Poison Control

Did your pet consume something they shouldn’t have? Are you worried your pet has eaten something dangerous? Early treatment is key for a favorable prognosis. Pet owners are encouraged to call the ASPCA Animal Poison Control Center hotline at 888-426-4435 or the Pet Poison Hotline at 855-764-7661 (fees apply for these hotlines). Ask for your case number so it can be accessed at the hospital, if needed.

According to the ASPCA-APCC Hotline, the top pet toxin cases involve:
10. Gardening products (fertilizer, herbicides, fungicides)
9. Insecticides (insect and pest poisons)
8. Plants (indoor plants, outdoor plants, bouquets)
7. Rodentcides (mice and rat poisons)
6. Household items (paint, glue, cleaning supplies)
5. Veterinary products (such as pet medications)
4. Chocolate (baked goods, candy)
3. Food (such as xylitol, grapes/raisins, onions/garlic)
2. Human prescription medication
1. Over the counter medications (pain relievers, cold medicines, herbal supplements)

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Over the past 11 years we have received many calls and questions about toxicities and accidental ingestions. A few notable topics stand out:

Lily Toxicity (Cats)

Lilies in the true lily and daylily families are serious dangers to cats. The toxin, while still not fully understood, targets a cat’s kidneys and causes irreversible acute renal (kidney) failure. Toxins from lilies are rapidly absorbed after ingestion. Clinical signs can start in as little as five minutes and may include vomiting, anorexia, depression, and hypersalivation (excessive saliva production.) Renal failure starts within 12 to 24 hours post-ingestion. Later signs include polyuria (increased urination), depression, and anorexia. If a cat is not treated quickly, the prognosis is grave.

The most alarming part of lily toxicity is that all parts of a lily are toxic to a cat: leaves, petals, pollen, stems, even water in the vase has potential to cause harm. Common lilies toxic to cats include tiger lilies, stargazer lilies, day lilies, all Asiatic lilies, and Japanese show lilies. Easter lilies are also quite dangerous: many accidental ingestions happen around the Easter holiday.

While there is no “cure” for lily toxicity, treatments are available that greatly improve the prognosis if administered promptly. This may involve decontamination, such as inducing vomiting, gastric lavage, and administering activated charcoal with sorbitol. Additionally, cats are started on aggressive fluid therapy (2-3x maintenance) for 48-72 hours. Gastroprotectants are also helpful (antiemetics, antacid, phosphate binders.) Some cats that recover from acute toxicity may be prone to developing chronic kidney disease later in life.

If you are uncertain if a lily is toxic, keep it out of your cat’s reach until you can contact your veterinarian or contact a pet poison hotline for more details.

Pyrethrin/Pyrethroids Toxicity (Cats)

Pyrethrins, and related but more potent pyrethroids, are common insecticides used in flea and tick prevention products for cats and dogs. Pyrethrins kill insects by preventing their nervous system from functioning properly. Unfortunately, pyrethrins and pyrethroids (especially permethrin) are not species-specific in their toxicity, meaning severe and significant problems in pets can arise. Cats lack the liver enzymes necessary to process these compounds and can result in super sensitivity.

Pyrethrin/pyrethroid toxicity in cats most often occurs when a pet owner uses a product intended for dogs on cats. Although products may appear similar in packaging and administration, the quantity of pyrethrin/pyrethroid “active ingredients” in dog products is far too much for cats to handle.

Clinical signs of pyrethrin/pyrethroid toxicity may include, but are not limited to:

• Loss of coordination (difficulty jumping, walking, or standing upright)
• Shaking, twitching, and tremors (which can be mistaken for seizures)
• Vomiting
• Breathing problems
• If left untreated, pyrethrin/pyrethroid toxicity can be fatal to cats.

Contact poison control or visit your veterinarian immediately if you suspect your pet has ingested or was exposed via the skin. Have the products you suspect your pet came in contact with available.

 

Xylitol Toxicity (Dogs)

Xylitol (also identified as birch sugar) is a natural sugar substitute. Xylitol has a sugar-like taste with less calories and lower glycemic index. Xylitol also contains anti-cavity properties. Although xylitol is a safe sugar substitute in humans, it is toxic to dogs. A few pieces of sugar-free gum has the ability to affect dogs within minutes. There is no antidote for xylitol toxicity, but the prognosis is good for dogs who are treated quickly.

