Baffled by barfing

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Peaches is a pudgy pooch with a past. An older dog, his original owner had been unable to care for him well, so Peaches had been living in less than ideal circumstances. Luckily for him, he was recently adopted by a new family. When a rescue animal moves to a new home,  he may arrive with behavioral baggage. It’s not his fault. He may never have been taught to come, sit, or stay. He may not have been taken outside to heed the call of nature, having to relieve himself inside, instead of being housebroken. Poor nutrition, inadequate rations, or unpredictable feeding schedules may cause possessiveness over food. Conversely, he may have been overfed and never exercised, leading to obesity and poor physical fitness. He might have been abused, neglected, or simply never socialized, learning to run away, hide, growl, even bite, in order to survive. New owners need patience and time to figure out a rescue dog’s special needs and how to help him adjust.

Peaches’s former life was not as tough as many rescues I have known, but he had his challenges, including obesity. Once he started settling in, we put him on a weight loss program. It’s not unusual for dieting dogs to try to foil our good intentions by finding, well, let’s call it “alternative food sources,” so I was not surprised when one day he presented with a complaint of vomiting.

“He was lethargic and off his food last night,” his owner said. “Then this morning he threw up five times, and he’s been having these spasms where his whole body twitches.”  Hhmmm. Twitching all over? That’s not a simple upset tummy.

“Any chance he got into the compost or garbage?” I asked.

Garbage intoxication — when a dog dines out on a meal of unidentified nasty stuff and  develops neurological symptoms in addition to the usual vomiting and diarrhea of plain, old gastroenteritis. Garbage intoxication may cause twitching, seizures, altered mental states, staggering, even coma and death. The clinical presentation depends on exactly what they ate. Moldy foods can release substances called tremorgenic mycotoxins. (Gotta love that sciencey talk.) Break down those long words and all that means is poisons (toxins) from mold (myco) that create (genic) twitching (tremors). Hallmarks of garbage intoxication include sudden onset and history of access to rotten food. If dogs run loose, we assume they are at risk, despite owners’ protestations of innocence.

My classic example is a dog named Pepper who lived in a rural part of the Island where she could safely hang out loose on her property, or at least that’s what her owners thought. The first time Pepper came in on emergency, she was twitching all over and feeling awful. We treated her symptomatically and she recovered. The second and third times, the twitching progressed to seizures and semi-comatose stupors. Each episode occurred after Pepper had been MIA from the yard. “Looks like garbage intoxication to me,” I ventured. “I think she’s found someone’s compost or trash and she runs off and binges, then gets sick.”

Pepper’s parents were skeptical, but they eventually agreed to keep her confined. The episodes immediately stopped. Several months later, they decided to let her out on her own one evening. Sure enough, that very night,  Pepper had another bout.

“We have a compost,” Peaches’s dad said, “but it’s totally enclosed, and her yard is fenced.”

I grilled him about possible exposure to other substances that could cause both vomiting and tremors. Snail bait, wild mushrooms, medications, insecticides. What about cigarettes?  Did anyone smoke in the house? Aha! Yes! In the backyard was a bucket used as an ashtray. Maybe this was nicotine poisoning?

Even Labradors (who will eat almost anything) usually eschew cigarettes. Tobacco just tastes terrible. But what about a dieting rescue dog? Was Peaches so hungry he ate the butts? Cigars, chewing tobacco, nicotine gum, nicotine patches, even e-cigarettes all can be toxic if ingested. Symptoms include tremors, vomiting, diarrhea, drooling, excitability, constricted pupils, abnormal heart rate, and sometimes seizures. If we catch it early, treatment involves inducing vomiting, giving activated charcoal, and anti-seizure medication if necessary.

For Peaches, it had been too long since he might have eaten them for vomiting to be useful. Besides, he had already emptied his stomach by barfing five times earlier that morning. One reason nicotine toxicity is uncommon is that, when eaten, it tends to evoke a rapid reflex vomiting. Good thing, because it doesn’t take much to kill a dog. For Peaches, at about 20 pounds, just half a cigarette would make him sick. Six could be lethal. If a dog lives past the first four hours, most survive, so Peaches had a good prognosis…if nicotine toxicity was in fact the diagnosis.

I began my exam. Peaches took my proffered treat and ate it happily. He showed no sign of the reported “spasms.” In fact, the only abnormality I could find was that he had a fever. Hhhmmmm again. Fever isn’t typical of either garbage intoxication or nicotine toxicity. With severe tremors, constant muscle activity can lead to an elevated body temperature, but Peaches wasn’t twitching at all now.  Just to confuse things more, he suddenly made a hacking noise, more of a cough than a gag. Fever and coughing? Could it be a respiratory infection? Had he aspirated when he vomited? Or could the fever indicate a tick-borne disease?

The owner went home to survey the compost, garbage, and cigarette receptacles but found no evidence of doggie dining. Peaches got an injection to stop the vomiting. We monitored his fever, and ran a lot of tests, ultimately concluding this was neither nicotine toxicity nor garbage intoxication. In fact, we thought he might have Rocky Mountain Spotted Fever, albeit an unusual clinical presentation — but that’s another column. Peaches responded well to antibiotics and continues to enjoy his new home. He’s slimming down and doing great in the housebreaking department. Now he just has to make friends with the cat.