Tuesday, June 28, 2016

Spot ate pot? And other strange but not uncommon toxicities...

Everyone seems to know that chocolate is toxic to dogs.  I’m also sure that everyone knows that marijuana (pot) is also toxic.  We see a larger amount of ingestions of drugs than people would probably believe.  Especially now with more and more states legalizing drugs and these drugs coming in higher concentrations and concoctions which can be tasty (pot butter, chocolate pot brownies, etc.) pets find them tasty too.  Sometimes the consumption of pot is an accident and sometimes it can be malicious.  Sometimes a neighbor, ex-boyfriend or other character will intentionally poison a dog.  
While the “tox screen” that they talk about on TV sounds like a great idea, there’s really no practical way for us to do that in veterinary medicine.  In order for us to test for everything under the sun that is a toxin it would involve too much expense (and blood or urine) that it’s just not practical.

We’ll get back to the marijuana toxicity a little later, but let me inform you of some other lesser known toxicities.  Garlic and onions can cause anemia (even though if you look on “Dr. Google” you will see these compounds as homeopathic flea repellants).  Mushrooms can cause liver failure, as can Sago Palms (a common houseplant).  When it comes to plants, I quite often refer people to the ASPCA Poison Control website where they have an exhaustive list.  Even though I'm mostly focused on dogs in this dog post, I would like to make sure everyone knows that lilies are so toxic in cats that even the pollen off of them is enough to send a cat into severe kidney failure where they are dependent on dialysis.  I love lilies and they were even in my wedding bouquet, but I do NOT allow them in my house because of my fear of them.
Xylitol, a compound that is in sugar free gum and other sugar free products is becoming more and more common and some “healthy, holistic” peanut butters now contain it so you must carefully read ingredients.  It is also often found in children’s dental products.  This is so toxic it can cause liver failure and seizures, as it causes extremely low blood sugar (I’ve actually seen this toxicity a couple of times).
Raisins and grapes are another toxin that is just too risky to allow in my house.  While chocolate is dose dependent (it depends on the amount the dog eats per body weight), raisins and grapes are not.  Some dogs can eat them without a problem.  Some dogs die from them.  We don’t know yet which dogs are more sensitive, so there is no way to know if it will be a problem for each particular dog.  Would you really want to take that risk?

In the advent of all the DIY products out there, making your own beer is becoming more common.  Did you realize that just a couple pellets of mash is enough to kill a dog?

One naproxen (commonly known as Aleve) can work great for human pain and inflammation.  It’s enough to kill a dog the size of a labrador.  I still have this medication in the household (it works the best for me) but I keep it in a room where my dog is not even allowed to go in.

When I worked in emergency medicine, it was quite frequently not just one thing the dog got into, but a bunch of different pills, medications or foods.  So it could sometimes be difficult to sort out how to treat each of the different toxins.  If your dog ever gets into something, please bring the wrapper or whatever information (or whatever is left of it) with you or take a picture of it, as that is valuable information for us.  It sometimes becomes a puzzle where we have a small fragment of candy bar wrapper and have to figure out what it is and how much of it is in a package that size.  We have an easy calculator for chocolate toxicity and we can do the calculations on rat poisons (I’ll save rat and mouse poison discussion for another day).  So you can always call a veterinarian up and simply ask if something is poisonous.  Also, common household products will often have a manufacturers number to call for accidental ingestion.  There’s also always the ASPCA poison control, who for a fee, will provide information to owner and veterinarian alike, especially helpful for the more obscure poisonings.

Ok, back to marijuana.  I can honestly say I’ve never smoked it, ate it or really had any other direct interaction with it or any other illicit drugs, but I’ve come to learn a lot about drugs over my past 20 years in veterinary medicine.  I can actually spot people with drug (and alcohol) problems.  It makes our job a little trickier because the people can be obviously impaired, not tell us the truth and be irresponsible (with payment and obviously generally irresponsible).

I’ve become rather adept at the whole, “Is there any way your dog could have gotten into something, maybe a neighbors backpack, or a park or something.”  I’ve found that letting people know you are not interested in calling the cops on them and you really don’t need (or want) to know the exact reasons of an intoxication can help them open up.  “I just need to know what your dog got into so I can help him/her.”  I had one situation early on in my career several years ago where it was quite apparent the puppy had either gotten into something or had a very serious genetic problem.  I asked the owner and his wife, two middle-aged people, “Is it possible he could have gotten something from your kids?”  The man said, “no, are kids are older, they know better.”  “How old are your kids,” I asked.  “15 and 17,” the man responded.  I then went on the line of questioning, “well maybe he could have gotten something out of a backpack of one of their friends?”  All of a sudden a light went on and the man said, “No, I'm going to kill my kids, I'm a cop. They can’t be doing drugs!”.  That was awkward…
I also know of a funny story about a government dog that is trained to sniff out drugs coming to the ER at the same time that there was a little yorkie who had gotten into the “nephew's" stash.  Both dogs needed to stay overnight in the ER.  Somehow they ended up getting placed in kennels next to each other.  Apparently that was a very bad idea because the whole night the police dog was letting everyone know there was pot next door to him.

I've heard all kinds of stories from, "some bad chicken" or a "bad avocado" when it's quite apparent that that is not the case.  Amphetamines, heroin and cocaine, fortunately we don't see as often but they also things dogs can get into.  I did have a dog who got into pot brownies and Ritalin, so it was quite a combination between the chocolate, pot and stimulant.  I've surprised some people before with being able to pick out people by their symptoms and smells, etc..  In this line of work, the weirdest thing will help you become a better diagnostician, even if that means an awareness of illegal substances.  Don't worry, I'm not planning any "independent research" into the subject, I feel I know enough of what it does...


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