Visiting Vet: On call

Dogs ingest a diverse diet of non-food items.


An August morning. I’m the veterinarian on call. Pendleton, an elderly Labrador retriever, has a mass the size of a large plum dangling from his belly. The growth had been there for years, never bothering him, so we had opted to leave it alone, but recently the bottom portion ulcerated. Now there was a funky, secondary bacterial infection and the mass needed to come off quickly. A fellow veterinarian, Dr. Amy Delisle, who happened to be spending August with her family in Oak Bluffs, agreed to do the surgery here, while I saw appointments and fielded emergencies. 

My first telephone call was about a medium-sized husky who had consumed several pieces of sugar-free gum. Now some people wouldn’t even know this was cause for concern but this owner was aware of the dangers. Many sugar-free foods are now sweetened with xylitol, a naturally occurring substance found in plants such as berries, lettuce, and mushrooms. Xylitol looks and tastes like sugar but has fewer calories so it’s use as a sweetener has become increasingly popular. It can be found in products including sugar-free gum, mints, toothpaste, mouthwash, peanut butter, cakes, and candy. People metabolize xylitol without difficulty but in dogs, xylitol ingestion can lead to a profound, life-threatening drop in blood sugar. Signs, which can persist for a day or more, include vomiting, lethargy, weakness, collapse, and seizures. In small dogs, ingestion of as little as one piece of gum can be fatal.

The dog in question weighed about 35 pounds and had eaten at most two to three pieces of gum. “Do you have the packaging?” I asked, hoping to gather more information. The owner had what was left of the wrapper but it was all chewed up and difficult to read. I wasn’t sure if the amount consumed was enough to cause serious hypoglycemia in a dog this size. In any case, it made sense to induce vomiting to try to remove the gum from his system, then to monitor his blood sugar. In some cases, depending on dose, we just spot check levels every few hours. In other cases, it is best to hospitalize the animal. If hypoglycemia develops, the dog must be started on intravenous fluids containing sugar in the form of dextrose and closely monitored. Since effects can last 24-plus hours, this husky might need to go off-Island for round-the-clock intensive care. I suggested the owner immediately call the ASPCA Pet Poison hotline, consult with their veterinary toxicologist for specific recommendations, then call me right back. 


In the meantime, the next call came in about a little dog who had been found chewing on a dead bat the night before. Because people can contract rabies, which is almost invariably fatal, rabies protocols are carefully mandated by state law. How we handle each case depends on whether the pet in question is currently vaccinated, whether the animal the pet was exposed to is wildlife or domestic, and whether the second animal is available for either quarantine or rabies testing. We have recently had two cases of confirmed rabid bats on the Vineyard. In 2012 a man on the Cape died from rabies from a bat bite. We don’t need to panic but must take these laws very seriously and be vigilant. 

The owner of the dog had contacted the Animal Control Officer earlier. She told me he was sending the bat’s remains to be tested for rabies. Another family member who had been subsequently licked by the dog had sought emergency care at the hospital and started post-exposure treatment. Since the dog had a current rabies vaccination, my job was simply to administer a booster and provide oral and written information about rabies. We should know in 24 hours if the bat was rabid. But then there was a glitch. 

Squeamish Alert. To test a dead animal for rabies, the lab needs the brain … but it turned out that the remains of the bat in question no longer included the head. Now what? Without a test, we have to assume it carried rabies, in which case the little dog must be quarantined for 45 days. But the owner had been planning on leaving the Island to return home the following day, walking on the ferry with the dog. In September 2003, 22 people received post-exposure prophylaxis treatment after contact with a puppy on the Nantucket ferry that was later determined to have rabies. Of course, there is an incubation period before which an animal is not infectious, and today’s little dog was vaccinated, so should be immune, but an ounce of prevention is worth a pound of cure, especially for a disease that has no cure. 

I called the Massachusetts Department of Public Health, Bureau of Communicable Disease, Division of Epidemiology. They passed me on to the Bureau of Animal Health, who said to call the local Board of Health, who said to call the Animal Control Officer. Silly me. I should have just called Animal Control Officer Tony Cordray in the first place. He had everything under control. Turns out the bat in question had been dead a long, long time. Because the remains were thoroughly dried out and dessicated, the state specialists were not concerned about rabies. They still mandated the dog get that booster shot but owner and pup were free to travel.

After sorting this all out, I realized I hadn’t heard back about the gum-eating husky. Time was of the essence if we were going to induce vomiting to “decontaminate.” Shuffling through scraps of paper piled on my desk, I found the phone number. “Hi, it’s the vet on call,” I said. “Any news from Animal Poison Control?” Turns out the particular product in question, Wrigley’s Sugarless Extra Long Lasting Flavor Sweet Watermelon Gum, is not sweetened with xylitol, but with sorbitol, a different sugar substitute that isn’t dangerous to dogs. No need to induce vomiting. No need for an emergency trip to the vet. Phew. And Pendleton’s surgery went just fine. Thanks, Amy.