Poisoning
Poisonings (intoxications) in pets represent a serious and potentially life-threatening situation that requires immediate veterinary intervention. Poisoning occurs through the ingestion, inhalation, or skin contact with toxic substances that impair the normal physiological functions of the organism. The severity of poisoning is significantly determined by the type of toxin, the amount ingested, the route of exposure, and the individual constitution of the animal.
Dogs and cats react very differently to certain toxins due to their different metabolic processes and enzymatic equipment. Cats, in particular, show increased sensitivity to certain substances such as paracetamol or essential oils due to their limited ability for glucuronidation, an important detoxification mechanism in the liver. These species-specific differences must always be considered in the diagnosis and treatment of poisonings.
Toxicokinetics describes the path of a toxin in the organism – from absorption through distribution and metabolism to excretion. These processes largely determine how quickly symptoms appear and which organ systems are primarily affected.
Causes
Poisoning can occur as a result of ingestion, inhalation, or skin contact with more or less harmful substances such as medications, chemicals, plants, or gases.
Many foods can also be toxic to dogs and cats (Fig.).
Poison baits also pose a poisoning risk for dogs and cats.
In rare cases, venomous animals can also be a source of poisoning.
For almost all poisons, the dose and type of contact play a crucial role.
Supplements
Poisoning can occur as a result of ingestion, inhalation, or skin contact with more or less harmful substances such as medications, chemicals, plants, or gases. For almost all poisons, the dose and type of contact play a crucial role.
Medications and Household Chemicals
Human medications are one of the most common causes of poisoning in pets. Particularly problematic are nonsteroidal anti-inflammatory drugs like ibuprofen and diclofenac, which can cause severe kidney damage and gastrointestinal ulcerations even in small doses. Paracetamol is especially toxic for cats, as they lack the enzyme for effective metabolism, which can lead to life-threatening methemoglobinemia.
Household cleaners, antifreeze (ethylene glycol), rat poison (anticoagulants), and insecticides like permethrin (particularly toxic to cats) are among the most common chemical causes of poisoning. Ethylene glycol tastes sweet and is therefore readily consumed by animals, but leads to severe kidney damage and, if untreated, death.
Toxic Foods and Plants
Various foods that are harmless to humans can be toxic to dogs and cats. These include chocolate (theobromine), onions and garlic (disulfides), grapes and raisins (unknown nephrotoxin), macadamia nuts, and the sugar substitute xylitol, which can cause life-threatening hypoglycemia in dogs.
In gardens and households, there are numerous toxic plants such as lilies (highly nephrotoxic for cats), oleander, yew, rhododendron, autumn crocus, monkshood, lily of the valley, and many others. Seasonal dangers include, among others, Christmas roses.
Poison Baits and Environmental Toxins
A particular problem is intentionally placed poison baits, which often contain rat poison, slug pellets (metaldehyde), or even glass shards. Depending on the region, venomous animals such as toads, snakes, or certain spider species can also pose a danger.
Environmental toxins such as pesticides, herbicides, or heavy metals can be ingested through contaminated water or direct contact. Blue-green algae in stagnant waters during summer also pose a serious poisoning risk.
Symptoms
Signs of poisoning may include:
- Redness or other abnormalities of the oral mucosa
- Altered odor of the animal or its breath
- Drooling
- Restlessness
- Vomiting
- Diarrhea
- Difficulty breathing
- Hyperactivity
- Muscle tremors
- Seizures
- Fatigue
- Shock
- Coma
The symptoms of poisoning are extremely diverse and depend on the type of toxin, the amount ingested, and the affected organ system. Often, symptoms develop rapidly and progressively.
General Signs of Poisoning
Signs of poisoning may include:
- Redness or other abnormalities of the oral mucosa
- Altered odor of the animal or its breath
- Drooling (hypersalivation)
- Restlessness or apathy
- Vomiting and diarrhea, often with abnormal smell or color
- Difficulty breathing or altered respiratory rate
- Hyperactivity or lethargy
- Muscle tremors, coordination problems, or seizures
- Changes in consciousness up to coma
- Changes in pupil size (miosis or mydriasis)
Organ-Specific Symptoms
Depending on the primarily affected organ system, additional specific symptoms may occur:
Gastrointestinal tract: Intense abdominal pain, bloody diarrhea, vomiting with blood, loss of appetite
Nervous system: Ataxia, tremor, seizures, behavioral changes, altered consciousness up to coma, abnormal pupillary reflexes
Cardiovascular system: Cardiac arrhythmias, blood pressure changes, collapse, pale or cyanotic mucous membranes, prolonged capillary refill time
Respiratory system: Dyspnea, abnormal breath sounds, cyanosis, coughing
Urogenital System: Oliguria or anuria, polyuria, hematuria, kidney failure
Liver: Jaundice (yellowing of mucous membranes), hepatomegaly, ascites
Skin: Contact dermatitis, redness, swelling, itching, skin necrosis
The temporal development of symptoms can provide important diagnostic clues. While some toxins like organophosphates or cyanides cause symptoms within minutes, others like rat poison (anticoagulants) may only become clinically apparent after days.
