Comparison of intravenous mixed micelle phytomenadione (vitamin K1) and traditional therapies for the treatment of anticoagulant rodenticide toxicosis in dogs and cats: a retrospective study.

Abstract

BACKGROUND: Ingestion of anticoagulant rodenticide is among the most common toxicoses seen in dogs and cats. Current treatment protocols in veterinary patients recommend the use of plasma-containing blood products to replenish clotting factors. Intravenous mixed-micelle phytomenadione (MMP) represents a safe and cost-effective alternative to traditional therapy. OBJECTIVE: Description of the use of MMP as a treatment for clinical anticoagulant rodenticide toxicosis, focusing on the incidence of adverse reactions and restoration of coagulation times. Duration of hospitalisation, cost of treatment and need for red blood cell-containing products were compared between two cohorts of patients receiving MMP and traditional therapy with blood products. METHODS: Retrospective search of electronic medical records from two Australian emergency and referral hospitals for patients treated for clinical anticoagulant rodenticide toxicosis between July 2021 and July 2024. RESULTS: 74 animals (71 dogs, 3 cats) were treated for anticoagulant rodenticide toxicosis within the study period. 44 dogs comprised the "control" group, and 27 dogs and 3 cats comprised the "MMP" group. One dog was excluded from each group. There was no difference in survival to discharge between groups (P = 0.28). No adverse reactions to MMP were recorded. Dogs within the "control" group were significantly more likely to receive fresh frozen plasma (FFP), there was no difference in requirement for red blood cell-containing products between groups (P = 1). Animals in the MMP group had significantly shorter hospitalisation time when compared with the control group (P = 0.01). CONCLUSION: Based on red cell transfusion requirements and survival data in this case series, it can be suggested that MMP is a comparable and cost-effective treatment alternative for clinical anticoagulant rodenticide toxicosis.