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Friday, 29 July 2011

Dog and Cat Poisoning - Common Poisons Part 2

Welcome to PercyPods Pet Emergency blogs. This week is the last blog on poisoning in dogs and cats for a while. The poisons we are going to discuss this week are pyrethrins and pyrethroids which are contained in some anti-flea products, metaldehyde which is in snail bait or slug pellets, ethylene glycol which is in antifreeze, and non-steroidal anti-inflammatory medications such as ibuprofen, aspirin and paracetamol or acetaminophen.

Pyrethrins and pyrethroids

Okay so let’s get started by discussing pyrethrins and pyrethroids. These substances kill insects and they are found in a large number of preparations that are readily available from a variety of outlets such as supermarkets, garden centres, DIY stores and of course the internet. Most relevant to us here is that these substances are found in a number of preparations that are sold for controlling flea and lice infestations in dogs and cats. We should stress that we are not saying that it is not safe to use these products; they are widely used without a problem in many animals and many households. The point however is that, as for many other products, they can be dangerous if they are not used correctly and in keeping with the recommended guidelines. We as vets see enough pets poisoned by these products to make us want to mention them in this blog.

So pyrethroids are now most commonly used in dogs and cats as so-called ‘spot on’ preparations that are applied onto the animal’s skin. This is usually done by parting the hair on the back of the animal’s neck and squirting the product out of a pipette-style packet. You are probably familiar with what we are referring to and examples of products that you may have used include those made by Bob Martins and Advantix made by Bayer Animal Health.

By far the most common scenario we as vets see are cats that are poisoned when their well-meaning carers apply products that are manufactured for use on dogs onto the cat. Sometimes this is by mistake when the owner does not realise that they have in fact bought a product for dogs; in other cases the owner mistakenly thinks that it will be ok to say apply half of the dog pipette onto the cat. Cats are very sensitive to this type of poisoning and you should only ever use a product sold for cats on cats; you should also make sure that you use the right strength of product, so for example don’t use a product designed for adult cats on kittens.
Another way in which cats have been poisoned is when a dog in the house is treated with one of these spot-on preparations and then, before the solution has dried, a cat either touches the area or licks the product directly off the dog.

The poisoning that pyrethroids cause in dogs and cats is similar for both species as is the treatment, although as we have said, cats are more susceptible and most cases seen by vets are cats. Signs of poisoning usually occur within a few hours, often sooner, and they mostly affect the nerves. Animals may show signs such as drooling and wobbliness, and flicking of the paws or twitching of the ears may occur in cats. Severely affected animals may become very depressed, show violent muscle tremors or seizure, and poisoning can be fatal without urgent treatment.

So if you think your pet has been poisoned in this way you should ring your veterinary practice immediately for advice. As always, be prepared to try and provide as much information as possible – what product was used? What does it contain? And so on. In some cases your practice may recommend washing the product off your pet but they will want to be sure that this is safe to do which will very much depend on the information you provide. The product can be washed off using a baby shampoo or mild detergent such as washing up liquid mixed with lots of tap water at room temperature but it is very important not to get this into your pet’s eyes. Make sure the water is not too hot or too cold and dry your pet thoroughly afterwards. But please bear in mind that it is not safe to try and wash an animal that is struggling or resisting or showing any sort of abnormal signs at all; it is very much something only to be considered in an animal that is cooperative and only very soon after the product has been applied. We would urge you to always ring your practice first to get their advice about whether washing your pet is appropriate and safe.

In the vast majority of cases the safest thing is for you to arrange to take your pet to your vet practice. Depending on how long it has been since the product was applied and what signs your pet is showing, he or she may need to be anaesthetised to be washed thoroughly. They may also need treatment with drugs to control nervous signs such as tremors and seizures as well as a fluid drip into a vein; in some cases your pet may need to remain anaesthetised for a lengthy period of time. You should note that this treatment may need to be continued in the worst cases for 3 days for example. However on the plus side even the most severely affected animals have a good chance of making a full recovery if they receive treatment as soon as possible and for as long as necessary.

Before we move on to the next type of poisoning then, just to reiterate that poisoning with pyrethroids is seen most often in cats when an anti-flea product intended for dogs is used on the cat. Poisoning can be life-threatening and you should really avoid using dog products on cats.

Metaldehyde

Okay so let’s move on and talk about something called metaldehyde. Metaldehyde is found in some pesticides that are used to kill slugs or snails. The most common type are pellets which are usually blue or green in colour. These pellets also contain cereals and other additives which make them tasty to dogs. As always cats are more picky and this type of poisoning is much less common in cats. It is worth knowing that although pellets are the most common type of slug or snail bait, some preparations also come as liquids or powders. Unfortunately some of these preparations also contain other types of poisons which can add to the problems they cause.

So dogs and cats become affected when they eat the poison. In our experience in many cases this happens when the slug pellets have been put away in the shed or garage and a dog gets into the room and helps themselves to the pellets which, as we mentioned, are tasty to dogs. When questioned thoroughly owners of poisoned dogs often realise that they had some slug pellets in the shed or garage and that the dog could well have got to them. It is very important to make sure that these products are stored securely and well out of the reach of hungry canines! Of course some dogs poison themselves by eating slug bait that has actually been put down in the garden or in public places such as parks and woodland.

