Ain't doin' right
Daffodil has always been a cat with attitude. She is affectionate with her owner, but despite behavioral modification and mood-altering medication, Daffodil has been known to bite the legs of guests entering the house and suddenly attack visitors drinking tea in the living room. Luckily for us, she has usually allowed us to work with her at the office, albeit cautiously. So when her mom called recently to say that Daffodil wasn't up to snuff, I figured we could handle it.
Daffodil arrived at my office with a presenting complaint of ADR. That's the mysterious and professional-looking acronym we use for those cases where the symptoms are vague and don't obviously point the doctor in a particular direction. It stands for "Ain't Doin' Right." Give me a vomiting Vizla, a limping Labrador, an Abyssinian with an abscess, and I immediately know where to focus my attention. Not so with an ADR.
Take Hardy, the Jack Russell terrier. Hardy usually sucks his food down like a vacuum cleaner and is energetically playful. When he didn't display his usual gusto at breakfast one day and seemed a bit subdued, his owners were concerned and brought him in to see me. On physical exam, he appeared fine. His temperature was normal. His heart, lungs, and abdomen all checked out okay. I hate it when I can't come up quickly with an explanation for a worried parent.
"Any coughing?" I asked. Nope. "Vomiting?" I continued. Nope. "Diarrhea?" I queried hopefully. Aha! His owner hadn't seen a bowel movement. Maybe Hardy had a little gastroenteritis that was putting him off his game. Let's check it out, I thought, putting on the old latex glove to try to get a stool sample rectally. You wouldn't believe the kinds of things I have retrieved this way from various ADR dogs. Rocks. Bones. Sand. Gravel. Paper towels. Balloons. String. Tinsel. Plastic bags. Toy soldiers.
Bird feed for the birds
Hardy stood fairly patiently while I did the doctor deed. Hmmm. Definitely not diarrhea. Rather the opposite. Lots and lots of small hard things. I extracted a chunk and examined it. (Being a veterinarian is so romantic.) Hardy's poop consisted almost entirely of sunflower seeds and kernels of dry corn. Ouch. "He does like to eat bird seed," his owner confirmed. "He must have gotten into the bag this time." Mystery solved. Take him home and keep him away from the chickadees.
Like Hardy, Daffodil's symptoms were nonspecific. She hadn't been eating well for a few days and was lethargic. For ADR cats who go outside and like to hunt, "dietary indiscretion" is high on our differential list. They probably wouldn't eat bird seed, but they sure eat lots of juicy critters. I call this the "she ate a bad mouse" diagnosis. But Daffodil rarely goes outside. An upset tummy from eating a bird or a rodent was unlikely. Ah, but here's a clue. Her mother arrived for her appointment pet carrier in one hand and a bouquet in the other. No, she wasn't bringing us flowers.
Daffodil had been snacking on the floral arrangement and her owner had very astutely brought it along to show us. Could Daffodil be sick from eating the bouquet? I recognized the daisies and carnations and knew they weren't toxic but there was one large stalk of foliage from which a large number of leaves had obviously been eaten. I had no idea what this particular plant was. Lots of houseplants are safe to munch on, but quite a few are poisonous.
"Let's look her over," I told her mom, taking Daffodil from her carrier. It didn't take more than a minute to see that Daffy was not in a good mood. In fact, she was seriously cranky. Seriously. Now I'm pretty good with mad cats, if I do say so myself, but there was no way I was going to be able to do a thorough examination or draw any blood from this one. And her mom was really worried. "Here's what we do," I told her. "I'm going to sedate Daffodil so I can handle her and do some diagnostics. You take this to the florist. Find out what it is.
I wasn't sure if the plant ingestion had anything to do with Daffodil's symptoms, but we needed more information to decide. We corralled Daffy into our "squeeze cage" which lets us medicate mad cats safely through the bars and gave her an injectable anesthetic while her mom headed out, bouquet in hand.
The florist identified the greenery quickly as Ruscus. That was as specific as they could get. As Daffy got sleepy, I searched my online veterinary data and learned that Ruscus is a member of the Liliaceae family. Drat. The Lily family is a huge one made up of almost 4,000 species in 280 different genera, ranging from edibles like asparagus, onions, and garlic to poisonous species with names such as stagger-grass and death camas.
I knew that at least two species of lilies (not Ruscus) are known to be highly toxic to cats. Ingestion of these two species can lead to fatal kidney failure. I couldn't find any specific references to Ruscus being a danger. There were, however, many different types of Ruscus described.
Not being a botanist, I decided to call in the experts and dialed the ASPCA Animal Poison Control. The toxicologist started her own research. Daffodil was only their second reported case on record of a cat ingesting Ruscus. The first case consisted of a cat that had eaten four other toxic plants along with the Ruscus, so it wasn't clear what had caused that kitty's problem.
As Daffodil snoozed quietly under the influence of our happy drugs, we drew blood to check her kidney function. No abnormalities. That was good news, but it didn't necessarily mean the Daffy was completely out of the woods. Lily-related kidney failure can happen up to 72 hours post-ingestion.
Check again tomorrow
The toxicologist and I conferred. There was nothing in the literature to suggest that Ruscus was toxic. It was probably just causing indigestion, like Hardy's birdseed had done, but there simply wasn't enough data to be positive." It probably wouldn't hurt to give her some intravenous fluids just in case," the specialist suggested. "Then check her again in 24 hours."
Better safe than sorry, I thought, pulling out an intravenous catheter. But as I lifted the clippers to shave her leg, it was clear that Daffodil was coming around. Fast. And she was still mad. Really mad. Without more anesthesia I wasn't going to be able to do anything further. Did I mention she was mad? With no clear evidence to expect serious toxicity, we opted to send her home and watch her closely.
The following day due to continued lethargy we sedated her again, gave her fluids, rechecked her kidney function, and ran some other tests. Everything continued to look okay. Two days late she passed a wad of plant roots in her bowel movement, and seems to be recovering slowly from her ordeal.
The take-home message is to pay attention to your environment. Your pet might choose to chow on something you wouldn't expect, like bird seed or a bouquet. If Hardy or Daffy ain't doin' right, look around for clues. Bring any suspicious items along to the veterinarian. That will help us make the most definitive diagnosis and treatment plan possible.
And one final seasonal note: mistletoe and holly are poisonous. Poinsettias are not, although ingestion may cause indigestion. Keep the plants away from the pets and vice versa. Have a happy holiday.