How to manage a pet that is having seizures

It’s a frightening experience to witness your dog or cat having a seizure. In everyday life, pets are conscious and aware of their owners, responding to your words and actions, but during a seizure, a dog or cat may be standing up or lying on their side, staring blankly, twitching, convulsing and drooling, or making some seemingly terrifying sounds. You may feel scared and helpless, not knowing what’s happening to your pet or what you can do to ease their seeming discomfort.

In this article, we’ll explore what pet seizures are, what the symptoms are, what triggers them, how they are diagnosed and what you can do to manage your pet’s seizures.

What is a pet seizure?

A seizure in a pet is a burst of abnormal brain activity or a temporary disruption of normal brain function. It results in the loss of control of an animal’s motor function, which is why their muscles stiffen and/or twitch or they experience convulsions. Having a seizure is fairly common in dogs, but rarer in cats. Seizures can be a once-off or they can happen fairly regularly, depending on the cause.

What causes seizures in pets?

Epilepsy is the most common cause of seizures in pets. When all other causes are ruled out, your pet may be diagnosed with idiopathic epilepsy. ‘Idiopathic’ refers to the nature of the condition in that it happens spontaneously with an unknown cause. Idiopathic epilepsy is the most common cause of seizures in dogs younger than eight years old, but there may be other causes of seizures such as:

blood abnormalities: anaemia; low blood sugar; stroke; poor blood circulation in the brain; high or low blood pressure
head trauma
calcium deficiency
infectious disease
kidney or liver disease
brain tumour
poisoning/ingesting toxins

Most dog seizure conditions have genetic causes, while in cats, seizures are more commonly caused by disease, tumours, or traumatic head injury. Cat diseases that can cause seizures include feline infectious peritonitis (FIP), feline leukaemia virus (FeLV), feline immunodeficiency virus (FIV), toxoplasmosis, and cryptococcus. Cats can also experience seizures when they’ve ingested toxins – such as pesticides or being given tick and flea medication that’s indicated for dogs – or due to metabolic disorders like diabetes.

What are the symptoms of pet seizures?

There may be different symptoms with different seizures, as no two experiences will be the same. Pets having a seizure may include some or most of the following signs and symptoms:

trembling, convulsing
standing motionless
running in circles
falling down
stiff legs/legs sticking straight out
paddling of limbs
staring/glazed look
drooling
persistent/rhythmic barking
loud vocalisation in cats
unprompted aggression
losing bowel control

What can trigger a seizure?

Seizures can be triggered by conditions that change the pet’s brain activity. From a drop in blood pressure or blood sugar, to the effect of liver and kidney function on the brain, to a pet’s excitement, reaction to feeding time, or falling asleep – there are many situations that may trigger a seizure.

Seizures caused by poisoning or an acute condition may be a once-off, while epileptic seizures can occur regularly, but with no warning signs.

Are seizures painful for pets?

Pet seizures are generally not painful for pets, even though it may look or sound like it. Seizures may be potentially harmful if they cause the pet to fall down a flight of stairs, run into something, or knock something over that can cause injury, but the seizure itself is not painful. Your pet may get confused or panic, but rest assured that they are not in pain.

What to do during a seizure

As a pet owner, you may want to do everything you can to prevent your pet’s discomfort during a seizure, but we recommend the following:

remain calm
keep your hands and face away from your pet’s mouth – they may bite
sit near your pet, but don’t try to touch or comfort them – they may be confused or panicked when they ‘come to’ and accidentally bite you
speak in a low, calm tone if you need to offer comfort
don’t worry about your pet swallowing their tongue – this won’t happen
do not touch your pet unless this is required to move them away from stairs or any objects with which they might injure themselves
time the seizure – this will give the vet important information with which to diagnose or monitor your pet’s condition
film the seizure – it may be difficult to re-experience, but filming your pet’s condition during the seizure will once again offer the vet critical information that will help with a diagnosis or monitoring your pet’s condition

If your pet has not yet been diagnosed with epilepsy or you have not seen the vet regarding their condition, it’s time for a veterinary appointment. Your pet’s seizure may last a few minutes, after which they will need some time for recovery. If they experience a seizure cluster, one seizure will follow another with a short recovery period in between. They may appear confused or exhausted afterwards. Once they have recovered enough to be transported, make an appointment with the vet for a thorough examination.

How are pet seizures diagnosed?

It is vital that you give the veterinarian as much information as possible about your pet’s seizure/s as well as their history, diet and lifestyle leading up to their first seizure. The vet may ask questions such as:

When did your pet experience their first seizure?
How long did it last?
Do the seizures occur frequently?
Have you noticed a pattern in the seizures, such as they occur only when your pet is excited, or after a meal, etc.?
Is your pet’s parasite medication up to date?
Do you think your pet has ingested something toxic (such as a poisoned rodent, rotten food, another animal’s faeces, etc.)?
Has your pet shown any other signs of illness or poorliness?

The vet will perform a physical examination of your pet and may do a full panel of blood tests to rule out any other possible illnesses that may be causing the seizures. X-rays and other imaging tests may be necessary, depending on each individual case.

How are pet seizures treated?

Treatment options will depend on the diagnosis reached. In the case of idiopathic epilepsy – the most commonly diagnosed cause of seizures in pets – treatment will focus on the underlying condition and reducing the risk of triggering seizures as well as reducing their severity. It is vital to follow the vet’s instructions for medicating and treating your pet. Any sudden changes to medication may worsen your pet’s condition or trigger more severe seizures.

Keep the vet up to date with your pet’s condition and record their symptoms and any information relating to their illness/seizures that would be relevant at your next visit to the vet.

Gastric dilatation volvulus

It’s a scary situation when your dog looks like he has a bloated tummy, but he’s really experiencing a life-threatening medical emergency. Gastric dilatation volvulus or GDV is also called bloat, but it’s more than just a bit of air in the stomach. Its other name – gastric torsion – describes how, once inflated with air, the stomach can also twist around itself and cut off blood supply to other major organs. The body then goes into shock and the condition becomes life-threatening.

What causes GDV?

A dog does not suddenly develop gastric torsion or GDV – there are behavioural elements to this condition. It most commonly happens in dogs who eat one large meal a day or who eat or drink a large volume of food or water, gulping air as they consume it. The delayed emptying of the digestive system (potentially due to consuming oil-enriched foods) can also be a factor. Engaging in vigorous play or exercise after eating can trap air in the stomach and twist it. Add to this a dog who is prone to stress and the chances of them developing GDV increase.

After the stomach has already twisted and the contents of the stomach can’t be released, it can continue to distend, pushing up against the diaphragm and putting stress on the heart and lungs. All of this may be going on inside the dog, but what does it look like from the outside?

What are the symptoms of GDV?

A stomach filled with food and air may or may not present as a distended belly, although this is a common symptom. The following symptoms might also present, but again – not all symptoms will show in all dogs with GDV:
•   Vomiting foam or retching without vomiting
•   Restlessness
•   Drooling
•   Look anxious
•   Pacing
•   Stretching with their front legs down and their hips up

If your dog shows any of these symptoms without an obvious cause, but you suspect gastric dilatation volvulus, get him to the vet immediately. If the condition worsens, his symptoms can progress to:
•   Shortness of breath
•   Rapid heartbeat
•   Pale gums
•   Weakness
•   Collapse and death

Which dogs are more likely to develop GDV?

Veterinarians and researchers have attempted to isolate the causes of GDV in order to reduce the risk of susceptible dogs from developing the condition, but not every dog with the risk factors will end up with this syndrome. GDV is most commonly seen in large breed dogs who are also deep chested. Think of Great Danes, German shepherd dogs, Dobermans, boxers, bassets, Gordon and Irish setters, St Bernards, Irish wolfhounds, Rhodesian ridgebacks and Weimaraners. Older dogs are more prone to developing GDV, however, it’s not impossible for any breed of dog at any age to experience this dangerous condition. Males are more commonly affected than females.

