Easter Toxins

Easter is a happy of time of year to celebrate with family and friends and welcome spring. But it is also a busy time of year for pet toxin ingestion making March Poison Prevention Month. The most common calls this time of year involve Easter lilies, chocolate, and Easter grass.

True lilies such as Tiger, Day, Asiatic, Easter, and Japanese Show lilies are highly toxic to cats. All parts of the Easter lily plant are poisonous – the petals, the leaves, the stem and even the pollen. Cats that ingest as few as one or two leaves, or even a small amount of pollen while grooming their fur, can suffer severe kidney failure. In most situations, symptoms of poisoning will develop within six to 12 hours of exposure. Early signs include vomiting, loss of appetite, lethargy and dehydration. Symptoms worsen as kidney failure develops. Some cats will experience disorientation, staggering and seizures.

There is no effective antidote to counteract lily poisoning, the sooner you can get your cat to the veterinarian, the better his chances of survival will be. If you see your cat licking or eating any part of an Easter lily, call our office or Pet Poison Helpline (855-764-7661-fee applies) immediately. If left untreated, his chances of survival are low.

Treatment includes inducing vomiting to get any remaining plant material out of the stomach, administering drugs like activated charcoal (to bind the poison in the stomach and intestines), fluid therapy to flush out the kidneys, and monitoring of kidney function through blood testing.

Tiger, Day, Asiatic, Japanese Show, and my personal favorite Stargazer lilies are popular in many gardens and yards. These lilies are also commonly found in florist bouquets, so it is imperative to check for poisonous flowers before bringing bouquets into the household.
Non-toxic types of lilies – such as the Peace, Peruvian and Calla lilies typically only cause minor drooling.

Thankfully, lily poisoning does not occur in dogs or people. However, if a large amount is ingested, it can result in mild gastrointestinal issues such as vomiting and diarrhea.

With Easter comes Easter baskets and decorations and Easter grass… the fake grass that often fills those decorative Easter baskets. When your cat or dog ingests something “stringy” like Easter grass, it can become anchored around the base of the tongue or stomach, rendering it unable to pass through the intestines. It can result in a linear foreign body and cause severe damage to the intestinal tract, often requiring abdominal surgery.

And what’s the other favorite thing in those Easter baskets? Chocolate of course! Chocolate rabbits and hundreds of kinds of chocolate eggs! While the occasional chocolate chip in one cookie is not typically an issue, certain types of chocolate are very toxic to dogs. In general, the darker and more bitter the chocolate, the greater the danger. Baker’s chocolate and dark chocolate pose the biggest problem. The chemical toxicity is due to methylxanthines (a relative of caffeine) and results in vomiting, diarrhea, hyperactivity, an abnormal heart rhythm, seizures, and possibly death. Treatment here too requires inducing vomiting to get as much of the chocolate out as possible. The colored foil wrappers on some of those chocolate eggs do make vomiting a colorful process in a lot of cases! The treatment is much the same as lily ingestion where we give activated charcoal (not at all the same as grill charcoal, so please don’t try that) to absorb the toxins. We control the seizures and abnormal heart rhythm with supportive medications as warranted. And give fluids to help flush the toxins out of the blood stream.

Just a reminder, our family of clinics always has a doctor on call 24/7, 365 days a year. Call one of our regular clinic phone numbers and follow the prompts to reach our emergency doctor.

Holiday Floral Threats

During the holidays, many homes may be decorated with traditional greenery – poinsettia, holly, mistletoe and lilies – which present potential toxic encounters for household pets. If these plants are part of your holiday tradition, limiting your pets' exposure is key.

Poinsettias, a common Christmas plant, only represent a mild concern with self-limiting signs. The white sap in the plant contains chemicals that if exposed to or ingested, may lead to skin irritation, drooling, vomiting or rarely diarrhea. These signs, when noted in dogs and cats, usually resolve without a need for medical intervention.

Mistletoe may be found in American (Phoradendron sertinum) and European (Viscum album) varieties, the American variety being less toxic – the berries contain various toxins and, if ingested in small quantities or accidentally, present similar signs to Poinsettia – drooling, vomiting and diarrhea. However, IF ingested in large amounts, more serious signs such as abnormal heart rate, hypotension, seizures and death have been reported.

Holly, with its spiny leaves and berries, may also cause mild digestive distress in dogs and cats. The leave, with the spines, can cause mechanical injuries on sensitive oral membranes, and berries contain several toxic substances that may lead to head shaking, vomiting, drooling and diarrhea.

