Bonus Episode : Protecting Your Pets from Holiday Hazards: A Comprehensive Guide with Veterinary Toxicologist Dr. Renee Schmid

Dr. Lindsey Wendt co- hosts our chat with Dr. Renee Schmid, a veterinary toxicologist from Pet Poison Helpline, who sheds light on the all-too-common issue of toxicity in pets during the festive period. From chocolate to poinsettias, human medications, decorations,  xylitol,  marijuana and more.  Dr. Schmid  highlights the common everyday hazards that pets may fall prey to, underscoring the importance of keeping these items out of their reach.
She  also offers practical advice for when your furry friend ingests something potentially toxic. Learn the vital importance of staying calm, gathering information, and understanding how certain substances can affect your pet. We wrap up with a look at the crucial role of veterinary clinics and public education in raising awareness about toxin concerns.

Useful Links:

Pet Poison Helpline : 1-855-764-7661
Website : https://www.petpoisonhelpline.com/

Transcript

Speaker 1: 0:00

Thank you so much for joining us. We're talking about toxicity in our animals and our pets, specifically dogs. Since this is a dog podcast, Do you want to introduce yourself a tad and let?

Speaker 2: 0:12

us know a little bit. Yeah, you bet, I'm Renee Schmidt. I'm a veterinary toxicologist with Pet Poison Helpline. I've been with Pet Poison Helpline for just over 10 years now and also the manager of veterinary medicine and professional services there. I'm a Kansas State graduate, very proud Kansas State graduate, and I've been. You know, toxicology was something that I never really had a huge passion for when I was in vet school or out in practice. I always kind of enjoyed it, but as time went on I found that it really allowed the blending of the things that I like to do and solving all the pieces of the puzzle, putting the pieces of the puzzle together and when animals get into things. So it's been a very enjoyable sector of veterinary medicine.

Speaker 1: 0:56

That's fantastic. I wanted to focus today, just right now, specifically have some questions. Since we're jumping into the holidays, I wanted to talk a little bit about some of the things that you find that pets may get into over the holiday season and if you see an uptick in cases during this time of year versus during other times of year.

Speaker 2: 1:21

Yeah, absolutely so.

Speaker 2: 1:23

November and December are generally our busiest two months out of the year with call, and so we definitely see a pretty large uptick in those two months and it varies from just the regular things that animals generally kind of get into.

Speaker 2: 1:40

But when we step back and we think about it, as you know pet owners and family members we're kind of a little bit discombobulated. These last couple of months of the year We've got changes to our schedule. We have a lot of different things going on. So maybe even the most in tune pet parents or maybe somebody who is really diligent about keeping things out of reach for their pets and they just kind of get off kilter a little bit and so they might leave something sitting out. Or when we have house guests, a lot of times there's a lot of traveling going on and so when you have somebody that's coming over to your house and visiting and they have that suitcase or that bag on the floor and their medications are there and then the animal gets into it, so really common things in that manner that we see a little bit calls from that animals have gotten into.

Speaker 1: 2:26

I just had. My mom was just here last week for the week and I had to keep repeatedly reminding her to put her medication on top of on the kitchen counter, not like next to her bed, and get the stuff off the floor constantly. Luckily my dog could care less about that stuff, but still it's. You know, you never know, so she's just not used to it. Yeah, you never know.

Speaker 2: 2:49

Yeah, you never know. My kind of phrase for the holiday is to anybody who's coming over to your house, you know, ask them right away do you have any medications? Let's put it up in a counter or up in a cabinet for you, absolutely To get it out of the way so it doesn't even become an issue. And even supplements. You know a lot of people. They think that if it's over the counter and it's a healthy supplement for them, it's healthy for their pets as well. So they don't think about the dog that maybe gets into a bottle of multivitamins or a bottle of their vitamin D3 supplements. And so even any little thing that a person might take, whether it be prescription medication or just a natural supplement, let's get it off the floor.

Speaker 1: 3:32

Let's make sure it's out of reach, make sure there's no risk at all, even if we don't really know Are there common things that dogs get into over the holidays, that we need to be prepared, or should we just cross the board? Just make sure everything is out of your pets reach, just to be cautious.

Speaker 2: 3:48

Yeah, you know, for human medications for sure, you know, obviously let's make sure those are out of reach. Chocolate they love to get into chocolate all of the time, but Christmas time is actually the holiday where we see the highest number of calls with animals getting into chocolate and I think it's just one. Because of parties and celebrations, people are baking more. They're getting gifts, baked goods, they're putting chocolate products under the tree. You know there's just a lot more out there for them to get into and so we see that time quite a bit. And then also around the holidays, and really all year round, but the holidays as well, the lilies so true lilies that we have to be concerned about with cats. There's a lot of holiday decorations. When you order a nice beautiful holiday centerpiece that will have the nice large, brilliant white lilies that are in there, those are usually going to be true lilies and can cause kidney failure in cats and we see those.

Speaker 2: 4:47

You know, valentine's Day, mother's Day, they're all around, but we can't forget about that in the Christmas time as well, and then anything that could potentially contain xylitol, so any of those food products during your baking time. If you are somebody who uses xylitol instead of sugar, be sure and really keep that out of reach for your pet, an animal that gets into pure xylitol you know baking powder. It takes a very, very small amount for them to have significant issues.

Speaker 1: 5:19

And what do those issues like? What do those issues look like?

Speaker 2: 5:24

Yeah, so if they were to get into xylitol they can have a drop in blood sugar, and so with that drop in blood sugar, called hypoglycemia, they can develop kind of difficulty walking a taxia, they're pretty sluggish, they can even have tremors and seizures occurring and then, if they get into a large enough amount which, depending on the size of the dog, may still be very little they can actually have liver failure and they can die from liver failure. And some signs of that would also be vomiting, maybe some yellow discoloration to their gums and to their eyes and skin. If that happens they've probably been sick quite a bit before the pet owner sees that, but they're just really off and significantly lethargic or sluggish.