Why is GDV a medical emergency?

The distension of the stomach is caused, in part, by its inability to empty its contents. Add torsion or twisting to this equation and suddenly there is increased pressure in the body, decreased blood supply to vital organs and damage to the cardiovascular system. Dehydration and systemic shock can ensue. There is no way for GDV to correct itself and it becomes life-threatening from a few minutes to a few hours. Some dogs go from having no visible symptoms to collapsing and dying, while others will show visible distress and need immediate veterinary attention.

How is GDV diagnosed and treated?

It’s important to tell the veterinarian that you suspect GDV, although in most cases, the dog’s distress will be evident. Looking at the breed, age and history of the dog can provide predetermining information that allows the vet to reach the GDV diagnosis. However, in this emergency situation, the vet’s first priority will be to relieve the pressure in the dog’s stomach to save the wall of the stomach (since there is always a risk of it bursting) and to remove pressure on other internal organs. They will attempt to insert a stomach tube, although this might be impossible due to the stomach torsion; in which case, the vet will insert a large needle through the skin to release the gas and relieve the pressure.

Treatment for shock can then begin (IV fluids and medicine to stabilise the dog’s vital signs) and as soon as the dog is stable, he can be placed under general anaesthesia so that surgical treatment can take place. The veterinarian may take X-rays to confirm the presence of gastric dilatation (distension) and volvulus (torsion) and to prepare for surgery. Some dogs will need a longer period of stabilisation before surgery, depending on how severe their condition was before treatment began.

The surgical intervention involves returning the stomach and spleen to their correct position in the body. If the spleen’s blood supply has been too compromised or if the spleen is the suspected culprit of the GDV, the whole organ may be removed. The vet may decide to perform a gastropexy to prevent GDV from happening again. This involves attaching the wall of the stomach to the wall of the dog’s body to position it permanently.

If stomach torsion has cut off blood supply to the stomach wall to the extent that necrosis (tissue death) has begun to set in, it may be necessary for the vet to remove part of the dog’s stomach – a procedure called a gastrectomy.

What is the prognosis after treatment?

Gastric dilatation volvulus is a traumatic and life-threatening event, followed by surgery. The prognosis depends on the severity of the condition before medical treatment was administered, the cardiovascular stability of the dog before surgery, and the level of aftercare received. The survival rate of GDV is around 80%, although this may be reduced by certain factors such as pre-existing heart problems, the tissue damage incurred during the ordeal, and the necessity of removing the spleen.

The dog must be hospitalised for a few days after surgery to keep a close eye on his progress and to catch any complications that may arise. There may be infections or sepsis, inflammation (peritonitis) or low blood pressure (hypotension) that could compromise his recovery and cause the dog to die.

Can GDV be prevented?

While no preventative steps can be 100% guaranteed, the following changes can be made to reduce the risk of your dog developing GDV:
•   Feed two or more smaller meals throughout the day, rather than one large meal
•   Give your dog time to rest after eating, before he engages in vigorous activity or exercise
•   Do not raise your dog’s food bowl off the ground unless instructed to do so by the vet
•   Ensure that your dog experiences a happy, relaxed environment – fearful, stressed dogs are more likely to develop GDV
•   Large dogs should eat large, high-quality kibble and not drink an excessive amount of water after eating

Address any concerns you may have over GDV with the vet and always have the emergency number for the vet on hand if your dog is susceptible to developing this condition.

Eclampsia in pets

What is eclampsia?

Eclampsia is a life-threatening condition in dogs and cats that have recently had a litter of puppies or kittens. It has been seen in pets that are pregnant or giving birth, but more commonly occurs one to four weeks after giving birth. It is a medical emergency caused by a sudden drop in blood calcium levels, usually due to calcium loss during pregnancy and nursing.

Eclampsia in pets is most commonly seen in small breeds of dogs (Chihuahua, miniature pinscher, Pomeranian and toy poodle) with large litters or large pups. It can, however, occur in any breed with any size litter and at any time from pregnancy to weaning. The drop in calcium levels in the blood can cause changes in behaviour and weakness to muscle spasms and full-blown seizures.

Eclampsia in pets is also known as puerperal tetany or hypocalcaemia.

What does eclampsia look like?

Eclampsia can seem to come out of nowhere. Affected animals are usually completely fine and healthy throughout their pregnancy and have an uneventful birthing. It is only once the milk production starts in earnest – usually from one to four weeks after giving birth – that problems arise. In dogs and cats eclampsia can start out very subtly. Pet owners may notice an unusual restlessness and pacing. Some animals may get unnaturally aggressive, are sensitive to light and sound, develop a high fever, whine and pant or even begin vomiting or have diarrhoea. This may progress to weakness then muscle spasms and twitches and eventually seizures. If left without treatment, these animals may fall into a coma and can die.

Eclampsia in dogs and cats can also occur during pregnancy, but this is not very common, though the symptoms will be similar. If an animal is affected while they are in the process of giving birth, you may notice that the contractions are not as strong as they should be. This may lead to a puppy or kitten getting stuck in the birth canal or simply unable to come out all the way. These animals need immediate assistance in order to save the litter.

What causes eclampsia?

Eclampsia is caused by low levels of calcium in the blood. This is most often due to a calcium-poor or poor quality diet during pregnancy. Other causes may be from calcium loss in pregnancy due to the development of the bones of unborn pups/kittens or even a problem with the parathyroid gland, which is responsible for calcium regulation in the body.

Calcium is a very important mineral in the body. It is not only found in the bones, but also in the blood where there is a constant flux between the two. One of the most important functions of calcium in the system is its influence at neuromuscular junctions. These are like little electrical circuits that control the ability of a muscle and nerve to communicate. The calcium manages this communication by allowing messages to pass through at the correct time. When calcium levels are low, like in the case of eclampsia, the messages come through without regulation and often without stimulus, leading to muscle twitches, spasms and even seizures and fits.

What should I do if I suspect my pet has eclampsia?

Eclampsia is a medical emergency and should be seen to immediately. First remove the puppies or kittens from suckling and keep them safe and warm. Mom should then immediately be taken to the vet. If the condition is diagnosed and treated in good time, recovery is fast and total.

What will the vet do if my pet has eclampsia?

The vet will get as much information about your pet’s history as possible. This background is important so that we do not miss any other potential causes of your pet’s symptoms. Some toxins and even epilepsy can present in the same way.

The vet will likely start by performing a physical examination and recommend bloodwork in order to check the calcium levels in the blood, blood sugar levels as well as other electrolytes. Where available the vet may make use of an electrocardiogram (ECG) to monitor your pet’s heart as eclampsia affects heart rate and rhythm.

If your pet is having a seizure, the vet will correct this with anti-seizure medication before administering any other treatment. Low levels of calcium are treated by replacing the calcium in the bloodstream. This is injected directly, but very slowly, into the vein. While low calcium levels lead to a high, erratic heart rate, replacing the calcium too fast causes slowing of the heart and possible arrhythmias (irregular heartbeats), so this must be done with care.

Giving the calcium directly into the blood usually has an immediate effect where muscles relax and seizures stop. Your pet may require hospitalisation and observation to ensure that the blood calcium levels have stabilised before being sent home. These cases will go home with calcium supplements to provide enough for the body in the long term.

Depending on whether puppies or kittens are old enough to start eating solids themselves, it is preferable to not allow them to suckle from mom for the next 12 – 24 hours after such a crisis. This is to prevent mom from losing too much calcium too fast in the milk, causing a repeat episode. Little ones should be fed milk replacer while mom recovers, and will likely need additional milk replacer supplementation until they are weaned. If the puppies/kittens are four (or more) weeks old, they should be weaned off mom, but if they are younger, they will need extra milk through milk replacer. Introducing them to solid food at three to four weeks of age will reduce the burden on mom and provide enough nutrients for the pups/kittens.

