Animal Poison Control Center seeing more cases of Xylitol toxicity in pets.

The sugar substitute, Xylitol, has been a great development in the fight against tooth decay and in helping diabetics gain better control over their disease. However, this popular sweetener may be devastating to the family pet. New research now being released shows that ingestion of Xylitol by dogs can cause liver failure and even death. Reports from the ASPCA Poison Control Center show the number of Xylitol related pet exposures is on the rise and that rise has many veterinarians and pet owners concerned.

For years, veterinarians have suspected that Xylitol could make dogs sick, but an article in the October issue of the Journal of the American Veterinary Medical Association (JAVMA) has documented the outcomes of several cases of Xylitol ingestions in dogs from 2003 to 2005. Five of eight dogs died or had to be euthanized due to complications stemming from Xylitol ingestion.

Often found in human mints, sugar-free gums, toothpastes, and sweets, Xylitol, has been a popular sugar substitute since the 1960s. However, researchers found that even small amounts of Xylitol can cause liver damage and even death in dogs.

Dogs that ingest large amounts of Xylitol have sudden and profound drops in blood sugar levels, leading to weakness and uncoordinated movements. Occasionally, seizures may be seen as well. However, even small amounts of Xylitol are not safe. As little as 1 gram of Xylitol can set off a chain of events leading to liver damage. A dog could receive this amount in just a few candies or sticks of gum containing this sugar substitute. Xylitol can also be found in children’s chewable multi-vitamins, certain cough medications and even mouthwashes.

Although most pet owners routinely give some sort of “people food” to their dogs, the JAVMA report should be a wakeup call, showing that many foods that are safe for humans can be harmful to pets.

Any pet owner concerned about anything their dog has ingested should seek veterinary medical attention immediately.

1. When cleaning your house, never allow your dog access to the area where cleaning agents are used or stored. Cleaning agents have a variety of properties; from those that could just irritate the gastrointestinal tract to those that have a corrosive action and can chemically burn the sensitive mucous membranes of the mouth, esophagus, and stomach.

2. When using rat or mouse baits, ant or roach traps, or snail (big problem in California) and slug baits, place the products in areas that are inaccessible to your dogs. Most baits contain sweet smelling inert ingredients, which can be very attractive to your dog.

3. Never give your dog any medications unless under the directions of veterinarian. Many medications that are used safely in humans can be deadly when used inappropriately. One extra strength acetaminophen tablet (500 mg) can kill a 7-pound cat.

4. Keep all prescription and over-the-counter drugs out of reach of your dogs. Painkillers, cold medicines, anti-cancer drugs, antidepressants, and diet pills are common examples of human medication that could be potentially lethal even in small dosages. Only one half of a 200 mg naproxen tablet could cause stomach ulcers in cats.

5. Low quantities include pennies (high concentration of zinc), mothballs (contain naphthalene or paradichlorobenzene – one or two balls can be life threatening in most species), potpourri oils, fabric softener sheets, automatic dish detergents (contain cationic detergents which could cause corrosive lesions), batteries (contain acids or alkali which can also cause corrosive lesions), homemade play dough (contains high quantity of salt), winter heat source agents like hand or foot warmers (contain high levels of iron), cigarettes, coffee grounds, and alcoholic drinks.

6. All automotive products such as oil, gasoline, and antifreeze should be stored in areas away from dog access. As little as one teaspoon of antifreeze (ethylene glycol) can be deadly in a 7 lb cat; one tablespoon kills a 10 lb dog.

7. When treating your lawn or garden with fertilizers, herbicides, or insecticides, always keep your dogs and cats away from the area until the area dries completely. Discuss usage of products with the manufacturers of the products to be used. Always store such products in an area that will ensure no dog exposure.

GARLIC, ONIONS AND OTHER MEMBERS OF THE LILLY FAMILY
The use of garlic and other members of the Lilly family such as onions, shallots, and chives in the cat’s diet is not advised. Ingestion of these plants in a raw, cooked, or dried form can lead to damage of the red blood cells, which are rejected by the body from the bloodstream, and a continue use of garlic or onions can eventually result in hemolytic anemia. If the anemia is not controlled by discontinuing the use of the plants, it can potentially lead to death. Less significant but important is that raw garlic and onions irritate the mouth, esophagus, and stomach and cause or exacerbate ulcers.
“Onion poisoning in the cat who reported a hemolytic anemia and increase in Heinz bodies in cats that had consumed onion soup. Allicin, which gives garlic its odor, is a strong oxidant, that is, a chemical that creates free radicals, which in excess, can be dangerous. Allicin can cause stomach irritation. If placed directly on the skin, allicin can cause blistering. Cats or Dogs should never be given raw, unaged garlic because it is very irritating to the mouth, esophagus, and stomach and can cause or exacerbate ulcers.
What are Heinz bodies? Heinz bodies are pieces of oxidized hemoglobin. What is Hemolytic anemia? The immune reaction against the bodies own cells is initated by exposure of the cat to a foreign antigen.