Speaker 1: 6:13

How long does it take for that to kick in, like immediately, he was saying, or like hours, or yeah yeah, so they can start to vomit within about 30 minutes after getting into xylitol.

Speaker 2: 6:26

Their blood sugar can drop in that timeframe, but usually within the first two hours and it can last. They can have that low blood sugar for up to two days in some cases and then the liver changes. We can see blood work changes within just a couple of hours, but liver failure itself usually it's gonna be around that 24 hours or the day after they've gotten into it. The good news I would say about xylitol I know we're just talking mainly about dogs, but for anyone who has multi pets or has some cats in the household, cats don't have an issue with xylitol and so it's really that big concern with dogs and I always like to call if you have an assassin cat in your household, so the one that likes to be on the countertop and knock things over for the dog in hopes of being the only pet in the household, and just to be aware of that. Not a concern for cats, but definitely the dogs we have to be really concerned with. Okay.

Speaker 3: 7:30

And then this is more of a technical question, but I actually I was not aware that it was only a toxicity for dogs. What is the underlying? I guess like pathology behind that. Cause usually cats are more sensitive. Yeah, isn't that? Yeah, cats rarely.

Speaker 2: 7:46

Cats rarely draw the long straw. They usually get the short straw on a lot of things and we don't know why. We don't know why cats are affected differently and it's actually very species specific with xylitol. So cattle have a toxicity to xylitol, but it's a much larger amount and how they would be exposed to it would be very minimal or rare. There's been studies that were done way back in like the 60s and 70s where they looked at cattle and pigs and horses and rabbits and you know they all have some degree of toxicity but the amount that they would need to get into is very different and we don't know why cats are resistant to it. But it's one of those things where it's like embrace, we'll embrace it for those cat lovers out there Definitely.

Speaker 3: 8:39

And then I know one thing that I've been seeing a lot more xylitol being in peanut butter. So can you speak to that too, cause that's been, it seems, like more of a trend, so that people can't just necessarily grab any peanut butter off the shelf. They really need to be reading the label.

Speaker 2: 8:54

Yeah, and you know we used to think back. You know, years ago we would say if it says it's sugar free, look for xylitol. And now there's xylitol in a lot of products that don't say anything about being sugar free, and there's even products that contain xylitol and sugar, and so now it's anything that would potentially require a flavor in the mouth. Look for xylitol is what I kind of say it's. Don't stop at sugar free, don't make an assumption anywhere one way or the other.

Speaker 2: 9:26

And as far as the peanut butter goes, so far we have not found any what I call mainstream peanut butter. So if you were to go to the main aisles of your grocery store and get either the the grocery store brand or, you know, some of those like Jiff and Skippy's, I haven't so far seen xylitol, even with their low sugar natural products. Most of them are in I call them the boutique brands. So the you know kind of go in that whole food section. Maybe they're more of the organic, they're kind of those specialty brands and that's where we could potentially see more xylitol. That being said, I would always look, you know, check. If you're going to give xylitol peanut butter to your dog, make sure, check you, check the bottle, because manufacturers can change their ingredients at any time, but so far, most of that's going to be those specialty brands. There are some peanut butter spreads that have different flavors, different types of flavors, not just peanut butter flavor, and so those are some of the ones that we're starting to see xylitol in as well.

Speaker 1: 10:31

Wow, can I circle back to holidays really quickly one more time? Yeah, point setters, are they toxic to dogs? I have a dog care business, so I have dogs in and out of here and I want to decorate for the holidays, but I'm always really cautious, as you mentioned, and I've read Nick's things. So what's your take?

Speaker 2: 10:52

on that yeah.

Speaker 1: 10:54

Yeah, so by definition.

Speaker 2: 10:56

point setters are toxic because they create a negative effect when they're when they're invested, the good news is is that they cause stomach upset.

Speaker 2: 11:05

Okay. So they're not going to be. They're not going to be fatal, unless let's say that that very rare dog that maybe keeps eating and eating and eating the point that is and is vomiting and diarrhea and becoming dehydrated and the owner isn't noticing it and isn't seeking treatment, you know something like that where they're having some some other effects from it. But otherwise usually it's just going to be some mild stomach upset, maybe some vomiting, maybe some loose stool. Usually it's going to correct itself on its own. So I wouldn't hesitate to put a point set in my house. So I have dogs and cats and I won't hesitate to put it in there. But if one of them just refuses to stop eating it, I may try to put it up higher, just because I don't want the mess, but I it's not something that we would ever expect to be fatal.

Speaker 1: 11:57

That's good, good to know.

Speaker 3: 12:00

Yeah.

Speaker 2: 12:00

Yeah.

Speaker 3: 12:01

Another holiday decoration. Oh sorry, Go ahead.

Speaker 2: 12:03

No, it's probably the biggest holiday myth. Okay good, I'm glad I yeah.

Speaker 1: 12:08

Okay.

Speaker 2: 12:10

Yeah, I mean, I don't want stomach upset in any of my guys either.

Speaker 1: 12:14

You know, but, but, at least I know. I'm not, you know, putting them in danger. Yeah, yeah.

Speaker 2: 12:20

Yeah, and I treat them very differently as opposed to like the lilies, the true lilies. If you have a cat in your house, I would. I would not have a, I would not have a true lily with cats in the house and I love lilies. They're beautiful flowers. But if you're going to have a cat in the house, keep the lilies away. Point set is I have at it, Put them in there. But if the dog or cat continues to chew on it, need on it and have stomach upset, then try to put it someplace.

Speaker 1: 12:44

That makes it more difficult to get. Dr Lindsey, you had another holiday question.

Speaker 3: 12:50

I was going to say other decorations, so, like I've heard you, plants, and then also I was wondering if you could address like Christmas trees, because I know they can be a toppling issue, but what about the water? Or like licking the resin or the sap, or any other plants that tend to be more holiday? Yeah, yeah you bet.

