Raisin Toxicity - Guess the number of raisins in a single cookie!

Grapes and Raisins are Toxic?
Actually, yes. The idea has floated around the internet as an urban legend, but it really is true. The exact mechanism that causes the toxicity is still unknown, but consumption of grapes or raisins by your dog can cause renal (kidney) failure which can lead to death.

How much is considered a toxic dose?
There are numerous variables that seem to play in to determining a toxic dose. The lowest known amount that caused a toxic response was about 1 oz, or 1/2 Tablespoon, of raisins. However, the animal's metabolism, other foods it may have eaten, size of the animal, and other factors combined determine whether an animal will be affected.

If you are a visual learner perhaps the following pictures will help you understand the potential danger. Some of our Veterinarians wanted to know just how many raisins are in a single oatmeal raisin cookie. So in the middle of a slow ER shift they found out! This dissection was of a standard 3" diameter cookie from a local supermarket bakery - the kind you might pick-up to bring to your next holiday party.

Cookie Dissection

One Cookie = 1 TBS Raisins

Drs. Fields & Germundson

Turns out this brand contains a whole tablespoon of raisins in a single cookie.  Who knew?  But really, in all seriousness, that means that if a 10 lb dog ate one cookie it could be a potentially deadly dose of raisins.

What should I do if my dog eats raisins or an Oatmeal Raisin Cookie?
The best thing to do is bring your pet to your veterinarian right away.  If the consumption of the raisins or cookies was recent the veterinarian will try to induce vomiting followed by administering activated charcoal to absorb any remaining toxins in the stomach.  A blood test will be used to check the blood chemistry values related to kidney function.  Your pet will be started on IV fluids to help flush the kidneys of the toxin and should be hospitalized to monitor blood chemistry levels as well as fluid input and output, another indication of renal condition.  If your pet is already exhibiting signs of renal failure medications such as furosemide, dopamine, or mannitol will be used to support the kidneys.

Caught soon enough, and provided with good supportive care,  your dog should make a full recovery.

If you perform any of your own at home dissection of oatmeal raisin cookies in the name of science be sure to let us know your results.  But, keep the raisins and grapes out of reach of your dog!

Thanksgiving Thankfulness

Thanksgiving is truly a wonderful holiday.  Time set aside for family, friends and remembering all there is to be thankful for.  Because really, no matter the circumstances, we can choose to find things for which we can be thankful.

Our pets usually rank on the "thankful for" list.  The funny noises, kisses, friendly swats, companionship and warmth make them wonderful additions to the family. 

As you prepare for your family dinner, no matter the size of your gathering, remember to keep your "Lucky" dog or cat safe with the food choices offered.  Cats and dogs don't usually do well with a lot of diet changes, especially if the food contains a lot of grease, fat, bones or skin.  So while your turkey tastes delectable you should only share a small portion of cooked meat and vegetables with your furry family members.

Another caution is to keep your pets out of the kitchen during prep time.  It is easy for pets to get under foot when they smell all the deliciousness being created in your kitchen, but that can be dangerous for you and/or your pet.  A recent patient found that out firsthand when the hot drippings from a roasted turkey got spilled on his back.  The 3rd degree burns healed and he is doing great, but Mom and dog learned to do things different the next time.

All the activity can be the way an otherwise indoor animal manages to escape outside when the door is open and closed to welcome visitors.  It's best to contain your pets to a room with a closed door or place them in a kennel until the activity level has died down a bit to keep them safe.

Warm wishes for a wonderful Thanksgiving from Central Veterinary Emergency Services at VRCC Veterinary Specialty & Emergency Hospital.

Picture from http://dynamitedogtraining.blogspot.com/

The Unforgettable Moment - The Loss of a Pet

So many of the Facebook posts and blog articles we post for VRCC are happy and carefree, sharing the excitement over the great outcome for a family and their beloved pet.  We love those stories - and rightfully so.  But what if you didn't get the happy outcome?  What if you, directly or indirectly, had to make a really hard decision and your pet isn't coming home?  What then?

“Zeke” Adopted February 4, 2000

Over the rainbow bridge and 

forever in their hearts –

September 24, 2009

Part of the everyday life of working with sick animals is walking through the process of letting go for pets and their humans.  It is a difficult process, whether it's a sudden accident or a long battle, and we don't take it lightly.  Sometimes it is easier than others, but they all have an impact.  We recognize that these animals are precious parts of other lives and each has a different story. 

As professionals in animal health we do our best to listen and empathize with clients during the pain of those moments. But we can't walk out the door with the clients and help them through the healing process.  What we can offer are some great resources that can help you or a friend on that journey.