DETERMINING WHAT IS NORMAL
1. It is important that you be able to assess your pet’s physical condition in order to evaluate his needs, especially since many animals are stoic and will not show pain or discomfort. One of the MOST important factors in evaluating your pet’s condition is to know what is normal for him or her. Take time BEFORE an emergency to check your pet’s normal temperature, pulse, color and respiration.

To take your pet’s temperature, use a rectal thermometer. Put some kind of lubricant on the tip (Vaseline, oil, etc.). Carefully insert the thermometer about 1 inch into the rectum. Keep the thermometer in place for 60 seconds, then remove it and read the temperature. Most dogs and cats have temperatures between 101 and 102 degrees F. To check pulse, you can often feel the heartbeat by placing your hand on the chest behind the front legs, or by feeling for a pulse along the inside of the back upper leg. The animal’s color can be assessed by looking at the gums or tongue, and the respiration rate can usually be observed by watching the chest.
     a) Hemostat or tweezers – (use to pull out thorns or as a clamp). Hemostats are like fine locking pliers or clamps. They are excellent for grabbing onto things like sticks, thorns, ticks, or anything else that may be caught in your pet’s mouth or skin.
     b) Thermometer – (normal temp in dogs and cats is 101 to 102 degrees F). A low temperature can indicate a very sick animal or hypothermia. In either case it is very important to warm the animal. A high temperature can indicate infection or hyperthermia. Temperatures above 106 or 107 degrees can cause brain damage to your pet.
     c) Styptic powder – This is most useful for stopping bleeding caused by torn toenails.

2. Bandage material – A variety of bandage materials can be used to cover wounds to keep them clean, to provide pressure to help stop bleeding, to cover an injured area so your pet doesn’t lick or scratch at it, to act as a temporary tourniquet or muzzle (even docile animals will snap hard if in pain), or to stabilize or protect a body part.
     1 roll cast padding or soft bandage
     1 roll adhesive tape or “sticky” bandage
     1 roll “Vet Wrap”
     Gauze Squares
     1 roll gauze (can be used for tourniquet, muzzle)

3. Syrup of Ipecac – (use 1 teaspoon per 10 lb. dog to induce vomiting_. If your dog does swallow something poisonous, the best treatment is to get it out of the stomach, UNLESS it is something irritating or caustic. Two of the most common poisons seen by veterinarians are rat poison and antifreeze. Ingestion of either of these is an emergency.

4. Artificial Tears – (To soothe or flush eyes). You can carefully use your hemostats to remove sticks or other foreign objects that may get into your pet’s eyes.

5. 325 mg Buffered Aspirin – (use 1 per 50 lbs for sore muscles, pain). This is very effective for reducing inflammation from sore muscles or joints. It can help alleviate your pet’s discomfort if injured. Not all dogs should take aspirin. Dogs may usually have aspirin every 8-12 hours. Cats are very sensitive to aspirin and should never be given aspirin more than once every 72 hours. Tylenol is poisonous to cats. Check with your veterinarian before giving any medications.

6. 25 mg Diphenhydramine (HCI) – This works well in reducing allergic reactions to insect bites. These reactions can be serious if a pet is stung in the mouth, since swelling could block the windpipe. Check with your veterinarian before using this medication.

7. Whistle – (to signal for help if hiking). If you or your pet is injured, you may often need this to attract help.

8. Triple Antibiotic Ointment – (for cuts and scrapes). This helps our pet avoid infection, as does bandaging.

9. Rescue Remedy – (give 2 drops on tongue every 5-15 minutes in case of shock or trauma). This is a human homeopathic remedy used to treat stress or shock. This can be used any time an animal is stressed or injured.

10. Arnica – (give 2 drops on tongue every 15 minutes for muscle injury and other trauma). A homeopathic remedy that is very safe for your pet.

11. Antiseptic Solution – for flushing wounds (hydrogen peroxide, chlorhexidine). Use this to clean out wounds before applying antibiotic ointment and bandaging.

