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All Posts in Category: Poisons

Pets, Snowstorms and Winter Emergencies

Nearly half of the U.S. has been buried under snow this year. In Charlottesville alone, we have had multiple school closures and heavy snowstorms. And during such storms, we constantly field calls about what to look for in terms of pet safety and what constitutes an emergency when driving conditions aren’t optimal (making the trip to the animal hospital more than a little challenging). Hopefully this post will clear up some of these types of questions.

TRAUMA
Trauma is one of the last things people consider to be a potential problem for pets this time of year, but it actually seems to be very common. Hidden ice can be just as treacherous for pets as for humans, often resulting in broken bones and/or soft-tissue trauma. Making sure your pet is always on a leash when walking on potentially icy areas — and avoiding icy areas altogether — is very important. Foot pad trauma and serious lacerations from sharp ice are also common problems. We also see a number of toenail traumas (pulled out toenails) due to getting caught in ice cracks or thick snow areas. The easiest solution to many of these problems is to outfit your pet with winter pet boots this time of year. Most dogs do just fine with tolerating the boots, which provide padding, grip and pad protection.

HIDDEN CAT TRAUMA
If you live in a neighborhood with outdoor cats, it’s very important to check under your car hood, near your fan belt and along the base of your car tires for a cat who may be using your vehicle to stay warm. Cats will seek warm spots in which to brave the cold, but they’re often unlucky in the timing of their naps. The severe trauma that comes from engine damage, once the car is started, unfortunately is something many veterinarians see far too often.

HYPOTHERMIA
Trust the old adage that if it’s too cold for you outside, it’s too cold for your pet to stay outside. If you can’t bring your pet into your house, consider a garage, basement, barn or heavily sheltered area with a heat source like an overhead heat lamp or heating pad. Many people assume that pets have thick fur coats and can adapt to frigid temps, but a domestic animal can get wet and hypothermic outside in a matter of minutes. If you suspect your pet has hypothermia, please SLOWLY start warming them up until you can seek veterinary help. One of the worst things you can do is warm an animal too quickly after being very cold for a long time — gradual warming might make the difference between life and death.

OUTSIDE TOXINS
If you’re a regular reader of this blog, you might be aware that antifreeze is toxic to pets and can lead to acute kidney failure and death (see our previous blog post here). There are some pet-friendly — and kid-friendly — antifreeze products made from propylene glycol, and we highly support using these. It’s important to check your car regularly to make sure you don’t have any unwanted leaks. These kinds of toxins are another good reason to walk your dog on a leash this time of year, to prevent them from ingesting fluids from underneath other people’s cars.

There are also many sidewalk deicers that are toxic to dogs. The majority are calcium based, which can cause local irritation to the skin and, in large enough doses, vomiting and diarrhea. Some magnesium-based deicers can, in large enough doses, cause hypotension, heart arrhythmias and unsafe changes in phosphate blood levels — conditions that would all require immediate veterinary care. If you think your pet may have walked through a deicer, you can wash the product off with water and a mild dish soap such as Dawn. In the vast majority of cases, doing so will be sufficient to prevent any problems. There are pet-safe, urea-based deicers on the market that cause less skin irritation, but these products are harder to find. Rock salt on roads and sidewalks can also be very locally irritating to skin and, if large enough amounts are consumed, can cause vomiting, excess drinking or urinating, muscle tremors and seizures. If you have put down rock salt, make sure you wipe down your pet’s feet after coming inside — and again, consider placing boots on your pet’s feet. As a good rule of thumb, all outside pets should have their feet rinsed after walking on treated sidewalks.

INSIDE TOXINS
This time of year, people are more likely to put down rat and mouse poisons, because — just like us — rodents want to be indoors where it’s warm. Make sure any such poisons are placed in areas where your pet would have absolutely no access to them, and in places where a rat wouldn’t be able to drag the poison out in the open (see our post on rat poison here).

Another common seasonal toxin is liquid potpourri. Make sure your potpourri is in an area where pets can’t knock it over and get it on their skin, in their mouth or in their eyes; the liquid can cause ulceration to all these areas.

Finally, when people are “trapped” inside during the wintertime, they are more prone to consume alcohol, coffee and chocolate. Make sure these are all kept out of reach of your pets (see our previous post on common toxic kitchen items here). Snack foods and other human treats are never good for your pets.

