A Foreign Body – Why Time is Important

by: Jennifer Oldfield

The month of March is Poison Prevention Awareness Month and we have had 2 posts this month on toxins to your pet, but sometimes things that aren’t technically toxic can be just as problematic if swallowed.  Occasionally cats, but much more frequently dogs, will eat items that really aren’t intended to be edible; items such as rocks, all kinds of toys, socks, even gloves.   In many cases if the item is small they are able to pass them through their system, or they will vomit them up, but sometimes they end up caught part way through being digested and surgery becomes required to remove the item.

Grace is one such dog who required surgery.  Her story is fairly simple.  One day she threw-up a gardening glove.  Grace appeared fine but her owner exercised caution and gave her a very small meal.  She didn’t vomit again, so a bit later she gave her more food.  She ended up vomiting all of it up.  Without hesitation Grace was brought in to us.  Although Dr. Liebe could feel a foreign body in Grace’s abdomen x-rays were taken to confirm.

Rad

Dr. Liebe got Grace into surgery right away.   The surgery only lasted 30 mins.  She was able to remove the foreign body (which turned out to be the other glove) and sew her back up without requiring any additional surgery time, thanks to Grace’s owner acting quickly and bringing her in right away.

 

Why is that time so important?  What difference would 12 or 24 hours have made?

There are 2 answers to that question:

  •  Especially quickly in cats, but certainly also in dogs, they can become sick enough that they don’t make it
  • Provided surgery can occur it is higher risk due to;
    • possible dehydration
    • abnormal blood results because the body is trying to fight what it sees as an infection
    • the tissue surrounding the foreign body begins to die (labelled in the image below as hypoxic intestine)

7___hypoxic_intestineOften the surgery to remove a foreign body is an hour or more in length.  This is due to the necessity of removing a section of the intestines, anywhere from a few inches to, on rare occasion, as much as a foot.

For your pet to have the best case scenario the sooner you get them in the better.  Our basic rule of thumb is:

  1. if you know they have eaten something they shouldn’t have, but you think they can pass it, monitor them
  2. if they are having diarrhea or vomiting they should be seen as soon as possible
  3. if they can’t keep anything down (especially water) do NOT wait any longer, they need to be seen immediately.

Ideally we will see your pet prior to getting to #3.  If your pet ate something and you are unsure if it will pass, please always call your veterinarian, they are your best source for information.

To see a video clip of part of Grace’s surgery, click here.

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Toxins & Your Pet: When to Call the Vet

by: Dr. Barb Eatock

At one time or another most pets, especially dogs, have eaten something that they weren’t supposed to eat.  Many of these things are harmless but some can be very toxic.  In this post we will discuss some common toxicities and what to do about them.
Some foods that can be toxic to your pet include chocolate, grapes, raisins, onions and garlic.

  • Dark chocolate and/or Baker’s chocolate is especially toxic.  Clinical signs of chocolate toxicity include:
    •  vomiting
    • restlessness
    • ataxia
    • muscle rigidity
    • seizures

part of bar

Death may result if enough chocolate was ingested.  Immediate veterinary care is required if clinical signs occur.  If you know that your dog got into chocolate, phone your veterinarian to see if the amount of chocolate consumed is a concern.

 

  • Grapes and raisins may cause kidney failure.  It is not known whether the toxic principle is the type of grape, a pesticide or whether there are genetic factors that make some dogs susceptible.  Clinical signs include
    • vomiting
    • diarrhea
    • not eating
    • lethargy
    • and increased drinking and urination.

Call your veterinarian immediately if you know that your dog ate some grapes or raisins.

  • Onions and garlic are toxic if large amounts are ingested.  They can cause gastrointestinal upset or anemia; clinical signs include
    • vomiting
    • diarrhea
    • lethargy
    • inappetance

lily

  • There are many plants that are toxic if ingested.  Some, such as poinsettia just cause mild gastrointestinal upset, whereas others such as lilies are much more serious if ingested.  Eating any part of a lily can cause kidney failure; signs are
    • not eating
    • vomiting
    • diarrhea
    • lethargy
    • increased drinking and urination

Some common household items that can cause toxicities if ingested are:

  • ibuprofen(such as Advil)pills
  • naproxen (such as Aleve)
  • Xylitol (read more about Xyltiol poisoning in our previous post)
  • batteries
  • fabric softener sheets that haven’t been in the dryer
  • acetaminophen (Tylenol) (in cats)

Call your veterinarian IMMEDIATELY if you suspect that your pet has gotten into any of these items.

In some cases, it may be possible to induce vomiting at home.  Never induce vomiting without first checking with your veterinarian.  It is dangerous to induce vomiting after the ingestion of caustic items (gasoline, chemicals, oil) or if the animal is seizuring, extremely depressed/listless or unconscious.  If it has been over 2 hours since ingestion of the toxic item, it is not helpful to induce vomiting as most of it will be digested at this point.  In order to induce vomiting at home, hydrogen peroxide or table salt work best.

