toxicology: myths, internet rumors & home remedies
TRANSCRIPT
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Toxicology: Myths, Internet Rumors & Home Remedies
Tina Wismer DVM, MS, DABVT, DABT
ASPCA Animal Poison Control Center
Urbana, IL
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Focus
• Poison prevention kit• Pet proofing
• Myths, internet rumors
• Common toxins
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Poisoning??
• Know your client’s veterinarian's procedures for emergency situations• Phone numbers for your vet, ER clinic
• Do not attempt any therapy without contacting a veterinarian
• If the animal is seizing, unconscious or having difficulty breathing, you should go directly to the veterinarian
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Poison Safety Kit
• Fresh bottle of 3% hydrogen peroxide
• Can of soft dog or cat food
• Turkey baster, bulb syringe or large medicine syringe
• Saline eye solution
• Artificial tear ointment
• Mild grease-cutting hand dishwashing liquid
• Rubber gloves
• Forceps or tweezers to remove stingers or ticks
• Muzzle (or length of gauze)
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3% Hydrogen Peroxide
• Acts locally by GI irritation• Needs to still fizz
• Always ask a vet before giving
• Give 1ml/lb, up to 45 ml • Can repeat dose once
• Large doses can cause bloody vomiting and diarrhea
• Cats – no
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Ocular Dilution
• Use large quantities of flush to decrease insult to the cornea• Tepid tap water
• Normal saline
• Artificial tears
• Do not use Visine® or other “get the red out” products
• Flush for 20 - 30 minutes
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Dermal Decontamination• Make sure to wear gloves!
• Never use a solvent • Kerosene, paint thinner
• Bathe in liquid dish soap • Do not use automatic dish washer
detergents
• Rinse copiously with warm water• Do not allow animal to get chilled
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Glue traps, Asphalt, Pine Sap
• Any oily substance (olive oil, mayonnaise, peanut butter, mineral oil, vegetable oil) can help remove non-water soluble compounds• Rub a small amount into the affected area
• Keep rubbing until substance breaks down into “gummy balls”
• Wash with liquid dish washing detergent to remove the oily substance
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BECAUSE- pets are nosey !
Photo: Rebecca Strieby
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Pet Proofing
• Physical abilities of pet• Remember that new pets are not the same as old pets
• “Lightening fast” toddlers that can climb!
• Remove medications, cleaners, chemicals, laundry supplies• Behind secure doors, locked cabinets, child-safety locks
• High shelves?
• Keep products in original containers, keep labels
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Pet Proofing
• Keep foods and trash out of reach
• Changing our own behavior• Pet medications should
not be kept with human medications
• Take own medications in room that pet does not have access to
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Petproofing
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Photo courtesy of Jamie Bobrowski
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Is that true???
• Myths, or ‘old wives tales’ • Common in veterinary medicine
• “I know he’s sick ‘cause his nose is warm.”
• “My dogs are brother and sister, they would never have puppies together.”
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• Internet rumors • Modern form of folklore
• Precautionary advice
• Evolve over time
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‘Badly burned dog’
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True or False?
• Animals know what is poisonous or harmful and will not eat it.
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Animals know what is poisonous/harmful and will not eat it
• False!
• If this were true I would not have a job ☺
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True or False
• All toxic substances will kill
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All toxic substances will kill
• False
• Dose determines the poison
• Apple seeds contain cyanide, but a borzoi would need to eat more than 2 cups of seeds to have a problem
• Hepatotoxic mushrooms, one bite can kill
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True or False?
• Chocolate gives dogs worms
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Chocolate gives dogs worms
• False
• Origin• Dogs who eat chocolate may vomit or have diarrhea and
the roundworms (already present in the dog) may be seen in the vomit or stool
• Chocolate and worms both can cause vomiting and diarrhea
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Chocolate
• The darker the chocolate, the worse it is
• Vomiting, diarrhea, restlessness
• Increased heart rate, tremors, seizure, death
• Signs may be delayed up to 12 hours
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Compound Theobromine
(mg/oz)
Caffeine (mg/oz)
White Chocolate 0.25 0.85
Milk Chocolate 58 6
Semi-sweet
Chocolate Chips
138 22
Sweetened Cocoa
Mix
138 22
Unsweetened
Chocolate
393 47
Unsweetened
cocoa powder
737 70
Cocoa Bean
Mulch
255 NA
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Chocolate
• 60 lb dog
• How much to cause seizures?• Milk chocolate = 26 oz
• Dark chocolate = 10 oz
• Bakers (unsweetened) chocolate = 4 oz
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True or False?
