Pet Poisoning in the News

pet poisons

March 19-25 is National Poison Prevention Week, sponsored by the Poisoning Prevention Council. The Council seeks to educate Americans about the risks of unintentional poisoning. I think this week is a good time to remind pet families of potential hazards in the home and to help pet families protect their favorite fur baby against unintentional poisoning.

Xylitol: Not So Sweet for Dogs
The first news of pet poisoning comes from our neighbors to the north, Canada. In Saskatchewan, a handsome German shorthair pointer named Ryker helped himself to 52 pieces of chewing gum. While most think this would simply be a sticky mess, the act was life-threatening. The chewing gum contained xylitol, a substance known to cause low blood sugar and liver failure in dogs. By the time Ryker arrived at the animal ER, he was already having seizures from low blood sugar. With prompt veterinary care, Ryker recovered, but not all dogs are so lucky. Xylitol is safe for humans, but can readily be consumed by your dog since it is an ingredient in many low-calorie products like mints, candies, peanut butter and low carb baked goods.

Pot Poisoning On the Rise
This story did not surprise me one bit since marijuana intoxication is common in AMC’s ER. Ingestion of marijuana plants, compost, trash food containing marijuana, or inhalation of marijuana smoke can affect dogs; they become glassy eyed, uncoordinated, and may be very sleepy. These dogs need intravenous fluids to maintain hydration and warming blankets to maintain their body temperature. Often, dogs intoxicated by marijuana dribble urine. Some dogs become hyperactive. Severely affected dogs may suffer seizures or become comatose requiring ventilator treatment until they regain the ability to breathe. Dogs typically recover in one to three days. Deaths from marijuana intoxication have been reported in dogs consuming concentrated tetrahydrocannabinol (THC) butter.

Lamp Poisoning?
The third news story on salt poisoning in cats was news to me. First, I had never heard of a salt lamp, but checked Amazon and found I could scroll through pages of Himalayan salt lamps in various configurations. Second, turns out that cats seem to like to like salt lamps, and since those furry gymnasts can get on your highest bookcase or into your smallest corner, they have the opportunity to lick enough lamp to develop salt poisoning. Ingestion of an excessive amount of salt in both dogs and cats results in clinical signs of vomiting, diarrhea, poor appetite, lethargy, staggering, abnormal fluid accumulation within the body, excessive thirst or urination, potential injury to the kidneys, tremors, seizures, coma, and even death if salt poisoning is not treatment immediately. Other sources of excessive salt include paintballs, homemade playdough and regular old table salt.

Prevention Accidental Poisonings in Your Pet

  • Read the labels of all food and candy you purchase to protect your dog from unintentional xylitol poisoning.
  • Securely dispose of medical marijuana waste.
  • Don’t expose pets to marijuana smoke.
  • Never use table salt to induce vomiting in your pet.

Medication Mix-Ups

Next week is Poison Prevention Week. According to ASPCA Animal Poison Control, the number one cause of poisoning in pets is prescription and over the counter drugs. The poisoning occurs because pets inadvertently consume either pet or human medications. To help raise awareness of potential sources of pet poisoning, here are some recent issues with medications reported to the veterinarians at The Animal Medical Center.

Name Swap
Most drugs have a brand name like Lasix® or Amoxi-tabs® and a corresponding generic name like furosemide or amoxicillin. I will admit I may use the brand name when speaking with pet owners but write a prescription for the generic medication because the generic brand is typically less expensive, though equally as effective. This dual naming system often creates confusion for the pet owner sometimes resulting in double medicating the pet. Oreo has heart failure and is being treated with Lasix. A second prescription of the same medication from a specialist said furosemide. The owner administered the new medication along with the old medication because she didn’t know the two were the same drug. Fortunately, the error was recognized and no harm came to Oreo.

Rainbow Roulette
Please keep in mind that your veterinarian usually doesn’t see the pills dispensed to your pet. Because I don’t see the pills, your description of “the oblong blue one” doesn’t help me determine the medication prescribed. Also keep in mind that generic medicines can be the same drug, but manufactured in different colors. If a medicine is dispensed and does not look like the last prescription for the same medicine, don’t hesitate to ask the pharmacist or someone at your veterinarian’s office to be sure the correct medication was dispensed.