The Pet Loss Support Page website has Ten Tips on Coping with Pet Loss on the home page.  They also have a directory of resources by state.  Just click on your states initials in the upper left hand corner of the home page.

Are you a parent wondering how to talk with your kids?  Gail Weinhold wrote an article in the Richfield Post talking about that very topic.  She has some great tips about memorializing the special place their pet had in their family and helping her children to grieve.  She also recommends the book Dog Heaven that can be found on Amazon.com. She ends the article with this thought.  "Think of their soft eyes, purring tummies or wagging tails and the answer is clear, they love seeing their loved ones happy.  In our house, we are still struggling day-by-day and sometimes hour by hour, but we recognize that our lives are better off because of the time we spent with our furry family member.  Life is precious and in the end every paw printed moment counts."  

Denver has The Human Animal Bond Trust (HABT) "which exists to serve those who are anticipating, or have lost, an animal companion".  The HABT provides the Denver Pet Loss Support Group which meets every Thursday evening at the Denver Area Veterinary Medical Society office at 191 Yuma Street in Denver.  Anyone is welcome to attend.  No reservation is needed.

CSU Veterinary Teaching Hospital has the privilege of having the Argus Institute on their campus that offers a client support program.  Counselors are available to help advocate for you and your pet's needs and to support individuals and families during and after the process of losing a pet. See their website for contact information and hours.  Argus Institute Website

The ASPCA offers a Pet Loss Hotline by calling (877) GRIEF-10.  This hotline can be utilized for assistance with the decision to euthanize as well as support after the loss.  The ASPCA website has additional articles and insights that might answer questions you still have.

Admittedly it is a sad subject, and yet one that is better acknowledged than ignored.  Loss is hard and I hope some of these resources, plus relationships to which you can turn, will help you on the journey to healing.

Will You Please Fill My Prescription?

More than a request.

As a Veterinary Emergency practice we often receive phone calls from clients who have run out of a prescription requesting that we either refill the medication ourselves or call the request into a Pharmacy.  The request seems innocent and simple enough, but there is more to the story.  Unless a veterinarian has examined the patient and prescribed the medication for the current condition we would not be able to say "yes" to the client's request.  Why?  It has to do with federal and state laws surrounding the Veterinarian-Client-Patient Relationship or VCPR.

The Creation of the VCPR.

The American Veterinary Medical Association, or AVMA, is made up of medically educated and licensed veterinarians who care deeply about the current practice and future well being of veterinary medicine as a profession.  Formed in 1863 and renamed to the AVMA in 1889 the association has helped form much of the foundation on which the profession operates.  Part of that foundation includes the Principles of Veterinary Medical Ethics of the AVMA originally approved by the House of Delegates in 1867 as the AVMA Code of Ethics.  The code of ethics includes the definition of the relationship between a veterinarian, their clients, and patients.  The state of Colorado has also defined the VCPR in the Veterinary Practice Act that governs the ability of veterinarians to dispense medications.

Establishing and Maintaining a VCPR

The VCPR is defined by the AVMA as a "relationship that exists when your veterinarian knows your pet well enough to be able to diagnose and treat any medical conditions your animal develops."  A VCPR is established when your veterinarian has the opportunity to examine your animal in person and continues only as long as regular visits with your veterinarian are maintained.  Once the VCPR expires, your pet would need to be reexamined by the veterinarian before any diagnoses or dispensing of medication could take place.  As stated by the AVMA "a valid VCPR cannot be established online, via email, or over the phone."

Ethical, Legal and Medical Basis

For those reasons the veterinarians at Central Veterinary Emergency Services have to deny the request to fill medication prescriptions for any animals they have not examined on an ethical, legal, and medical basis.  We truly want the best for your pet.  Our veterinarians have on average 8+ years of training and internships that give them the basis of knowledge by which they can examine, diagnose and treat your pets condition.  To be certain the best care is provided to your pet a personal examination is necessary in order to establish the relationship with you and your pet.  It couldn't be said better than as stated by the AVMA "a hands-on physical examination is incredibly valuable to your pet and can't be replaced by a phone conversation, web-based conversation, or e-mail description".

For more information about the VCPR visit the AVMA and Colorado's Practice Act websites

Marijuana Is NOT Safe for Pets

Dispensaries have popped up everywhere in Colorado since the legalization of medical marijuana.  As a result, our veterinary emergency service has also seen a marked increase in marijuana toxicity cases.  We see 2-3 cases of marijuana ingestion/toxicity per week compared to the 2-3 per month that used to be the norm for our hospital.

There is lots of information on the web that makes light of animals getting exposed to marijuana either accidentally or on purpose.  Unfortunately, some of the information would actually put your animal at risk if you followed the advice.