Speaker 2: 13:08

So you plants Japanese use are probably the most common in the United States, and a lot of times they are used to build to make wreaths for garland, just because of their availability, their durability, and so you may have a wreath in your house a live wreath that actually isn't made of like pine or fir but is made of you, and that's something that's very toxic. It contains what we call cardiac glycosides. So these are heart toxins. They cause heart blood pressure, heart rate arrhythmias, rhythm issues, and can definitely be fatal. So that would probably be one as well that if I had a dog or a cat in the household, I would watch my wreath carefully to make sure that if it starts to die and fall you know, fall down that night I take care of it at that point. And then and then the Christmas tree.

Speaker 2: 14:06

So the Christmas tree has, you know, come is some essential oils, and the sap that's in there can be very irritating to the stomach and the intestinal tract.

Speaker 2: 14:18

The water itself isn't usually going to be much of an issue. The little fertilizer or plant food, tree food that gets poured in there, that usually is not a big issue either, if they get into a little bit of that where it becomes more problematic is depending on how you care for the tree and what you read. Some people will put aspirin in their, in their tree water, and so that is definitely problematic, more so for cats, and when I think about the tree stand and the tree water underneath the tree. My dog can't get to it but my cats sure can, and so that's something to be to be cautious of as far as that goes. But the tree itself, the pine needles or the fur needles or whatever they're ingesting, those are definitely irritating and if they can ingest enough of them could potentially cause an obstruction if they, you know, if they're really going to town on it. But not a huge concern as far as toxicity goes.

Speaker 1: 15:22

Okay, can I? I want to circle back again. Again I'm circling back. I want to focus on chocolate because I I've also heard mixed things about chocolate. Is it that it's different kinds of chocolate that can cause an issue? The amount of chocolate? I've certainly had dogs who've had like a chocolate chip cookie and they were and I was freaking out and they were completely fine. My sister's dog has eaten batches of chocolate chip cookies and had to have his stomach pumped like maybe three or four times during this lifetime Just to be safe. He was definitely like a you know counter surfer. But can we kind of cause that's a really common toxin in our pets and then we hear a lot about it? Can we really kind of dive into that and talk about some of the best of some of the realities and what we need to look for.

Speaker 2: 16:12

Absolutely so with chocolate, and this is goes for dogs or cats, so whichever, if you have a mixed household, it works for either animal. It really is going to depend on several things, like you mentioned. How much did they get into? Because in toxicology the dose makes the poison, and so while something may be toxic, there's always an amount that needs to be ingested or exposed to before it's actually an issue. And then we have to think about what kind of chocolate. So you alluded to that as well.

Speaker 2: 16:45

If easy kind of rule of thumb, I think about the less sweet chocolates, the more concerning they are. So there's a component in chocolate that's called theobromine, and that's the biggest concern. It also contains caffeine, but small amounts, and so we don't usually get too worried about that. It's the theobromine portion that's more problematic, and so the the higher percentage of like real chocolate, full chocolate, is going to be more concerning. So think about your baker's chocolate, or maybe you're 90% and higher, dark chocolate, cows or pure chocolate, pure cacao, think about your semi sweet chocolates, and then kind of, we're going to go down from there. So we have dark chocolate in different percentages, and I think in order to be named a dark chocolate, if I remember right it needs to be around 50 or 52% cacao or dark chocolate cacao, but there's different, there's varying percentages, and so that's going to vary the amount of theobromine that's in there.

Speaker 2: 17:48

And then work our way down to milk chocolate that's nice and sweet, and then go to white chocolate, which really just has some cocoa butter in it, not much theobromine at all. And so if you were to take a 10 pound dog that ingested one Hershey kiss versus a 10 pound dog that ingested the same amount of baker's chocolate, could have very different effects with that. So one Hershey kiss in a dog probably not going to be a big issue, but that same amount in a 100% pure chocolate or baker's chocolate could definitely be a concern in our small dogs, and so the weight of the dog is going to really make that issue, make that change or determination as well. So how much can they get into?

Speaker 1: 18:33

that makes sense and does it present itself the same way? The the, the, the effects of the toxicity, like vomiting, diarrhea or what does that look like. So people can get into that.

Speaker 2: 18:46

Yeah you bet. So what I suggest is, you know, call us, call us before panicking. Call us before taking matters into your own hands. We unfortunately get calls from extremely well meaning pet owners that actually cause more harm with trying to treat the pet and then calling us and we have to say well, what they got into isn't problematic, but what you've done is, and so now you do need to go into that, into the veterinarian. But I would say that you know anything over that Hershey kiss. You know, let's call and see, because what we can do is we can do calculations to determine, based on what it is that they got into and based on their pet size, how problematic is this going to be?

Speaker 2: 19:31

And there's kind of different layers of chocolate poisoning that we get concerned with. So any animal that gets into chocolate can develop stomach upset because it's a, it's a, it's a rich food, and so they may vomit, they may have some loose stool, they could even develop pancreatitis, so an inflammation of the pancreas because they're trying to digest this rich food. And that doesn't even have to be a toxic level, that can be a small amount. And then, as they ingest more of that, then we can see a high heart rate. We can see a high blood pressure. They're antsy, they're agitated, they're kind of, you know, restless, they're kind of bouncing around a lot. Maybe they have some body tremors. As this keeps going up, we can see some heart rhythm problems and changes. We can see seizures developing.

Speaker 2: 20:20

It definitely can be fatal depending on how much they get into. Fortunately, I think pet owners know a lot about chocolate in the sense of this could be bad, and they recognize minds and they get therapy. Most animals, if they get treated for early on, do extremely well. We've had cases that unfortunately don't go as well, are usually ones where they just they, they waited it out, and so then it was too long to do any type of kind of decontamination or trying to trying to get rid of some of that chocolate that they've ingested and then they end up having some really significant signs. Okay.

