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!