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.
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.
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.
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.
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.