Rat Poison Anticoagulant Rodenticide Dog
By DVM Rounds·April 1, 2026·1 question
☠️Toxicology🚨Emergency
🧭 Routing
The case involves an acute ingestion of a rodenticide, requiring immediate decontamination and management of a toxin. Toxicology is essential for specific toxin information, treatment protocols (Vitamin K1, PT monitoring, duration), while Emergency is crucial for acute stabilization and decontamination procedures.
☠️Lisa NguyenToxicology Specialist
Alright, colleague, this is a classic and manageable scenario if we're aggressive upfront. Brodifacoum is a long-acting anticoagulant, so our main goals are immediate decontamination followed by a prolonged course of the specific antidote, Vitamin K1. The 1-2 hour window for ingestion is excellent news.
My Decontamination Specialist has laid out the immediate action plan perfectly.
* Decontamination: Induce emesis immediately with apomorphine (0.03 mg/kg IV/IM). For your 25kg patient, that's 0.75 mg. Following successful emesis, administer activated charcoal at 1-2 g/kg (25-50 g total) to adsorb any remaining toxin and interrupt enterohepatic recirculation.
Once decontamination is complete, we move to antidote therapy, as detailed by my Antidote Specialist.
* Antidote: Start Vitamin K1 at 2.5-5 mg/kg per day, divided BID. For your 25kg dog, this is a total of 62.5-125 mg daily. It's crucial to administer this orally with a fatty meal to maximize absorption.
* Duration: The standard course for a second-generation anticoagulant like brodifacoum is a full 30 days.
Monitoring: The most critical step is the post-treatment prothrombin time (PT) check. Discontinue the Vitamin K1 after 30 days, then check a PT 48-72 hours after the last dose*. This confirms the patient's clotting cascade is functioning independently. Do not stop treatment without this confirmation.
There's no need for a baseline PT if you're decontaminating and starting Vitamin K1 prophylactically. Clinical signs of coagulopathy won't appear for 2-5 days, so we treat based on exposure. Remember, never give Vitamin K1 intravenously due to the risk of anaphylaxis. This is a straightforward protocol, and with prompt action, the prognosis is excellent.
My Decontamination Specialist has laid out the immediate action plan perfectly.
* Decontamination: Induce emesis immediately with apomorphine (0.03 mg/kg IV/IM). For your 25kg patient, that's 0.75 mg. Following successful emesis, administer activated charcoal at 1-2 g/kg (25-50 g total) to adsorb any remaining toxin and interrupt enterohepatic recirculation.
Once decontamination is complete, we move to antidote therapy, as detailed by my Antidote Specialist.
* Antidote: Start Vitamin K1 at 2.5-5 mg/kg per day, divided BID. For your 25kg dog, this is a total of 62.5-125 mg daily. It's crucial to administer this orally with a fatty meal to maximize absorption.
* Duration: The standard course for a second-generation anticoagulant like brodifacoum is a full 30 days.
Monitoring: The most critical step is the post-treatment prothrombin time (PT) check. Discontinue the Vitamin K1 after 30 days, then check a PT 48-72 hours after the last dose*. This confirms the patient's clotting cascade is functioning independently. Do not stop treatment without this confirmation.
There's no need for a baseline PT if you're decontaminating and starting Vitamin K1 prophylactically. Clinical signs of coagulopathy won't appear for 2-5 days, so we treat based on exposure. Remember, never give Vitamin K1 intravenously due to the risk of anaphylaxis. This is a straightforward protocol, and with prompt action, the prognosis is excellent.
Decontamination Specialist
For a 25kg Labrador that ingested brodifacoum 1-2 hours ago, immediate decontamination is crucial. The 1-2 hour window is ideal for emesis induction.
Rationale: Brodifacoum ingestion warrants aggressive decontamination due to its high toxicity and long half-life. The 1-2 hour timeframe is well within the optimal window for inducing emesis.
* Drug: Apomorphine
* Dose:
* Intravenous (IV) or Intramuscular (IM): 0.03 mg/kg
* For a 25kg dog: 0.75 mg IV/IM
Alternatively (less reliable, slower onset):* Conjunctival route (0.25 mg/kg tablet dissolved in saline or water, placed in conjunctival sac). Rinse eye thoroughly once emesis occurs or after 15-20 minutes if no emesis.
* Administration: Administer IV or IM for rapid and reliable effect.
* Monitoring: Observe closely for emesis. If no emesis occurs within 15-20 minutes, a single repeat dose (IV/IM) may be considered, or the conjunctival route can be attempted if not used initially. Monitor for excessive vomiting or protracted nausea.
Rationale: Brodifacoum is well-adsorbed by activated charcoal, and AC helps interrupt enterohepatic recirculation, which is significant for anticoagulant rodenticides. Administer after successful emesis.
* Formulation: Aqueous slurry (without sorbitol for the initial dose, if possible, to avoid dehydration/hypernatremia, especially if repeat doses are anticipated).
* Dose: 1-2 g/kg
* For a 25kg dog: 25-50 grams of activated charcoal
* Administration: Administer orally as a slurry. Ensure the patient is fully conscious and has a protected airway to prevent aspiration.
* Monitoring: Observe for signs of aspiration, constipation, or gastrointestinal upset.
---
Note: Gastric lavage is generally not indicated for brodifacoum ingestions unless emesis is contraindicated or unsuccessful, and a massive, life-threatening ingestion is confirmed, due to the higher risk of complications compared to emesis.
Immediate Decontamination Protocol
1. Emesis Induction (Apomorphine)
Rationale: Brodifacoum ingestion warrants aggressive decontamination due to its high toxicity and long half-life. The 1-2 hour timeframe is well within the optimal window for inducing emesis.