Metaldehyde causes problems in dogs and cats by causing excessive stimulation of the nervous system. Signs often develop very quickly, for example in less than an hour, but in some cases it can take longer. The typical signs shown include muscle twitching and tremors and seizures or fitting. These signs can really be very severe and urgent treatment is recommended. One of the consequences of these tremors and seizures is that your dog will become very hot, a bit like a dog with heatstroke, and this makes the situation worse still. Metaldehyde poisoning is sometimes referred to as the ‘shake and bake syndrome’ because of this combination of signs.

Because slug bait poisoning can be very severe, including leading to death, it is important that all cases are treated urgently as emergencies and you should ring your vet practice as soon as you become concerned that your dog may have been poisoned. Inducing vomiting at home is typically not safe in these dogs because of the signs they are showing; we discussed this at some length in the first of these blogs so please read that if you haven’t already.

In the vast majority of cases the safest thing is for you to arrange to take your pet to your vet practice. Your vet is likely to want to anaesthetise your dog to wash out his or her stomach thoroughly. After that your dog may also need treatment with drugs to control nervous signs as well as a fluid drip into a vein; in some cases we have to keep your dog anaesthetised for a lengthy period of time. Intensive treatment often needs to be continued for one to three days. However on the plus side even the most severely affected animals have a good chance of making a full recovery if they receive treatment as soon as possible and for as long as necessary.

Ethylene glycol

Okay so let’s move on from metaldehyde and talk about ethylene glycol. Ethylene glycol is a sweet-tasting and sweet-smelling liquid used primarily as an antifreeze, screen wash and windshield de-icing agent. Dogs and cats are most commonly poisoned by ingesting antifreeze and this tends to occur in one of two ways.

The first is when people drain their car radiators and fail to dispose of the used antifreeze safely. Poisoning is most likely to occur in late autumn and early spring when antifreeze usage increases. Used antifreeze should be drained into clean labelled containers, for example plastic bottles, which are then tightened securely. Depending on where you live and what facilities are available locally, this used antifreeze may be disposable at a local garage, some of whom may actually be able to recycle it, or alternatively may be handed in to a local waste disposal centre.
Used antifreeze should NOT be poured into floor drains, sewers, or on the ground, and it also should not be mixed with other waste products.

The second most common route in which dogs and cats are exposed to antifreeze is when containers of new unused antifreeze are not stored safely. Safe storage means in sealed containers out of reach of animals and indeed children.
Another route in which dogs and cats may come across antifreeze is from outdoor ornamental ponds. Some people add antifreeze to these ponds to prevent freezing and animals may drink from them.

So what is the problem with antifreeze? What does it do to dogs, cats and indeed humans? Well, the most severe problem is injury to the kidneys leading to kidney failure. Some animals also show nervous signs and in general the more antifreeze is consumed the more severe the resulting problems are. Within one hour of ingesting the antifreeze animals may become depressed and wobbly; they may also vomit and some animals drink more water. In severe cases seizures, coma and death may occur.
After these initial signs, some animals – especially dogs – may appear to get better for a while. However they then start to show other signs as kidney failure sets in.

You should contact your veterinary practice immediately if you think your pet may have been exposed to antifreeze. In some cases it will be appropriate to make your pet vomit the antifreeze back up. Your vet is likely to run some blood and urine tests to check for signs of kidney failure.

Antifreeze poisoning is one type of poisoning for which an antidote or specific treatment does exist, although this can only be used before kidney failure develops. Once you pet has kidney failure, there is no indication to use an antidote and a fluid drip into a vein becomes the most important treatment. The first and best antidote is a drug called 4-MP or fomepizole. However this drug is not available in all areas and all countries and where it is not available, for example in the United Kingdom, the next option is to use alcohol as an antidote. In some cases this is administered into a vein, in others it may have to be given directly into the stomach via a stomach tube. However please note that you should never administer alcohol to your pet yourself; a specific type of alcohol is needed and alcohol administration carries some significant risks if not done properly. This is very much something that has to be done with your pet hospitalised at the practice.

For animals already in kidney failure, the extent of damage to the kidneys will dictate how long they need to be in the hospital, whether they need further treatment and also their chances of making a full recovery. The outlook for dogs and cats poisoned by antifreeze depends on a number of things most important of which is how quickly they receive the right treatment. Treatment with an antidote usually needs to be started within a few hours of the animal being exposed to the antifreeze to be successful. Once severe kidney failure sets in unfortunately the outlook is extremely poor; the kidney failure is typically not reversible and putting your pet to sleep may be the kindest option. Sadly many pets are not seen by vets until they have already reached this stage.

The take home messages therefore are very much that prevention is key and also that you should contact your veterinary practice to arrange an emergency consultation the moment you become concerned that your pet may have been exposed to antifreeze.

Non-steroidal anti-inflammatory drugs

Okay so let’s now move on and finish this podcast by talking about poisoning of pets by a group of drugs known as non-steroidal anti-inflammatories. These drugs can be considered in three groups for our purposes here and let’s talk about each in turn.

The first group are drugs such as ibuprofen and naproxen which are sold widely over-the-counter for use in people. This group also includes drugs that are specifically designed for use in animals such as carprofen or meloxicam. These drugs are used as anti-inflammatory pain-killers as well as to treat fever.

As is often the case, poisoning by this group of non-steroidal anti-inflammatories is more common in dogs than cats. Poisoning occurs when the dog eats an excessive amount. However it is very important to note that we also see a number of cases in both dogs and cats where either the owner accidentally gives their pet way too much of a veterinary drug that has been prescribed for treatment, or decides to administer a human drug to their pet without first checking that this is okay.