• If you give your dog water after it eats mouse poison it will explode
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If you give your dog water after it eats mouse poison it will explode
• False
• Pest control operators, ‘This poison causes the mice to leave the house looking for water and once they drink, they explode.’
• No rodenticides cause mice to explode
• PCO doesn’t want you knowing that the mice are dying inside the walls of your house
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Rat and Mouse Poison
• Blocks, pellets and granules
• Blue, green, red or tan• Color does not indicate what
type
• Bleeding
• Kidney failure
• Brain swelling
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True or False?
• To prevent heartworm in dogs, once a year you give two copper pennies by mouth
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To prevent heartworm in dogs, once a year you give two copper pennies by mouth
• False
• Copper in the pennies is attracted to the heart and will kill the worms
• Pennies cause zinc toxicity • Anemia, renal failure
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Pennies
• X-ray
• Endoscope or surgical removal
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True or false?
• Garlic is a natural way to get rid of fleas
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Garlic is a natural way to get rid of fleas• False
• Garlic is not efficacious for treating fleas
• Can cause anemia• Dogs > 10 g/kg of fresh garlic (or its equivalent) may be a
problem
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Selected Toxins
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Silica Gel Dessicants
• Chemically and
biologically inert
• Mild GI signs possible
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Toilet Water (Tank Drop-Ins)
• Concentrated forms (gels, tablets) may be corrosive
• GI irritants once diluted in toilet water
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Ant and Roach Baits
• Much safer than 10-20 years ago
• Inert ingredients such as peanut butter, breadcrumbs, sugar and vegetable or animal fats
• Plastic/metal = obstruction
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N-P-K fertilizers, Bone meal
• Low toxicity• Vomiting, diarrhea
• Added insecticides, herbicides or iron • Increase toxicity
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Paints
• Latex • Mild stomach upset if ingested
• Oils• Stomach upset, risk of aspiration
• Heavy metals - artist’s paints
• Do not use solvents to remove
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Polyurethane Adhesives
• Expanding wood adhesives• Gorilla Glue®, Elmer’s
ProBond®
• Large gastric foreign bodies requiring surgery
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2 ounces of glue in a 60 pound dog
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The finished product!
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Acetaminophen
• Non-aspirin pain reliever
• Always contact your veterinarian before giving any over the counter medication.
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Acetaminophen
• Changes blood so it can’t carry oxygen• Gums and blood muddy brown in color
• Liver failure
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Bella
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ACETAMINOPHENGlucuronideConjugate(non-toxic)
SulfationConjugate(non-toxic)
CytochromeP450
NAPQI
Methemoglobinemia
Cats, dogs (high dose)8 sulfhydryl groups on cat hemoglobin vs 4 in dogs vs2 in humans
Liver failure
Dogs, Humans (rarely cats)
Kidney failure(rare)Humans
PAP
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Acetaminophen
• How much is too much?
• Toxic Doses for 60# dog• Liver toxicity – 6 extra strength (500 mg) tablets
• Methemoglobinemia – 12 extra strength (500 mg) tablets
• There is no safe acetaminophen dose for cats
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Ibuprofen/naproxen
• Non-steroidal anti-inflammatories
• Ibuprofen• Motrin®, Advil®
• Naproxen• Naprosyn®, Aleve®
• Stomach ulcers, kidney failure
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Ibuprofen/naproxen
• NSAIDs decrease pain and inflammation by stopping the production of prostaglandins• However prostaglandins also do
good things in the body
• ↓ prostaglandins• ↓ blood flow to stomach, ↓
mucus layer in stomach, ↑ stomach acid = stomach ulcers
• ↓ decrease blood flow to kidney = kidney cell death
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Ibuprofen: overdose
• 60 lb dog• 12 pills for stomach ulcers
• 24 pills for kidney failure
• Prognosis: good if caught early• GI protectants, IV fluids for 48 hours
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Naproxen
• Extensive body recirculation • Prolonged half life = 74 hours in dogs
• Stomach ulcers, kidney failure
• One pill in 60 lb dog• Stomach ulcers
• Two pills• Kidney failure
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Ethylene Glycol
• Automotive antifreeze
• Aircraft de-icers
• Brake fluids
• Home solar units
• Condensers/heat exchangers
• Portable basketball goal post bases
• Winterizing toilets
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Ethylene Glycol
• Any exposure should be considered potentially serious
• Cats, rabbits most sensitive
• Humans, dogs
• Kidney failure, seizures, death
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Plants
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Alison West 2007
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“Well it has green leaves”…
• Plant identification is always a big problem• Many different common names
• Same common name for different plants
• Even “non-toxic” plant material may cause mild GI upset if ingested
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Spring blooming bulbs
• Tulips, daffodils, amaryllis
• Leaves, flowers = stomach upset
• Bulbs = bloody vomiting, tremors, seizures
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Insoluble Calcium Oxalates
• Found in many common houseplants
• Shiny, thick green leaves
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Philodendron spp.