How can I prevent eclampsia in my pet?

As in all things, prevention is better than cure. The most important aspect of prevention is the provision of a high-quality, nutrient-dense, balanced and appropriate diet throughout pregnancy and lactation. Diets designed for lactating moms and little ones are ideal. The calcium to phosphorus ratio is very important and should ideally be 1.2:1.

Food and clean water should be available at all times during lactation. Removing the little ones for an hour a few times a day will give mom a break and let her eat and get enough calcium from her food. Most commercially available dog and cat foods have sufficient calcium. Do not supplement calcium during pregnancy as this will actually cause eclampsia rather than prevent it. Calcium can be supplemented after giving birth, especially in high risk cases or where eclampsia has happened before. This is most important when milk production is at its peak and the demand for calcium is at its highest.

Encourage puppies and kittens to start eating solids once they are three to four weeks old. They will start trying out mom’s food first. Once you see the interest, you can provide them with puppy and kitten mousses, which are easy to eat, and later providing them with a suitable puppy/kitten diet.

What is the prognosis for pets diagnosed with eclampsia?

If diagnosed and treated promptly any pet affected with eclampsia usually makes a full and complete recovery. Unfortunately if a pet has had the condition once, it can occur again. In this case, discuss with the vet any methods to prevent the problem from happening again.

Unfortunately once the condition has progressed to full seizure activity, this can lead to brain swelling. These cases do not respond as quickly as others as the swelling in the brain needs to be treated too. Not all of these animals go home and may have a poorer prognosis.

Dilated cardiomyopathy (DCM) in dogs and cats

What is dilated cardiomyopathy?

Cardiomyopathy is a disease condition of the heart muscle that inhibits its ability to function properly. In the case of dilated cardiomyopathy (DCM), the heart muscle is stretched and the muscle is thin and flabby, affecting its pumping ability. Dilated cardiomyopathy can affect both pets and people.

The heart is designed as a pump where each contraction pushes blood from the lungs to the rest of the body and back again. This allows the oxygen we breathe in to be absorbed in the blood and distributed to where it is needed. When the pump itself is affected, the distribution and flow of blood is compromised. In DCM, the bottom chambers of the heart, which are the power house for the pumping action, are dilated and thin, and unable to properly expel the blood presented to them from the lungs and body. This leads to a backup behind the heart. Depending on which side of the heart is more severely affected, this usually ends up with fluid and blood buildup in the lungs. In DCM, it is usually all four chambers of the heart that are stretched and affected, not just one side. This stretching of the muscle also affects the electrical conduction of the heart and its ability to pump at a normal rhythm.

How does dilated cardiomyopathy occur?

DCM is an acquired disease, meaning that an animal or person is not born with the condition, but it develops over time. DCM can be classified as:

primary, where the cause is genetic or unknown, or
secondary, where damage to the heart occurs as the result of toxins or infections.

Primary DCM is the most common and is seen more often in certain breeds of dogs, namely large and giant breeds such as the Doberman pinscher, Newfoundland, Great Dane and Irish wolfhound, as well as boxers and cocker spaniels.

Secondary DCM can be caused by viral infections to the heart muscle (myocarditis) or due to deficiencies in certain amino acids such as taurine (cocker spaniels) and carnitine (boxers). These causes of DCM are, however, rare in modern day due to the development of protective vaccination and well-researched and high quality pet diets.

Is there any truth to the connection between grain-free diets and heart disease in pets?

Yes, according to the United States Food and Drug Administration (FDA) there does seem to be a correlation between the use of grain-free pet diets and the development of heart disease, specifically DCM in both dogs and cats. In 2017 veterinary cardiologists noticed a rapid increase in the number of DCM cases they were seeing. These cases were occurring in dog breeds that were not known to be genetically predisposed to DCM, such as mixed breeds, beagles, golden retrievers and even small breed dogs.

In July 2018 the FDA in conjunction with nutritionists and veterinary cardiologists began to investigate the relationship between the cases of DCM and grain-free pet diets. A strong correlation between the two were found, however the exact cause is still not known. The diets most commonly implicated were those using sweet potato or potato and legumes such as lentils and/or peas instead of grains. The protein sources varied in these diets from conventional chicken and beef to exotic sources such as bison, kangaroo or lamb. Due to the change in ingredients, it may be that an amino acid deficiency plays a role as it did in the past, or possibly that these ingredients affect the absorption or metabolism of these amino acids. The investigation is still ongoing.

How will I know if my pet has DCM?

In early cases of DCM the heart may still be able to cope and thus show very few signs of disease. It is when the heart becomes less able to cope and do its job that symptoms start to arise. At first it may be mild changes such as poor tolerance for exercise. These pets tire quickly when playing or exercising, which is sometimes accompanied by a soft cough, which almost sounds like they are clearing their throat.

As the condition progresses, signs may become more pronounced, like breathing fast and with difficulty. Affected animals may have a persistent cough, made worse by activity or exercise. You may notice fainting episodes, weight loss, poor appetite and even an increase in the size of your pet’s abdomen from fluid accumulation – also called ascites. Severely affected animals are restless, unable to lie down and rest comfortably, and have very little interest in food. If the heart has reached the point of being unable to cope, leading to symptoms as mentioned above, this is called heart failure.

What should I do if I suspect my pet has DCM?

If you are concerned that your pet has heart disease, it would be best to schedule an appointment with the veterinarian. The vet will perform a thorough physical examination and listen to your pet’s heart and lungs. Some cases of DCM will present with a soft heart murmur, and if there is congestion in the lungs this can sometimes be heard too.

My dog is one of the predisposed breeds and has a family history of heart disease. What should I do?

It would be wise to consult the vet as soon as possible to have your dog screened for DCM. This would involve a scan of the heart, known as an echocardiogram, as well as an electrocardiograph (ECG), which measures heart rate and rhythm through the heart’s electrical impulses. Some vets use a Holter ECG which is strapped to your dog for 24 hours in order to get the best possible picture of their heart’s electrical activity through the day.

These tests will indicate if your dog is at risk of developing DCM, even if they show no signs of the disease. Pets at risk of developing DCM and showing early indicators are treated with heart medication. This will not prevent the disease from developing, but will slow down the rate of degeneration through medical management. This is a lifelong treatment regimen. The earlier the vet can catch the condition, the better able we are to prolong your pet’s lifespan.

What about cats?

The main cause of DCM in cats has been found to be taurine deficiency, which was identified in the 1980s. Since this discovery cat food companies have supplemented taurine in their diets, resulting in this disease being a rare occurrence in this day and age. Dogs are able to produce their own taurine from other amino acids supplied through protein in the diet and do not suffer from this malady as often, but with a few exceptions. Cocker spaniels and golden retrievers are more sensitive to taurine deficiency and may develop taurine responsive DCM. Cats on grain-free diets have been known to develop DCM.

Cats can still develop heart disease with symptoms similar to DCM, namely hypertrophic cardiomyopathy and restrictive cardiomyopathy. Like in dogs, heart disease in cats can be primary (genetic in cases of ragdolls, Maine coons and some American shorthair breeds) or secondary in origin due to high blood pressure and high thyroid hormone levels.

Cats with heart disease are usually seen with breathing difficulty, poor appetite and weight loss. Treating these pets is usually focused on managing the underlying cause before focusing on the heart. Diagnosing a cat with heart disease is done in the same manner as dogs, discussed below.

What will the vet do if my pet has DCM?

Aside from the physical exam mentioned above, the vet will ask for a detailed history of your pet’s health, including diet, breathing difficulty and response to exercise. If there is any suspicion of heart disease the vet will likely recommend an x-ray and an echocardiogram. X-rays allow the vet to see the overall shape of the heart as well as see any changes to the lungs, whether it be fluid in the lungs (pulmonary oedema), fluid around the lungs (pleural effusion) as well as changes to the blood vessels in the chest. Where there is fluid buildup in the abdomen, this can also be seen on an x-ray.