First Aid
The poison control centers are primarily intended for humans and not for animals. Unfortunately, there is no special emergency call center for animals in Germany.
- Remove your pet from the danger zone.
- Remove visible toxins without endangering yourself.
- Rinse or wipe out the oral cavity. For rinsing, your pet must be responsive so that you can be sure that the protective reflexes (swallowing reflex) are functioning.
- Keep the label if your pet has eaten the contents of a package.
- In case of skin contact with a toxin, wash or preferably shower your pet thoroughly for at least 15 minutes. If you clean your pet in a bathtub, use fresh water repeatedly.
- Wear gloves yourself.
- In case of eye contact with a toxin, rinse your pet’s eyes with lukewarm water for at least 15 minutes.
- In case of vomiting, ensure that the tip of the mouth is the lowest point of the animal. Animals that are conscious will assume this position on their own. For animals that are not fully mobile, you must support your pet. To do this, lift your pet by the abdomen and pelvis so that the vomited stomach contents can drain and not enter the airways.
- Clean the oral cavity with a paper towel or similar. Make sure that the throat is clear.
- Do not push food chunks towards the back of the throat.
- Do not administer anything orally.
- Do not try to induce vomiting in your pet yourself.
Take your pet to a veterinarian as quickly as possible.
Allow X-rays to be taken of the esophagus as well.
If possible and without endangering yourself:
- Take the suspected toxin and/or the packaging, label, and package insert with you to the veterinarian.
- Note when your pet ingested the toxin, the (estimated) amount, and how (eaten, inhaled, through the skin).
- Are there toxic plants in the household or garden, or was there clear contact during a walk?
- Have insecticides, plant poisons, or rat baits been used in the household or in areas accessible to the pet?
- Is your pet currently taking any medications, and if so, which ones?
Diagnosis
Diagnosing poisoning presents a particular challenge, as the symptoms are often non-specific and can overlap with many other diseases. A systematic, diagnostic approach is crucial.
Medical History and Clinical Examination
A detailed medical history is of central importance. The following information should be collected:
- Time and type of suspected poison exposure
- Estimated amount ingested
- Route of exposure (oral, dermal, inhalation)
- Temporal course of symptoms
- Presence of toxic substances in the animal’s environment
- Current medication of the animal
The clinical examination includes a complete evaluation of all organ systems, with particular attention to neurological abnormalities, vital signs, and mucous membrane condition.
Laboratory Diagnostics
Basic laboratory tests include:
- Complete blood count and differential blood count
- Serum biochemistry with liver and kidney values
- Electrolytes and acid-base status
- Coagulation parameters (especially if anticoagulants are suspected)
- Urinalysis
Specific toxicological examinations can be performed on blood, urine, stomach contents, or fecal samples. However, these are often time-consuming and not always available in emergency situations.
Diagnostic Imaging
X-rays can be helpful if poisoned bait with radio-opaque components is suspected or to assess secondary organ damage. Ultrasound examinations allow the assessment of organ changes, particularly in the liver, kidneys, and gastrointestinal tract.
The diagnosis is often based on a combination of medical history, clinical symptoms, and laboratory results, as direct toxicological detection is not always possible.
Further veterinary measures
After an assessment of the risk by the veterinarian, uniform principles apply for intoxications.
Vital functions are secured. This requires appropriate basic diagnostics.
The removal of the toxin, usually started by the pet owner through cleaning of the fur and skin (decontamination), is continued comprehensively if necessary.
Decontamination also includes inducing vomiting, administering activated charcoal, or gastric lavage for toxins already in the gastrointestinal tract, unless the time course contraindicates this.
An antidote is used if available.
For toxins from snakes found in Europe (common European viper, asp viper, and sand viper), the mixed antiserum “Antivenin” exists.
The use of Antivenin is only recommended in critical cases due to the risk of an anaphylactic reaction.
Otherwise, symptomatic therapy is provided, depending on the effect of the particular toxin.
Supplements
The treatment of poisonings follows a multi-step approach, with stabilization of vital functions always being the first priority.