Poisoning by these drugs can cause a number of problems, the most common and severe of which are injury to the stomach and intestines, including possible ulceration, and kidney failure. Poisoned animals may vomit or have diarrhoea, both of which may contain blood in them. Bloody vomit often has an appearance of ground coffee. Both of these problems may require your pet to be hospitalised for treatment including a fluid drip into a vein, various medications and potentially even surgery. These problems can be very severe, including life-threatening, so it is a very serious matter.

The second type of non-steroidal anti-inflammatory drug that we would like to mention is aspirin. Again aspirin is very widely available over-the-counter. It is used to treat specific problems in dogs and cats but as with people, if too much is given, severe problems can occur. This is especially the case in cats and if you are ever considering giving aspirin to your pet of your own accord, we would strongly encourage you to speak to your vet first.
Problems that aspirin can cause include injury to the stomach and intestines; kidney failure; nervous system signs; breathing problems and unexplained bleeding.

The third type of non-steroidal anti-inflammatory drug that we would like to mention is acetaminophen which is also known as paracetamol for example in the United Kingdom. Acetaminophen is used extensively by people and is widely available over-the-counter. It is contained in a variety of preparations either on its own or with other drugs including for example aspirin and codeine.

Acetaminophen has been used in dogs to treat certain conditions. However it is not used very widely nowadays given that there are now a number of drugs specially produced for animals. Again, acetaminophen is only safe in dogs if it is used at the right doses and you should definitely consult your vet practice if you are considering giving acetaminophen to your dog.
Now, it is very important to realise that acetaminophen should NEVER EVER BE GIVEN TO CATS. It is very very dangerous to cats and even tiny amounts can be life-threatening.

The two main problems that acetaminophen or paracetamol can cause are liver failure and damage to red blood cells; red cells in the blood carry oxygen around the body. Animals with liver failure may vomit, go off their food, and become jaundiced. Jaundice is when the gums, the skin and the whites of the eyes take on a yellow appearance.
Damage to red blood cells may make your pet’s gums look brown, like a chocolate appearance, or blue or purple. Some animals, especially cats, may also develop swelling of the face or paws, and breathing problems. These signs may start within a few hours of your pet being poisoned by acetaminophen.

It is very important that you ring your vet practice immediately if you think your dog and especially your cat has been poisoned by acetaminophen. There are several aspects to the treatment of acetaminophen or paracetamol poisoning which might include making your pet vomit or washing out their stomach; admitting them to the hospital for a fluid drip into a vein; and providing them with a variety of different medications.

Acetaminophen poisoning is one type of poisoning for which a couple of different antidotes or specific treatments exist and may prove life-saving. The first antidote is a drug called N-acetylcysteine which may be given by injection into a vein; there are also tablets available to be given by mouth. Treatment may need to be given for up to 2 days. Vitamin C is another drug that your vet may decide to use to treat paracetamol poisoning and there are various other options too.

The outlook for dogs and cats poisoned by acetaminophen or paracetamol depends on how much they consume, how long it is before treatment is started and whether treatment can be continued for as long as necessary. Acetaminophen poisoning can be life-threatening and we cannot stress enough how careful you need to be, especially to make sure that cats never get exposed to this drug.

Okay so that brings us to the end of this PercyPods Pet Emergency blog. We hope that you have found it useful and learned a little about some of the more common poisons affecting dogs and cats. The next blog will be in approximately 2 weeks time when we will move on from poisoning to discuss vomiting. Before we sign off just to remind you that you can contact us in various ways. Via email on percypods@gmail.com; via the PercyPods Facebook page; or via Twitter on @PercyPods. We would really love to hear your comments on this podcast as well as suggestions for future topics. Also don’t forget to subscribe for future episodes via the email feed. So thank you for reading and until next time, may you and your pets be safe.

Dog and Cat Poisoning - Common Poisons Part 1

Welcome to PercyPods Pet Emergency blogs. This week: why having a sweet tooth can be deadly for your pet, two different causes of kidney failure, and the perils of rat poison.

So in our first blog we looked at some general information relating to poisoning in dogs and cats. We are now going to move on and discuss some of the more important poisons. Although there are a very large number of potential poisons, many of the cases that we as vets see are the result of the same substances and we are going to concentrate on ten of these in these podcasts. This week’s podcast will look at xylitol, grapes/raisins/currants, lilies, chocolate and rat poison. The next blog in 2 weeks time will look at pyrethrins and pyrethroids which are contained in some anti-flea products, metaldehyde which is in snail bait or slug pellets, antifreeze, non-steroidal anti-inflammatory medications such as ibuprofen, and paracetamol or acetaminophen.

Xylitol

Okay so let’s start with xylitol. Although xylitol poisoning is not that common, it is a relatively new poison to have been uncovered. Xylitol is a naturally-occurring sugar alcohol found in small amounts in a variety of fruits and vegetables. However it is also extracted commercially and used as a sweetener in low carbohydrate and diabetic products. These products include for example baked goods such as cakes and biscuits. The use of xylitol has also been increasing due to its effects in reducing tooth decay. This has led to xylitol being included in products such as chewing gums, sweets and toothpastes. It is important to realise that manufacturers do not have to specify that a product specifically contains xylitol so just because it does not say on the wrapper that the product contains xylitol, it still may and we need to be aware of this.