An echocardiogram is an ultrasound scan of the heart. This is often performed by a diagnostic imaging specialist and the heart is visualised in motion. Each chamber as well as the valves can be seen and evaluated. The size of the heart chambers, wall thickness and the pumping effectivity of the heart are all measured with an echocardiogram. Often an ECG is also done at the same time, measuring the rate and rhythm of the heart.

Pets and people with DCM often have abnormal electrical conductivity of the heart due to the changes in structure and shape. This leads to an abnormal heart rhythm (arrhythmia). This asynchronous contraction of the heart makes for a very inefficient pump and may lead to fainting episodes as blood is not getting to where it needs to go, specifically to the brain. In severe cases arrhythmia can result in sudden death.

Can DCM be treated?

DCM is a devastating disease. Once a pet is symptomatic and in heart failure, the condition can only be managed, but not cured. The existing damage is irreversible; however, treatment does significantly improve their quality of life and life expectancy.

If deficiency or diet-related DCM is suspected, some pets will respond to supplementation and dietary adjustment. The mainstay of DCM treatment, however, is medical management. DCM can be managed through the use of heart medications, which assist the heart in coping in its weakened state. Other medications such as diuretics (medication that promotes the increased production of urine) are often combined with these to reduce the buildup of fluid in the lungs and abdomen. Blood pressure medications can also be useful. If arrhythmia is a problem in your pet, then medication can be provided to assist with this as well. Each patient is unique and treatment is tailored individually.

Following up with the vet is important, especially in the beginning to monitor progress and to see if treatment adjustments need to be made. The vet will likely advise follow-up echocardiograms and x-rays at regular intervals.

My pet has been diagnosed with DCM. How long do they have?

Any pet diagnosed with DCM is given a poor prognosis, which is especially true once pets are in heart failure. Most pets diagnosed with the condition succumb to it. The severity of the disease and the breed of pet determines their life expectancy. In clinically affected Doberman pinschers, for example, life expectancy is less than a year. However, cocker spaniels tend to progress a little more slowly and can live more than a year with treatment.

Domestic pet poisoning

Poisoning is a common occurrence in domestic animals like dogs and cats. The most widely observed route of poisoning is via the mouth (orally), but topical poisoning and other routes of intoxication are also possible. No matter the route of poisoning, it’s critical to treat each individual case of poisoning as a matter of urgency, as some poisons could be life-threatening for the pet. In this article, we give an overview of the most commonly encountered poisons in private practice in this part of the world.

What is poisoning?

For our purposes, poisoning is defined as any substance that is ingested or absorbed via the skin, which causes harmful effects in a dog or cat. The substances that are poisonous to pets can range from regular human medications (over the counter, prescription and/or vitamins); human food that is not supposed to be fed to animals such as chocolates or grapes; pesticides; plants; or topical tick and flea treatment that is incorrectly used on the wrong species of pet.

How will I know if my pet has been poisoned?

There is often a rapid onset of the effects of poisons when the toxic dosage has been met – i.e. it will show quickly when your pet has ingested something poisonous. An exception to this is warfarin, which is used in rat poisons. This is a slow-acting poison that, if ingested by your pet, will only show symptoms up to a week or more later. In poisoning cases that are brought to the vet, pet owners usually report a sudden onset of symptoms, presence of the suspected poison in the home environment, rumours of recent malicious activity in the neighbourhood and, most importantly, definite reports of confirmed exposure to the poison; for example, seeing the animal eating the poison.

Common symptoms of poisoning

Signs of poisoning differ between the affected systems. Common symptoms of poisoning include excessive salivation, foaming at the mouth, vomiting, diarrhoea, muscle tremors and/or seizures, as well as abnormal bleeding. At other times the pet might show non-specific signs. However, as mentioned before, a suspicion of poisoning can be made given the sudden onset of the signs fitting poisoning.

Different types of poisoning

Rat poisons

Rat poisons are the most common poisons encountered in practice. Rat poisoning cases can be both as a result of accidental consumption in the home or when visiting neighbours and family, or malicious activity. There are two main types of rat poisoning: a slow-acting poison that affects blood clotting and a fast-acting poison that affects the nervous system as well as exerting effects on the digestive tract. Both types of poisons can prove to be fatal if the specific antidote is not given in time.

RATTEX (warfarin/coumarin) is an example of a poison that affects blood clotting. Usually, if the pet is not seen consuming this type of poison, symptoms will begin to show after a week. The pet can be lethargic and anaemic, as well as have abnormal bleeding. Blood tests are usually performed as part of the diagnosis and treatment monitoring. In general, pets begin to show signs of improvement once the specific antidote is started. Treatment can continue for up to three weeks depending on each case.

Organophosphate and ‘two-step’ poison are examples of poisons that affect the nervous system. These poisons are highly potent and fast-acting. In cases of malicious poisoning, with high dosages of poison being delivered in food, the pet is usually found dead within an hour of ingesting laced food. There is an antidote for this poison, which is beneficial when administered in time. In-hospital care is required for this type of poisoning.

Human medicines

What is very good for the pet owner is often not the best thing for the pets. Human medicines are notorious in animal poisoning cases. They are easily accessible to pets, which means they become common causes of poisoning in animals. Human medicines that can be harmful to pets include painkillers, vitamins and supplements. They can result in kidney injury, gastric ulceration, bone marrow suppression, cardiac function depression, and sometimes, particularly in female unsprayed dogs, female reproductive problems. Given the vastness of the potential effects of human medicines, symptoms are quite diverse and will depend on the specific medication consumed. To further complicate the situation, some effects are not seen immediately and can possibly take a couple of months before being evident. This means the connection between the pet’s symptoms and the consumption of human medicine might be missed.

Human food

Human food consumed by dogs and cats can also cause pet poisoning. Grapes, chocolate, xylitol, alcohol and macadamia nuts are notorious for poisoning pets. Several other products can also cause poisoning in animals; lists of which are found on the national poison database. Again, depending on the food product consumed, signs of food toxicity can range from diarrhoea, vomiting and nausea, to hyperactivity, tremors, seizures, hypoglycaemia, renal failure and/or death. In general, the vet can induce vomiting if the pet consumed the toxic food less than two hours prior.

Plant poisoning

Different types of toxic plants exist in our home environments. Toxic plants can include flowers or other ornamental shrubs and trees. These plants can cause various detrimental effects in our pets, ranging from localised mouth and tongue reactions, liver damage and liver failure, kidney injury and/or failure, and heart failure. Plant poisoning in dogs and cats can prove to be extremely difficult to diagnose in practice unless the pet owner mentions clues when speaking to the vet. Diagnostic tests can make the case work-up easier and provide a better outcome for the pet. Since there are no antidotes to plant poisonings, pets will be treated for their symptoms and their health managed accordingly.

The elephant leaf garden plant is an example of a plant poison that causes localised irritation and swelling in the mouth and tongue. This type of poisoning is often seen in puppies who will chew at everything they can get to out of curiosity. Treatment is mainly targeted at managing the symptoms and often carries a good prognosis.

Cycad seeds are notorious for causing liver problems in dogs. Usually, pets are presented to the vet showing gastrointestinal signs such as vomiting, increased thirst and profuse salivation. Bloodwork will show evidence of liver disease. In other instances, symptoms are non-specific until a diagnosis is reached following a thorough history-taking and relevant blood test results.

What to do if your pet is poisoned

Simple: take your pet to the vet! If you cannot get to the vet’s office immediately, phone in and ask for advice.

