Hellebore poisoning is rare. Hellebores are said to have a burning taste and among other toxins contain protoanemonin; a toxin that irritates both the skin and the mucous membranes. This tends to dissuade animals from consuming a large amount of the plant. Sometimes called anemonol or ranunculol; Protoanemonin is found in all parts of the plant and in all plants of the buttercup family (Ranunculaceae). Similar to the way that members of the Araceae family protect themselves with calcium oxalate crystals, members of the ranunculaceae produce and release protoanemonin as a self defense mechanism to being eaten. Upon being damaged by an animal, an enzymatic process ensues by which protoanemonin is produced from the glucoside ranunculin. This causes nearly immediate discomfort to the mouth, mucosa and esophageal lining which can lead to blistering or rashes of the mouth and throat.
If the animal is somehow able to tolerate ingesting the plant, then they are at risk for digitalis like symptoms from the cardiac glycosides: helleborin, hellebrin and helleborein. These can cause considerably more severe symptoms to include neurological and cardiovascular disturbances that could possibly culminate in death. Additionally, once ingested protoanemonin can lead to kidney dysfunction (oliguria, anuria) and affect the central nervous system, initially causing central stimulation and then paralysis up to respiratory arrest.
In cases involving the ingestion of a small amount of the plant treatment will generally consist of induced vomiting or gastric lavage followed by the administration of activated charcoal. Gastrointestinal upset should be treated with antacids. Demulcents such as pectin, glycerin, honey and syrup that form a film to soothe the irritated membranes may also be administered to ease discomfort. This will be followed by close monitoring to ensure that more serious clinical signs do not present. In cases involving a large ingestion, treatment will be largely symptomatic and supportive. If the animal is beginning to suffer cardiac abnormalities it may be necessary to administer intravenous or intramuscular atropine to stabilize the pet. Atropine can be used to treat Bradycardia slowly through an IV at a dose of 0.01 mg/kg body weight repeated every 5 minutes if necessary. Additionally monitoring kidney function is essential and close scrutiny needs to be placed on monitoring the cardiac activity for arrhythmias. As the non palatability of the plant leads to very few poisoning documentation regarding a specific treatment regimen is sparse. Prevent further ingestion of the plant and consult your veterinarian.
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