Hazards

Topics:


Acetaminophen Poisoning
    
When pets are in pain, our first instinct is to relieve their suffering. Before administering any type of pain medication to your pet, it is advised that you consult your veterinarian. The pain medication may mask vital symptoms and the veterinarian will not be able to make a clear and informed assessment of the condition.
Acetaminophen (Tylenol) is widely used by humans to relieve pain and fever. However, it is not a drug to be used on our pets. Dogs have some tolerance for acetaminophen but an overdose can easily result in a severe, life threatening condition. Cats are extremely sensitive to the drug and even small doses result in poisoning.
     Clinical signs of acetaminophen poisoning are cyanosis (blue colouring due to deficient oxygenation of the blood), facial edema, depression, hypothermia (cold temperature), anorexia (not eating), salivation, and vomiting.
     Treatment, if seen within four hours of ingestion, will include: induction of vomiting, administration of activated charcoal to decrease the absorption of the drug, and supportive care (oxygen therapy, intravenous fluids, etc.) There is an antidote to acetaminophen but not all pharmacies have it on hand.
     If you know your animal has ingested acetaminophen, or any other poison, it is important to get veterinary assistance as soon as possible. Prognosis depends on the amount of poison ingested and how quickly the animal is seen by a veterinarian.

Dog Parks
     Are you thinking of taking your pet to the dog park? The local dog park can be a venue for socialization and exercise of dogs and their owners. If you do plan on using the dog park, there are a few things you should consider:
  • Go to the park first without your dog. Observe the park. Is there a set of rules posted for the park? Is it clean? Is there a separate area for small dogs? Observe the park activity at different times of day. 
  • Know your dog. If your dog is timid in nature or getting on in age it may be intimidated by the boisterous activity of large, rambunctious dogs. Select a time of day that most suits you and the temperament of your dog. 
  • Before going to a dog park, make a visit to your veterinarian. Make sure your pet is up-to-date with it's vaccinations including bordetella (kennel cough). Put your pet on a parasitic control like Advantage, Advantage Multi, or NexGard that will protect your pet from picking up fleas, worms, and ticks. 
  • If your pet is fearful or aggressive, do not take it to the park. If a female dog is in heat, do not take it to the dog park. 
  • Be a responsible owner. Watch out for your pet at all times. Exercise with him/her and pick up your pet’s feces.
Source: Knowing Your Dog, Park Etiquette. College of Veterinary Medicine, Biomedical Sciences, Texas A&M University, Pets Magazine Sept/Oct 2011

Dog Attack: The Aftermath - By Brad Henderson, Clinic Summer Student 2016
    A dog attack on your canine friend can be unexpected and frightening, and can result in a variety of medical complications. Upon entering the clinic, the victim of the dog attack must be assessed to determine the severity of the attack. If the dog is in shock, or has a high fever, the dog must be stabilized before assessing any further damage. The dog will be given intravenous fluids and monitored until it has returned to a steady state. The veterinarian will palpate the entire body to assess any damage from bites, making sure to palpate each leg for any signs of a fracture. If there is suspicion of a fracture or damage to an organ, the veterinarian will perform a radiograph (x-ray) and/or ultrasound. 
    Another problem that can arise after a dog attack is the development of a hernia. Hernias occur when there is a tear in the abdominal wall of the animal, allowing abdominal contents to protrude from the abdominal cavity and into the subcutaneous space. Hernias range in severity depending on what is protruding from the tear. If the tissue entrapped in the hernia is limited to omentum and fat, the patient is usually asymptomatic and the hernia non-life-threatening. If the hernia includes major organs such as the uterus, bladder, or intestines, the pet may present with intense abdominal pain, vomiting, depression, and possibly inability to defecate. In these cases, the situation must be treated as dire and surgical intervention is necessary to ensure the safety of the pet. The diagnosis for a hernia begins with palpation of the swelling. If the veterinarian suspects that your pet may have a hernia, they can employ a few diagnostic techniques to confirm their diagnosis. A contrast radiograph can be taken to get a view of the digestive tract; the purpose of this is to see if any intestine has looped out of the abdominal cavity through the hernia and become entrapped. To perform a contrast radiograph, a radioactive dye is given orally or as an anal enema. This radioactive dye fills the intestines and/or colon, providing a contrast on the x-ray picture between the digestive tract and the rest of the body. Another diagnostic technique that can be helpful is performing an ultrasound. Ultrasounds generally give the clearest view of soft tissue injuries, and help to give a picture of any possible protrusions out of the abdominal cavity. Once it is determined that your pet does indeed have a hernia, a surgical procedure known as a herniorrhaphy is performed. The goal of is to return any herniated organ to its appropriate location inside the abdominal cavity and then to suture closed any tears in the muscle wall to prevent future herniation. A skin incision is made either laterally to the area of swelling or along the ventral mid line. Once through the skin layer, the abdominal area can be assessed and any herniated organs replaced into the abdomen. In some severe cases, when a loop of intestine has herniated and undergone necrosis (cell death), resection and anastomosis may have to be performed. This involves removal of the non-viable section of bowel, followed by the stitching together of the two ends of bowel in order to restore function of the intestine. After the hernia has been repaired, a standard three layer closure is performed to close the incision. 
    Another complication that can arise following a dog bite is the risk of infection and internal abscessing. Canine teeth can be very sharp, and upon puncturing the skin can create a “highway” for bacteria to travel into the body. In cases of serious infection, surgical intervention to remove infected tissue may be necessary. If, for example, a testicle on a male dog develops an abscess post-dog attack, that testicle should be removed and the abscess drained. A small tube can also be inserted into the skin during surgery to drain any remaining fluid from the abscess. After surgery, the dog will be sent home with antibiotics to prevent the spread of infection to other areas of the body.