If you have just witnessed your pet consuming poison (within the last two hours or less), quickly get your pet to the vet to induce vomiting – if applicable. In the case of anticoagulant poisons like warfarin, it’s neither wise nor helpful to induce vomiting, as ingestion and digestion would have occurred days before. Depending on the oral poison ingested, it can sometimes be helpful to give your pet activated charcoal to reduce the amount of poison being absorbed. If your pet has just been exposed to a topical poison, the best would be to wash the area on the skin to decontaminate it and reduce the amount of poison being absorbed. Thereafter, rush your pet in for emergency care at the veterinary hospital.

If your pet is experiencing seizures, it is important to protect them from inadvertently injuring themselves. Keep them in a padded area that is free of sharp protruding objects.

If you know which poison your pet has ingested, take the packaging with you, as this will be useful to the vet. It will save a lot of time unnecessarily searching for diagnostic clues and researching other symptoms and effects to anticipate.

Case management at the veterinarian

A case of poisoning is always addressed as an emergency until an antidote is given and the pet patient is stable. Following the collection of a relevant, brief and concise case history by the vet, any of three main routes might be elected. These include:

Inducing vomiting and stomach washing
Giving the antidote if available, and
Case workup to identify exact systems affected and hopefully the exact cause of poisoning.

Once a diagnosis is reached, treatment is given along with the necessary case monitoring. Patient follow-ups are also very important, and this is where adhering to the vet’s recommendations will be beneficial to the pet.

Prognosis

Prognosis with poisoning cases is case dependent. However, factors that could improve the prognosis of each case include early diagnosis and intervention, the availability (and timely use) of an antidote, and the proper post-treatment follow-up. When dealing with poisons without antidotes, a good response to treatment without permanent vital organ damage usually carries a good prognosis. Prognosis is therefore poor when there is no (or delayed) intervention, as well as damage to vital organs, which could prove detrimental.

As a pet owner, you are encouraged to be vigilant about your pet’s access to potentially poisonous materials. Should they end up in the unfortunate position of being accidentally poisoned, do not rely on home remedies to treat your pet – rather get them to the vet as soon as possible.

Malicious poisoning of dogs

What poisons are used on dogs?

The most commonly used poisons are organophosphates (malathion, disufloton, acephate, parathion), carbamates (Aldicarb, Temik/‘two-step’) and rat poison. Organophosphates and carbamates are insecticides used for both agricultural and household applications. Temik is often used despite being a restricted substance, and may be combined with other substances. The tiny bluish-black granules, which are white on the inside when crushed, are commonly hidden in something tasty such as a piece of sausage, polony, meat or bread. Clinical signs of poisoning start within minutes to hours after exposure to the poison. Temik can kill dogs very quickly or even suddenly due to a build-up of secretions in and/or paralysis of the breathing system.

Symptoms of ‘two-step’ poisoning can include the following:

Excessive drooling, runny nose or tearing of the eyes
Pinpoint pupils
Vomiting, diarrhoea
Difficulty breathing, very fast breathing or coughing up slime (excessive secretions in the airways)
Abnormally slow heart rate
Muscle tremors, shaking, twitching, weakness or loss of balance
Convulsions, seizures
Disorientation, unconsciousness

The complication of rat poison

Rodenticides are also sometimes used, either alone or in combination with other poisons. Rat poison is available in several pelleted and cake forms and is sold under different brand names. One particularly important difference from other poisons is that it is designed to start causing signs of poisoning only three to seven days after being ingested, after which death can occur quickly.

Remember that your dog doesn’t necessarily have to eat the poison itself; they can also be poisoned by eating or chewing another animal that has eaten the poison. Rats can travel quite far in a short amount of time and it is not uncommon for them to ingest poison at one house and scavenge a few blocks away to succumb or be caught at another house. Both first and second (longer acting, more toxic) generation coumarin and warfarin products are ‘blood thinners’ – they prevent blood clotting, which both prevents and stops bleeding. Clinical signs are thus related to bleeding, but keep in mind that you may not necessarily see any blood as the bleeding is often internal, i.e. into the stomach and chest cavities.

Typical signs of rodenticide poisoning include:

Lethargy, weakness, exercise intolerance
Pale gums
Bleeding or bruising of the gums or skin
Bleeding from the nose
Prolonged bleeding without stopping, from minor wounds or scratches
If bleeding occurs into the joints, you may notice limping and/or swollen joints
If bleeding occurs into the lungs, you may notice coughing or difficulty breathing
Bloody diarrhoea or dark ‘tarry’ faeces, vomiting blood

What to do if you think your dog has been poisoned

Time is of the essence when discovering a poisoning – the faster you act the better your dog’s chances of survival, although there are never any guarantees. Follow these steps immediately:

Remain calm and focus on what you need to do, but do not waste any unnecessary time.
Have someone phone the vet to tell them you are on your way or, if you are alone, phone the vet in between the following actions.
Vomit and excretions often contain some of the poison – keep all animals, children and uninformed persons away from these excretions. Confine your dog in a small room or courtyard if necessary; ideally an area with a tiled floor as it will be easier to clean afterwards. Keep in mind that some poisons can be absorbed via the skin – take extra care when handling your dog if it has soiled itself. Wear gloves if possible and wash any areas of exposed skin that come into contact with the excretions.
Remember that poisonings are often a preparatory step for a premeditated crime – notify your security company or the police immediately.
DO NOT try to dose any home remedies (e.g. eggs, milk, etc.) – these are ineffective and will only serve to waste valuable time in getting your dog to the vet. Activated charcoal may absorb some poisons, but getting your dog to the vet ASAP should take preference above the potential benefit of dosing activated charcoal.
Preferably do not try to induce vomiting – consider doing so only in extreme circumstances.*
Get your dog into the car and rush to the vet. Use an old blanket or towel as a stretcher to carry your dog if it is unable to walk by itself. Be careful if your dog is convulsing or otherwise not fully conscious – you may get bitten accidentally.
When arriving at the vet, try to remember how long ago you discovered the poisoning, which symptoms presented and everything you have done since discovering the poisoning. The vet will choose the correct treatment protocol based on clinical signs and the information you provide.

*When can I induce vomiting?

As stated, it is not advisable to induce vomiting as at-home methods are often ineffective and will likely end up wasting valuable time. Only consider it when instructed to do so by the vet or otherwise in extreme circumstances where you are unable to get your dog to the vet immediately and have no other option. Furthermore, inducing vomiting, if successful, will only buy you some more time – you must still rush your dog to the vet as soon as possible.

Do not induce vomiting if your dog has vomited already

Only consider inducing vomiting if your dog is fully conscious, not having seizures or convulsions, not having any difficulty breathing and able to swallow. If at any point in time your dog develops these signs, stop immediately and rush your dog to the vet. If you are not successful after a maximum of 10 minutes, stop and rush your dog to the vet. Do not let your dog or any other animals re-ingest the vomit.

Do not induce vomiting if your dog is showing signs of rat poisoning (such as bleeding) – it takes several days to start showing signs, by which time the poison will have already moved out of the stomach.

How to induce vomiting

Prepare a ball of high-foaming washing powder mixed with a small amount of water to form a paste and force it down your dog’s throat. Alternatively you can prepare a 50/50 solution of 3% hydrogen peroxide and water. Measure 1 ml per kg of bodyweight (e.g. 6 ml if your dog weighs 6 kg, 20 ml if your dog weighs 20 kg) and force it down your dog’s throat. Do not repeat this procedure more than twice.

Safely cleaning up afterwards

Cleaning up afterwards is a messy and likely emotional job.

