Tag: Veterinarian

Chocolate Toxicity

chocolate toxicity

Ingestion of chocolate can be a deadly mistake for dogs and cats. Chocolate (cacao) contains the substances caffeine and theobromine.  These substances can have detrimental effects on the GI system, central nervous system, heart, and kidneys of pets. In dogs and cats the ‘half-life’ (length of time it takes for 50% of the substance to break down in the body) for theobromine is over 17 hours.  This means that after 17 hours, half of the theobromine ingested is still in their systems. Humans can metabolize caffeine and theobromine more efficiently than pets can, which is why chocolate is not toxic to humans.

How much chocolate is considered toxic?

chocolate toxicityNo amount of chocolate is safe for an animal to ingest. The effects of chocolate consumption in pets depends on type of chocolate, quantity consumed, and the size (body weight) of the pet. Some types of chocolate contain higher amounts of caffeine and theobromine.

Reported combined caffeine & theobromine content in different chocolates:

  • Dry cocoa powder contains 800 mg/oz
  • Unsweetened baker’s chocolate contains 450 mg/oz
  • Cocoa Bean hulls (mulch) contains 255 mg/oz
  • Semisweet dark chocolate contains 150-160 mg/oz
  • Milk Chocolate contains 64 mg/oz
  • White chocolate contains an insignificant amount.

The most toxic, cocoa or baker’s chocolate, causes a life-threatening emergency when ingested. The moderately toxic dark chocolates can lead to hospitalization and serious illness in pets when amounts as small as one-tenth of an ounce per pound of body weight are consumed. Even pets that devour less than a half ounce of milk chocolate per pound of body weight are at risk of developing clinical signs. 

Online chocolate toxicity calculator can be helpful for pet owners and veterinarians to calculate the potential toxicity of chocolate ingestion.


Symptoms of Chocolate Ingestion

Clinical signs of chocolate toxicosis usually occur within 6–12 hours of ingestion.

Initial signs may include:

  • Increased thirst
  • Vomiting
  • Diarrhea
  • Restlessness

Signs may progress to:

  • Hyperactivity
  • Increased urination
  • Incoordination or trouble walking
  • Fever
  • Twitches & tremors
  • Rigidity & seizures
  • Racing heart progressing to abnormal rhythms

chocolate toxicityTreatment of Chocolate Toxicity

If you suspect your pet has ingested chocolate, you should immediately contact your veterinarian.

If ingestion has occurred within the past 2 hours, the first step is to recover as much chocolate from the patient as possible by inducing vomiting. For many patients, removing the undigested chocolate converts the toxicity from a life-threatening poisoning to just an upset stomach that is easily managed.  Absorbents, such as activated charcoal, are administered by mouth to bind the chocolate and prevent absorption of theobromine and caffeine through the gut. The patient may be administered SQ fluids to help flush the system. Pets may be treated on an out patient basis if minor quantities of chocolate have been ingested and treatment is started before clinical signs develop.

If a pet has consumed larger quantities of chocolate, has developed clinical symptoms, or treatment has been delayed then hospitalization may be required.  Hospitalized patients receive IV fluids to help flush the kidneys and frequent trips out to go potty are needed to prevent re-absorption of the toxins.  Laboratory blood testing may be required to monitor the kidneys. ECG will be used to monitor the heart for changes in rate and rhythm. A variety of medications are used to help treat symptoms such as seizures and arrythmias. Patients may need intensive care for 24 to 48 hours.

The prognosis after chocolate ingestion can be variable depending on the type and quantity of chocolate consumed, and the timing of treatment.

The prognosis is favorable if decontamination, including induction of vomiting and administration of activated charcoal occurs within 2 hours of ingestion and before clinical signs began, the prognosis is favorable. Patients that receive prompt treatment may be treated as outpatients and their symptoms may not progress beyond mild GI upset.

If treatment is delayed past 4 hours of ingestion, and mild clinical signs have started, the pet will need to be hospitalized for 12 to 36 hours for monitoring and supportive care. Pets that have developed symptoms of toxicity have a more guarded prognosis. If symptoms progress to seizures and cardiac arrhythmias the prognosis is poor, and the toxicity may be fatal.

In the days following chocolate ingestion, patients should be monitored carefully. The high fat content of chocolate products may trigger secondary pancreatitis in some patients.