H2O2 and NaCl

  • The dose of hydrogen peroxide is 1-5mL/kg by mouth with a maximum dose of 50mL for dogs and 10mL for cats.  The dose can be repeated after 20 minutes if necessary.
  • The dose of salt is 1-3 tsp orally.

In a situation where toxins are involved, speed is of the essence.

  • Phone your veterinarian immediately rather than searching the internet for answers.
  • If it is necessary to bring your pet in please bring in the drug or toxin container if at all possible.
  • If your pet has eaten ANYTHING that you are uncertain of, contact your veterinarian.

In general, the sooner you act, the better the outcome!

Xylitol – Sugar Substitute or Poison?

by: Jennifer Oldfield

Xylitol is a sugar alcohol that is used as a sugar substitute.  It is becoming increasingly common as a substitute in many human products because it does not cause insulin spikes in people and because it has a fraction of the calories of regular sugar.  Although in humans xylitol does not appear to be at all harmful, it is completely the opposite for dogs.  Within 30 mins of ingesting xylitol your pet can go into hypoglycemia (a potentially fatal drop in blood sugar levels) and eventually liver failure.

Where can this product be found?  Check your pockets, your purse, your pantry, even your bathroom.

The most common items containing xylitol are:

  • Candies
  • Gum
  • Mints
  • Sugar-free foods
  • Baked goods

xylitolHowever, more and more items are containing this lethal toxin – chewable vitamins, dental hygiene products, even some prescription medications.  You can also purchase a bag of xylitol to use as a sugar substitute at home.
The amount of xylitol needed to cause problems is pretty low, only 0.1g/kg for hypoglycemia and only 0.5g/kg to cause liver failure.  This means in a 20kg dog (44lbs) as little as only 2 grams of xylitol can cause potentially fatal results.  Part of the problem is that you don’t know exactly how much xylitol is in that package of gum or that sugar free pudding.  It may only take a few pieces of ingested gum for you to lose your faithful companion.

Initial symptoms after ingestion may include:

  • Vomiting
  • Weakness
  • Lethargy
  • Loss of coordination
  • Collapse
  • Seizures

There are some dogs who have shown no initial clinical symptoms in the first 12-24 hours and then seemingly out of the blue end up in severe liver failure.

xylitol-products-300x300“The cause of xylitol-related liver failure in dogs is not well understood, but scientists suspect it has to do with the fact that xylitol and its metabolites deplete adenosine triphosphate stores in the liver. Adenosine triphosphate is a chemical substance that gives cells energy. Without a sufficient amount of this chemical, the cells in the liver die off”.*

What is involved in treatment?

If caught very early (immediately after ingestion) dogs can be made to vomit.  You may do this at home if you can not get to the vet immediately, although you really do need to head to the vet as fast as possible.  Patients are put on fluids and blood glucose is monitored regularly for up to 24-48 hours depending on how the patient is doing. If required medications are given to increase the blood sugar levels.  Approximately 24 hours after ingestion the liver enzymes are checked, medication is given if needed and in either case, the enzymes are checked again approximately a week later.  Due to the regenerative nature of the liver, it is not suspected that there is any long term effect if the patient has a full recovery.

What can you do?

Check the products you have in your home, make sure that items with xylitol are completely out of reach of your dog.  Be certain not to share any sugar-free treats like pudding, with your pet.  If your dog does ingest a product with xylitol the faster you react the better the outcome.  Call your vet as you are heading there to alert them to the emergency.  Do NOT wait.  The sooner your pet receives treatment the better the outcome will be.

Speaking from the heart

I personally have dealt with this in my dogs.  Unknowingly a package of gum was left where my dogs could get at it – in my purse that got set on the floor.  I discovered the chewed up package about 5 mins or less after it happened.  There was at least 16 pieces of gum in the pack.  Although I was fairly certain which dog was the culprit I couldn’t be sure both dogs hadn’t ingested it.  I got the dogs in the car and while I drove in to the clinic, my husband calledahead to let them know I was on my way and what had happened.  The first step was getting them to vomit – my one dog ate 2 pieces, my other dog vomited up a well chewed pile of gum – enough to make our entire treatment room smell like mint.   We immediately put them on fluids and monitored their blood sugar levels overnight.

Finny & Drift

Fortunately due to my fast actions they never had a drastic dip in levels.  The next day their liver enzymes were checked and a week later again they were checked.  Each time the blood work came back in the normal ranges.

