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Christmas can be a very busy time for veterinary clinics; here are a list of common intoxications and conditions to keep an eye out on during this festive period.

Chocolate

  • There are numerous online calculators to determine whether a toxic dose has been consumed – they are a great place to start
  • I always perform emesis in patients that have ingested chocolate even hours after ingestion as often large amounts can reside in the stomach
  • Remember that cardiac arrhythmias can also occur in clinically normal looking patients so perform an ECG
  • The toxic components can be reabsorbed through the bladder wall therefore urinary catheterisation is a part of management of this intoxication.

Onions

  • Onions used in roasts and on BBQ’s can cause heinz body formation, haemolytic anaemias and pigmenturia
  • This is not a common intoxication but should be considered in anaemia patients and those with discoloured urine.

Raisins

  • Commonly used in Christmas cakes and puddings.  It can cause acute kidney failure, the exact mechanism of action is unknown and there does not appear to be a dose dependant relationship
  • It should always be a differential for azotemic patients this time of year
  • IV fluid induced diuresis for 48 hours is the safest way to manage raisin exposure

Mistletoe

  • The berries can be fatal even if only a couple are ingested

Ethylene glycol

  • In colder climates, ethylene glycol can be a very common toxicity.
  • This sweet liquid is very attractive to pets and can cause acute renal failure with the first signs being acute onset ataxia.

Macadamia Nuts

  • Macadamia nuts are common in some parts of the world.  It results in joint pain in the hocks and carpus leading to weakness and ataxia
  • Often confused with trauma and soft tissue injuries.  Hyperextension of the hocks and sometimes flexion of the carpus are the clinical features.

Xylitol

  • Xylitol is a sugar-free product used in lollies and in baking
  • In dogs, it triggers endogenous insulin to be released and a subsequent hypoglycemia develops.  It can also cause hepatic failure.

As a general rule, I approach all intoxications as if they could be fatal as it is rare to know exactly how much of the toxic agent they have been exposed too. I consider that if a patient that I am treating for an intoxication never develops clinical signs and I wonder whether it was going to or not is the best outcome.

Strings

  • Look under the tongue
  • Linear foreign bodies can be difficult to diagnose, some features on abdominal radiographs to look out for include: abnormal bunching of the small intestines and “c” and “comma” shaped gas patterns

Christmas meals

  • Gastroenteritis is the most common presenting condition over the Christmas period with dietary change and indiscretion often being the culprit
  • Bones can lead to obstructions from oral cavity to the intestines and can also cause constipation
  • Leftover meat trimmings, often fat laden, are a common cause of pancreatitis

Christmas decorations & presents

  • Ornaments and decorations can shatter easily causing cuts and wounds or be ingested and cause intestinal issues and complications.
  • Chewing through light cables can cause a nasty electric shock.

Fireworks:

  • These can cause major stress in dogs, who when scared will run away – often ending up in the emergency room because they were hit by a car or hurt themselves in unfamiliar territory.

BBQ skewers

  • In some parts of the world (Australia especially) BBQ’s are common around Christmas time
  • BBQ skewers can cause gastrointestinal tract perforation and septic peritonitis
  • Because they are not radiopaque they are often difficult to diagnose.

Here’s to a very merry – and safe – Christmas!