Marijuana is toxic to cats, and dogs.  The most common type of exposure is ingestion of the plant, or a baked good that contains various forms of the plant, like "marijuana brownies", "canabutter", or "hash cookies".  The main ingredient in marijuana is Tetrahydrocannabinol or THC.  THC can vary in strength from 0 - 70% depending on how it was prepared - the "canabutter" tends to be the most potent.  Dogs are far more likely to ingest marijuana than cats - 97% to 3%. 

Clinical signs of marijuana exposure (usually ingestion) include prolonged depression, vomiting, in-coordination (ataxia), sleepiness or excitation, increased heartbeat (tachycardia) or decreased heart beat (bradycardia),excessive drooling, dilated pupils, low blood pressure, low body temperature, uncontrolled urination, seizure, coma,  or even death - though it is very rare.

Should your animal display any of these symptoms it is important to bring  him/her to the vet right away.  It is also important to let the Veterinarian know about the possible exposure to marijuana.  The other most common toxicity that has the same clinical signs as marijuana is Ethylene Glycol.  The testing and treatment for Ethylene Glycol is much more involved and requires longer hospitalization to ensure the patient doesn't go into kidney failure.  The Veterinarian is not under obligation to report the owner/client to the police and it is better for all involved to treat the animal appropriately.


Treatment may include causing the animal to vomit if the ingestion happened within the last 2-4 hours. They are then given activated charcoal to decrease the absorption of THC or other psychoactive substances found in marijuana.  

Animals that ingest the marijuana in brownies or the hashish butter are at risk for chocolate toxicity or pancreatitis as well as the marijuana toxicity.  Additional treatment may be necessary to combat the effects of the other toxins.

Your pet may be hospitalized for observation of temperature, heart rate, and breathing, and for treatment with intravenous fluids, repeat administration of activated charcoal, and intensive nursing care if critical.  Some animals require sedation with Valium.  Most animals recover fully following treatment.

The moral of the story...Fluffy and Fido should not get into the stash.

Garden Design with Your Pets In Mind

Today is the official first day of spring and I'm itching to get into my garden.  Of course, your dog or cat usually follows you into the garden and there is always that one favorite spot where they like to dig or curl up for a nap, usually right on top of your favorite flower.  So how can we garden, with our pets in mind, to make it enjoyable for them and us?

I found lots of websites with ideas for designing your garden or landscaping with your pets in mind. The Gardening Know How website has a great post on Creating a Dog Friendly Garden and Sunset Magazine included an article titled How to Landscape a Dog-Friendly Garden.  Both are great articles and include some ideas to get your creative juices flowing.  Maybe your dog will even help with the digging. (just kidding)

In an emergency practice, of course, we see cases where animals have gotten themselves in trouble in the great outdoors, including the backyard garden.  So whether you are planning your spring planting, or your next major landscaping project, here are some additional things to keep in mind to keep your pets safe.

Thorns
First, consider the roses.  I love roses, but as I was pruning some this weekend I was reminded of my love/hate relationship with all those thorns.  If you plan to have roses, or other bushes with thorns, consider putting them behind a fence or up against the house where there is less likelihood of "Lucky" getting some nasty scrapes on the snout or in the eye.  The thorns can scratch the cornea causing permanent injury, infection and potentially loss of sight; thorns can also get embedded in the skin and form an abscess.

Mulch
In dry Colorado many plants do better with mulch to retain some moisture. Be aware that "Cocoa Mulch", which consists mainly of cocoa bean shells, is potentially dangerous to your pets.  The cocoa bean shells contain theobromine, a substance similar to caffeine that is not easily metabolized by animals.  Theobromine can cause vomiting, diarrhea, seizures,  ataxia (unsteady on their feet), and in serious cases, even death.

Lawn Edging
The metal demarcation between lawn and garden is supposed to keep the grass where it belongs.  Unfortunately,  it is a dangerous knife in the grass waiting for a soft paw to step just right and cause a serious injury.  Choose a plastic edging material, treated wood, or other natural material for your yard to eliminate this danger.  In a study done by Colorado State University Veterinary Teaching Hospital of the 60 dogs injured by lawn edging in the study, 85 percent of them needed surgery, and 18 percent required extensive surgical repair of skin, subcutaneous tissue, and muscle, tendon, or fascia.  We see multiple lawn edging injuries every year.

Wood Chips or Rock
Creating a rock walkway or zero scape area is pretty common and usually a great option in landscaping design.  But, if you have a dog that likes to eat wood chips or rocks it could become a daily hassle.  Some dogs, more so the large breed dogs like labs or golden retrievers, have a fetish for eating rocks or wood chips.  If it's just one or two rocks or a couple wood chips, no problem, it all comes out the other end.  But, if for some reason the dog gets stressed out or is overly bored and decides to eat lots of rocks or wood chips, you could be looking at a foreign body obstruction that requires surgery.  So consider your pet's habits when you choose a landscaping material or you may be saying "no, don't eat the rocks" many more times than you'd like.