Emergency Call
    The clinic has received an emergency call and an animal is on its way. Suddenly the atmosphere of the clinic changes and the staff is in high alert. Be it the emergency traumatic in nature (eg. hit by car), a suspected poisoning, or a recumbent animal of unknown cause, preparations are being made even before the animal arrives. Staff members grab supplies, eg I.V. fluids, I.V. lines, catheters, tourniquets, and adhesive tape. Medications are pulled from the cupboards according to the type of emergency coming in. 
    Even as the animal is carefully and quickly removed from the vehicle and transported into the clinic, an assessment of the animal’s condition is underway. Dr. Wright and the staff are observing respiratory rate, eye reflex, pupil dilation, mucosal colour, and the state of alertness of the patient. Once in the clinic, a staff member attempts to get as much history as possible on the patient from a frightened and stressed client. Meanwhile Dr. Wright and other staff members treat life threatening conditions (eg. excessive bleeding, blocked airway, etc.) and continue with the emergency assessment. The level of hydration is determined, heart rate is taken, eyes observed for reflex action, dilation, and nystagmus (twitching). As Dr. Wright proceeds to establish a venous access to administer I.V. fluids and emergency medications, the animal’s temperature is taken, capillary refill assessed, and any outward traumas noted. Time is crucial and all this assessment is done in a matter of several extremely intense minutes. 
    The goal of the emergency assessment, and subsequent action taken by the staff, is to stabilize the patient. The assessment of all the vital signs, history presented by the owner, and presenting symptoms will aid the doctor in determining other emergency actions that need to be taken. 
    In traumas, any excessive life-threatening bleeding needs to be stopped and the animal treated for shock. In poisonings, action has to be taken to counteract the poison. If warranted, an emetic needs to be administered to induce vomiting followed by the administration of toxin absorbing activated charcoal. If a caustic substance has been ingested, a mucosal protectant needs to be administered to protect the lining of the digestive tract. 
    In emergencies where the immediate cause is unknown, blood work may be required in addition to initial assessment to determine organ function. The veterinarian will draw upon all his knowledge and experience to determine what action will be required to achieve stabilization. 
    The length of time to stabilize a patient varies considerably. It is determined by the type of emergency presented, the severity of the patient’s condition upon arrival and the length of time the patient has been distressed. A dog or cat admitted for a broken leg with no other injuries could be stabilized within thirty minutes. A dog presented suffering from grand mal seizures, may take hours to stabilize. Once stabilization is achieved then it is time to consider further treatment, eg. x-rays, surgery and further diagnosis and treatment regimens will be instigated depending on the situation. The patient has to be stable before any extensive action can be taken without risk to the patient. 
    During these periods of emergency the staff is focused, efficient, and professional in spite of the tension and pressure upon them. Once stabilization is achieved there is much elation and the staff can begin to relax. Unfortunately, there are times despite all their efforts, stabilization cannot be achieved and the animal dies or needs to be euthanized. This is devastating to our clients but also devastating to the staff. 
    When emergencies arrive during scheduled appointment times, we ask clients to wait patiently. Dr. Wright will attend to your pet as soon as he is able. Depending upon the severity of the emergency, it may be necessary to re-schedule your routine appointment to a future date. We thank you for your understanding and patience during these situations. 
    Everyone wishes for their pets to live long, happy and uneventful lives. However, the unexpected happens and you may have to visit the clinic for an emergency situation. Be assured that Dr. Wright and his dedicated staff will do the utmost to achieve a positive outcome for you and your pet. They are awesome.

