Darnitall That Xylitol

Did you know?
Dogs and Xylitol do not mix. Picture this. You come home to find that "Lucky" discovered your pack of Trident gum sitting on the coffee table and couldn't resist that minty fresh smell. Strewn across the floor are multiple gum wrappers and as "Lucky" comes over to give you a welcome home lick you realize her breath never smelled so good. Unfortunately, "Lucky" has just earned an immediate trip to the Vet.

Let me tell you why!
Multiple flavors of Trident gum contain Xylitol, a natural sugar alcohol manufactured from birch trees or other natural xylan-rich sources. Xylitol occurs naturally in many fruits and vegetables and is even produced by the human body during normal metabolism. Xylitol is used as a sugar substitute in low carbohydrate foods and sugar free candy and gum, including popular brands like Trident, Orbit, Icebreakers, and Altoids or Xylitol gum found in health food stores. Scientific studies have found this natural sweetener to have numerous health benefits for humans, but for dogs ingestion can be dangerous or even lethal.

In dogs Xylitol is absorbed extremely quickly. The immediate result is that it fools the pancreas into releasing a huge spike of insulin, which is quickly followed by a precipitous drop in blood sugar (acute hypoglycemia) since there isn't really any surplus sugar for the insulin to work on. The next problem, which isn't quite as well understood, is severe (and often fatal) liver toxicity and failure. There isn't yet clear evidence of causation and these cases may be due to late discovery and a progression of the severe hypoglycemia rather than a direct connection to the Xylitol. Either way, it isn't good. It doesn't take a whole lot of xylitol to be a toxic dose, and the effects are so rapid that the window of opportunity to treat the dog is extremely small.

Symptoms of Xylitol toxicity include weakness, uncoordinated movements, vomiting, and depression. Your veterinarian will likely induce vomiting if the ingestion is recent. Other treatments can include administration of fluids by IV and glucose supplementation based on lab tests to monitor Blood Glucose levels, plus other supportive measures to maintain proper liver function. The outcome is dependant on the amount of Xylitol ingested relative to the size of the animal and the time lapse between ingestion and treatment. The more immediate the treatment, the better.

The moral of the story...no matter how bad her breath smells don't let "Lucky" chew gum.

Grapes and Their Shriveled Cousins

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MMMM, grapes! They were on sale at the local market this week so I got a bag each of green and red. Buying them reminded me of a recent poisoning case from the grapes shriveled cousin - the raisin. A dog had consumed an unknown number of raisins and wasn't feeling like himself. His owners called after he had vomited a few times on the kitchen floor and was advised to bring the dog to our ER for medical care right away.


Let me tell you why!

Seriously, there seems to be something in the skin or fleshy part of grapes and raisins that when ingested by some dogs and cats makes them very ill and can lead to kidney failure. It is a relatively recent toxin alert for veterinarians and there is still much to be learned. There have been very few, if any, studies about this toxin since its discovery so the amount of consumption is sketchy as well. The safest bet is to keep all grapes and raisins out of reach for the four legged people in your house.

Signs of grape or raisin toxicity include vomiting, diarrhea, not eating, increased drinking, and abdominal pain. Kidney failure can occur within 48 hours of ingestion. It's best to begin treatment very quickly after ingestion, especially since it is unknown what quantity of grapes or raisins may make your animal sick.

Your family veterinarian or emergency vet will give your dog medicine to make him vomit (much more difficult to do in cats, but they are also less likely to eat raisins). After vomiting the dog will be given activated charcoal in an attempt to block the absorption of the toxin in his intestinal tract. Additionally, he will be started on IV fluids to try to flush the toxin from the kidneys. Blood tests will help monitor BUN, creatinine, phosphorous, and calcium levels, all indicators of kidney function. The vomiting will be controlled with a medicine known as an antiemetic. The veterinarian will also be watching for the amount of urine produced by the animal - another indicator of kidney function. All of this monitoring is best done in the hospital by a trained veterinarian and should not be attempted at home.

Outcomes are best for animals that start treatment as soon as the ingestion is discovered.

The moral of the story...whether smooth or wrinkly the grapes and raisins are best left in the cupboard.

The Grass Blade

Did you know?
There could be danger lurking in your backyard. According to the calendar it is spring here in the Rocky Mountain West with summer right around the corner. Spring and summer months usually equate with landscaping projects - like getting your grass to grow in a contained space. There are many options for trying to contain those pesky blades. The danger lies with choosing metal lawn edging that sits flush, or slightly higher than your lawn.

