Laurie Anne Walden, DVM  Antifreeze is toxic to animals and people. Even a small amount of antifreeze licked from a paw or lapped from a puddle could kill a cat or dog. If you think your pet has been exposed to antifreeze, contact a veterinarian immediately.
The main ingredient of most types of antifreeze is ethylene glycol, a type of alcohol. Ethylene glycol has a naturally sweet taste. Protect your pets by keeping them away from fluids that have leaked out of cars. Store antifreeze in sealed containers out of the reach of animals and children. Consider using antifreeze made of propylene glycol instead of ethylene glycol; it’s safer for pets. Sources of ethylene glycol Antifreeze (radiator coolant) is used in the engines of cars and other motor vehicles. The risk of exposure might be higher when seasons change and people change the antifreeze in their cars. Dogs have also been poisoned by drinking toilet water that has had antifreeze added to keep it from freezing.[1] Although antifreeze is the most common source of ethylene glycol poisoning in dogs and cats, ethylene glycol can be present in other products:
Signs of poisoning The earliest symptoms are caused by the ethylene glycol itself. Symptoms that appear later are caused by toxic substances produced when ethylene glycol is broken down in the liver. The symptoms of poisoning occur in 3 stages.[4] Stage 1: During the first 12 hours, symptoms are similar to those of alcohol intoxication:
Stage 2: From about 12 to 24 hours after ingestion, the animal may seem to improve as “drunken” symptoms go away. But toxic products of ethylene glycol begin to alter the body’s acid-base balance and damage the kidneys. Signs include the following:
Stage 3: Between 12 and 24 hours after exposure (cats) or 36 and 72 hours (dogs), the kidneys stop working. The patient shows symptoms of acute kidney failure and other problems:
Diagnosis and treatment A blood test can detect ethylene glycol in the first few hours after ingestion. After a few hours, blood and urine tests begin to show evidence of acid-base disturbances and kidney damage. Diagnosing ethylene glycol poisoning can be tricky if no one saw the pet swallow antifreeze and the pet doesn’t arrive at the veterinary clinic until it is showing signs of kidney failure. The sooner treatment begins, the better the prognosis. An antidote to ethylene glycol is available and should be given soon after exposure. This drug stops ethylene glycol from being converted to toxic substances. After most of the ethylene glycol has been metabolized by the liver, the antidote is less likely to be effective. Other treatment is given to correct the body’s acid-base balance and support kidney function. Pets with ethylene glycol poisoning will probably need to stay in the hospital for a few days, even if the poisoning is caught early. Prognosis The prognosis is good for animals that begin treatment soon after ingesting antifreeze. For those that develop kidney failure, the prognosis is guarded to poor. References 1. Antifreeze poisoning in dogs & cats (ethylene glycol poisoning). Pet Poison Helpline website. https://www.petpoisonhelpline.com/pet-safety-tips/antifreeze-poisoning-in-dogs-cats-ethylene-glycol-poisoning/. Accessed March 11, 2019. 2. Grauer GF. Overview of ethylene glycol toxicity. Merck Veterinary Manual website. https://www.merckvetmanual.com/toxicology/ethylene-glycol-toxicity/overview-of-ethylene-glycol-toxicity. Accessed March 11, 2019. 3. ToxFAQs for ethylene glycol. Agency for Toxic Substances and Disease Registry website. https://www.atsdr.cdc.gov/toxfaqs/tf.asp?id=85&tid=21. Published November 2010. Accessed March 11, 2019. 4. Brownie CF. Managing ethylene glycol toxicity (proceedings). DVM360 website. http://veterinarycalendar.dvm360.com/managing-ethylene-glycol-toxicity-proceedings. Published August 1, 2010. Accessed March 11, 2019. Photo by Ana Silva on Unsplash
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Laurie Anne Walden, DVM  Chronic kidney disease is common in cats. It can affect cats at any age but is most common in older cats.[1] The disease has no cure. The goals of treatment are to slow the progression of the disease and maintain a good quality of life for the cat.