PET FOOD SUBSTITUTES
If you happen to run out of dog food because you’re snowed in, there are many online recipes for bland, human-based pet food alternatives. Boiled chicken and rice is one of our favorites, but you can substitute pasta for rice, and hamburger or lean beef for chicken. Try to avoid raw meat and fatty or heavy foods like pork and fatty beef. You would need to transition your pet from bland dog food to human food (hopefully only for a day or two) and then transition back with very gentle meals. In these cases, multiple, smaller feedings will be much better for your pet than larger, heavier meals.

Remember, most cities and areas have an emergency vet office that will be open or at least available for calls during snowstorms. The Greenbrier Emergency office has beds for our on-duty staff, just in case, and we encourage you to give us a call if your regular vet is closed. Be safe, stay warm, and stay off the roads if at all possible — and think of the coming warm springtime weather!

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Marijuana Toxicity in Pets Becoming More and More Common

Marijuana. It has many nicknames — pot, weed, grass, reefer, honey oil, Mary Jane — but if it is consumed by your pets, it can be harmful.

As more states and districts legalize marijuana, we anticipate seeing more marijuana toxicity in pets. Although people use pot recreationally or medically, it’s toxic to pets. Dogs (and very, very rarely cats) usually present with in-coordination and stupor and act like they want to fall asleep while standing, then quickly right themselves. The dog will likely have dilated pupils, deep-injected bloodshot eyes and rapid breathing, and they are often incontinent. The culprit ingredient is delta 9-tetrahydrocannabinol, more commonly known as THC.

The most common ingestion we see in the ER is marijuana-infused baked goods, especially brownies. Pot brownies have the double effect of chocolate toxicity to go along with marijuana toxicity. We get dogs that have eaten the owner’s entire “stash” (along with the plastic bag), as well as marijuana-infused butter products, which are even more toxic due to higher THC concentration.

Most signs of toxicity usually start 30-180 minutes after ingestion, and because THC is stored in fat, the signs can persist for up to 96 hours. While the mild-to-moderate symptoms listed above are more common, we have seen dogs present with more serious conditions from active seizing to total unconsciousness. We also have to treat plastic bag ingestion or chocolate toxicity in certain cases (see other blogs on these topics.)

If you suspect your pet has ingested marijuana, it’s important to be honest during the history-taking part of your visit! This is very important and can save your dog from unnecessary tests, as well as prevent you from spending money on tests your dog does not need. Understand that in the U.S., veterinarians are not obligated to report marijuana intoxications to the police, and having your vet know what he/she is treating is extremely helpful to the management of your pet’s problem. This can be especially important because other toxins can present themselves in similar ways, but can be fatal or far more serious.

If the ingestion has occurred within 30 minutes we usually try to induce vomiting in your pet. However if your pet is already showing clinical signs, the antinausea effects of THC can make it very difficult to induce vomiting. We will usually also give a product called activated charcoal to help bind up any remaining marijuana in the gastrointenstinal tract. Marijuana can undergo something called “enterohepatic recirculation,” where it goes from the GI tract to the liver and back to the GI tract, causing the effects to last longer. Multiple doses of charcoal, spaced apart by several hours, are often used to help prevent this situation. Intravenous fluids are also used to help stabilize your pet and assist him/her in eliminating the drug. If your pet is seizing or has lost consciousness, more intense treatment may be given as well over a longer duration in the hospital.

With good supportive care, the majority of pets with marijuana toxicity do well. Unfortunately, depending on the amount your pet has ingested and the severity of signs, marijuana toxicity could also be fatal. Like any toxin, early diagnosis and treatment of the problem are always crucial. Do not be shy when telling the vet what your pet got into — it might save his/her life!

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Tremorgenic Mycotoxin Toxicity: The Moldy Shakes

The compost pile, a seemingly innocuous feature of your outside garden, can seem like a great idea, for a variety of reasons. Unfortunately, this kind of eco-friendly heap of decomposing organic matter can also look like a free meal to your dog. As food in a compost pile starts to decay, a variety of molds can grow on it — molds that won’t always deter a dog from wanting to enjoy an outside feast. Many of these molds (at least 20 varieties are known to inhabit compost piles) produce mycotoxins that can have negative health effects. Ingesting even a small amount of mold can cause small muscle tremors and ataxia (which will cause your pet to look like he/she is drunk or having trouble walking) for a period of hours or days. A large amount of mold exposure can cause severe tremors, seizures and even death.

Spoiled food and fats in the compost pile can also cause gastrointestinal problems, including vomiting and diarrhea (sometimes bloody). Moldy dairy products such as cheese, moldy nuts such as walnuts or peanuts, moldy grains, and pastas are often the culprits behind these kinds of issues.