Corneal Ulceration

A corneal ulcer occurs when the protective surface layer of the eye’s cornea is lost or damaged. Corneal ulcers range from superficial abrasions and small circular lesions to deep craters. The deeper layers of the cornea are exposed and become prone to infection and injury. These deeper layers contain many nerves, and irritation of these nerves is very painful. Ulcers may be complicated by secondary bacterial infections.

There are many causes of corneal ulceration, including:
• Trauma from cat scratches or other foreign objects
• Abnormalities of the eyelids including entropion (eyelids rolled inward) or abnormal ingrown eyelashes
• Decreased blinking due to neurologic problems or from sedation and general anesthesia
• Exposure to irritants such as chemicals, soaps, or smoke
• Infections with bacteria, viruses, or fungal agents
• Chronic dry eyes from poor tear production
• Corneal infiltrates such as calcium, cholesterol, or edema
• Brachycephalic breeds of dogs or cats with flat faces and prominent eyes are very prone to corneal ulcers because their eyes protrude beyond the eyelids.

Clinical Signs
Pain is a hallmark sign of corneal injuries and ulceration. A pet with a painful eye may have increased tearing, squinting, blinking, and pawing at the eye. The animal may also be quiet and withdrawn. The eye is usually red and thick eye discharge may develop with infection. The cornea may be cloudy or have visible irregularities. Other signs, such as swelling of the eyelid, inward rolling of the eyelid, protrusion of the third eyelid, or bruising around the head, may occur depending on the cause of the ulceration. Signs of an upper respiratory tract infection may be noted in cases of herpes virus infection in cats or distemper virus infection in dogs.

Diagnostic Tests
A veterinarian diagnosis a corneal ulcer by performing an ophthalmic exam.

Fluorescein staining of the cornea is used to confirm the presence of a corneal ulcer. The stain adheres to deeper corneal layers that are exposed when the corneal surface is damaged. The damaged area if cornea is visible as apple green under blue light. Other ocular tests such as a Schirmer tear test, testing of reflexes, examination of the eyelids and interior of the eye, and glaucoma testing may also be indicated. If a severe bacterial infection is suspected a culture may need to be submitted.


Treatment Options
Most corneal ulcers in dogs and cats can be treated on an outpatient basis by a general veterinarian.

Medications and treatments prescribed for corneal ulcers:
• Topical antibiotics drops or ointment administered directly to the eye to treat active infections and/or to prevent infections.
• If the ulcer is deep and there is concern about infection within the eye, then oral antibiotics may also be prescribed.
• Topical atropine (pupil dilator) may be administered as an ointment or drop directly to the eye.
• Oral nonsteroidal anti-inflammatory drugs may be considered for marked inflammation and discomfort.
• Administration of the pet’s own blood serum as eye drops to provide nutrients to encourage healing.
• Elizabethan cone collar to prevent self-trauma.
• Debridement of the ulcer with cotton swab to remove dead tissue

Referral to a veterinary ophthalmologist may be recommended if the ulcer is deep or not healing. An ophthalmologist can offer application of soft contact bandage lenses or placement of a third eyelid flap to protect the cornea. An ophthalmologist can also offer treatments for underlying conditions such as entropion correction, removal of foreign materials, or abnormal eye lashes.

Follow-up Care
Recheck exams are needed to assess healing and response to treatment. Visit frequency can range from every 24-48 hours to every 7-14 days, depending on the severity of the corneal ulcer. Fluorescein staining of the cornea is performed at most visits to highlight the ulcer and to determine when it has healed. Brachycephalic breeds such as boxers, bull dogs, and Persians may need more intensive follow-up.

Most superficial corneal ulcers and abrasions caused by trauma respond to treatment quickly and heal with minimal scarring. Pets that have underlying chronic conditions such as entropion or ingrown eye lashes may need to have minor procedures to correct the abnormality. Chronic conditions, such as dry eye, may need lifelong treatment with eye drops to prevent future corneal ulcers. Deep ulcers and ulcers that are infected are more difficult to treat and may leave the cornea scarred and pigmentated resulting in decreased vision. In rare instances corneal ulcers that that do not receive treatment and become infected can result in perforations of the eye and loss of vision, and in severe cases even loss of the eye.