• There is no antidote for this toxin (AFB1).
  Toxic effects promote free radical associated cellular injury. There is a linear dose/toxicity relationship. Experimental evidence suggests that the toxin may be retained covalently bound to circulating proteins (e.g., albumin) for up to 60 days.
  
• Because dogs have lower liver tissue glutathione (GSH) concentrations than many other species, failure to effectively conjugate and metabolize AFB1 may augment its toxicity. Medications that promote increased hepatic GSH synthesis include:
  1. N-acetylcysteine, for initial management of overtly intoxicated dogs (icteric, vomiting, anorexic). Administer over 20 min; 20% solutions should be diluted 1:4 before use.
     Loading Dose: 140 mg/kg IV given once through a syringe filter, 0.2 µm.
     Maintenance Dosing: 70 mg/kg IV every 6-8 h.
     
  2. SAMe (s-adenosylmethionine), nutraceutical used to fortify GSH synthesis and as a methyl donor for protein synthesis; also can promote cell replication.
     Dose: 20 mg/kg PO per day, on an empty stomach for best absorption.
     
• Milk thistle (silymarin), nutraceutical promotes GSH production, directly intervenes in certain toxins and may promote cell replication/recovery.
  Dose: 2-5 mg/kg PO per day.
  
• a-Tocopherol (vitamin E), required for optimal function of antioxidant system and terminates lipid peroxyl reactions.
  Dose: 10 IU/kg per day.
  
• L-carnitine, essential nutrient that enhances fatty acid mobilization from the liver and mitochondrial function.
  Dose: 25-100 mg /kg per day.
  
• Vitamin K₁ administration usually will not correct coagulation problems in aflatoxisosis cases. However aflatoxin is a coumadin-like derivative that undergoes some metabolism similar to vitamin K and so vitamin K treatment may be helpful.
  Dose: 0.5-1.5 mg/kg Sub-Q or PO q 12-24 h.
  
• Blood component therapy. Infusions of plasma can help control bleeding tendencies in severely affected dogs. Packed red blood cells may be needed when enteric hemorrhage that accompanies acute onset of portal hypertension.
  
• Antemetics are essential to control vomiting. Metoclopramide (Reglan®) at constant rate infusion dosed for dogs with hepatic injury and titrated to patient response. If emesis continues, combining ondansetron (Zofran®) may be effective.
  
• Sucralfate (Carafate®) slurry is recommended for dogs with hematemesis or showing signs of esophageal colic.
  
• Nutritional support is recommended for recovering dogs.

Dogs exposed to foodborne aflatoxin may develop chronic liver disease or be prone to develop neoplastic hepatic disorders. Hepatocarcinogenicity is recognized as a sequella to chronic aflatoxin exposure in humans, but is not well studied in the dog. Routine health assessments in recovering dogs are advised (i.e., periodic liver function testing and biochemical profiling).

Cornell's Animal Health Diagnostic Center offers aflatoxin testing on pet food. Whenever an animal is suspected of aflatoxin poisoning, 1 kg of the potentially contaminated food should be saved, because the delay between exposure and clinical signs may be several weeks. Samples should be taken from different areas of the bag, combined, and submitted in a clean, dry container. Caution is advised when handling the food as aflatoxin is a carcinogen. Please note that low aflatoxin concentrations in the food do not rule out exposure.

Excerpted from Canine Foodborne Aflatoxicosis Synopsis: 2006, Cornell University College of Veterinary Medicine.

Antithrombin III and Protein C Assays: Requires 1 mL of separated citrated plasma for each test.
Turn around time: 2-3 days
Test Code: S86149