Speaker 3: 21:00

Okay, one thing I actually wanted to ask you. So I know, as a veterinarian, because I used to practice emergency medicine, I became very used to calling you all for many cases, but I also had access to a calculator where I myself could determine okay, this is the amount of chocolate that they ate, this is their weight. What range of concern is this in? Are there any resources like that available to pet parents so that you know, especially during the holidays when I know you know pet poison hot like like you get inundated with calls so sometimes the wait times can be long. Are there other options for pet parents as a resource?

Speaker 2: 21:36

You know that's a great question and I'm not. I don't know of any that are out there available. You know that calculator and there's one that's you know it's limited to veterinary members of a particular organization for continuing education and things that's available. I'm not aware of one that's out there for pet parents themselves, and you could certainly go to our website, just petpoisonhelplinecom. You could type in chocolate and there's some information there that kind of helps guide you as to what kind they got into and things like that, but I'm not sure it's going to actually do kind of the calculations for you.

Speaker 2: 22:16

The one thing that I would also mention is that there are a lot of you know there's a lot of different technology out there now. There's AI, there's a lot of chat places where you can chat in and ask questions, and I would really encourage everyone to use caution with those. We've played around with them, we've tested them. A lot of it is not right. Some of it is accurate. It's difficult for a pet owner to know what's right and what isn't, because the answer that's given is very confident, and so it's really something where I would highly encourage someone to contact their veterinarian. If they're not available, contact an animal poison control center, like pet poison help line, and really get the information that you need. And I know there's a fee and a lot of people are hesitant to pay the fee, but let's get the right information. If we can save you a trip into the emergency clinic, if we can save you from getting additional care, you know it's well worth the money and the peace of mind. In my opinion.

Speaker 3: 23:21

As an emergency veterinarian, I know for me when people would come in. Despite what the patient might have eaten, I oftentimes would call a poison hotline so that I could have guidance on how to treat and to give them more information. So one thing I started encouraging a lot of pet parents to do is if they can call when they're on their way to the emergency hospital so that we can then take that case number, call and have more immediate attention.

Speaker 3: 23:48

So, I was wondering if there's any other kind of tips that you have for pet parents Like I know. Another one I used to tell people is whatever they eat, grab the packaging, grab your pet, get in the car and start driving to the emergency hospital If you can safely call while you're on your way. But are there any other kind of tips or tricks that we can do to make our jobs together easier and then increase the rate of care that they're receiving?

Speaker 2: 24:12

Yeah, you bet. So your tips are excellent and a lot of times if that pet owner or pet parent can call when they're in route or before they've left their home and we may be able to save them the trip from going in and say you're OK to wait, or maybe they didn't think about grabbing that packaging. Or maybe we get plenty of calls where they leave in a panic, and I would do the same thing when something happens with my pets. I am no longer a veterinarian, I am a panicked, concerned owner and the logic kind of flies out the window because there are family members and so we're really concerned about them and so it's very normal for pet owners to panic. But that's probably my first tip is to say don't panic, take a step, take a breath and really think about gather all of that packaging.

Speaker 2: 25:03

As you said, if there's medication, if there's pills that are strung out on the floor, grab as many as you can. Try to get as much information about the exposure as possible. So when you go to your veterinarian, if you tell them that your pet ingested some green rat bait, it's not going to guide them into what needs to be done, and I think that's another kind of common misconception is people often think that rat baits have the same treatment, same active ingredients, and they don't. They have very different mechanisms and very different outcomes. And so just finding all of that information that you can to either give to your veterinarian or to give to pet poison helpline so that we can make that best assessment.

Speaker 2: 25:48

It's very natural for pet owners to be a little bit discouraged when they call in because they say all I know is that they got into bait and you should help me know what this is. And unfortunately we kind of need some more information. And so if they can have some packaging available to them, if we can know how much it is that they got into, if they got into that bottle of ibuprofen, what was it to begin with? How many was in there to begin with? How long have you been using it? Or prescription medications. Sometimes we send those owners back into their pharmacy and say we'll find out what that milligram strength was when it was filled. How many times are you taking it a day to try and get an idea as to how much is there? And so those are all things that can be very helpful at determining what it is that, if it's going to be an issue or not, what it is that they got into and how much of a problem it is.

Speaker 1: 26:44

If I can share a story. I had a client who, when he was five, we were not 100% sure what he ate. It was incredibly scary. We were pretty sure it was rat bait. He ended up in the emergency vet for nearing three weeks. He was a rare case. They kept him there. His family had lots of resources so they opted to keep it going and they had vets calling from all over trying to. You know, because it was a case study. But he ended up living a long, long life. He passed away at about 15.

Speaker 1: 27:19

But they think that it was either rat bait or they kept asking about vitamin D, like if they had eaten some like cortisone, like you know, like dermatology cream or something like that. So it was one of the and we couldn't no one claimed that, but the only thing we could think of that he was a golden retriever, so he got into everything out in the world. So we figured he must have picked up some sort of rat poison. It was really really scary. I mean, essentially they kept him alive while it worked through his system and they flushed it all out of his system. I mean it was very scary and he was very lucky. But we had that firsthand experience. So what are you saying? That their different rat poison does different things? Is that you never? Yeah, yeah.

Speaker 2: 28:05

Yeah, so there's three main types of rat and mouse baits that are sold for kind of residential use. One of them is Koli calciferol, which is vitamin D3.

Speaker 2: 28:18

I always say I think the market, I think the marketing people decided well, we can't call it vitamin D3 because people use it in a supplement, so let's call it by its other name, koli calciferol. But they're the same thing and takes a very small amount to be problematic for dogs or cats and this will cause high calcium, blood calcium levels, which then can cause damage to multiple organs, including the sensitive kidneys, and can cause kidney failure to occur. So that's probably why they thought it was either a rat bait or a vitamin D supplement, because the effects are the same. And then one of the other types of rodenticide would be bromethylene, and bromethylene causes brain swelling to occur, so it causes neurologic issues completely different than Koli calciferol, and the amount that the animal has to get into is different than Koli calciferol.