Xylitol poisoning has been reported in dogs but at the time of this blog there are no reports of clinical poisoning in cats. Poisoning occurs when the dog eats a product that contains xylitol. The two main problems that this can cause in dogs are hypoglycaemia, in other words low blood sugar, and liver failure.

Low blood sugar occurs because in dogs xylitol increases the production of insulin; this effect does not occur in people however. The effect of xylitol in lowering blood sugar is what we call ‘dose-dependent’; that means the more xylitol a dog eats, the lower blood sugar is likely to fall. Blood sugar may fall so low that the dog starts to show signs such as lethargy, weakness and depression. In severe cases wobbliness and even seizures may occur and this is a life-threatening emergency. These signs may develop within one hour of the dog eating the xylitol, but they can also take longer to come on.

Xylitol can also cause liver failure and this can actually occur even if only a very tiny amount has been eaten. It is for this reason in particular that we recommend that all dogs that have eaten xylitol are treated aggressively. Signs associated with liver failure take longer to develop than those from low blood sugar, for example up to 3 days. They include evidence of bleeding say from the gums or in faeces, as well as signs of jaundice where the dog’s gums, skin or whites of the eyes take on a yellow appearance.

We would strongly encourage you to contact your veterinary practice if you think your dog may have ingested some xylitol regardless of the amount. Depending on your individual dog, it may or may not be appropriate to induce vomiting; this was discussed in greater detail in the first of these blogs. Alternatively your vet may want to wash out your dog’s stomach under a general anaesthetic. Additional treatments that may be required specifically for xylitol poisoning include sugar supplementation and treatment for liver failure. Your vet will be able to discuss this with you in more detail.

However it is worth saying that if your dog develops severe signs such as seizuring or being in a coma after eating a product containing xylitol, it may be appropriate for you to try and administer some sugar at home before taking him or her to your practice as these signs may be due to severely low blood sugar. Of course you must be careful not to get bitten and we also would not recommend that you actually try and feed the sugar to your dog. These animals are usually not in a condition where they are able to swallow and trying to force the sugar down them is not a safe way forward. The best thing for you to do is to get some honey or mix some normal sugar with water and rub this onto your dog’s gums. If this helps his or her signs, you can repeat it as often as you need to. However we must stress that this is very much a short-term life-saving measure while you make your way to your veterinary practice; it is not safe to try and continue to treat these dogs at home.

Tests that your vet may want to perform when they see your dog include blood tests to check blood sugar and to check for signs of liver injury including how well your dog’s blood clots.

The outlook for dogs that have been poisoned by xylitol really depends on two things. The first is whether they can receive treatment in time and for as long as is required. The second is how severely affected the liver is. Regrettably some dogs develop severe liver failure and putting them to sleep becomes the kindest option.

Before moving on from xylitol, just a word of caution. There are some products on the veterinary market designed for use in dogs to improve the condition of their teeth and help prevent tooth decay. Some of these products contain xylitol. As we are unsure at the moment exactly how xylitol causes problems, we personally would not recommend the use of these products in dogs. To us it does not seem a risk worth taking when we know how severe the consequences can be.

Grapes/Raisins

Okay so now let’s move on and talk about poisoning from grapes, raisins or currants. It has been known since the late 1990s that these fruits can be poisonous to dogs. However at the time of this podcast there have been no reports of poisoning occurring in cats; nevertheless we cannot be sure that they are not harmful to cats and it is best to try and avoid cats gaining access to grapes, raisins or currants. Thankfully cats are unlikely to eat such items anyway – in general cats are less likely to poison themselves than their doggy counterparts.

Poisoning in dogs is associated with injury to the kidneys and in the worst cases life-threatening kidney failure can occur. At the moment it is not known exactly how these fruits harm the kidney. However one point that is essential to realise is that poisoning in dogs may occur following ingestion of all types of fresh grapes and commercially available raisins including organic ones.

What is especially worrying about grape, raisin and currant poisoning in dogs is that there appears to be no way of predicting that this might occur. Many poisons are ‘dose-dependent’ which as we said a few minutes ago means that the more the dog eats, the more likely it is that poisoning will occur and the more severe the signs are likely to be. However at the moment it is suspected that poisoning in dogs due to grapes, raisins and currants is not dose-dependent. This means that one dog could eat a whole bunch of grapes many times throughout their life without ever having a problem while on the other hand another dog might eat just a few grapes and develop kidney failure. It is because of this unpredictable nature of the poisoning in dogs that we recommend that no dogs should be fed grapes or any products containing raisins or currants, and we also recommend that any dog that does eat any of these fruits, no matter how little the amount, is treated immediately.

Okay so what signs might your dog show if they are suffering from this type of poisoning? Well, vomiting is reported in almost all cases and this usually occurs within 24 hours of ingestion; grapes, raisins or currants may be identified in the vomit although I am not sure how many people are willing to actually inspect their dog’s vomit! Other signs that may occur include loss of appetite, lethargy, diarrhoea and signs suggestive of pain in the dog’s stomach area or abdomen.

As most dogs suffering from this type of poisoning are already vomiting, it is usually not necessary for your vet to make your dog vomit or to wash out his or her stomach to get rid of the fruit. However they may recommend that your dog is fed some activated charcoal for a while; this is intended to basically mop up any of the poison still left in your dog’s stomach or intestines. The poison is then passed out of your dog in their faeces.

