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Posted on 01-23-2017

Amanita  "Death Cap" Mushrooms – Why Should I Care About Those?

We are glad for all of the rain that’s been falling in the Bay Area but not for the toxic mushrooms that come with it.  Due to the recent rains, there’s a bumper crop of wild mushrooms growing, including the very toxic and deadly Amanita phalloides also known as “Death Caps.”

Unfortunately, the Bay Area of California has a high prevalence of Amanita mushrooms, one species of which you have probably heard of – the Death Cap mushroom (Amanita phalloides).  Dogs, puppies  in particular, seem interested in these mushrooms, and may ingest them.  This will result in severe, often fatal toxicity.  Over ten years ago, many believed that patients who were clinical for this toxicity would universally have a fatal result.  However, we now know that with rapid and very intensive intervention, some of these patients can be saved.

Anyone who hikes in this area is likely aware of the multitude of mushroom species that grow.  Not all cause the severe degree of pathology as the Amanita species.  Many are non-toxic or may cause only transient GI distress. The focus of this blog will solely be on Amanita mushrooms, although other non-Amanita mushrooms may cause serious pathology as well.  Distinguishing between toxic and non-toxic mushrooms based on appearance can be very difficult, and is best left to trained individuals.  However, typical appearance is as follows:

(Photo credit http://www.mykoweb.com/CAF/species/Amanita_phalloides.html)

Clinical Signs –

The clinical signs associated with Amanita toxicity vary dependent on severity of cyclopeptide toxic effect, as well as the time course of illness.  This can make establishing a suspicion for Amanita toxicity difficult if the ingestion was not witnessed.

Up to 12 hours after ingestion, many patients will exhibit non-specific gastrointestinal signs including vomiting, diarrhea, and abdominal discomfort.  Some patients may improve for 12-24 hours, although bloodwork may show mild elevation in liver values.  Following this phase of apparent improvement, Amanita toxicity patients will exhibit more significant deterioration with lethargy, return of vomiting and/or diarrhea, low blood sugar, severe liver damage, and sometimes kidney failure.

Treatment options –

If there is a known, recent ingestion of a potentially toxic mushroom, vomiting should be induced.  Treatment with activated charcoal is typically recommended.  For any patients known to have ingested an Amanita mushroom, or any patient showing clinical compromise, veterinary evaluation should be performed right away.  Intensive care at a 24 hour emergency clinic (Silicon Valley Veterinary Specialists) with IV fluids, medications, sugar supplementation, hemostatic compounds, and other interventions may be able to save patients that might otherwise have a fatal outcome.  Multiple factors including amount of mushroom ingested, time course until medical intervention, and level of intensive care provided likely explain variation in outcome of patients that have ingested  Amanita mushrooms.  Patients can appear severely affected, but may still survive with very intensive support.

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