Functions of the Kidneys The kidneys filter the blood and excrete waste products into the urine. When the kidneys don’t work properly, these waste products accumulate in the body. The kidneys balance the body’s water level by adjusting the urine concentration. Kidney disease impairs the ability to concentrate the urine and retain water in the body, so animals with kidney disease become dehydrated. The kidneys also help regulate blood pressure, red blood cell production, and acid-base balance. Signs of Kidney Disease Kidney disease is already advanced (at least two-thirds of kidney function lost) by the time signs of illness appear. Cats typically have the following signs:
Keep an eye on the size of the urine clumps in your cat’s litter box. Enlarging urine clumps can mean that urine volume is increasing, which is one of the earliest signs of kidney disease. Other disorders (like diabetes) can also increase the urine volume, so larger-than-usual urine clumps warrant a visit to the veterinarian. As chronic kidney disease progresses, the loss of kidney function leads to further problems:
Causes of Kidney Disease Acute kidney injury is a rapid loss of kidney function over hours to days. Some of the many possible causes are toxins, infections, and shock. Depending on the cause and severity, acute kidney damage can sometimes be reversed with treatment. Chronic kidney disease is more common than acute kidney injury in cats. In chronic kidney disease, kidney function gradually decreases over time. The cause is usually not known. The same entities that cause acute kidney injury can lead to chronic kidney failure. Other possible causes are high blood pressure, abnormal kidney development, infection or inflammation of the kidneys, disorders that alter blood flow to the kidneys, and cancer.[2] Diagnostic Tests Tests are used to diagnose kidney disease, assess the stage of the disease, identify metabolic problems caused by the disease, diagnose other disorders (like thyroid disease) that cats with kidney disease sometimes also have, and possibly reveal the cause of the kidney problem. Blood tests and urinalysis (analysis of urine) are typically the first diagnostic tests for cats with suspected kidney disease. Blood pressure measurement, urine culture to test for bacterial infection, and ultrasound or x-ray imaging of the urinary tract are also commonly performed for cats with kidney disorders. Cats with chronic kidney disease benefit from regular testing to monitor disease progression and adjust treatment. In general, these cats should see a veterinarian for blood tests, urinalysis, and blood pressure measurement every 3 to 6 months.[2] The stage and substage of chronic kidney disease are evaluated with specific tests[3]:
Treatment Chronic kidney disease can’t be cured, but it can be managed. The prognosis is variable; some cats can live with the disease for years. If your cat has kidney disease, work with your veterinarian to craft a treatment plan that will give your cat a good quality of life. Treatment strategies are based on the stage of disease and the individual cat’s needs and may include the following[1,4]:
References 1. Sparkes AH, Caney S, Chalhoub S, et al. ISFM consensus guidelines on the diagnosis and management of feline chronic kidney disease. J Feline Med Surg. 2016;18(3):219-239. 2. Brown SA. Renal dysfunction in small animals. Merck Veterinary Manual website. https://www.merckvetmanual.com/urinary-system/noninfectious-diseases-of-the-urinary-system-in-small-animals/renal-dysfunction-in-small-animals. Accessed February 26, 2019. 3. International Renal Interest Society. IRIS staging of CKD. http://www.iris-kidney.com/pdf/IRIS_2017_Staging_of_CKD_09May18.pdf. Updated 2017. Accessed February 26, 2019. 4. International Renal Interest Society. Treatment recommendations for CKD in cats. http://www.iris-kidney.com/pdf/IRIS_2017_CAT_Treatment_Recommendations_09May18.pdf. Updated 2017. Accessed February 26, 2019. Photo by Nicolas Picard on Unsplash Laurie Anne Walden, DVM  Roundworms are some of the most common internal parasites in dogs and cats. They can also infect humans. According to the Centers for Disease Control and Prevention (CDC), 13.9% of people in the United States have antibodies to roundworms, meaning they have been exposed to the parasite at some point in their lives.