Your vet is likely to run some blood and urine tests to check for signs of dehydration and kidney failure. In many cases it may be appropriate for your dog to be admitted to the practice to receive a fluid drip into a vein for 2 days or possibly longer. The extent of damage to the kidneys will dictate how long your dog needs to be in the hospital, whether he or she needs further treatment and also their chances of making a full recovery. If the kidney failure is not reversible, putting your dog to sleep may be the kindest option.

Lilies

Okay so now we are going to move on from grapes to talk about lily poisoning in cats. Domestic cats are the only animals that have so far been reported to be susceptible to lily poisoning with no reports of poisoning in dogs at the time of this podcast. It is thought that all species of lily are poisonous to cats including Easter lily and Tiger lily as well as day lilies. Also all parts of the plants including the flowers and the pollen are poisonous to cats. Most cats are poisoned by ingesting lily plants kept in the home, and even very small amounts can cause serious problems. It is worth specifically mentioning the pollen as it can drop on the floor very easily and may then get onto the cat’s paws and then be licked off. Cat owners beware – please do not keep lilies in the house! Yes, they are beautiful plants but it really is not a risk worth taking!

Lilies cause injury to the kidneys in cats and in the worst cases kidney failure may occur. At the moment it is not known exactly how or why this happens. Although lilies can also cause other problems in cats, kidney failure really is the main one. Cats may start showing signs of being unwell very quickly after eating the plant, even within 10 minutes. They may vomit, drool and appear lethargic or depressed. They will lose their appetite and as time goes by become more and more dehydrated as kidney failure sets in over one to two days.

As with grapes, raisins and currant poisoning in dogs, we would strongly recommend that any cat that is thought to have eaten some lily plant is seen by a vet as soon as possible. If the cat is not already vomiting, this may need to be induced or your vet may want to wash out your cat’s stomach under a general anaesthetic.

Your vet is likely to run some blood and urine tests to check for signs of dehydration and kidney failure. In many cases it may be appropriate for your cat to be admitted to the practice to receive a fluid drip into a vein for 2 to 3 days or possibly longer. The extent of damage to the kidneys will dictate how long your cat needs to be in the hospital, whether he or she needs further treatment and also their chances of making a full recovery. If the kidney failure is not reversible, putting your dog to sleep may be the kindest option.

Chocolate

Okay so now we move on to chocolate, yes delicious lovely chocolate. It might surprise you given the amount of chocolate some people seem able to put away but chocolate poisoning can occur in humans – admittedly this is very rare and aren’t we thankful for that! However chocolate poisoning is not so rare in domestic pets. These species are more vulnerable because they metabolise chocolate much more slowly than people do.

Unsurprisingly cases of chocolate poisoning are more common in dogs and also tend to occur more commonly at certain times of the year for example Christmas, Easter, birthday parties or other times of the year when chocolates and chocolate cake are more likely to be in the house. In many cases the dog will also have consumed some of the paper in which the chocolate may be wrapped, although the wrappers are usually of much less concern than the chocolate itself.
It is worth saying that so-called chocolates or chocolate drops that are specially made for animals are safe because they are not made from cacao beans and do not contain the poisonous substance found in human chocolate.

So what is the poisonous substance contained in chocolate? Well, chocolate is made from cacao beans and contains a substance called theobromine. This substance is very similar to caffeine and in fact chocolate also contains a smaller amount of caffeine as well. Not all types of chocolate are created equally as far as the risk of causing poisoning is concerned. The risk depends on the amount of theobromine the particular chocolate contains and is greatest for plain or dark chocolate as well as cocoa powder. Milk chocolate is the next most dangerous and finally white chocolate is the safest.

The main problem with chocolate in dogs and cats is that it causes widespread stimulation in the body including of the brain, the heart, breathing and the muscles. Your pet is likely to start showing signs within 24 hours of eating the chocolate but it is often much sooner than that and these signs could go on for two to three days. They include vomiting and pain in the stomach area, the abdomen. Poisoned animals may become very excitable, wobbly when walking, and start to pant or breathe quickly. In the most severe cases your pet may start to show twitching and tremoring of the muscles as well as to have fits or to seizure. Some dogs will seem to want to drink more water and to pass more urine.

When you contact your vet, as we discussed in the first of these blogs, it is important to try and give them as much information as possible.  So for example how much chocolate or cake has gone missing and also what type of chocolate is it.

In terms of treatment for chocolate poisoning, it may be appropriate to make animals vomit if they are not already vomiting. We have to be careful here to remember that there are some situations in which making a pet vomit is not a sensible idea, for example if the animal is seizuring or overly excited as can occur with chocolate poisoning. Precautions as far as making animals vomit were discussed in the first of these blogs and you should always contact your veterinary practice for advice before deciding to administer any kind of medications or treatments to your pet.

When your vet sees your pet they may want to run blood tests and especially to perform what we call an electrocardiogram or ECG. This is to look at your pet’s heart rhythm because it is common for chocolate to cause fast heart rates and an abnormal heart rhythm. Your vet will advise you whether they think this is necessary or not based on their examination of your pet.

There is no specific treatment for chocolate poisoning and patients will receive supportive care based on how severely affected they are. This may include being admitted for a fluid drip into a vein, and for medications such as something to stop them vomiting or a sedative if they are very excitable. Your vet may also have to give your pet something to treat an abnormal heart rhythm.
Finally your pet may need to be given some activated charcoal which as we discussed earlier is intended to mop up any chocolate left in the stomach or intestines.

