Background
The true incidence of pet intoxication due to illicit drugs is unknown. CNS stimulation is one of the major systemic actions of cocaine. We describe the case of a cat that presented with abnormal behaviour and AKI after ingestion of cocaine.
Case Presentation
A 4-year-old, male, neutered European cat presented to the Emergency Hospital with an acute history of abnormal behavior, hyperexcitability, pupillary dilation, ataxia and vomit. On clinical examination, the cat was disoriented, with a reduction of pupillary light reflex time, sinus tachycardia (220 bpm), and hypertension (SBP 180 mm Hg). The owner was asked about possible access to toxins, and he confirmed the presence of some cocaine powder in his house and the possibility of ingestion by the cat. A venous blood gas and a complete biochemistry panel were performed. Cell blood count was within normal range, while blood gas revealed a moderate metabolic acidosis (pH 7.2; HCO3- 15.7 mmol/L [19–24 mmol/l]; BE-ecf-12.2 mmol/L [-2-+2 mmol/L]; hyperlactatemia 2.5 mmol/L [0–2 mmol/L]; hyperkalemia 7.7 mmol/L [3.5–5.8 mmol/L]) and increase in renal parameters with BUN 60 mg/dl [16–30 mg/dl] and creatinine 3.3 mg/dl [0.8–2 mg/dl]. Cat was hospitalized and continuously monitored. Ringer lactate was administered intravenously at 5 ml/kg/h. Calcium gluconate (1 mg/kg IV) was given to protect the myocardium from potential cardio-toxic, pro-arrhythmic effects of hyperkalemia. Dexmedetomidine (1 µg/kg IV) was administered to promote sedation and reduce hyperexcitability.
Other supportive therapies administered included N-acetyl cysteine (50 mg/kg IV) and maropitant (1 mg/kg SC). After 48 h from hospitalization, renal parameters and acid-base status returned within normal range. The cat was discharged uneventfully.
New/Unique Information
To the authors’ knowledge, this is the first documented case of cocaine ingestion confirmed in a cat. In this case, we suppose AKI might have developed by glomerular arterioles vasoconstriction and direct proximal tubular toxicity as reported in human medicine.
E-mail: gianilaceccherini@virgilio.it