‘Treats’ That Aren’t So Tasteful,
But Toxic!
Patricia A. Talcott, MS, DVM, PhD, Diplomate ABVT
WSU College of Veterinary Medicine
Professor; Toxicology Section Head: Washington Animal Disease
Diagnostic Laboratory
[email protected]
509-335-0807
‘Desiccant Packs’ AND ‘Oxygen Absorber
Sachets’
• Prolong shelf life, protect food (and other things) from
discoloration, decomposition, spoiling
• Silica gel, and other ingredients (activated charcoal,
iron carbonate, sodium chloride, ascorbate, citrus,
etc.)
– Moisture/oxygen absorbents – shoe boxes, lamps,
medications, electronic equipment, foods
– White powder / granular / liquid
– Paper/plastic packets or cylinders
– Low toxicity / mild GI upset
– *Make sure they pass – drink lots of water – case of
dog that ate several and was constipated
– Some have iron (50-70%) – discoloration to urine
– Rare, but may require chelation for iron
Batteries
• 1-year-old Australian Shepherd found
chewing on two AA alkaline batteries
• Two types:
– Dry cell batteries: acid (ammonium
chloride, manganese dioxide) or
*alkaline (K, Na hydroxide)
– *Lithium disc/button batteries: no
corrosives; alkalinic on cathode side
and acidic on anode side as current
passes through battery
• **Both damage mucosal lining!!!
• If not damaged, want to see them pass in
*36 hours / should pass undamaged / go
and retrieve if doesn’t
• Prolonged exposure and battery is
damaged – cause problems over time –
leaching of metals is not a big concern
(such as Pb, Hg, Zn, Co, Cd)
• Tx:
–
–
–
–
Emesis? - NO
Activated charcoal? - NO
Dilution – yes!
Radiograph – may need to remove if suspect
puncture or just is not passing (36 hours)
– GI protectants: bulk cathartics, demulcents /
protectants (sucralfate) / H2-antagonists, proton
pump inhibitors, analgesics, antibiotics?
misoprostol
Mercury
• Not all forms are created equal
• Calls: dog ate a mercury containing glass thermometer /
dog ate new energy saving liquid mercury light bulb
Why???
• Elemental mercury: ingestion OK – bulk diet (bread,
pumpkin), GIT protectants for the glass (watch for
anorexia and blood in stool or vomit), radiographs, should
pass in a day or so / inhalation not good
• Inorganic mercury: BAD – severe gastrointestinal
damage and multisystemic effects
• Organic mercury: BAD – nervous system
Phoenix, AZ
Hand / Feet Warmers
• Ingredients: iron, water, cellulose, salt, vermiculitepulverized wood-polyacrylate, activated carbon
• Poison Control: GI upset / rarely will you see iron high
enough to be a problem (so chelation therapy not
common) / liver, heart, vascular problems may occur at
high exposure doses
• Non-activated ones a risk
• Activated – iron oxide
• Urine might be ‘brown-dark red’ color if exposure is
high
• Tx: emesis, ± activated charcoal, milk of magnesia
(bulk cathartic)
• Can typically see on radiographs!
Somewhere in WA
Glow Jewelry
• Dibutyl phthalate
• Risk: cats; others
• Acute onset:
–
–
–
–
Salivation
Behavior change: catnip-like
Unpleasant taste
Eye irritant as well
• Rinse (mouth, eye, bathe body) / dilute /
resolve over few hours
• Zinc sulfide / strontium aluminate
– Irritant, neurologic (ataxia, confusion),
cardiac irregularities, acute respiratory
arrest
Dryer Sheets
• A little pug dog was exhibiting GIT signs after
‘nibbling/chewing on a dryer sheet’
• Fresh ones (unused):
– Cationic detergents: 25-50%, as high as 95%: coat the
surface of the fabric to provide lubrication (feel soft) and
conduct electric charges (reduce static): static is –
charged, cationic substances are + charged
– Fragrances: smells good
– Cationic detergents: toxicity related to concentration
+ pH: GIT inflammation and necrosis
• Used – foreign body possibly but most will pass –
rarely a problem
• Tx: options include: GI protectants, analgesics, antiinflammatories, PEG tube, endoscopy, antibiotics
Vomit is Our ‘Friend’
Paintballs
• Lewiston, ID
– 25#, mixed breed dog ingested
‘mound of paintballs’ – now
showing neurologic signs
• Ingredients
–
–
–
–
–
–
–
–
Polyethylene glycol
Glycerin
Sorbitol
Dipropylene glycol
Mineral oil
Dye
Ground pig skin
Water
• Toxic dose?