Many patients with chocolate poisoning make a full recovery as long as they can be supported for long enough. However chocolate poisoning can be very serious and regrettably is fatal in some cases. You must therefore be careful not to allow your pets to eat chocolate although we realise that sometimes this is easier said than done – young dogs in particular are amazing at helping themselves to chocolate delights! Most of the cases we have seen seem to have been young Labradors or Boxers!

Anticoagulant rodenticide

Okay so the last type of poison we are going to discuss in this podcast is rat or mouse poison. However not all types of rat or mouse poison are the same and we are going to discuss the type that can cause problems with blood clotting leading to bleeding and bruising. This type of poisoning has been recognised in pets for a long time and can be caused by many different products available from various supermarkets, garden centres and so on. The different types can vary in terms of how long they cause a problem for but they all basically cause the same problem which is bleeding. Without going into too much detail, this bleeding occurs because these poisons prevent the blood from clotting properly; they do this by interfering with vitamin K in the body – vitamin K is essential for blood to clot properly.

As is often the case, problems with rat poison are seen much more commonly in dogs than in cats and it is worth pointing out that although most cases occur when the dog directly eats the rat poison, there have been cases where a problem has occurred after a dog – or indeed a cat – ate a rat or a mouse that had been poisoned; this is because the poison can remain active in the dead rat or mouse for quite a long period of time.

So what signs might you expect to see in a dog suffering from this type of poisoning? Well the first thing to say is that these signs usually take some time to come on, typically at least 2 days and potentially as long as 7 days. It is very important to bear this in mind when you are answering questions your practice asks you – for example was your dog off the lead earlier in the week in the park or did you put down rat poison in the shed a few days ago?

The typical picture we expect to see is that of a bleeding dog although the area in which they are bleeding can vary. Some dogs have breathing difficulties or coughing because of bleeding into the chest or lungs. Others may show bleeding from the nose or the gums or in their faeces. The signs can vary but the basic problem is the same, unexplained bleeding. If the bleeding is severe enough or goes on for long enough, your dog will start to look pale in their gums and can go into shock.

The treatment of this type of poisoning can be quite complicated as it depends on when your dog ate the poison, how severely affected he or she is, and whether the specific type of rat or mouse poison in question is known. Make sure if you know that you tell your vet the name of the product, including the name of the active ingredient, written on the packaging.

If it has only been a few hours since your dog ate the rat poison, then it may be appropriate to make him or her vomit. However this is not indicated once it has been a few hours since ingestion. Your vet may want to do blood tests to check how well your dog’s blood is clotting and these may need to be repeated several times during the course of treatment. They may also want to do blood tests to look for evidence of significant blood loss and in severe cases your dog may need a fluid drip into a vein and potentially a blood transfusion.

Thankfully this type of poisoning is one for which an antidote or specific treatment does exist. Because rat poison prevents vitamin K in the body from working properly as mentioned before, it is possible to treat these dogs with vitamin K. Depending on the individual dog this may be given by injection first but then continued as tablets and this treatment may need to go on for several weeks. Again your vet will discuss this with you. Vitamin K treatment takes some time to start working. Some of the more severely affected dogs therefore need a plasma transfusion to help their blood to clot properly while we are waiting for the vitamin K to take effect.

As we say the treatment of dogs affected by rat poison can be quite complicated but your vet will explain everything to you should your dog be one of the unlucky ones to be affected. Many dogs that suffer this type of poisoning go on to make a full recovery. However this does depend very much on whether they can receive the necessary care that they require, including as we say in some cases blood and plasma transfusions. The outlook also depends on where the bleeding is occurring as some sites in the body can cause more problems than others. Finally just to stress again that vitamin K treatment may need to continue for a period of several weeks so be prepared!

Okay so that brings us to the end of this PercyPods Pet Emergency blog. We hope that you have found it useful and learned a little about some of the more common poisons affecting dogs and cats. The next blog will be in approximately 2 weeks time when we will consider pyrethrins and pyrethroids contained in some anti-flea products, metaldehyde contained in snail bait or slug pellets, antifreeze, non-steroidal anti-inflammatory medications such as ibuprofen, and paracetamol or acetaminophen. Before we sign off just to remind you that we would really love to hear your comments on this blog as well as suggestions for future blogs relating to emergencies in dogs and cats. Also don’t forget to subscribe for future episodes via the email feed. So thank you for reading and until next time, may you and your pets be safe.

Dog and Cat Poisoning - General Information

Welcome to PercyPods Pet Emergency blogs. This inaugural blog will discuss what we mean by an ‘emergency’ and then go on to talk about some general information relating to poisoning in dogs and cats. Future blogs will then cover some of the more common poisons encountered in greater detail.

What is an emergency?

Before we discuss some general information about poisoning, a quick word or two about what we mean by an ‘emergency’ – what makes an emergency? What cases are considered to be emergencies?
In the narrowest sense emergency cases are ones in which the animal’s problem poses an immediate risk to his or her life or requires urgent intervention to prevent it from escalating and becoming life-threatening. However animals that appear to be in pain may also be considered to be emergencies and presenting them to the vet in order to obtain pain relief is very valid. Even if the cause of the pain does not pose an immediate threat to your pet’s life improving their welfare is still very important.

A final category of patients seen as ‘emergencies’ do not have a problem that poses a risk to their life or health and are not suffering as such. However you as the carer are not expected to realise this and may reasonably be very concerned. Addressing your concern, stress or distress is also a valid reason for emergency consultation.