• Philodendron
• Panda plant
• Parlor ivy
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Dieffenbachia spp.
• Dumbcane
• Dieffenbachia
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Spathiphyllum spp.
• Peace lily
• White anthurium
• Mauna loa
• Spathe flower
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Epipremnum areum
• Pothos
• Heartleaf vine
• House ivy
• Devil’s ivy
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Insoluble calcium oxalates
• Epipremnum spp.• Pothos, devil’s ivy
• Zantedeschia spp.• Cala lily
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Insoluble calcium oxalate-containing plants
• Many, many others• Alocasia antiquorum
• Anthurium spp.
• Arum spp.
• Calla palustris
• Syngonium podophyllum
• Monstera spp.
• Caladium spp.
• Schefflera spp.
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Calcium Oxalate Crystals
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Calcium Oxalate Plants
• Oral irritation, drooling, gagging, vomiting• Usually self limiting
• Concern with swelling in throat
• Milk or yogurt may aid in easing discomfort
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Poinsetta
• Vomiting
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Cycad (Sago )Palms
• Native to FL
• Houseplants
• All animal species susceptible
• Liver failure• Toxin destroys liver cells
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Cycad Palms
• All parts of the plant are poisonous• Highest levels of toxins in the seeds
• Dogs• 1-2 seeds have caused vomiting, liver
failure and death
Cycad seeds
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Foods
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Grapes and Raisins
• Kidney failure
• Toxic principle is thought to be tartaric acid• High in grapes and
tamarind
• Dogs uniquely sensitive
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Grapes and Raisins
• How much is too much?• 0.7 oz/kg of grapes
• 0.1 oz/kg of raisins
• Anecdotal cases of 1 raisin??
• Cooking decreases risk
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Macadamia nuts
• Dogs
• Weakness, vomiting, tremors
• Signs last 12-48 hours• Most recover on their own
• No long term effects are expected
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Sugarless Gum/Candy
• Read the label• Aspartame (Nutrasweet®)
• Saccharin
• Sucralose (Splenda®)
• Sorbitol
• Maltitol
• Xylitol – not safe in dogs
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Xylitol
• Sugar alcohol
• Used in sugar-free chewing gums, candies and for baking
• Dogs• Stimulates insulin release for several hours
• Hypoglycemia
• Liver failure
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Bread Dough
• Raw yeast dough
• Gastric distention
• Ethanol production
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Moldy Food
• Garbage, compost piles• moldy meat, nuts, fruit,
pasta and dairy products
• Tremors, seizures
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Marijuana (Cannabis sativa)
• Contains at least 61 cannabinoids and > 300 other substances • THC (∆-9-Tetrahydro-cannabinol)
• Fresh plant: minimally toxic
• Toxicity ↑• Heating, drying, smoking, aging
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Marijuana
• More cases• Truly an increase in intoxicated pets?
• Changing attitudes?
• More potent forms?
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Potency and changing exposures
• Increasing Potency• THC levels have more than doubled in the last 25 years
• Past: plant material from baggies or joints
• Now: Edibles (cookies, brownies, etc.) and concentrates (oils, waxes, shatters)
• While both dogs and cats willing ingest plant material, dogs are the most likely to consume edibles
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Human dosing of THC products
• THC 10 mg
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Marijuana - Clinical Signs
• Most common signs • Depression (25% agitated)
• Ataxia
• Incontinence (dribbling urine)
• Hyperesthesia (over reaction to stimuli)
• Coma, hypotension, death (concentrates)
• If your pet is unresponsive or cannot walk, it needs to go to the vet
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Points to remember:
• Keep things out of reach of your pet• Pet proof your home and garden
• Keep pesticide labels
• Learn genus and species names of plants
• Remember that new pets are not the same as old pets
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Questions?