Speaker 2: 29:14

And then the most what we call traditional, the ones that people think about most frequently, are the anticoagulants. Those are the ones that cause bleeding issues to occur. There's multiple different active ingredients in that same class and those have been around the longest for sure, but they're also being phased out to an extent because of the EPA makes decisions as to what can be sold here and there, and several of them have been phased out or banned because of the negative effects on wildlife and trying to preserve the wildlife population and those cause bleeding issues to occur. So if you think about those three different things, we have calcium and kidney failure, we have brain swelling, we have bleeding issues. The treatments are all going to be very different and so if we make an assumption that it's this one or that one, we will be completely missing the boat in some of these cases.

Speaker 1: 30:14

We got very lucky there, yeah.

Speaker 3: 30:17

For sure. So one thing that I have been seeing that's gaining a lot of popularity is there's an actual product that is being plugged in many social media channels. That's an activated charcoal and it's small little charcoal beads and people and it has a high price point as well. But people are being urged like by this, so that if your dog gets into chocolate or this or that and they're just listing all of these things like give this basically insinuating to give that and then seek out veterinary care or just give that and kind of care for your pet yourself. I was curious your opinion on that because I know as a practitioner activated charcoal is not always recommended.

Speaker 3: 30:59

And then oftentimes, when they do ingest things, we're actually inducing vomiting. So the concern of them aspirating or accidentally inhaling that charcoal that the pet parent gave with good intentions could end up causing more damage than if they would have just waited and pursued treatment through a veterinary.

Speaker 2: 31:17

Yeah, for sure. I'm glad you brought it up. It is something that came out just a couple of months ago and, reading up on the product, there is some concern about the way that it is marketed, as you mentioned, to give it and then figure out what it is later. It is charcoal doesn't bind to everything. It doesn't work for every toxin and sometimes we do want to induce vomiting first, and sometimes we wouldn't want to give charcoal even if it doesn't work.

Speaker 2: 31:51

There may be other reasons why we wouldn't want to give it, and so I think it's a great product in the sense that if an owner doesn't have another resource, maybe there's three hours away from a clinic. We've talked to pet owners who they live on an island and the ferry isn't coming until tomorrow or it's a blizzard and they cannot get out, and so being guided to do that is something that there could definitely be benefit for. But I am a bit concerned with using that first off. Personally, as a veterinary toxicologist, I would never give my pet charcoal before knowing if it is necessary or doing anything else first. So I would encourage pet parents who have that, or if they're considering that, talk with your veterinarian first. Talk with pet poison helpline. First talk with the experts, find out what needs to be done and if it should be even given.

Speaker 1: 32:57

On those same lines. What about the hydrogen? I think it's hydrogen peroxide. At times when some of my clients have had eaten chocolate or chocolate cookies, I've had their parents text me instead of texting the vet, for whatever reason, and say maybe I should give the pomeo hydrogen peroxide. What are your thoughts on that? Is that a good thing? Is it a bad thing? Is it depends on the situation? Oh yeah, it's both.

Speaker 2: 33:27

Yeah Well, in my opinion, I think that hydrogen peroxide is a very polarizing topic in toxicology. You'll have veterinarians who will be for it and you'll have veterinarians who will be absolutely against it. I respect both. I feel that it's good to have a healthy disagreement with it. I would say that we, clinically, we have been able to prevent animals from developing poisoning or clinical signs. We've been able to prevent them from having to go into the clinic if necessary, where it wouldn't have. We've been able to do things with dogs by recommending hydrogen peroxide. That being said, we check every box. The animal needs to be the right breed. It needs to be. The timing needs to be right. The health of the animal needs to be right. The thing that they ingested needs to be right.

Speaker 2: 34:23

We would never just give hydrogen peroxide for the fun of it, but we really have to check the boxes. We never give hydrogen peroxide in a cat period. There's no time where we would ever do that, because they are very sensitive. They don't handle it very well. When we think about hydrogen peroxide, the way it works is it's a stomach irritant. It's going to irritate the wall of the stomach and that's what causes that vomiting to happen. Cats it causes. It can cause some ulcerations and more and kind of worsening issues. It can happen in dogs. It's unlikely. It's less likely to occur if you use a specific dosing. We never want to give hydrogen peroxide until they vomit.

Speaker 2: 35:12

We definitely have had calls where people have said I don't know, I just poured hydrogen peroxide down my dog and he didn't vomit.

Speaker 2: 35:20

Those are ones that are concerning that are going to develop issues. When I tell a pet parent about hydrogen peroxide, I would say never give it on your own, give it under the direction of a veterinarian or a toxicology expert. They're going to check the boxes and say, yes, your pet would probably benefit from that. There's a lot of times where we've gotten that call within five or 10 minutes. They've given hydrogen peroxide. Whatever it is that they got into, come right back up and we've saved the animal. There's times when inducing vomiting at home with hydrogen peroxide would not be ideal and they would need to go into the clinic. I have great respect for people who disagree and say it should never be given and that's okay. But I know that for us, out of the hundreds of thousands of millions of cases that we've managed, the number of animals who have had negative effects is extremely low in comparison with the number of animals that have benefited from it.

Speaker 3: 36:23

As a follow up on that. We've talked about charcoal, we've talked about hydrogen peroxide. Are there any items or tools that pet parents can have on hand at home to help even calling into pet poison helpline that can help them better treat their pet if they're not able to get to about, like you were saying, if they're far away or just a half on hand, Is there anything that you would recommend that they keep at home?

Speaker 2: 36:51

Yeah, that's a tough question for cats, unfortunately probably not. There's really nothing there unless they get into something that can cause corrosive issues or ulcerations, burns. Then certainly just using water to irrigate and flush or something in their eye. For dogs, really, that hydrogen peroxide that should be unexpired and fresh is something that is probably good to have on hand. Obviously, something to just water and diluting, depending on what they get into. Sometimes, not very often but there's a few things that we might recommend giving a little bit of milk to to help. I would also say, if you're going to have xylitol in the household, let's make sure that maybe you have a caro syrup or even pancake syrup or something like that, so that if the animal does get into it, you can give some type of a heavy glucose source or sugar source to help minimize that risk of that low blood pressure from occurring before you get them into the clinic.

