Visiting Veterinarian : Alcohol and pets don't mix, on Martha's Vineyard or anywhere else
He had just finished watching Saturday Night Live. I used to watch SNL but nowadays usually nod off by nine o'clock. "I thought I'd have a nightcap," he told me on the telephone at quarter to two in the morning. "So I poured myself a bit of bourbon." I used to pour myself a bit of bourbon too, but, nowadays usually nod off by . . . (see SNL reference above). Sincerely apologetic for waking me, he had good cause. After getting his drink, he had stepped out of the room momentarily, setting his glass on the floor. Upon returning, he discovered his six-pound Yorkshire terrier had drunk an ounce of bourbon and was passed out on the floor.
I've seen dogs high after eating marijuana brownies, twitching all over from ingesting cigarettes, doped up from any number of drugs, legal and illegal. Most survived. Some died. I have also intentionally gotten dogs drunk. No, it's not animal abuse. It's treatment for antifreeze poisoning. Antifreeze tastes sweet and animals will drink it from driveway puddles, winterized toilets, leaking radiators. As little as a teaspoon can cause fatal kidney failure.
If seen by a veterinarian within a few hours of ingestion, they can sometimes be saved, either with a commercial antidote or by taking intravenous alcohol for several days. (Do not try this at home. Seriously.)
We actually use diluted vodka in controlled amounts, but it's enough to cause some odd behavior. I remember a huge Newfoundland who lurched around the clinic — a big, happy, sloppy, drunk. And a Blue Tick Hound who got unpleasantly agitated if caged but would calm down if we let her climb on a table in the waiting room, where she would sit howling and singing. I've seen people do that at bars.
But our Yorkie, let's call him Johnnie Walker, he was a different story. One ounce of bourbon in a six-pound dog is like an average person drinking 20 shots. Johnnie had alcohol poisoning.
The toxic component in alcoholic beverages is ethanol. Beer is three to five percent ethanol. If Dad had poured a Budweiser before bed, Johnnie would have been fine. Wine is a bit higher, at nine to twelve percent. Hard liquor, even higher at 40 to 90 percent. On an empty stomach, alcohol gets absorbed quickly, within 15 to 30 minutes. A full stomach may slow things down by an hour or two, but clearly in this case the alcohol had gone rapidly into Johnnie's bloodstream.
An intoxicated dog may have symptoms much like an intoxicated person. Staggering. Excitability. Slowed reflexes. Increased urination. When we get into the realm of true toxicity, however, alcohol depresses all kinds of vital functions and we can see hypotension, hypothermia, low blood sugar, coma, even cardiac or respiratory arrest and death.
Alcohol suppresses the gag reflex, so Johnnie was also at risk of choking if he vomited. So even though the ingestion was recent, it was too dangerous to induce vomiting to empty his system. What about giving activated charcoal that can bind some toxic substances and prevent further absorption? "It doesn't really help with alcohol," the toxicologist at the ASPCA Animal Poison Control told me when I called for input.
The best we could do was treat Johnnie with intravenous fluid therapy to keep his blood pressure up and counteract the diuretic effect of the alcohol. He needed to be kept warm and watched carefully so if he did vomit, he wouldn't inhale and choke. At any moment he might need anti-seizure medication, or oxygen. He might go into cardiac arrest.
Normally I would have sent Johnnie off to Cape Cod Veterinary Specialists in Bourne, where they have round-the-clock nursing care. But short of chartering a plane or calling in the captain of the Patriot, Johnnie wasn't getting off the Island at 3 am. I got an i.v. line going, set up a cozy cage with heating pad and hot water bottles, sent his dad home, and settled in for a long night watching and waiting.
Johnnie lay in a deep stupor, but would occasionally lick his lips, as though to vomit. Nothing came up, but his tongue would roll, doubled over on itself and pushed into the back of his mouth, partially occluding his airway. I would open his mouth and reposition his tongue so he could breathe better, but moments later he would start licking again, and we would repeat the whole rigamarole. Eventually he would fall back into deep sleep. His heart rate was stable, color good, blood pressure low but holding, temperature still subnormal but coming up slowly.
"Maybe I'll put my head down on the desk," I mused groggily. He sure was sleeping soundly.
Wait a sec! Was he breathing? Johnnie? No. He wasn't breathing. I pushed on his chest, rubbed him vigorously, called his name. Johnnie inhaled abruptly and started breathing regularly again. I guess I wouldn't put my head down just yet.
Over the course of the night, Johnnie gave me a few more scares, but basically stayed the same. Out cold. I called the toxicologist repeatedly. "It usually takes eight to 12 hours," she said, "but can be as long as 24."
The Sunday morning sun came up. Eight hours post-ingestion, no change. My assistant relieved me for a few hours so I could nap. Nine hours. No change. Ten hours. Eleven hours. I was beginning to get worried he might have permanent brain damage.
Then, almost exactly 12 hours to the minute after Johnnie's post-SNL nightcap, he opened his eyes and looked around, dazed but conscious. I dropper fed him some water. He licked enthusiastically. Because tiny dogs are prone to low blood sugar, I soon offered a teaspoon of beef baby food. He ate quickly, eagerly looking for more. Two hours later, Johnnie couldn't quite stand, but his tail was wagging, and his owner took him home to nurse what I imagine was a whopping hangover.
Next Saturday night, maybe a nice cup of warm milk?