Lilies, Xylitol and Chocolate: Common Toxins Seen in the Emergency Room

Poison Prevention Week, which occurs during the third week in March each year, has inspired us to discuss three of the most common causes of toxicity-related incidents we see in CARE’s Emergency Room. We believe that awareness is instrumental in prevention, so take a minute to familiarize yourself with the risks (and signs and symptoms of ingestion) associated with the ingestion of toxins such as lilies, xylitol and chocolate.

Lilies:

While lilies are beautiful and fragrant flowers, they have been recognized as causing acute renal failure in cats. All parts of the plant are toxic, though many owners are unaware of the dangers even when seeing their cat chewing on the flowers. If you notice that your cat has eaten part of a lily, seek treatment immediately. The sooner your cat gets treatment, the better his or her chances are for survival.

Symptoms can begin within two hours of ingestion and include vomiting, dehydration, unwillingness to eat and depression. Within 24 to 72 hours, the development of kidney failure is well underway.

The key to treatment is to neutralize or flush the toxin from the body. Treatment options vary depending on the stage of renal failure:

1. Flush the stomach to remove any remaining plant material; a neutralizing agent, such as activated charcoal, may be used to assist
2. Intravenous (IV) fluid therapy to help prevent kidney failure
3. Dialysis if your cat’s kidney has already failed to operate normally

Xylitol:

Xylitol is a common sugar substitute found in many products such as gum, toothpaste and some kinds of peanut butter. The primary concerns of Xylitol toxicity are low blood sugar and destruction of liver tissue, though the prognosis is much more favorable, especially when caught early.

Signs of low blood sugar include vomiting, weakness, disorientation, tremors and potentially seizures. Symptoms can begin within 30 minutes of ingestion and last for 12 hours. Sometimes, however, absorption can occur at a slower rate and clinical symptoms can be delayed for up to 12 hours.

Consumption of Xylitol (typically higher doses) may also result in liver damage. This can be seen 8 to 12 hours after the onset of clinical symptoms. In severe cases, acute liver failure with clotting abnormalities can be seen.

It can be difficult to determine the amount of Xylitol the dog consumed, but even one stick of gum can be toxic to a small dog. Upon realizing your dog has swallowed a piece of gum (or any other product containing Xylitol), immediately induce vomiting. However, if your pet is already showing signs of digestion, call your vet to determine next steps. In this circumstance, treatment varies per case:

1. Hospitalization
2. Fluid therapy with solutions containing Dextrose (sugar)
3. Liver protectants
4. Monitoring of blood glucose levels and liver enzymes

Chocolate:

These are probably one of the more common toxicities seen at this time of year – who doesn’t love a chocolate bunny?! Unfortunately, our canine friends cannot process substances in the chocolate and it makes them sick. Remember, the darker the chocolate, the more toxic to dogs. As with all toxins, the amount consumed determines the severity of the reaction, but symptoms of chocolate consumption vary widely. The prognosis is usually good.

Clinical symptoms include vomiting, diarrhea, hyperactivity and restlessness, muscle tremors, seizures, increased heart rate which can progress to abnormal rhythms and in severe cases, death.
Though unlikely, pancreatitis, a painful inflammatory condition of the pancreas, can also be caused by chocolate ingestion due to the large amounts of fatty food being consumed and can be fatal. Symptoms include vomiting, diarrhea and abdominal pain, and will likely show up several days later.

Once again, treatment depends on the amount (and type) of chocolate consumed along with your pet’s reaction:

1. If discovered and treated early, vomiting can be induced to rid the body of the toxin
2. Administration of activated charcoal to bind additional toxin
3. Intravenous (IV) fluid therapy and supportive care for increased heart rate, abnormal rhythms, vomiting and diarrhea that may occur

Whether you witness (or discover that) your pet has eaten any of the aforementioned toxins or notice unusual behavior or symptoms, reach out to your vet immediately for consultation. CARE’s Emergency Services are available 24/7/365, so in dire situations or outside normal business hours, please contact us directly for instructions.