A Pill for You and a Pill for Me
Last week one of our cat patients was inadvertently given one of her owner’s medications. Both pill bottles were sitting side by side on the counter. Even worse, the medication contained Tylenol® (acetaminophen), a human drug which is very toxic to cats. The owner quickly recognized the problem and successfully induced vomiting, but it could have been a disaster for the cat.

Yes, We Mean Three Times a Day
Three times a day does not mean, put all three pills in the food and hope your pet eats a bite of food containing a pill every eight hours. Don’t count on your pet to count the hours between doses. Give each pill separately at the prescribed intervals to avoid over- or under-dosing your pet.

Words to the Wise

  • Ask the prescribing veterinarian what each medication prescribed for your pet is meant to treat. If there are multiple medications to treat the same problem, ask if they are duplicate medications with different names on the labels.
  • If you see more than one veterinarian for your pets multiple problems, take all the medication bottles with you to each visit. Be sure each veterinarian knows what the other has prescribed.
  • Do not talk about the color of the pills with your veterinarian. We prefer the names of the medication to be read off the bottle. Even badly pronounced drug names are better than a description like “the white one, a little smaller than a dime.”
  • To avoid a medication mix-ups, store your medications in a different location than you store Fluffy’s.
  • Keep the toll free number of an animal poison hotline handy for an emergency:

– Pet Poison Helpline (800) 213-6680
– ASPCA Animal Poison Control (888) 426-4435

Pot for Pets

The New York Times recently announced that via executive action, New York Governor Andrew Cuomo will relax the laws governing medical marijuana use in the state. New York State has some of the most restrictive and punitive laws regarding illegal drug usage, hold-overs from the Rockefeller era drug laws of the 1970s, and many feel these changes are long overdue. What does this mean for pets?

Increased Toxicity Cases Veterinarians in New York State will need to be prepared to treat more dogs with marijuana intoxication if the experience in Colorado holds true here. Colorado is a state where medical marijuana is legal. Veterinarians in Colorado studied the number of dogs experiencing inadvertent toxicity from ingestion of marijuana. These researchers found a four-fold increase in the number of dogs treated for marijuana ingestion over a five year period. The increase paralleled the increase in the number of registered users of medical marijuana in Colorado. Pet Poison Helpline reports an increase in calls about canine marijuana intoxication as well.

Dog OD Ingestion of marijuana, marijuana containing foods or inhalation of marijuana smoke can affect dogs; they become glassy eyed, uncoordinated, and may be very sleepy. These dogs need intravenous fluids to maintain hydration and warming blankets to maintain their body temperature. Often, dogs intoxicated by marijuana dribble urine. Some dogs become hyperactive. Severely affected dogs may seizure or become comatose requiring ventilator treatment until they regain the ability to breathe. Dogs typically recover in one to three days. Sadly, the study of Colorado cases of marijuana reports the death of two dogs ingesting baked goods made with medical grade tetrahydrocannabinol (THC) butter.

Iguana Intoxication! Although dogs are the most commonly affected by marijuana intoxication, I found a report of three intoxicated iguanas. The iguanas had clinical signs similar to intoxicated dogs – seizures, stomach upset and one even required antiseizure medication. All three recovered fully.

Veterinary Medical Marijuana So with marijuana legalized in some states for medicinal purposes, is medical marijuana for Fluffy and Fido next? Despite the obvious risks outlined above, some pet owners have taken marijuana for pets into their own hands. Currently marijuana belongs to the group of drugs most tightly regulated by the Food and Drug Administration. Even though I have a license to prescribe some controlled substances, marijuana is not on the list of those I can prescribe. This tight regulation also restricts research with marijuana. Research is needed to help veterinarians understand what conditions the drug helps and how to use the drug safely and efficaciously in veterinary patients. So for now, I don’t know how to appropriately dose THC in my patients and I can’t do it legally.

If your pet inadvertently ingests marijuana or a THC containing product:

1. Keep marijuana and medical marijuana products out of reach of your pets.

2. Call animal poison control if you think your pet has eaten marijuana:

  • ASPCA Animal Poison Control (888) 426-4435
  • Pet Poison Helpline (800) 213-6680

3. Tell the animal ER what your pet ate. Making the ER veterinarians play a guessing game about your pet’s condition can delay appropriate treatment.