12. Scissors – Use to cut bandages. A knife is also very useful.

13. Blanket – Animals often to into shock when injured. A blanket will help keep them warm. It can also double as a stretcher.

YARD
The most common source of accidental pet poisoning in California is SNAIL BAIT.

HOME
* ONIONS are TOXIC to DOGS and CATS (and horses) – they can cause Anemia.
* Raw sour dough (as in breadmaking) can have enough ethanol for a pet to be poisoned (play dough contains high levels of salt).

Animals, especially puppies, will find any holiday things appealing and tempting to play with or explore. Shock, electrocution, ingesting odd objects, knocking over things to get at something, burns, broken glass, and toxic plants or painted items can wreck havoc on your pet by injuring or killing them and the efforts to save them can be costly both emotionally and financially. Preventing the hazards by taking precautions is the best cure.

INSTRUCTIONS FOR ADMINISTERING CPR TO YOUR DOG
“Artificial breathing is an emergency procedure used to exchange air in the unconscious dog. Heart massage is used when no heartbeat can be hard or felt. When heart massage is combined with artificially breathing, it is called cardiopulmonary resuscitation (CPR). As cessation of breathing is soon followed by heart stoppage and vice versa, cardiopulmonary resuscitation is most often required in the life-threatening situation. CPR can be performed by one person, but it is easier if two people are available. One does the breating and the other does the heart massage. The following emergencies may require artificial breathing or CPR: Shock, Head Injury, Poisoning, Electric Shock, Prolonged Seizure, Obstructed Airways (choking), Coma, Sudden Death.

Determine which basic life-support technique to employ in an unresponsive dog:
IS THE DOG BREATHING? Observe rise and fall of the chest. Feel for air against your cheek.
IF YES, pull out tongue, clear airway. Observe.
IF NO, feel for pulse.
DOES THE DOG HAVE A PULSE? Feel for the femoral artery located in the groin.
IF YES, employ Artificial breathing.
IF NO, employ CPR.

ARTIFICIAL BREATHING (MOUTH-TO-NOSE BREATHING)
1. Lay the dog on a flat surface with his right side down.
2. Open the mouth and clear secretions. Check for a foreign body. If found, remove. If impossible to reach, execute the Heimlich maneuver.
3. Pull the tongue forward and close the mouth. Place your mouth over the dog’s nose. Blow gently into the dog’s nostrils. The chest will expand. Release to let the air come back out. Excess air will escape through the dog’s lips, preventing overinflation of the lungs and overdistension of the stomach.
4. If the chest does not rise and fall, blow more forcefully; or if necessary, lightly seal the lips with your hand.
5. The breathing rate is one every four to five seconds (12 to 15 per minute).
6. Continue until the dog breathes on his own, or as long as the heart beats.

CPR (ARTIFICIAL BREATHING AND HEART MASSAGE)
1. Continue with mouth-to-nose breathing.
2. Prepare for heart massage. Place the fingers and thumb on either side of the sternum, behind the elbows.
3. Compress the chest firmly six times; administer a breath. Then repeat. Massage rate is 80 to 120 compressions per minute.
4. If possible, do not stop heart massage while administering a breath.
5. Pause every two minutes for 10 to 15 seconds to check for pulse and spontaneous breathing.
6. Continue until the heart beats and the dog breathes on his own, or until no heartbeat is felt for 30 minutes.
It would probably be a good idea to find your dog’s sternum, elbows, femoral artery before you need to know them, that way, it will be one less thing to worry about should you ever need CPR.

HIGHLY TOXIC PLANTS
* A few Holly berries – moderate toxicity, causes vomiting, diarrhea and depression.
* Mistletoe (berries) – Get upset, causes irregular heartbeat, vomiting, diarrhea and heart shock.
* Epoxy adhesives.

HOUSE TOXINS
* Onions – cause severe Anemia.
* Snail Bait – number one poison in California.
* Raw sour dough – used to bake bread, contains ethanol.
* Antifreeze – sweet taste, most commonly found on garage floor.
* Garlic and other members of the Lilly family as are: onions, shallots, chives . Any form, raw, cooked, dried. Causes Hemolytic Anemia
* Raw garlic and onions also irritate the mouth and stomach and can cause ulcers.
* Pennies – zinc.
* Mothballs with naphthalene – one to two is life threatening.
* Homemade play dough – contains a large amount of salt.
* One teaspoon of antifreeze kills a 10# dog.

