#FurbabyFridays Revisits Heat Stroke and Warm Weather Death Traps

I originally posted the following blog on May 9, 2012. In light of the death of a patient because it was left in a car at a BART station for nearly 7 HOURS while the owner went off for the day to Goddess knows what, I thought it was important to bring up the topic again. The day this Pit bull died? It was in the low 70's and clear blue skies. We weren't dealing with a heat wave, just a sunny day and a dog left in a car that quickly became an oven and an instrument of death.

Don't like the thought of a dog seizuring out of control for hours? Don't like the image in your head? Me either and neither did the Good Samaritans who called the police when they saw the dog seizuring in that car. Please, please, please! Don't leave your pets or your children in cars alone unattended while you "run a quick errand." Leaving them home or with supervision and the  air conditioner on could save their lives. 

Read on to learn more about heat stroke.
~Dr. Tammy



People don't often realize how dangerous warm weather can be for their pets. Not only are there the obvious dangers of being hit by cars, allergic reactions to insect bites, snake bites, and the ever "evil" pieces of weed seed called foxtails commonly found here in California, there is something else that ranks up pretty high in the danger list as the temperatures rise above 70 degrees.

Heatstroke is unfortunately a very common occurrence this time of year, and not just for dogs left in cars. Although rare in cats, it has been reported in cases were the feline was trapped in a clothes dryer, left in carriers in hot vehicles or indoors with little or no ventilation. Exotic pets can also be victims. Rabbits, chinchillas, rats and guinea pigs are frequently presented to emergency veterinarians near death because their hutches and cages are placed in areas with little or no shade and are provided with little to no water while their body temperatures soar.

For the purpose of this article, I will focus more on dogs, but honestly all the information discussed here can be applied to the other furry friends. There are many ways animals can become dangerously overheated. Dogs have sweat glands only on the pads of their feet and cool themselves primarily by panting. When the air is hot and humid, they cannot rid themselves of the excess heat efficiently. Heat exhaustion or heat stroke is more likely to occur during the first hot days of spring or summer when it's 70-75 degrees than on a 100 degree day in August.

Why? Because by the end of summer dogs are used to the heat and typically their owners know enough by then to take it easy with themselves and their pets. It's early on when dogs and people are simply not acclimated to the heat and can easily overexert themselves in the new warm temperatures.

Quite a few people travel with their pets when the days are warm, even running errands with their pets "riding shotgun." Unfortunately, unless you plan on leaving the engine running and the air conditioning on full blast, leaving your dog in the car while you run into that store for a "few seconds" is simply NOT an option. Whether or not you leave the windows down or up, park in the shade or not, it doesn't matter. Here's a chart demonstrating how hot the inside of the car can get at various outdoor temperatures.

Pretty frightening isn't it? Within 20 minutes your car can be 30 degrees warmer than the outside temperature! Being left inside a car isn't the only cause of heat stroke. Here are a few others.

1. Physical exertion during the heat of the day. This can include going for a run with their owner, playing outside, running along the backyard fence, etc. Heat stroke can even occur inside if the house is warm and the dog becomes excited.

2. Being outdoors in hot weather without access to cool water and shade. Dogs that are tied or kenneled outside can sometimes get trapped out of reach of shade or water.

3. Being a certain breed whose physical conformation makes them unable to cool themselves effectively. Bulldogs, Boxers, Pit bulls, Rottweilers, Boston Terriers, etc all have short noses, small airways and excess tissue at the back of their throats that can make it difficult to get rid of excess heat.

4. Confinement in a poorly ventilated cage or crate especially under a cage dryer such as when a dog is being groomed.

5. Being overweight

6. Having medical ailments such as heart or airway diseases that can impair breathing. Heart failure, arrhythmias, laryngeal paralysis, pulmonary hypertension, asthma, and bronchitis can all make dogs predisposed to heatstroke.

7. Being very old or very young

So what are some of the symptoms of heatstroke? Each patient is different, but if you see any of these with your dog on a hot day, it would be wise to seek help from a veterinarian earlier rather than later.

