8-month-old male Boxer dog was evaluated at an emergency hospital for progressive ataxia and inappropriate mentation. The initial physical examination identified marked hypothermia (32.7°C [90.9°F]), intermittent sinus bradycardia (60/min), stuporous mentation with intermittent aggression, and severe ataxia. Neurologic status deteriorated to comatose mentation within 2 hours of presentation. The initial diagnostic evaluation (eg, CBC, serum biochemistry profile, venous blood gas, and electrolyte determination) revealed a respiratory acidosis and thrombocytopenia. The owner reported that the dog was exposed to an SC containing Damiana leaf, Marshmallow leaf, and Athaea leaves. Initial treatment included IV fluids and supplemental oxygen. Mechanical ventilation was provided due to hypoventilation and periods of apnea. Intravenous lipid emulsion therapy was administered as a bolus (1.5 mL/kg) and continued as a continuous rate infusion (0.5 mL/kg/h) for a total of 6 hours. The dog became rousable and was weaned from mechanical ventilation approximately 15 hours following presentation. The dog was eating and walking with no ataxia, had a normal mentation at approximately 33 hours following presentation, and was discharged home at that time. Communication with the owners 5 days following discharge revealed that the dog was apparently normal.
  
  
  CONCLUSIONS
  Based on this case and other reports in the literature regarding human exposures, SC ingestion may result in more severe clinical signs than marijuana ingestion in dogs. Significant clinical intervention may be necessary. Intravenous lipid emulsion treatment may be beneficial due to the lipophilicity of SC.
authors.affiliation: From the Emergency Animal Clinic, Gilbert, AZ.
authors.forename: Keysa
authors.initials: K
authors.lastname: Williams
authors.affiliation: Emergency Animal Clinic, 86 West Juniper Avenue, Gilbert, AZ 85233 (Wells);
authors.forename: Raegan J
authors.initials: RJ
authors.lastname: Wells
authors.affiliation: ASPCA National Animal Poison Control Center, Urbana, IL. 61802.|Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: McLean
mesh_terms: D031583:Althaea; D000818:Animals; D002186:Cannabinoids / Q000633:toxicity*; D004283:Dog Diseases / Q000139:chemically induced*; D004285:Dogs; D005440:Fluid Therapy; D008297:Male; D010100:Oxygen; D012121:Respiration, Artificial; D029647:Turnera
chemical_list: D002186:Cannabinoids; D010100:Oxygen
keywords: intravenous lipid emulsion; marijuana; mechanical ventilation; toxicity