Speaker 1: 37:59

How much would honey work for that I? Was going to say how much would you give of that to help counteract that, like a tablespoon or something, or it just depends on the animal.

Speaker 2: 38:11

It depends on the size of the dog. A lot of times I'll say just rub it on their gums. Just rub a little bit on their gums. If they're starting to show signs where they're wobbly and they're losing their footing, then try to give a little bit more with that while you're in route to the clinic. I kind of say take that with you so that as things change because xylitol does work so quickly- I was going to ask would honey work as well, just in a pinch?

Speaker 3: 38:38

Is that an option?

Speaker 2: 38:39

Yeah, so you could use honey. We typically say don't use honey and dogs that are like less than six months of age and just there's always that botulism concern. So you could definitely use honey if you needed to just a little bit along the gums. But caro syrup is probably the one that we say that reach for first if you have it. If you're not in a household that bakes and most people don't have caro syrup around, so then I say, grab the pancake syrup. Or even if you just have some a little bit of sugar and you have nothing else that you can do, just some of the granules of the sugar, just anything to try and help get some glucose absorbed, to help with that.

Speaker 3: 39:21

Can you talk a little bit more about the botulism? Sorry, I know that it was kind of a passing pattern but I don't think that's something that most people know about, so it might just be.

Speaker 2: 39:31

Yeah, I think there's. You know, when you think about infants, they recommend avoiding making sure that honey isn't used at a certain age, just because they can be at a higher risk of that. And so I think we try to just give that same, that we just kind of put that same concern over on the animals, just to make sure that that isn't. You know, that they're old enough and their body's healthy enough that if there was any potential risk of contamination, that they would be able to take care of that.

Speaker 3: 39:57

So what I wanted to talk about next is actually kind of leaving the holidays and when in the clinic. I would love to hear your opinion on urine drug tests for animals that do get into illicit drugs, because that unfortunately happens pretty frequently on an emergency basis. What is the validity? Because most of those tests are human urine drug tests. So are those tests sensitive enough that we should be using them or recommending them in our pets, or what?

Speaker 1: 40:30

would you?

Speaker 3: 40:30

recommend for both pet parents and practitioners. Actually, yeah, that's a great question.

Speaker 2: 40:35

So I typically don't put a lot of weight into a urine drug test because there's a lot of times there's a lot of different metabolites. So as that drug is being processed and worked through the body and metabolized through the body, there's different metabolites between humans and animals and so those urine drug tests they are validated on human urine and they're not validated on animal urine and so you may have some false positives, you may have some false negatives. I generally say we're going to treat the signs. If it looks like a duck, it walks like a duck, it talks like a duck, we're going to treat it as a duck.

Speaker 2: 41:20

And we've certainly had calls where the urine drug test has been positive for, let's say, methamphetamines or methamphetamine, and methamphetamine would give a really high CNS or central nervous system stimulation. So these guys should be bouncing off the walls, they should have a really high heart rate, a high blood pressure, they should be extremely agitated and this guy is really subdued and he's dribbling urine and he's ataxic and so we're going to treat him for marijuana, because that's what his signs most likely are from, versus methamphetamine, where he's not showing any of those signs. So a lot of people use them If the results are accurate, then it's great, but they're so unreliable that I typically say let's just treat the signs and that's where we all come down to it anyways. When that dog gets into something at the park and they don't know what it is, and he starts displaying these particular signs, we know enough about what's out there and what things can cause those signs that we're going to treat them symptomatically and supportively, really regardless of what that test may say.

Speaker 3: 42:35

And then you actually gave me the perfect segue, because the next thing I wanted to talk about was THC toxicity. So I know that obviously. So, to give you a little bit of background, I actually use cannabis quite a bit in my practice, obviously in a much different way, and so what I will often tell people is the reason that we see THC toxicity so much on an emergency basis is because these animals are getting into strains that have been developed for humans that are incredibly high THC. They're not being used in a proper therapeutic way. But I also have heard a lot of debate. I've heard a lot of veterinarians say that THC is lethal, that it actually can lead to death. At least for me, when I've looked at the research, there's actually no. So there's something called an LD50 or a lethal dose. There's no LD50 that's been found, at least for rats with THC. They haven't done the studies on dogs or cats, but I just wanted you, if you don't mind, kind of speaking to that and just any insight or opinion you have on that.

Speaker 2: 43:36

Yeah, you bet. So there is a lethal dose in dogs of three grams per kilogram, which is, if you think, if you think about a traditional marijuana joint, that's a lot. Three grams for a like a 50 pound dog, that's almost 23 kilograms. That's many ounces and ounces of this product. So, unless you're maybe a drug dealer and the dog gets into it, probably not going to have that much around, and so it's rarely fatal.

Speaker 2: 44:07

We do have, however, calls with some dogs that have been. They are just extremely negatively affected from it and dogs have more receptors, more kind of those endocannabinoid receptors, than humans do, and so they're much more sensitive than humans and so there's not really a good what we call a toxic dose or what amount do they have to get into before they see signs. It's very kind of individual, very variable with each dog, so some dogs are far more sensitive, some are a little bit less, but any exposure to THC or a marijuana product is potentially likely enough to cause some type of signs developing, and with that we used to have our most common calls were from the plant products, so the traditional joint or the buds that were there, and now we're seeing a lot more edibles, edibles, gummies, things that are. Maybe they also have chocolate in them, maybe they also have xylitol in them, maybe they are mints, and so there's a lot of different products that way that we're seeing animals getting into. And you bring up a good point. As far as you know, that the cannabis plant itself, decades ago there was a much lower THC concentration and now the THC concentration I want to say it was maybe like 13%, 13%, 14%, back in like the 60s and 70s, and now the plants are having about 30% or more concentration of THC. So that same amount has more THC in it. And then when you look about an edible, they can put in whatever kind of concentration they want to, and so these guys are getting into this and they're getting significant signs.