1. Heavy panting: rapid or labored breathing

2. Bright or brick red gums. These may also be dry to the touch

3. Weakness or collapse

4. Elevated rectal temperature. Normal is between 100-102.5 degrees Fahrenheit. Seek IMMEDIATE veterinary care if the temperature is 105 or higher. Once an animal's body temperature approaches 109 degrees, brain damage is highly likely.

5. Vomiting

6. Bloody diarrhea

7. Dark urine

8. Bleeding from the mouth

9. Seizure or coma

DEATH can occur within 20 minutes or in a couple of days from delayed complications such as kidney failure.

Now that you've scared the heck out of us, what do we do to prevent our pets from getting heatstroke?

It's all basic common sense. Don't leave your dog in the car when the outdoor temperatures are over 70 degrees and definitely not on bright sunny days. Restrict your pets activity during the heat of the day. Don't go jogging at high noon with your dog. It's way too hot for him and for you. 

Allow your pets to gradually acclimate to warm weather, especially if they are physically active. Always provide access to shade and cool water when dogs are outside Keep breeds at risk, very old, very young or dogs with health conditions indoors in cool, well ventilated areas. If there is a heat advisory issued, please keep all animals inside. If unable to do so, use misters, fans, or wading pools to provide extra cooling measures for outdoor pets.

What do we do if our pet does suffer from heat exhaustion or heat stroke?

First of all, try not to panic! Your pet needs swift and immediate intervention in order to give it the best chance of survival.

1. Immediately move the dog indoors or to a cool area. If in an enclosed crate, remove the dog from it immediately.

2. Wet the dog down with cool water. Do not use ice water as that will make internal cooling more difficult by constricting blood vessels.

3. Take the rectal temperature. If it's over 105 degrees, transport immediately for veterinary care. Know where the nearest emergency clinic is located. Call en route to let them now you are coming.

4. Do not cover your dog during transport, not even with a wet towel as that can prevent heat from escaping.

5. Offer water to drink during transport, though not to a vomiting patient. Only offer small amounts of water at a time and do not force it down your pet!

6. Transport in an air-conditioned car or lower windows so circulating air can help with evaporative cooling.

7. Stop cooling measures when the rectal temperature reaches 103 degrees so you don't over do it and result in hypothermia.

8. Even if your pet seems to respond to treatment, it is still best to have them evaluated by a veterinarian to check for internal problems. Complications from heat stroke can develop several hours to days later due to organ damage caused by high internal temperatures.

Still not convinced it could happen to you and your beloved pet? Click on the link below...

What happens to a dog in a hot car?

The above link is to a graphic that I found today discussing what actually happens to that dog left in a car on a nice day...even with the windows down! I see way too many cases of heat stroke during the nice days here in California. The biggest excuse I hear from people? "I was only gone a few seconds." Yeah, right! You try staying in a hot car with a fur coat for just a few seconds and you tell me how you feel. What you THINK is only a few seconds is actually a few seconds too long when it comes to the health and well being of your dog.

Not only is this dangerous for dogs, it's also a problem for cats, rabbits, other small rodents and birds. Why take the chance people! Leave you pets at home when you run errands, or have someone stay in the car with them with the air conditioner running.

Did you know that in most cities across the country it is ILLEGAL to leave a pet unattended in a car? Just because you haven't been caught doing it, doesn't mean that it's okay to keep doing it. So please, please, please be a responsible pet owner and keep them safe in ALL weather!

#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

#FurbabyFridays: A Penny For Your Thoughts? NOT!

How many of you have dogs (or even cats!) that eat or try to eat everything they come across? Now how many of you have had pets that have swallowed coins—specifically pennies? If you are of the group who have answered yes to that last question, you know exactly where this blog will be going and you'll probably relive some pretty frightening moments for you and your pet. For those of you who've never experienced that kind of problem, then stick around. We're about to take another ride on the pet toxins train! All Aboard!

Why are pennies toxic?

