Regardless of what others, including your vet, may have told you, if you suspect that your dog has been poisoned you have very little time in which to collect yourself and determine what to do. This is the time for immediate action because if you lack the tools and supplies with which to begin treatment the result is a dead dog.
The reality is that if you are not prepared to treat poisoning resulting from ingestion of a toxic substance, you lose and your dog dies. Acute poisoning requires accurate assessment. The threat is not only related to the potency of the poison but also the quantity consumed, the duration of exposure, and the presence of other active ingredients such as adjuvants and solvents. The difference between immediate appropriate action and delayed response is the difference between life and death. It is therefore vital to be prepared, which means not only having antidotes and treatments to hand but being familiar with the signs and symptoms of poisoning and knowing what risks are in your dog's environment.
Prior knowledge
The first step in treating poisoning is prior knowledge. You have to be able to recognise that there has been a poisoning. Symptoms may vary significantly from animal to animal, from substance to substance and with the amount ingested. You must be accurate in your differential diagnosis. To treat on the basis of the wrong diagnosis is to increase the probability of death.
The second step of treatment is prior knowledge. You must know what poisons are in the dog's environment.
The third step in treatment is prior knowledge. You must know the immediate actions required, which can include artificial respiration/resuscitation.
One way of thinking about poisoning in dogs is to relate it to poisoning in children because whatever poisons are there for a child to ingest are also there for a dog.
Lead comes first on the list of 275 toxic substances prioritised by the Toxic Substances and Disease Registry of the US Department of Health. There remain enough old products covered in lead paint to constitute a real hazard even though lead paint was prohibited years ago. In fact, paint is the most common source of poisoning in dogs in North America. Copper pipes with lead solder is also another major source of lead.
Household cleaners are notoriously toxic. Toilet cleaners and drain deblockers, various polishes and dishwasher soaps, paint removers, carburetor cleaners. Anti-freeze, bird repellants, insecticides, rodenticides, snail bait, herbicides, fertilisers are all toxic.
Most household and garden plants are also extremely toxic and landscape timbers edging flower beds tend to be toxic having been preserved to prevent infestation and wood rot.
Moles which have been poisoned by strychnine underground are a source of poisoning and whether or not in a mole, strychnine is strychnine nonetheless.
The medicine cabinet is another repository for dog killing substances. Painkillers which can be bought over the counter constitute a major risk to dogs, as do anti-inflammatories. The most common cases of dog poisoning in this way are the result of dogs being given or themselves taking ibuprofen, aspirin and indomethacin.
Aspirin can be toxic to dogs. Toxic doses disrupt the acid/base balance and may result in metabolic acidosis (low blood pH) or compensated respiratory alkolosis (high blood pH).
Symptoms include: restlessness, hyperventilation, deafness, rapid pulse, nausea, vomiting, high temperature, dehydration, pulmonary oedema (abnormally large amounts of fluid in intercellular tissue spaces), acute renal failure, abnormally low blood glucose levels and abnormal bleeding. Stupor and coma are indications of severe poisoning. Peptomismol commonly used to combat stomach upset and diarrhea also contains aspirin.
NSAIDS are non-streroid anti-inflammatory drugs with narrow safety ranges. Acute poisoning may cause nausea, vomiting, epigastric pain, deafness, dizziness and diminished urine output. Apnea (cessation of breathing) and near coma, liver and kidney failure are possible.
Prescription preparations used to treat menstrual irregularities and moderate pain may cause convulsions in overdose quantities.
Categorising poisons Organising poisonous substances by category makes it possible to treat a class of poisons with relative confidence, even when the identity of the exact poison is unknown. These categories are given below. For the dog owner diagnosis of category of poison is probably the most important information that can be given to the attending veterinarian.
Being prepared "The lethality of modern toxins is such that the niceties of having a veterinarian administer all treatment is overcome by events and a lack of time in which to respond".(Cargill & Thorpe-Vargas). So one has to be prepared and this means you must have certain supplies to hand. The absolute minimum is:
Syrup of Ipecac, 3% hydrogen peroxide, activated charcoal and vegetable and mineral oil. Some breeders also keep Diazepam (Valium) on hand to reduce convulsions (or to take themselves!)
If a dog is somewhere that concentrated agricultural pesticides are mixed, it might be worthwhile to keep atropine in case of organophosphate poisoning. Organophosphates don't have to be ingested. They work effectively on contact.