Depending on the plant species, lilies represent a mild threat to a severe one to cats. Less toxic species such as Peace, Peruvian and Calla Lilies may cause only short-term signs of foaming at the mouth, drooling and vomiting. Of greater concern are true lilies of Lilium or Hemerocallis species, such as Day, Tiger, Easter, Red and Western Lilies. Even small amounts ingested of a few petals or even vase water may result in acute kidney failure. If your cat is seen eating any part of a lily, immediate veterinary attention is indicated. Decontamination via induced vomiting, intravenous fluid therapy and kidney function tests may all be indicated.

If there are any suspected toxic exposures to any of the plants discussed, call our offices for recommendations. Remember, preventing contact with and keeping these decorative plants out of reach helps ensure a peaceful holiday for all.

Why do I need bloodwork before anesthesia and surgery?

So you’ve been told your pet needs surgery. For many, hearing those words brings on all kinds of emotions, fears and anxieties. Seems everyone knows someone who knows someone who has an unpleasant story to tell either human or veterinary, with regards to either anesthesia or the surgery itself. There are many kinds of surgery performed in veterinary medicine from the cosmetic bump removal to the most extensive of orthopedic reconstructions. Some veterinarians specialize in only certain surgeries, I.E. veterinary ophthalmologists and eye surgery. Others are limited to only soft tissue surgeries and yet others, only orthopedic surgery. But common to all is the need for anesthesia, a procedure by which our patients are rendered immobilized, unconscious, and free of pain and anxiety before, during, and after the procedure is performed.

Humans come in all sizes and shapes but the variability in size, body conformation, weight, and even species is far greater in the veterinary setting. To compound this even further there are species specific issues and even individual breed variabilities within a species that play a role in deciding what is the best and safest protocol for a given patient. In many instances, particularly the elderly or very sick, or severely injured patient, the anesthesia is the highest risk part of the overall surgical event. Unfortunately, we cannot always wait for the patient to get better to do their surgery as the surgery itself may be the only way to get better.

Every patient undergoing anesthesia at our hospital is given a physical exam prior to administering any anesthetic agents. This is on top of the exams that have been done in establishing the reason for surgery, either by our own doctors or the referring doctors. In addition to physical exams, preoperative bloodwork is routinely done. While the physical exam is very important, many things cannot be determined by the exam alone. Bloodwork is our means of assessing the internal functions of the animal and combined with exam, help us to choose the best, safest means of anesthesia that allows for the procedure to be completed. Like the scan tool used to diagnoses automotive problems, bloodwork can uncover issues before they are even noticed by the owner as an issue, Considering a liver could lose up to 80% of its functional ability before liver disease is seen or it may take up to up to 66-75% loss of kidney function before obvious urinary/kidney disease signs are reported, bloodwork becomes very important to the overall assessment of a patients overall health. Our goal is have the entire surgical experience be successful and this includes being able to wake up from the anesthesia and not suffer from some other disease process that the anesthesia was detrimental to. With all this said there are still some issues that exam and bloodwork are simply incapable of predicting. Allergic /hypersensitivity reactions, blood clots to name just a couple. While adverse reactions under anesthesia are uncommon, we do whatever we can to know the potential for one beforehand AND be prepared for the unknowns during. The placement of IV catheters and fluid administration during surgery is the norm to aid in maintenance of blood pressure, perfusion of vital organs with oxygen carrying blood, aid in elimination of anesthetic drugs afterwards and to provide a port for the immediate administration of emergency drugs should the need arise. In addition to all these measures, monitoring of the anesthetized patient by trained veterinary technicians and is carried out throughout the whole preoperative time.

Thankfully “problems” during anesthesia and surgery are rare thanks to the exams, tests, agents used and monitoring. But, when they do occur, being trained to recognize it early and prepared to respond to it can be the difference between a pet owner still having a successful outcome or having an unpleasant story of their own.

Intestinal Parasites: What’s Lurking In Your Yard?

There are three common intestinal parasites that not only infect your dog or cat, but can also infect you and your family. Those parasites are roundworms, hookworms and giardia and they are found in sandboxes, soil, grass, and water. The parasites are released through an animal’s feces and the eggs can live in the environment for months. Transmission occurs by ingesting the worm egg, drinking contaminated water, or penetration of the skin by larvae. 