Emergency Measures and First Aid
If poisoning is suspected, pet owners should take the following first aid measures:
- Remove the animal from the danger zone
- Remove visible toxins without endangering yourself
- In case of skin contact, rinse the fur thoroughly with lukewarm water (for at least 15 minutes)
- In case of eye contact, rinse eyes with lukewarm water for at least 15 minutes
- In case of vomiting, ensure that the tip of the mouth is the lowest point to avoid aspiration
- Do not attempt to induce vomiting independently
- Do not administer anything
- Secure packaging, label, or samples of the suspected poison for the veterinarian
Decontamination
Veterinary decontamination includes various measures to remove or inactivate the poison:
Enteral decontamination:
- Emetics such as apomorphine (dog) or xylazine (cat) can be used for recent oral ingestion (< 2-4 hours) and when fully conscious
- Gastric lavage under general anesthesia for severe poisonings or when vomiting is contraindicated
- Activated charcoal binds many toxins in the gastrointestinal tract and prevents their absorption (multiple doses for enterohepatic circulation)
- Laxatives accelerate the passage of toxins through the intestines
Dermal decontamination:
- Thorough washing with mild shampoo
- Use of degreasing washing solutions for lipophilic substances
Eye decontamination:
- Continuous rinsing with physiological saline solution
Antidote Therapy
Specific antidotes are available for some poisons:
- Vitamin K1 for anticoagulant poisoning (rat poison)
- N-Acetylcysteine for paracetamol poisoning
- Atropine and pralidoxime for organophosphate poisoning
- Ethanol or 4-methylpyrazole for ethylene glycol poisoning
- Antivenin for snake bites (only in critical cases due to risk of anaphylaxis)
Supportive Therapy
Symptomatic and supportive therapy is often crucial for treatment success:
- Fluid therapy to promote renal elimination and stabilize circulation
- Oxygen administration for respiratory problems
- Anticonvulsants for seizures
- Temperature management
- Analgesia for pain
- Support of organ functions (liver, kidney)
- Intensive care monitoring with vital sign monitoring in severe cases
In particularly severe cases, extracorporeal elimination methods such as hemodialysis or hemoperfusion may be considered, especially for kidney failure or poisoning with dialyzable toxins.
Prognosis and aftercare
The prognosis for poisonings depends on various factors and requires an individual assessment of each case.
Prognostic Factors
The following factors significantly influence the prognosis:
- Type and amount of poison ingested
- Time between exposure and start of treatment
- General condition and pre-existing illnesses of the animal
- Severity of organ damage
- Availability of specific antidotes
- Quality of intensive care
With early detection and adequate treatment, the prognosis for many poisonings is good. However, severe organ damage, especially to the kidneys, liver, or nervous system, can lead to permanent functional impairments or death.
Aftercare and Recovery
Aftercare following a poisoning includes:
- Regular monitoring of organ functions through clinical examination and laboratory diagnostics
- Dietary adjustments for organ damage (e.g., kidney-friendly diet)
- Medicinal support of organ functions
- Physiotherapy for neurological deficits
- Regular monitoring of long-term medications (e.g., Vitamin K1 for anticoagulant poisonings)
The recovery phase can last from days to months depending on the severity of the poisoning. Long-term aftercare is particularly necessary for damage to the nervous system or kidneys.
Prevention of Future Poisonings
An essential aspect of aftercare is advising pet owners on preventing further poisoning cases:
- Safe storage of medications, chemicals, and cleaning agents
- Removal of toxic plants from living areas and gardens
- Use of pet-friendly alternatives to toxic household products
- Caution when using pesticides and fertilizers
- Leash requirement in areas with known poison bait problems
- Training dogs to avoid ingesting foreign substances
Summary
Poisonings in dogs and cats represent a common and potentially life-threatening emergency situation. The causes are diverse, ranging from medications to household chemicals to toxic plants and intentionally placed poison baits. The symptoms vary greatly depending on the toxin and can affect almost every organ system.
The diagnosis is based on a thorough medical history, clinical examination, and targeted laboratory diagnostics. The therapy follows a multi-step approach consisting of decontamination, antidote administration (if available), and supportive treatment. The prognosis depends on the time of intervention, the type of poison, and the extent of organ damage.
Crucial for successful treatment is the rapid recognition of poisoning and immediate veterinary presentation. Pet owners should know basic first aid measures and identify and eliminate potential sources of danger in the household.
The species-specific differences between dogs and cats regarding metabolic processes and sensitivity to certain toxins must be considered in both diagnosis and therapy. Interdisciplinary collaboration between veterinarians, toxicologists, and emergency physicians can improve treatment success in complex cases.
Outlook on current research
Veterinary toxicology is a dynamic field of research, with continuous advances in diagnostics and therapy.