Poisonous Plants
It's always good to review the lists of poisonous plants.  Unless they smell especially tasty it is unusual for the common plants found in most landscapes to be consumed by pets, but it's always better to be safe than sorry.  The fact that we had Peony's for years and our cats and dogs never touched them would be little consolation if yours decided to take a sample.

In the end, there is more likelihood of lots of enjoyable hours with your pet in the garden and your troubles could be as small as an occasional hole, stolen vegetables, or a squashed flower.  Just keep these few tips in mind and we wish you lots of happy gardening.

After the Vet Visit: The At Home Care Instructions

Imagine with me...it's 2 am and you  just got home from an emergency visit to the veterinary hospital.  "Lucky", your 2 year old black lab, was running in the yard and cut a tendon in his leg on the lawn edging.  You make it back home with his fresh bandage, e-collar, and a bag with pills in it and all you want to do is fall into bed.  When you wake in the morning your late night saga comes rushing back and you vaguely remember that "Lucky" needs a dose of medicine.  But you can't quite remember what to do.

Does that sound familiar?  Perhaps a different scenario, but the part about being confused about medicine or bandage changes, follow-up visits or food restrictions might resonate with you.  It can be confusing, and maybe even overwhelming, to get a sick or injured pet back home and be responsible for his/her care.  The important thing is to make sure before leaving the hospital that the instructions are written down and you ask questions.  Then never hesitate to call your Veterinarian's office if you don't understand the instructions.

Here are some typical home care instructions and why it is important to follow them:

1.  Medication instructions:  Most medications have a very specific amount and administration frequency to ensure the best outcomes for your pet.  It is important that you follow those instructions.  For instance, check if it needs to be refrigerated, whether the medicine should be given with food or on an empty stomach.  Read all instructions on the bottle and/or in the written instructions from your veterinarian.  If you are unsure, please call for clarification.  Also, if it appears your pets condition is not improving or you think the medicine isn't working consult with your veterinarian before increasing the amount or frequency of dose.  Increased doses could be harmful to your pet.

2.  Restrict Activity:  This is a tough one, but can be vitally important.  Fractured bones, deep or large cuts, stitches, neurological problems, etc are all conditions that may require one or more days of confinement for your pet so that healing can take place.  If your pet gets too active too quickly there is a greater possibility of added injury or longer healing time.  A crate, small room with a door, or quiet companion can all help to keep your pet from getting too rowdy.

3.  Bandage Instructions:  If your pet is sent home with a bandage the instructions will most likely include something like:

- Keep the bandage clean and dry.

- Check the toes twice a day for swelling. 

- Check the bandage for slippage, loosening, pain, limping, bleeding, heat, foul odor, etc.

- Check for rubbing or pressure sores at the top or bottom of the bandage/cast.

- Keep your pet from chewing at the bandage.

- The bandage should be checked by a Veterinarian in 3-5 days to reassess the wound and decide if the bandage needs to be replaced.

All these instructions are important to decrease the risk of infection and to increase the chances for healing.  If you are unsure call your vet and say "I don't know if this is a big deal or not, but".... and describe what is happening with the bandage and the area where the bandage is applied.  It's always better to ask.

4.  Elizabethan Collar or E-Collar:  We like to call them their "party hat"!  Not many pets like their party hat, but it is important to keep it on.  Pets have a propensity for chewing on bandages or ripping out sutures if left with access to the wound.  They may also try to lick a painful area excessively which can aggravate and cause additional problems.  So the longer they can wear the party hat the better.

5.  Diet Restrictions or Changes:  Often, if an animal comes in for vomiting and diarrhea the veterinarian will recommend restricting access to food or water for a short period.  This can help the pet feel better and can also be an indication of underlying causes should the conditions continue.  Other types of diet changes may include feeding a bland diet of rice or boiled chicken or perhaps adding some sort of fiber to the diet.  These instructions are important and should be followed as close as possible.  

6.  Re-check:  If you take your pet to an animal ER it is always good to call your family veterinarian to let them know about the visit and make sure they got a copy of the medical record.  You might also need to follow-up with bandage changes, staple or suture removals, or additional diagnostics.  Your family veterinarian can help with the follow-up care.  Re-checks and bandage changes are important to ensure a safe and full recovery or to find out sooner than later that maybe additional or different medications are needed or that the wound needs additional care.  Be sure to get back to a veterinarian if a re-check is recommended.