What makes xylitol dangerous for dogs? Human and canine blood sugar levels are both controlled by the pancreas and its ability to release insulin. Xylitol does not cause the release of insulin in humans. In canines it triggers a large release, causing a spike in blood sugar. This can cause hypoglycemia, a dangerous drop in blood sugar. In addition, xylitol can cause liver damage. While researchers are unsure of the correlation between xylitol and the liver at this time, liver enzymes often become elevated in dogs after they eat xylitol. Most cases of liver enzyme elevations are mild, but very large doses of xylitol in dogs can lead to liver failure, a serious and possibly fatal condition.

As little as 50mg of xylitol per pound of body weight can cause hypoglycemia and its effects can begin to occur in as little as 10 minutes. While different brands contain different amounts, typically the range is 300 to 1500 mg per piece. To put this into perspective, if a piece of gum has 1,000mg of xylitol, a 20 lb. dog may experience its effects after ingesting just one piece.

Clinical signs develop rapidly, usually within the first 15-30 minutes after ingestion. Signs of xylitol ingestion can include, but are not limited to:

• Vomiting
• Ataxia (lack of coordination)
• Lethargy
• Tremors/ seizures
• Coma

Common products containing xylitol are chewing gums, candies, mints, toothpastes, and mouthwashes. Some baking mixes, puddings, baked goods, nut butters, and home and beauty products may also contain xylitol. Pet owners are encouraged to read product labels before bringing these items into the home.

Chocolate (Dogs)

One of the most commonly searched toxicities, chocolate contains both theobromine and caffeine, both of which speed the heart rate and stimulate the nervous system. Structurally similar, these two chemicals belong to a group of chemicals called methylxanthines. In human medicine they can be used as diuretics, heart stimulants, and blood vessel dilators. Pets are not built the same as humans and cannot easily metabolize these substances.

While cats are also at risk of chocolate toxicity, the overwhelming majority of cases treated are dogs. The amount of caffeine and theobromide in chocolate varies wildly on the type of chocolate. Cocoa beans and powder are the most concerning, followed by baker’s chocolate, semisweet dark chocolate, and milk chocolate. “White” chocolate has an insignificant amount of methylxanthines to cause major problems, but should still not be given to pets. It should also be noted that some companies sell cocoa bean mulch, which is still cocoa beans — and quite toxic to pets if ingested!

A pet’s risk of becoming sick from chocolate depends on several factors: the type of chocolate consumed, the quantity ingested, and the weight of the dog. A few squares of dark chocolate may not be life threatening to a Great Dane but may cause a Pug serious concern. 

Clinical signs of chocolate poisoning may develop over the course of a few hours post ingestion and may include:

• Vomiting
• Diarrhea
• Restlessness
• Rapid and/or irregular heartbeat
• Excessive thirst and/or urination
• Muscle tremors
• Seizures
• Heart problems

If a pet is suspected of consuming chocolate, contact a pet poison control immediately. Include details like the type of chocolate consumed, elapsed time since ingestion, any clinical signs you may notice, and the pet’s weight. Treatment may include intravenous fluid therapy, medication to induce vomiting, or activated charcoal to block absorption.

Alliums: onions, garlic, shallots, leeks, chives, scallions

A kitchen staple across the globe, alliums are a relatively large family of herbs and vegetables which include onions, leeks, garlic, chives, and garlic. Alliums are especially concerning because toxicity applies in all forms: fresh, dried/dehydrated, powdered, cooked, and liquid forms are dangerous. Pet owners are urged to read labels, as many items thought of as “safe” can contain some kind of allium – baby foods, broths, pasta sauces, sauces and dips, human nutritional supplements, and more. Allium toxicity can affect both cats and dogs, but cats are more sensitive to their effects.

Very little of these herbs and vegetables are needed to be ingested to cause damage. For onions, consuming as little as 5g/kg (five grams per kilogram of body weight; 1 kilogram is equal to approximately 2.20 pounds) in cats and 15-30g/kg in dogs can cause “clinically important” red blood cell damage. Not all alliums are as potent as others: garlic is the most toxic, approximately five times more concentrated than onions – making one clove of garlic very dangerous for cats and small dogs.