If all the circulating US coins, only the penny is toxic. Those minted after 1982 have a core made out of zinc which is then copper plated. These coins are 97.5% zinc. Canadian pennies made from 1997 to 2001 are 96% zinc. For some animals, one penny is more than enough to cause kidney, liver, gastrointestinal and hematopoietic issues like severe, life-threatening anemia. Death can result from the anemia or multiple organ failure.

The scariest part is that the toxic dose of zinc isn't known. Just like with grape and raisin toxicity, the amount can vary for each animal. Also we don't know exactly how zinc causes destruction of the red blood cells or how it causes the damage to the kidneys. What we do know is the acidic environment in the stomach dissolved the copper plating of the penny, thereby releasing the zinc rapidly.

What are the clinical signs?

Since more often than not, the ingestion of the pennies is not witnessed, we don't have clear cut documentation as to how long it takes for the first symptoms to occur. Dogs who have made a snack of pennies can exhibit some or all of the following signs and symptoms.

1. jaundice (icterus)
2. anorexia
3. vomiting
4. anemia
5. kidney failure

The severe anemia is the worst symptom and is what attacks multiple organs of the body. Once that happens, you can see collapse, seizures, coma and death. How can you tell if your pet is anemic? Take a look at their gums. Flip up the lip and relax your pressure on it so you don't get a false pale look! If they are less than nice and bright pink, it's abnormal and needs to be checked out. If you see pale pink or even white, you pet is anemic and needs to be seen by your veterinarian IMMEDIATELY.

Birds are another family pet that can suffer from zinc (and lead) toxicosis because they too love to chew on everything in their environment. Some cage materials are constructed of hardware cloth which has lead and zinc in the welds. Being the little destructive creatures that they are, within no time the birds can ingest enough of the zinc and/or lead to become quite ill.

How is it diagnosed?

Diagnosis is based on the clinical signs, history of witnessed penny ingestion and radiographic identification of the coins. Sometimes the coins can cause and obstruction and get held up at some point in the stomach or small bowel. Other times they've passed straight through to the colon by the time they are seen on an x-ray. At this point the patients are usually quite ill as the pennies have been in their systems for several hours at this point. Blood work and a urinalysis are needed to determine the extent of the anemia, kidney and liver disfunction or failure. These samples are also needed to determine the zinc levels in the blood plasma and the urine.

Treatment is of course aggressive supportive care to help correct the abnormalities. The most important part of the whole thing is to remove the pennies from the animal. This can be risky if the anemia is severe, but until the source of the zinc is out, further damage will result and maybe become irreversible.  The zinc itself is a potent irritant in the GI tract so medications like sucralfate and metoclopramide are usually part of the protocol as well, along with blood transfusions, intravenous fluids and in a few cases even dialysis if the kidneys are not producing urine (anuria).

Unfortuanately, something as "simple" as ingestion of a few coins could lead to THOUSANDS of dollars in veterinary bills. Most of these patients will recover within 72 hours of removal of the pennies if treated aggressively. If the pennies are in the colon, then multiple warm water enemas will be performed in order to get them to pass quickly. If the coins got held up in the stomach or small intestine, endoscopy or surgery will be done. Of course, follow up x-rays will be done after the procedures to be sure that all of the pennies have been removed. 

How to prevent this?

Besides pennies, zinc can be found in many other products. Here's a partial list, far from complete but at least it's a starting point. If you have any of these items in your home, please lock them up to keep them out of reach of your pets AND your children. Zinc toxicity also affects humans.

1. diaper rash ointments such as Desitin  
2. nuts
3. bolts
4. staples
5. board game pieces ( Monopoly anyone?)
6. zippers
7. jewelry
8. certain lozenge brands
9. some lotions

To summarize, keep small metal objects and zinc containing creams out of reach. Be on the look out for the nuts and bolts on kennels and carriers. Some may contain zinc so it's best to just assume they all do to keep safe. Use caution when using lotions and ointments on your pets. Unless the product has been specifically prescribed by your veterinarian, DO NOT use them until you can clear it with them as safe to use on your fur baby.

Next week we talk about chocolate toxicity. With Easter coming up, you don't want to miss that one!

~Dr Tammy