I am so thankful that I caught this so quickly.  Had I not discovered the chewed package for half an hour or more I very possibly could have lost one, if not both my dogs. What do I do with xylitol products now?  Personally I don’t buy them.  They are not allowed in my home.  I have a dog that loves to go on the hunt for anything she can find and I am just not willing to take the risk that next time the outcome won’t be so good.

 

Additional Sources:

Xylitol: This Toxic Sugar Substitute Could Be in Your Purse, Pocket or Pantry     *Quote taken from this article

Xylitol Kills Dogs! So Kill the Xylitol in Your Diet

 

 

Dental Health is So Very Important

by: Meghan Eggertson

Managing dental disease is one of the most common and important ways in which we can relieve pain and suffering in pets. By the age of 3, 80% of dogs and 70% of cats have some degree of dental disease. The rate at which dental disease develops depends a lot on the individual animal’s confirmation and genetics; some animals can go several years without ever needing their teeth cleaned, while others need annual dentals to prevent the progression of periodontal disease.

moderate-gingivitisTeeth are held in place by the bones, ligaments, and gums surrounding them. Periodontal disease is the progressive loss or destruction of these tissues around the teeth, and can lead to infection and loss of teeth. The earliest sign of periodontal disease is gingivitis. This is inflammation of the gums caused by the body’s inflammatory response to plaque. Plaque is the biofilm of bacteria and their by-products, salivary components, and oral debris that accumulate on the teeth. It is what is removed during brushing. If not brushed off, plaque mineralizes to form tartar/calculus within about 24 – 48 hours, and this promotes the accumulation of even more plaque. Brushing does not get rid of tartar; it can only be removed by scaling. Gingivitis can be reversed with a proper dental cleaning. Just remember, if the gums are red, they are infected and painful!

DDD_dog_gum_diseaseAs the tartar continues to build up, it begins to push down between the teeth and the surrounding tissues. This weakens the bones and ligaments and causes the teeth to become loose and the roots to be exposed. At this point the affected teeth need to be extracted to prevent chronic pain and infection.  This is why it is recommended to do a dental cleaning under general anesthetic when gingivitis first becomes evident.

A dental cleaning under general anesthetic is a relatively safe and routine procedure that can be done at almost any age. We start with removing all the tartar off the teeth with an ultrasonic scaler that can clean both the crown of the tooth and below the gums. Once the teeth are clean, we are able to do a thorough exam using a dental probe to check for any pockets, root exposure, or lesions. Then radiographs (x-rays) are taken to see what the roots and surrounding periodontal structures look like. They can show us fractures, resorptive lesions, root infections, and bone loss that are under the gums and may not be evident during the exam. The teeth are all charted and the veterinarian decides if any need to be removed. Removing a tooth can be an extensive process because dog and cat teeth have much longer roots than human teeth. We start with cutting the tooth into its individual roots, then elevating each root separately to detach it fully from the ligaments and bone. The gums are sutured over the resulting opening(s). All teeth are polished and rinsed with an antiseptic solution to smooth the surface of the teeth and make it more difficult for plaque to build up again. Watch our video of a dental cleaning.

Cleaning teeth with a hand scaler on an awake patient is not recommended. The plaque and tartar under the gum line, which is what really causes the progression of periodontal disease, and on the inside surfaces is not removed. Therefor the teeth look clean, but dental disease continues to progress and the pet can still be in pain and lose teeth due to it. Scaling without polishing also creates an etched surface on the tooth so plaque accumulates more quickly and again promotes the progression of periodontal disease.

Home care is the most essential component in both preventing and treating periodontal disease. Brushing is the single most effective means of removing plaque and should be done on a daily basis. Introduce brushing to your pet gradually as early as possible since young animals are more tolerant; that being said, even older pets can learn to accept having their teeth brushed if you work on it slowly and make it enjoyable. Watch our video on how to brush your pet’s teeth.

Dental diets and chews encourage chewing and have either a texture that reduces the accumulation of dental deposits (Hills t/d, Veggident chews) or an enzyme coating that helps break down plaque (Royal Canin Dental, CET chews). We recommend a product with a VOHC (Veterinary Oral Health Council) seal of approval. These diets and chews should be used in conjunction with brushing. Chlorhexidine gluconate oral rinse is the oral antiseptic of choice for animals. Oral rinses augment mechanical oral hygiene (ie brushing) but will not prevent gingivitis on their own. Even with proper and extensive home care, most animals will still need to have their teeth cleaned professionally (just like people!) but it will slow down the progression of dental disease and increase the time between dental cleanings.

Dental Group

Maintaining good oral health in your pet has many benefits including better smelling breath, decreased pain, and a longer lifespan. Small dogs and cats live 15-20% longer and large dogs live 10-15% longer if they receive dental care as needed throughout their life. This is because infection in the mouth may cause disease of organs throughout the body including the heart and kidneys. If you have any more questions regarding dental disease or to book an appointment for a dental exam, please contact us.