Apart from food found in compost piles, moldy refrigerator food thrown outside or in the trash can also potentially expose your dog to toxic molds. If you suspect that your pet has gotten into a compost pile or moldy trash, please take him/her to a vet immediately. Depending on whether the pet is showing signs of toxicity, your dog may be made to vomit. We never recommend the inducing of vomiting at home, due to possible complications. For instance, if your pet isn’t stable, he/she could inhale their own vomit or bloat. At the vet, a dose of activated charcoal is also often given to help absorb toxins from the GI tract.

Most dogs with this kind of mold toxicity likely will be kept in the hospital on IV fluids and given muscle relaxants to address any tremors, until the tremors cease. Antibiotics are also sometimes used to treat any diarrhea. A hospital stay can range from one day to several days, depending on how much mold your pet consumed and how quickly they were treated by a veterinarian.

Just like anything else, with mold toxicity, prevention is key. Keep compost piles in areas out of reach of your pet, or keep the material in a secure composting container. Also, don’t throw food away in inside trash cans. Most outside trash cans are much sturdier, and some are made to be difficult for a dog to open — even if the can is overturned. Finally, avoid throwing moldy food from your refrigerator in your backyard.

© 2012 Greenbrier Emergency Animal Hospital. All rights reserved.

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Nicotine Toxicity in Pets

Recently here at Greenbrier Emergency Animal Hospital, we had a patient that presented with full body tremors, was drooling, was excited, and started vomiting and experiencing diarrhea. The owner had stated the dog was normal in the morning, and the dog’s presentation condition was consistent with her getting into something. However, after asking the owner numerous questions, we were unable to identify what the dog potentially could have ingested. It wasn’t until the next morning, when the owner was smoking, that she noticed several cigarette butts in front of her house were missing.

Nicotine toxicity in dogs and cats is more common than most people think, and it is especially common in pets with owners who leave cigarette packs out or toss cigarette butts outside. Nicotine is most commonly found in cigarettes, cigars, nicotine gum and candy, and nicotine transdermal patches. The average cigarette (depending on the brand, blend and whether it is marketed as a “light cigarette”) contains 13-40 mg of nicotine, and it doesn’t take much nicotine to cause problems — the lethal dose for a dog is 9.2 mg of nicotine per kilogram of your pet’s body weight. Incidentally, an average cigarette butt contains about 25 percent of the nicotine present in an unsmoked cigarette, so they can be toxic as well.

Nicotine gum actually has to be chewed — not swallowed (which most dogs will do) — to release nicotine. However, the sweetener xylitol, which is also toxic to pets, is often added to nicotine gum.

Once nicotine is ingested, signs typically develop within 15-90 minutes. However, in some cases it can take hours for symptoms to emerge. Initially you might see your pet being hyperactive or acting overexcited. They might also start drooling, experience vomiting or diarrhea, or even look like they are having trouble breathing. At higher doses or for longer exposures, your pet might show signs of weakness, start twitching or having muscle tremors, have an elevated heart rate, collapse, and even die. So nicotine toxicity is a potentially life-threatening condition.

As with any toxicity, early treatment and diagnosis are crucial, so be sure to bring your pet to your regular vet or to Greenbrier Emergency Animal Hospital. If your pet is not already vomiting upon arrival, a drug is typically given to make them vomit. Activated charcoal is also administered to help absorb nicotine from the GI tract. Your pet will also likely be put on IV fluids; started on antacids; and given oxygen, if they are having trouble breathing. Usually within 24 hours of treatment, your pet should be almost back to normal (although diarrhea can sometimes take 1-3 days to resolve).

Our cigarette butt eater here at Greenbrier came through just fine, but the experience should serve as a reminder to all pet owners who smoke: Keep your cigarettes, cigars and other nicotine-containing products out of reach of your pet. And think twice before just tossing that cigarette butt!

© 2012 Greenbrier Emergency Animal Hospital. All rights reserved.

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PODCAST: Rat Poison and Pets

Unfortunately, many pets get into toxins — even toxins that were meant to get rid of pests like mice and rats. An extremely common type of toxicity is rodenticide, or rat poison. There are three main groups of rat poison used, and they can all be very toxic to dogs and cats (and our exotic pets, too).