How dogs and cats are infected Almost all puppies are born with roundworms. The type of roundworm that most often infects dogs, Toxocara canis, transfers from a mother dog to unborn pups through the placenta. T canis can also pass to puppies through the mother’s milk. Infected animals excrete roundworm eggs in their stool, so dogs can be infected by eating feces or swallowing roundworm eggs in the environment. Dogs can also become infected by eating a small animal (like a rodent) that is carrying roundworms. The most common roundworm in cats is Toxocara cati. Cats and kittens are usually infected by swallowing roundworm eggs in the environment or by eating an infected animal. T cati does not pass to unborn kittens through the mother’s placenta. Ingested T canis and T cati eggs hatch into larvae in the intestines. The larvae migrate through body tissues to the lungs, are coughed up and swallowed, grow into adult worms in the intestines, and begin producing eggs that pass into the environment through the feces. Roundworm larvae can remain dormant in body tissues of adult animals instead of maturing in the intestines. These arrested-development larvae can’t be detected by fecal tests for worm eggs because they don’t produce eggs. Dormant larvae in a pregnant dog can become active and move through the placenta to the pups. In other words, a female dog with a negative test for roundworms can pass roundworms to her puppies anyway. Signs of infection Infected animals often have no symptoms at all. Dogs and cats (especially puppies and kittens) with lots of roundworms may develop a potbelly, vomiting, diarrhea, weight loss, or dull coat. Heavily infected animals sometimes vomit worms, which look a bit like spaghetti noodles, or pass worms in the stool. Treatment and prevention in pets Young puppies and kittens should receive multiple doses of deworming medication. The Companion Animal Parasite Council recommends deworming puppies and kittens every 2 weeks starting at age 2 weeks for pups and 3 weeks for kittens, continuing until they are about 2 months old, and then beginning monthly parasite preventives. Many heartworm preventives also prevent roundworm infection. To reduce the chance your pets will be infected, remove feces from the environment and try to keep them from eating rodents or other wild animals. Have your veterinarian regularly test your pets for parasites, and give them parasite preventives all year round. Infection in humans People can be infected by T canis or T cati if they ingest contaminated dirt or feces. Toxocara eggs can survive in the soil for years. Children and people who own dogs or cats have an increased risk of infection, says the CDC. Many people with Toxocara infection don’t develop serious disease and have no symptoms. But T canis and T cati larvae can migrate through the bodies of humans, as they do in dogs and cats. Larvae that migrate to internal organs (such as the liver) damage these tissues, a disease process called visceral larval migrans or visceral toxocariasis. Symptoms depend on the organs affected. Sometimes larvae migrate to the eye, causing a disease known as ocular larval migrans or ocular toxocariasis. People with this condition may develop retinal inflammation and vision loss. Prevention in humans The CDC recommends these steps to prevent toxocariasis:
For more information Ascarid (Companion Animal Parasite Council) Cat Owners: Roundworms and Dog Owners: Roundworms (Pets and Parasites) Toxocariasis FAQs (CDC) Photo by Berkay Gumustekin Laurie Anne Walden, DVM Tooth root abscesses are painful and need prompt treatment, but the signs can be easy to miss. Dogs don’t always show that their mouths hurt, and tooth abscesses can mimic other conditions.