TIP
Pinesol cleaning products. Alternative to aerosol cleaning products, 1:12 solution(one pint bleach/water) with a little dish soap, cleans well, smells good and is safe.

Anemia results from a low number of red blood cells in the circulation. Red blood cells normally carry oxygen and vital nutrients to all tissues of the body. Anemia can occur because not enough red blood cells are produced or because excess numbers are lost, as with hemorrhage or are destroyed because of a disease or toxins, like Zinc.

Hemolysis is defined as the destruction of red blood cells which normally occurs in the spleen and is how old red blood cells are normally removed. Certain conditions can cause excessive destruction and can result in Hemolytic Anemia.

In 1983, the US Government began minting pennies made of zinc coated in copper instead of pure copper. Puppies and kittens often swallow pennies. This is how Zinc Toxicity became recognized.

Other sources of zinc include nuts and bolts and zinc oxide based skin preparations like diaper rash ointment and sunscreen.

CLINICAL SIGNS
The signs of Zinc Toxicity include:
* Vomiting, diarrhea, and red-colored urine.
* A yellowish color to the gums and Jaundice resulting from liver failure.
* Kidney failure can also occur.

DIAGNOSIS
Zinc is visible on x-rays and should be removed promptly.

TREATMENT
Support is crucial. Fluids are important to prevent kidney failure. A blood transfusion may be necessary to replace red cells in severe anemia. Some dogs also need anti-nausea medication.

Many people are unaware of this because this is a very recently described problem.

PREVENTION
Puppy-proof your home.

WHAT YOU CAN DO
* Bee stings are a frequent problem in dogs, especially the curious puppies that stick their noses in the wrong spots. The most common sign is a big swollen muzzle. You can make a thick paste out of baking soda and water and cover the sting. This is very soothing because it helps neutralize the acid venom. If you have Benadryl on hand then call your vet for the correct dose. This is an antihistamine and helps decrease the swelling. You can also rub one drop of nettle extract directly on the sting. Most dogs will be fine, but occasionally, some dogs have breathing difficulties and need to be watched carefully for 24 hours.

* If you’re camping or taking your dog out on the trails, it’s a good idea to get a snakebite kit. Buy the kind that uses suction to remove the venom. If your dog does get bitten by a snake, compress the wound and the area above the wound, pick up your dog, and take him to the vet for a shot of anti-venom. Try to keep him as still as possible because movement increases the circulation, which increases the rate at which the venom moves into your dog’s body. Don’t put ice on the wound for the same reason.

SYMPTOMS
* Facial swelling around the mouth and nose is common if your dog has been stung by a bee.
* Snakebites may cause your dog to tremble, drool, vomit, or even collapse.

In spite of our best efforts, emergencies happen. You should know your vet’s procedures for emergency situations, especially the ones that occur at odd hours. Being able to recognize a true emergency allows you to react more appropriately in a stressful situation. Keep the telephone number of your vet, as well as that of a local emergency facility, posted in a convenient location.

EMERGENCY SITUATIONS
* Pet poisoning is a major problem. Three of the most common types of poisoning are antifreeze, rodenticide, and garbage. Anytime you suspect a poisoning, call your vet as soon as possible. Symptoms of some poisons do not become apparent until 24 to 72 hours after the fact. In the case of antifreeze, the first few hours are critical. After that, most dogs die because of irreversible kidney damage regardless of therapy.
* In addition to poisonings, other conditions that usually require emergency care include automobile accidents, suspected broken bones, severe bleeding, eye injuries, difficulty in breathing, collapse or convulsions (seizures), inability to urinate, choking, vomiting and/or diarrhea for over 24 hours, appetite loss for over two days in a row, severe depressions, bloated stomachs, or rectal temperatures under 97F or over 104 F.

TIP
Knowing the exact product involved can make the difference between life and death with certain poisons. It’s also helpful to collect any vomitus and/or diarrhea, put it in a Ziploc back and bring it to the vet.

