From episode 148 on the ECC Feed with toxicology experts, Nick Merwood and Kasra Ahmadi.
We all know and love (hate?!) the black stuff that we shove down throats for our toxin ingestion cases to try to mop up some of the toxin, right? But did you know that there is another option? The team from Animal Poisons Helpline shared what we know about using Cholestyramine as a decontaminant. (Note - it’s pretty new information, so we lack good data, but this info is based on what makes sense, some studies, and some anecdotal reports.)
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It’s a human cholesterol-reducing medication.
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Can be used to bind to some toxins that undergo enteroheptic recirculation.
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A large range of compounds would theoretically bind to it, but we have limited evidence so far.
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We DO have evidence that it effectively binds and reduces re-absorption for
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Vit D toxicity (eg Vit D supplements, some face creams, and some commercially used rodenticides.)
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An NSAID called Tenoxicam, where it was shown to be significantly more effective than charcoal at reducing re-absorption.
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We don’t have evidence for any other NSAID’s, but in theory it should work.
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Cholestyramine is not absorbed systemically, and has no systemic effects or notable side effects with short term use. (Ie - no real harm in trying it.)
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Dose: Large range, but a practical dose would be 400mg/kg, or 1 sachet of the 4g commercially available product (Questran-Lite) per 10kg dog, every 6-8 hours for 3-5 days.
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