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Oleander poisoning
Synonym(s): Poison, Poisoning, Plant
Introduction
- Cause: ingestion of oleander (Nerium oleander).
- Signs: anorexia, depression, signs of abdominal pain, weakness and arrhythmias.
- Diagnosis: based on history of exposure, clinical signs and post-mortem findings.
- Treatment: supportive.
- Prognosis: poor.
Geographic incidence
- Oleander is a perennial, evergreen shrub or small tree, native to Southern Europe, and now widely distributed in most tropical and sub-tropical areas of the world.
- Thrives in hot climates - used in landscaping and as potting plants.
- Leaves are simple, lanceolate, 7.5-25.5 cm long, dark green above, leathery, with a prominent midrib and veins.
- White, pink or red showy flowers from 2.5-7.5 cm in diameter that grow in clusters.
- Yellow oleander, lucky nut Cascabela thevetia (previously Thevetia peruviana) and (Cascabela thevetioides previously Thevetia thevetioides) are common to tropical areas, and are equally toxic
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Cost considerations
- Multiple animals may be affected with associated costs for veterinary care.
- Hospitalization may be required for animals with significant signs.
- Food safety issues for milk.
Special risks
Cardiac glycosides may pass into milk.Pathogenesis
Etiology
- Green leaves appear to be unpalatable unless mixed with feed.
- Circumstances include:
- Access to pasture bordered by oleander plants .
- Access to cuttings of oleander.
- Ingestion of leaves mixed with fodder.
- Access to pasture bordered by oleander plants
Predisposing factors
General
- Access to plants.
- Lack of or inability to access other forage.
Pathophysiology
- All parts of the plant are toxic, including the dried leaves.
- Oleander contains a complex mixture of cardiac glycosides, mainly oleandrin, which are potent cardiac toxins.
- Cardiac glycosides interfere with the cellular membrane sodium-potassium (Na+ -K+ ATPase enzyme system) pump resulting in depletion of intracellular potassium and an increase in serum potassium. This causes irregular heart activity, and eventual complete block of cardiac conduction.
Timecourse
- Signs generally start within 6 hours.
- Death may occur rapidly (within a few hours) or up to 48 hours after ingestion.
- Recovery may take several days.
Epidemiology
- Oleander is widely cultivated.
- Poisoning can occur wherever oleander plants are grown.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Varga A, Puschner B (2012) Retrospective study of cattle poisonings in California: recognition, diagnosis and treatment. Vet Med: Res Rep 3, 111-127.
- Langford S D & Boor P J (1996) Oleander toxicity: an examination of human and animal toxic exposures. Toxicology 109, 1-13 PubMed.
- Galey F D, Holstege D M, Plumlee K H, Tor E, Johnson B, Anderson M L, Blanchard P C & Brown F (1996) Diagnosis of oleander poisoning in livestock. J Vet Diag Invest 8, 358-364 PubMed.
- Oryan A, Maham M, Rezakhani A & Maleki M (1996) Morphological studies on experimental oleander poisoning in cattle. J Vet Med A 43 (10), 625-34 PubMed.
- Rezakhani A & Maham M (1992) Oleander poisoning in cattle of the Fars Province, Iran. Vet Human Toxicol 34, 549 PubMed.
- Mahin L, Marzou A & Huart A (1984) A case report of Nerium oleander poisoning in cattle. Vet Human Toxicol 26, 303-304 PubMed.
- Liu S K (1957) The pathology of oleander poisoning in cattle. Memoirs of the College of Agriculture; National Taiwan University 5, 75-82.
- Soto-Blanco B, Fontenele-Neto J D, Silva D M, Reis P F & Nobrega J E (2006) Acute cattle intoxication from Nerium oleander pods. Trop Anim Health Prod 38 (6), 451-4 PubMed.
- Vermunt J (1987) Oleander - decorative and very poisonous. NZ Vet J 35, 138-139 PubMed.
- Falciola C, Davanzo F, Rivolta M, Molino L, Colombo ML (2015) Nerium oleander: case report of a severe poisoning case involving numerous cows [abstract]. Clin Toxicol 53 (7), 753.
Other sources of information
- EMA (2015) CVMP assessment report regarding the request for an opinion under Article 30(3) of Regulation (EC) No. 726/2004 in relation to the potential risk for the consumer resulting from the use of lidocaine in food producing species. EMA/CVMP/118717/2015. Available from www.ema.europa.eu.
- Burrows G E & Tyrl R J (2013) Toxic Plants of North America. 2nd edn. Wiley Blackwell, USA.
- Sakha M & Rezekhani A (2002) Treatment of oleander poisoning with V285 [abstract]. XXII World Buiatrics Congress, Hanover 18-23 August.
- Cooper M R & Johnson A W (1998) Poisonous Plants and Fungi in Britain. 2nd edn. The Stationery Office, UK.
- Galey F D, Holstege D M, Johnson B J & Siemens L (1998) Toxicity and diagnosis of oleander (Nerium oleander) poisoning in livestock. In: Toxic Plants and Other Natural Toxicants. Eds: Garland T, Barr A C, Betz J M, Reagor J C, Bailey E M Jr. CAB International: Wallingford, UK. pp 215-219.
- Rezakhani A & Maham M (1994) Cardiac manifestations of oleander poisoning in cattle and donkeys. In: Plant-associated Toxins: Agricultural, Phytochemical and Ecological Aspects. Eds: Colegate S M, Dorling P R, Allen J G, Huxtable C R & Panter K E. CAB International: Wallingford, UK. pp 534-537.
Organisation(s)
- Cornell University. Poisonous Plants Informational Database. www.ansci.cornell.edu/plants.
- ASPCA Animal Poison Control Center. www.aspca.org.
- Veterinary Poisons Information Service (VPIS). www.vpisglobal.com.