As a final word of caution, it is essential to remember that it is not possible for your vet to truly appreciate the needs of your pet until he or she is examined. Although your practice may ask for lots of information over the phone and make the best educated judgment they can, there is no substitute for actually examining your pet and there is much to be said for a ‘better safe than sorry’ approach.

Emergency costs

Before we move on to discuss poisoning, we would just like to say a few words about a potentially awkward subject, namely money, as many pet owners have to pay for veterinary care. Some emergencies develop during times of the day when veterinary practices are normally open. Nevertheless there may be an additional charge above the routine consultation fee for your pet to be seen as an emergency. Moreover, veterinary emergencies have an uncanny knack of happening outside of normal working hours, namely at night and on the weekends. You will find that virtually all practices charge an out-of-hours fee that is considerably greater than the charge for a routine consultation during normal working hours; the exact amount varies according to the practice and also the time of the night or weekend.

Whether or not the cost influences your decision to take your pet to the practice is ultimately up-to-you but please do not misinterpret being told this information in advance as some form of preoccupation with money on the part of your practice. Veterinary staff will always have your pet’s welfare at the forefront of their minds; nevertheless they are obliged to try and give you this essential information beforehand.

General discussion about poisoning in dogs and cats

Okay, so we are now going to move on and discuss some general information about poisoning in dogs and cats, what signs might suggest that your pet has been poisoned, what treatment your pet may need and so on. Future blogs will look in more detail at some of the more common poisons affecting dogs and cats.

It is common for companion animals to be presented as emergencies because of suspected or witnessed poisoning. This is much more the case for dogs than cats, and in many cases the poisoning episode will not have been directly witnessed by your or anyone else. Poisoning is often a presumed diagnosis based on suggestive information you provide and consistent signs in your pet. Although tests can be done to confirm some types of poisoning they are not commonly used due to the delay in obtaining the results, the small number of laboratories that actually run such tests, and the costs that you would incur.

So there are a very large number of potential poisons that can affect dogs and cats and the consequences can vary from essentially none at all right the way through to being life-threatening. This depends on the specific poison of course but also usually on the amount to which the animal is exposed. In the majority of cases animals are exposed to poisons by eating them but some cases occur when the animal’s skin or eyes come into contact with the poison – so-called topical poisoning – and rarely, a poison may be breathed in. We will discuss some steps that you can take to try and minimise the chances of your dog or cat being poisoned at the end of this blog.

There is a large amount of free information available to you about potential poisons in dogs and cats, what to look out for and so on. This information includes leaflets produced by veterinary or other animal-related organisations – such as the RSPCA or the British Veterinary Association in the UK – and then of course there is the good old internet, the fountain of all knowledge and wisdom! Seriously though, although the internet can be very useful we would strongly encourage you to limit your research to reputable websites where you know you will be receiving accurate and reliable information. These sites include for example on the Veterinary Poisons Information Service website, the RSPCA’s website in the Health and Welfare section, or the Animal Poison Control Centre’s website from the American Society for the Prevention of Cruelty to Animals.

What signs or findings may suggest that your pet has suffered poisoning?

Signs most often associated with poisoning include sudden and rapid onset of an illness in a previously healthy animal especially after a period of being unsupervised; you may for example notice gastrointestinal signs – that is, vomiting or diarrhoea. Many poisons affect the nerves and muscles and therefore you may notice sudden onset of tremors, muscle twitching or seizures in a previous healthy animal; these signs often get worse over a period of minutes to hours. Suspected cases of companion animal poisoning often have a history of possible exposure to poisons through a change of diet, access to new areas or environments, or indeed access to veterinary or human medications.

Telephone communication

When you first ring your practice because you are concerned that your pet may have been exposed to a poison, the staff member is likely to ask you a series of questions in order to obtain some basic information. In some cases, your pet will be already be showing severe symptoms and questioning will be kept to a minimum with immediate transport to the practice being the only appropriate recommendation. Some of the questions you may be asked include the following:

  • Did you see your pet being exposed to a poison? If you did not but you suspect this has happened, why do you suspect this?
  • What poison or poisons are involved? Are you able to provide more specific details – for example how much or the strength of the poison?
  • If the poison was originally in a container, do you still have the container? If so, it is always wise to take this to the practice with you if you end up going there as information on the container may prove very useful. If the suspected poison is a plant, take this with you as it may be able to be identified using the internet or other resources.
  • So continuing with the information you may be asked for, other questions include: What is your pet’s species, breed, age, and estimated body weight?
  • How long ago did exposure occur?
  • By what route did exposure occur – did your pet eat the poison or was his or her skin exposed to it?
  • Is your pet showing symptoms? If so, what are they, when did they start and have they changed at all?
  • Is this is the only animal to be affected?
  • Does your pet have any pre-existing medical conditions?
  • Is he or she currently taking any medications?

This information will be used to advise whether your pet needs to be presented to the practice or may be managed conservatively at home. However in some cases on the basis of these questions your practice will feel that they need to get further information before they can provide you with a reliable recommendation about the best way forward for your pet. In such cases they will end the telephone call, obtain the further required information, and then ring you back. Obtaining further information is usually about your practice getting expert information on the particular poison you are concerned about – there are too many poisons for practice staff to keep all this information in their heads! – and they will also be trying to establish the possible severity of the poisoning to which your pet may have been exposed. In order to do this they will most likely consult resources such as books on veterinary toxicology or the Veterinary Poisons Information Service.