Causes Tooth root abscesses are pockets of pus caused by bacteria that invade the deep structures of the tooth. They often occur in teeth with severe periodontal disease or gingivitis (gum disease), especially if the gum has receded around the tooth. Teeth that are cracked or fractured are also at risk for root abscesses. Teeth can fracture when a dog chews on something hard, like a bone, cow hoof, ice cube, hard nylon toy, or rock. Fractures that expose the pulp cavity (the inner part of the tooth) give bacteria a route to the tooth root. Affected teeth The upper fourth premolar—the large cheek tooth on each side of the upper jaw—is a common site of root abscess. This tooth, also called the carnassial tooth, is used to crush food. When a dog crunches something hard, a carnassial tooth can sustain a slab fracture (shearing off a slab from the side of the tooth) or can crack down the center. The roots of the carnassial tooth reach nearly to the eye, so an abscessed root causes swelling just below the eye. Root abscesses can occur in any tooth. The large canine (fang) teeth are frequently broken and are also common sites of root abscesses. Symptoms Although tooth root abscesses are very painful, dogs’ signs of mouth pain can be subtle. Some dogs don’t show any symptoms at all. Signs of a tooth root abscess can include the following:
A veterinarian may be able to find evidence of a tooth root abscess during examination of an awake patient. However, dogs with tooth root abscesses sometimes have too much mouth pain to allow much of an oral examination without sedation. Diagnosis often requires dental radiographs (x-ray images) or at least a full oral examination with the patient under anesthesia. Dental radiographs sometimes reveal tooth root abscesses that can’t be seen any other way. Treatment Untreated tooth root abscesses cause prolonged pain and tooth loss. The infection can spread to other tooth roots and to the face, potentially even affecting the eye. Dogs with tooth root abscesses need antibiotics and pain relief. The source of the infection must also be removed. There are 2 options for treating an abscessed tooth root:
If you think your dog might have a tooth root abscess, make an appointment with your veterinarian as soon as possible. Your veterinarian will examine your dog and, if the signs indicate an abscess, will probably prescribe an antibiotic and an analgesic (pain reliever). The next step will be either another appointment with your veterinarian for tooth extraction or referral to a dental specialist for possible root canal therapy. Both extraction and root canal therapy require general anesthesia. If you would like your dog to keep his tooth, root canal treatment is the best option. Antibiotics alone are rarely enough to treat a root abscess. However, not all teeth are candidates for root canal therapy. The dental specialist will evaluate dental radiographs to see if root canal treatment is a good option and will extract the tooth if necessary. Prevention Sometimes tooth root abscesses are unavoidable. But you can take some measures to reduce your dog’s risk:
Laurie Anne Walden, DVM  Are you tempted to skip your pets' heartworm and flea medicines during the winter? Dogs and cats actually need parasite prevention all year round. Year-round parasite control for pets helps keep the whole family safe from parasite-transmitted disease.
Warm spells during the winter are common in North Carolina, so we can’t count on cold temperatures to suppress insects that carry disease. Mosquitoes, fleas, and ticks can also live through the winter in areas that are protected from the cold. Heartworms Heartworms are transmitted by mosquitoes. Mosquitoes become active when the temperature rises above about 50°F (which happens routinely in North Carolina during the winter). But occasional warm winter days aren’t the only reason pets need year-round heartworm prevention. Heartworm preventives work by killing tiny heartworm larvae that are already in an animal’s bloodstream. These larvae came from mosquitoes that bit the animal in the past month or more. Skipping a month of heartworm prevention could mean that your dog isn’t protected from heartworm larvae that he was exposed to when it was warmer. The American Heartworm Society recommends giving heartworm preventives all year round. Intestinal parasites (worms) Some heartworm preventives also control intestinal parasites like hookworms and roundworms. These parasites can infect humans too. Giving parasite prevention to your pets throughout the year is a sensible safety measure. Fleas Fleas don’t just causing itching. They also transmit diseases like cat scratch disease, tapeworms, and plague. Fleas lay eggs that drop off the infested animal into the environment. This means that flea eggs are present everywhere the animal has been, including inside a home. After the eggs hatch, the larvae and pupae (intermediate stages) can stay dormant for weeks to months before becoming adult fleas. Because fleas can go through their life cycle indoors, they don’t need to wait for warm weather to develop into adult fleas. Flea infestations are easier to prevent than to treat, so the best chance of avoiding a flea problem is to give your pets year-round flea prevention. Ticks Ticks carry many diseases that affect both pets and people. Some tick species, including the type that transmits Lyme disease, are active during the winter when the temperature is above freezing. Ticks tend to live in leaf litter, crevices of buildings, and underbrush. When they’re ready to take a blood meal, they move to grassy areas or shrubbery near paths and latch onto a passing animal or person. Ticks can be hard to see through fur, so you might not realize that your dog has picked up a tick. Because of the risk of serious disease, the safest approach is to limit tick exposure: control ticks around your home and give your pets tick preventives recommended by your veterinarian. Photo by Justin Veenema Laurie Anne Walden, DVM  ’Tis the season for charitable giving. What better way to honor our pets than to help other animals and the people who take care of them?
