#FurbabyFridays: Pets and #Chocolate Can Be a Deadly Combination

Hello and welcome back to Furbaby Fridays with Dr. Tammy. This week we are counting down to Easter and I thought today would be a great time to remind folks about the dangers of chocolate. Yesterday, one of my clients came in because one or both of her dogs ate dark chocolate truffles—enough to make them both seriously ill. Their visit reinforced the need to take time out to discuss the dangers of chocolate for our fur babies.

 This tasty treat comes in all shapes and sizes and formulations whether in cocoa products like candies, cakes , cookies and brownies, but also in cocoa beans and mulches.  The most accidental exposures of pets to chocolate of course occur more around the holidays and Easter is a big one.

Because dogs tend to be the pets that tend to eat just about anything, we don't usually see cats with this toxicity, but there are a few of those pesky felines who pretend they are dogs and ingest some odd things. So to be safe, keep chocolate away from all fur babies.  This includes some cocoa bean hull mulches. Not only do the mulches smell like chocolate Pop Tarts, they are readily available for pet for some pets because of their use in gardens and landscapes. Of course the makers of the mulches will say there has only been one documented death from the ingestion of these kind of mulches, this does not mean that animals are not sick from them. In fact, even Hershey one of the makers of these mulches admit that 50% of dogs who ingest their mulch can get sick from it.  Here's an article by snopes.com that talks a bit more about it.

What makes chocolate toxic to animals?

Methylxanthines are the culprits here, specifically theobromine and caffeine. That's right. There are TWO toxic components in chocolate and each will vary in concentration depending on the type of product. The rule of thumb is the darker the chocolate the higher the amounts of both of these compounds. White chocolate has 0.25mg theobromine per ounce and 0.85mg of caffeine per ounce. In contrast, dry cocoa powder has 737mg theobromine and 70mg of caffeine per ounce.  Now what does that mean? 

Animals can show mild signs after only ingesting 20mg/kg of either theobromine or caffeine. Severe signs are seen at 40mg/kg and seizures at 60mg/kg. So if you have a 20 pound dog (roughly 10 kg) it would have to eat 400 mg of the toxins to start showing some signs.  So only 1/3 of an ounce of the dry cocoa powder can be dangerous and only one ounce of the cocoa bean hulls in the mulches could do it as well. Less than 1 ounce of milk chocolate per pound of body weight is potentially lethal for dogs. Milk chocolate is nearly 100 times as toxic as white chocolate. Baker's chocolate is SIX TIMES more toxic than milk chocolate. 

A lot of figures, I know but I wanted you to see the comparisons. If your dog decides he likes your dark chocolate candy bar you've been saving in your purse, you very well may have an emergency on your hands. 

 For an article about chocolate intoxication and a chart that includes the amounts of the types of chocolates and caffeine sources click HERE. It's a page on the ASPCA website with articles aimed more for veterinarians. The article is a PDF that will download to your computer if you click on the link.

It's not only the actual amount of chocolate we have to worry about when our pets ingest these kinds of foods. More often than not, the ingestion takes the form of eating candy in wrappers. Those can be just as bad leading to obstructions in the stomach and bowel loops. Even if the mulches are of the variety that have been treated to remove the theobromine, the debris itself could cause an obstruction if enough is eaten.  

What are the clinical signs to look for?

Usually withing six to twelve hours of ingestion you will see the first clinical signs. These include polydipsia (drinking a lot of water), vomiting, diarrhea, bloating and restlessness. If enough of the chocolate has been ingested, the signs can progress to an animal that ends up extremely agitated/hyperactive, urinating a lot, tremors or even seizures.  Other symptoms include high heart rates, arrhythmias, elevated body temperatures, coma and even death.  It's the arrhythmias that can cause death in these patients so it's imperative that you seek immediate veterinary care if your pet gets a hold of any kind of chocolate. It's better to be safe than regret it later.

How is chocolate intoxication treated?

