I am happy to report that at my office we made it through Valentine’s Day and Easter without seeing too many dogs who binged on holiday chocolate or cats exposed to Easter lilies. (Yes, lilies are toxic to cats. If you don’t know that by now, you haven’t been reading my column faithfully. Bad reader! Go lie down!)
The next big national holiday coming up, if we don’t count Cinco de Mayo or Hallmark occasions like Mother’s Day, is (gulp) Memorial Day. You know what that means. People across the Island opening up houses that have been closed all winter. Caretakers going, with their dogs, to turn the water back on in houses with antifreeze in the toilets. Summer folk arriving, with their dogs, to houses with trays of forgotten rat poison in the kitchen.
Every spring it goes something like this. “Hey Doc, I just opened the house I caretake and Deke, my dumb dog, ran in and before I knew it, he was lapping the antifreeze in the john. Is that gonna be a problem?” Or “My dear Dr. Jasny. We are so glad to be back. We just arrived for the season, and Fifi, bless her heart, well, it seems our dreadfully careless caretaker left some rather nasty rat poison out and wouldn’t you just know it? Our little darling actually ate it. I do think we ought to come see you right away, don’t you agree?”
Yes and yes. As far as antifreeze goes, let me just hit the key points quickly. Antifreeze. Deadly. Even in tiny doses. Get help immediately. Really. Immediately. Like in right away. Not after lunch. Not after you finish what you’re doing. RIGHT NOW!! Do not wait to see if Deke starts looking sick. Clinical signs of antifreeze toxicity can take days to appear. By that point Deke is not only a dumb dog, he is a dead dog. Now let’s move on to today’s main topic.
Anticoagulant rodenticides (ACRs). Now that’s a mouthful. Anticoagulant means “against clotting.” Rodenticide means “rodent killer.” ACRs work by messing with an animal’s ability to properly produce Vitamin K, which is essential for normal blood clotting. A critter who consumes enough ACR eventually bleeds to death. But just like with antifreeze toxicity (which kills by causing kidney failure), the deleterious effects of ACR ingestion do not occur immediately. It can take days before Deke shows signs. Therefore, veterinarians can face two different situations with ACR ingestion.
The first scenario is ” acute ingestion,” i.e. Deke ate the stuff within the last few hours. In these cases, the first priority is to get the poison out of Deke’s gastrointestinal tract by inducing vomiting. It is best to have your veterinarian do this with apomorphine rather than your trying at home with hydrogen peroxide, since the former is more effective in completely emptying the stomach than the latter. Time is of the essence, so get to the doctor fast, but do take a minute to collect any remaining product and packaging you can find to bring along.
Most commercially available rodenticides are anticoagulants, but there are other products out there such as metaldehyde, strychnine, zinc phosphate, and bromethalin that have different mechanisms of action and require different treatments. Packaging will help the doctor accurately identify the toxin, as well as the strength and precisely how much Deke ate. Even you can only salvage a few saliva-soaked scraps of paper, over the years I have pieced together many such jigsaw puzzles to get useful information.
After Deke upchucks, your veterinarian may administer activated charcoal (a substance which stays in the gut binding any remaining toxin to prevent further absorption) then prescribe oral vitamin K supplements for two to four weeks. Some ACRs can be extremely long-acting, so length of treatment depends on the particular toxin, another good reason to bring that package. If Deke absorbed some of the poison despite our decontamination efforts, giving oral vitamin K during this period insures we will avoid any clotting problems.
Some veterinarians, if confident that their patient really barfed up all the poison, will not give the oral vitamin K but instead will regularly monitor Deke’s clotting ability over time. Frankly, I am too chicken for this approach and would rather be safe than sorry. When Deke has completed his course of Vitamin K, blood tests can confirm that his clotting ability is up to par all on his own.
The second scenario veterinarians see occurs three to five days after ACR ingestion, when Fifi develops clinical signs. These may include lethargy, depression, bruising, nose bleeds, or blood in her stool, urine, or vomit. If she is bleeding internally all you may see is coughing and pale gums. Clinical ACR toxicity is a deadly situation. It is too late for simple Vitamin K administration, which can take up to 24 hours to kick in. Fifi could bleed to death in the meantime. She needs to be hospitalized, at a speciality facility with a blood bank where she can get multiple transfusions of plasma or whole blood, 24-hour-care, oxygen, and specific therapy depending on where in her body she is bleeding. The worst prognosis is bleeding into the brain or lungs. The good news is that if you get Fifi to the specialist quickly enough, the prognosis is fairly good. Unlike dogs with clinical antifreeze toxicity who usually die from irreversible kidney failure, Fifi has a good chance of surviving the crisis and coming home within a few days.Home. Where from now on you are going to make sure any mouse and rat poison is safely ensconced in pet-proof ” black boxes” from the hardware store, right?
Now go open those houses, but leave the dog in the truck (or the BMW) until you have thoroughly checked for antifreeze in the john and rat poison in the kitchen. You did well so far this year keeping them safe from the chocolate and flowers. Keep up the good work.