Dr. Betsy, “What’s The Strangest Thing You’ve Seen As A Veterinarian?”

Dr. Betsy, “What’s The Strangest Thing You’ve Seen As A Veterinarian?”

When in casual social settings in the Cary community one of the most common statements made to me is, “I bet you see some unusual things in veterinary practice!” 

Of course it is true! I have enough stories of veterinary oddities to cover a five course meal and then some. Today, with Valentine’s Day right around the corner, I will share 2 particularly memorable ones. 

As usual at the first part of the business day at Creature Comforts, we check our after-hours messages and receive calls from clients with emergency pet concerns. On this particular day, a pet owner called concerned about breathing issues in her small dog. It didn’t sound good from her description, and I instructed her to come to the office right away. Upon arrival she rushed into the waiting room with her beloved pet clutched to her chest and was immediately instructed to go the exam room. When met by staff members, there was indeed a crisis, but it was not the pet in crisis! In removing the dog from the clutches of the owner’s arms it was glaringly evident she had forgotten to put on a shirt! The dog had no major issues.

The second episode was in my own household. It was Valentine’s Day and our first since adding Taco Belle, my dachshund-chihuahua mix, to our family. Although she was 10 months old and in our “puppy proofed” house, my teenage son had not “received the memo” about keeping his room puppy-proofed. I always get concerned when the house is too quiet with a puppy around. I decided to make a quick inspection. Sure enough, there was a trail of candy wrappers and candy coming out of my son’s room where a stash of Valentine’s candy had been casually left on the floor. And there she was – Taco Belle – standing in the middle of the collection with a guilty look. You know the look… the “I have been a bad dog” look. 

Of course dog behaviorists tell us they are simply reading their owner’s body language, but however you interpret it, Taco Belle definitely had the “guilty as charged” expression. It was evident something was in her mouth.  As the good dog she is, she immediately dropped the item on command. It was a candy heart that said “I love you.” I laughed and hugged her and all was forgiven.  No harm done, the amount of candy consumed was minimal, and my son had a lesson that was quickly forgotten on the risks of leaving things on the floor with pets around. 

I was fortunate that Taco Belle’s potentially toxic episode was minor. Bottom line: Keep candy away from your pets! But in practice, I see many more poisonings that are catastrophic and fatal. 

Several of my clients have questions about Melamine poisoning and Xylitol poisoning. Today I’ll touch on both. 

QUESTION: I thought melamine was a dinnerware. Why was it in the news in 2007 with pet food poisoning?

ANSWER: Melamine is a component in dinnerware, whiteboards, insulation, and laminate flooring.  In 2007, there were many unexpected death of pets due to kidney failure.  During the process of the investigation, it was discovered that many respected brands of pet food were contaminated with melamine.  China (the world’s largest exporter of melamine) some exporters of wheat, corn, and rice gluten illegally added melamine to cheaply elevate the detectable, nutritional protein levels (for which they were paid). Later investigations exposed contamination in fish, livestock feed, eggs, and baby formula. Recent discoveries of small amounts of melamine in food from animals and crops treated with the insecticide cyromazine, also warrant further study.

QUESTION: How many pet foods were recalled, and how many dogs and cats were actually poisoned?

There is no centralized government database of animal sickness or death in the United States as there is in people. The on-line self-reporting hotline reported 3600 sickened pets, while the US Food and Drug administration reported only 14 confirmed cases. A startling 180 pet food brands were recalled.

QUESTION: What was the outcome of the public outcry from such gross negligence by chemical manufacturers?

After the death of Chinese children in 2008 from melamine tainted baby formula, new standards of laboratory detection of melamine were developed. Melamine can be found in some food packaging & dinnerware where it may leach from such materials in storage, hot food use, and microwaving. This has led to recommendations to not microwave food or use foods with high acidity (ex. tomato sauce) in these containers.  There are ongoing investigations as to the amount of melamine that in cumulative exposure places pets and people at risk for bladder stones, behavioral changes, and certain cancers. Thus, always read recommended uses of plastic dinnerware before random use or switch to ceramic or metal products.

From a veterinarian’s standpoint, the melamine incident was when consumers started looking for grain free ingredients in their pet foods. Although this has evolved into a concern for food allergies (for which the risk is small, and low carbohydrate diets for cats to lower the risk of diabetes), the melamine catastrophe of 2007 was a tipping point.

While the 2 men responsible for the melamine scandal were executed in China, the whistle blower in the infant formula contamination, Jiang Weisuo from Shaanxi province, was stabbed and eventually died as a result of  the injuries in a suspected cover up by authorities.

And now about Xylitol...

QUESTION: What is Xylitol and why is so toxic to dogs and cats?

Xylitol is a naturally occurring sugar substitute in many gums, baked goods, and medications (prescription, vitamins, tooth paste, and mouth wash among others) that lower calories in products made for human consumption. Unfortunately, in dogs and cats  that inadvertently  consume such products, the body falsely recognizes the chemical as high sugar content. The pancreas then releases massive amounts of insulin based on the amount of xylitol consumed and the pet’s body weight. Subsequently seizures, liver failure, and death may occur. 1 piece of 1 gram Xylitol sweetened gum can cause significant low blood sugar in a 20 lb. dog within 1 hour of consuming the gum out of a purse. It is much more toxic to pets than chocolate.

QUESTION: I understand about the consumer goods when it comes to Xylitol, but, should I be concerned about human liquid medications prescribed by my veterinarian, especially generic ones?

Yes. You should talk to the pharmacist before giving a human medication to a pet. It is not always clearly labeled on a medication written for human usage that it contains Xylitol, and there may be no veterinary product substitute for the dosage needed. Take, for example, a nerve pain reliever “gabapentin” that is a 100 mg capsule for people. A 10 lb. dog may start with a ¼ capsule. That is difficult to score, so the liquid version of the medication maybe offered as a substitute. However, the sweetener in liquid gabapentin is xylitol, unless it is specifically compounded for pets. In addition, medications such at OTC children’s vitamins chosen by pet owners for senior pet supplementation may also contain xylitol.  Signs of Xylitol poisoning include weakness, vomiting, staggering, seizures, and depression. The poison pet hotline is 800-213-6680. There is no antidote, only supportive care. Thus prevention of exposure is critical.

Thank-you for any feedback and please let me know any topics of interest.

-Dr. Betsy