As soon the pet arrives, the veterinary staff will be in motion. Stabilization first involves decontamination of the stomach by inducing vomiting. This will be done only if the patient is stable enough for it to happen. If your dog is seizuring, the induction of vomit will NOT occur. Instead the seizures will be brought under control first. Once more stable then decontamination will occur using stomach tubes to remove as much of the chocolate that remains and to administer activated charcoal without sorbitol. (In the paint ball toxicosis article you will recall that sorbitol is one compound that can cause issues all on it's own. 

If it's been within a two hour period of ingesting the chocolate, emesis (vomiting) will be induced. Trust me, some of the dogs that have come into my clinic after eating chocolate have amazed me with the sheer amount of the stuff in their stomachs. One patient at a box of mint cookies covered in dark chocolate. My treatment room reeked of minty chocolate for hours after that pooch tossed his cookies...pun intended. ;)  

Intravenous fluids, close monitoring of vital signs to make sure elevations of temperature and heart rates don't occur. If the signs do progress, then medications are administered to control seizures and arrhythmias. Usually our patients present early enough that just 12 hours of IV fluids, and monitoring are all that's needed after the decontamination. Activated charcoal is sometimes split into three different doses in order to continue to absorb any chocolate that got into the intestinal tract.  The patients that have the longest recovery are those who are treated after the bad symptoms have already started or they've ingested chocolate that contains other "ingredients" such as marijuana, laxatives, "magic" mushrooms and other recreational drugs. 

So do yourself and your pets a huge favor and lock up all products containing chocolate and caffeine. Even if it's white chocolate containing very little toxin per ounce, it's best to just keep it out of reach. Don't leave any candies out in dishes, Christmas stockings, wrapped under the Christmas tree, in Easter baskets accessible to pets, boxed chocolates on Valentine's Day, or baked goods out where your pets have access.  I know that all seems like common sense, but you'd be surprised by the number of folks who say "my dog never jumps up on the counter. Why would I put the chocolate away?"  Here's another good one, "It's a dog. They don't eat chocolate."  

This is where I usually hear Bill Engvall's "Here's Your Sign" routine.  LOL

#FurbabyFridays: Dr. Tammy's Manic Mondays, Terrible Tuesdays, And Wild Cat Wednesdays

Welcome to Furbaby Fridays. I'm Dr. Tammy and today I thought I would share a post I did in October of last year. It was written right after a particularly stressful Monday at my veterinary hospital. Not that it was atypical for it to go down the way it did, but having so many patients with similar ailments was a bit odd.  

Mondays tend to be one of our busiest days in general because people don't feel like giving up their days off to take their sick pets into the vet and don't get me started about animals that get sick after hours!  I've discussed this numerous times before. It's an honor and a privilege to own a pet, not a RIGHT. Along with pet ownership comes huge responsibilities including but not limited to: keeping your pet healthy with routine checkups, vaccinations, flea control, and heart worm prevention; seeking medical attention when the pet is ill, providing clean and protected housing.  If you can't provide these things for yourself and your family, you really shouldn't be a guardian for a pet until you can.  I'm sorry if that sounds harsh, but it's a bit of advice that can save you a lot of heartache in the long run.  

Now to today's post...

I've worked over twenty years of Mondays as a veterinarian and to this day, it's my least favorite part of my work week. Not only is there always a rush first thing in the morning with client's who conveniently "forgot" we were open on the weekends, there usually is a literal flood of transfers of patients from the emergency clinics. The 8 am doctor is usually swamped and by the time I get in there at 10 am it's chaos at it's best. 

There are the usual dogs and cats that have been sick for at least the last three days and of course NOW it's an emergency to their owners. Each and every single one feels their pet is sicker than the rest and should be taken care of first. We have a basic triage system at our hospital. Each patient is given a stability check. If they are deemed stable to wait, they will wait their turn. If they are thought to be critical, they move up the list. Even appointments have to be delayed if an emergency walks in the door. Most folks understand that, but there are those chosen few...you all know the folks I'm talking about. The ones who come into the lobby crying and screaming "My BABY! My Baby is dying and I need a doctor NOW! Lawdy Jesus, save him. He's got the epilepsy and he's been having seizures for the last three days straight..." When asked why they waited to bring their precious in, our ears are assaulted once again. "We ain't got no money! You have to save him. You took an oath!"