 Fox Tapeworm
      The Ontario Health Network has notified veterinarians of the emergence of the fox tapeworm or Echinococcus multilocularis (EM) in Ontario.(1)  This tapeworm has been previously known to exist in other parts of Canada but not in Ontario until 2012. Recent cases have involved animals with no history of travel outside of the province.

     The tapeworm’s primary hosts are canids including fox, coyotes, wolf and dogs. The infected canid sheds eggs in their faeces which are eaten by other canids and rodents. After ingestion, these eggs hatch into larvae that migrate primarily to the liver and form budding cysts. These cysts resemble tumours.
     Humans can accidentally ingest the eggs of this tapeworm and develop these cysts. Take the necessary precautions:

  • Do not allow pets to hunt animals or scavenge dead animals.
  • Do not allow them to eat faeces.
  • Pick up pet faeces promptly to prevent contamination of the environment, and wash hands thoroughly.
  • Deworm your pet(s) regularly for tapeworms as well as other intestinal worms as advised by your veterinarian.
  • When working in soil that could be contaminated with faeces from dogs, cats or wild canids, wear gloves and wash your hands thoroughly.
References:
(1) Emerging Risk: Echinococcus Multilocularis in Ontario – Infographic http://oahn.ca/?s=echinococcus+multilocularis&x=10&y=9
There’s a New Tapeworm in Town, Pets Magazine, May/June 2016, pg 18 

Green Algae Caution

    Blue-green algae is not algae but a bacterium of the cyanobacteria group. It proliferates in puddles, lakes, ponds, and streams; creating blooms in hot weather, mid to late summer. You will recognize it by the green-blue or green pea colour of the water. It can appear as a scum on top of the water or a slime that accumulates on the bottom of the affected water body. Cyanobacteria can produce toxins that are harmful to humans, animals, and birds affecting their liver, skin, and neurological systems. Public Health organizations keep vigilance over public water bodies and when a toxic bloom appears, issue public advisories to warn about the potential risk of the affected areas.

    People and animals can become contaminated by swimming and ingesting contaminated water. Animals also risk ingesting the toxin by licking contaminated fur when grooming.

    Signs of toxicity range from vomiting, skin irritation, muscle tremors, respiratory failure, shock, and death, Avoidance is the best method of prevention. Follow all public health advisories and keep yourself and pets away from any contaminated water. Supervise your pet’s activities around all water sources.

    Should your pet come into contact with potentially contaminated water, wash them clean as soon as possible with clean water. Avoid soaps and detergents. Do not allow them to ingest the toxins by grooming themselves. If your pet has ingested suspected blue-algae water seek medical advice. It may be necessary to treat your pet to prevent any adverse effects from the ingestion of blue-algae.

References:
https://www.cdc.gov/healthcommunication/toolstemplates/entert ainmented/tips/AlgalBlooms.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984099/
https://www.google.ca/search?tbm=isch&q=pictures+blue+green+algae&chips=q:pictures+blue+green+algae accessed March 17, 2018
Cooper, K., Pets Magazine. Backyard Hazard Series:Blue-Green Algae, July/August 2016.


Marijuana Toxicity
     There is a lot of talk about the legalization of marijuana by the federal government. Therefore, it is timely to talk about accidental marijuana poisoning in our pets.
     Marijuana or Cannabis sativa contains chemicals that when ingested or inhaled alter body function. Those chemicals do this by affecting receptors in the brain which in turn alter normal neurotransmitter function.
     Toxicity in pets is not common but does occur. In the United States, marijuana has been legalized in several states and has resulted in an increase in accidental poisoning in pets. “While fatalities are rare, a pet poison helpline in the U.S. has seen a 330% rise in calls about stoned pets over the past five years”. (1)
     Dogs and cats can be exposed by ingesting the leaves, buds or food laced with marijuana or by inhaling the second-hand smoke. They are affected by marijuana just as humans can be. They will show signs of depression or lethargy, encumbered locomotion, slow heart-rate, dilated pupils, and occasionally acute blindness. In cases of severe toxicity, seizures and vomiting are exhibited followed by coma and possibly death. The degree of toxicity will depend upon the size of your pet, the amount of marijuana ingested, the strength of the marijuana and the source of the marijuana (eg. ingesting dried leaves or cannabis oil versus food laced with marijuana).
     Treatment is supportive being mainly stomach lavage, intravenous fluids and anti-nausea medication.
     Keep marijuana and cannabis products out of reach of pets. If you know or suspect that your pet has accidentally ingested marijuana do not hesitate to call your veterinarian.