Donate Money Local animal shelters and rescue groups can always use financial contributions. Money donated to national organizations may not find its way to local groups. Consider making a donation in memory of a pet you’ve lost. Memorial donations can also be thoughtful gifts for other animal lovers. The choice of charity is personal (and if you’re making a donation on someone else’s behalf, it’s a good idea to send it to one of their favorite charities). You might want to donate to an organization that funds research on animal health, like the Morris Animal Foundation, the Winn Feline Foundation, or a veterinary school. Do you have a friend or family member with a new dog or cat but not a lot of cash? The cost of vaccinations, spaying/neutering, and preventive medicine (like heartworm pills) adds up. They might appreciate a contribution to a health care fund for their new pet. Donate Pet Food or Supplies Our hungry neighbors need help feeding their pets too, and some food banks accept pet food donations. Mallard Creek Animal Hospital is holding a pet food drive for Second Harvest Food Bank through December 30, 2018. Drop off food or cash donations at the office. We (and the animals) are grateful for our clients’ generosity! Shelters and rescue groups usually need pet food, towels, blankets, cleaning supplies, training toys, cat scratching pads, and other items. Check with the organization before donating supplies; many post wish lists on their websites. Volunteer Shelters and rescue groups depend on volunteers. Some volunteer positions require training and an ongoing time commitment. If you have only a few hours, consider hosting a pet food or supply drive or holding a fundraiser. Need community service hours for school or an organization? Minor children usually can’t work directly with shelter animals, but children can set up donation drives or fundraisers like lemonade stands. Kids can also make pet items (like small blankets or catnip toys) at home and then deliver them to the shelter—but as always, check with the shelter first. Foster a Rescue Animal Do you have time, space in your home, and the right family (and pet) situation for a temporary house guest? Many rescue groups depend on fosters to house animals awaiting adoption. Animals in shelters also benefit from spending time in a foster home. Animals in foster care may have medical or behavioral issues that need to be addressed before they’re ready for adoption, so discuss the foster requirements with the rescue group. Are you a cat person? Charlotte-Mecklenburg Animal Control needs people to foster kittens at home or help out in the kitten nursery. Adopt an Animal Adopting is a great way to help—but never give an animal as a gift! The exception is adopting a pet into your own household (when you’re prepared to take lifelong care of it) as a “gift” for the family. If you want to give a pet to someone else, consider instead giving them money or a homemade gift certificate toward the adoption or purchase of a pet of their choice when they're ready. Photo by uschi2807 Laurie Anne Walden, DVM  On December 3, the Food and Drug Administration (FDA) warned pet owners of potentially toxic vitamin D levels in some dog foods. The affected foods have been recalled. A list of recalled brands is posted on the FDA website: https://www.fda.gov/AnimalVeterinary/NewsEvents/ucm627485.htm.
