the central nervous system. The gastrointestinal effects can consist of nausea and vomiting, excess salivation, abdominal pain, diarrhea that may contain blood, and especially in horses, colic. Cardiac reactions consist of irregular heart rate, sometimes characterized by a racing heart at first that then slows to below normal further along in the reaction. Extremities may become pale and cold due to poor or irregular circulation. The effect on the central nervous system may show itself in symptoms such as drowsiness, tremors or shaking of the muscles, seizures, collapse, and even coma that can lead to death. Oleander poisoning can also result in blurred vision, and vision disturbances, including halos appearing around objects. Oleander sap can cause skin irritations, severe eye inflammation and irritation, and allergic reactions characterized by dermatitis. Treatment Poisoning and reactions to oleander plants are evident quickly, requiring immediate medical care in suspected or known poisonings of both humans and animals. Induced vomiting and gastric lavage are protective measures to reduce absorption of the toxic compounds. Activated carbon may also be administered to help absorb any remaining toxins. Further medical attention may be required depending on the severity of the poisoning and symptoms. Temporary cardiac pacing will be required in many cases (usually for a few days) until the toxin is excreted. Digoxin immune fab is the best way to cure an oleander poisoning if inducing vomiting has no or minimal success, although it is usually used only for life-threatening conditions due to side effects. Drying of plant materials does not eliminate the toxins. It is also hazardous for animals such as sheep, horses, cattle, and other grazing animals, with as little as 100 g being enough to kill an adult horse. Plant clippings are especially dangerous to horses, as they are sweet. In July 2009, several horses were poisoned in this manner from the leaves of the plant. Symptoms of a poisoned horse include severe diarrhea and abnormal heartbeat. There is a wide range of toxins and secondary compounds within oleander, and care should be taken around this plant due to its toxic nature. Different names for oleander are used around the world in different locations, so, when encountering a plant with this appearance, regardless of the name used for it, one should exercise great care and caution to avoid ingestion of any part of the plant, including its sap and dried leaves or twigs. The dried