Neurotoxic and antihypertensive effects of phenytoin in turkeys

Broad-Breasted White male turkeys were fed a control diet until 4 weeks of age, at which time they were randomized into a control group and two treatment groups which received 0.06% (38.7 mg/kg) and 0.09% (58.2 mg/kg) phenytoin, respectively, until termination of the experiment at 12 weeks of age. Plasma concentrations of phenytoin on the two dosages were 8.0 +/- 0.8 and 15.7 +/- 1.7 micrograms/ml. Systemic arterial blood pressure in the control turkeys was 214 +/- 5/171 +/- mm Hg and was reduced in a dose-related fashion to 185 +/- 8/143 +/- 11 and 156 +/- 5/125 +/- 4 mm Hg in the two treatment groups; likewise, the rate of systolic ejection (dp/dt maximum) was less in the phenytoin-treated turkeys. Heart rate also dropped significantly with drug administration but the difference between the two treatment groups was not significant. Evidence of neurotoxicity developed in 25% of the turkeys on the lower drug schedule; these birds had mean plasma phenytoin levels of 12.8 micrograms/ml as contrasted to the concentration of 8.0 micrograms/ml for the entire group. On 0.09% phenytoin 50% of the birds had abnormal signs and a mean phenytoin concentration of 20.5 micrograms/ml, whereas the mean drug level for the entire group on this drug level was 15.7 micrograms/ml. Early signs of neurotoxicity developed within 2 to 3 days of initiation of phenytoin and consisted of extensor rigidity of the neck and hyperactivity; at the higher drug concentrations, back pedaling and somersaulting appeared. General health and weight gain were not affected. No qualitative or quantitative changes were found in the Purkinje cells in the cerebellum of the affected turkeys.