Meet the Breeds: Ask a Question

During the last weekend of September, The Animal Medical Center staffed an information booth at the American Kennel Club’s annual Meet the Breeds Show at New York City’s Jacob Javits Center. I spent several hours answering questions from pet owners on Sunday afternoon. The questions were important ones for all pets, so I decided to share my answers with everyone through The AMC blog.

Are caterpillars toxic?
A concerned dog owner found her dog snacking on the big, furry caterpillars that had invaded the potted plants on her terrace. Certain insects can injure pets if they are venomous, like wasps or bees. Most caterpillars are not venomous and are not listed as toxic on Animal Poison Control or Pet Poison Hotlines' websites. Although Survivorman eats caterpillars, the hairs on the skin of certain ones can be very irritating and for me, just thinking about a dog swallowing these hairy little creatures makes me gag. It is best not to let your dog (or cat) eat caterpillars, but consumption of one or two probably carries a low level of risk.

Is a one hour walk a day enough for my older dog?
Just like your doctor recommends you practice a well-rounded fitness routine, your dog needs more than a walk on a nice flat street. The Mayo Clinic recommends exercise include aerobic fitness, muscular fitness, stretching, core exercise and balance training. Challenge your dog by walking up and down hills. Be sure to include games like fetch to encourage your dog to run to increase her heart rate. Don’t forget to include stairs as part of your dog’s routine. For stretching and balance fitness, view The AMC’s exercise tips for dogs.

My 7 month old Chihuahua has a pink lump that comes and goes in the corner of his eye. Is this serious?
Without seeing this dog, I can only speculate as to what the problem is. However, I am guessing the dog has a condition veterinarians call “cherry eye.” Cherry eye is the tear gland from the third eyelid, an important source of tears to keep your dog’s eyes moist, and it occurs most commonly in Cocker Spaniels and English Bulldogs. The AMC’s ophthalmologist, Dr. Alexandra van der Woerdt recommends the gland be tacked back into place during a minor surgical procedure to preserve its function. The cause of cherry eye is suspected to be a weakness in the ligament that holds the gland in place.

My dog woke up one morning and couldn't walk, so I gave him some of my medications and now he’s better. Should I keep giving the pills?
The answer to this question is not about pills but about the need to see your veterinarian to get pet-safe prescriptions. Every year, thousands of dogs and cats are sickened from accidental ingestion or purposeful administration of human medications. Veterinarians do sometimes prescribe human medications for dogs and cats, but you should never give your pet any medications without clearing it through your veterinarian first.

Household Cleaning Products: A Pet Danger

It’s spring cleaning time, but if you have pets please clean cautiously since some of the most common cleaning agents can be toxic to your pet. Birds are especially sensitive to the fumes from household cleaning agents.

Chlorine bleach has an extremely wide spectrum of activity against common bacteria and viruses. Its low cost makes bleach an attractive disinfectant and laundry additive. Bleach disinfects by oxidizing cell membranes, rupturing and killing cells. Bleach has the same effect on the gastrointestinal tract if your pet drinks undiluted bleach or chews on the bleach container. A splash of bleach into the eye of a curious pet can cause tearing, irritation and even an ulcer.

Some websites recommend the use of phenol-containing pine scented cleaners as a deterrent for cats who urinate outside their litter boxes. If you use these products, you may no longer have a healthy cat and the litter box issues will seem insignificant. When walking across your freshly mopped kitchen floor, your cats get phenol on their feet. Phenol is caustic to the delicate paw pads. Then, when cats groom, they ingest the cleaner which damages their liver and kidneys. When compared to dogs, cats are extremely susceptible to phenol toxicity since their liver lacks an important enzyme for metabolism of phenol.

Although not technically toxic, steel wool and metal mesh scouring pads can cause intestinal obstruction if consumed by your pet. At first glance these products do not have much culinary appeal, but when encrusted with steak bits from the grill or some scrambled eggs from the frying pan, a scouring pad becomes a tasty treat for your dog or cat. As you can see in the x-ray, the scouring pad unravels and prevents food from normally passing though the intestine. The sharp strands can also slice into the intestinal wall. Emergency surgery is required for removal.

Quaternary ammonium compounds are disinfectants with a broad spectrum of antimicrobial activity against bacteria, viruses and fungus. These compounds are popular cleaning agents colloquially called “quats.” Serious injury can result to both pets and people if they inadvertently come in contact with quats. Caustic burns, convulsions, low blood pressure and even death occur following ingestion or contact with the skin.