One of the matters that typically needs to be discussed in cases in which it is either known or suspected that a poison has been eaten is whether it is appropriate to make your pet vomit to bring the poison back up. Your ability or otherwise to do this at home is one of the major factors that often guides whether or not your pet should be seen at the practice. This will be discussed further shortly.

Home management

Once your practice is satisfied they have as much information as they need and based on your wishes too, a recommendation will be made about whether your pet needs to be seen at the practice as an emergency or can be managed at home. If it is decided between you that it is okay for your pet to remain at home, your practice will brief you thoroughly on what to look out for and what signs should prompt you to ring back.

One of the key steps in managing animals that have been exposed to a poison is trying to limit the amount of poison that they actually absorb into their bloodstream. This is often achieved by making the animal vomit to try and empty the stomach of as much of the poison as possible. However there are certain cases in which making the animal vomit is not recommended and part of the information your practice will ask for on the phone will be designed to help make this decision. The recommendation will depend on the time since the poison is thought to have been eaten, the signs your pet is showing, and what products you have available in the home for making animals vomit.

Some of the scenarios in which it would not be appropriate to make your pet vomit include the following. Cases in which there is an increased risk of the animal inhaling some of the vomit; examples of this would be an animal that is very depressed or one that has a breathing abnormality such as paralysis of the vocal cords. Animals that are already vomiting clearly do not need vomiting to be induced and it should also not be induced in any animal that has ingested a caustic or corrosive substance, for example something containing an acid. Making these animals vomit will bring the hazardous substance back into contact with the oesophagus, that is the tube that connects the mouth to the stomach, and with the inside of the mouth itself causing further injury. In these cases it is better to encourage the animal to drink some milk or water, again as long as they are not depressed or having breathing difficulty. It should be stressed that if there is any doubt about whether vomiting can be induced in your pet at home or not, then taking him or her to the practice for a consultation is the safest way forward – again, ‘better safe than sorry’!

So if it is appropriate and considered safe to make your pet vomit at home, what can you use?

The safest thing to use is soda crystals, also known as washing soda. A half to one crystal is placed on the tongue at the back of the mouth depending on the size of your pet and vomiting typically occurs within 10-15 minutes. If vomiting does not occur, the dose can be repeated. It is extremely extremely important to make sure that you use washing soda and NOT CAUSTIC SODA or sodium hydroxide. Caustic soda will cause severe injury to your pet which can be very distressing and potentially life-threatening. We cannot stress enough how important it is to make sure that you are using the right thing and if there is any doubt, don’t give it!

Other things that have been used to make dogs and cats vomit include syrup of ipecacuanha but this product is not readily available, at least not in the United Kingdom. Some resources suggest the use of table salt but vomiting is unpredictable and administering table salt to your pet can cause significant adverse effects. If table salt is given, it is essential to make sure that your pet has free access to water but personally we would not recommend the use of table salt. For us it is a visit to the vet or using washing soda.

Transportation advice

If you do need to take your pet to the practice as an emergency it is important to take any necessary precautions during transportation and always remember the saying ‘less haste more speed’. Make sure you are in a fit state to drive, otherwise ask someone else to drive. Even if you do drive, it is always preferable to take someone else with you in the car if possible, for example your partner, a nearby friend or a neighbour. Avoid lifting big dogs that are unable to walk on your own as you may seriously injure yourself and be careful when moving a seizuring animal that you do not get bitten. If your pet is seizuring, especially dogs, it is important to make sure they are protected from injury during the journey, for example using lots of soft bedding as protection, and to keep them cool if possible, for example by having the air conditioning on or the windows open. Unconscious animals should be kept warm.

Poison-proofing your house

Okay so before ending this blog, as promised, we will share some tips on how you can try to reduce the risk of your pet being exposed to a poisonous substance. The first aspect to this is to be as informed as possible about what substances can be poisonous to pets and to remember that some things are thought to be poisonous to dogs but not cats, for example grapes, raisins and currants, while others are currently not thought to be poisonous to dogs but are known to be poisonous to cats, for example lily plants. Although there are a very large number of potential poisons, many of the cases that we as vets see are the result of the same sorts of substances – for example, chocolate, human medications, anti-parasite preparation and insecticides – and you should try and be informed about these hazardous substances. In particular two of the most common causes of poisoning in dogs are rat or mouse poison, which can cause bleeding, and slug or snail pellets which can cause severe muscle tremors and seizures. We will discuss these in greater detail in future blogs.

The second aspect to preventing poisoning is to try and keep substances that have the potential to be hazardous out of the reach of your pet. Keep them locked away in secure cupboards and return them there straight after use; keep handbags out of the reach of your pet; do not buy poisonous plants; use insecticides and cleaning products according to the recommended guidelines keeping your pet away from the area for long enough; and so on. It is an old saying but absolutely true that prevention is better than cure.
One other point that warrants specific mention is that you should not assume that food consumed or medications used by people are safe in pets. For example onions and garlic can be poisonous to animals. Also medications which may be relatively safe in one species, may be very dangerous to another. For example paracetamol, or acetaminophen, can be used safely in dogs as long as the right dose is given, but should never ever be given to cats. We would strongly urge you to get veterinary advice if you are considering giving any human medication to your pet.

Okay so that brings us to the end of the inaugural PercyPods pet emergency blog. We hope that you have found it useful and learned a little. The next blog will be in approximately 2 weeks time when we will start to consider some of the more common causes of poisoning in dogs and cats. Thank you for reading and until next time, may you and your pets be safe.