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Toxins

By Robert Gaunt, VMD – Emergency Clinician

Common toxins:

Unfortunately pets ingestion toxins fairly frequently and depend on the type and amount of toxin that is ingested the signs can be minimal to very severe. If your pet does ingest a known toxin it is important to have your pet evaluated by a veterinarian and to bring along any information that you have regarding what was ingested. Knowing both the type and amount of toxin is very important to help determine what, if any significant signs will arise.  Unfortunately for the majority of toxins there is no specific antidote and the majority of treatment relies on early intervention, decontamination (removing/binding the substance), supportive care (hospitalization, GI protective medications, intravenous fluids)  and monitoring of various organ parameters.

Specific treatments include inducing vomiting if the toxin was recently ingested and giving your pet a dose or doses of activated charcoal. Activated charcoal is a substance that will help bind various toxins in the GI tract and prevent further absorption. Both of these treatments are important to help reduce the overall dose and hopefully reduce the severity and duration of any clinical signs.

If you are concerned that your pet may have ingested a toxic substance you should contact your veterinarian or the ASPCA Animal Poison Control (800-548-2423) to determine if the amount ingested is toxic or will cause any significant problems.  The ASPCA poison control website has a plethora of information about toxins. More information is available at https://www.aspca.org/pet-care/animal-poison-control.

Chocolate: 

Chocolate is toxic to dogs. That being said, dark and semi-sweet chocolates are much more toxic than milk chocolate.  And white chocolate is not toxic, as it does not actually contain any chocolate. When enough chocolate is ingested it can cause vomiting, diarrhea, hyperactivity, rapid heart rate and arrhythmias, high blood pressure, tremors, and seizures. Usually side-effects will occur within the first few hours and last 12-24 hours, but this is variable depending on the amount and type of chocolate ingested. If ingestion recently occurred a veterinarian can induce vomiting, administer activated charcoal, and sometimes hospitalize your pet to monitor and treat the toxic effects of chocolate. When these recommendations are followed chocolate ingestion is rarely fatal.

Xylitol:

Xylitol is a sugar substitute that is becoming more common in human foods and products. It is not toxic to humans, but is toxic to dogs. Common products that xylitol is found is include sugar free gums, some mints, toothpastes and some specialty peanut butters among others.  What xylitol does is cause a sharp increase in insulin secretion leading to a very rapid drop in dog’s blood sugar. This can show up as severe lethargy, weakness, difficulty walking or being wobbly, or seizures.  It can also lead to liver damage and even acute liver failure if high enough doses are ingested. Treatment often involves inducing vomiting and hospitalization for monitoring and treating low glucose levels. Often a liver protectant (Denamarin) will be used to help treat any possible underlying liver damage.  The prognosis is often good with early treatment for the low blood sugar, but if severe hepatic damage occurs it can be fatal.

Raisins:

Grapes and raisins cause an indiosyncratic toxicosis in dogs. This means that we don’t know what the mechanism of toxicosis is and not all dogs are sensitive to the toxicity. Because we cannot predict which dogs will experience the toxicity and because it does not appear to be dose-related, the recommendation for any grape or raisin ingestion is to be seen immediately by a veterinarian. Treatment consists of inducing vomiting, administration of activated charcoal, and 48 hours of hospitalization with IV fluids. These treatments are used to try to prevent the toxicity which causes acute kidney failure which can be fatal. In most, if not all cases, appropriate treatment results in an excellent prognosis for the pet.

Lilies:

Lilies are extremely toxic to cats. Any part of the lily (stem, petal, pollen, leaf) can be harmful to your cat, and the exposure is not dose dependent. This means that even if only a small portion of the lily was ingested, your cat can experience the poisonous effect. Lilies cause acute renal (kidney) failure in cats and this damage can be irreversible. If you suspect that your cat ate a part of a lily, the safest thing to do is to bring your cat into the hospital. If you can remember to do so, bring the flower (or take a picture of it) into the hospital to show the doctor.  Treatment includes decontamination (inducing vomiting, administering medications to bind to the toxin), baseline bloodwork, and hospitalization for IV fluid therapy for 48-72 hours. Some cats require dialysis, particularly if they have signs of kidney injury on their initial bloodwork. Prognosis for cats who eat lilies is good, particularly when the toxin ingestion is caught early.

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