Emergency Treatment for Diacephenone Intoxication in a 25-kg Goat
Immediately contact a veterinary poison control center or toxicology specialist for expert guidance, as diacephenone is a rodenticide anticoagulant requiring specific antidotal therapy with vitamin K1, and supportive care should be initiated while awaiting expert consultation. 1
Immediate Stabilization and Assessment
- Ensure airway patency and provide respiratory support if the goat shows signs of respiratory distress, as this takes absolute priority in any poisoning case 1, 2
- Assess for active bleeding including examination of mucous membranes, gums, conjunctiva, and body orifices, as diacephenone causes anticoagulant toxicity similar to warfarin 1
- Monitor vital signs closely including heart rate, respiratory rate, temperature, and capillary refill time every 15-30 minutes initially 3
- Do not induce vomiting as this is contraindicated in poisoning cases unless specifically advised by poison control 1, 2
Specific Antidotal Therapy
Vitamin K1 (phytonadione) is the specific antidote for anticoagulant rodenticide poisoning:
- Administer vitamin K1 at 2.5-5 mg/kg subcutaneously or intramuscularly as the initial dose for a 25-kg goat (62.5-125 mg total dose) 1
- Continue vitamin K1 therapy at 2.5-5 mg/kg orally every 12-24 hours for 3-4 weeks, as diacephenone has a prolonged half-life requiring extended treatment 1
- Avoid intravenous administration of vitamin K1 due to risk of anaphylactoid reactions 1
Supportive Care Measures
- Establish intravenous access and administer lactated Ringer's solution or other isotonic crystalloids to maintain hydration and support circulation 4
- Minimize stress and handling to reduce risk of hemorrhage, as excessive movement can precipitate bleeding in anticoagulated animals 4
- Provide fresh whole blood transfusion or fresh frozen plasma if severe hemorrhage or coagulopathy is present, as this provides immediate clotting factors 1
- Monitor packed cell volume (PCV) and total protein serially to assess for ongoing blood loss 4
Decontamination Considerations
- Administer activated charcoal (1-2 g/kg orally) only if ingestion occurred within 1-2 hours and the goat is alert with intact gag reflex, though this should not delay antidotal therapy 1, 4
- Ensure airway protection before any oral administration to prevent aspiration, as compromised animals are at high risk 1, 4
Monitoring and Laboratory Assessment
- Obtain baseline coagulation parameters including prothrombin time (PT) and activated partial thromboplastin time (aPTT) if available 1
- Recheck PT 48-72 hours after initiating vitamin K1 therapy to assess response to treatment 1
- Monitor for signs of hemorrhage including pale mucous membranes, tachycardia, weakness, dyspnea, hematuria, melena, or epistaxis 4
- Assess for secondary complications such as anemia, hypovolemic shock, or organ dysfunction from hemorrhage 1, 4
Critical Pitfalls to Avoid
- Do not discontinue vitamin K1 therapy prematurely, as diacephenone has an extremely long duration of action (weeks to months) and early cessation will result in recurrent coagulopathy 1
- Do not delay treatment waiting for laboratory confirmation, as clinical diagnosis based on history of exposure and signs should prompt immediate therapy 1, 5
- Avoid intramuscular injections after the initial vitamin K1 dose until coagulation normalizes, as this can cause hematoma formation 1
- Do not administer anything by mouth if the goat is obtunded or seizing, as aspiration risk is extremely high 1, 2
Duration of Treatment
- Plan for minimum 3-4 weeks of oral vitamin K1 therapy for diacephenone specifically, as second-generation anticoagulant rodenticides require prolonged treatment 1
- Recheck PT 48-72 hours after completing vitamin K1 therapy to ensure coagulation remains normal and treatment was adequate 1
- Restart vitamin K1 if PT becomes prolonged after discontinuation, extending therapy for an additional 1-2 weeks 1