– 15 in a 41-kg dog
• False + EG kit
Paintballs
• Osmotic agents
– Acid/base: acidosis
– Electrolyte:  Na
• Clinical signs
– Vomiting, diarrhea, ataxia, tremors
(< 60 minutes)
–  HR, weakness, hyperactivity,  T,
blindness, seizures
• Treatment
– Emesis (AS) / IV fluids (slow),
symptomatic + supportive / 2007
VECC
September 22, 2016 – Eagle, ID
• Mushroom found in the lawn
grass; high degree of suspicion
that the dog had ingested some
(pieces and parts scattered
around)
• Patient presented: vomiting,
diarrhea, ↑ ALT (387 – range: 14151)
• Patient discharged < 12 hours
later, following Tx anti-emetic, GI
protectants
What To Think About and Do?
• DVM:
– *Email images – give location!
– *Maropitant if vomiting – most start with
this!
– *Decontamination if appropriate: activated
charcoal with sorbitol
– IV fluid therapy, in hospital for *24 hours
– ISTAT: at least *chemistry panel
– Send home with *liver and *GIT
protectants, 1-2 weeks
– Request *follow-up biochemistry panel in
48 hours
– *Clinician’s Brief, March 2015
• Top categories of mushrooms:
– Gastrointestinal distress – most all start
this way
– Muscarine containing mushrooms
– Hepatotoxic (and renal)
– CNS: either excitation or obtundation
– Nephrotoxic
• Can see fatalities, with hepatotoxic,
nephrotoxic and CNS mushrooms
Not so tasty, but it is a dog….
• 10-year-old, F/S, 50#
• 3-year-old, M/C, 25#
• Both: presented
“comatose” – emergency
service (CA)
Heart beat regular, strong; normal rhythm; lungs
clear; pupils pinpoint; no reflexes
• Both dogs running loose (few hrs)
• Within 30 min returning home
–
–
–
–
–
–
Staggering
Ataxia
Falling down
Tongues hanging out
Collapsed
2 other dogs fine
• Cody
• Frankie
– CBC, panel: ok
– Gastric lavage
• Dog food, scrambled eggs
– 120 ml AC + sorbitol
– 15 min: cardiac and
respiratory arrest
– CPR: unsuccessful
– CBC, panel: ok
– Gastric lavage
• Dog food
– 120 ml AC + sorbitol
– ICU overnight
•
•
•
•
Warm blankets, heating pads (T)
O2 nasal catheter
Rotated / Expressed bladder
IV LRS
Running Around
• Cody
– 3:45 PM next day (24 hrs) –
no improvement
– 5:00 PM
•
•
•
•
•
Slight anal tone
No palpebral reflex
No poisons
Shoots coyotes
No “bad” neighbors
– O elected euthanasia
Running Around
• PM
– Large chunks of “tripe”-type
material, meat with skin and
black hair attached
• Owner euthanized horse
several weeks ago
– Dug up by wild boars
– Dead pigs, coyotes, birds
• Case in North Carolina: 110
hours!
• Looks “anesthetized” – just
might be
Birth Control Pills
• Get this question A LOT!
• Estrogens / progesterones /
placebos
• In general: < 1 mg/kg estrogen
will cause no problem /
progesterones may cause mild
sedation
• Iron – may cause GI upset and
discoloration to urine
Does ‘Natural’ Mean Safe??
• 3-year-old girl ‘moused up’ 2, 12-weekold, kittens (4-5#)
• Presented: HR:380 BPM, lateral
recumbency, non-responsive, panting,
tremors, ‘seizure-like’, miotic pupils
• Responded well to IV fluids, bathing
• Progesterone: decontaminate if exposure
> 10 mg/kg / mild and self-limiting ataxia
and lethargy, that can progress to
recumbency and seizures
Laundry Detergent Pods
• Ionic and non-ionic surfactants
• Topical, ocular, and oral exposures
are potential problems
– Self-limiting vomiting; coughing, lethargy,
nasal discharge, dyspnea (signs of
respiratory irritation)
– Rare to see more serious consequences
• D for dilution (no emesis, no activated
charcoal, no cathartic)
• Symptomatic: anti-emetic, GI
protectants, keep well hydrated,
possible antibiotics, analgesia, scope?
Meat Package Padding – ‘Meat
Diapers’
• Silica gel: super-purified sand
• Cellulose: super-purified plant fiber
• POLYGEL: gel based super absorbent
sachet – various heat-bonded plastic
materials
• Non-toxic: mild GI upset, make sure
pass, absorb lots of fluid
Hot/Cold Gel/Ice Packs
• Ingredients:
– Ammonium nitrate
– Iron powder
– Water, propylene glycol, urea, cellulose
• Expect: mild gastrointestinal upset
• Tx: induce emesis?, gastrointestinal
protectants, symptomatic care / will
cause false positive on EG kit
• Contamination concern?: examples
include ethylene glycol, diethylene
glycol
Flares, Matches and Fireworks
• Nitrates – sulfates – phosphorus /
potassium chlorate
• Gastrointestinal distress, CNS
depression if high exposures?
• Large exposures - ?methemoglobinemia