The call came in. A 5-month-old pit bull was coming in that could have gotten into any or all of the following: Adderall, methamphetamine, marijuana, ecstasy, Ambien. The first words out of my mouth were, “But it’s only Tuesday morning. Can you imagine what their weekend must have been like?” Toxicity in pets is not uncommon. Most people know of the usual suspects: rat poison, poinsettias (actually not so bad) and maybe antifreeze. But in this wonderful modern age of better living through chemistry, there are a lot more opportunities for toxicity. In addition to pills, which make our lives more comfortable, a lot of tasty treats for us humans can be dangerous for our dogs. I bet a pet owner has at least one of the following dangerous pills, foods or poisons in the house right now. Are they safely out of a dog’s reach? Sleep Aids, Antidepressants The rise in toxicity in animals resulting from sleep aids (Ambien, Lunesta) and selective serotonin reuptake inhibitors (SSRIs)—drugs commonly used to combat depression (Prozac, Paxil, Zoloft)—has skyrocketed in my years of working veterinary ER. This is probably because bottles of these drugs are kept on nightstands and on the counter, where they can easily fall on the floor. Pain Medications We are always taking pain medication, the most common being NSAIDs such as Advil (ibuprofen) and Aleve (naproxen), which are strong, fast-acting and sometimes prescription strength or stronger. And because dogs mimic our lives, we have non-steroidal anti-inflammatory medications for them, too. Usually for dogs, these drugs are chewable and tasty. Rimadyl (carprofen), Metacam (meloxicam) and Deramaxx (deracoxib) are among the more common ones. We can’t bear to have our dog in pain, and they do perform little wonders. Some taste great, just like candy. The problem is when a dog gets into a bottle and can’t seem to have just one. Kidney damage occurs in higher doses, and in lower doses, gastric ulcers. After at least 48 hours on intravenous fluids and 10 to 14 days of gastrointestinal protectants like Pepcid or sucralfate, the dogs usually go home uneventfully. But not always. Xylitol One of the lesser-known toxins is sugarless gum. Many sugarless gums and other sugarless foods contain an ingredient called xylitol. The effect on dogs—cats rarely eat it for some reason—is to initially lower blood sugar levels, which could increase the likelihood of seizures and potentially result in liver damage. Xylitol is dose- and size-dependent, so a Great Dane swallowing one piece of gum isn’t much of a problem, but a Shih Tzu or pug that eats a pack of gum—or sometimes a Costco-size jumbo pack—is a very real concern. Time matters, and the earlier the intervention, the better. Induce vomiting, start IV fluids with dextrose and constant monitoring of blood sugar levels for 12 to 24 hours, and check for changes in liver values, adding liver protectants as needed. We usually pull these dogs out of the crisis if we get them in time. Grapes, Raisins These fruits can be pesky because they do not always cause toxicity and are not always size or dose dependent. It is best to never give them to dogs, but if consumed, a quick decontamination works well. Anecdotal stories of kidney failure and death have been reported. Proper protocol involves decontamination by inducing vomiting, especially if the food was ingested within the past couple of hours. Activated charcoal is then given to help absorb organic matter not already vomited. Baseline kidney values are obtained, and here comes the good part: Dogs need at least 48 hours of intensive IV fluids and monitoring of kidney levels for 24 to 48 hours to ensure no damage has been done to those precious, sensitive organs. Call it the $1,800-plus box of raisins. Chocolate Chocolate is another common presentation, but in more than 30 years of practice I’ve had only a handful of dogs succumb to death by chocolate. The darker the chocolate and the smaller the dog, the worse the potential for toxicity. So a Mastiff eating a Hershey’s kiss is not in danger, but a miniature pinscher breaking into a bag of semisweet chocolate nuggets usually is. By the way, white chocolate is not a problem because it is not really chocolate. The side effects initially found with chocolate toxicity are usually gastrointestinal. Many dogs will vomit on their own, which can be a good thing as long as they don’t aspirate. Then they have to be monitored for 12 to 24 hours to look for irregular, rapid heart rhythms and tremors, some of which can lead to seizures and, on rare occurrences, death. Again, swift decontamination—up to six hours after ingestion—is effective in bringing up stomach contents. Once vomiting has settled, activated charcoal is administered in amounts needed to help prevent recirculation by the liver and to aid in the passing of the toxin. IV fluids and hospitalization are recommended for at least 12 hours and sometimes 24 hours. Although primary signs of chocolate toxicity usually end after about 24 hours, dogs can exhibit secondary gastrointestinal issues a day later, many times due to pancreatitis. Other Human Foods Onions, onion powder, garlic and garlic powder are potentially toxic to dogs, causing hemolytic anemia. Rat Poison Rodenticide ingestion is common in urban areas. Cities bait alleys, and landlords place poison traps without dog owners’ knowledge in communal laundry rooms, under stairs, etc. Most rodenticides are anti-coagulants, meaning they prevent normal blood clotting. Owners sometimes witness dogs chewing on a box—the bait often is bright green—which is better because we can induce vomiting quickly. But sometimes they spot it in the dogs’ stool, which is not so good. The majority of these poisons take two to three days after ingestion for signs to develop. These signs can run the gamut from blood in the urine or stool to nosebleeds to skin bruising or labored breathing. We have a good chance to save them the earlier we get them. If ingestion is recent, induce vomiting and give activated charcoal. An antidote to anti-coagulant rodenticides is vitamin K1. The catch is that 24 to 48 hours is needed for vitamin K to kick in, so if the dog got into the poison days before, it’s more of a challenge, usually including one or multiple blood or plasma transfusions to give the antidote a chance to work. Vitamin K is continued for at least 30 days. On a side note, many larger hardware stores now carry bromethalin as their go-to rodenticide. This poison does not cause bleeding disorders but rather cerebral edema, or swelling of the brain. This type of poison has no antidote, and dogs not seen getting into it have a greater chance of death once they start to show signs. So clients who buy rodenticide should read the label. And they should put away the pills and food. Resources Pet Poison Helpline: 855-764-7661, petpoisonhelpline.com ASPCA Animal Poison Control Center: 888-426-4435, ASPCA.org Dr. Jerry Klein, an emergency and critical care veterinarian, is emeritus emergency department head at MedVet Chicago. He also serves as the American Kennel Club’s chief veterinary officer. Originally published in the March 2017 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
