Our latest webinar “All About Toxicities”, presented by Sophie McMurrough RVN VTS (SAIM) tells you exactly about what it says on the tin. In this webinar we focus in on some of the most common toxicities in dogs; xylitol, metaldehydes, and NSAIDs.
The webinar starts off with some really important resources. I’m going to copy them right here for all of you just in case:
- VPIS (Veterinary Poisons Information service) Animal Poison Line: 1202 50 9000
- VetsNow Tox Box
- BSAVA Poisons Database
Sophie also suggests an in-house toxicity log for when these (and other toxins) come into your practice. The result is an up-to-date case log that you can use to learn from in the future. I’ll also interject that it’s a great resource for students who are seeing EMS! It is suggested to include the date/details of the patient and the toxin details (brand name and active ingredients). These will help you refer back in the future. It’s also important to record information such as ingested dose, clinical signs, lab results, treatment administered, outcome, and external advice if you ring the VPIS number or use any other resources!
If the client phones in, remember to ask them to bring in the packaging. It can contain really important information like active ingredients, concentration, and volume. This can help you to investigate the dose that the pet has ingested.
Unfortunately, one of the most common toxicities in dogs is xylitol poisoning. Xylitol can be found in all sorts, but particularly in some peanut butters. Clients occasionally use peanut butter as a treat, in baked goods (which are snatched off the counter), or as a training method. For some new owners, xylitol might not be on their minds when choosing a peanut butter for their puppy! You can also find it in chewing gums, toothpaste, mouthwash, baked goods, multivitamins, liquid medication, and body care products.
Sophie McMurrough covers signs of toxicity and how long after ingestion you’re likely to see clinical signs. As xylitol causes hypoglycaemia and liver injury, these clinical signs are quite broad and can range from lethargy to coagulopathies to signs of encephalopathy and seizures. The step-by-step treatment and investigation is covered beautifully in the webinar in a really clear and concise way.
Going camping with your dog sounds idyllic, far away from everyone and getting some peace and quiet in front of a big bonfire. Our next toxin is unfortunately lurking right around the corner and is really important to know about if you’re a gardener, a slug farmer, or an avid camper.
One of the most common toxicities in dogs who rummage in gardens, metaldehydes, can be found in slug or snail bait. It’s usually bright green or blue. It can also be found in some solid fuels for camp stoves. It’s a particularly unpleasant toxin. The clinical signs are usually characterised by the phrase “shake and bake”.
The webinar covers the clinical signs, treatment, and management further and Sophie makes an excellent point that bears repeating in this blog. As the seizures can result in hyperthermia, it’s important to actively cool the animal. However, with active cooling we no longer recommend wet towels as they become an insulator, and we no longer recommend cold water as it can result in hypothermia. Instead, put a fan or AC on in the room and make sure everything is cool. Remember to control the seizures as they are the primary factor causing the hyperthermia.
In the case that the seizures are unable to be controlled, total intravenous anaesthesia is an option that you have in your toolbelt. While the patient is anaesthetised, take advantage of your monitoring equipment. This could be capnography, blood pressure monitoring, body temperature monitoring and monitoring urination. As always, it’s important to keep the oxygen flowing, turn the patient regularly and monitor for signs of DIC.
Despite all the above, McMurrough gives a bit of a shining light in the story. With appropriate supportive care and hospitalisation, metaldehyde poisoning carries a good to excellent prognosis.
NSAID’s are everywhere in veterinary medicine. Everyone knows the brand names Rimadyl and Metacam, and homes with elderly pets often have a bottle of NSAIDs lurking about. You wouldn’t think that one of the most common toxicities in dogs is a prescribed medicine but with the event of beef-flavoured NSAIDs, scavenging dogs are at a higher risk of scoffing the whole bottle and putting themselves in danger.
The general rule with veterinary NSAID toxicity is that for GI signs to occur, the patient has ingested five times the therapeutic dose. In the case that acute kidney injury has occured, the patient has ingested at least 10 times the therapeutic dose. However, this can be patient dependent!
Widespread vasoconstriction is the culprit for a lot of the signs we see, including gastric ulceration, renal failure and injury, coagulation disorders and liver failure. The liver failure is due to the hepatocellular necrosis associated with toxicity.
Sophie McMurrough covers a whole host more clinical signs more in depth, and also lets us know of treatment and management. An interesting note that I hadn’t thought about previously is that these patients will often be painful in the areas of the kidneys, so remember to use analgesics! The webinar also has a lot of emphasis on monitoring urine output, and remembering that you should weigh your patient twice a day to monitor water input/output. Sophie lets us know that the degree of azotemia does not always correlate with patient outcome, so take the high values with a pinch of salt.
The list of toxicities for dogs grows and evolves all the time and as these are often cases that come rushing into the clinic, it’s important to keep your knowledge up to date so you can act quickly. Sophie McMurrough does a brilliant job of conveying information in a really interesting and aesthetically pleasing way. The slides are wonderfully designed and I can only say good things about Sophie as a speaker.
I had the opportunity to interview Sophie a few weeks ago in our Facebook group for members, so make sure to check that out. If you’re not a member of The Webinar Vet, you can still join our open Facebook group for more exclusive goodness.