Rodenticide Toxicity

What is Rodenticide Toxicity?

Rodenticide toxicity, or poisoning from rat poison, is a significant health concern because different types of rodenticides work in various ways, making it difficult to predict symptoms. The majority of people get exposed to rodenticides by accident, often involving young children. The symptoms of rodenticide poisoning can greatly vary. They can range from bleeding caused by the poison affecting the blood’s ability to clot, to changes in brain function and metabolism.

It’s crucial to quickly figure out which rodenticide was ingested for effective treatment. This involves gathering a detailed account of the incident, conducting a thorough physical check-up, and looking for the rodenticide packaging or other clues that might indicate the specific type of poison. Treatment involves first stabilizing the patient, and then administering specific antidotes or supportive care, depending on the type of rodenticide ingested.

It’s also important to talk to poison control centers or toxicologists, who are experts in dealing with poison, for advice on how to best treat rodenticide poisoning.

What Causes Rodenticide Toxicity?

Although rat poisons known as rodenticides, which include common substances like anticoagulants, are often used today, there are many other types of rat poisons available. This means that poisoning symptoms can depend on the specific type of rat poison swallowed. The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA), regulated by the Environmental Protection Agency (EPA), is a law that controls the labeling, distribution, selling, and use of all rat poisons.

According to FIFRA, rat poisons need to have labels with special words to warn about how toxic they are.

The word “danger” labeled on the rat poison means it is highly toxic. These types of rat poisons include substances like thallium, sodium monofluoroacetate (also known as SMFA or fluoroacetate), strychnine, zinc phosphide, aluminum phosphide, phosphorus, arsenic, and barium carbonate. Some dangerous rat poisons which are seldom used or banned include tetramethylenedisulfotetramine (also called TETS or tetramine), aldicarb, alpha-chloralose, and pyrinuron.

The label “warning” on rat poison means it is moderately toxic. Examples include alpha-naphthylthiourea and cholecalciferol.

Lastly, rat poisons labeled with the word “caution” are of low to very low toxicity risks, such as superwarfarin, warfarin, norbormide, bromethalin, and red squill.

Risk Factors and Frequency for Rodenticide Toxicity

As per the 2022 Annual Report by the American Association of Poison Control Centers, over 8000 cases of rodenticide (rat poison) ingestion were reported in the U.S alone. More than half of these poisoning cases were in children under 6 years old. The majority of these cases, over 3000, involved anticoagulant rodenticides (substances that prevent blood from clotting). Bromethalin, a potent rodenticide, was identified as the second most commonly swallowed substance, with a total of 1681 cases.

Signs and Symptoms of Rodenticide Toxicity

Children are at a higher risk of being poisoned by rodenticides mainly because of accidental ingestion, although some adults intentionally consume rodenticides to attempt suicide. The most common rodenticides used in the United States are anticoagulants. If consumed, anticoagulant rodenticides can cause symptoms like blood in urine and phlegm, nose bleeds, side pain, bruising, and small red spots under a blood pressure cuff. However, different rodenticides can cause different symptoms, so it’s essential to identify which kind was ingested. This might involve asking friends or family members or law enforcement to help look for the packaging or other indicators of the specific rodenticide involved in the poisoning.

Rodenticide toxicity is classed according to how much of the poison would cause death in half of the exposed animals, known as the lethal dose 50, or LD50. In places like the United States, the toxicity of a rodenticide is indicated on the product label with words like danger, warning, or caution. ‘Danger’ means it’s very toxic (LD50 of 0-50 mg/kg), ‘warning’ means it’s toxic (LD50 of 50-500 mg/kg), and ‘caution’ suggests it’s less toxic (LD50 of 500-5000 mg/kg).

Symptoms of toxicity from specific rodenticides include:

Thallium: Acute exposure might result in acute gastroenteritis, cranial nerve dysfunction, painful peripheral neuropathy, seizures, hair loss, and darkening of the skin. Long-term exposure might cause symptoms like tremors, uncoordinated movements, distal motor weakness, double vision, uncontrolled eye movements, seventh cranial nerve palsy, and cloudy ocular lens.
Fluoroacetamide (Compound 1080) and Sodium Monofluoroacetate: These can cause seizures, metabolic acidosis, shock, heart rhythm disorders, and low calcium in the blood. Late-stage complications might include acute kidney injury, liver dysfunction, and shrinkage of the brain tissue.
Strychnine: This could cause muscle spasms, jaw muscle contractions, facial grimace, arching of the back, lactic acidosis, and raised body temperature. Rhabdomyolysis could also occur due to muscle damage.
Zinc and Aluminum Phosphide: Ingesting these may cause acute gastroenteritis, acid-base disorders, heart rhythm irregularities, kidney failure, blood-filled lung edema, respiratory failure, liver damage, and break down of red blood cells.
Elemental Phosphorus: Symptoms of poisoning can include acute gastroenteritis, burns on the skin or inside the mouth, glowing vomit or stool, heart rhythm issues, kidney failure, and liver damage.
Arsenic: Consumption of arsenic could lead to a garlic taste, vomiting, bloody diarrhea, low blood pressure, prolonged QTc, acute kidney injury, delirium, and seizures. It can also cause coma in extreme cases.
Barium Carbonate: Poisoning symptoms might include gastroenteritis, hypertension, arrhythmias, shortness of breath, and muscle paralysis.
Tetramethylenedisulfotetramine (Tetramine), Aldicarb, Alpha-chloralose, Pyriminil, Cholecalciferol (Vitamin D3), Anticoagulants (Superwarfarins and Warfarin), Norbormide, Bromethalin, Red Squill: Each of these can lead to a range of symptoms including gastroenteritis, heart problems, neurological issues, respiratory challenges, bleeding, kidney failure, and even coma, among others.

Testing for Rodenticide Toxicity

If your doctor thinks you might have been poisoned by a rodenticide (rat poison), they’ll need to identify the specific type of rodenticide quickly. Tests that help with this identification can include lab tests or diagnostic tests. However, it’s important to note that while these tests can show that something is not normal, they can’t always pinpoint exactly which rodenticide was ingested if it’s unknown. Here are some common tests that might be used:

Comprehensive Metabolic Panel

This test looks at the overall function of your body’s metabolism and can pick up changes caused by several different rodenticides. For example, it can spot low blood sugar levels that might be caused by zinc or aluminum phosphide, or high blood sugar levels from pyriminil. It can also find changes in calcium and potassium levels, signs of kidney damage, or liver damage.

Serum Phosphate

This test looks specifically at levels of phosphate in your blood and can detect high levels caused by ingesting white phosphorus.

Creatine Phosphokinase

This test checks for muscle damage, which might be a sign of poisoning from strychnine.

Serum Lactate

This measures the amount of lactic acid in the blood, which can increase after ingesting certain rodenticides like SMFA or fluoroacetamide.

Serum Lipase

This test checks for the enzyme lipase in the blood, which might be elevated after swallowing pyriminil.

Troponin

This blood test checks for damage to the heart muscle, which might be caused by the ingestion of zinc and aluminum phosphides.

Complete Blood Count

This test measures different components of the blood and can reveal if there’s a drop in the number of red blood cells, which might be caused by zinc or aluminum phosphide.

International Normalized Ratio and Activated Partial Thromboplastin Time

These blood clotting tests might show changes if you’ve ingested rodenticides that act as anticoagulants, such as warfarin and superwarfarins.

12-Lead Electrocardiogram

This heart test can show changes in heart rhythm that might be caused by certain rodenticides such as SMFA, fluoroacetamide, white phosphorous, or arsenic.

Chest and Abdominal X-Rays

These X-ray tests can show the presence of radiopaque rodenticides (those that show up on radiographic images), like barium carbonate, arsenic, and thallium.

Treatment Options for Rodenticide Toxicity

If someone has been exposed to a rat poison, the immediate steps to take include making sure the person can breathe properly and has a steady heartbeat. Once these vitals are stable, any remaining poison should be washed off the person’s skin with water, and their clothes should be taken off. At the same time, it’s important to get in touch with a poison control center or a poison expert for advice.

There are methods to clear the stomach of the poison, such as pumping the stomach, giving the person activated charcoal to absorb the poison or washing out the bowel. But these methods should only be used after consulting with a poison expert and typically are not the first line of treatment. There is limited evidence that these methods actually improve the chances of survival.

Other steps that may need to be taken after the person is stable might be to give fluids for dehydration, start cooling measures if the patient has a high temperature, and give medication to manage nausea or vomiting. In cases where the person has come into contact with a certain type of rat poison called aldicarb, doctors may use medications that block some of the effects of the poison.