Yeah, I do see those kind of clients more often than I care to admit, but today was a mixture of emotions I hadn't felt in a while. Two good Samaritans brought in a stray Chihuahua they found on the side of their street. This poor dog was in severe shock after being hit by a car. He had a broken back leg, broken pelvis, fractured ribs creating what is referred to as a flail chest, and major head trauma. These wonderful people took the time to carefully transport this older dog to us so we could end his suffering. He had no microchip, was not neutered, and had no collar or tags. He would have died along the side of the road, alone and afraid if it wasn't for these two men. From the bottom of my heart I thanked them for helping this animal die with dignity. 

I wade through the next several drop ins and appointments until I come across one where the owner wants to talk about a weight loss program for her cat. You see, he's just a little larger than your average cat. He tops the scales at just over TWENTY-FIVE POUNDS!!! Holy Guacamole!

This cat doesn't like to get very active at home and he feels he's run a marathon just getting from his litter box to the couch every day so he's not thrilled with the idea he has to earn his keep. After going through how many calories he is to get TOTAL per day and an exercise program for him, my staff took over to draw blood from him for his Senior Wellness panel. Well, let's just say the blood draw went very well, but not the collection of urine. He was much too big to even feel his bladder and the our needles weren't long enough to reach it through all of his body fat. Ugh!  (yes he could have been a twin to the one shown in the picture!)

Besides all the pets with major diarrhea issues over the weekend, multiple pets came in with broken nails. Not one of them broke them outright. No, they had to be partially broken so that we have to let them grow out some more in order to cut them back. At least they were all good spirits about it. Cookies go a long way with the bouncy Pitbull who keeps trying to lick your glasses off when you are placing the padded bandage on his front foot. And of course, let's not forget the wrestling job we have to go through to get the E-collar on! LOL

We didn't get any patients ingesting their owner's marijuana stashes today, but one energetic boxer decided to polish off half a chocolate cake around 8am. What time did his owner actually bring him in you ask? Well, 2:15 pm. That would be beyond the window we have to induce vomiting and he really should be admitted to the hospital for intravenous fluids and a seizure watch. What were we allowed to do? Subcutaneous fluids and activated charcoal. That's it. Hopefully that will be sufficient. I guess we will find out more by morning when the dog is transferring from one of the emergency clinics for convulsing all night long! 

Sometimes we get patients in because their owners are actually going through some medical issues of their own...the psychiatric kind. I had one of those today. This very nice woman insisted her cat was covered in bugs that were burrowing under her skin creating these horrible sores on her body. We went round and round about it and finally I got her whole story out. The owner had been off her own meds for too long and was actually self medicating with Goddess knows what. One thing she was doing was coating her body in Desitin. She thought she would put some on her cat and did, but luckily she thought better of it. Desitin has zinc in it and can cause serious life threatening anemia if it's ingested by a cat. Oy! 

Finally I got the woman to listen to me when I told her that her cat was healthy and only had a flea allergy. I also told her that her home was infested with fleas since they were also biting her and she was digging the shit out of herself. She agreed to call the exterminator again in the morning. 

Today was also the day of the "land shark." I'm sure you've heard the term from me from time to time. It's used in the veterinary field to describe the little dog that introduces itself to you with a snapping jaws. Wouldn't you know that all of my land sharks today were chihuahuas? One of them even lunged at me as I was leaving the room. Well, I went right back in and the dog backed up cowering behind the owner. I took the leash and walked him back out. Ha! He was more than okay to be my friend then. Stinker!  

I had one cat today that made it's way onto the land shark list. All claws and teeth this one. Of course he was on his "best" behavior with me, but as soon as my staff took over for testing, he turned into the Tasmanian Devil! What the hell? He even launched himself around our treatment room daring my technicians to catch him long enough to give him his tapeworm medication. Whew!

One last thing before I end for the day. I know many folks like to keep a bowl of fresh fruit out on their tables or counters. If you have pets, it's probably a good idea to be sure you don't include grapes in those bowls. Grapes and raisins can be very toxic to dogs and cats. If they eat enough for their body, they can end up with kidney failure. How much is too much? No one knows. The amount varies from pet to pet so it's best to just keep grapes and raisins safely locked in the refrigerator. 