The AMC Emergency and Critical Care staff recently teamed up to save the life of a young Yorkshire Terrier with severe oral swelling and respiratory distress from ingestion of quaternary ammonium. Read his story: Yorkie Ingests Deadly Poison and Survives.

Not sure if a product is pet-safe? Download the material safety data sheet for any product you might purchase to prevent bringing a dangerous product home.

Pills and Poison Prevention

Last week was National Poison Prevention Week and the 50th anniversary of this poison prevention campaign. The theme for the 2012 National Poison Prevention week, “Children act fast, so do poisons,” could also be: “Pets act fast, so do poisons.”

Here is the story of Sadie, a beautiful 9-month-old Weimaraner who acted fast and almost didn’t make it to her first birthday.

Weimaraners are energetic dogs, originally developed for hunting. Maybe that’s what got Sadie into trouble; she was hunting and the target of her attentions was an entire bottle of 200mg ibuprofen tablets. She consumed all the contents, as well as the bottle. Ibuprofen is a drug which should never be used in dogs. Sadie ate so many tablets she ingested 455mg of ibuprofen per kilogram of body weight. The over-the-counter dosage for an adult human is 400mg, given three times daily.

Triage

Sadie’s regular veterinarian initiated treatment by giving intravenous fluids, inducing vomiting, and administering activated charcoal to prevent absorption of the ibuprofen. Despite these treatments, Sadie’s condition deteriorated and when she arrived at The Animal Medical Center, she was nearly comatose and was having seizures.

Dogs are highly sensitive to the toxic effects of ibuprofen. The gastrointestinal tract and the kidneys are the primary targets. The ER staff administered three different drugs in an attempt to stave off rupture of an ibuprofen-induced gastric ulcer and the hemodialysis team was called in for consultation on how best to manage the potential kidney damage.

Charcoal perfusion

Oral administration of activated charcoal is a common treatment for intoxication. The charcoal is not systemically absorbed, but stays in the intestine and absorbs the toxin, preventing signs of illness. A novel method for using activated charcoal in cases of intoxication is to use charcoal hemoperfusion. Our hemodialysis team recommended a four-hour charcoal hemoperfusion treatment for Sadie and used the hemodialysis machine and a special charcoal cartridge instead of the standard cartridge used for patients with kidney failure. The treatment was completed very early in the morning and by the time of morning rounds, she was alert and feeling so well she was eating hospital food with gusto.

Only a few days in the hospital

Sadie stayed at The AMC for less than a week after her hemoperfusion treatment while her ibuprofen-induced diarrhea resolved. There was a brief scare when one of the kidney blood tests increased, and everyone held their breath while we waited to see if Sadie would take a turn for the worse. Happily, she was discharged to her relieved family five days after her charcoal hemoperfusion. Today, Sadie is a normal, happy 2-year-old Weimaraner.

Ibuprofen poisoning is common

According to the ASPCA Animal Poison Control Center, the number one cause of poisoning in pets is prescription and over-the-counter drugs, both of the human and pet variety, including painkillers, cold and flu preparations, and antidepressants. The Pet Poison Hotline reports nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen are the fourth most common dog poisoning in their database for 2011.

Be sure you have the pet poison hotline numbers posted where you can easily find them, so you can act fast if your pet ingests something toxic like ibuprofen.

ASPCA Animal Poison Control
888-426-4435

Pet Poison Hotline
800-213-6680

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This may also be found in the Tales from the Pet Clinic blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

The Danger of Xylitol to Your Dog and Ferret

My regular trip to the grocery store this week brought a health risk for dogs and ferrets to the forefront of my mind.

As I was standing in the checkout line, I noticed a number of hard candies and mints with xylitol on the label. Xylitol may help keep us slim and protect our teeth, but it is deadly for our dogs and ferrets. The Animal Medical Center’s Emergency Service has seen several dogs suffering from xylitol-induced illness. The danger is serious enough to have caused the FDA to issue a warning to pet owners because xylitol poisoning is on the rise.

Xylitol is an organic compound and a naturally occurring sugar alcohol used as a low calorie sweetener. Chewing gum and candies are commonly sweetened with xylitol. Recipes abound on the Internet for home baked treats using the sweetner as an ingredient. Medical products such as throat lozenges, cough syrup, children’s multivitamins, toothpaste and mouthwash contain xylitol because it helps prevent tooth decay.

