What is the treatment for Bufo or Rhinella toad toxicity in a dog including decontamination and arrhythmia management?

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Accepted Answer

Oral decontamination is the immediate priority and should begin before the dog reaches the clinic — flush the oral mucous membranes copiously with water, with the dog's head tilted laterally and the rinse directed away from the throat to prevent aspiration and further toxin ingestion.13 Initiating oral lavage as soon as possible is recommended, as the clinical syndrome is evident almost immediately after exposure.14 The clinical syndrome in dogs includes profuse ptyalism, gastrointestinal signs, respiratory signs, and neurologic signs, with cardiac arrhythmias developing less frequently but representing the most life-threatening component.1 Neurologic signs occur in 87.5% of dogs, respiratory signs in 76.9%, and cardiac signs in 74.5% of dogs exposed to Incilius alvarius, a closely related toad species with a similar clinical syndrome and treatment approach.4 Cardiac monitoring is essential throughout treatment, as severe arrhythmias can develop.1 Atropine is indicated for bradyarrhythmias.1 The clinical syndrome and treatment of Rhinella marina and Incilius alvarius intoxications are similar, and supportive care alongside oral lavage are the mainstays of therapy for both.4 Prognosis with early and appropriate treatment is excellent — 99% of dogs (206/208) survived to discharge in a cohort of I. alvarius exposures.4 Without early treatment, Rhinella marina exposure can carry a high fatality rate.1 | Component | Protocol | Efficacy | Key Caveat | |---|---|---|---| | Oral lavage | Copious water flush; head tilted laterally, rinse directed away from throat | Mainstay of therapy; initiate immediately134 | Begin before clinic arrival if possible4 | | Supportive care | Stabilization of respiratory and neurologic signs | Mainstay of therapy alongside oral lavage4 | Neurologic signs in 87.5%, respiratory in 76.9% of dogs4 | | Cardiac monitoring | Continuous ECG monitoring | Arrhythmias in 74.5% of dogs4 | Severe arrhythmias less frequent but potentially fatal1 | | Atropine