Fatal Amanita muscaria poisoning in a dog confirmed by PCR identification of mushrooms

Abstract

Diagnosing mushroom poisoning in dogs can be difficult and often includes identification of suspect mushrooms. Visual identification may be hindered by mastication, oral medications, or poor quality of environmental mushroom samples. Other analytical techniques may thus be necessary to aid in mushroom identification. A 5-y-old neutered male Labrador Retriever dog developed acute onset of vomiting, diarrhea, tremors, seizures, and somnolence. The dog was treated at a veterinary clinic and was briefly stabilized, but died during transport to an emergency clinic. On postmortem examination at the University of Kentucky Veterinary Diagnostic Laboratory, the dog's stomach was full of mushrooms covered with activated charcoal. Mushrooms were damaged, fragmented, and discolored, precluding accurate visual identification. Mushroom pieces were sent to the Department of Plant Pathology at the University of California-Davis for PCR identification; the neurotoxic mushroom Amanita muscaria was identified. A qualitative liquid chromatography-mass spectrometry (LC-MS) method was developed to detect ibotenic acid and muscimol, the toxic compounds present in A. muscaria. Mushrooms, stomach contents, and urine were analyzed by LC-MS; ibotenic acid and muscimol were detected in all samples. Because identification of ingested mushrooms is sometimes necessary to confirm mushroom poisoning, PCR can identify ingested mushrooms when visual identification is unreliable.

A retrospective evaluation of mushroom ingestions in 421 dogs in Norway (2011–2022)

“…Two dogs died within 2 h after ingestion of one and multiple A. muscaria , respectively, corresponding to a previous report. 17 In the clinically affected dogs, CNS signs (90%) and GI distress (60%) were common, in accordance with previously published cases. 17 , 18 , 19 Decontamination is recommended in asymptomatic dogs, followed by supportive treatment.…”

Effect of Four-in-One Optimized Emergency Nursing Procedure on Symptoms and Vital Signs of Patients with Mushroom Poisoning

“…The patient treatment was changed from routine blood purification to blood purification in the emergency ICU, and deep vein catheterization was performed in the emergency rescue room, which reduced the preparation time for blood purification in the emergency ICU. The green channel was opened for patients with mushroom poisoning to reduce the waiting time for payment and dispensing and receiving medication to enable patients to receive medication more quickly [ 16 , 17 ]. The absolute value of the treatment efficiency of patients receiving four-in-one optimized emergency nursing intervention was found to be higher than that of patients receiving the routine emergency nursing intervention, but the difference was not significant.…”

Acute, fulminant hepatic and renal failure and subsequent death following Amanita phalloides ingestion in a 4‐month‐old puppy

“…Diagnosis of mushroom toxicity can be challenging and is commonly based on clinical and laboratory findings and suspected mushroom exposure. Confirmatory techniques such as detection of alfa amanitin in urine, serum, and hepatic and renal tissue via ELISA have been successfully reported,8 as well as PCR analysis of gastric content containing mushrooms or direct identification of the mushroom,16 but definitive diagnosis requires examination of fresh liver or kidney tissue 8 16…”

“…Given the rapid progression of the clinical signs, prompt, aggressive emergency measures were aimed at reducing toxin absorption in order to improve the chance of survival. Gastric decontamination is recommended if ingestion occurs within the preceding 8 hours of presentation and includes induction of emesis or gastric lavage within the first 3 hours followed by activated charcoal (1–3 g/kg) 4 16…”