For cats, make sure you keep any and all lilies out of their reach. Not all of them will cause kidney failure in cats, but many do. Two in particular, the Easter Lily and the Tiger Lily will cause kidney failure if any part of the plant or flower is eaten. Peace Lilies will cause horrible gastroenteritis...yeah tons of vomiting. So do yourselves and your inquisitive cats a favor and don't have these flowers/plants around.

Well, that's it for me. Another Manic Monday under my belt and I'm wiped out. Time to head to bed and rest up for Terrible Tuesday! LOL  

Until next time...
~Dr. Tammy

#FurbabyFridays: Chocolate Toxicity

Hello and welcome back to my weekly installment of Furbaby Fridays with Dr. Tammy. This week we are counting down to Easter and I thought today would be a great time to remind folks about the dangers of chocolate. This tasty treat comes in all shapes and sizes and formulations whether in cocoa products like candies, cakes , cookies and brownies, but also in cocoa beans and mulches.  The most accidental exposures of pets to chocolate of course occur more around the holidays and Easter is a big one.

Because dogs tend to be the pets that tend to eat just about anything, we don't usually see cats with this toxicity, but there are a few of those pesky felines who pretend they are dogs and ingest some odd things. So to be safe, keep chocolate away from all fur babies.  This includes some cocoa bean hull mulches. Not only do the mulches smell like chocolate Pop Tarts, they are readily available for pet for some pets because of their use in gardens and landscapes. Of course the makers of the mulches will say there has only been one documented death from the ingestion of these kind of mulches, this does not mean that animals are not sick from them. In fact, even Hershey one of the makers of these mulches admit that 50% of dogs who ingest their mulch can get sick from it.  Here's an article by snopes.com that talks a bit more about it.

What makes chocolate toxic to animals?

Methylxanthines are the culprits here, specifically theobromine and caffeine. That's right. There are TWO toxic components in chocolate and each will vary in concentration depending on the type of product. The rule of thumb is the darker the chocolate the higher the amounts of both of these compounds. White chocolate has 0.25mg theobromine per ounce and 0.85mg of caffeine per ounce. In contrast, dry cocoa powder has 737mg theobromine and 70mg of caffeine per ounce.  Now what does that mean? 

Animals can show mild signs after only ingesting 20mg/kg of either theobromine or caffeine. Severe signs are seen at 40mg/kg and seizures at 60mg/kg. So if you have a 20 pound dog (roughly 10 kg) it would have to eat 400 mg of the toxins to start showing some signs.  So only 1/3 of an ounce of the dry cocoa powder can be dangerous and only one ounce of the cocoa bean hulls in the mulches could do it as well. Less than 1 ounce of milk chocolate per pound of body weight is potentially lethal for dogs. Milk chocolate is nearly 100 times as toxic as white chocolate. Baker's chocolate is SIX TIMES more toxic than milk chocolate. 

A lot of figures, I know but I wanted you to see the comparisons. If your dog decides he likes your dark chocolate candy bar you've been saving in your purse, you very well may have an emergency on your hands. 

 For an article about chocolate intoxication and a chart that includes the amounts of the types of chocolates and caffeine sources click HERE. It's a page on the ASPCA website with articles aimed more for veterinarians. The article is a PDF that will download to your computer if you click on the link.

It's not only the actual amount of chocolate we have to worry about when our pets ingest these kinds of foods. More often than not, the ingestion takes the form of eating candy in wrappers. Those can be just as bad leading to obstructions in the stomach and bowel loops. Even if the mulches are of the variety that have been treated to remove the theobromine, the debris itself could cause an obstruction if enough is eaten.  

What are the clinical signs to look for?

Usually withing six to twelve hours of ingestion you will see the first clinical signs. These include polydipsia (drinking a lot of water), vomiting, diarrhea, bloating and restlessness. If enough of the chocolate has been ingested, the signs can progress to an animal that ends up extremely agitated/hyperactive, urinating a lot, tremors or even seizures.  Other symptoms include high heart rates, arrhythmias, elevated body temperatures, coma and even death.  It's the arrhythmias that can cause death in these patients so it's imperative that you seek immediate veterinary care if your pet gets a hold of any kind of chocolate. It's better to be safe than regret it later.