Symptoms of poisoning:
- drooling
- vomiting
- tiredness
- convulsions
This combination in an otherwise healthy animal not known to have central nervous system problems from trauma, high fever, distemper etc is immediately suggestive of poisoning.
Following is a list of categories of poisons and their associated treatments.
First aid protocols
Immediate first aid generally breaks down into two protocols:
¢ Corrosives - do not induce vomiting, give some oil orally.
¢ Non-corrosives - induce vomiting followed by gastric lavage or activated charcoal slurry (ACS).
It is extremely important to get these two protocols correct.
For poisoning with acids, alkalis, petroleum distillates and stinging nettles DO NOT INDUCE VOMITING. These substances can cause great damage coming out, especially if aspirated.
In both protocols, treatment for shock and other supportive therapy such as intravenous fluids and oxygen may be needed. In any event, standard first aid procedures of checking the airway, breathing and circulation should be part of the initial evaluation.
NB: Some poisons have antidotes, others have none, The sooner the poison is removed or absorbed or moved through the system, the less its effects will be.
Inducing vomiting To induce vomiting Ipecac syrup is recommended and activated charcoal for gastric lavage. Similarly, 1-2 teaspoonsful of hydrogen peroxide 3% can be given every 15 minutes until vomiting occurs. Soapy water can also be used to induce vomiting.
Activated Charcoal Slurry ACS After vomiting,give ACS - activated charcoal mixed with water to a slurry consistency( I teaspoon for dogs less than 25 lbs 2 teaspoons for dogs over 25 lbs )
CATEGORY 1:DO NOT INDUCE VOMITING POISONS
Acids. Do not induce vomiting but rinse the mouth and other areas that have come into contact with the acid. Give 1-2 tablespoonsful of cooking or mineral oil.
Alkalis (laundry detergents, ammonia, paint removers) as for above.
Petroleum distillates (petrol, pain thinner, charcoal lighter) as above
Stinging nettles as above. Note: the dog may exhibit slow and irregular pulse.
CATEGORY 2: INDUCE VOMITING POISONS
Bird repellent, an extremely toxic white powder. Symptoms include excitability, increased salivation, tremors, uncoordination, convulsions, cardiac or respiratory arrest. If responsive induce vomiting, give ACS. Seizures may require anti-convulsant medications.
Anticoagulant rodenticides (rat and mouse poisons). Symptoms vomiting, abdominal pain, bloody stool, lethargy. If ingestion occurred less than 12 hours you may induce vomiting, give ACS. Follow up care: Vitamin K treatment by a vet.
NB: The new generation of rodenticides can persist in the body for 6 months as the liver keeps changing them to another form of anticoagulant, therefore treatment should continue for at least 6 months.
Anti-depressants. Overdoes symptoms include drowsiness, agitation, hyperactive reflexes, muscle twitching, rigidity, convulsions, respiratory depression, coma, low blood pressure, irregular pulse. If responsive, induce vomiting and give ACS. Treat seizures with Diazepam (Valium).
Arousal using toe pinches can keep the dog from drifting into a coma while on the way to the vet.
Arsenic (herbicides and insecticides) Induce vomiting and give ACS.
Aspirin and salicylates Induce vomiting, give ACS
Barbiturates (sleeping pills/sedatives): drowsiness, failure of muscular coordination, confusion, stupor, and coma. Deaths may occur from cardiac and respiratory arrest.Induce vomiting, give ACS.
Bufo - toad poison. Toads are attracted to dog's watering dishes and may sit long enough at the rim to leave sufficient toxin to make a dog ill. Untreated, the death rate is significant and with some breeds of American toads, may be 100%.
Dogs may also mouth toads, thereby getting a large dose of bufo toxins which are secreted from the skin and paratid glands. Symptoms generally include profuse foamy salivation that looks like shaving cream, difficulty breathing, convulsions, paralysis, ventricular fibrillation, vomiting, cyanosis and hallucination.
Treatment involves dealing with 3 poison mechanisms: Cardiac effects, effects on blood pressure and hallucinogenic effects.
If the dog is sufficiently alert, vomiting may be induced. Repeated doses of oral charcoal (every 2-6 hours) may help reduce the duration of poisoning, Saline or Sorbitol may be given with the first charcoal dose. Intravenous insulin and sodium bicarbinate may be required to combat life threatening elevated serum pH levels. Atropine, phenytoin and lidocane may also be useful to manage abnormally slow pulse and other cardiac irregularities
Carbamates - insecticide, herbicide and fertilisers. Induce vomiting, give ACS. Atropine, administered by a vet, should be started as soon as possible.
