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.

Albuterol Toxicity : Why Inhalers Help You, but Harm Lucky

Written by:  Sara Shypkoski

For many of the 22 million people in the United States with asthma a simple device known as an inhaler can offer almost immediate relief during an attack.

Inhalers are composed of a small pressurized canister that contains a solution of asthma medicine fitted into a plastic actuator that releases a fixed dose of the solution in an aerosol or inhalant form.  An Inhaler can either be used in emergencies to manage acute symptoms or on a daily basis to control chronic symptoms.  The majority of rescue inhalers contain albuterol, a drug used to stimulate the bronchial muscles in the lungs to relax and allow the air passages to open.  When used properly, an   inhaler is the safest, quickest, and most effective way to manage an asthma attack.

Unfortunately, to dogs the colorful plastic, small size and odd smell is something they won’t just pass by if they find it lying around. When his sharp teeth puncture the pressurized canister, the entire contents are released instantly. In a 60-lb dog, a full inhaler contains approximately 10 times the therapeutic dose of albuterol. In an overdose, these drugs affect both the bronchial muscles as well as the cardiac muscles. The results are immediate, severe, and include the following:

•    Increased heart rate (up to 200 beats a minute!)
•    Abnormal heart rhythms (arrhythmias)
•    Increased respiratory rate or panting
•    Abnormal behavior (Tremors, shaking, restlessness, hiding, agitation, lethargy, weakness)
•    Low or high blood pressure
•    Electrolyte abnormalities, most commonly low potassium
•    Nausea and/or vomiting

If you see your pet bite into or ingest an inhaler, or if your pet is experiencing symptoms of albuterol toxicity, take him to your nearest emergency clinic for immediate care. Bring the inhaler, and if available, the original packaging as well as any medications that your pet is currently taking. Do NOT induce vomiting at home or give your pet any over-the-counter medication.

Lucky will typically need to be hospitalized on IV fluids for 12 to 48 hours while his body metabolizes or gets rid of the albuterol.   An electrocardiogram or ECG machine will provide continuous visualization of his heart rate and rhythm, and his blood pressure will be regularly monitored. Blood tests will be used to check his electrolytes and regular doses of a beta antagonist (aka beta blocker) may be used to counteract the effects of the albuterol, an agonist. Other drugs may be given for muscle tremors, seizures, arrhythmias, vomiting, or diarrhea.

If treated promptly albuterol toxicity is rarely fatal, though pre-existing heart conditions or pets on other medications are at greater risk for complications. The best thing you can do for your pet is to keep those inhalers out of their reach. Avoid disposing of used canisters in trash cans that are accessible to pets as even used inhalers can be dangerous. Central Veterinary Emergency Services is available night, weekends, and holidays so that, if Lucky does take a bite out of your inhaler, you can breathe easier knowing that he’s in the best of hands and hearts.

Hit By A Car

It's scary when it happens.  Your pet darts into the road at the wrong time and gets tangled with an oncoming car.  But what do you do next?  How should the pet be handled? Should you take him directly to the vet?  What if he has an open wound? Or, what if he doesn't look hurt at all?

These are all great questions, but the main one I want to answer is the last one, what if he doesn't look hurt?  Maybe your pet came out of the incident with a small cut or a slight limp and you are debating whether a trip to the veterinarian's office is required.  On the one hand "Lucky" has lived up to his name and it's great that the external injuries are minimal.  However, the potential internal injuries that can't be seen are actually still life threatening.

When a client brings an animal to the vet that has been hit by a car obviously the external injuries are easier to see and treat.  Any lacerations, penetrating injuries, or fractures need to be assessed and treated appropriately.  But the Veterinarian is also observing and evaluating the animal for appropriate gum color, breathing difficulties, bleeding from the mouth, nose, or rectum, blood in the urine, indication of pain when touched, uneven pupil dilation, staggering, or inability to stand.  All of these are indications of potential head injury or internal organ damage that, if left untreated, can be critical or even fatal.

