Visiting Veterinarian : Hard to digest

By Michelle Gerhard Jasny V.M.D.
Published: July 17, 2008

My secretary Elise leans over the Dutch door that separates my desk and hers. I hate the suspense. "There's a lady on the phone whose dog just ate..."

I hold my breath, waiting for the punch line. If I'm lucky, it's something I know. "Your Great Dane ate a brownie? No worries. That's not enough chocolate to affect a large dog." Other times I need to play detective. Like the 1 am call last night.

A medium-sized mutt ate three chocolate bars. "What kind of chocolate?" I yawned. "Hershey's milk with almonds," the owner replied apologetically. "How many ounces per bar?" I put my head down on my desk like a first-grader as the owner found his glasses to read the half-chewed wrappers. "They're 1.45 ounces each," he said. A few calculations later I was able to tell the owner what to do and go back to bed. But it's been a crazy week. I've actually got the number for the ASPCA Animal Poison Control memorized.

Windy's mother called in the middle of a hectic afternoon. Her seven-month-old mixed breed dog had gotten hold of a vial of prescription pain pills left over from her spay months earlier. "What time did she eat them?" I asked. Her owner was unsure. With any poisoning, one of the first things we want to know is time of ingestion. Why? Because if Windy ate the pills within the last few hours, we can minimize exposure by inducing vomiting. "How many did she eat?" Her owner was unsure. Together we determined the maximum number of tablets that might have been in the vial. "That's five times the recommended dose," I said, doing the math. "My text says doses up to ten times normal have been ingested without causing problems, but I'm still concerned. Tell you what..."

I paused. Normally I try to do this kind of research for my clients but did I mention it was a really crazy day? "If you think she ate them within the last few hours, force-feed her a little hydrogen peroxide. It will make her vomit. And call Animal Poison Control, just to be sure there's nothing else we should do." I gave her the number.

The following day another family called. Something was seriously wrong with their eight-month-old pups, Tweedledee and Tweedledum. Dee was agitated, shaky, panting heavily, and drooling. Dum looked, well, worried. It was a hot, muggy day so at first I thought it might be heat stroke. "Hose Dee down in the tub," I suggested. "If he's still panting in 15 minutes, call me back." Dee didn't calm down. His owners arrived with him post haste. Dee was salivating profusely and twitching all over. He could not stand and every minute or two his whole body jerked uncontrollably. Dum was in better shape but also drooling and twitching.

"Could have gotten into the garbage?" I asked, preparing to place an intravenous catheter. "Compost, spoiled food?" No, they were confined to a fenced yard and the house. "They have been chowing down on our hostas, but they've been doing that for months," their owner said."

"I don't think hostas are toxic," I said, thinking of the deer that routinely decimate mine. I gave Dee an injection of Valium to stop the tremors, started intravenous fluids, and began my exam. Dee was pale, his heart racing. His feces contained huge wads of shredded plant material. "He certainly has been eating some kind of flora," I commented. Dum's symptoms were similar though much milder. While the IV dripped, I ran a literature search about hostas. I learned they might cause an upset tummy but were considered nontoxic. "I'd better call Poison Control and double check," I said, watching Dee twitch and drool.

As Tweedledee and Tweedledum received treatment, the specialist assured me hosta was not a problem. "Any mushrooms in their yard?" she asked. The owners didn't think so, and since vomiting and diarrhea are usually the first signs of mushroom toxicity, we decided this too was unlikely.

"What about mulch?" the doctor asked.

"Cocoa mulch?" I countered, knowing this product had gotten a lot of press for potential pet poisonings.

"Yup. But other kinds of mulch too. They can get moldy and contain mycotoxins causing signs like these." I was about to question the family about their landscaping habits, when one of the owners remembered leaving a bottle of prescription medication on the table earlier. Maybe the dogs had gotten the vial? "Go home right now and look," I instructed. Sure enough, Dee and Dum had eaten a bottle of prescription medication that accounted for their symptoms. A definitive diagnosis allowed us to tailor our treatment appropriately with further help from Animal Poison Control.

Later that evening, as I sat with Dee, who was still getting intravenous fluids, I got another call. A five- pound toy poodle pup had just swallowed seven matches. "Matches?" I mused. I had never had a case of match ingestion before. I put the caller on hold and went back to the computer. Hmmm. Not much information. A few worrisome comments about methemoglobinemia, a blood disorder that could be serious. In most cases I wouldn't have been too concerned, but this dog was tiny. "Here's the number for Animal Poison Control," I said yet again. We learned that matches may in fact cause a problem in smaller dogs. The rule of thumb is you start to worry at one match per pound body weight. Since this teeny poodle had eaten seven matches to his five pounds body weight, Poison Control advised that the owner induce vomiting.

How does an owner make a poodle barf at home? The standard method is to give 3 percent hydrogen peroxide, which many people have in their medicine chests. For years I have advised owners to force feed the nasty stuff to their dogs but Animal Poison Control had a pleasant alternative. First feed a little food, like a piece of bread. This will give some bulk to help bring everything up out of the stomach when the dog vomits. Then mix the peroxide dose in something the dog likes. The tiny poodle ate his teaspoon mixed in peanut butter. The sixty-pound Windy drank her three tablespoons in milk. Both dogs threw up and are now doing fine.

If peroxide doesn't work, your veterinarian can use other methods to induce vomiting. Never give peroxide to cats. In dogs, peroxide can occasionally cause serious side effects. In some cases, vomiting is contraindicated, so always check with your veterinarian or Animal Poison Control first. The number is 1-888-4-ANI-HELP. I know it by heart. Uh-oh. Here comes Elise again. "There's a lady on the phone. Her cocker spaniel just ate a bunch of chicken bones...."

Gotta go.