Protect yourself! The poison is just as dangerous to you as to your dog and can potentially be ingested, inhaled and absorbed through the skin. Wear rubber gloves, protective clothing and closed shoes. Do not smoke, eat or drink, touch your face or handle any uncontaminated household articles before changing your clothes and thoroughly washing your hands and other exposed skin.
Restrict access to all contaminated areas to only the persons cleaning up. These areas include any floor or surface that has been in contact with vomit, saliva, faeces or any other secretions. Do not allow any animals, children or uninformed persons into the area until it has been thoroughly cleaned.
Collect all remaining poison and seal it in a plastic container. Sprinkle slaked lime over the area and water down the area as well as any run-off very well. Collect all solid waste and soiled articles and seal them in plastic containers.
Brush a 10% solution of sodium bicarbonate into carpets, floors, furniture, doors and other household items that were in contact with the poison or excretions from your dog; leave for at least eight hours before washing off with water. Absorb the water into an absorbent material (wood-based cat litter pellets also work well) before washing a second time with a strong household detergent. Do not dispose of washing water in the drain or garden!
Wash all washable items such as rugs, tablecloths, towels, cushions, etc. thoroughly in the washing machine.
Contact your local municipality or Poison Information Centre for advice regarding the safe disposal of toxic waste.
Seek medical attention immediately if you or a family member starts to feel ill during the cleaning process – you may have been exposed to the poison and started experiencing symptoms of poisoning yourself.

Prevention of poisoning

Keep the vet’s contact details and address saved on your cell phone as well as in an easy-to-find place in your home. If your usual vet does not have 24-hour facilities, find out which other practices in your area do and make sure to have their contact details ready at hand – you never know when you might end up needing them.

Frequently check all areas accessible to your dogs for any strange food sources and dispose of these immediately when found. Pay special attention to fence lines along your property as well as any areas where you think it might be easy to toss something over a fence/wall/hedge into your property.

Contact a dog trainer or behaviourist for advice on how to discourage your dog from eating anything other than their usual food or taking titbits from strangers.

Pay attention when taking your dogs for a walk and do not let them chew or eat anything they find. Do not let your dogs off to rummage around for strange things to eat in overgrown areas, bushes or shrubbery – stick to pathways and pavements and keep your dogs on a leash.

Discourage all animals in your household from catching, chewing or eating any rodents and pick up and dispose of any dead rodents in your yard or house as soon as you find them.

Reconsider your use of rodenticides and ask your neighbours to do the same. It’s not just family pets that may be negatively affected, but also birds of prey and other predatory animals that feed on rodents. If you have a mouse or rat problem, rather use a humane trap and ask for advice from your nearest owl or raptor rescue centre.

Acute Abdomen

Now and again pet owners are faced with emergency situations when their pets are suddenly in severe belly pain. Unexpectedly, both the owner and the pet are in a moment of anxiety and distress. So what could possibly be going on? This sudden severe belly pain is what veterinarians call an acute abdomen.

What is acute abdomen?

Acute means to happen suddenly, while the abdomen is the lower part of the trunk of the body, often referred to as the belly. The term acute abdomen refers to sudden pain in the belly. This sudden, severe pain in an animal’s belly should be treated as an emergency and requires immediate evaluation and response by the vet.

Pet owners will often report that their dog or cat was fine yesterday or earlier in the day before showing the sudden signs of terrible belly pain. The pain could arise from any of the following:

gastrointestinal tract (GIT) and inner lining of the abdominal body wall
other organs in the abdominal cavity (liver, pancreas, spleen, kidneys, reproductive tract, lymph nodes, diaphragm)
muscle and skin around the abdominal cavity
emanating from other systems outside the abdominal area such as back pain.

Acute abdomen can be life-threatening and should be considered an emergency.

What will I see if my pet has an acute abdomen?

Since there are so many possible causes of acute abdomen, it is not surprising that its symptoms will be equally diverse. Further complicating the situation is the fact that the symptoms may be non-specific to any one particular cause. So, how can a pet owner judge from home that their pet is in a crisis situation? To help pet owners reach the decision to take their pet to the vet for examination, below is a summary of possible symptoms of acute abdomen.

Pet owners should look out for:

restlessness
unusual panting
arching of the back
body posture changes such as assuming the praying position (with their front legs on the ground and their rear end in the air)
retching or trying to vomit without success
loss of appetite
marked sensitivity when owners attempt to stroke their pets in the belly area
distention of the belly such as with advanced pregnancy, or when there is a marked accumulation of fluids in the abdominal cavity

With very painful conditions or when shock sets in, the respiratory rate and heart rate might be elevated and there may be a loss of colour in the mucous membranes.

What can cause an acute abdomen?

Acute abdomen can be caused by problems in any of the various systems located inside and/or (less frequently) outside the abdominal cavity. Potential causes of the syndrome range from injury, infection, swelling or inflammation, blockages in organ systems, to cancer.

Trauma

The pet owner may have missed potential injury or incidents of trauma. Forces from a kick, bump or a fall can lead to organs shifting to unusual positions in the body, which would normally be impossible for a pet owner to realise. These incidents can cause excruciating pain. Examples of this include diaphragmatic hernias, where internal organs punch up into the chest cavity and cannot slip back out. This is commonly seen when a pet is bumped by a car.

GIT obstruction

Pain in the belly can also originate from the GIT. Blockages in the stomach or intestines can be caused when objects such as toys or bones are swallowed whole. Pain and injury to these organs can occur when the stomach or intestines twist around themselves or even ‘telescope’. Other organs such as the spleen can also twist in association with the stomach torsion – another emergency and cause of acute abdomen in itself.

Inflammation/Disease

Life-threatening inflammatory conditions affecting the liver or pancreas are also frequently seen as causes of acute abdomen. Pancreatitis or liver disease (abscesses or cancer, as examples) are also a common cause of acute abdomen.

Examples of other possible causes of this syndrome include peritonitis, stomach ulcers, kidney disease and infections and cancer of the reproductive tract – in both male and female patients. Disc disease (back pain) is an example of pain outside the abdomen that can present as acute abdomen.

What should I do if I suspect my pet has an acute abdomen?

Severe belly pain should be treated as a medical emergency. Take your pet to the nearest vet ASAP. Any delay can have fatal consequences.

What can I expect when I get to the vet?

Sequence of events at the veterinary hospital:

Upon arrival at the veterinary hospital, the patient will be attended to as an emergency in line with the pet owner’s complaint. The vet will then seek to confirm if the symptoms are truly suggestive of acute abdomen.

To confirm the vet’s speculation of acute abdomen, the pet owner would need to give an accurate and detailed history of the pet’s condition and lifestyle. The vet will ask many in-depth questions to get a better idea of the pet’s medical history and what might be causing their discomfort. Information will be requested regarding the names of current medications the pet is receiving, recent abdominal surgery the pet would have undergone, time estimate of when they noticed signs of pain or distress as well as the progression of the symptoms. As much as it might feel like an interrogation by the vet, this detailed information assists in speeding up the process of providing the best care for the pet.

Depending on initial findings by the vet, some pets would require stabilisation before he can do a more thorough physical examination. Once this examination is completed, a diagnostic workup plan is designed by the vet and discussed with the owner. The findings from the diagnostic tests performed will inform the staff on how best to care for the pet patient. The best care for the patient with acute abdomen can only be achieved through in-hospital care for a couple of days.

Which steps will my veterinarian take in order to find the problem?

Acute abdomen affects other body systems apart from the gut. Systems that put the patient’s life at risk that are commonly affected are the cardiovascular system, respiratory system, central nervous system, renal (kidney) system and the hepatic (liver) system. Blood tests will assist in providing an overview of the state of health of most systems. Imaging (x-ray and ultrasound scan) of the abdomen and chest areas also forms part of the diagnostic tests.

Depending on what is found on these tests, the vet may recommend surgical intervention. This may include an exploratory laparascopy where all the organs can be visualised and surgically corrected where appropriate. A host of other tests might be ordered if deemed necessary for the survival of the patient. Some tests might be repeated in the days to follow as part of monitoring the patient’s response to treatment.

How is acute abdomen treated?