New Diagnostic Methods
Current research approaches focus on developing faster and more precise diagnostic tests for common poisonings. Point-of-care tests increasingly allow for rapid identification of certain toxins directly in veterinary practice. Complex approaches enable the identification of specific biomarkers for various poisonings, which can accelerate diagnosis.
Innovative Therapeutic Approaches
Research on new antidotes and treatment protocols is progressing. Lipid therapy (intravenous fat emulsions) has proven to be a promising approach for poisonings with lipophilic substances. Nanoparticle-based adsorbents with higher binding capacity than conventional activated charcoal are in development.
Extracorporeal therapy methods are increasingly being adapted and optimized for veterinary medicine, expanding treatment options for severe poisonings.
Monitoring and Prevention
Digital monitoring systems for poisoning cases enable the detection of regional clusters and new sources of danger. Mobile applications for identifying toxic plants and substances, as well as for first aid for poisoned animals, are being developed and improved.
The exploration of the genetic basis for different sensitivities to toxins could enable individualized prevention and treatment strategies in the future.
Frequently asked questions (FAQs)
- What signs can indicate poisoning in my pet?
Typical signs include sudden vomiting, diarrhea, increased salivation, trembling, seizures, changes in consciousness, dilated or constricted pupils, as well as breathing and circulatory problems. The sudden onset of several of these symptoms without any other apparent cause is particularly suspicious. - Which foods are toxic to dogs and cats?
Dangerous foods include chocolate, coffee and other caffeine-containing products, onions, garlic, grapes and raisins, macadamia nuts, avocados, and products containing the sweetener xylitol. Toxicity varies depending on the animal species and the amount ingested. - What should I do if I suspect my pet has eaten something toxic?
Remove your pet from the danger zone, secure any remains of the poison or its packaging if possible, and contact your veterinarian immediately. Do not attempt to induce vomiting or administer home remedies on your own, as this may worsen the situation. - How long does it take for symptoms to appear after poisoning?
The timeframe varies significantly depending on the poison, the amount ingested, and the route of exposure. Some toxins like organophosphates or cyanides can cause symptoms within minutes, while others like rat poison may only become clinically apparent after days. - Can I give my pet activated charcoal if I suspect poisoning?
The administration of activated charcoal should only be done after consulting a veterinarian. It is only effective for certain poisons and is even contraindicated for some poisonings. Additionally, the correct timing of administration is crucial for its effectiveness. - How can I make my home safer for my pets?
Store medications, cleaning agents, and chemicals in locked cabinets. Remove toxic houseplants or place them out of reach of your animals. Educate yourself about poisonous garden plants and use pet-friendly alternatives to toxic products. - Are cats more sensitive to poisoning than dogs?
Cats are indeed more sensitive to certain substances due to their specific metabolic processes. Particularly problematic for cats are paracetamol, permethrin, essential oils, and lilies, which can lead to more severe poisonings in them than in dogs. - How are poisonings treated by veterinarians?
The treatment, depending on the case, includes decontamination (inducing vomiting, gastric lavage, administering activated charcoal), administering specific antidotes (if available), and supportive measures such as fluid therapy, oxygen administration, or seizure control. - How long does recovery take after poisoning?
Recovery time varies greatly depending on the type and severity of the poisoning, as well as the general condition of the animal. Mild poisonings can heal within a few days, while severe cases with organ damage may require lengthy convalescence or result in permanent damage. - What are the most common causes of poisoning in pets?
The most common causes are medication poisonings (especially human medications), household chemicals, pesticides, rat poison, chocolate, ethylene glycol (antifreeze), and toxic plants. Regionally, deliberately placed poisoned baits can also be a significant problem.
Literature
- Malik R, Ward MP, Seavers A, Fawcett A, Bell E, Govendir M, Page S.: Permethrin spot-on intoxication of cats Literature review and survey of veterinary practitioners in Australia. Permethrin spot-on intoxication of cats Literature review and survey of veterinary practitioners in Australia. J Feline Med Surg. 2010 Jan;12(1),5-14.
- https://www.tierschutzbund.de/information/hintergrund/heimtiere/vergiftungen-bei-heimtieren/
- Löwe, G. and Löwe, O. (2021). Emergencies in Dogs and Cats – A Veterinary Guide. Kreuztal: Kynos-Verlag. 208 p.
- Löwe, G. and Löwe, O. (2021). Poisonings in Dogs and Cats – A Veterinary Guide. Kynos-Verlag. 225 p.
- Gupta RC, editor. Veterinary Toxicology: Basic and Clinical Principles. 3rd ed. London: Academic Press; 2018.
- Merola V, Dunayer E. The 10 most common toxicoses in cats. Veterinary Medicine. 2020;115(4):173-184.
