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Victor

Toxicology: True or False

I thought we’d stick with toxicology today.  Kirk’s Current Veterinary Therapy XIV has a wonderful chapter entitled “Urban Legends of Toxicology: Facts and Fiction”.  While the Internet is a great source of information it also contains a lot of misinformation.  If you are concerned about a potential toxin exposure your best resource is either your veterinarian or the ASPCA poison control (888) 426-4435. 

• Ingestion of Swiffer WetJets causes liver failure in dogs. FALSE:  The only potential and likely problem following ingestion is foreign body obstruction.  

• Tea is a good poisoning antidote for cats and dogs.  FALSE:  Tea actually contains more caffeine than semisweet chocolate, therefore making it more toxic than semisweet chocolate.

• Ingestion of pennies are of little concern.  FALSE:  United States’ pennies made after 1982 contain zinc.  Zinc toxicity can occur from just one penny.  Clinical signs include anemia via destruction of red blood cells and severe gastrointestinal signs.  The anemia can be so severe that the patient requires blood transfusions.

• Febreze, the odor elimination production, is dangerous for pets.  FALSE:  The pre-1998 formulation did contain Zinc chloride, which has since been removed. 

• Vitamins A and D are toxic for most pets.  TRUE: Vitamin A toxicity can cause muscle weakness, bone abnormalities and blindness.  This is rare but can occur by consuming large amounts of liver or supplements containing cod liver oil.  Vitamin D toxicity can lead to high levels of calcium, which results in calcium deposition leading to heart and kidney damage.  Vitamin D toxicity is also rare but I've seen Vitamin D toxicity secondary to a dog consuming the owner’s entire bottle of Vitamin D supplements and as a result of ingestion of choleciferol-containing rodenticides.

• DEET Mosquito repellent products are safe for use on cats and dogs. FALSE:  All are toxic to pets.  Clinical signs included hypersalivation, vomiting, tremors, ataxia and seizures within 6 hours of exposure.  There is no antidote.  Decontamination and supportive therapy need to be initiated as soon as possible.

Please remember anything and everything can be potentially toxic for your pets.  Dose is everything.  If you suspect poisoning please either call your veterinarian or the ASPCA poison control, which has veterinary toxicologists on call 24/7.    

Lily Poisoning in Cats

Lilies seem to becoming more and more popular in floral arrangements and while they are beautiful, they are deadly to cats.  All parts of the plant are toxic and it only takes a tiny amount to cause acute kidney failure in cats.  Examples of these plants are the Easter Lily (Lilium longiflorum), Tiger Lily ( Lilium tigrinum), Day Lily (Lilium hemerocallus), Asian lily (Lily asiatic spp.) and Rubrum Lily ( Lilium rubrum).  However, any plant in the lily family can result in poisoning.

Clinical signs

• Vomiting, hypersalivation, depression, and anorexia usually occur within 1 to 2 hours after ingestion, followed by absence of urination and severe renal failure 2 to 4 days later. 

• If you know or think your cat might have eaten a lily, even just a tiny portion, take you cat to your veterinarian RIGHT AWAY.  The sooner treatment is begun, the better the prognosis.

Treatment

• The most important course of treatment is emptying the stomach of all plant components within 4 hours of ingestion.   
• Then administering medications to prevent absorption of the toxin.
• Also, diuresis of the kidneys via intravenous fluid therapy for 48 hours is very important to make sure that the kidneys continue to function appropriately.

Prognosis

• If emptying the stomach and administering medications to prevent absorption of the toxin are effective and fluid diuresis is performed, the prognosis for recovery is usually excellent.
• If enough toxin is absorbed to lead to acute kidney failure, the prognosis is guarded. This makes it very important to seek emergency care immediately after ingestion of the lily plant. 

For more information on lilies and other toxic plants please visit the ASPCA Poison Control website.

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Hepatitis A - Infectious Hepatitis

Number 4 on the CDC's top 5 causes of drinking water outbreaks is Hepatitis A.

"Hepatitis" means inflammation of the liver.  Hepatitis A is a contagious liver disease caused by an infection with the Hepatitis A virus.    Unlike hepatitis B and C, hepatitis A does not cause chronic liver disease and is rarely fatal.   

It is a virus that replicates in the intestinal tract and then spreads to the liver. The virus is then shed in the feces.  Virus shedding is greatest just before symptoms appear (i.e. when a person is not sick) and during the first week of illness.  It is typically associated with crowed conditions and poor hygiene.  

Approximately 3,600 cases of hepatitis A are reported each year in the US (keep in mind many more people are infected than are reported).

Transmission

• Person to person via fecal-oral
•  Ingestion of contaminated water or food  
• The most common food source is raw shellfish including oysters, clams, and mussels

Clinical Signs

• Fever, jaundice (yellow skin), nausea, vomiting, pale or clay colored stools and dark urine

Prevention

• Wash your hands  - hopefully you're noticing a theme by now!
• Hepatitis A vaccine
• Good sanitary practices, especially sewage treatment 
• Avoiding the consumption of uncooked shellfish 

 
If you have any further questions on Hepatitis A please contact your physician.

Daily Digital

Aurora

Human Foods That Are Dangerous for Pets

There are a number of human foods that are tasty to us but have been proven to be toxic and even deadly to our pets.  While it is tempting to give your pet human food, pets should not consume human food unless it's recommended by your veterinarian.