A good diagnostic workup informs the decision on how to treat or manage the case. Having a diagnosis helps to categorise whether the case will be managed medically, as a surgical emergency, or as a delayed surgical case requiring the patient to be stabilised before undergoing surgery. Fluid replacement in the form of a drip is generally advocated in all cases of acute abdomen as it aids in supporting the heart and blood pressure. Medical management entails the use of appropriate drugs to relieve the patient from pain, treat infections, and addressing other possible symptoms such as stopping vomiting and diarrhoea. Surgery is reserved for cases that require surgical intervention for survival.

Conclusion

Acute abdomen is a medical and/or surgical emergency in which time is of the essence. Early intervention improves the chances of the pet’s survival. Unfortunately, due to the broad possible causes of presenting signs, proper management of each case relies heavily on a thorough diagnostic workup. Good pet owner cooperation with the veterinary teams at the hospital is of paramount importance, and dare I say, could be the difference between life and death.

Help! My pet has just drank some Anti-Freeze

Winter has arrived and many people, as a precautionary measure, are putting antifreeze into their cars’ radiators, to prevent the water from freezing.

Ethylene glycol is the main ingredient found in antifreeze. Antifreeze is not as commonly used in South Africa as on other very cold parts of the world, as we do not get the very cold temperatures found in some parts of the Northern hemisphere. It is however found in many other products, which are found in South Africa. It is found in lower, less harmful concentrations in hydraulic brake fluid, solvents, motor oils, paints, film-processing solutions, wood stains, inks and printer cartridges.

Ethylene glycol is a sweet, odourless liquid that dogs and cats may find quite tasty. Ethylene glycol has a very narrow margin of safety. This means that only a very small amount needs to be ingested in order for it to be toxic and very often fatal.

As little as a tablespoon may cause severe acute kidney failure in dogs and as little as one teaspoon may be fatal to cats. Animals are often attracted to ethylene glycol due to its sweet taste. It has a repulsive aftertaste but often the animal has ingested enough of the fluid by the time the aftertaste kicks in, to cause disastrous effects.

What are the signs that your animal may have been ingested ethylene glycol?

Early signs of intoxication may be seen from 30 minutes to 12 hours after ingestion and may include any combination of the following signs:

Drunkenness
Excessive thirst or urination
Nausea or vomiting
Panting
Sedation
Halitosis (bad breath)
Muscle twitching
Fatigue
Coma

Ethylene glycol poisoning can be divided into three stages:

Stage 1: occurs up to 30 minutes after ingestion and includes fatigue, vomiting, incoordination, excessive urination, excessive thirst, low body temperature (hypothermia), seizures and coma.
Stage 2: occurs 12 to 24 hours after ingestion. Some of the clinical signs seen in the first 30 minutes may improve but during this stage, the animal may become very dehydrated and develop an increased heart rate and breathing rate.
Stage 3: occurs 36 to 72 hours after ingestions. There is generally severe kidney dysfunction at this stage. The dog or cat is generally in much pain and they do not produce urine (this is referred to as anuria). The patient may become more depressed and tired. They may lose their appetite and vomit. They may have a seizure or fall into a coma, which eventually leads to death.

How is ethylene glycol toxicity diagnosed?

If you suspect that your dog or cat may have ingested antifreeze or any other product containing ethylene glycol, it is important to seek immediate veterinary attention. If your animal is showing any of the clinical signs described, it is important to bring your pet to the vet immediately to be looked at. If there is any possibility that your pet may have been exposed to ethylene glycol but not showing any signs, they should still be brought to the vet.

If your pet has vomited or had diarrhoea, collecting a sample to bring to the vet may be beneficial in making a diagnosis. If a diagnosis can be made quickly and supportive treatment is given sooner, the prognosis, although still very poor, is that much better.

It is important to provide the veterinarian with a good history with as much detail as possible. The onset of symptoms may give a very important clue as to the potential cause. In some countries, there is a specific test for ethylene glycol toxicity but this is not widely available. The ethylene glycol concentration in the blood also decreases very rapidly so it is important to test as soon as possible after suspected ingestion. Diagnosis is usually made from history, clinical signs and laboratory data.

Ethylene glycol is processed or metabolised by the liver into toxic by-products that are damaging to the kidneys. Kidney function is measured by two main products in the blood, namely Creatinine and Blood Urea Nitrogen, both of which are nitrogenous waste products. If the kidneys are not functioning properly, these two products build up in the blood. These levels can be tested relatively easily. They are not a specific test for ethylene glycol poisoning, but they do indicate kidney damage. By the time these levels increase, it is unfortunately very often too late.

Looking at the urine may also assist in confirming exposure to ethylene glycol and subsequent kidney damage. The urine is often very dilute and contains blood, proteins and specific crystals. The urine is often acidic.

Is there a treatment?

Quick action and treatment are essential if there is any chance of survival. There is an antidote for ethylene glycol toxicity but it is very expensive and unfortunately not readily available in this country. The antidote also needs to be given within five hours of ingestion. Alternative treatment such as ethanol are available but animals need to be monitored closely as the drugs used for treatment have side effects. Sodium bicarbonate administered in the drip will assist with the metabolic acidosis.

In suspected cases, supportive treatment is essential and this will include intensive monitoring, fluid therapy to correct dehydration and correction of any pH imbalances in the body. Despite treatment, the prognosis is often grave to poor and many animals do not survive antifreeze poisoning.

The old saying, “Prevention is better than cure”, stands true here. It is important to be aware of any household products that contain ethylene glycol and store them safely, away from animals. Clean up any potential spills immediately and if you are unsure of potential exposure seek veterinary care immediately. There are many potential threats within a home of which the drinking of antifreeze is only one, and so it is important to be aware of them and take the necessary precautions to safeguard your animals.

My puppy is trying to chew the cord of my laptop charger

Although this may sound like a very unusual topic to discuss it is something that happens far more frequently than we would like. The most common reason for our pets to get electrocuted is chewing on electrical cords. In general the age groups affected in both cats and dogs are approximately 2 months to 2 years of age – the young and the curious. During this phase of their development they tend to be curious about the world. Teething and growing creates the perfect atmosphere for chewing anything in their path. The incidence of electrocution can often coincide with the festive season with all the decorative lighting being put up but for most of us who work with a laptop from time to time and has to plug it in to charge, this could pose a risk for our pets.

Clinical signs and potential complications

Burns are a frequent occurrence following electrical shock. The severity depends largely on the time and intensity of the electrical shock sustained. Something to remember is that it is the amperes and not just the voltage that make the electrical current more (or less) dangerous, which is why getting shocked from an electric fence is painful but not deadly, whereas an electric socket in your house can be much more dangerous. The burns can vary from superficial burns to the upper layers of the skin and mucous membranes in the mouth, or may damage and kill deeper layers of tissue by leaving large open wounds. The effects of the electric burns may not be seen immediately after the incident and the tissue may even appear normal initially. The cells that are damaged first swell and then die off. This process can take hours to days, depending on the intensity of the electrical shock. The hair and whiskers around the affected area may also be singed. Some electrical shocks can produce enough energy to fracture teeth.

Electric shock can affect your pet’s heart immediately, during and after the shock. During the shock the heart may go into fibrillation (an excessively rapid heart rate where very little blood is actually pumped by the heart) and asystole (where the heart starts beating erratically and then stops beating). Both of these may result in death. Following the electrocution your pet’s heart may demonstrate other cardiac (heart) arrhythmias which need to be monitored by your vet.

The next complication to discuss is the negative effect on the respiratory system. Swelling over the mouth and throat regions, spasm of the diaphragm (the main muscle for breathing in the chest) and pulmonary oedema (fluid on the lungs), are all potential complications of electric shock. During the shock breathing may stop, but generally once they are separated from the source of electricity they do start breathing on their own again. Clinical signs that the respiratory system may be affected include rapid harsh breathing, blue gums, coughing, or absence of breathing all together. The swelling is caused by direct injury to the tissue of the mouth. The fluid on the lungs is actually secondary to damage to the nervous system from the electrical shock which then causes changes in blood pressure and heart function with a build-up of pressure in the blood vessels of the lungs and leakage of fluid out of the vessels into the tissue of the lung. Within 24 to 48 hours this already starts resolving on its own and veterinary care is necessary until breathing stabilises.