SHOCK
* Being able to recognize signs of shock helps save lives. Shock is defined as a collapse of the heart and lungs; which is the cardiovascular system. Shock involves a group of signs that occur as a result of a life-threatening disease process or situation. There are different types of shock, and each type can be associated with a different type of emergency situation.
* Signs of shock include bright red gums initially, later they become pale white; rapid heartbeat; collapse; shivering; cold extremities: the feet, toes, and ears; and weak pulses. Severe shock will lead to irreversible damage and death unless treated promptly. Treatment consists of fluids to restore the blood volume, medications to counteract harmful inflammation, warming to raise the body temperature, and therapy for the underlying disease or condition.
* In an emergency, you can evaluate your dog’s condition by taking his rectal temperature (normal is 101-102.5F); measuring his heart rate (normal heart rates are 110-120 beats per minute for puppies, 80-120 for small-breed adult dogs, and 60-80 for large-breed adult dogs); and measuring his rate of respiration (normal is 20-22 breaths per minute in a young dog, and 14-16 in an adult dog). Check his gums for color and his capillary refill time. To check capillary refill time press on the gums with your index finger for one second and release – the gum color should return to a normal bright pink color in one to three seconds. You should know how to apply a muzzle and have one on hand. If you feel it is the only option, you should also be able to perform CPR. Checking for corneal eye responses allows you to tell whether an animal is actually alive.
TIP
When you contact your vet or the emergency facility, be ready to provide the following information: your name, address, and telephone number; information about any poison (amount eaten, time since the exposure occurred, exact type of poison involved), the breed, age, sex, and weight of the dog or dogs involved; the problem or current status of the animal.
(NOTE: Be sure your dog can swim to prevent drowning. Water can contain toxic levels of many chemicals and harmful e-coli bacteria.)

Heatstroke is caused by a combination of high temperatures, humidity, and poor ventilation. In spite of the warnings, many dogs suffer from heatstroke because they are left in cars on hot summer days.

SYMPTOMS
* Open mouth.
* Panting.
* Restless, distressed.
* Drooling.
* Unsteadiness on feet.
* Bright red gums.

WHAT YOU CAN DO
* Do not leave your dog in a parked car, as the inside temperature can reach 120F or higher in less than 30 minutes when the outdoor temperature is 85F. Dogs do not sweat like people do; they must pant to cool down. Therefore, they are very susceptible to heatstroke. Breeds with pushed-in faces like Pekingese and pugs, the very young, and the elderly are at greatest risk.
* Quick action is needed to save the life of a dog suffering from heatstroke. Permanent brain damage can occur when the body temperature reaches or exceeds 106F. If untreated, heatstroke can lead to kidney failure. Coma and death can result in severe cases.
* To cool your dog down, bring him inside, soak him in cool or lukewarm water and offer cool fluids but do not force feed water. Take his temperature, normal is 101.5F, and call your vet. Monitor your dog’s temperature at intervals of roughly 10 minutes and when it decreases to less than 103F, take him out of the water. In certain cases, your vet may give fluids as well as medications to decrease the body temperature.

COMPLEMENTARY TREATMENTS
HOMEOPATHIC REMEDIES
Glonoine 30c can help to bring relief in cases of heatstroke (two pellets while on the way to the vet).

To make enough energy to stay warm, outdoor dogs burn 50 percent more calories in the winter so they can make enough energy to stay warm. Their food must be increased accordingly. Normal rectal temperature for a dog is 100-102F, classically 101.5F is the average.

FROSTBITE
* Temperatures below 20F are too cold for most dogs. Cold weather can cause frostbite and sub-normal body temperature called hypothermia. The areas most susceptible to frostbite are the extremities. The nose, toes, ear tips, and tail.
* Frostbitten tissues turn a grayish-white color and require gradual rewarming. Don’t rub or irritate the areas. Give a lukewarm bath and offer warm fluids like chicken broth.

SYMPTOMS
Frostbite:
* Shivering.
* Areas of skin on the extremities become discolored then become red and swollen.
* Hair loss may result.

OTHER HAZARDS
* All dogs are at risk from antifreeze poisoning, which can prove fatal. Antifreeze poisoning is a major wintertime hazard in the cold north. Ethylene glycol is the active ingredient, and has a sweet taste. Less than two tablespoons kills a 10-lb dog. Signs include depression, incoordination, vomiting, and seizures. You must catch this within the first two hours for treatment to be effective. If you are changing your own antifreeze, be sure to clean up any spills promptly and store the rest in a sealed container. Currently a new type of antifreeze called “Sierra” is available. Its active ingredient is propylene glycol, which is much safer for your dog, and still works for your car.
* Salt and de-icing chemicals are irritating to your dog’s feet. Keep a spritzer bottle by your front door and spray feet with water when your dog comes inside, then dry his feet off to prevent irritation.
(NOTE: Wrapping cold dogs in a heat-retaining blanket helps warm them up.)