Calcium cyanamide or nitrolime, used as a fertiliser, insecticide and herbicide. Note that this has a different effect than cyanide. Symptoms are vertigo, difficult or laboured breathing, abnormally quick pulse, high blood pressure. Induce vomiting and give ACS. Note: Atropine is not antidotal. Give IV fluids if needed and vasosupppressor drugs if necessary.
Chocolate, contains theobromine which triggers epileptic seizures in susceptible animals and can cause cardiac irregularity leading to heart attack and death. Chocolate also irritates the gastrointestinal tract to the extent that it may cause internal bleeding that can kill within a couple of days. Induce vomiting, give ACS.
Cyanide - rodenticide, is one of the fastest acting poisons, death occurring in just a few minutes. Symptoms usually appear within seconds of exposure and involve giddiness, palpitations, breathing difficulties, loss of consciousness, convulsions and death. If responsive, induce vomiting and give ACS. Administer 100% oxygen as soon as possible.
Ethylene glycol (antifreeze, colour film processing solutions, heat exchange fluids, ice-rink freezing equipment, windscreen de-icer, brake and transmission fluids). Quick treatment is necessary to prevent the formation of toxic metabolites. Symptoms are similar to alcohol intoxication and include staggering, excessive thirst, excessive urination, nausea and vomiting. If treatment is provided less than 4 hours after ingestion absorption can be prevented by inducing vomiting and gastric lavage. After that period, metabolism of ethylene glycol must be blocked by other means. Until recently, only ethanol was available to inhibit the formation of toxic metabolites. An alternative, 4-methylpyrazole 5% has since been used as an inhibitor in dogs. Preference is given to the latter as it does not suppress the central nervous system.
Lead is found in paint, insecticides, ceramics, linoleum, golf balls. . Symptom include seizures, bizarre behaviour, inability to coordinate voluntary muscle movements, lethargy,sporadic vomiting. If you live in a house built or painted before 1980 you can realistically suspect that there is lead in the environment. Induce vomiting, give ACS.
Metaldehyde or slug killer Symptoms include increased salivation, abdominal cramps,, vomiting and generalised tremors or seizures. Some dogs stagger, show signs of overheating and cardiac irregularity. Induce vomiting, give ACS . Anti-convulsants may be necessary. Iv fluids help protect the liver, assist detoxification and facilitate excretion.
Non-steroidal anti-inflammatory agents (NSAIDS) -(Panadol, ibuprofen, etc) Induce vomiting,give ACS. Diazepam (Valium) may be used to control seizures.
Opiates. Poisoning with morphine and other opioids depresses the central nervous system resulting in drowsiness to deep coma, respiratory depression, low blood pressure and hypothermia. Spasticity, muscle twitching and convulsions may be present. Induce vomiting, give ACS. Narcotic antagonists such as naloxone may be needed.
Organophosphates or insecticides (dichlorvos. Fenthion, Malathion, etc) are very quick acting. Symptoms include constricted pupils, increased salivation, bradycardia, low blood pressure, constricted breathing, vomiting, diarrhea, urinary incontinence, muscular weakness, restlessness, anxiety, convulsions, coma and respiratory failure. If sufficiently alert, induce vomiting and give ACS. If oxygen is available administer before giving atropine.
If the dog is unconscious the stomach still needs to be emptied which must be done by a vet by gastric intubation. Treatment may need to be continued for several days and respiratory failure may last several days also.
Phenols (Lysol, creosote, fungicides, herbicides, wood preservatives). Decking is often treated with these and puppies and dogs chewing this can develop a problem. Symptom include salivation, vomiting, dizziness, loss of pupillary reflexes, hyperthermia, convulsions and coma. Vascular collapse is the cause of death, with respiratory depression a contributory factor. Induce vomiting and give ACS. If creosote has been ingested, however, and swelling and redness of the throat are evident, do not induce vomiting. Valium may be required to control seizures.
Sodium chorate is a defoliant and soil sterilant. Onset of symptoms may be delayed some 12 hours after ingestion. Symptoms include vomiting, abdominal pain, diarrhea, hypotension. There may also be cardiac effects. Death results from shock, lack of oxygen in the blood, heart failure or disseminated intravascular coagulation. Induce vomiting, give ACS and sodium thiosulphate to decompose the remaining chlorate. Sorbitol may be administered if diarrhea is present. Oxygen, IV fluids and blood transfusion may all be required.