The nervous system (brain, spinal cord and nerves) can be over stimulated and injured during an electric shock. This can lead to muscle tremors, seizures, limb rigidity and even death.

When bringing your pet to the vet inform us immediately that your animal has undergone electric shock, as this will guide further diagnostics and treatment. This allows the vet to work more efficiently. Some diagnostic that the vet will carry out may include an ECG (monitoring the electrical activity of the heart for arrhythmias), radiographs (X rays) especially of the chest to evaluate the lungs, and blood tests to assess the overall wellness of the patient’s body and its functions.

Treatment of shock varies largely depending on the presentation of your pet. If they are in shock this will be treated aggressively with drip placement and monitoring of heart and blood pressure parameters. Fluid therapy is used to maintain and stabilise blood pressure and is very carefully used so as not to overload the system and worsen any fluid on the lungs that may be present. If the pet is presented in respiratory distress (breathing difficulty), the reason must be determined quickly and a source of oxygen supplied immediately. If there is excessive swelling around the face and neck then a tracheostomy (a hole directly into the trachea) may be performed and air supplied through the hole until the swelling can be treated. With fluid on the lungs, oxygen is supplied and medication can be given to promote the drainage of fluid away from the lungs and dilation of the airways. The first 24 hours are always the most critical. In very severe cases they may even have to be placed on ventilator to ensure adequate oxygen supply to the tissues.

Any burn wounds are treated conservatively with cleaning and topical treatment. Antibiotics may be necessary if there is any concern for infection. A very important aspect of any treatment is pain control. As far as we can tell, animals feel pain as much as humans do and we need to provide relief with oral or injectable painkillers. Once the tissue has healed enough to ensure good surgical success any major wounds can then be operated on without the risk of many complications. This may take a number of days as the damaged tissue may slough, so do not be too impatient. Premature surgery may lead to a wound pulling apart (dehiscence) which will then require further surgery and discomfort for the animal.

Prevention

Try to keep all electrical wires well covered and unexposed, especially around young pets. In the event the worst happens bring your pet to the vet immediately.

My dog makes a strange snorting sound with funny gagging movements almost like something is stuck in his/her throat.

What is reverse sneeze?

Reverse sneezing is repetitive, forceful inspiratory (breathing in) efforts generally caused by irritation of the lining of the naso-pharynx or area at the back of the mouth and nose where these two openings join into one. Unlike a normal sneeze where air is forcefully pushed out the nose to clear the irritation, a reverse sneeze involves air being pulled forcefully and rapidly into the nose. This is commonly seen in small and toy breeds breeds with long thin nasal passages like Miniature Pinchers, Toy Poms, Chihuahuas, Malteses, Dachshunds, Poodles, Yorkshire Terriers and other Terriers, etc., and brachycephalic (short nose) breeds like Pugs, Boston Terriers, Shih Tsus, Pekingeses, etc.

How to recognise a reverse sneeze:

It is a noisy forceful inspiration of air through the nose resulting in a strange snorting sound. When seeing a reverse sneeze for the first time it can be quite a startling event for owners who often think their dog is choking or even struggling to breath. During an episode of reverse sneezing the dog will often stand still, with elbows pulled away from the body, head and neck stretched out straight, with a backwards head motion, mouth closed and lips sucked in making a loud strange snorting sound. Their eye may even be bulging adding to the shock of an owner witnessing this. These episodes may last from seconds up to a few minutes. Although reverse sneezing can be startling to observe there is no real risk to the dog and they are generally normal after the episodes. Something to remember is that some dogs may even reverse sneeze throughout their lives with no untoward effects. This may be confused with the goose honking cough noted in tracheal collapse, a common condition in certain small breed dogs. It can also be confused with stertor which is commonly associated with activity and excitement; snoring occurring during sleep, and retching and gagging involving expectoration involving an open mouth. Another common condition it may be confused with is Kennel Cough with the major difference being that Kennel Cough causes a dry honking cough usually ending up with an open mouth gagging or retching at the end of the episode (as if there is a bone stuck in the dog’s throat), whereas with reverse sneeze, the dog’s mouth tends to stay closed and it is almost like they are trying hard to swallow something, which just does not want to go down the throat. Kennel cough is caused by a number of difference viruses and bacteria and is usually a condition which will clear up over time and disappear completely, whereas reverse sneeze often seems to be a lifelong condition.

Diagnosing reverse sneeze

If these episodes are something that happen frequently, are concerning for you, or seem to distress your pet, it is better that you take them to the vet for a proper clinical examination. Generally, the veterinarian will attempt to determine the cause of the symptoms by doing a thorough work-up which may include the consideration of the age and breed of your dog, a good history of the condition and the clinical signs seen, a full clinical examination from nose to tail, a nasal work up (X-rays, flush, biopsies etc.), endoscopy (with sample collection and visualisation) and response to treatment trials. The extent of the work-up is determined by clinical signs, frequency of episodes and your willingness as an owner to go through the process. A very important point to remember is that often despite the best attempts and in-depth work-ups, a final answer or underlying cause may never be found. This may be in part because this condition may have a behavioral component to it. Please read below under Causes for more information.

There are a number of other conditions affecting the throat, the heart and the lungs, which may mimic reverse sneeze and therefore it is important to rule out these conditions, as some of them may end up being life threatening and ignoring the symptoms and merely saying that it is a behavioral problem, may be too simplistic.

Causes:

So what may be some of the possible causes? The consensus, given current knowledge available on this conditions, seem to indicate that this is a response by the body to some form of irritation of the upper respiratory tract. These can include rhinitis and sinusitis, which is an inflammation of the tissues of nose and sinuses. The cause of the inflammation may be infectious (bacteria, viruses and fungi), environmental (dust, irritant aerosols, cleaning agents, grass awns and seeds etc.) and allergic conditions, where it’s the body’s over response to normal environmental contaminants that causes the problem. Other causes may also be eating or drinking too quickly, pulling on the lead around the neck, and even excessive excitement. Even excessive vomiting may cause inflammation of the nose and throat.

Tumours of the oro- and nasopharynx (mouth, nose and throat) and even severe dental disease may be the reason behind reverse sneezing. Excessive vomiting may also cause inflammation of the nose and throat.

The behavioural component or cause of the condition is not yet well understood but there seems to be a school of thought which says that the condition starts as a result of one of the reasons above and may have been self-limiting, had it not been for the fact that the concerned pet owner immediately pays attention to their dog during one of these episodes, which lead to some form of attention seeking behaviour from the dog with future episodes. It is unlikely to be completely voluntary (i.e. the dog “taking its owner for a ride”) but it does seem like the concern an attention shown to a dog during some of these episodes may perpetuate the problem and cause it to recur. If other pathological causes for the condition have been ruled out through a proper clinical workup by the vet, it may actually be of benefit to ignore the dog during these episodes and not make a fuss of it at all. Please discuss this with the vet before you assume this is the case with your dog.

Treatment:

In general there is no specific treatment for reverse sneezing and in most cases no treatment is required. During the episode it helps to calm your pet, stroke them gently on the head and neck in an attempt to calm and sooth them. As mentioned previously these episodes often resolve on their own with no complications and ignoring an episode may in actual fact be a better treatment that to hold and stroke your pet and talk to them. Treatment deals with the underlying cause, if it can be found. Response to treatment is often used by the vet as a cost effect diagnostic tool for the more common reasons for reverse sneezing. Treatments prescribed by the vet may include anti-inflammatories, steroidal treatment, antihistamines and even decongestants. If a specific cause is found more direct treatments may include, dental therapy, antibiotics, or even surgery.