With all mammals, red blood cells carry oxygen throughout the body. The toxic components of alliums, disulfides and thiosulphates, attach to oxygen molecules and damage a pet’s red blood cell membranes. The body then sees these red blood cells as foreign bodies attacks the cells. These damaged cells are prone to burst, resulting in anemia (specifically Heinz body formation.) Without healthy blood cells transferring oxygen, a pet will be weak and may pant in an attempt to get more oxygen into their body.

Clinical signs of allium toxicity typically develop within 24 hours of ingestion, but may be delayed based on the amount ingested and weight of the animal. Signs of allium toxicity include, but are not limited to:

• Lethargy/weakness
• Pale, yellow, or brownish gums
• Nausea
• Abdominal pain
• Vomiting
• Increased heart rate
• Elevated respiratory rate
• Dark or unusually colored urine
• Collapse

Harmful Algal Bloom (HABs)

Many aquatic organisms depend on algae for food. Algae in general is a healthy freshwater organism that carries out photosynthesis. Some blooms become toxic, and others do not. Unfortunately, it is impossible to know the difference by sight alone. Blue-green algae is a cause for concern as it can produce cyanotoxins.

Harmful algal blooms occur when nutrients mix with warm weather and still water. Algal blooms can occur almost anywhere (lakes, ponds, rivers, reservoirs, etc.) across Pennsylvania as temperatures rise, most commonly seen between mid June through Labor Day. Algal blooms can appear foamy, scummy, or oily on the surface. Ongoing blooms make take on a blue, green, red, orange, yellow, or even brown color. Dying blooms can release a rotting-type odor that may attract dogs.

Both humans and pets can be affected by waters affected by toxic algae blooms. Humans who come in contact with this algae may notice blisters, hives, or rashes in the areas of contact. If swallowed, diarrhea, vomiting, dizziness, headache, and abdomen pain may occur. Pets (especially dogs) are more susceptible to this toxic algae than humans. In addition to drinking water, algae can also be ingested when a dog licks their paws/fur that have remnants of algae on them.

Signs of algae poisoning can include, but are not limited to:

• Excessive salvation
• Staggered, “drunk” walking
• Weakness/collapse
• Difficulty breathing
• Convulsions

Most signs begin within 30 minutes of exposure, but depends on the size of the dog, amount of algae ingested, and concentration of the toxins. Algae ingestion is a true medical emergency – pets can die from the cyanobacterial poisoning.

Pet owners who see bodies of water with possible algae blooms should not let their pet drink from or play near the area. Leave the area and wipe fur and paws with pet-friendly wipes or soap and water. If possible, contact your local DEP office to report the bloom. 

Drug-Related Toxicities

As the nation decriminalizes and adopts new policies on drugs, it increases a pet’s risk of drug-related toxicity. The most common type of drug-related toxicity seen at VREC  is marijuana. Pets can be exposed via smoke inhalation, ingestion of the marijuana itself, or through ingestion of foods with marijuana in them (especially baked goods.)

Marijuana’s active ingredient is THC (tetrahydrocannabinol,) a naturally occurring psychoactive substance. This should not be confused with CBD (cannabidiol,) another chemical compound found in marijuana. Unlike THC, CBD is not psychoactive, meaning it will not produce the “high” that is associated with marijuana. CBD products are found in many pet stores, though their effectiveness has not been determined in clinical trials at this time.

Both dogs and cats are susceptible to marijuana: dogs are more likely to ingest the drug, while cats are more likely to be sickened by exposure to smoke. Clinical signs may develop as soon as five minutes to 12 hours after exposure, and signs of  exposure can include, but are not limited to:

• Dilated pupils
• Agitation or sedation
• Tremors
• “Drunken” stumbling walk/ swaying
• General disorientation
• Vomiting
• Drooling
• Urinary incontinence

Veterinarians care little about the illegal aspects of drugs – their goal is to treat pets to the best of their abilities. If you suspect your pet has ingested an illicit drug, please do not hesitate to bring them in for evaluation. Some may have an aversion to seek care due to stigma or the fear of legal repercussions. Veterinarians will not call the police.

Regardless of the drug, a pet’s prognosis is greatly improved the sooner proper treatment begins. In suspected cases of drug exposure, veterinary staff greatly prefer honesty as it helps quickly diagnose and treat a pet. Key information such as type of substance, time of exposure, time of first noticed clinical signs, along with their type and duration are incredibly helpful.