Patients that have the best prognosis from this type of toxicity are usually those that are actually seen eating the rat poison by their owners, who then bring them in for treatment right away.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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Grape toxicity and pets: Delicious but deadly

Grapes may be one of people’s favorite fruit-based snacks, but they are not a safe snack for our pets. While grapes don’t cause humans any harm, they can cause acute kidney failure in dogs, and even possibly in cats. Despite recent research, the exact agent in grapes that causes the toxicity is still unknown. It was previously thought that perhaps something related to pesticides or heavy metals in grapes was causing the problem, but that hypothesis has since been disproven. Current theories suggest that the fleshy portion of the grape, rather than the seed, is the toxic culprit. Thompson seedless grapes, the common green ones from the supermarket, statistically seem to create the highest number of problems in animals — however, this could just be because that variety of grape is the most commonly purchased. Other products made from real grapes, such as raisins, grape juice and grape jelly, have also shown to cause problems. And heated and fermented grape products, like those used in baked cookies and cakes with raisins, can also be toxic to pets. One notable exception is grape seed extract, which is found in some pet products and synthetic grape-flavored medications, and is not currently thought to be a pet hazard.

One of the most frustrating things for owners is just how small an amount of grape ingestion can be toxic. I have had people tell me, “Well, he only ate 2 or 3 grapes,” or “Well, he got into some trail mix with raisins, but there weren’t many in it.” Unfortunately, any known grape ingestion — regardless of the amount — could potentially cause a problem.

People also tell me, “I have been giving my pet grapes for years without a problem.” Regardless of what you may have given your pet in the past, that doesn’t ensure that your pooch won’t react badly to grapes in the future. In fact, some dogs that have eaten grapes in the past with no signs of toxicity ultimately may run into trouble with them. The consequences of grape toxicity can be severe, so why take the risk? To avoid these kinds of problems, we highly recommend not giving your pet grapes in any amount.

Like many other products that are toxic to animals, your pet may appear normal for up to 24 hours after they eat grapes or a grape product. Within 24 hours or so, you might start seeing them not wanting to eat, vomiting, acting like their abdomen is in pain or experiencing diarrhea. Within 48 hours after ingestion, they can start experiencing more serious problems, such as showing a decrease in the amount of urine they produce — or not producing urine at all. These are some of the signs of acute kidney failure.

And just like any toxicity, early treatment is the key. If you suspect your pet has eaten grapes, raisins or products containing them, bring your pet to Greenbrier Emergency Animal Hospital or to your regular vet as quickly as possible. Grapes can sit in the stomach for hours after being ingested, so your vet will most likely give your pet an injection to make them vomit. They may also be given what is known as activated charcoal to help bind up any additional grape products in the GI tract. Your pet will also likely be placed on intravenous fluids for 48 hours and have their kidney function checked daily for 72 hours via a blood test. The prognosis of any given case usually corresponds with how soon you realize that your pet has eaten the grapes — and how fast you react to get them the proper treatment.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Winter Hazards for your Pet

Now that the holidays are upon us, I thought it would be a good time to remind pet owners of the many common household items that can be hazards to pets during the winter season. I’ll start with a list of common food items that can present serious problems for pets. Many of these items have their very own blog entries, so please search our blog after you read this post if you’d like more detail. I am constantly surprised by how many people aren’t aware that these foods are potentially toxic to pets, so I don’t think we can list them too often.

Foods
Yeast bread dough: converts to alcohol, causes bloating
Moldy foods: contain toxins that can cause tremors
Macadamia nuts: can lead to weakness, depression, vomiting
Chocolate: GI and cardiac signs, can make pets hyper excitable
Onions, garlic, leeks, onion powder: can lead to anemia
Xylitol (contained in sugarless gum): causes low blood sugar, liver toxicity and blood clotting disorders
Grapes/raisins: can lead to kidney failure. For some dogs, it only takes a few.
Fatty foods: can cause pancreatitis

Plants
The following plants are toxic to pets:
Lilies: can cause kidney failure in cats
Holly: can cause gastrointestinal problems, lethargy
Mistletoe: can cause gastrointestinal problems and is a cardiotoxin
Poinsettia: can cause irritation to the mouth and gastrointestinal problems and is a mild toxin

Holiday-related items
Since many of the items below only come out seasonally, they can be a novelty — especially for those curious cats or puppies. Take care to pet-proof your holiday decorations!
Christmas tree water: can be laden with bacteria and/or pesticides; causes gastrointestinal signs
Ribbons/tinsel: cats especially love these, and they can cause linear foreign bodies requiring surgery
Liquid potpourri: can cause severe oral, ocular and dermal damage
Electric cords: can lead to electrocution, fluid in lungs

Other toxic items
Antifreeze: Extremely toxic to animals!! Lethargy, “drunk” behavior, kidney failure
Ice melt: irritating to skin, paws and mouth

Please keep your pets safe this holiday season. If you think your pet has ingested any of the above, please seek veterinary attention immediately. Many of these toxins can be mitigated with early veterinary intervention.