Strychnine -rodenticide Symptoms include exaggerated reflexes and muscle contractions especially in dogs legs. If responsive and reflexive symptoms haven't started, induce vomiting and give ACS. Otherwise veterinary treatment is required, Valium may control the convulsions. By keeping the dog very quiet it may be possible to avoid the onset of convulsions.
Sympathomimetic agents such as amphetamines, adrenaline, ephedrine, naphazoline, various 'cold/flu' decongestants, cough mixtures, appetite suppressants. Symptoms include irritability, agitation, hyperactivity, dilated pupils, rapid heart beat. Confused mental states may be observed and in severe overdose, seizures and cardiac failure. Induce vomiting and give ACS.
Theophylline and related drugs (asthma medications) medications which tend to be left out where dogs have access to them. Symptoms include nausea, severe and intractable vomiting, abdominal pain, gastrointestinal bleeding with severe toxicity, agitation, restlessness, dilated pupils, convulsions and cardiac effects. Induce vomiting if it has not already occurred and if vomiting can be controlled give ACS. Control convulsions with Diazepam (Valium). Hydration may be required.
Tobacco Nicotine is extremely toxic and very little is required to kill a dog. It has a history of being used as an insecticide and has very potent properties.
After ingestion a dog may present with central nervous system derangement, hypersalivation, vomiting, diarrhea, rapid heartbeat hypertension and hyperthermia followed by total collapse. Induce vomiting if conscious and responsive and ACS.
Hops. Spent hops from home brewing presents a danger to dogs and is potentially fatal in four out of five cases. Symptoms include panting, restlessness and signs of increasing pain. The most significant symptom is a rapid increase in temperature called malignant hypothermia. Treatment involves gastric lavage,charcoal slurry, cold water baths and IV sodium bicarbonate to reverse metabolic acidosis.
Plant Poisons Poisonous plants are common and within easy access for most dogs. It is virtually eliminate them from a dog's environment. Treatment generally involves inducing vomiting, giving ACS and supportive treatment.
Really poisonous plants are mostly ornamentals and include ivy, holly, oleander, laurel, privet.
Certain kinds of mushrooms are also highly toxic.
Surviving poisoning If a dog is to survive poisoning there will almost certainly be some damage to major organs and various metabolic processes will have been disrupted.
Commonly, the liver and, to some extent, the kidneys are injured. The liver I the major organ responsible for the breakdown of toxins, Everything that is absorbed from the lower gut is transported to the liver by the portal vein. An overload of toxins can cause such severe damage that death from secondary causes can result.
The liver manufactures most of the plasma proteins and all of the proteins responsible for blood clotting. It also monitors and maintains blood sugar levels. Bile, also manufactured by the liver, breaks down dietary fat and is the chief mechanism for extracting heavy metals.
One of the ways the liver helps rid the body of toxins is to chemically alter them so as to make them more water soluble. At this point the poison can be excreted by the kidneys and to some extent by the skin and lungs. But sometimes these breakdown products or metabolites can actually be more dangerous in their chemically activated forms. Ethylene glycol (found in anti-freeze) is a good example of this as the various metabolites formed when the liver breaks down this substance will sequentially attack the central nervous system, lower the pH of the blood to fatal levels and damage the kidneys.
Those metabolites not excreted by the kidneys are processed by certain enzymes. If there is a lack of these the activated metabolites build up in the bloodstream and create havoc with the liver and kidneys. Thus there is great danger of a toxic detox reaction. Nutritional support favours the sequential elimination of toxins and can prevent or ameliorate the damage done.
Recovery This may be long and uphill. Nutritional support is considered by some vets to be effective. The aim is to reduce the work load of the liver and kidneys so a bland rice of white rice is recommended for a few days and it is advisable not to feed proteins or fats which are processed by these organs.
Some vets also recommend a range of antioxidant vitamins and minerals.
Stress reduction is also especially important during detoxification.
Conclusion Prevention is better than cure. Potential for poisoning is everywhere. Anything you can do to poison proof your house is worth doing for your dogs. Unfortunately, it isn't possible to remove all toxins from the environment. Therefore you need to be prepared. Keeping this article available for reference may be of help.
Helen Graham - March 2011
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