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Main Street Pet Care- Holiday Pet Hazards Pt. 2- December 3, 2013

Dr. Ben Leavens discusses some of the other dangerous products your pet may face during the holidays and winter.

DANGEROUS PET PRODUCTS

Ice Melts

Many brands of sidewalk ice melts are on the market. The most common ingredients in these ice melts are sodium chloride, potassium chloride, magnesium chloride, calcium carbonate, and calcium magnesium acetate. A few ice melts contain urea. Cats may be exposed by walking on the ice melts themselves or by ingesting granules brought inside on the shoes of the owner’s.

Ingestion of urea is not a toxicity issue in non-ruminants. Ingestion of sodium, potassium, calcium and magnesium salts can lead to vomiting and electrolyte abnormalities. Monitor electrolyte levels and treat with appropriate fluid therapy.

Liquid Potpourri

Liquid potpourri is commonly used during the holiday season. Cats are often exposed to liquid potpourri by direct ingestion from simmer pots or spills, or by rubbing against leaky bottles or simmer pots containing the potpourri, or from spilling the containers upon themselves. Oral exposures result following grooming. Exposure of cats to some types of liquid potpourris can result in severe oral, dermal and ocular damage.

Liquid potpourri is a combination of cationic detergents and essential oils. Cationic detergents can cause extensive systemic and local effects at concentrations as low as 2%. Local tissue injury caused by cationic detergents resembles that seen with exposure to other corrosives. In addition, cationic detergents can cause systemic toxicity including CNS depression, coma, seizures, hypotension, muscular weakness and fasciculations, collapse, pulmonary edema, and metabolic acidosis; the mechanism of these signs is not known. Treatment of local exposure includes dilution with milk or water, pain control (opioids), GI protection (sucralfate slurries) and supportive care (antibiotics, feeding tube). Systemic signs should be treated symptomatically (i.e. fluids for hypotension, diazepam for seizures, etc.).

Ethanol

Due to their small size, cats are far more sensitive to ethanol than humans are. Even ingesting a small amount of a product containing alcohol can cause significant intoxication. Cats are attracted to mixed drinks that contain milk, cream or ice cream (e.g. White Russian, alcoholic eggnog, Brandy Alexander). Ethanol is rapidly absorbed orally and signs can develop within 30-60 minutes. Alcohol intoxication commonly causes vomiting, loss of coordination, disorientation and stupor. In severe cases, coma, seizures and death may occur. Cats who are inebriated should be monitored by a veterinarian until they recover.

Anticoagulant rodenticides

Anticoagulants in use as rodenticides today are almost all second-generation derivatives of either warfarin or indane 1,3-dione. They are active in the liver where they inhibit the activity of vitamin K epoxide reductase, which converts the vitamin K epoxide to the active reduced form. This reduced vitamin K is crucial to activation of clotting factors II, VII, IX, and X.

If ingestion was witnessed or a window of opportunity places it within a couple hours, we generally start with inducing emesis. If little or no bait is recovered, administration of activated charcoal is next. If the ingested dose is over 0.02 mg/kg and there has been no decontamination, you can simply institute Vitamin K1 without initial testing. Because the body has several day’s worth of active Vitamin K stored in the liver (the site of the re-activation activity), there is a delayed onset of effect on blood clotting after ingestion of an anticoagulant. Factor VII has the shortest half-life, so we can get the earliest valid estimate of effect by checking the prothrombin time (PT). The PT is expected to elevate within 24-48 hours post ingestion. A normal PT at 48-72 hours, with no elevation from baseline, is good evidence that there is no need for Vitamin K1 therapy.

When K1 therapy is needed, the dose is 3-5 mg/kg/day. There is no real need to give via injection unless the animal is not eating. If injecting, use the smallest needle possible and give IM or SQ, not IV. Giving Vitamin K1 via IV significantly increases the risk of an anaphylactic reaction. The dose can be divided bid and given with a small amount of fatty food to aid absorption. If necessary, the injectable form can be given by mouth (very small animal, difficult to pill, capsules not available). If there has been a large ingestion or if PT is very high, it is a good idea to repeat the PT after several days. If it is not yet in the normal range, you may need to increase the dose. Repeating the PT 48 hours after the final dose of K1 can determine that treatment has been sufficient.

Early signs of anticoagulant toxicosis are vague, and depend on the site of a bleed. You may see lethargy, a soft, non-productive cough, intermittent lameness, mild anemia, or even sudden collapse. Frequently there is no obvious hemorrhage. Petechiae and ecchymoses are more often seen later in the course of illness, after the platelet numbers have been depleted in smaller bleeds. If there is active bleeding, whole blood transfusions or fresh frozen plasma should be used to replace clotting factors quickly.

Cats are not big bait eaters (when compared to dogs) but they can experience secondary (or relay) toxicosis. This occurs when cats ingest rodents which have ingested anticoagulant baits. Indoor cats which ingest the occasional mouse are not considered to be at risk, but animals which consume large amounts of rodents (barn cats) can develop toxicosis.

Venlafaxine

Venlafaxine (Effexor®) is a bicyclic antidepressant; it is a potent serotonin and noradrenaline reuptake inhibitor as well as a weak dopamine reuptake inhibitor. While it is rare for cats to willingly ingest medications, cats seem to readily eat venlafaxine. Doses as low as 2-3 mg/kg can cause signs. Mydriasis, vomiting, tachypnea, tachycardia, ataxia and agitation are the most common signs. Treatment would consist of emesis in asymptomatic individuals. Activated charcoal can be administered with a repeated dose in 4-6 hours if an extended release formulation was involved. Heart rate and blood pressure should be monitored. Acepromazine may be used for the agitation, and cyproheptadine (2-4 mg per cat, PO or rectally) may be useful in antagonizing the serotonin effects.

Glow-in-the-dark Sticks and Jewelry

Glow-in-the-dark items are popular novelty items and include glo-sticks and glow-in-the-dark jewelry (necklaces, bracelets, etc.). The primary luminescent agent in these types of products is dibutyl phthalate (n-butyl phthalate), an oily liquid that is also used as a plasticizer and insect repellent. Dibutyl phthalate is of low toxicity (LD50 >8000 mg/kg in rats) so serious problems are unlikely.

Even though the extremely unpleasant taste of dibutyl phthalate may limit exposure, some very dramatic signs may be seen. Signs generally occur within seconds of the pet biting into the item. Cats may display profuse salivation and foaming, with occasional retching and/or vomiting. More dramatic are the behavioral effects in cats from exposure to glow items; signs such as hyperactivity, aggression, head shaking, hiding, and agitation have been reported. In all cases, signs are generally self-limiting and should resolve once the cat gets the taste of the product out of their mouth. The exposure is managed by diluting the taste of the dibutyl phthalate using milk or highly palatable food (e.g. canned tuna). Any chemical that has gotten on skin or fur should be bathed or wiped off to prevent re-exposure when the animal grooms themselves; taking the pet into a darkened room will aid in identifying the luminescent chemical on the skin or coat.

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