When a dog or ferret consumes xylitol, blood sugar drops dangerously low (hypoglycemia) and can result in seizures. Even if the hypoglycemia is reversed with administration of intravenous sugar (glucose), there is still the potential for development of liver failure and death.

If your dog inadvertently ingests one of the many xylitol-containing foods, medications or any other potentially toxic substance, go to an animal emergency room immediately as the drop in blood sugar occurs very quickly. Take the package, bag or box containing the xylitol product with you. The information on the package will help when your veterinarian contacts one of the animal poison control services included in the links below. These services are open 24 hours a day to advise pet owners and veterinarians on optimal management for pet poisonings.

For more information on other foods toxic to pets, visit:

Fur the Love of Pets: Kitchen Catastrophies

ASPCA: Poison Control

MSPCA Angell Poision Control Hotline

Pet Poison Helpline

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Lilies and Your Cat

The genesis of this week’s blog did not come from one my patients at The Animal Medical Center, but from a trip to my local Food Emporium. As I walked in through the produce section, the smell of lilies wafted towards me. They were beautiful…and deadly, at least to cats.

The entire lily family, including Easter lilies, Asian lilies, the elegant calla lily and even the feline named tiger lily should be off limits for cat owning households. The toxic substance in lilies is unknown but the toxin appears to affect only the cat and not the dog. In addition to finding a freshly mangled plant on the windowsill, cat owners will see vomiting and diarrhea following lily ingestion. Blood tests often reveal kidney failure which in some cases can require treatment with dialysis and may be fatal.

Lily ingestion is a year round problem because some cats cannot resist sampling the vegetation used to decorate the house — and the problem is not just with lilies. Many other ornamental plants can be toxic to cats. Common springtime flowers on this list include amaryllis, crocus, narcissus, daffodil and azalea. Cat owners must carefully select their houseplants to avoid a trip to the emergency room following unplanned consumption of a toxic cat salad.

If your cat inadvertently ingests one of these plants or any other plant for that matter, contact your veterinarian’s office to determine if treatment is necessary. You may also contact one of the animal poison control services included in the links below. These services are open 24 hours a day to advise pet owners and veterinarians on optimal management for pet poisonings.

Animal Poison Control Center

Angell Poison Control Hotline

Pet Poison Helpline

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.

Kitchen Catastrophes

New pet owners often ask their veterinarian, “What is the greatest danger to my pet? Is it the dog park, the sidewalk or being cat-napped?” It may come as a surprise to you, but your kitchen holds some of the greatest dangers for your pet.

Xylitol, a sweetener found in low-calorie foods, induces excessive insulin release in dogs. No one knows why insulin production ramps up in response to xylitol, but the result can be a fatal low blood sugar in your dog. Dogs consuming xylitol may experience vomiting, lethargy, lack of coordination progressing to seizures and liver failure. If your dog eats food containing xylitol, see a veterinarian immediately.

Dogs have a bit of a sweet tooth and often find grapes and raisins tasty. Tasty can turn into tragedy because some dogs develop kidney failure following consumption of even a few grapes or raisins. The toxin has not been identified, but a quick trip to the veterinarian and a short hospital stay can help prevent long-term kidney damage.

Both cats and dogs have red blood cells which can be damaged by ingestion of onions, garlic or garlic powder. Red blood cell damage can result in the need for a blood transfusion, so avoiding these ingredients in your pet’s diet is critical. Typically dogs get into onions by snacking from the trash can. On the other hand, cats may have problems if they are fed human foods flavored with garlic powder.

Birds love human foods too, but bird owners should be cautious about avocados, which can cause respiratory distress and death. Like in dogs and cats, the caffeine-like substance in chocolate can be dangerous for birds. Baking chocolate contains the most of the caffeine-like substance, dark chocolate somewhat less and white chocolate the least. Ingestion of the caffeine-like substance can cause hyperactivity, heart rhythm abnormalities and seizures. Too much salt is bad for all of us including birds, so it is best to keep the salty snacks on your plate rather than your bird’s.

The AMC recommends you check with your veterinarian before feeding your pets any human food. Keep these foods out of your pet’s reach and ensure that your garbage is not easily accessible by them as well. If your pet has ingested any foods that may be toxic you should contact your veterinarian immediately or call Animal Poison Control at (888) 426-4435, 24 hours a day.

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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.