Zinc toxicosis in a dog secondary to prolonged zinc oxide ingestion

Abstract

Zinc toxicosis is commonly associated with ingestion of metallic zinc objects. This report documents an uncommon presentation of zinc toxicosis, secondary to prolonged ingestion of a zinc oxide cream. A 5.6 kg 6-year-old ovariohysterectomised female Poodle cross presented as a transfer to an emergency practice for severe anaemia, pigmenturia, weakness, and inappetence. She had a history of vomiting and nine days of diarrhoea. Amongst other supportive treatments, a zinc oxide cream had been applied to her hind end due to severe diarrhoea scalding, and in hindsight, the owners realised she had ingested large quantities of this cream. She developed a severe Heinz body haemolytic anaemia, along with spherocytosis, left-shift neutrophilia, prolonged activated partial thromboplastin time, and mildly elevated blood urea nitrogen. The serum zinc concentration was markedly elevated. She was treated supportively and made a full recovery. This case illustrates the importance of a thorough medical history. Zinc toxicosis can have a good prognosis when diagnosed and treated promptly.

Zinc toxicosis in a cat associated with ingestion of a metal screw nut

“…Prolonged APTT has been described in dogs with zinc toxicosis. 2 , 9 , 10 It has been speculated that zinc could cause inhibition of coagulation factors VIII, IX, XI and/or XII. 2 , 17…”

“…1 In dogs, zinc toxicosis, in addition to gastrointestinal signs and haemolytic anaemia, can also cause pancreatitis, hepatopathy and acute kidney injury. 1,2,[4][5][6][7][8][9][10][11][12][13][14] In dogs with zinc toxicosis, intravascular haemolysis with normocytic or macrocytic, hypochromic anaemia and Heinz bodies is the most consistent abnormality observed. 1,2,11 While there are no reports of anaemia secondary to zinc toxicosis in cats in the current literature, ferrets have been described to develop anaemia secondarily to gastrointestinal bleeding in an experimental study.…”

“…Prolonged APTT has been described in dogs with zinc toxicosis. 2,9,10 It has been speculated that zinc could cause inhibition of coagulation factors VIII, IX, XI and/or XII. 2,17 Increased ALT and ALP activity, and hyperbilirubinaemia are typical findings of zinc toxicosis in dogs.…”

Zinc in Dog Nutrition, Health and Disease: A Review

“…Reports of chronic ingestion of high doses of zinc in dogs are scarce, however, a publication by Siow described ingestion of up to 125 g of an antiseptic healing cream containing 15.25% w/w zinc oxide over seven days, which was estimated to constitute a daily intake of 386.4 mg/kg bodyweight of elemental zinc [ 186 ]. The clinical symptoms resembled the ones described for acute zinc toxicosis, without apparent pancreatitis nor nephrotoxicity associated [ 186 ].…”