Speaker 2: 46:02

And the vast majority of dogs are going to be really lethargic and sedated. Now a lot of people laugh and say, well, just, we're just going to let them sleep it off, but along with that they could have a low blood pressure, they could have a low heart rate, they could have low body temperature and if those things aren't addressed, then they can actually cause negative effects on other organs of the body. And so I typically recommend, if an animal gets into THC is to go in and get an examination to see that everything's OK and decide at that point if they need to be in the hospital for supportive care or if they can go home and just be monitored, because it's difficult for a pet parent to know what their blood pressure is or what their body temperature is and to treat those types of things. Then there are a small amount of dogs who will actually have the opposite occur and they will become really agitated and they'll have a high heart rate and a high blood pressure and they'll need to actually be sedated. And so there are some dogs that work a little bit differently.

Speaker 2: 47:08

Almost most of the dogs will dribble urine, and so when you take a pet into the veterinarian and you don't want to tell them they got into THC, but they're dribbling urine the entire way and they're having a hard time walking on the cats out of the bag. So they got into THC. No matter what you say, that's probably what happened. So treatment of those is usually something that can happen. Fatalities are quite rare. We've, surprisingly, have had several really bad cases and if I remember right I think they were can't remember if they were gummies or edibles that they got into and they were just. It was a really large amount. So I think as we see more and more of these gummies and edibles going out there, we're going to see animals become more and more affected.

Speaker 1: 47:54

But yeah, I've had clients whose dogs picked up a joint on a walk and then someone dropped their weed out in the world. And when they were walking there.

Speaker 1: 48:07

I had recently a client whose puppy got into somebody's on a walk and she had no idea what it was. Luckily it was a case to just sleep it off. She did take the dog into the vet just to figure out what it was, but it was super scary. And then she was like so frustrated that people just irresponsibly toss it around and where your animals can get into them.

Speaker 2: 48:28

So yeah, yeah, and as more and more states legalize marijuana, it's become more socially acceptable to discuss it and our calls. Over the last five years compared to 2018, we had over a 700% increase in calls regarding marijuana, and I think it's a combination of one it is more readily accessible, but, two, it's more socially acceptable to say that their pet got into it, whereas in the past, when I was in practice, you knew this dog had gotten into marijuana as it came into the clinic. You knew it and it was like pulling teeth to get them to come clean with it. And now they just they'll just say that it happened, even in states where it's not legal. So it's interesting because of just the differences in state requirements, but also the differences in uses.

Speaker 2: 49:26

As you said, using it in different ways with cannabis and CBD is a big topic of discussion, and CBD in itself doesn't have those psychoactive effects. However, you have to be really careful to find pure CBD products and there's really no good regulations at this point with CBD products. And so they did some studies. Was it a year or two ago where they tested a lot of different CBD products and they found most, if not all, of them also had THC in them as well. They weren't pure CBD. And that's where our pets can get into problems, because when they say gosh, they got into CBD. This shouldn't be an issue, but he's acting like he has marijuana poisoning. It's typically because it's not a pure product.

Speaker 3: 50:16

And then, just out of curiosity, the cases where there is, you know, unfortunately a lethal kind of result from the ingestion. Is that normally because, like with something like an opioid, like morphine, it's breathing depression? What does that look like for a fatal THC toxicity? Is that normally just the low blood pressure or low heart rate, just like system?

Speaker 2: 50:40

shutdown. Yeah, so this last one that we had and I'm not sure if he did die he was probably the closest to dying that I've managed in quite a while and he was completely comatose, unresponsive, completely unresponsive. His body temperature was extremely low. Even with efforts to get his body temperature up, he wasn't able to they weren't able to get his body temperature up to a healthy state and his blood pressure was extremely low and he was having heart arrhythmias as well and he was not responding well to the therapy. He wasn't responding well to medications to increase his blood pressure or to stop the arrhythmias, and so he was in, he was in the clinic. I think he was in the clinic. When I talked with him, he was in there for his second or third day.

Speaker 2: 51:38

Most of these guys go home after 12 or 24 hours, so usually when they require hospitalization it's not a prolonged period of time. But this guy was in, he was in a specialty practice, they had the means to do everything kind of necessary for him and he just was not responding to the therapy. And that, unfortunately, is something that can happen, because sometimes owners aren't able to financially be able to do everything for their pet, and then other times you can do everything for your pet and it's still not. It's still not be enough to save them.

Speaker 3: 52:12

So garlic? I know this is hotly debated. So In the holistic community there are people that recommend providing garlic as an option for natural parasite prevention, Under very strict recommendations of cut it up, wait about 10 or 15 minutes and then offer it, and then there's guidelines. But I know as a conventional veterinarian I was taught that garlic is toxic period. It was very clear to me that there was not this room to be able to provide it in a certain kind of format or presentation, and I'm wondering if that comes back to us lumping it with onions, because that it seems like the toxicities for those two are actually more different than people discuss or believe. But I was wondering if you could talk about that, because I know garlic has been a big topic, at least in social media feeding garlic to dogs and cats.

Speaker 2: 53:09

Yeah, so it's our understanding that the mechanisms are fairly similar. It's the sulfur changes that cause homolysis to occur to the red blood cells. Dogs and cats are actually more sensitive to garlic than they are to onion, and so in my opinion, it'll be the debate again. It's probably one of those things where, depending on what your experience is if you've had good experience using it or not, so we know that there's an established toxic dose for onions and for garlic and for they are extremely more sensitive than onions, and for a cat, just to kind of throw it out, it's like three to five grams per kilogram.

Speaker 2: 53:58

Is is a toxic dose for cats and that's a decent amount of garlic that has to be given in the fresh form.

Speaker 2: 54:07

But if you were to take that and put that into a garlic powder, where it's so much more sensitive, it's a very, very small amount that they would need.