Vitamin D: both an essential nutrient and a poison Vitamin D helps regulate calcium and phosphorus levels in the body. This vitamin is necessary for bone health and for normal muscle and nerve function. Vitamin D is fat soluble, not water soluble, so the body stores extra vitamin D in the liver and fatty tissues instead of expelling it in the urine. Excessive levels of cholecalciferol, the active form of vitamin D, lead to dangerously high levels of calcium and phosphorus in the blood. Calcium deposits form in body tissues, especially tissues that have a large blood supply, like the kidneys. Mineral deposits in the kidneys cause kidney failure, which is the usual cause of death in animals with vitamin D poisoning. Rodenticides (rat and mouse poisons) that contain cholecalciferol are typical sources of vitamin D poisoning in pets. Even small amounts of cholecalciferol-containing rodenticides can cause severe kidney damage in dogs and cats. Human vitamin supplements and contaminated pet foods can also cause cholecalciferol toxicosis in pets. According to the FDA, some of the recalled dog foods contained 70 times the expected level of vitamin D. Symptoms of vitamin D poisoning Watch for these symptoms, especially if your dog has been eating one of the recalled foods:
Signs of poisoning usually appear within a day or two after an animal ingests a toxic level of vitamin D. By this time, the kidneys have already been affected. Blood tests show increased levels of calcium, phosphorus, and markers of kidney disease. What you should do If your dog has been eating one of the recalled diets, stop feeding the diet immediately. The FDA recommends disposing of the food in such a way that other animals (including wildlife) and children cannot reach it. Seek veterinary care immediately if you think your pet might have vitamin D poisoning. The symptoms are not specific to vitamin D toxicosis (lots of things cause vomiting), so your veterinarian will perform bloodwork and possibly other diagnostic tests. Take either the bag of dog food or a photo of the label, including the lot number, to the clinic with you if your dog might have eaten a recalled food. The sooner treatment starts, the better the chance of recovery. Treatment involves hospitalization for several days, intravenous fluids, medications to help flush calcium out of the body and support kidney function, and repeated blood tests to monitor kidney function and levels of calcium and phosphorus. The FDA suggests that pet owners and veterinarians report possible cases of vitamin D poisoning through the online Safety Reporting Portal. For more information FDA Alerts Pet Owners about Potentially Toxic Levels of Vitamin D in Several Dry Pet Foods, FDA.gov website Cholecalciferol, Pet Poison Helpline website Cholecalciferol, Merck Veterinary Manual website Photo by Ruby Schmank on Unsplash Laurie Anne Walden, DVM  Keep your pets safe, happy, and out of the emergency clinic with these Thanksgiving safety tips.
No fatty food Turkey skin, meat drippings, gravy, bacon, butter, and other fatty foods can cause pancreatitis (inflammation of the pancreas) in dogs. This potentially painful condition leads to vomiting, loss of appetite, and dehydration. Pancreatitis can land a dog in the veterinary hospital for intensive care. Any dog can develop pancreatitis, but some breeds are more prone to it than others. Miniature schnauzers are the poster dogs for pancreatitis. No bones Don’t give your pet a turkey leg. Bones can get stuck in the digestive tract (esophagus, stomach, or intestines). Sharp bones can puncture the digestive tract. No turkey brine The solution used to brine turkeys might taste great to pets, but the high salt content can lead to salt toxicosis. Symptoms include vomiting, diarrhea, loss of appetite, increased thirst, tremors, and seizures. No raw meat or raw eggs Raw meat and eggs can carry harmful bacteria like salmonella. Dogs and cats are just as susceptible to food poisoning from bacteria as humans are. No raisins, grapes, or currants Even small amounts of these fruits can cause kidney damage in dogs. No raw bread dough Raw yeast dough expands in a dog’s stomach, potentially causing bloat. Raw yeast dough also produces ethanol, which can give a pet alcohol poisoning. No chocolate or artificial sweeteners Chocolate is toxic to dogs and cats; the darker the chocolate, the higher the risk. Many low-sugar and sugar-free foods (including some baked goods) contain xylitol, a sweetener that is very dangerous for dogs. No onions or garlic Cats are highly sensitive to compounds in onions, garlic, leeks, and chives that can cause anemia. Dogs and cats may also develop upset stomachs from eating these vegetables. Take out the trash Bones, corncobs, and string used to truss a turkey are all enticing to pets that have access to the garbage can. These items can cause intestinal blockages. Keep kitchen trash sealed away from your pets while you’re preparing the big meal. If you plan to block your pets out of the kitchen, remember that children and guests might leave interior doors and baby gates open. Watch the exits Pets may not be used to guests coming and going, and your company might not be prepared to stop your pets from dashing out of an open door. Make sure your pets all have identification (collar tag, microchip, or both) in case of an escape. Give your pets a safe space Give your pets a quiet place to get away from the action. Some pets are much more comfortable staying safely in another room the whole time guests are at your house. Guests who aren’t accustomed to having pets underfoot might appreciate this too. See the blog post about human foods that are toxic to pets for more details. Photo by Chevanon Photography Laurie Anne Walden, DVM Some substances that are not particularly dangerous for dogs or humans are highly toxic to cats. Cat owners who are unaware of the risks may inadvertently expose their cats to toxins like canine flea control products or over-the-counter pain medications.