The Veterinarian will likely recommend x-rays to view the size and shape of internal organs, silhouette of the lungs, and whether there looks like free fluid in the abdomen.  Additional diagnostics may include a blood test that might indicate internal bleeding, and an ultrasound to get a better view at the internal organs if there is suspicion of injury.

Your pet may also need treatment for shock which would include intravenous fluids and hospitalization to stabilize before heading home.

Of course, we hope for the best possible outcome; that the pet truly has sustained no more than a couple scrapes and all is well.  We also believe that it is in your pet's best interest to get checked out at the Veterinarian's office should such an unfortunate event occur.

Gorilla Glue: Apparently To Pets It's Rather Tasty

Video Courtesy of KSL.com

Resting comfortably in his cage is a one year old boxer named Wiley who had an up close and personal experience with Gorilla Glue. Fortunately he didn't eat much, but what remained in his stomach had to be surgically removed.  He'll be feeling much better in a couple days.

CVES sees about 3 to 4 cases a year of Gorilla glue ingestion and so far most of those cases have had a positive outcome.  The problem with gorilla glue is that it can actually adhere to the stomach lining and, depending on the amount of time it remains in the stomach, may require removal of some of the stomach with the gorilla glue to get it out.

This is an example of the type of mass the glue can grow into.  This was not the actual glue removed from Wiley.  You can see that about three quarters of the bottle was consumed and it grew into a size significantly larger.

On the Gorilla Glue website you'll find this statement:  Gorilla Glue is a polyurethane glue. All polyurethane glues foam when they come in contact with moisture and may cause gastro-intestinal blockage if swallowed. This is not unique to Gorilla Glue, but true of all polyurethane glues. If you think there has been a case of ingesting the glue, seek medical or veterinary advice immediately.

The primary signs of a problem after gorilla glue ingestion are vomiting, diarrhea, and poor appetite.  If you suspect your pet has ingested gorilla glue get him or her to a veterinary hospital right away.  Gorilla Glue has its place, but do your best to make sure that place in not in your pet's stomach.

Hypothermia in Pets

Winter finally hit in Colorado.  With temperatures in the teens and 20s and overnight lows dropping below zero it is important to take some extra precautions to keep you pets warm.  Some dogs are more sensitive to the cold than others. Small breeds, short haired dogs, puppies and geriatric dogs, dogs that are normally "indoor" pets, and those with heart or other medical conditions are all more sensitive to colder temperatures. A dog's normal body temperature is between 99.5 and 102.5. When a dog fitting one of the above descriptions is exposed to colder temperatures he or she often has a difficult time keeping his/her core body temperature within the normal range. When the temperature dips below the normal range hypothermia sets in. Hypothermia means that your dog is loosing body heat faster than it can be replaced.

Signs of hypothermia:
- shivering
- lethargy
- stiff muscles
- pale or gray gums
- stumbling or lack of coordination
- fixed and dilated pupils
- low heart and breathing rates
- collapse
- or even coma

With mild hypothermia your dog is likely to be shivering and appear lethargic. As the hypothermia increases in severity the other symptoms become evident.  Your dog becomes increasingly unresponsive as his body goes into heat conservation mode. At this time your dog's focus will be on keeping his vital organs working by restricting the blood flow from all other parts of the body. If it's not treated, hypothermia can be fatal.

Prevention is Key
Dogs sensitive to cold should be kept inside with quick potty breaks outside. The small dogs and short haired breeds benefit from a doggy jacket that helps to keep their core warm. Booties may also be a good idea as lots of heat escapes through a dogs foot pads.

Treatment
Mild hypothermia can be reversed by getting back in a warm environment and wrapping your dog with a blanket until the shivering stops. Hypothermia that has dropped the dogs temperature to the 90-94 degree range will require rewarming methods. Water bottles filled with warm water placed around your dog deliver a safe warm heat source. Stay away from heating pads as it is easy to burn your dog's skin. It is recommended that you take your animal to your family veterinarian or veterinary emergency service for observation and/or treatment if you need to treat for hypothermia. Severe hypothermia requires immediate veterinary intervention. Unfortunately, it may be difficult to reverse the damage at this level of hypothermia, but we can hope for the best.

Cuddle up with your four-legged friends and stay warm!