Speaker 2: 54:17

And we don't have a lot of animals that get into enough of the fresh onion, but some that do get into enough of the fresh garlic, but more so those that are getting into, like our onion powders and garlic powders, because it's so concentrated those are often the ones where we start to see the most severely affected from them. I am kind of of the school of knowing what that can cause in my pet. I typically would avoid it. But I think if you're staying again, the dose makes the poison. And if you're recommending an amount that's well below the toxic dose, is it necessarily problematic? Probably if you feed it on an everyday basis, but if it's a once here and there and it may not be detrimental to them to have it. As long as you're staying below that well below that toxic dose and I'm not sure how much they're using in the holistic world as far as an amount, what kind of dosing they're using for that?

Speaker 3: 55:28

So kind of what spurred this for me was my own dog got into she's 13. And she decided that she wanted to get into a bag of fertilizer that had been in our yard for two years. So I called the poison helpline. I stepped into a pet parent's shoes and I was freaking out and I had the nicest toxicologist help me. And when I was talking to her because I let her know I was a practitioner she mentioned something that I thought was fascinating.

Speaker 3: 55:55

So it was in regards to joint supplements and the issue with manganese toxicity. And I had no, I would have never even thought of that. I mean, in general, whenever a pet eats too much of anything, I tell people just play it safe and call a poison hotline. But I was wondering if you could share, even just briefly, like any of the oddball toxicities that maybe are a little bit more we should be more aware of than we are, because I would never have thought of joint supplements and that specific toxicity, but just anything that we normally are giving our pets. I know if they're eating too much, of course there can be a toxic level, but just any of the ones that you've seen. That maybe even took you by surprise, or it would be nice for pet parents to just keep in mind.

Speaker 2: 56:43

Yeah, and I think some of them are still common ones that we get calls on. So the like grapes and raisins. A lot of people don't know that grapes and raisins are problematic. When I was in practice, I had a client that that's the only way she gave her pet medication every single day was putting it through into a grape, and the dog did fine. And so it's the dose makes the poison. There's individual sensitivities, but a lot of people don't aren't aware with gosh.

Speaker 2: 57:10

Grapes are healthy, raisins are healthy for us to eat, and so that's one that I think a lot of people don't know about. We talked about xylitol. That's one that a lot of people just aren't aware of. When you because it makes sense to not be aware of it. When you think about all the other artificial sweeteners or sugar alcohols that are out there, xylitol is the only one we care about. It's the only one that is going to be problematic, and so that's something that I think is a surprise to people.

Speaker 2: 57:40

The onions and garlic, you know you're bringing that up again. I think it's a surprise. A lot of people don't don't realize that that could be an issue. And then I think pain medications pain medications are really a surprise to to pet parents. So we will get calls from pet parents who, again with the best of intentions, have given ibuprofen or naproxen or some other type of human anti inflammatory for their pets pain, and then they they they're really thinking about the dosing or the amount or the sensitivity of it, and then these guys are, you know, they're coming in and they've got stomach ulcerations and they're in kidney failure. And this is happening with pharmacists and human physicians and nurses and pet parents who don't have a medical background, because they they are. They aren't expecting it to be such a difference between dogs and cats and humans, and so I think that's a really big surprise for a lot of them.

Speaker 3: 58:42

My last many questions, because you brought up grapes. Do we know the toxic component, like what part of the grape it's in, because I know for a while we didn't, but I've heard recently that perhaps there's more information that's available.

Speaker 2: 58:55

Yeah, so there was a paper published last year that was potentially linking tartaric acid, which is an ingredient in grapes and raisins, as being the component. There's a lot of research that needs to be done to be for us to be able to say that's what it is. If I remember correctly, the paper was was comparing three cases and so we kind of need a little bit more. In the paper stated you know, we need more research before we can really say that's what it is. I think a lot of people have taken that paper and really run with it and say this is what the cause of it is. It might be very well, might be, but there's also a chance that we that it's coincidental and we still don't know what it is. We know that line is usually not going to be an issue and grape juice is usually not going to be an issue. So things that have been kind of processed aren't as big of a concern, but grapes and raisins even. You know, some people think if you raise them bread wouldn't be a concern because it's heated. The downside is that, yes, if it is tartaric acid, heat can. Heat can destabilize that, but we don't know what that temperature is, and so there's still a. There's still a risk, even if it's, you know, even if it's a baked product. So we usually because the outcome is fatal, the outcome is irreversible kidney failure we typically still treat them pretty, pretty cautiously.

Speaker 2: 1:00:28

So we have a campaign called toxin tails and it's we send out a press release every month and something that we use. It's an educational campaign to help parents become more aware of different toxins that are out there, as well as the veterinary community, and the good news about toxin tails is that they all have a happy ending and so it's a great story if you want to feel good and it kind of be excited about these animals that have had. Some of them maybe have had a near death experience in the sense of being extremely ill. Some of them had just a close call where maybe they weren't as effective but they were in. The story was great and something to get out there and it might be. It might be something like xylitol or we had a dog that ingested a fit bit and the owner identified, figured out which dog got into it, because she took each one of them for a trip around the block and found which one was still tracking because her fit that was still tracking on her.

Speaker 1: 1:01:30

I know it's not funny at all, but I just can't help it.

Speaker 2: 1:01:34

It is, yeah, it's a great story. He did have to have it removed, but he did extremely well. So it's just little stories like that, and so we like to highlight the work that the veterinary clinics are doing to save these animals lives on a daily basis and just to educate the pet owners and the in the public in general on different toxin concerns.

Speaker 1: 1:01:58

That's fantastic. All right well. Thank you, dr Schmidt and Dr Lindsay. I appreciate both of you today and have a wonderful holiday season. We're heading into the thick of it.

Speaker 3: 1:02:09

Yeah, thank you so much for your time and your expertise.

Speaker 2: 1:02:12

Yeah, you're welcome.

Speaker 3: 1:02:13

Thank you so much for the invitation.