After the initial emergency care, treatment usually focuses on supporting the patient’s recovery. But different types of rat poison need different specific treatments:

For poisonings caused by heavy metals such as thallium, arsenic, or barium, kidney therapies such as dialysis may be helpful
In cases of arsenic poisoning, some medications can help by binding to the arsenic in the body and helping to remove it
A special type of dye called Prussian blue can help to treat thallium poisoning by binding to it
If someone has swallowed a type of poison called barium carbonate, they may be given sodium or magnesium sulfates
In cases of a very strong poison called strychnine, medications that help to control muscle spasms or seizures, may be used
With a poison known as pyriminil, it may be helpful to give a vitamin called nicotinamide or certain medications that can help with low blood pressure
In cases of poison containing a toxic element called red squill, a drug that binds to it and helps to remove it may be used

Please note that all these treatments should only be provided under medical supervision. It’s important to reach out to a healthcare provider or a poison control center if you suspect poisoning.

When someone is possibly poisoned by a rodent killer (rodenticide), they can show a wide variety of symptoms. It’s important that treatment begins as soon as possible if the person has definitely been exposed to the rodenticide and is showing related symptoms. If it’s not clear whether the person has been exposed to the rodenticide, the doctor should also consider other conditions that might explain the symptoms. These could include:

Stomach flu (acute viral gastroenteritis)
An infection caused by a bad bacterium called Clostridioides difficile
Getting poisoned from eating food that has harmful substances in it (foodborne toxin exposure)
Sudden inflammation of the liver (acute hepatitis)
Withdrawal from alcohol or opioids
Diabetic ketoacidosis, a serious diabetes complication where the body produces high levels of blood acids (ketones)
A blood clotting problem (disseminated intravascular coagulation)
Getting poisoned by insecticides (organophosphate or carbamate toxicity)
Epilepsy
Bleeding inside the brain (intracranial hemorrhage)
Stroke
Getting bitten by a rattlesnake

What to expect with Rodenticide Toxicity

The future health status or ‘prognosis’ after consuming rodent poison highly depends on the kind of rodenticide consumed and the amount ingested. Those who get early treatment for this type of poisoning tend to have better recovery prospects than those whose treatment is delayed. This highlights the importance of getting a detailed medical history, a thorough physical check-up, and identifying the type of rodenticide consumed as soon as possible.

Long-term exposure to rodenticides carries more health risks compared to a one-time poisoning event. However, a large single dose of rodent poison can be extremely dangerous and is often linked to a high risk of death.

Possible Complications When Diagnosed with Rodenticide Toxicity

The problems that can result from rodenticide poisoning depend on the specific poison that’s swallowed. Serious issues can include kidney and liver failure, irreversible harm to the nervous system, and even death.
Potential Complications:

Kidney failure
Liver failure
Permanent damage to the nervous system
Potential death

Preventing Rodenticide Toxicity

When you’re using rodent poisons, it’s critical to always follow the instructions given. You should also be cautious to prevent people from accidentally coming into contact with them. All these poisons must be kept in places where children and pets can’t reach, preferably in secure containers that are clearly labelled. Be aware that some rodent poisons are bright in color, making them look like food, and could be mistakenly eaten.

Additionally, please use rodent traps that resist tampering to prevent anyone from accidentally consuming the poison. Remember, any poisoned rodents need to be put in secure trash containers. For anyone tasked with disposing of these rodents, you should always wear gloves so you don’t touch the poison on the rodents.

Frequently asked questions

Rodenticide toxicity refers to poisoning from rat poison, which is a significant health concern due to the various ways in which different types of rodenticides work. Symptoms can vary greatly, ranging from bleeding to changes in brain function and metabolism.

Over 8000 cases of rodenticide ingestion were reported in the U.S alone.