Cats can be exposed to toxic agents either by eating them directly or by licking them from their fur. The symptoms of poisoning depend on the toxin and can include drooling, vomiting, lethargy, tremors, and seizures. If you think your cat may have swallowed a toxin, do not try to make your cat vomit. None of the home “remedies” that have been used to induce vomiting in people or dogs are considered safe in cats. Call your veterinarian or an animal poison control hotline right away. When you take your cat to the veterinary clinic, also take the package or product label of the substance your cat was exposed to. If your cat ate a plant and you’re not sure of its identification, bring a photo of the plant if possible. Topical insecticides Permethrins in topical flea control products marketed for dogs commonly cause toxicosis in cats. Cats are highly sensitive to these insecticides, which are in the pyrethroid family. Permethrin products are available as spot-on products, dips, and sprays. Cats are typically exposed either directly (by an owner using a dog-strength product on a cat) or indirectly (by contact with a dog recently treated with a permethrin product). Permethrin toxicosis causes tremors, seizures, loss of coordination, and drooling. Other topical insecticides sometimes cause skin irritation in cats. Cats that lick topical products may react to the taste, so apply these products to an area your cat can’t reach with its tongue, like the back of the head. Read labels carefully and be sure to treat your cat only with products labeled for cats. Medications A single tablet of acetaminophen (Tylenol) can kill a cat. In cats, acetaminophen interferes with the oxygen-carrying ability of red blood cells and causes anemia. Cats with acetaminophen toxicosis may have brown gums, rapid heart rate, and lethargy. Ingestion of acetaminophen is a medical emergency in cats. Cats do not process nonsteroidal anti-inflammatory drugs (NSAIDs) the same way that humans and dogs do and are more likely to experience adverse effects. Examples of these pain relievers are ibuprofen, carprofen, naproxen, etodolac, and meloxicam. Cats that ingest NSAIDs may develop stomach ulcers, kidney failure, or seizures. The antidepressant medication venlafaxine (Effexor) is a relatively common cause of toxicosis in cats. According to ASPCA Animal Poison Control, cats will readily eat venlafaxine capsules. Other antidepressants can also be dangerous to cats. Symptoms of toxicosis are dilated pupils, vomiting, rapid breathing and heart rate, and loss of coordination. Amphetamines cause tremors, seizures, and heart rhythm abnormalities in cats. Even small amounts of amphetamines in medications or illicit substances can be toxic. Lilies All parts of lilies, including the pollen, cause potentially fatal kidney failure in cats. Lilies that are dangerous to cats are members of the Lilium and Hemerocallis genera, such as Easter lilies, Asiatic lilies, tiger lilies, stargazer lilies, wood lilies, and daylilies. Calla lilies, peace lilies, and Peruvian lilies (Alstroemeria) are not “true” lilies and do not damage cats’ kidneys. If your cat is exposed to a lily, seek veterinary care immediately; early treatment improves the prognosis. Rodenticides Mouse and rat poisons are toxic to all mammals, not just to rodents. Cats are exposed either by eating the bait or by eating the animal that ate the bait. Different rodenticides work by different methods. Treatment depends on the active ingredient, so be sure to bring the product label to the veterinary clinic if your pet has been exposed. Anticoagulant rodenticides cause fatal internal bleeding by preventing blood from clotting. Bromethalin rodenticides cause lethal nervous system damage. Rodenticides containing cholecalciferol (vitamin D3) cause calcium-phosphorus imbalance that leads to kidney failure. Zinc and aluminum phosphide baits cause toxic gas to build up in the digestive tract (toxic fumes in vomit are also dangerous to anyone nearby). For more information
Photo by Federica Diliberto Laurie Anne Walden, DVM  You may have read recent news reports about a possible association between grain-free diets and heart disease in dogs. Here’s what we know about this issue so far.
