This information was recently presented at a seminar by Dr. Beth Davidow at ACCESS.
The following list includes some of the common toxins we see in general practice, what the presenting signs are, and finally some resources for you. They are in no particular order.
ACCESS ER alone saw 51 cases in 2013 and 71+ in 2014. With the legalization of Cannabis and its many forms (inhalant, dried leaves, oils), it makes it easier for pets to be exposed. Clinical signs can last up to 72 hours and include nervousness, disorientation, depression, bradycardia, urine incontinence, hypothermia, ataxia, and nystagmus (rapid eye movement). The oils/butter are particularly toxic.
Xylitol is a sweetener used in many sugarless gums (Orbitz, Trident) and baking products. Xylitol can cause rapid and sever hypoglycemia leading to liver failure. To be sure, check the ingredients list on food labels. It will be listed as xylitol gum.
Easily the most common toxicity seen in an ER. Clinical signs are agitation, tachycardia, seizures, and potentially death. The Theo Bromine is the toxic ingredient. The highest concentration is in dark (baker’s) chocolate.
Prognosis is dependent on dose amount and time of ingestion. In other words, remember how much and when your pet ate the questionable toxin.
Non-Steroidal Anti-inflammatories (NSAIDS)
NSAIDS include Ibuprofen, Carprofen (Rimadyl), Deracoxib (Deramaxx), Previcoxx, Meloxicam, Piroxicam, Aspirin, and Acetaminophen (different toxicity). These products cause gastrointestinal ulceration, kidney toxicity, and death. Ibuprofen can cause Neurological signs at high doses.
Always follow dose recommendations. Do not leave medications around—especially Rimadyl, which is highly palatable in the chewable form—and don’t use these medications in cats.
Rat Poison (d-Con)
These rodenticides are anticoagulants. Clinical signs are not evident for 24-36 hours after ingestion and often present 3-7 days after ingestion.
Signs include lethargy, weakness, anorexia, pale mucous membranes, bleeding from the gums/rectum, coughing (bleeding into lungs), bloody urine, abdominal distension (blood in abdomen), hematomas anywhere on body, and excessive bleeding from a venipuncture site.
Be sure to save the box of Rat Poison if you have it. There are several types of anti-coagulants, and having the box will help determine which treatment to prescribe. The antidote is Vitamin K. Length of treatment depends of the type of anticoagulant. Vitamin K is VERY expensive, especially for treating large dogs!
Always give the antidote for the prescribed amount of time. I know it is expensive, but I have seen owners lose their pets by stopping too soon with treatment!
Grapes & Raisins
The toxic principle is unknown, and the toxicity varies among dogs. The toxicity leads to acute kidney failure. There have been 43 reported cases with a 53% survival rate. Treatment for grape and raisin toxicity is dialysis for 2 weeks, which costs between $6-10,000.
Slug Bait (Metaldehyde)
Slug bait, compost, moldy garbage and cheese (mycotoxins from fungus), and Permethrins (in older flea products) used on cats can all cause full body tremors. Most of these cases can be saved with standard toxicity treatment and anticonvulsants.
Ingestion of Vitamin D supplements (liquid, capsules, or ointment) can cause kidney failure by calcification of the kidneys. Clinical signs are vomiting and excessive thirst and urination.
Easter, Tiger, Japanese Showy, Day, and Stargazer Lilies are all toxic. Calla and Peace lilies are not. The toxic principle is unknown but it may be concentrated in the pollen. The toxicity is caused by dermal contact. The lilies cause kidney failure.
Multiple types of mushrooms in the PNW are toxic. Mushrooms are seen especially in late Summer and Fall. General Rule: If you can get your pet to vomit within 4 hours of ingestion, it is unlikely to be fatal. After 4 hours, worry! If you want to try to identify the type of mushroom, wrap it up in a paper bag, not plastic. Immediately induce vomiting at home if you see your pet has eaten mushrooms. If you are not sure of time of ingestion, get to an ER.
Types of mushrooms:
- Amanita phalloides “Death Cap” is seen in association with oaks and birches. Pets develops liver failure but can also develop kidney failure, often develops hypoglycemia, sever coagulopathy, and encephalopathy.
- Amanita pantherina is seen in conifers and deciduous forests in PNW. Clinical signs are muscle weakness, seizures, vestibular signs, and coma. Complete recovery is usually within 12-36 hours.
- Psilocybes are the hallucinations and delirium mushrooms. They are in most of the backyards of PNW.
In summary, in order for the ER DVM to help you, have an idea of when the pet was exposed to the toxin, have as much information as possible about the toxin ingested, and any other information you deem relevant. Be sure to call the ER first, to see if vomiting is recommended for your particular pet’s toxin exposure.
Time can be critical. I have listed the ASPCA phone number. I suggest that you also include your local emergency hospital’s phone number in your contact list on your phone—you never know!