* Drug: Apomorphine
* Dose:
* Intravenous (IV) or Intramuscular (IM): 0.03 mg/kg
* For a 25kg dog: 0.75 mg IV/IM
Alternatively (less reliable, slower onset):* Conjunctival route (0.25 mg/kg tablet dissolved in saline or water, placed in conjunctival sac). Rinse eye thoroughly once emesis occurs or after 15-20 minutes if no emesis.
* Administration: Administer IV or IM for rapid and reliable effect.
* Monitoring: Observe closely for emesis. If no emesis occurs within 15-20 minutes, a single repeat dose (IV/IM) may be considered, or the conjunctival route can be attempted if not used initially. Monitor for excessive vomiting or protracted nausea.
2. Activated Charcoal (AC)
Rationale: Brodifacoum is well-adsorbed by activated charcoal, and AC helps interrupt enterohepatic recirculation, which is significant for anticoagulant rodenticides. Administer after successful emesis.
* Formulation: Aqueous slurry (without sorbitol for the initial dose, if possible, to avoid dehydration/hypernatremia, especially if repeat doses are anticipated).
* Dose: 1-2 g/kg
* For a 25kg dog: 25-50 grams of activated charcoal
* Administration: Administer orally as a slurry. Ensure the patient is fully conscious and has a protected airway to prevent aspiration.
* Monitoring: Observe for signs of aspiration, constipation, or gastrointestinal upset.
---
Note: Gastric lavage is generally not indicated for brodifacoum ingestions unless emesis is contraindicated or unsuccessful, and a massive, life-threatening ingestion is confirmed, due to the higher risk of complications compared to emesis.
Antidote Specialist
Here is the complete Vitamin K1 protocol for a 25kg dog exposed to brodifacoum:
| Parameter | Protocol Details
Vitamin K1 Protocol for Brodifacoum Exposure (25kg Dog)
| Parameter | Protocol Details
🚨Marcus ColeEmergency Specialist
Alright, a classic but always serious presentation. Good on you for getting on it quickly. The 1-2 hour window is key here; we have a good chance to decontaminate effectively.
My Triage Specialist has provided the essential calculations for decontamination, which I've reviewed. Here's my approach and how we'll manage this case from an ER perspective.
First, immediate decontamination is the priority. As noted, apomorphine (0.03 mg/kg IV) is the emetic of choice. Get that in now. Following successful emesis, administer the first dose of activated charcoal with sorbitol (1-2 g/kg PO). Remember, subsequent doses of charcoal should be sorbitol-free to avoid inducing hypernatremic dehydration.
Once decontaminated, we have two primary pathways:
Monitor and Wait: The most cost-effective approach if the owner is compliant. You'll send the dog home after decontamination and have them return for a baseline Prothrombin Time (PT) check at 48 hours post-ingestion, and I'd recommend another at 72 hours. Brodifacoum's peak effect is delayed as the body depletes its existing Vitamin K-dependent clotting factors. If the PT is prolonged at either check, you initiate treatment immediately.
Prophylactic Treatment: If ingestion is certain, the amount could be significant, or you have any doubts about owner compliance for rechecks, the safest route is to start Vitamin K1 therapy empirically after decontamination.
For treatment, the standard starting dose for a second-generation anticoagulant like brodifacoum is 2.5 mg/kg PO BID for a minimum of 30 days. It is absolutely critical that the owner administers this with a fatty meal to maximize absorption. Do not give Vitamin K1 intravenously due to the risk of anaphylactoid reactions.
The most important monitoring step is the final one: check a PT 48 hours after the last dose of Vitamin K1 has been given. This confirms that the body can maintain normal coagulation without supplementation. If the PT is still normal, you can discontinue monitoring. If it's prolonged, treatment needs to be extended, typically for another 1-2 weeks before rechecking.
I've covered the ER and critical care management. For more detailed information on the specific toxicokinetics of brodifacoum and the nuances of anticoagulant classes, I'll defer to my colleague in Toxicology, Dr. Nguyen.
My Triage Specialist has provided the essential calculations for decontamination, which I've reviewed. Here's my approach and how we'll manage this case from an ER perspective.
First, immediate decontamination is the priority. As noted, apomorphine (0.03 mg/kg IV) is the emetic of choice. Get that in now. Following successful emesis, administer the first dose of activated charcoal with sorbitol (1-2 g/kg PO). Remember, subsequent doses of charcoal should be sorbitol-free to avoid inducing hypernatremic dehydration.
Once decontaminated, we have two primary pathways:
For treatment, the standard starting dose for a second-generation anticoagulant like brodifacoum is 2.5 mg/kg PO BID for a minimum of 30 days. It is absolutely critical that the owner administers this with a fatty meal to maximize absorption. Do not give Vitamin K1 intravenously due to the risk of anaphylactoid reactions.
The most important monitoring step is the final one: check a PT 48 hours after the last dose of Vitamin K1 has been given. This confirms that the body can maintain normal coagulation without supplementation. If the PT is still normal, you can discontinue monitoring. If it's prolonged, treatment needs to be extended, typically for another 1-2 weeks before rechecking.
I've covered the ER and critical care management. For more detailed information on the specific toxicokinetics of brodifacoum and the nuances of anticoagulant classes, I'll defer to my colleague in Toxicology, Dr. Nguyen.
Triage Specialist
Here are the requested calculations for a 25kg Labrador with suspected brodifacoum ingestion:
| Intervention | Calculation | Dose for 25kg Dog | Notes
| Intervention | Calculation | Dose for 25kg Dog | Notes
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