Holiday toxins part 2, feline and canine
Cats are not normally big alcohol drinkers. Holidays can sometimes get them in trouble. Cats fascinated by mixed drinks containing milk, cream or ice cream (White Russian, alcoholic eggnog, Brandy Alexander). Cats are far more sensitive to ethanol than humans due to their small size. Ethanol is rapidly absorbed orally and clinical signs develop within 30-60 minutes. Alcohol intoxication commonly causes vomiting, loss of coordination, disorientation and stupor. In severe cases, coma, seizures and resulting death may occur. Ethanol numbs receptors in the back of the throat that tells the epiglottis to close during vomiting. Aspiration pneumonia is common in patients. These cases need intensive monitoring, IV fluids and hospitalization. Inebriated cats need be monitored by a veterinarian until they recover or die. IV fluids are very important to maintain normal blood pressure and hydration (alcohol is a diuretic). Make sure these guys remain warm. This list of alcohol issues is scary how it parallels human overconsumption.
Death by Chocolate, it is more than dessert.
Chocolate is separated into three groups: Milk chocolate, semisweet chocolate and baking chocolate. Generally the less sweet a chocolate is the more toxic it can be. Unsweetened baking chocolate contains almost nine times theobromine as milk chocolate. This explains why dogs can eat an occasional piece of milk chocolate and appear to beat the odds without showing clinical signs. The theobromine in chocolate coated candy is less than a solid bar of chocolate. The other reason to not give any chocolate to dogs is simple you make a chocolaholic out of a dog and they will actively seek out chocolate and consume it. If dogs are trained to find illegal drugs it stands to reason you can not hide chocolate from a dog. Eventually they will find it and over consume and will not beat the odds.
Type of chocolate Methylxanthine content toxic dose for 60 # dog
Milk chocolate 44 mg/oz (154mg/100 gm) 60 oz
Semisweet chocolate 150 mg/oz (528 mg/100 gm) 18 oz
Baking chocolate 390 mg/oz (1365 mg/100 gm) 6 oz
From Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment, 6th edition 2000
Cats aren't big chocolate eaters as compared to dogs. Dogs and cats certainly get into trouble if they eat enough. Chocolate has caffeine and theobromine, both are classed as methylxanthines. Clinical signs seen are: vomiting, diarrhea, agitation (hyperactivity), polyuria (urination), polydipsia (drinking), lethargy, tachycardia (rapid heart rate), tremors, cardiac arrhythmias, seizures and death, depending on the dose. Treatment is emesis (if not vomiting), activated charcoal, IV fluids (flush / diuretic), cathartic to speed elimination of chocolate active ingredients, and urinary catheter to prevent reapportion of caffeine by bladder wall. Medications administered may include acepromazine for agitation; propranolol for tachycardia; methocarbamol for tremors; and diazepam for seizures.
If you suspect your animal has gotten into chocolate contact your veterinarian, Animal Emergency Clinic (734-971-8774), or ASPCA poison control (888-426-4357). You will need to know: 1) what type of chocolate ingested (milk, semi or baking). 2) The maximum amount ingested (worst case scenario). Information may be found on package or recipe being used that gives type of chocolate> 3) will need to get exact weight of animal. Early signs can be seen with as little as 0.25 oz of baking chocolate in a 10 pound animal. As a rule of thumb mild signs may be seen in animals ingesting 20 mg/kg of body weight. Severe clinical signs are seen at doses over 40 mg/kg of body weight. The half life of chocolate is 17.5 hours in a dog. This means it takes 17.5 hours to eliminate ½ of the chocolate in the system.
Antidepressants:
Why is an antidepressant a worry for cats? They do not have to shop, wrap and give away the goods. There may be relatives or friends visiting that are using prescribed antidepressants. Cats like to play with pills on the nightstand or get into a purse. Cats aren't usually pill eaters. Any one that has had to give a cat a pill understands this on a personal level. Cats do like the taste of the antidepressant venlafaxine (Effexor). Venlafaxine is potent serotonin and noradrenaline reuptake inhibitor (SNRI). A level in the range of 2 - 3 mg/kg may cause clinical signs in a cat. Mydriasis (dilated pupils); vomiting, tachypnea (rapid breathing), tachycardia (rapid heart rate), ataxia and agitation are the most common clinical signs seen. Treatment consists of emesis in symptomatic individuals. When in doubt treat them all. Activated charcoal can be administered, with a repeated dose in 4-6 hours if an extended release formulation was involved. Pump it in again. Heart rate and blood pressure need to be monitored. Acepromazine may be used for the agitation, and cyproheptadine (2-4 mg per cat, PO or rectally) may be useful in antagonizing the serotonin effects. Prognosis for recovery is good with prompt aggressive treatment.
Glow sticks:
There may be a problem with glow sticks and glow-in-the-dark jewelry (necklaces, bracelets, etc.) around New Years Eve or even after this time. Cats are fascinated with these items and will readily play with them. There must be a neuron synapse completion for cats with these items. Things go well, until the cat bites into the glow jewelry. The primary luminescent agent in these types of products is dibutyl phthalate. Dibutyl phthalate is low toxicity (LD50 >8000 mg/kg in rats) but tastes horrible! Cats begin to salivate and foam, will occasionally retch and / or vomit. What is more exciting are the behavioral effects from this compound. A cat will run around crazily head shaking, hissing and hiding. All cases with clinical signs are generally self-limiting and usually resolve once the cat gets the taste of the product out of their mouth. Exposure is managed by diluting the taste of the dibutyl phthalate using milk or highly palatable food (canned tuna), if the cat will eat at this time. The cat should be placed in a dark room and any glowing areas need to be wiped off. If not wiped off the cycle repeats when the cat grooms itself. You really do not want your cat lit up this way.
For more information about a specific case, consult your veterinarian.
Mike Sweet, DVM