Dr. Elvira Hoskins

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What did my dog get into … ivermectin?

Here at Greenbrier Emergency Animal Hospital, we’ve had two very interesting cases lately. This first one was a middle-aged dog who was disoriented. On examination, he was suddenly and completely blind! The second case was a 7-week-old puppy who was normal when the owner went to bed — but In the morning, when the owner woke up, the puppy couldn’t walk and was barely responsive. On examination, this puppy was also suddenly blind! What did these two cases have in common? They were both either on or near a horse farm. Ivermectin toxicity was suspected in both cases, and within a few hours (for the puppy) and a few days (for the older dog), they were completely back to normal.

Ivermectin is a drug commonly and safely used in many dogs to treat a variety of parasitic infections. This drug is also commonly used in cattle and horses at much higher doses — which can be toxic to dogs, if they are exposed to the medication. Certain types of dogs, including but not limited to collies and Australian shepherds, are also far more susceptible to the toxic effects of the drug.

Toxicity signs include depression, disorientation, nonresponsiveness, blindness, drooling, tremors, and walking like he/she is “drunk.” More severe signs, especially in the susceptible breeds, include low heart rate, low breathing rate, coma and death.

Treatment often is centered around supportive care, which may include intravenous fluid therapy, nutritional support and appropriate nursing care. Although ivermectin toxicity can be fatal in rare cases, many dogs do well and make full recoveries. Sometimes it just takes time. If your pet is displaying any abnormal neurologic behavior, or you suspect your pet has ingested anything toxic, bring him/her to your local veterinarian (or to Greenbrier after hours) immediately.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Common Kitchen Items that are Toxic to Your Pets!

We just had a client come in to Greenbrier Emergency Animal Hospital the other night with a common case of toxicity involving a seemingly harmless snack. The owner had been feeding her dog grapes when her friend (thankfully) walked in and informed her that grapes are, in fact, toxic to dogs. We also recently had a dog come in after getting into her owner’s chewing gum stash. Both dogs had to be hospitalized, but happily both are doing just fine now. In both instances the owners asked, “Why didn’t I know that this was toxic to dogs?” The reality is that quite a number of commonly used household items and foods are dangerous if ingested by your pets. So in the interest of public awareness, here’s a list of potentially dangerous items that you may have in your own home. Some of these you might already be aware of — but some will probably surprise you.

Grapes/raisins/currants
These toxins are relatively new toxin discoveries in the veterinary literature. They can cause kidney damage and failure, although the mechanism by which the damage occurs is still unknown at this point. They affect all dogs differently, so the lowest dose for toxicity has not yet been worked out. It’s best not to give your dogs or cats any of these!

Yeast dough
Yeast dough can cause problems for your pet in two different ways. The stomach provides a warm environment for yeast to rise, and this kind of expansion in the stomach can cause a lot of discomfort. In extreme cases, the intestines can rupture. The other harmful effect of yeast is that as it ferments, it produces alcohol, which can actually cause alcohol poisoning — just as liquor would in your pet.

Onions/garlic/chives
These toxins can cause gastrointestinal upset if eaten in small amounts. Larger amounts can cause damage to red blood cells, causing them to rupture and resulting in anemia, which can in some cases be severe.

Xylitol
Xylitol is an artificial sweetener that is becoming more and more prevalent in the kitchen. Xylitol is often found in chewing gum and toothpaste and is now also showing up in some baked goods. Its toxicity is unknown in cats, but in dogs it causes low blood sugar in small doses, and liver failure in larger doses.

Macadamia nuts
Signs of macadamia nut toxicity include weakness, depression, tremors, abdominal pain and an elevated temperature. The exact mechanism of toxicity is not fully understood.

Chocolate/coffee
Many people are aware that chocolate and coffee are toxic to pets. Patients with this kind of toxicity present with a really elevated heart rate and can, in severe cases, suffer a heart attack. While many people would not feed their pets coffee, we have had pets come in to Greenbrier with coffee toxicity from getting into coffee grounds in the household compost pile. And when it comes to chocolate, the darker the chocolate, the more toxic it is.

All of the above can cause signs ranging from mild irritation and toxicity to more severe symptoms. It’s very important, if you suspect that your pet has gotten into any of the above, that you seek advice from your veterinarian or animal hospital to determine the optimal next steps for your pet. Many times, your vet will recommend that your dog be made to vomit and/or receive supportive care and further decontamination in a veterinary hospital. But the best treatment is prevention! Spread the word!

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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