In July 2018, the US Food and Drug Administration (FDA) notified the public that they were investigating reports of dilated cardiomyopathy in dogs eating diets whose main ingredients were legumes (such as beans, peas, and lentils) or tubers (potatoes and sweet potatoes). These ingredients are common in diets labeled “grain free.” Dilated cardiomyopathy is a disease of the heart muscle. In this disease, the heart chambers enlarge and the chamber walls become thinner and weaker. Patients may develop a murmur and an irregular heartbeat. If untreated, the condition leads to heart failure and death. Symptoms, which often don’t appear until the patient is in heart failure, include decreased energy, coughing, and episodes of collapse. The causes of dilated cardiomyopathy are not fully known, but several factors have been implicated. The disease is thought to have a genetic link; it’s familial in Dobermans, boxers, and other large breeds. In cats and sometimes in dogs, it is also associated with dietary deficiency of the amino acid taurine. Taurine is not considered an essential dietary nutrient for dogs. Normally dogs (unlike cats) can synthesize taurine from other nutrients in their diets. But some dogs, notably golden retrievers and Cocker spaniels, do develop taurine deficiency that leads to dilated cardiomyopathy. The dogs with dilated cardiomyopathy in the recent reports were of various breeds, not just the breeds considered typical for dilated cardiomyopathy. Some of the dogs with dilated cardiomyopathy who were eating grain-free diets had normal blood taurine levels, so simply adding taurine to the diet might not solve the problem. Dr Lisa Freeman, a veterinary nutritionist at Tufts University, has suggested that changes in how the body processes taurine could lead to a functional taurine deficiency even if levels of taurine in the diet and the blood are normal. A high proportion of legumes in the diet could affect the way a dog’s body metabolizes amino acids (by altering gut bacteria, for instance). Other explanations of how grain-free diets could be connected to dilated cardiomyopathy have been proposed, although most are still speculative. Taurine deficiency could potentially result from increased excretion of taurine in feces. A diet with legumes and tubers as main ingredients could be deficient in nutrients dogs need to make taurine. Other ingredients, like exotic protein sources, could also be associated with dilated cardiomyopathy, according to Dr Freeman. At this point, the potential link between grain-free diets and dilated cardiomyopathy is not clear. The FDA is continuing to investigate, and cardiologists from several veterinary schools (including the University of California, Davis) are collecting more data. What you should do So far there is no evidence that legumes and potatoes in dog food cause a problem if they are not main ingredients—that is, if the food is a conventional diet that also happens to include these ingredients. If you’re currently feeding your dog a grain-free diet or one containing exotic ingredients (like kangaroo), talk to your veterinarian about the possible risks. Also ask your veterinarian if your dog really needs to eat that diet. For the vast majority of dogs, a grain-free diet has no benefit over a conventional diet. Consult your veterinarian if your dog is showing symptoms of heart disease. If your dog has dilated cardiomyopathy, your veterinarian can test her blood taurine levels. Veterinarians and pet owners can report suspected cases of diet-associated dilated cardiomyopathy to the FDA through the online Safety Reporting Portal or by calling their state’s FDA Consumer Complaint Coordinator. Photo by John Price on Unsplash |
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March 2019
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