Calcipotriene Poisoning in Dogs

Calcipotriene is a popular ointment used to treat psoriasis, which is a disease of the skin that is characterized by scaly and red patches caused by an ever production of skin cells. Calcipotriene is a synthetic derivative of calcipotriol, or vitamin D3. This ointment slows down the production of skin cells in people that suffer from psoriasis. The vitamin D, or calcitriol, is the steroid that is effective in regulating the body’s production of calcium and phosphorus.

Topical ointment poisoning in dogs, or calcipotriene poisoning, is the result of dogs ingesting this type of topical ointment used for the skin disease. This ointment is an effective source of vitamin D, which can be very poisonous to dogs when ingested in high quantities. It can raise the calcium levels in the body of the dog to deadly amounts, known as hypercalcemia, which can then cause kidney and renal failure.

Topical ointment poisoning in dogs from the ointment known as calcipotriene occurs when dogs ingest the substance. Psoriasis creams and vitamin D supplements contain this ingredient.

When dogs ingest calcipotriene, symptoms may occur within 24 to 72 hours from the point of ingestion. Symptoms of this type of topical ointment poisoning in dogs are:

• Vomiting
• Diarrhea
• Excessive thirst
• Lethargy
• Weakness
• Excessive urination
• Drooling
• Seizures
• Loss of appetite
• Collapse

Types

It is very important to be aware of the types of medications that are in the home. It is also important to know alternate names for medications that can be poisonous to dogs. Alternate names for calcipotriene include:

• Calcipotriol
• Vitamin D3
• Cholecalciferol
• Dovonex
• Taclonex
• Generic psoriasis ointment

Calcipotriene toxicity is highly dependent upon the amount of calcipotriene that is ingested.  Calcipotriene is a derivative of calcitriol and also known as cholecalciferol, and specific causes of calcipotriene poisoning are due to the following factors:

• Metabolized into calcitriol
• Increases the uptake of calcium from the gastrointestinal tract
• Enhances the reabsorption of the calcium from the kidneys
• Mineralization of tissues
• Acute renal failure occurs

If you suspect your dog has ingested calcipotriene, or if you find a tube that has been chewed, call your veterinarian immediately. Be sure to take any evidence with you that will point to the fact that he ingested psoriasis cream. This will help the veterinarian come to a conclusive diagnosis quickly.

The veterinarian will do bloodwork, urinalysis, and ultrasound of the abdomen, and an echocardiogram. The ultrasound of the abdomen and the echocardiogram may show mineralization of soft tissue, which is further evidence of vitamin D toxicity. The veterinarian may also perform a serum analysis, creatinine analysis, and test the blood for blood urea nitrogen concentrations.

If you are unsure that the dog has ingested calcipotriene, the veterinarian will need to rule out any other causes for hypercalcemia. The veterinarian will need to test thyroid function, the adrenal system, utilize the findings of the bloodwork to check for hyperparathyroidism, in the functionality of the liver.

If your dog has ingested calcipotriene, symptoms can occur within 24 hours. Immediate treatment will begin with decontamination. Treatment methods include:

Decontamination

The veterinarian will induce vomiting and administer activated charcoal to aid in the absorption of the remaining toxic substance after emesis has occurred. Activated charcoal is the method that veterinarians prefer in order to prevent any toxic remains from being absorbed into the dog’s system.

Monitoring

The amount of calcium in the blood, as well as phosphorus, will be monitored to ensure the levels do not become elevated. In doing so, intravenous fluids will be given to help stabilize blood calcium and phosphorus levels. Monitoring will be also conducted in the case of high creatinine amounts in the blood and blood urea nitrogen.

Diuresis

Hypercalcemia can be controlled through intravenous fluids. Sodium chloride is the method used because the sodium ions can increase the excretion of the calcium through the kidneys. Within the intravenous fluids, furosemide, pamidronate, and steroids may be given.

After the initial treatment from the veterinarian, and once you take your companion home, treatment will need to be continued via outpatient basis. This can take several weeks to carefully monitor the dog and continue to give him any intravenous fluids, if necessary.

In terms of prognosis, it does depend on the amount of calcipotriene ingested in the time it took to get proper treatment. In most cases, the prognosis is good; however, prognosis is fair to guarded if renal failure has occurred.

Once your dog is home, the veterinarian may suggest giving him foods that are low in phosphorus in calcium. If there are any other after-treatment suggestions, your veterinarian will specifically explain what needs to be done at home. It will be important for you to monitor your dog and be sure no new symptoms develop; if this were to occur, you must call your veterinarian immediately.