Immediate diagnosis and proper therapy is critically important to minimize morbidity and mortality because this condition, affecting thousands of patients annually, is reversible. These rodenticides are readily available household environmental hazards and are sometimes consumed accidentally or as manifestations of psychiatric disease. Superwarfarins are 2 orders of magnitude more potent than warfarin and have a half-life measured in weeks. Serious bleeding manifestations are common.
Vitamin K3 (Synkayvite, Roche) is not effective for treating rodenticide toxicity due to its delayed onset of action.Severe deficiency of vitamin K–dependent proteins in patients not maintained on vitamin K antagonists is most commonly associated with poisoning by or surreptitious ingestion of warfarin, warfarin-like anticoagulants, or potent rodenticides (“superwarfarins”), such as brodifacoum. Subcutaneous injection of Vitamin K1 is the preferred parenteral route of administration because intravenous Vitamin K1 can cause anaphylaxis, and hematomas may form at intramuscular sites. Vitamin K for preoperative prophylaxis should be given at 1.1 mg/kg SQ q. In order to prevent relapse, continue therapy for 6 weeks. Taper the maintenance dose by one-half every 2 weeks during treatment. Maintain oral Vitamin K1 at 1.1 mg/kg PO q 12h for a total of 2 weeks. Initiate parenteral Vitamin K1 as for warfarin (2.2 mg/kg SC).Īdminister Vitamin K1 at 1.1 mg/kg SC, q 12h until hematocrit value stabilizes and active bleeding subsides. To treat toxicity from second-generation, or long-acting rodenticides (bromadiolone, brodifacoum, or diphacinone, pindone):
Then substitute an oral vitamin K1 preparation (Mephyton) at the same twice-daily dosage. Warfarin is a relatively short-acting rodenticide, and treatment for a total of 1 week usually is adequate.Īdminister an initial dose of Vitamin K1 (Aquamephyton, Merck, Sharp, Dohme), 2.2 mg/kg SC.įollow with a dose of 1.1 mg/kg SC, q 12h, until active bleeding subsides. Other vitamin K deficient states include: biliary obstruction, intrahepatic cholestasis, intestinal malabsorption and chronic oral antibiotic administration. Vitamin K reverses the anticoagulant effect of rodenticides over a period of 24 to 48 hours from initiation of therapy. It is often initiated pending test results, but maintenance of vitamin K is not indicated for patients having diagnoses of thrombocytopenia, hereditary factor deficiencies, or DIC.Īnticoagulant rodenticide toxicities are the most common cause of severe vitamin K deficiency in dogs and cats. Vitamin K therapy improves hemostasis in Vitamin K deficient patients.
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