In our pets, infection with these parasites can cause allergic reactions, blood loss and anemia, digestive problems, and damage to internal organs. People infected with these same parasites may experience digestive problems, liver and lung damage, partial or total blindness, and itching skin lesions. Early detection of intestinal parasites is the first step in control and protection.

The Companion Animal Parasite Council (CAPC) recommends the following fecal test schedule:

      • Puppies and Kittens: 2-4 times a year
      • Adult pets not taking a broad-spectrum heartworm preventative: 
        2-4 times a year
      • Adult pets taking a broad-spectrum heartworm preventative: 

        1-2 times a year

Some action to protect your pet and family include:

      • All year us of a broad-spectrum heartworm preventative

      • Remove pet feces from your yard as often as possible

      • Keep sandboxes covered when not in use

      • Wash hands after working in the soil or playing with pets

      • Teach children not to eat dirt   

By following these simple tasks,
we and our pets can safely enjoy our time spent outside!

Turtles and Lizards and Snakes, Oh My!

Exotic pet medicine is an exciting field of veterinary medicine that can greatly differ from the traditional care given to dogs and cats. Many different species are considered “exotic pets” including small mammals, birds, reptiles, and even fish. As you can imagine, the practice of medicine on a rabbit is greatly different from a goldfish.

If you have an exotic pet, the first step is to simply call and ask your veterinarian to see if he/she is comfortable seeing that species. Even veterinarians who see exotics do have some limitations. For example, I will not see monkeys, miniature pigs, or spiders. Some veterinarians who do not have a lot of experience with certain animals may be comfortable with seeing your pet initially, but may have to refer you to another veterinarian if there is an issue that they do not have the right equipment or supplies to treat (just like we have to do with some of our dog and cat patients). You can also ask if your veterinarian is a member of any special organizations. My biggest interest is reptiles, so I am a member of the Association of Reptilian and Amphibian Veterinarians and attend an annual conference to learn about cutting edge topics and share stories about interesting cases with other reptile veterinarians.

When you bring your exotic pet to the vet, make sure you bring all of your pet’s “husbandry” information with you. “Husbandry” refers to the way exotic pets are kept and includes details about their diet and habitat. This is the biggest difference between exotic pets and dogs / cats. Most exotic pets require specific temperature, moisture, and lighting requirements. Even the best owners cannot perfectly replicate the natural environment or diet exactly the same as the animal would experience in the wild. So, we continually re-evaluate husbandry, especially on animals that are sick. If your veterinarian asks you specific questions about how you keep your pet or offers you advice on possible improvements, this is only because the vet is trying to help you keep your pet as healthy as possible.

The internet is not a bad place to look for husbandry requirements, but do not trust everything you read online. Care sheets from websites of exotic animal hospitals are more reliable than a random message board. Also, please remember that recommendations are always evolving based on new research to help us adjust the husbandry standards to provide the best care for our exotic pets. There are many older resources out there that were considered reliable until research proved that alternatives were better.

One example of an outdated resource is a reptile textbook from the 1970’s that I recently came across. In its time, this book was considered a reliable resource. Within the book is a strategy recommending putting turtles in the freezer to induce anesthesia. This technique is now considered very cruel. The same type of outdated information is out there for husbandry techniques for many exotic pets, so please be careful what you follow. If you have any questions, please ask an exotic veterinarian for recommendations for trustworthy resources.

Xylitol: Sweet...but Deadly!

Xylitol is a low-calorie sugar substitute that has helped diabetics and weight loss seekers to get their sugar fix without the calories. Xylitol is appearing in products you'd never suspect. New products on the market such as sleep aids, multivitamins, sedatives, antacids, stool softeners amy contain unexpectedly large amounts of xylitol. Dogs that ingest these products may face a double risk – poisoning by the xylitol (a sugar alcohol) and also liver failure.

Just a small sample of some of the more popular household products containing xylitol.

Xylitol is also sold in bulk to substitute of table sugar for baking and home use. Pet Poison Helpline has had several cases of dogs becoming severely intoxicated after ingesting homemade bread, muffins and cupcakes made with xylitol.

Toxicity is dose dependent. The dose necessary to cause dangerously low blood sugar could be as little as one piece of xylitol chewing gum for a 10-pound dog. To obtain a list or which products contain xylitol, google “products containing xylitol.”

If you suspect that your dog has ingested a xylitol containing product, call the Poison Control Hotline at 1-800-548-2423.