  
   Ouch! This dog definitely bit off more than he could chew! More than 100 quills were removed from his mouth, lips, nose, and ears.
    Porcupine quills are barbed (much like a fish hook) with several barbs along the shaft. This makes them very difficult to pull out. Instead, the barbs enable the quills to work their way inward. The quills can also vary greatly in size from long, thick quills to very thin quills less than half an inch long. If not removed, the quills can migrate deeper into tissue and even into internal organs where they can cause infection and abscesses. If quills puncture an eye, the dog could lose the eye.
    If your dog should encounter a porcupine:
  

DO....

  • Keep the dog quiet and minimize his/her activity. Movement can allow the quills to migrate further into the tissues.
  • Call your veterinarian. The pet will require sedation which enables the veterinarian to pull the quills safety without the pet lashing out or experiencing excessive pain. It also allows the veterinarian to thoroughly inspect the mouth and palpate the entire surface of your pet to detect quills hidden in the hair or embedded under the skin. He/she will also prescribe an antibiotic treatment to prevent any infection or abscesses from developing.

 DO NOT....

  • Crush or cut the quill shafts. There is a myth that says if you let the air out of the quills they will be easier to pull or that they will back out…..wrong! If the quills are crushed, this weakens the shaft and makes it much more difficult to pull out. If the quills are cut making the shafts shorter, again this makes it more difficult to remove the quills.
  • Delay visiting your veterinarian. A study by the Western College of Veterinarians showed that the longer a client waited to present their pet to a veterinarian, the likelihood of complications from a porcupine encounter increased.

Reprinted in part from “The Pawsitive Express”, Vol 1, Spring 2012.


Quarantining A New Pet
     Spring is a time of new beginnings. This time of year we see some clients adding a new member to their family. It may be a new kitten or puppy, or it may be an older cat or dog. We understand the excitement and enthusiasm that comes with welcoming a new pet to the household. And the family is anxious to see how the new pet will be received by the current resident pet(s). However, problems can arise if precautions are not taken when this new animal is introduced into the household.
     We always recommend to clients that a period of quarantine is required when they are bringing a new pet into a household where another pet or pets reside(s). Although we make this recommendation compliance is extremely poor.
Your new family member may harbor fleas, intestinal worms, viruses or fungal infections (ringworm). Introducing the new pet into the family immediately may allow these problems to spread to the other pet(s) or family members. It is advised that the new pet be kept apart from the other household pets for a minimum period of three weeks.
     Quarantine can be accomplished by setting up the new pet in a laundry room or other room in the house that has low traffic flow. A three week quarantine period should be sufficient time for any existing problems to surface and have them treated before introducing the new pet to others. It also allows the family time to take the new pet to a veterinarian for a thorough exam and initial vaccinations for its protection as well.
Although it is our recommendation to quarantine a new pet it is the most difficult recommendation for our clients to follow.

Rabies  
     Rabies is a virus that affects all mammal species including humans. It is a fatal disease. The virus attacks the nervous system and salivary glands. Consequently, the saliva carries large amounts of the virus and is the major means of transmission usually with a bite from an infected animal. Occasionally, but rarely, rabies can also be transmitted by aerosolization (eg. spit, sneeze or cough). 
     All mammals can harbour the rabies virus. However, foxes and skunks were the traditional sources for rabies outbreaks in the past. The Ontario Ministry of Natural Resources distributes oral vaccine bait packages throughout Southern Ontario in late summer/early fall each year. This program started 25 years ago and resulted in the number of fox and skunk cases in the province decreasing dramatically. Until the recent outbreak of raccoon rabies, brown bats had been the most likely source of rabies. As brown bats eat only insects, the Ministry of Natural Resources has not been able to stem the spread of the virus by baiting bats. Vaccination and preventing contact with an infected animal is paramount as there is no cure for rabies.
     Vaccination is the first line of defense. All pets in Ontario are required by law to be vaccinated for rabies even inside cats. It is possible for an indoor cat to escape to the outdoors or to have nose to nose contact with an infected animal through a screen door.
     An infected animal can harbour the virus for a prolonged period of time in their saliva before clinical signs of disease are apparent. Therefore, we should avoid any contact with any wildlife or strange pets and ensure that our pets avoid contact as well.
     When spring arrives, there is a greater chance of contact with wildlife. “Immediately notify local public health authorities when an animal bite to human has occurred or whenever there is the possibility of contact with a rabid animal.” (2)
     For more information on rabies go to the following links:


References:

(1) Wellington-Dufferin-Guelph Public Health, https://www.wdgpublichealth.ca/?q=hpprabies accessed March 30, 2015

(2) Birchard, Sherding, Saunders Manual of Small Animal Practice, W. B.Saunders Company, Pennsylvania, 1994, page 170.

McCurnin, Bassert Clinical Textbook for Veterinary Technicians, 5th Ed., Saunders, Philadelphia, 2002.

OVMA Focus March/April 2016, Vol. 35, No.2.


UPDATE as of Spring 2017:
      In the 2016 fall newsletter, we reported the status of racoon rabies. It is imperative that we continue our vigil and make sure our animals are protected. The Ontario Ministry of Agriculture Food and Rural Affairs (OMAFRA) reported two new cases of Fox Rabies and 17 new cases of Racoon Rabies since December 28, 2016. This brings the total of confirmed cases of Fox Rabies to seven and the total of confirmed cases of Racoon Rabies to 282 since the outbreak of Racoon Rabies in December 2015. As spring arrives the potential for new cases increases. Make sure your pets are up-to-date with their Rabies Vaccination.
    By following this link, http://www.omafra.gov.on.ca/english/food/inspection/ahw/rabieszone.htm , you will find a map showing outbreak areas. The grey area indicates an enhanced surveillance zone. OMAFRA is monitoring these areas more intently. The Ministry of Natural Resources will distribute rabies bait packages in these areas in the spring. The OMAFRA website has up-to-date information on rabies in the province.


“The best protection against rabies for both domestic animals and people is to avoid contact with potentially rabid wildlife and to keep domestic animals up-to-date on rabies vaccination.”


Xylitol
    Xylitol is an artificial sweetener found in chewing gum, candy, breath fresheners, mouthwashes, toothpastes and some medications. It is used as a sweetener because it is sweet like sugar but does not stimulate the release of insulin like sugar. It has minimal effects on insulin levels in humans. Products containing xylitol are very popular with people who are diabetic or on low carbohydrate diets.
    Although it is not absorbed by the gastrointestinal tract of humans, it is readily absorbed by the gastrointestinal tract of animals other than primates. Dogs and cats are susceptible to xylitol poisoning. Dogs picking up chewing gum off the sidewalk are at risk. Once absorbed through the gastrointestinal tract, xylitol triggers a massive release of insulin into the bloodstream. This causes the blood glucose level to drop severely causing low blood sugar (hypoglycaemia). The animal becomes ataxic (walking unsteadily), weak, and depressed. Seizures and death can follow. Toxicity to xylitol can develop within 30 minutes after ingestion. The exact level of toxicity is unknown but appears to depend upon the size of your pet and how much xylitol it ingests. Early diagnosis and intervention is critical.

    Treatment will be based upon the clinical signs presented. Diagnostic blood work will show a low blood sugar level. Xylitol can suppress blood sugar levels for 48 to 72 hours after ingestion. Therefore it is necessary for the animal to be hospitalized. The treatment regimens will involve dextrose administration, intravenous fluids, blood sugar monitoring, and possibly the administration of liver protectants. Prognosis is good if the poisoning is identified early. Once coma has set in prognosis is grave.
    Xylitol has become a popular artificial sweetener and therefore is being used more often. You should become aware of what products use this sweetener and prevent exposure to your pet. Once again prevention is the key. "If you personally use products containing xylitol, make sure they are stored safely, out of reach of your pets." (1)

References:
Xylitol Poisoning in Dogs, Veterinary Newsletter of Commissioners Pharmacy
Grognet, Dr.Jeff, Xylitol, Dogs in Canada, Apriil 2007 
(1)
http://www.vcahospitals.com/main/pet-health-information/article/animal-health/xylitol-toxicity-in-dogs/4340 accessed March 29, 2016.

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