Signs and symptoms of Rodenticide Toxicity can vary depending on the specific rodenticide ingested. Here are some common signs and symptoms associated with different rodenticides: - Thallium: Acute exposure can result in acute gastroenteritis, cranial nerve dysfunction, painful peripheral neuropathy, seizures, hair loss, and darkening of the skin. Long-term exposure may cause symptoms like tremors, uncoordinated movements, distal motor weakness, double vision, uncontrolled eye movements, seventh cranial nerve palsy, and cloudy ocular lens. - Fluoroacetamide (Compound 1080) and Sodium Monofluoroacetate: These rodenticides can cause seizures, metabolic acidosis, shock, heart rhythm disorders, and low calcium in the blood. Late-stage complications might include acute kidney injury, liver dysfunction, and shrinkage of the brain tissue. - Strychnine: Ingesting strychnine can lead to muscle spasms, jaw muscle contractions, facial grimace, arching of the back, lactic acidosis, raised body temperature, and rhabdomyolysis due to muscle damage. - Zinc and Aluminum Phosphide: Consumption of these rodenticides may result in acute gastroenteritis, acid-base disorders, heart rhythm irregularities, kidney failure, blood-filled lung edema, respiratory failure, liver damage, and breakdown of red blood cells. - Elemental Phosphorus: Symptoms of poisoning from elemental phosphorus can include acute gastroenteritis, burns on the skin or inside the mouth, glowing vomit or stool, heart rhythm issues, kidney failure, and liver damage. - Arsenic: Consumption of arsenic can lead to a garlic taste, vomiting, bloody diarrhea, low blood pressure, prolonged QTc, acute kidney injury, delirium, seizures, and in extreme cases, coma. - Barium Carbonate: Poisoning symptoms associated with barium carbonate might include gastroenteritis, hypertension, arrhythmias, shortness of breath, and muscle paralysis. - Tetramethylenedisulfotetramine (Tetramine), Aldicarb, Alpha-chloralose, Pyriminil, Cholecalciferol (Vitamin D3), Anticoagulants (Superwarfarins and Warfarin), Norbormide, Bromethalin, Red Squill: Each of these rodenticides can lead to a range of symptoms including gastroenteritis, heart problems, neurological issues, respiratory challenges, bleeding, kidney failure, and even coma, among others. It's important to note that these are just some examples, and different rodenticides can cause different symptoms. Identifying the specific rodenticide involved in the poisoning is crucial for proper treatment and management.

Rodenticide toxicity can occur through ingestion of rat poisons containing toxic substances such as anticoagulants, thallium, sodium monofluoroacetate, strychnine, zinc phosphide, aluminum phosphide, phosphorus, arsenic, barium carbonate, and other dangerous chemicals.

The doctor needs to rule out the following conditions when diagnosing Rodenticide Toxicity: 1. Stomach flu (acute viral gastroenteritis) 2. Infection caused by Clostridioides difficile 3. Foodborne toxin exposure 4. Acute hepatitis (sudden inflammation of the liver) 5. Withdrawal from alcohol or opioids 6. Diabetic ketoacidosis 7. Disseminated intravascular coagulation (a blood clotting problem) 8. Organophosphate or carbamate toxicity (getting poisoned by insecticides) 9. Epilepsy 10. Intracranial hemorrhage (bleeding inside the brain) 11. Stroke 12. Getting bitten by a rattlesnake

The types of tests that are needed for Rodenticide Toxicity include: - Comprehensive Metabolic Panel - Serum Phosphate - Creatine Phosphokinase - Serum Lactate - Serum Lipase - Troponin - Complete Blood Count - International Normalized Ratio and Activated Partial Thromboplastin Time - 12-Lead Electrocardiogram - Chest and Abdominal X-Rays

The treatment for rodenticide toxicity depends on the specific type of poison involved. In general, the immediate steps include ensuring the person's ability to breathe and maintaining a steady heartbeat. The poison should be washed off the skin and the person's clothes should be removed. It is important to contact a poison control center or expert for advice. Clearing the stomach of the poison, such as through pumping the stomach or giving activated charcoal, may be considered but should only be done after consulting with a poison expert. Other steps that may be taken include giving fluids for dehydration, managing symptoms like nausea or vomiting, and using medications to counteract the effects of certain types of rat poison. Specific treatments for different types of rat poison include kidney therapies for heavy metal poisonings, medications to bind and remove arsenic, the use of Prussian blue dye for thallium poisoning, and the administration of sodium or magnesium sulfates for barium carbonate poisoning. Medications to control muscle spasms or seizures may be used for strychnine poisoning, and certain medications or vitamins may be given for other types of poison. It is important to note that all treatments should be provided under medical supervision, and healthcare providers or poison control centers should be contacted if poisoning is suspected.

The potential complications when treating Rodenticide Toxicity include kidney failure, liver failure, permanent damage to the nervous system, and potential death.

The prognosis for rodenticide toxicity depends on the type of rodenticide consumed and the amount ingested. Those who receive early treatment tend to have better recovery prospects than those whose treatment is delayed. Long-term exposure to rodenticides carries more health risks compared to a one-time poisoning event.

A healthcare provider or a poison control center.