Let me tell you why!
If your dog loves to race around your backyard and chase after the ball, no matter where it lands, there is a very good likelihood that the metal lawn edging is a blade waiting in hiding to slice at your dogs paw or leg. Veterinary Pet Insurance consistently reports that lacerations are the number one type of injury requiring a vet visit and subsequent claim submission. The seriousness of injury from metal lawn edging ranges from a minor cut needing some cleaning and a couple stitches, all the way to a slash through multiple layers of skin, tissue and tendon with a long healing process or even permanent damage and loss of mobility.

CVES strongly recommends removing the metal lawn edging from your yard and finding a more pet friendly alternative. Home stores market a plastic cap that can be pushed onto the top edge, which for a time does decrease the risk, but the plastic is fragile after freezing and heating or being hit by the weed wacker a few times. The broken edges of the plastic cap can be just as dangerous.

Here are a couple lawn edging alternatives found in a quick website search:
http://tiny.cc/y28i8
http://www.guard-n-edge.com/

The moral of the story...get the blade out of the grass.

That Bloated Feeling

Did you know?
I grew up with large breed dogs (Golden Retriever, German Shepherd, Greyhound), but until I started working for an animal ER I knew nothing about "bloat" in dogs. Turns out it is a very serious condition that needs immediate medical attention for the affected dog to survive.

Let me tell you why!
There are two kinds of bloat. GASTRIC DILATATION, an excess build-up of food and gas causes the stomach to rapidly expand or dilate; and GASTRIC DILATATION VOLVULUS (GDV), after expanding the stomach actually turns along its long axis and thereby twists the esophagus and small intestine closed so there is no passage of stomach contents or gas in or out of the stomach. Both conditions are very painful, but the GDV is life threatening to your dog. Veterinarians and scientists are still trying to pinpoint the cause of bloat. However, from a study conducted in 2004, Purdue University researchers site the following five risk factors to keep an eye on.

• Large chest. The deep chested boys and girls are more susceptible - like Irish setters, Rottweilers, Great Danes, Mastiffs, collies, standard poodles.
• Raised food dishes. Turns out it is better to keep the dish on the floor.
• Genetics. If the mom or dad in the blood line had a bloat then its offspring might as well.
• Age. Geriatric dogs are more likely to get GDV.
• Gulping. Dogs that devour their food or water all in one swallow often ingest a lot of air at the same time.

The symptoms of bloat or GDV can be similar to other illnesses. The two tip offs are when your dog's abdomen looks like someone put an inflated balloon in his stomach and/or if your dog is retching - trying to vomit without success. Other signs include excessive drooling, restlessness or pacing, fast heart rate, indications of abdominal pain - whining or groaning when pressure is applied to the belly, cold and pale gums, biting at stomach, and labored breathing.

The only solution for GDV is surgery. The surgeon will untwist the stomach, release the trapped gases, and inspect the tissue and organs to ensure the blood flow has returned to all the vital areas. The surgeon will also perform a gastropexy that secures the stomach to the abdomen wall and decreases the risk of the stomach twisting again should the dog experience another bloat.

The moral of the story...know your dog and get "Lucky" to the animal ER right away if you suspect a bloat.

d-Con - The Sneaky Poison

Did you know?

From a recent random survey of our Doctor and Tech staff at Central Veterinary Emergency Services I learned that the number one least known danger for pets at home is d-Con. Now if you've had a pesky mouse in your walls, or rats in the neighborhood dumpster, you probably know what I'm talking about. d-Con is the brand name of a popular rodenticide, a.k.a mouse poison. Many animal owners don't realize that the same poison that kills those pesky creatures (my apologies to mice and rat lovers) is also a deadly substance for their own pets.

Let me tell you why!

d-Con and other rodent poisons contain either the chemical warfarin (brand name Coumadin) or Brodifacoum. Both chemicals decrease the active levels of Vitamin K created by the liver until the animal's blood has no clotting ability. A poisoned animal will suffer progressively worsening internal bleeding, leading to shock, loss of consciousness, and eventually death. d-Con and other brand name rodenticides (Finale, Fologorat, Havoc, Jaguar, Klerat, Matikus, Mouser, Pestoff, Ratak+, Rodend, Talon, Volak and Volid) are all produced to be odorless and tasteless so mice and rats will continue to eat until the agent has the effect it was created to induce. Dogs especially seem to like the taste of the grain-chemical combination and tend to ingest large amounts.