How is chocolate intoxication treated?

As soon the pet arrives, the veterinary staff will be in motion. Stabilization first involves decontamination of the stomach by inducing vomiting. This will be done only if the patient is stable enough for it to happen. If your dog is seizuring, the induction of vomit will NOT occur. Instead the seizures will be brought under control first. Once more stable then decontamination will occur using stomach tubes to remove as much of the chocolate that remains and to administer activated charcoal without sorbitol. (In the paint ball toxicosis article you will recall that sorbitol is one compound that can cause issues all on it's own. 

If it's been within a two hour period of ingesting the chocolate, emesis (vomiting) will be induced. Trust me, some of the dogs that have come into my clinic after eating chocolate have amazed me with the sheer amount of the stuff in their stomachs. One patient at a box of mint cookies covered in dark chocolate. My treatment room reeked of minty chocolate for hours after that pooch tossed his cookies...pun intended. ;)  

Intravenous fluids, close monitoring of vital signs to make sure elevations of temperature and heart rates don't occur. If the signs do progress, then medications are administered to control seizures and arrhythmias. Usually our patients present early enough that just 12 hours of IV fluids, and monitoring are all that's needed after the decontamination. Activated charcoal is sometimes split into three different doses in order to continue to absorb any chocolate that got into the intestinal tract.  The patients that have the longest recovery are those who are treated after the bad symptoms have already started or they've ingested chocolate that contains other "ingredients" such as marijuana, laxatives, "magic" mushrooms and other recreational drugs. 

So do yourself and your pets a huge favor and lock up all products containing chocolate and caffeine. Even if it's white chocolate containing very little toxin per ounce, it's best to just keep it out of reach. Don't leave any candies out in dishes, Christmas stockings, wrapped under the Christmas tree, in Easter baskets accessible to pets, boxed chocolates on Valentine's Day, or baked goods out where your pets have access.  I know that all seems like common sense, but you'd be surprised by the number of folks who say "my dog never jumps up on the counter. Why would I put the chocolate away?"  Here's another good one, "It's a dog. They don't eat chocolate."  

This is where I usually hear Bill Engvall's "Here's Your Sign" routine.  LOL

Dr. Tammy's Manic Monday

I've worked nearly 20 years of Mondays as a veterinarian and to this day, it's my least favorite part of my work week. Not only is there always a rush first thing in the morning with client's who conveniently "forgot" we were open on the weekends, there usually is a literal flood of transfers of patients from the emergency clinics. The 8 am doctor is usually swamped and by the time I get in there at 10 am it's chaos at it's best. 

There are the usual dogs and cats that have been sick for at least the last three days and of course NOW it's an emergency to their owners. Each and every single one feels their pet is sicker than the rest and should be taken care of first. We have a basic triage system at our hospital. Each patient is given a stability check. If they are deemed stable to wait, they will wait their turn. If they are thought to be critical, they move up the list. Even appointments have to be delayed if an emergency walks in the door. Most folks understand that, but there are those chosen few...you all know the folks I'm talking about. The ones who come into the lobby crying and screaming "My BABY! My Baby is dying and I need a doctor NOW! Lawdy Jesus, save him. He's got the epilepsy and he's been having seizures for the last three days straight..." When asked why they waited to bring their precious in, our ears are assaulted once again. "We ain't got no money! You have to save him. You took an oath!"

Yeah, I do see those kind of clients more often than I care to admit, but today was a mixture of emotions I hadn't felt in a while. Two good Samaritans brought in a stray Chihuahua they found on the side of their street. This poor dog was in severe shock after being hit by a car. He had a broken back leg, broken pelvis, fractured ribs creating what is referred to as a flail chest, and major head trauma. These wonderful people took the time to carefully transport this older dog to us so we could end his suffering. He had no microchip, was not neutered, and had no collar or tags. He would have died along the side of the road, alone and afraid if it wasn't for these two men. From the bottom of my heart I thanked them for helping this animal die with dignity. 

