Herbal Poisonings

Petra A. Volmer, DVM, MS, DABVT, DABT

EPHEDRINE AND PSEUDOEPHEDRINE Administration of activated charcoal binds the caffeine and prevents Description and Causes further absorption. Hospitalization for monitoring and treatment Ephedrine and pseudoephedrine are naturally found in the plants is necessary for animals with severe exposures. Anticonvulsants, Ephedra sinica (ma huang, yellow horse, sea grape plant) and Sida sedatives, medications to correct heart arrhythmias, and intrave- cordifolia (Indian common mallow). These compounds are used nous fluids may be administered. medicinally for weight loss and as decongestants, and they are used Prognosis illicitly as herbal ecstasy and as precursors for methamphetamine. Prognosis is good for animals receiving prompt treatment. If treat- Toxicity ment is delayed or prolonged or severe signs occur, prognosis is They are rapidly acting central nervous system stimulants. poor. Clinical Signs Initial signs can include restlessness, agitation, pacing, panting, ST. JOHN’S WORT and vocalizing. Changes in heart rate can occur. Muscle tremors Description and Causes and seizures are common and are associated with increased body St. John’s wort (Hypericum perforatum ) contains hypericin temperature. Death can occur. and pseudohypericin, compounds that act on the central nervous system. Other common names are rosin rose and Klamath Diagnostic Tests weed. Diagnosis is based on a history of exposure and compatible clini- Toxicity cal signs. Pseudoephedrine can be identified in blood and urine. St. John’s wort stimulates a number of neurotransmitters in the brain. Treatment Options Signs can develop quickly, so vomiting is induced only under the Clinical Signs direction of a veterinarian, and only if no clinical signs are appar- Initial signs can include vomiting, diarrhea, and lethargy. ent. Activated charcoal may be administered. In severe cases, hos- Vocalizing, increased body temperature, muscle tremors, and sei- pitalization is required for monitoring of heart rate and rhythm and zures can occur with large ingestions. In rare cases, the liver may to provide treatments such as anticonvulsants or sedatives. be affected. Prognosis Prognosis is good for animals that receive prompt treatment. Diagnostic Tests Diagnosis is based on a history of exposure and consistent clini- GUARANA cal signs. Description and Causes Guarana is an herbal stimulant derived from Paullinia cupana Treatment Options seeds, which contain 3-5% caffeine. Guarana is used as a caf- Vomiting is induced only under the direction of a veterinarian, feine source by the soft drink industry. Some herbal stimulants and only if the animal is not exhibiting signs. Activated charcoal contain combinations of ma huang and guarana, which enhances is beneficial if large amounts were consumed. Hospitalization their toxicity. may be needed for administration of medications to control trem- Toxicity ors or seizures, excessive vomiting, or diarrhea and to support Caffeine is a rapidly acting central nervous system stimulant. the liver. Prognosis Clinical Signs Mild signs usually resolve in 24 hours. Animals with liver disease Initial signs include vomiting, hyperactivity, and increased drink- require periodic monitoring. ing, urination, and heart rate. Muscle tremors and seizures are common. Death can occur. ECHINACEA Diagnostic Tests Description and Cause Diagnosis is based on a history of ingestion and consistent clini- Echinacea purpurea (purple cone flower, scurvy root) is used as cal signs. Caffeine can be detected in stomach contents, blood, or an immune stimulant. urine. Clinical Signs Treatment Options Echinacea has a wide margin of safety. The most common signs Signs can occur quickly, so vomiting is induced only under the are vomiting or diarrhea. Although it is uncommon, a severe aller- direction of a veterinarian, and only if no signs are apparent. gic response (anaphylaxis) is possible. Continued

Petra A. Volmer, DVM, MS, DABVT, DABT

Diagnostic Tests Clinical Signs Diagnosis is based on a history of exposure and consistent clini- Valerian root has a wide margin of safety. Clinical signs can cal signs. include drowsiness and weakness.

Treatment Options Diagnostic Tests Most exposures do not require any treatment. For large ingestions, Diagnosis is based on a history of exposure and consistent clini- vomiting can be induced as directed by your veterinarian. Most cal signs. gastrointestinal signs are self-limited. Treatment Options Prognosis Prognosis is excellent. The sedative effects from most ingestions are short-lived and do not require treatment. Affected animals should be confined to pre- vent self-injury (such as falling from furniture or down stairs). VALERIAN For large ingestions, vomiting can be induced under the direction Description and Causes of your veterinarian, provided the animal is not exhibiting signs. The root of Valerian officinalis is used as a sedative and sleep- Activated charcoal may be administered. ing aid. Other common names are all-heal, vandal root, and Prognosis heliotrope. Since valerian root has a wide margin of safety and clinical signs Toxicity in most cases are of short duration and self-limited, the prognosis The compounds in Valerian root produce sedation. is excellent.