Symptoms of d-Con poisoning include bleeding gums, bloody nose, blood in the urine, weakness, and labored breathing (from bleeding into the chest). The trouble is that rodenticides have a cumulative, long-acting effect which means that symptoms of poisoning may not be evident in your pet for a few days or even a week. Unfortunately, once the symptoms are evident treatment is more involved, the prognosis is poor, and it may be too late to reverse the effects and save the poisoned animal. Immediate treatment is recommended as it provides the best chance for a happy ending.

Treatment for d-Con poisoning, when recently ingested, may include making your pet vomit followed by the administration of activated charcoal to rid the body of as much of the poison as possible. The antidote for rodenticide poisoning is treatment with Vitamin K1 which will decrease the internal bleeding by increasing the clotting factors in the blood. Vitamin K1 therapy usually lasts for 4 weeks to combat the long acting effects of the poison. A blood test called a PT/PTT may be performed to test the prothombin levels in the blood, directly related to the Vitamin K1 levels and blood clotting factors.

The moral of the story...let the cat catch the mouse and don't believe any exterminator who tells you rat/mouse poison is safe around your animals.

Easter Bunny Belly

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Easter is over, but I bet there's still chocolate in your house. Let's suppose your sweet Lab puppy "Lucky" decides to play with the chocolate Easter Bunny and accidentally eats the whole thing. "Lucky" is no longer so lucky. If fact, depending on whether the bunny was white, milk, or dark chocolate, "Lucky" could become a very sick dog, and I'm not just talking about a tummy ache.

Let me tell you why!

Chocolate contains two ingredients, theobromine and caffeine, that are dangerous to dogs, cats, birds, rodents, and reptiles. Both act as a stimulant and can affect the gastrointestinal tract as well as multiple organs and, depending on the type and quantity consumed, can lead to seizures and even death. Poisoning is more common in dogs because of their propensity towards eating large quantities of unusual foods.

The three questions typically asked when a client calls about chocolate ingestion are: what kind of chocolate; how much chocolate; and how much does your dog weigh? The Merck Veterinarian Manual states "One ounce of milk chocolate per pound of body weight is a potentially lethal dose in dogs." This might seem like a lot of chocolate, but consider that theobromine levels in semi-sweet chocolate can be five times the amount found in milk chocolate. That 35 ounces of milk chocolate needed for toxicity in a 35 pound dog is reduced to 7 ounces of semi-sweet or dark chocolate. It would only take 3-5 ounces of baker's chocolate to be deadly to the same dog.

There is no antidote for chocolate poisoning. Even if "Lucky" hasn't consumed a toxic dose of chocolate it may still be advisable to bring him in to induce vomiting to remove as much of the theobromine and caffeine from his system as possible, especially if the consumption is recent. In addition, activated charcoal may be administered to absorb the two toxins from the stomach and IV fluids can help decrease dehydration, flush internal organs, and increase urination, the only other way to rid the toxins from the body. For higher levels of ingestion the Veterinarian will also monitor for heart irregularities. Even if the dose is not toxic the fat and sugar content of the chocolate may also lead to vomiting and diarrhea, an unpleasant side effect. We recommend a call to your family vet, or to our animal ER, to ask more questions should you suspect chocolate consumption by your pet.

The moral of the story...don't let the chocolate Easter bunny get cozy with your pets.

Pretty Poison

Did you know?

Spring is trying to appear here in the Rocky Mountains and the grocery stores are spiffed up by those glorious Easter Lilies for the holiday. Before you pick the best specimen, drink in the heady perfume, and head for the check-out counter, consider that Lilies can be a pretty poison for "Lucky" the cat.

Let me tell you why!

Members of the plant genus Lilium produce a chemical, present throughout the plant, which can cause a cat to suffer fatal kidney failure. It can be deadly for a cat to simply bite into a lily leaf or petal, lick lily pollen from its paws, or drink water from a vase containing cut lilies. Easter lilies, stargazer lilies, tiger lilies, day lilies and Asiatic lilies seem to be the most hazardous of this group of plants.

If you suspect that "Lucky" has been nibbling on your Lily plant call your veterinarian immediately, or bring "Lucky" to Central Veterinary Emergency Services. Signs of exposure include vomiting, refusing to eat, and acting depressed. Treatment is centered on kidney function for which repeated blood tests will track progress. "Lucky" will receive supportive care administered by way of IV fluids, and medications to control nausea and vomiting. Immediate treatment will provide better chances of recovery. This is not something to "wait and see" about.

The moral of the story - buy the Easter Orchid and leave the lilies for the pet free homes.