I wade through the next several drop ins and appointments until I come across one where the owner wants to talk about a weight loss program for her cat. You see, he's just a little larger than your average cat. He tops the scales at just over TWENTY-FIVE POUNDS!!! Holy Guacamole!

This cat doesn't like to get very active at home and he feels he's run a marathon just getting from his litter box to the couch every day so he's not thrilled with the idea he has to earn his keep. After going through how many calories he is to get TOTAL per day and an exercise program for him, my staff took over to draw blood from him for his Senior Wellness panel. Well, let's just say the blood draw went very well, but not the collection of urine. He was much too big to even feel his bladder and the our needles weren't long enough to reach it through all of his body fat. Ugh!  (yes he could have been a twin to the one shown in the picture!)

Besides all the pets with major diarrhea issues over the weekend, multiple pets came in with broken nails. Not one of them broke them outright. No, they had to be partially broken so that we have to let them grow out some more in order to cut them back. At least they were all good spirits about it. Cookies go a long way with the bouncy Pitbull who keeps trying to lick your glasses off when you are placing the padded bandage on his front foot. And of course, let's not forget the wrestling job we have to go through to get the E-collar on! LOL

We didn't get any patients ingesting their owner's marijuana stashes today, but one energetic boxer decided to polish off half a chocolate cake around 8am. What time did his owner actually bring him in you ask? Well, 2:15 pm. That would be beyond the window we have to induce vomiting and he really should be admitted to the hospital for intravenous fluids and a seizure watch. What were we allowed to do? Subcutaneous fluids and activated charcoal. That's it. Hopefully that will be sufficient. I guess we will find out more by morning when the dog is transferring from one of the emergency clinics for convulsing all night long! 

Sometimes we get patients in because their owners are actually going through some medical issues of their own...the psychiatric kind. I had one of those today. This very nice woman insisted her cat was covered in bugs that were burrowing under her skin creating these horrible sores on her body. We went round and round about it and finally I got her whole story out. The owner had been off her own meds for too long and was actually self medicating with Goddess knows what. One thing she was doing was coating her body in Desitin. She thought she would put some on her cat and did, but luckily she thought better of it. Desitin has zinc in it and can cause serious life threatening anemia if it's ingested by a cat. Oy! 

Finally I got the woman to listen to me when I told her that her cat was healthy and only had a flea allergy. I also told her that her home was infested with fleas since they were also biting her and she was digging the shit out of herself. She agreed to call the exterminator again in the morning. 

Today was also the day of the "land shark." I'm sure you've heard the term from me from time to time. It's used in the veterinary field to describe the little dog that introduces itself to you with a snapping jaws. Wouldn't you know that all of my land sharks today were chihuahuas? One of them even lunged at me as I was leaving the room. Well, I went right back in and the dog backed up cowering behind the owner. I took the leash and walked him back out. Ha! He was more than okay to be my friend then. Stinker!  

I had one cat today that made it's way onto the land shark list. All claws and teeth this one. Of course he was on his "best" behavior with me, but as soon as my staff took over for testing, he turned into the Tasmanian Devil! What the hell? He even launched himself around our treatment room daring my technicians to catch him long enough to give him his tapeworm medication. Whew!

One last thing before I end for the day. I know many folks like to keep a bowl of fresh fruit out on their tables or counters. If you have pets, it's probably a good idea to be sure you don't include grapes in those bowls. Grapes and raisins can be very toxic to dogs and cats. If they eat enough for their body, they can end up with kidney failure. How much is too much? No one knows. The amount varies from pet to pet so it's best to just keep grapes and raisins safely locked in the refrigerator. 

For cats, make sure you keep any and all lilies out of their reach. Not all of them will cause kidney failure in cats, but many do. Two in particular, the Easter Lily and the Tiger Lily will cause kidney failure if any part of the plant or flower is eaten. Peace Lilies will cause horrible gastroenteritis...yeah tons of vomiting. So do yourselves and your inquisitive cats a favor and don't have these flowers/plants around.

Well, that's it for me. Another Manic Monday under my belt and I'm wiped out. Time to head to bed and rest up for Terrible Tuesday! LOL  

Until next time...
~Dr. Tammy