Nicotine (cigars, cigarettes, chewing tobacco, e-juice, gums)

Nicotine poisoning is a concern in any situation where cigarettes, chewing tobacco, or even nicotine gum, patches, or e-cigarettes are present. Cigarette butts are also of concern, as they are small, easily chewable, and contain a good deal of residual nicotine after use.

As with many accidental ingestions, a pet is affected to a greater or lesser extent based on the quantity ingested and their weight. Some pets have been reported to experience clinical signs at doses as low as one milligram per kilogram of body weight (one kilogram is 2.20 pounds,) but the median lethal dose in dogs is 9.2mg/kg. To put this into perspective, the average cigarette contains between 9-30 mg of nicotine, and cigarette butts can contain up to 25% of the original quantity of nicotine. E-cigarettes use a cartridge that contains a nicotine solution and flavoring. This solution, often called “e-juice,” can contain anywhere from 6mg to 24mg of nicotine.

Many times nicotine poisoning is difficult to pinpoint, as its clinical signs may be mistaken for another ingestion or even a virus. If you did not see a pet ingest nicotine – but you or a family member has nicotine products – be sure to let a veterinarian know so specific tests can be run.

Signs of nicotine poisoning include, but are not limited to:

Mushrooms

Did you know Pennsylvania farms lead the nation in white mushroom production? These commercially grown mushrooms are not of concern to pet parents – the wild varieties are. According to research, Pennsylvania is home to seven varieties of mushrooms with potential to inflict serious harm to pet parents and their pets.

Wild mushrooms can grow in backyards as well as in parks and undeveloped spaces such as parks and trails. Mushrooms grow quickly when exposed to damp conditions and are quite difficult to remove permanently. Pet parents with mushrooms growing on their property accessible to dogs should do a thorough daily evaluation daily and/or consult a mycology (mushroom) expert. Prevention is key, as even with prompt attention mushroom toxicity cases come with a grave prognosis.

Depending on the variety ingested, size of dog, and time elapsed since ingestion, signs of toxicity may vary. Toxic mushrooms attack the liver, so prompt care is essential. Common signs may include, but are not limited to:

• Tremors
• Wobbling/loss of balance
• “Drunk” walking (ataxia)
• Salivating
• Dehydration
• Yellow skin/”whites” of eyes
• Vocalization
• Seizure
• Rapid heartrate (tachycardia)

Pet parents who suspect a pet has eaten even a small amount of a potentially toxic mushroom should understand that time is of the essence. If possible, safely obtain a sample of the mushroom eaten. If a physical sample cannot be obtained, photos of the cap and stems also are beneficial. Contact a poison control center or veterinarian immediately.
More information about mushrooms can be found here

Sago Palm

Sago palms are popular landscaping plants in the Southern US and have gained popularity nationwide thanks to houseplant and bonsai sized offerings available at nurseries and home improvement centers. Also known as coontie palms, cardboard palms, or zymias, the plants contain a toxin called cycasin which can cause liver failure within days. If a body’s liver is incapacitated, blood cannot be detoxified. The build-up of toxins affects the central nervous system and can cause neurological concerns.

As with lilies, all parts of the sago palm are considered poisonous, but its seed (nut) is the most dangerous. Cycasin works quickly, with clinical signs displaying as quickly as 15 minutes after ingestion in dogs, cats, and horses. Initial signs of sago palm ingestion include, but are not limited to:

Snake bites

Although not a “poison,” VREC receives calls about snake bites (especially in warmer months.) Pennsylvania is home to over 20 different snake species. Three species are venomous: Eastern Copperhead, Timber Rattlesnake, and Eastern Massasauga. All venomous snakes found in Pennsylvania possess key indicators: vertical eye pupils (similar to a cat’s eyes), an indentation on each side of the head between the eye and nostril, and a single row of scales on the underside of the tail.

Pennsylvania’s venomous snakes are generally nonagressive but will not hesitate to fight back if threatened. Snake bites usually occur while a pet (or person) attempts to advance on or handle a snake. If a pet is bitten, remain calm and contact a veterinarian for further instruction. Keep your pet as immobile as possible until seen by a medical professional. VREC stocks antivenin, an anti-venom product which counteracts the dangerous effects of snake venom. In order to utilize antivenin, it must be administered no more than a few hours after the bite.