Chocolate, Coffee, Caffeine

Chocolate contains a chemical called theobromine, that is toxic to dogs in large enough quantities. Chocolate also contains caffeine which is also toxic. Different types of chocolate contain different amounts of theobromine and caffeine. Baking and Dark chocolate contain the most, then milk chocolate followed by white chocolate which contains the least.  In other words a  dog would need to consume more milk chocolate in order to become ill. However, even a few ounces of chocolate can be enough to cause a small dog to become ill, so really no amount or type of chocolate should ever be considered “safe” for a dog to eat. Chocolate toxicity can cause vomiting, diarrhea, hyperactivity, rapid or irregular heart rate, muscle tremors, and seizures. Death can occur within 24 hours of ingestion.

 

Xylitol 

Xylitol is used as a sweetener in many products, including gum, candy, breath-mints and toothpaste. It causes a sudden insulin release in dogs, which leads to low blood sugar levels. It can also cause liver failure in dogs. Initial signs of toxicosis typically within 30 minutes of ingestion include vomiting, lethargy and loss of coordination. These signs can then progress to recumbancy, seizures and death. Elevated liver enzymes and liver failure can be seen within a few days.  

   

Grapes and Raisins

Both grapes and raisins can cause kidney failure in both dogs and cats.  The toxic substance in these fruits is unknown.   Vomiting, increased drinking and lethargy can occur 5 to 6 hours after ingestion, followed by anorexia, lack of urination, and tremors.  One to two grapes may be enough to cause these clinical signs.

  

Onions, Garlic, Chives

These vegetables and herbs can cause gastrointestinal irritation but more importantly can lead to red blood cell damage resulting in anemia. Although cats are more susceptible, dogs are also at risk if a large enough amount is consumed.  

Avocado

The leaves, fruit, seeds and bark of avocados contain a substance called Persin, which can cause vomiting and diarrhea in dogs and cats.

 

Macadamia Nuts

Macadamia nuts are commonly found in cookies and candies. The mechanism of toxicity is unknown, but ingestion can caused weakness, depression, vomiting,  and tremors in dogs. Signs usually occur 6 or more hours after ingestion and last approximately 12 to 48 hours.

Please visit the ASPCA Poison Control for more information or if you think your pet has consumed any of these foods.
 

 

Norovirus

Continuing with water related diseases.  The number 3 cause of drinking water outbreaks is Norovirus.

Noroviruses are a group of related viruses (Calicivirus) that cause nausea, vomiting, diarrhea, abdominal cramps and fever in humans.   It is the most common cause of acute gastroenteritis in the US, causing more than 20 million cases each year.  Formerly, known as Norwalk viruses named after the original strain, which caused an outbreak in a school in Norwalk, Ohio, in 1968

How do you get it?

• Fecal contamination of water and food, such as salads, in restaurants, camps, schools
• Uncooked or partially cooked oysters, clams, cockles or other shellfish that have been harvested from sewage-polluted estuaries
• Contaminated ice

• It is a highly contagious and resistant virus which is why outbreaks are common

Vaccine and Treatment

There is no vaccine and no drug to treat people who get sick from the virus.  Antibiotics won’t work because it's caused by a virus, not a bacteria.  Therefore, treatment is symptomatic and aimed at preventing dehydration. 

Prevention

• Once again good hygiene – WASH YOUR HANDS 
• Environmental surfaces should be disinfected using a chlorine bleach solution 5-25 tablespoons of household bleach per gallon of water
• Food and water safety is very important
• Noroviruses are relatively resistant and are able to survive freezing and temperatures as high as 60°
• Noroviruses can survive in up to 10 mg/liter chlorine 
•  US EPA guidelines for municipal water systems recommend residual chlorine concentrations of at least 0.2 mg/liter  

Historical Outbreaks

• In 2010 twenty-one NBA players and three staff from thirteen teams in eleven states were affected. 
• Butter Cream Frosting Incident.  In 1982, one man mixing icing for a Minneapolis-St. Paul area bakery caused some 3,000 illnesses.  Investigators discovered the infected worker mixed the uncooked icing in a giant vat with his bare arms and hands. 
• 1987 two related outbreaks involving ice produced by a company that supplied both Philadelphia’s Franklin Field stadium and to a museum fundraiser in Wilmington, Delaware.  The cause was traced to flooding of the company wells from an infected stream.

Shigellosis

Keeping with the topic of water related diseases I thought we'd continue with the list of top 5 drinking water outbreaks and briefly talk about number 2 on the list Shigellosis.


Shigellosis is an intestinal infectious disease caused by a group of bacteria called Shigella.  Humans are the only natural hosts however Shigellosis has been diagnosed in monkeys.  According to the CDC there are approximately 14,000 reported cases in the US every year.  

How do you get it?

•  Ingestion of feces-contaminated water, vegetables or dairy products

Clinical Features

• It is most often seen in pre-school age children in nurseries and daycare.  Not to gross you out but remember transmission is fecal-oral.
• Symptoms typically include bloody diarrhea (secondary to ulceration of the colon wall), fever, nausea and stomach cramps. 
• Mild cases usually resolve within 5 to 7 days without treatment.  However, severe infections can occur in children under the age of 2 years old.

 Prevention

• Strict hygiene is the key - frequent and correct hand washing!  It's very important to teach pre-school age children good hygiene habits.  Try to make hand washing fun by singing a song so he/she knows just how long to wash.
• Keep children with diarrhea out of child care settings.